Research Roundup |
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September 8, 2015, Volume 62, No. 04 |
University Research & Development Affects Spatial Development of Neighborhoods
Chronic Insomnia Sufferers May Find Relief with Half of Standard Sleeping Pill Dosing Regimen
Processing Arrested Juveniles as Adults Has Small Effect on Criminal Recidivism
University Research & Development Affects Spatial Development of Neighborhoods
A white paper released in August by the Penn Institute for Urban Research (Penn IUR) finds that university-based research and development (R&D) affects the spatial development of universities, as well as their surrounding urban areas. The paper, “From Science Parks to Innovation Districts Research: Facility Development in Legacy Cities on the Northeast Corridor,” explores the spatial aspects of university-led R&D in older, industrial Northeast cities that have experienced significant population and job loss in recent decades.
“We still have a lot to learn about how university-based R&D affects the ways in which university campuses and their neighborhoods change, transform and grow,” says the paper’s author, Penn IUR co-director, Genie Birch. “But one thing is clear: there is an important link between R&D and spatial development, and in order to better understand how universities can anchor and support their surrounding environments, we need to monitor and explore this phenomenon.”
One challenge in understanding this link is that university-led urban revitalization is very often a slow process. A second challenge, according to the report, is that research universities tend to accommodate the demand for research space in ways that meet their specific contexts and needs, often in partnership with their localities. This leads university-driven development to manifest itself in diverse, varied and distinct ways.
The paper finds that university-based R&D is often funded by structured, federal grants, which pay researchers’ and doctoral students’ salaries and also pay for laboratories and other facilities in which the researchers work. This leaves physical imprints in the nation’s cities and suburbs in four major ways: campus expansion (including technology parks), corridor/highway developments, downtown redevelopments and scattered-site projects.
Chronic Insomnia Sufferers May Find Relief with Half of Standard Sleeping Pill Dosing Regimen
The roughly nine million Americans who rely on prescription sleeping pills to treat chronic insomnia may be able to get relief from as little as half of the drugs, and may even be helped by taking placebos in the treatment plan, according to new research published on August 3 in the journal Sleep Medicine by researchers from the Perelman School of Medicine at the University of Pennsylvania. Their findings starkly contrast with the standard prescribing practices for chronic insomnia treatment.
The findings, which advocate for a dosing strategy of smaller and fewer doses of sleep drugs and use of placebos, would decrease the amount of medication needed to maintain medication effects over time, allowing the individual to maximize their clinical gains with respect to falling and staying asleep while reducing side effects and cutting prescription drug costs.
“The clinical effects of sleeping pills cannot be relied on to last forever, and long-term use increases risk of psychological dependence and side effects including daytime drowsiness, nausea and muscle pain,” said the study’s senior author, Michael Perlis, an associate professor in Penn’s department of psychiatry and director of the Penn Behavioral Sleep Medicine Program. “Our research found that changing the industry standard for maintenance therapy can maintain treatment responses and lower the incidence of side effects.”
The study treated 74 adults experiencing chronic insomnia with 10 mg of the sleeping pill zolpidem (Ambien) for four weeks. Those responding to the treatment were randomized into three dosing groups for 12 weeks: nightly dosing with 10 mg or 5 mg, “intermittent dosing” of 10 mg 3 to 5 days a week, or “partial reinforcement” through nightly pills in which half were 10 mg capsules and half were placebo capsules.
All three strategies the team tested were effective in maintaining people’s ability to fall and stay asleep, but those in the intermittent dosing group slept worse and reported more medical symptoms and greater symptom severity than those in the other dosing groups.
“When it comes to day-to-day quality of therapeutic outcomes, the strategy we use most frequently, the intermittent dosing strategy performed worst,” Dr. Perlis said. “Our findings also go against the standard practice of ‘start low and go slow,’ in favor of a ‘start high and go low’ dosing strategy in which a patient starts with 10 mg nightly and then when the desired result is reached, switch to either a lower nightly dose or intermittent dosing with placebos on non-medication nights.”
The authors see the findings as a path diverting from the tendency to increase dose over time, thus making use of these medications potentially safer in the long run with the added benefit (in the case of nightly dosing with 5 mg or 10 mg doses interspersed with placebos) of being up to 50 percent less expensive. These savings could cut costs drastically for both consumers and pharmaceutical companies (as consumers take a higher percentage of placebos, the profit margin would be higher on placebos than it is on the drug).
“The full dose may or may not be required to get the initial effect,” said Dr. Perlis, “but certainly maintaining the effect can be done with less medication.” The Penn study also offers the first data confirming that 5 mg can be effective as a maintenance strategy. This supports a 2013 decision of the FDA that required lowering the recommended dose of the sleep medication zolpidem in non-elderly women, citing a risk of next-morning impairment, including problems with alertness while driving.
“What is particularly novel about the present study is the use of placebos on non-medication nights and that such a practice appears to extend a level of therapeutic benefit that is not seen with intermittent dosing,” Dr. Perlis said. “This effect is thought to occur owing not only to the enhancement of patient expectancy but to the conditioning of medication effects, i.e., the medication induced effects may be elicited, with conditioning, by the medication capsule itself and that this can be sustained over time with occasional use of full dose medication (partial reinforcement).”
Dr. Perlis notes that if sufficient data can be gathered to show that such conditioning is possible, in the future, this may influence how medications are prescribed for maintenance therapy.
The research team includes Penn authors Michael Grandner, Jarcy Zee, Erin Bremer, Julia Whinnery, Holly Barilla, Priscilla Andalia, Phil Gehrman, Knashawn Morales and Michael Thase. The work builds on earlier work by late researchers Richard Bootzin of the University of Arizona and Robert Ader of the University of Rochester. The study was supported by a NIH National Center for Complementary and Integrative Health grant.
Processing Arrested Juveniles as Adults Has Small Effect on Criminal Recidivism
Penn researchers have found a 3-5% reduction in the probability of criminal recidivism among a sample of juveniles arrested for felony drug offenses, some of whom were processed as adults due to their age at the time of their arrests. In a study published in the Journal of Research in Crime and Delinquency, Charles Loeffler, an assistant professor of criminology in the School of Arts & Sciences, and Ben Grunwald, a doctoral candidate in the criminology department, analyzed the effect of processing juveniles as adults using a regression discontinuity design.
The study, “Processed as an Adult: A Regression Discontinuity Estimate of the Crime Effects of Charging Nontransfer Juveniles as Adults,” estimated the effect of the juvenile and adult justice systems on recidivism for non-transfer-eligible juvenile offenders by comparing the four-year re-offending rates of juveniles arrested for drug distribution just a few weeks before and after they reached adulthood.
The results suggested that processing these juveniles as adults slightly reduced the probability of recidivism. Based on the rapid onset and limited change in size of the effects over a four-year follow-up and based on the concentration of the effects within a sub-group having the lowest risk of incarceration, the researchers attributed this finding to a combination of enhanced deterrence and incapacitation in the adult justice system.
“These results suggest that processing juveniles in the adult system may not uniformly increase offending, as many scholars have thought, and may actually reduce offending in some circumstances,” Dr. Loeffler said.
The study examined the recidivism of felony drug offenders arrested a few weeks before their 17th birthday who were processed in the juvenile justice system and those arrested a few weeks after their 17th birthday who were processed in the adult criminal justice system.
Past studies have found that serious juvenile offenders transferred into the adult system as part of automatic, presumptive or discretionary transfer mechanisms re-offend much more often than similar juvenile offenders retained in the juvenile system. Such findings have led scholars and policymakers to conclude that exposing youth to the adult justice system exacerbates criminal offending.
However, Dr. Loeffler said that the existing empirical literature is primarily focused on the most serious or frequent juvenile offenders. There is relatively little information on the effects of processing more typical juveniles in the adult system. Similarly, the existing literature has used research designs that make it difficult to separate the effects of processing juveniles as adults from pre-existing differences in the risk of recidivism between juveniles who are processed in the two different legal systems.
The results of Dr. Loeffler and Mr. Grunwald’s study, which differed from some of the early empirical literature examining the effects of processing juveniles as adults, adds to a growing number of studies observing that offending among older juveniles is relatively insensitive to the exact legal system in which they are prosecuted. The researchers attributed this divergence between earlier and newer studies to both the samples of offenders examined and the estimation strategies employed. |