Gender differences in a resources-demands model in the general population

Background The population-based study examined postulated effects, derived from a resources-demands-model about gender-related aspects of self-efficacy, optimism, chronic stress, and exhaustion. Methods Data acquisition was carried out by a market research institute with a multi-topic questionnaire in the general population (N = 2,552). Instruments administered were the Questionnaire for Self-Efficacy and Optimism, the Trier Inventory for Chronic Stress, and the Chalder-Fatigue-Scale. Households and target persons were selected randomly. The analyses focused on structural equation modeling. Results There were significant differences in structural relations among the resource paths. In particular, significant gender differences were found with respect to self-efficacy, and among the exhaustion paths, namely in the mental dimension of exhaustion. The observed measures of chronic stress were found to be operating equivalently for both genders. Results suggest that resources play an important role in the understanding of how chronic stress is preceded and may lead to exhaustion in both genders. Conclusion Personal resources seem to be more expressed by men than by woman, for whom the relation of resources to health is of greater importance than for men

NUCB2/nesfatin-1 Is Associated with Elevated Levels of Anxiety in Anorexia Nervosa

Objective NUCB2/nesfatin-1 is an anorexigenic hormone with elevated levels in obese and decreased levels in anorexia nervosa (AN) patients. Moreover, a role in the regulation of stress and emotions was suggested by several rodent and preliminary human studies. Since anxiety and depression are common comorbidities in AN, we investigated the association of NUCB2/nesfatin-1 with anxiety, depression and perceived stress in AN. Methods We analyzed circulating NUCB2/nesfatin-1 levels in 64 female inpatients diagnosed with anorexia nervosa (body mass index, BMI; mean±SD, 14.7±2.3 kg/m2). At the same time anxiety (GAD-7), depression (PHQ-9), stress (PSQ-20) and disordered eating (EDI-2) were measured psychometrically. Results No correlation was observed between NUCB2/nesfatin-1 and BMI (r = 0.06, p = 0.70). The study population was divided in patients with low anxiety (n = 32, GAD-7 scores, mean±SD, 7.5±3.3) and high anxiety (n = 32, 16.0±3.0, p<0.001). Patients with high anxiety scores displayed 65% higher NUCB2/nesfatin-1 levels (p = 0.04). This was reflected by a positive correlation of GAD-7 and NUCB2/nesfatin-1-levels (r = 0.32, p = 0.04). Scores of PSQ-20 (73.3±14.3 vs. 48.6±17.2) and PHQ-9 (18.8±5.0 vs. 10.3±5.1) were higher in the high anxiety group (p0.05). EDI-2 total score was also higher in the high anxiety group (52.3±14.1 vs. 40.2±16.0, p = 0.02), while no correlations of EDI-2-scores with plasma NUCB2/nesfatin-1 were observed (p>0.05). Conclusions Circulating NUCB2/nesfatin-1 levels correlated positively with perceived anxiety, whereas no association with BMI or eating disorder symptoms was observed. NUCB2/nesfatin-1 might be primarily involved in the modulation of anxiety and subsequently in the regulation of eating habits and body weight in AN

A Comparison between Groups and an Analysis of Predictors

Objective For the treatment of obesity, both conservative and surgical procedures are available. Psychological factors are likely to influence the choice of treatment; however, to date, systematic studies that investigate these factors are few in number. The aim of our study was to analyze whether patients who undergo a surgical treatment differ from those who require a conservative treatment in regard to psychological factors, regardless of their somatic conditions. Furthermore, predictors of treatment choice will be examined. Methods A total of 244 patients (189 women), with a mean body mass index of 45.1 kg/m2, underwent a weight reduction treatment, with 126 patients undergoing bariatric surgery and 118 patients participating in a conservative, multimodal outpatient weight reduction program. Differences in the results of the psychological questionnaires between conservatively and surgically treated patients were evaluated through the use of t-tests, χ2-tests and an ANCOVA. For the analysis of the predictors, logistic regression models were calculated. Results Surgically and conservatively treated obese patients differ in psychological, somatic, and socio-demographic factors. The psychological differences between the groups are independent of obesity- related co-morbidities, such as body mass index (BMI), type 2 diabetes mellitus, hypertension and coronary heart disease. The following psychological and somatic factors equally predict the choice of bariatric surgery: apathy, delegated active coping, a sense of coherence, complaints, type 2 diabetes mellitus, BMI, and age. Conclusion Longitudinal studies are required to assess the predictive value of the psychological factors in regard to the postsurgical weight course to improve the pre-surgical screening and treatment selection process. The pre-surgical identification of psychological predictors should result in a more personalized medicine course and may ensure long term outcomes

working conditions and individual resources as related factors

Objectives This study developed and tested a research model that examined the effects of working conditions and individual resources on work–family conflict (WFC) using data collected from physicians working at German clinics. Material and methods This is a cross-sectional study of 727 physicians working in German hospitals. The work environment, WFC and individual resources were measured by the Copenhagen Psychosocial Questionnaire, the WFC Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism. Descriptive, correlation and linear regression analyses were applied. Results Clinical doctors working in German hospitals perceived high levels of WFC (mean=76). Sociodemographic differences were found for age, marital status and presence of children with regard to WFC. No significant gender differences were found. WFCs were positively related to high workloads and quantitative job demands. Job resources (eg, influence at work, social support) and personal resources (eg, resilient coping behaviour and self- efficacy) were negatively associated with physicians’ WFCs. Interaction terms suggest that job and personal resources buffer the effects of job demands on WFC. Conclusions In this study, WFC was prevalent among German clinicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WFC. Our results give a strong indication that both individual and organisational factors are related to WFC. Results may play an important role in optimising clinical care. Practical implications for physicians’ career planning and recommendations for future research are discussed

Interactions of Gastrointestinal Peptides: Ghrelin and Its Anorexigenic Antagonists

Food intake behaviour and energy homeostasis are strongly regulated by a complex system of humoral factors and nerval structures constituting the brain-gut-axis. To date the only known peripherally produced and centrally acting peptide that stimulates food intake is ghrelin, which is mainly synthesized in the stomach. Recent data indicate that the orexigenic effect of ghrelin might be influenced by other gastrointestinal peptides such as cholecystokinin (CCK), bombesin, desacyl ghrelin, peptide YY (PYY), as well as glucagon-like peptide (GLP). Therefore, we will review on the interactions of ghrelin with several gastrointestinal factors known to be involved in appetite regulation in order to elucidate the interdependency of peripheral orexigenic and anorexigenic peptides in the control of appetite