Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men

Objectives: To examine the association between self perceived psychological stress and cardiovascular disease in a population where stress was not associated with social disadvantage. Design: Prospective observational study with follow up of 21 years and repeat screening of half the cohort 5 years from baseline. Measures included perceived psychological stress, coronary risk factors, self reported angina, and ischaemia detected by electrocardiography. Setting: 27 workplaces in Scotland. Participants: 5606 men (mean age 48 years) at first screening and 2623 men at second screening with complete data on all measures Main outcome measures: Prevalence of angina and ischaemia at baseline, odds ratio for incident angina and ischaemia at second screening, rate ratios for cause specific hospital admission, and hazard ratios for cause specific mortality. Results: Both prevalence and incidence of angina increased with increasing perceived stress (fully adjusted odds ratio for incident angina, high versus low stress 2.66, 95% confidence interval 1.61 to 4.41; P for trend <0.001). Prevalence and incidence of ischaemia showed weak trends in the opposite direction. High stress was associated with a higher rate of admissions to hospital generally and for admissions related to cardiovascular disease and psychiatric disorders (fully adjusted rate ratios for any general hospital admission 1.13, 1.01 to 1.27, cardiovascular disease 1.20, 1.00 to 1.45, and psychiatric disorders 2.34, 1.41 to 3.91). High stress was not associated with increased admission for coronary heart disease (1.00, 0.76-1.32) and showed an inverse relation with all cause mortality, mortality from cardiovascular disease, and mortality from coronary heart disease, that was attenuated by adjustment for occupational class (fully adjusted hazard ratio for all cause mortality 0.94, 0.81 to 1.11, cardiovascular mortality 0.91, 0.78 to 1.06, and mortality from coronary heart disease 0.98, 0.75 to 1.27). Conclusions: The relation between higher stress, angina, and some categories of hospital admissions probably resulted from the tendency of participants reporting higher stress to also report more symptoms. The lack of a corresponding relation with objective indices of heart disease suggests that these symptoms did not reflect physical disease. The data suggest that associations between psychosocial measures and disease outcomes reported from some other studies may be spurious

Limitations of adjustment for reporting tendency in observational studies of stress and self reported coronary heart disease

Recently, observational evidence has been suggested to show a causal association between various "psychosocial" exposures, including psychological stress, and heart disease. Much of this evidence derives from studies in which a self reported psychosocial exposure is related to an outcome dependent on the subjective experience of coronary heart disease (CHD) symptoms. Such outcomes may be measured using standard symptom questionnaires (like the Rose angina schedule). Alternatively they may use diagnoses of disease from medical records, which depend on an individual perceiving symptoms and reporting them to a health worker. In these situations, reporting bias may generate spurious exposure-outcome associations. For example if people who perceive and report their life as most stressful also over-report symptoms of cardiovascular disease then an artefactual association between stress and heart disease will result

Buoyant Venus station mission feasibility study for 1972 and 1973 launch opportunities. Volume 3 - Configuration definition. Part 1 - Configuration Final report

Configuration definitions for buoyant Venus station missions for 1972 - 1973 launch perio

Rippled Cosmological Dark Matter from Damped Oscillating Newton Constant

Let the reciprocal Newton 'constant' be an apparently non-dynamical Brans-Dicke scalar field damped oscillating towards its General Relativistic VEV. We show, without introducing additional matter fields or dust, that the corresponding cosmological evolution averagely resembles, in the Jordan frame, the familiar dark radiation -> dark matter -> dark energy domination sequence. The fingerprints of our theory are fine ripples, hopefully testable, in the FRW scale factor; they die away at the General Relativity limit. The possibility that the Brans-Dicke scalar also serves as the inflaton is favorably examined.Comment: RevTex4, 12 pages, 5 figures; Minor revision, References adde

Generalized Hurst exponent and multifractal function of original and translated texts mapped into frequency and length time series

A nonlinear dynamics approach can be used in order to quantify complexity in written texts. As a first step, a one-dimensional system is examined : two written texts by one author (Lewis Carroll) are considered, together with one translation, into an artificial language, i.e. Esperanto are mapped into time series. Their corresponding shuffled versions are used for obtaining a "base line". Two different one-dimensional time series are used here: (i) one based on word lengths (LTS), (ii) the other on word frequencies (FTS). It is shown that the generalized Hurst exponent $h(q)$ and the derived $f(\alpha)$ curves of the original and translated texts show marked differences. The original "texts" are far from giving a parabolic $f(\alpha)$ function, - in contrast to the shuffled texts. Moreover, the Esperanto text has more extreme values. This suggests cascade model-like, with multiscale time asymmetric features as finally written texts. A discussion of the difference and complementarity of mapping into a LTS or FTS is presented. The FTS $f(\alpha)$ curves are more opened than the LTS onesComment: preprint for PRE; 2 columns; 10 pages; 6 (multifigures); 3 Tables; 70 reference

Life events and hemodynamic stress reactivity in the middle-aged and elderly

Recent versions of the reactivity hypothesis, which consider it to be the product of stress exposure and exaggerated haemodynamic reactions to stress that confers cardiovascular disease risk, assume that reactivity is independent of the experience of stressful life events. This assumption was tested in two substantial cohorts, one middle-aged and one elderly. Participants had to indicate from a list of major stressful life events up to six they had experienced in the previous two years. They were also asked to rate how disruptive and stressful they were, at the time of occurrence and now. Blood pressure and pulse rate were measured at rest and in response to acute mental stress. Those who rated the events as highly disruptive at the time of exposure and currently exhibited blunted systolic blood pressure reactions to acute stress. The present results suggest that acute stress reactivity may not be independent of stressful life events experience

Targeting Mr Average: Participation, gender equity and school sport partnerships

The School Sport Partnership Programme (SSPP) is one strand of the national strategy for physical education and school sport in England, the physical education and school sport Club Links Strategy (PESSCL). The SSPP aims to make links between school physical education (PE) and out of school sports participation, and has a particular remit to raise the participation levels of several identified under-represented groups, of which girls and young women are one. National evaluations of the SSPP show that it is beginning to have positive impacts on young people's activity levels by increasing the range and provision of extra curricular activities (Office for Standards in Education (OFSTED), 2003, 2004, 2005; Loughborough Partnership, 2005, 2006). This paper contributes to the developing picture of the phased implementation of the programme by providing qualitative insights into the work of one school sport partnership with a particular focus on gender equity. The paper explores the ways in which gender equity issues have been explicitly addressed within the 'official texts' of the SSPP; how these have shifted over time and how teachers are responding to and making sense of these in their daily practice. Using participation observation, interview and questionnaire data, the paper explores how the coordinators are addressing the challenge of increasing the participation of girls and young women. The paper draws on Walby's (2000) conceptualisation of different kinds of feminist praxis to highlight the limitations of the coordinators' work. Two key themes from the data and their implications are addressed: the dominance of competitive sport practices and the PE professionals' views of targeting as a strategy for increasing the participation of under-represented groups. The paper concludes that coordinators work within an equality or difference discourse with little evidence of the transformative praxis needed for the programme to be truly inclusive. © 2008 Taylor & Francis

Bootstrap Confidence Intervals For Local Likelihood, Local Estimating Equations And Varying Coefficient Models

Four powerful generalizations of the usual local polynomial nonparametric regression methodology are (a) local polynomial methods in generalized linear models; (b) varying coefficient generalized linear models, where the possibly multivariate coefficients in a generalized linear model are estimated nonparametrically; (c) local likelihood methods; and (d) local estimating equations, which generalize nonparametric regression to the estimating equation context. We construct bootstrap confidence intervals for the nonparametrically estimated functions in all four contexts