Differences in Heart Disease Risk Perception and Actual Cardiac Risk in Men vs. Women

Differences in Heart Disease Risk Perception and Actual Cardiac Risk in Male vs. Female Cardiac Patients Amanda Dietz, Julie Borsack, Steve Martin, Kathy L. Hill, Thomas Meade, Stephen F. Crouse, FACSM, and John S. Green, FACSM Texas A&M University, College Station, TX (Sponsor: John S. Green, FACSM) PURPOSE: To describe gender differences in both risk perception and actual coronary risk in patients with coronary artery disease (CAD). METHODS: 33 females and 67 males with documented CAD completed a questionnaire designed to assess CAD risk perception. They also underwent assessments for all ACSM risk factors. Five-point Likert scale responses to the question “Compared to others of your own age and gender, how would you rate your risk of ever having a heart attack?” were used to quantify CAD risk perception. To quantify actual risk, the number of ACSM risk markers for each subject was tabulated. It should be noted that, since all of the subjects had active CAD, they were all at high risk. Tabulations and Likert scale responses were compared using Chi-square analysis or Fisher’s Exact test with significance accepted at p\u3c0.05. To further assess risk perception accuracy, Chi-square analysis with pre-determined expected cell count percentages was used. RESULTS: Likert responses for perceived risk between genders were not significantly different but showed perception inaccuracies of the entire cohort. Only 41% of the subjects perceived their risk as “higher” or “much higher” than their peers while 27% perceived their risk as lower or much lower. 32% of the subjects perceived their risk to be the same as their peers. Comparison of risk marker number between genders was significantly different (Fisher’s exact test, p = .046) with males having 33% more markers than females. Chi-square analysis using an expected cell percentage of 75% in the “higher” Likert category, 25% in the “much higher” Likert category, and fractions of 1 in the other categories revealed significance (p\u3c.0001) with only 29.8% of subject responses in the “higher” category and 11.9% in the “much higher” category. The female cohort showed similar results with test percentages of 73% in the “higher” category and 27% in the “much higher” category. Responses were significantly different (p\u3c.0001) with only 30% choosing the “higher” category and 10% choosing the “much higher” category. CONCLUSIONS: Although significant differences in actual cardiac risk exist between genders in a cohort of cardiac patients, perceived risks are not significantly different. Both genders greatly underestimate their risk

Profiles of Coronary Artery Disease Risk in Cardiac Patients: Actual versus Perceived

PURPOSE: To describe interrelations and differences between actual vs. perceived cardiac risk in a cohort of coronary artery disease (CAD) patients. METHODS: 33 females (HT: 164 cm, WT: 80kg) and 67 males (HT: 179 cm, WT: 93kg) with documented CAD completed a questionnaire designed to assess CAD risk perception. They also underwent assessments for all ACSM risk factors. Five-point Likert scale responses to the question “Compared to other persons of your own age and sex, how would you rate your risk of ever having a heart attack?” were used to quantify CAD risk perception. To quantify actual risk, the number of ACSM risk markers for each subject was tabulated. It should be noted that, since all of the subjects had active CAD, they were all at high risk. Tabulations and Likert scale responses were compared using Chi-square analysis or Fisher’s Exact test with significance accepted at p\u3c0.05. To assess risk perception accuracy, Chi-square analysis with pre-determined expected cell count percentages was used. RESULTS: When compared to diagnosis driven expected frequencies of risk perception being higher or much higher (75% and 25% respectively), patients responses were only 30% and 11% respectively (Chi-square=19696.9, p\u3c.0001). Also, as the number of actual ACSM risk markers increased for each patient, no increase in patient risk perception was found (Chi-square=40.2, p=0.29). Factors associated with accurate perception include age, resting ECG status, and number of bypass grafts. Factors that were not accurately included in risk perception include family history, waist circumference, number and type of angioplasties, smoking, having had a heart attack, number of additional structural cardiac abnormalities present, the presence of arrhythmias, elevated blood lipids and blood glucose, and elevated systolic and diastolic blood pressures. CONCLUSION: Although substantial differences in number and type of actual cardiac risk exist in a cohort of cardiac patients, individual perception of these risks is not accurate in the majority of cases

Climate Action In Megacities 3.0

"Climate Action in Megacities 3.0" (CAM 3.0) presents major new insights into the current status, latest trends and future potential for climate action at the city level. Documenting the volume of action being taken by cities, CAM 3.0 marks a new chapter in the C40-Arup research partnership, supported by the City Leadership Initiative at University College London. It provides compelling evidence about cities' commitment to tackling climate change and their critical role in the fight to achieve global emissions reductions

At the Service of Community Development: The Professionalization of Volunteer Work in Kenya and Tanzania

This article explores the changing nature of the “volunteer” as an official role within health and development interventions in East Africa. Contemporary development interventions require the engagement of volunteers to act as links between project and community. This role is increasingly professionalized within development architectures with implications for the kinds of people who can engage in volunteering opportunities. Volunteers in development interventions are likely to be drawn from public sector staff and from educated youth seeking access to positions of paid employment. Volunteering as a formal status within the organization of development programs is recognized as a kind of professional work by those seeking to engage with development organizations. Volunteers perform important work in linking development programs with beneficiaries. At the same time, volunteering provides opportunities for personal transformation

Non-Canonical Gauge Coupling Unification in High-Scale Supersymmetry Breaking

The string landscape suggests that the supersymmetry breaking scale can be high, and then the simplest low energy effective theory is the Standard Model (SM). Considering grand unification scale supersymmetry breaking, we show that gauge coupling unification can be achieved at about 10^{16-17} GeV in the SM with suitable normalizations of the U(1)_Y, and we predict that the Higgs mass range is 127 GeV to 165 GeV, with the precise value strongly correlated with the top quark mass m_t and SU(3)_C gauge coupling. For example, if m_t=178\pm1 GeV, the Higgs boson mass is predicted to be between 141 GeV and 154 GeV. We also point out that gauge coupling unification in the Minimal Supersymmetric Standard Model (MSSM) does not imply the canonical U(1)_Y normalization. In addition, we present 7-dimensional orbifold grand unified theories (GUTs) in which such normalizations for the U(1)_Y and charge quantization can be realized. The supersymmetry can be broken at the grand unification scale by the Scherk--Schwarz mechanism. We briefly comment on a non-canonical U(1)_Y normalization due to the brane localized gauge kinetic terms in orbifold GUTs.Comment: RevTex4, 28 pages, 4 figures, 2 table

A mitochondria-targeted mass spectrometry probe to detect glyoxals: implications for diabetes

The glycation of protein and nucleic acids that occurs as a consequence of hyperglycaemia disrupts cell function and contributes to many pathologies, including those associated with diabetes and aging. Intracellular glycation occurs following the generation of the reactive 1,2-dicarbonyls methylglyoxal and glyoxal and disruption to mitochondrial function is associated with hyperglycemia. However, the contribution of these reactive dicarbonyls to mitochondrial damage in pathology is unclear due to uncertainties about their levels within mitochondria in cells and in vivo. To address this we have developed a mitochondria-targeted reagent (MitoG) designed to assess the levels of mitochondrial dicarbonyls within cells. MitoG comprises a lipophilic triphenylphosphonium cationic function, which directs the molecules to mitochondria within cells and an o-phenylenediamine moiety that reacts with dicarbonyls to give distinctive and stable products. The extent of accumulation of these diagnostic heterocyclic products can be readily and sensitively quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS), enabling changes to be determined. Using the MitoG-based analysis we assessed the formation of methylglyoxal and glyoxal in response to hyperglycaemia in cells in culture and in the Akita mouse model of diabetes in vivo. These findings indicated that the levels of methylglyoxal and glyoxal within mitochondria increase during hyperglycaemia in both cells and in vivo, suggesting that they can contribute to the pathological mitochondrial dysfunction that occurs in diabetes and aging

Radio source calibration for the VSA and other CMB instruments at around 30 GHz

Accurate calibration of data is essential for the current generation of CMB experiments. Using data from the Very Small Array (VSA), we describe procedures which will lead to an accuracy of 1 percent or better for experiments such as the VSA and CBI. Particular attention is paid to the stability of the receiver systems, the quality of the site and frequent observations of reference sources. At 30 GHz the careful correction for atmospheric emission and absorption is shown to be essential for achieving 1 percent precision. The sources for which a 1 percent relative flux density calibration was achieved included Cas A, Cyg A, Tau A and NGC7027 and the planets Venus, Jupiter and Saturn. A flux density, or brightness temperature in the case of the planets, was derived at 33 GHz relative to Jupiter which was adopted as the fundamental calibrator. A spectral index at ~30 GHz is given for each. Cas A,Tau A, NGC7027 and Venus were examined for variability. Cas A was found to be decreasing at $0.394 \pm 0.019$ percent per year over the period March 2001 to August 2004. In the same period Tau A was decreasing at $0.22\pm 0.07$ percent per year. A survey of the published data showed that the planetary nebula NGC7027 decreased at $0.16\pm 0.04$ percent per year over the period 1967 to 2003. Venus showed an insignificant ($1.5 \pm 1.3$ percent) variation with Venusian illumination. The integrated polarization of Tau A at 33 GHz was found to be $7.8\pm 0.6$ percent at pa $= 148^\circ \pm 3^\circ$.}Comment: 13 pages, 15 figures, submitted to MNRA

Follow-up observations at 16 and 33 GHz of extragalactic sources from WMAP 3-year data: I - Spectral properties

We present follow-up observations of 97 point sources from the Wilkinson Microwave Anisotropy Probe (WMAP) 3-year data, contained within the New Extragalactic WMAP Point Source (NEWPS) catalogue between declinations of -4 and +60 degrees; the sources form a flux-density-limited sample complete to 1.1 Jy (approximately 5 sigma) at 33 GHz. Our observations were made at 16 GHz using the Arcminute Microkelvin Imager (AMI) and at 33 GHz with the Very Small Array (VSA). 94 of the sources have reliable, simultaneous -- typically a few minutes apart -- observations with both telescopes. The spectra between 13.9 and 33.75 GHz are very different from those of bright sources at low frequency: 44 per cent have rising spectra (alpha < 0.0), where flux density is proportional to frequency^-alpha, and 93 per cent have spectra with alpha < 0.5; the median spectral index is 0.04. For the brighter sources, the agreement between VSA and WMAP 33-GHz flux densities averaged over sources is very good. However, for the fainter sources, the VSA tends to measure lower values for the flux densities than WMAP. We suggest that the main cause of this effect is Eddington bias arising from variability.Comment: 12 pages, 13 figures, submitted to MNRA