Dyadic and mediation analyses of coping with cardiovascular disease

AbstractThe purpose of this study was to investigate the relationship between attachment security and health outcomes of cardiac patients and their spouses. Dyadic coping and relationship quality were proposed to mediate this relationship. Participants were 72 couples in which one member of the couple was participating in cardiac rehabilitation. Results showed that participants with higher attachment avoidance perceived their general and mental health worse and were less likely to exercise. Patients with higher attachment avoidance perceived their partner as less supportive and this was negatively associated with their general and mental health. Spouses’ positive support and marital happiness partially mediated the relationship between their attachment anxiety and mental health. Patients with spouses with higher attachment anxiety exercised more; whereas spouses of patients with higher attachment anxiety exercised less

The effects of the spontaneous presence of a spouse/partner and others on cardiovascular reactions to an acute psychological challenge

The presence of supportive others has been associated with attenuated cardiovascular reactivity in the laboratory. The effects of the presence of a spouse and others in a more naturalistic setting have received little attention. Blood pressure and heart rate reactions to mental stress were recorded at home in 1028 married/partnered individuals. For 112 participants, their spouse/partner was present; for 78, at least one other person was present. Women tested with a spouse/partner present showed lower magnitude systolic blood pressure and heart rate reactivity than those tested without. Individuals tested with at least one nonspousal other present also displayed attenuated reactivity. This extends the results of laboratory studies and indicates that the spontaneous presence of others is associated with a reduction in cardiovascular reactivity in an everyday environment; spouse/partner presence would appear to be especially effective for women.\ud \u

Genetic and environmental contributions to stability in loneliness throughout childhood.

Heritability estimates based on two small cross-sectional studies in children indicate that the genetic contribution to individual differences in loneliness is approximately 50%. A recent study estimated the genetic contribution to variation in loneliness in adults to be 48%. The current study aims to replicate and expand these findings by conducting longitudinal analyses in order to study causes of individual differences in stability of loneliness throughout childhood. Univariate and multivariate longitudinal analyses are conducted in a large sample of young Dutch twins. Information on loneliness comes from maternal ratings on the Child Behavior Checklist. Using an average score of loneliness over ages 7, 10, and 12, results from the two previous studies are replicated and a heritability estimate of 45% is found. The remaining variance is accounted for by shared environmental influences (12%), and non-shared environmental influences (43%). The long-itudinal analyses, however, show that heritability is 58% at age 7, 56% at age 10, but drops to 26% at age 12. A parallel increase in influences of shared family environment is observed, explaining 6% of the variance at age 7, 8% at age 10 and 35% at age 12. The remaining variance is explained by relatively stable influences of nonshared environmental factors. Stability in loneliness is high, with phenotypic correlations in the range of 0.51-0.69. This phenotypic stability is mainly caused by genetic and nonshared environmental influences. The results indicate the importance of both innate as well as nonshared environmental factors for individual differences in loneliness. Further, different results between causes of individual differences for the average score of loneliness and results for age 12 from the longitudinal analyses, indicate the importance of longitudinal analyses with data at well-defined ages. © 2007 Wiley-Liss, Inc

Impact of social ties on self reported health in France: Is everyone affected equally?

<p>Abstract</p> <p>Aim</p> <p>To examine the association of social ties and income with self reported health, in order to investigate if social ties have a greater impact on the health of people on low incomes compared to those financially better off.</p> <p>Methods</p> <p>A nationally representative cross-sectional study of 5205 French adults using data from questionnaires which asked about health, income and relationships with family and friends etc.</p> <p>Results</p> <p>Less than good self-rated health (SRH) is twice as frequently reported by people in the lowest income group than those in the highest income group. People with low incomes are also more likely to have felt alone on the previous day, received no phone call during the last week, have no friends, not be a member of a club, and to live alone. Socially isolated people report lower SRH. Likelihood ratio tests for interaction vs. main effect models were statistically significant for 2 of the measures of social ties, borderline for 2 others and non-significant for one. For 4 of the 5 indicators of social ties, larger odd ratios show that social isolation is more strongly associated with less than good SRH among people on low incomes compared to those with a higher income.</p> <p>Conclusion</p> <p>Social isolation is associated with 'less than good' self-rated health. This effect appears to be more important for people on a low income.</p

Delivery of a Small for Gestational Age Infant and Greater Maternal Risk of Ischemic Heart Disease

Background: Delivery of a small for gestational age (SGA) infant has been associated with increased maternal risk of ischemic heart disease (IHD). It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. Methods and Findings: Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999–2006), a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95 % CI: 1.8; 1.2, 2.9; p = 0.012). The association was independent of the family history of IHD, stroke, hypertension and diabetes (family historyadjusted OR; 95 % CI: 1.9; 1.2, 3.0; p = 0.011) as well as other risk factors for IHD (risk factor-adjusted OR; 95 % CI: 1.7; 1.1, 2.7; p = 0.025). Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36) years. Conclusions: Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes tha

Gender-related mental health differences between refugees and non-refugee immigrants - a cross-sectional register-based study

<p>Abstract</p> <p>Background</p> <p>Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden.</p> <p>Methods</p> <p>A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Outcome: Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders.</p> <p>Results</p> <p>The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15 - 1.40).</p> <p>Conclusions</p> <p>Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers.</p

Deficient of a Clock Gene, Brain and Muscle Arnt-Like Protein-1 (BMAL1), Induces Dyslipidemia and Ectopic Fat Formation

A link between circadian rhythm and metabolism has long been discussed. Circadian rhythm is controlled by positive and negative transcriptional and translational feedback loops composed of several clock genes. Among clock genes, the brain and muscle Arnt-like protein-1 (BMAL1) and circadian locomotor output cycles kaput (CLOCK) play important roles in the regulation of the positive rhythmic transcription. In addition to control of circadian rhythm, we have previously shown that BMAL1 regulates adipogenesis. In metabolic syndrome patients, the function of BMAL1 is dysregulated in visceral adipose tissue. In addition, analysis of SNPs has revealed that BMAL1 is associated with susceptibility to hypertension and type II diabetes. Furthermore, the significant roles of BMAL1 in pancreatic β cells proliferation and maturation were recently reported. These results suggest that BMAL1 regulates energy homeostasis. Therefore, in this study, we examined whether loss of BMAL1 function is capable of inducing metabolic syndrome. Deficient of the Bmal1 gene in mice resulted in elevation of the respiratory quotient value, indicating that BMAL1 is involved in the utilization of fat as an energy source. Indeed, lack of Bmal1 reduced the capacity of fat storage in adipose tissue, resulting in an increase in the levels of circulating fatty acids, including triglycerides, free fatty acids, and cholesterol. Elevation of the circulating fatty acids level induced the formation of ectopic fat in the liver and skeletal muscle in Bmal1 -/- mice. Interestingly, ectopic fat formation was not observed in tissue-specific (liver or skeletal muscle) Bmal1 -/- mice even under high fat diet feeding condition. Therefore, we were led to conclude that BMAL1 is a crucial factor in the regulation of energy homeostasis, and disorders of the functions of BMAL1 lead to the development of metabolic syndrome

Domains of Chronic Stress, Lifestyle Factors, and Allostatic Load in Middle-Aged Mexican-American Women

Abstract available at publisher's website

Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting

Background—The aim of the study was to examine the efficacy of a collaborative care intervention to reduce depression, pain and fatigue and improve quality of life. Participants—A total of 261 patients with advanced cancer and 179 family caregivers were randomized to a web-based collaborative care intervention or enhanced usual care. The intervention included (1) a website with written and audiovisual self-management strategies, bulletin board, and other resources; (2) visits with a care coordinator during physician appointment every two months; and (3) telephone follow up every two weeks. Primary patient outcomes included measures of depression, pain, fatigue, and health related quality of life. Secondary outcomes included Interleukin (IL)-1α, IL-1β, IL-6, IL-8, Natural Killer (NK) cell numbers, and caregiver stress and depression. Results—At baseline, 51% of patients reported one or more symptoms in the clinical range. For patients who presented with clinical levels of symptoms, and were randomized to the intervention, reductions in depression (Cohen’s d=0.71), pain (Cohen’s d=0.62), and fatigue (Cohen’s d=0.26) and improvements in quality of life (Cohen’s d =0.99) were observed when compared to the enhanced usual care arm at 6-months. Reductions in IL-6 (phi=0.18), IL-1β (phi=0.35); IL-1α (phi=0.19); IL-8 (phi=15) and increases in NK cell numbers (phi=0.23) were observed when compared to enhanced usual care arm at 6-months. Reductions in caregiver stress (Cohen’s d=0.75) and depression (Cohen’s d=0.37) were observed at 6-months for caregivers whose loved one was randomized to the intervention arm. Conclusions—Integration of screening and symptom management into cancer care is recommended