PANIC DISORDER, ANXIETY, AND CARDIOVASCULAR DISEASES

Different data indicate that psychological and/or emotional disorders may play an important role in the natural history of heart diseases. Although the major evidence is that related to depression, epidemiological data would indicate that anxiety and panic disorders are highly represented in cardiac patient, thus influencing mortality and morbidity. The diagnosis of panic disorder in patients with chest pain is crucial to a correct therapeutic approach, as well as to reduce the risks and costs of inappropriate treatments. Anxiety and panic may accelerate different direct and indirect processes involved in the pathogenesis of cardiovascular diseases: lifestyle risk factors, arterial hypertension, myocardial perfusion, autonomic nervous system or hypothalamus-pituitary-adrenal axis, platelet activation, and inflammation processes. Panic disorder seems to correlate particularly with sudden death: this suggests that it may be considered one of the main inducers of life-threatening arrhythmias, rather than to be linked to the development and progression of coronary atherosclerosis. Beyond hard outcomes, panic disorders produce negative effects on both global adjustment and life quality that may impair the course of the cardiac diseases. Interestingly, specific antipanic and anxiolytic agents seem to be particularly effective upon life quality. In any case, adequate controlled clinical trials are necessary in order to confirm the possibility of cardiovascular risk reduction by means of anxiety and panic disorder treatment

A kinematically selected, metal-poor stellar halo in the outskirts of M31

We present evidence for a metal-poor, [Fe/H]$\sim-1.4$ $\sigma$=0.2 dex, stellar halo component detectable at radii from 10 kpc to 70 kpc, in our nearest giant spiral neighbor, the Andromeda galaxy. This metal-poor sample underlies the recently-discovered extended rotating component, and has no detected metallicity gradient. This discovery uses a large sample of 9861 radial velocities of Red Giant Branch (RGB) stars obtained with the Keck-II telescope and DEIMOS spectrograph, with 827 stars with robust radial velocity measurements isolated kinematically to lie in the halo component primarily by windowing out the extended rotating component which dominates the photometric profile of Andromeda out to $<$50 kpc (de-projected). The stars lie in 54 spectroscopic fields spread over an 8 square degree region, and are expected to fairly sample the halo to a radius of $\sim$70 kpc. The halo sample shows no significant evidence for rotation. Fitting a simple model in which the velocity dispersion of the component decreases with radius, we find a central velocity dispersion of 152\kms decreasing by -0.90\kms/\kpc. By fitting a cosmologically-motivated NFW halo model to the halo stars we constrain the virial mass of M31 to be greater than 9.0 \times 10^{11} \msun with 99% confidence. The properties of this halo component are very similar to that found in our Milky Way, revealing that these roughly equal mass galaxies may have led similar accretion and evolutionary paths in the early Universe.Comment: 13 pages, 12 figures, accepted in ApJ. substantially revised versio

Tracing Galaxy Formation with Stellar Halos II: Relating Substructure in Phase- and Abundance-Space to Accretion Histories

This paper explores the mapping between the observable properties of a stellar halo in phase- and abundance-space and the parent galaxy's accretion history in terms of the characteristic epoch of accretion and mass and orbits of progenitor objects. The study utilizes a suite of eleven stellar halo models constructed within the context of a standard LCDM cosmology. The results demonstrate that coordinate-space studies are sensitive to the recent (0-8 Gyears ago) merger histories of galaxies (this timescale corresponds to the last few to tens of percent of mass accretion for a Milky-Way-type galaxy). Specifically, the {\it frequency, sky coverage} and {\it fraction of stars} in substructures in the stellar halo as a function of surface brightness are indicators of the importance of recent merging and of the luminosity function of infalling dwarfs. The {\it morphology} of features serves as a guide to the orbital distribution of those dwarfs. Constraints on the earlier merger history (> 8 Gyears ago) can be gleaned from the abundance patterns in halo stars: within our models, dramatic differences in the dominant epoch of accretion or luminosity function of progenitor objects leave clear signatures in the [alpha/Fe] and [Fe/H] distributions of the stellar halo - halos dominated by very early accretion have higher average [alpha/Fe], while those dominated by high luminosity satellites have higher [Fe/H]. This intuition can be applied to reconstruct much about the merger histories of nearby galaxies from current and future data sets.Comment: 21 pages, 20 figures. To appear in the Astrophysical Journa

The Red Halo Phenomenon

Optical and near-IR observations of the halos of disk galaxies and blue compact galaxies have revealed a very red spectral energy distribution, which cannot easily be reconciled with a normal, metal-poor stellar population like that in the stellar halo of the Milky Way. Here, spectral evolutionary models are used to explore the consequences of these observations. We demonstrate that a stellar population of low to intermediate metallicity, but with an extremely bottom-heavy initial mass function, can explain the red halos around both types of objects. Other previously suggested explanations, like nebular emission or very metal-rich stars, are shown to fail in this respect. This indicates that, if the reported halo colours are correct, halo populations dominated by low-mass stars may be a phenomenon common to galaxies of very different Hubble types. Potential tests of this hypothesis are discussed, along with its implications for the baryonic dark matter content of galaxies.Comment: 6 pages, 3 figures, Accepted for publication in Ap

The Haunted Halos of Andromeda and Triangulum: A panorama of galaxy formation in action

We present a deep photometric survey of M31, conducted with the CFHT and INT, covering the inner 50 kpc of the galaxy, the Southern quadrant out to 150 kpc, and extending to M33. This is the first systematic panoramic study of this very outermost region of galaxies. We detect several streams and other large-scale structures, and two new dwarf galaxies: And XV and XVI. The discovery of substructure on the minor axis, together with the fact that the light profile between 0.5 < R < 1.3 follows the exponential ``extended disk'', is particularly important in shedding light on the mixed and sometimes conflicting results reported in previous studies. Underlying the substructures lies a faint, metal-poor, smooth and extremely extended halo, reaching out to at least 150 kpc. The smooth halo component in M31 has a profile that can be fit with a Hernquist model of immense scale radius ~55 kpc, almost a factor of 4 larger than theoretical predictions. Alternatively a power-law with exponent -1.91 +/- 0.11 can be fit to the profile. The total luminosity of this structure is similar to that of the halo of the Milky Way. This vast, smooth, underlying halo is reminiscent of a classical monolithic model and completely unexpected from modern galaxy formation models. M33 is also found to have an extended metal-poor halo component, which can be fit with a Hernquist model also of scale radius ~55 kpc. These extended slowly-decreasing halos will provide a challenge and strong constraints for further modeling. [Abridged]Comment: 38 pages, 55 figures, submitted to ApJ. High resolution version available at http://palantir.u-strasbg.fr/~ibata/pdf/0704.1318.pdf Please do not bother with the astro-ph version - the figures are devoid of informatio

“You Are the Key”: A co-design project to reduce disparities in Black veterans’ communication with healthcare providers

Interventions are needed to overcome a key barrier to patient-provider communication, namely that patients hesitate to participate in clinical conversations because they believe their expected role is to be passive. This expectation is reinforced for veterans, who replicate their experience of military hierarchy in the patient-provider relationship. Black veterans, moreover, encounter structural racism that compounds this power imbalance. This paper describes a co-designed intervention to empower Black veterans to talk with providers, using shared decision-making (SDM) for lung cancer screening (LCS) as an exemplar. We worked with a diverse group of 5 veterans to develop materials that normalize participating in clinical conversations. We then interviewed 10 Black veterans selected from a national sample to assess the booklet’s impact and contextual factors. The co-design team produced a 30-page booklet that includes veteran narratives describing positive clinical interactions, as well as didactic information about SDM and LCS. We identified four themes related to Black veteran participants’ healthcare experience: (1) they want truthful and complete information exchange with providers they know; (2) they often feel their concerns are disregarded; (3) poor communication worsens medical treatment; and (4) they are confused and angry about treatment in clinical encounters that they feel are racist. The booklet was described as interesting and informative. The veteran narratives in the booklet particularly resonated with readers. Assessment of the booklet’s overall impact on planned engagement with providers varied. Co-designed materials that normalize participation in clinical encounters can play a role in reducing disparities in patient-provider communication. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens