Does chronic caregiving stress accelerate T cell immunosenescence?

First paragraph: It is now well understood that the human immune system undergoes considerable changes, termed immunosenescence, as part of the ageing process, resulting in an increased rate of infections and inflammation. The impact of stress is often studied in the context of such age-related changes, as detailed in this issue by Prather et al. (2018). In the innate immune system, immunosenescence changes include increased levels of inflammatory cytokines and markers such as CRP, accompanied by decreased anti-inflammatory cytokines; a skewing toward myeloid cell differentiation of haematopoietic stem cells; decreased phagocytosis, intracellular killing and dysregulated chemotaxis in neutrophils and macrophages/monocytes, increased NK and NKT cells but decreased cytotoxicity (Bosch et al., 2013). In the adaptive immune system, these alterations encompass decreased production of naïve T cells, especially cytotoxic CD8+ T cells, due to thymus involution and CMV exposure, decreases in T cell activation, reduced numbers of naïve B cells, and a switch towards accumulation of memory and effector T and B cells (Bosch et al., 2013). Chronic stress is known to exacerbate these changes further and affect a range of immune cells and immune processes such as slower wound healing and reduced antibody response to vaccination (Segerstrom and Miller, 2004)

Assessing the feasibility and impact of an adapted resistance training intervention, aimed at improving the multi-dimensional health and functional capacity of frail older adults in residential care settings: protocol for a feasibility study

Background Frailty is a common and clinically significant condition in older adults, predominantly due to its association with adverse health outcomes such as hospitalisation, disability and mortality. Exercise interventions have been shown to be a beneficial treatment for frail older adults. However, more high-quality studies are needed within this area to assess the feasibility and impact of these interventions in frail geriatric populations within different settings, and with regards to their impact on broader aspects of health and wellbeing. Methods This study will utilise an interventional, randomised, controlled research design in order to assess the feasibility (acceptability, demand, implementation, practicality, adaptation, integration, expansion) and potential impact (limited-efficacy testing) of a specially adapted resistance training intervention; aimed at improving the multi-dimensional health and functional capacity of frail geriatric care home residents. Discussion The most immediate implication of this research from a scientific perspective is informing the feasibility, and potential efficacy, of a proposed future clinical trial within this setting. Additionally, if the study proves feasible, and the limited-efficacy testing proves positive, this study also has the potential to lead to advancement in the care for frail geriatric populations within residential care settings; and the ability to measurably improve various aspects of health and functional capacity within this population. This study has been granted a favourable ethical opinion by the London Harrow NHS Research Ethics Committee and is sponsored by the University of Birmingham. The findings of this study will be disseminated through publication in open access scientific journals, public engagement events, online via social media, conference presentations and directly to study participants

Fusion of heart rate variability and salivary cortisol for stress response identification based on adverse childhood experience

Adverse childhood experiences have been suggested to cause changes in physiological processes and can determine the magnitude of the stress response which might have a significant impact on health later in life. To detect the stress response, biomarkers that represent both the Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenal (HPA) axis are proposed. Among the available biomarkers, Heart Rate Variability (HRV) has been proven as a powerful biomarker that represents ANS. Meanwhile, salivary cortisol has been suggested as a biomarker that reflects the HPA axis. Even though many studies used multiple biomarkers to measure the stress response, the results for each biomarker were analyzed separately. Therefore, the objective of this study is to propose a fusion of ANS and HPA axis biomarkers in order to classify the stress response based on adverse childhood experience. Electrocardiograph, blood pressure (BP), pulse rate (PR), and salivary cortisol (SCort) measures were collected from 23 healthy participants; 11 participants had adverse childhood experience while the remaining 12 acted as the no adversity control group. HRV was then computed from the ECG and the HRV features were extracted. Next, the selected HRV features were combined with the other biomarkers using Euclidean distance (ed) and serial fusion, and the performance of the fused features was compared using Support Vector Machine. From the result, HRV-SCort using Euclidean distance achieved the most satisfactory performance with 80.0% accuracy, 83.3% sensitivity, and 78.3% specificity. Furthermore, the performance of the stress response classification of the fused biomarker, HRV-SCort, outperformed that of the single biomarkers: HRV (61% Accuracy), Cort (59.4% Accuracy), BP (78.3% accuracy), and PR (53.3% accuracy). From this study, it was proven that the fused biomarkers that represent both ANS and HPA (HRV-SCort) able to demonstrate a better classification performance in discriminating the stress response. Furthermore, a new approach for classification of stress response using Euclidean distance and SVM named as ed-SVM was proven to be an effective method for the HRV-SCort in classifying the stress response from PASAT. The robustness of this method is crucial in contributing to the effectiveness of the stress response measures and could further be used as an indicator for future health

Undiagnosed Obstructive Sleep Apnea and Physical Activity in Older Manual Workers

First paragraph: Sleep is essential for life and integral to health and well-being (Roehrs, 2000). However, during the aging process, sleep patterns become disrupted, which leads to sleep deprivation (Stanley, 2005). Inadequate sleep has adverse effects on the body, including the production of higher cortisol (stress hormone) levels, which causes wear and tear physiologically, and further contributes to wakefulness (Stanley, 2005)

Transient landscape and stratigraphic responses to drainage integration in the actively extending central Italian Apennines

Drainage networks in continental rifts are generally reported as dynamic features that produce transitions between endorheic and exorheic conditions. While this is of major importance for landscape development, sediment dispersal, and basin stratigraphy, the controls of drainage network evolution across an array of normal fault bounded basins are still not well understood. In this study we use the central Italian Apennines – an area that has been affected by active normal faulting and regional uplift over the last ~3 Myrs – to determine the controls on drainage network evolution and its impact on transient landscape evolution and basin stratigraphy. We compile previously published stratigraphic and fault-related data with new geomorphological constraints for the Aterno River system (~1300 km2), for which a wealth of data has been collected following the destructive L'Aquila earthquake in 2009. We use this compilation to demonstrate how the different basins along the river system were initially isolated during the Early Pleistocene but became fluvially integrated with one another and the Adriatic coast between ca. 1.2 and 0.65 Ma. We conclude that the spatial and temporal pattern of drainage integration is mostly explained by a long-term increase in sediment and water supply relative to basin subsidence due to the Early to Middle Pleistocene climatic transition, the progressive increase in fault-related topography, and the transport of sediment and water down-system as drainage integration occurred. Overall we conclude that rates of sedimentation and basin subsidence in the central Apennines are well-matched, allowing tipping points between over- and under-filled conditions to be easily reached. We also show that consecutive drainage integration events produce discrete waves of river incision and terrace formation, and conclude that drainage integration is of major importance, at least equivalent to tectonics and climate, in controlling transient landscape evolution and rift basin stratigraphy.publishedVersio

Resilience, work engagement and stress reactivity in a middle-aged manual worker population

Work stress is a growing problem in Europe. Together, the negative physiological effect of stress on health, and increasing age increases the risk of developing cardiovascular disease in those aged over 50 years. Therefore, identifying older workers who may be at risk of work-related stress, and its physiological effects, is key to promoting their health and wellbeing in the workforce. The present study examined the relationship between perceived psychological resilience and work-related factors (work engagement and presenteeism) and the physiological response to acute psychological stress in older manual workers in the UK. Thirty-one participants, mean (SD) age 54.9 (3.78) years reported perceived levels of resilience, work engagement, and presenteeism using standardized questionnaires. Cardiovascular measurements (heart rate (HR) and blood pressure (BP) and salivary cortisol were used to assess their physiological response to an acute psychological stress task. Resilience was not associated with work-related factors or reactivity. However, workers with higher work engagement showed lower SBP (p = 0.02) and HR (p = 0.001) reactivity than those with lower work engagement. Further, those with higher sickness presenteeism also had higher HR reactivity (p = 0.03). This suggests a potential pathway by which higher work stress might contribute to the risk of future cardiovascular disease

Physical activity interventions for treatment of social isolation, loneliness or low social support in older adults: A systematic review and meta-analysis of randomised controlled trials

Objectives This article reviews the effects of physical activity (PA) interventions on social isolation, loneliness or low social support in older adults. Design Systematic review and meta-analysis of randomised controlled trials (RCTs). Method MEDLINE, EMBASE, PsycINFO, the Cochrane CENTRAL, CINAHL, were screened up to February 2017. RCTs comparing PA versus non-PA interventions or control (sedentary) condition were included. Risk of bias was assessed using the 12 criteria Cochrane Review Book Group risk of bias. The outcome measures were: social isolation, loneliness, social support, social networks, and social functioning. Standardised mean differences (SMDs) with associated 95% confidence intervals (CIs) were calculated for continuous outcomes. Meta-analysis was performed using a random effects model. Results The search strategy identified 38 RCTs, with a total of 5288 participants, of which 26 had a low risk of bias and 12 had a high risk of bias. Meta-analysis was performed on 23 RCTs. A small significant positive effect favouring the experimental condition was found for social functioning (SMD = 0.30; 95% CI, 0.12 to 0.49; P = 0.001) with strongest effects obtained for PA interventions, diseased populations, group exercise setting, and delivery by a medical healthcare provider. No effect of PA was found for loneliness, social support, or social networks. Conclusion This review shows, for social functioning, the specific aspects of PA interventions can successfully influence social health. PA did not appear to be effective for loneliness, social support and social networks

Physical Activity Intervention for Loneliness (PAIL) in community-dwelling older adults: protocol for a feasibility study

Background Low-quality social relationships in older adults are strongly associated with feelings of loneliness. Physical activity interventions could reduce loneliness and improve psychological well-being, among other health benefits. The aim of this study is to examine the feasibility of a Physical Activity Intervention for Loneliness (PAIL) in community-dwelling older adults at risk for loneliness. Methods/design This feasibility study is a two-arm randomised controlled trial (RCT) with a wait-list control group using a mixed-methods research design. The primary aim of the feasibility study is to estimate recruitment, retention and adherence rates; the appropriateness of the intervention design and its practicality; the acceptability of the intervention by participants; and the set of instruments and measures and primary outcome measures to inform a future large-scale randomised trial. After eligibility screening, randomisation will be conducted using computer-based random sequence generation. Baseline and post-intervention assessments for intervention and control groups will include height, weight, body mass index, resting blood pressure, physical activity using accelerometry, loneliness, social support, social networks, anxiety and depression, self-efficacy for exercise, satisfaction with social contacts, and expected outcomes and barriers for exercise using questionnaires. Focus groups will be conducted at the mid-point and post-intervention period using a phenomenological approach to analyse the participants’ experiences of taking part in PAIL. Discussion This trial will provide important information regarding the feasibility of PAIL in community-dwelling older adults at risk for loneliness using a mixed-methods approach combining quantitative and qualitative research methods

A shot in the arm for research: Why are vaccinations interesting to psychologists?

First paragraph: Next time you get flu or a cold after a particularly difficult week, don’t dismiss it as coincidence. Interdisciplinary work between psychologists and immunologists has shown that factors like stress could be the trigger. By studying the response to vaccination, we can examine immune function in a clinically meaningful way. This technique has demonstrated relationships between factors such as stress, social support, and personality and vaccination-induced protection against disease. The types of stress and social support that influence our immune response also change as we age, emphasising the importance of a life course approach to study

Blunted cardiovascular reactivity to acute psychological stress predicts low behavioral but not self-reported perseverance: A replication study

Emerging evidence suggests that individuals with poor behavioral perseverance show low or blunted physiological responses to acute psychological stress. For example, a recent preliminary laboratory study demonstrated that blunted responders give up sooner and take fewer attempts when endeavoring to complete an impossible puzzle, but do not self‐report poor perseverance. This present research is a replication of the previous study with an increased sample size, longer recovery periods between tasks and addition of social evaluation to the cold pressor. Participants (147) completed a self‐report perseverance questionnaire (Short Grit Scale) and behavioral perseverance tasks (impossible Euler puzzle and socially evaluated cold‐pressor (SECPT)). The number of attempts and time spent trying to complete the unsolvable puzzle, and duration of hand submergent during the SECPT, were recorded as behavioral perseverance measures. Difference in blood pressure (BP) and pulse rate (PR) from baseline to a 10‐min paced auditory serial addition task (PASAT) were computed as reactivity. As previously, reactivity did not relate to self‐reported perseverance and blunted BP reactivity to the PASAT was associated with less time persevering at the unsolvable puzzle. Additionally, blunted BP and PR reactivity to the PASAT related to poorer perseverance during the SECPT. These findings, replicating the previous study, increase confidence that blunted reactivity is a physiological marker of poor behavioral perseverance. Moreover, given that self‐reported perseverance does not relate to reactivity, this suggests that blunted responders are not conscious of this detriment in perseverance, but likely need additional support when persistence is critical (e.g., during behavior change)