Does the Perception That Stress Affects Health Matter? The Association with Health and Mortality

OBJECTIVE: This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally-representative sample of U.S. adults. METHODS: Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to healthcare factors. RESULTS: 33.7% of nearly 186 million (n=28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.20, 1.71]). CONCLUSIONS: High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death

Polarization Maintaining, Very-Large-Mode Area, Er Fiber Amplifier for High Energy Pulses at 1572.3 nm

We demonstrate the first polarization maintaining, very-large-mode-area Er-doped fiber amplifier with ~1000 square micron effective area. The amplifier is core pumped by a Raman fiber laser and is used to generate single frequency one microsecond pulses with pulse energy of 368 microJoules, M2 of 1.1, and polarization extinction greater than 20 dB. The amplifier operates at 1572.3 nm, a wavelength useful for trace atmospheric CO2 detection

Circumferential strain in the wall of the common carotid artery: Comparing displacement-encoded and cine MRI in volunteers

The walls of conduit arteries undergo cyclic stretching from the periodic fluctuation of arterial pressure. Atherosclerotic lesions have been shown to localize to regions of excessive stretching of the arterial wall. We employed a displacement encoding with stimulated echoes (DENSE) sequence to image the motion of the common carotid artery wall and map the two-dimensional (2D) circumferential strain. The sequence utilizes a fully-balanced steady-state free-precession (SSFP) readout with 0.60 mm in-plane resolution. Preliminary results in volunteers at 1.5T (N = 4) and 3.0T (N = 17) are compared to measurements of the lumen circumference from cine images. The agreement between the two independent measurements at both field strengths (P ≤ 0.001) supports the use of DENSE as a means to map the pulsatile strain in the carotid artery wall

Disparities in human papillomavirus vaccine awareness among U.S. parents of preadolescents and adolescents.

BackgroundImproved parental awareness of human papillomavirus (HPV) vaccines could increase uptake of vaccines early in the life course, thereby reducing adolescents' later risk for HPV infection and cancer. As such, we sought to determine factors related to parental awareness of HPV vaccines, using a nationally representative population-based sample.MethodsWe examined data on 5735 parents of preadolescents and adolescents aged 8 to 17 years from the 2010 National Health Interview Survey. Parents were asked if they had ever heard of HPV vaccines or shots. Multivariable logistic regression analyses were used to examine the odds of parental awareness of HPV vaccines, controlling for relevant covariates.ResultsMost US parents (62.6%) heard of HPV vaccines. Multivariable results revealed parents of children who were older, female, and insured were more likely to have heard of HPV vaccines; parents who were female, white (non-Hispanic), English speakers, born in the United States, married or living with a partner, more educated, and had higher income were also more likely to be aware of HPV vaccines. Notably, parents of children who had a well-child checkup in the last 12 months were significantly more likely to have heard of HPV vaccines (odds ratio, 1.23; 95% confidence interval, 1.04-1.46).ConclusionsGiven the significant disparities in parental awareness of HPV vaccines, improving access to preventive pediatric health care could offer an opportunity to increase parental awareness. In addition, public health efforts that provide culturally sensitive information in a variety of languages may be an effective way to reach vulnerable groups

Correlates of physiological and psychological stress among parents of childhood cancer and brain tumor survivors.

ObjectiveFirst, we sought to determine if parents of children with cancer or a brain tumor had greater stress compared to parents of healthy children and to evaluate the correlates of stress among parents of children with cancer or brain tumors. Second, we sought to examine the relationship between perceived stress and symptoms of stress and how that relationship may differ for parents of children with cancer.MethodsIn-person, interviewer-assisted surveys were administered to 73 case dyads (children with cancer or a brain tumor and their parents) and 133 comparison dyads (children without health problems and their parents from a community sample). Descriptive analyses and multivariable logistic regressions were performed for case-comparison and case-only analyses to distinguish correlates of parental stress.ResultsParents of children with cancer exhibited higher levels of physiological symptoms of stress than parents of healthy children. Poor sleep quality and greater social stress (negative social interactions) were significant correlates of increased levels of stress in parents of children with cancer (odds ratio 4.23, 95% confidence interval 1.15-15.60; and odds ratio 1.07, 95% confidence interval 1.00-1.14, respectively). A subset of parents reported symptoms of stress but not perceived stress, and this discordance was more pronounced among cancer caregivers.ConclusionsImplementation of screening tools that include symptoms of stress may help clinicians to comprehensively identify parents of children with cancer who are in need of additional services. Targeted stress-reduction interventions that address sleep quality and negative social interactions may mitigate the deleterious effects of caregiving, improving the psychosocial well-being of both parents and children with cancer

Parental depressive symptoms and childhood cancer: the importance of financial difficulties.

PurposeResearch suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer.MethodsData are from 215 parents of children diagnosed with cancer or brain tumors (n = 75) and a comparison group of parents of healthy children (n = 140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms.ResultsCaring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR = 4.93; 95 % CI 1.97-12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR = 4.89; 95 % CI 1.26-18.96).ConclusionsCaring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents

Racial and ethnic disparities in personal capital during pregnancy: findings from the 2007 Los Angeles Mommy and Baby (LAMB) study.

The objectives of this study were to determine if racial and ethnic differences in personal capital during pregnancy exist and to estimate the extent to which any identified racial and ethnic differences in personal capital are related to differences in maternal sociodemographic and acculturation characteristics. Data are from the 2007 Los Angeles Mommy and Baby study (n = 3,716). Personal capital comprised internal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) during pregnancy. The relationships between race/ethnicity and personal capital were assessed using multivariable generalized linear models, examining the impact of sociodemographic and acculturation factors on these relationships. Significant racial and ethnic disparities in personal capital during pregnancy exist. However, socioeconomic status (i.e., income and education) and marital status completely explained Black-White disparities and Hispanic-White disparities in personal capital, whereas acculturation factors, especially nativity and language spoken at home, partially mediated the disparities in personal capital between Asian/Pacific Islander women and White women. Findings suggest that the risks associated with low socioeconomic status, single motherhood, and low acculturation, rather than race or ethnicity, contribute to low personal capital for many pregnant women. As personal capital during pregnancy may influence subsequent maternal and child health outcomes, the development of interventions should consider addressing sociodemographic and acculturation factors in order to reduce racial and ethnic disparities in personal capital and ultimately in poor maternal and child health outcomes