Values, value conflict and stress the prediction of stress by values and value conflict

The aim of this paper was to investigate the relationship between stress, values, and value conflict. Data collected from 400 people working in a wide variety of companies in Flanders indicated that the values openness to change, conservation, self-transcendence, self-enhancement, and value conflict were important predictors of stress. Participants open to change reported less stress, while respondents scoring high on conservation, self-enhancement, and self-transcendence perceived more stress. People reporting high value conflict also experienced more stress. Separate analyses for the male and female subsamples demonstrated that sex differences regarding the relationship between the four value types and stress cast new light on the findings for the total sample. The article concludes with a discussion of the results and future research directions

Values, value conflict and stress the prediction of stress by values and value conflict

The aim of this paper was to investigate the relationship between stress, values, and value conflict. Data collected from 400 people working in a wide variety of companies in Flanders indicated that the values openness to change, conservation, self-transcendence, self-enhancement, and value conflict were important predictors of stress. Participants open to change reported less stress, while respondents scoring high on conservation, self-enhancement, and self-transcendence perceived more stress. People reporting high value conflict also experienced more stress. Separate analyses for the male and female subsamples demonstrated that sex differences regarding the relationship between the four value types and stress cast new light on the findings for the total sample. The article concludes with a discussion of the results and future research directions

pitfalls in coronary artery stenosis assessment in takotsubo syndrome the role of microvascular dysfunction

n/

The impact of drop-out in cardiac rehabilitation on outcome among coronary artery disease patients

Background: The effect of adherence to cardiac rehabilitation (CR) on outcome is not clear. Therefore, we aimed to assess the impact of drop-out for non-medical reasons of CR on event-free survival in coronary artery disease (CAD). Methods: A total of 876 patients who attended CR after acute coronary syndrome (ACS), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) were included. Drop-out was defined as attending 50% of the training sessions. A combined endpoint of all-cause mortality and rehospitalization for a cardiovascular event was used to specify event-free survival. Differences in clinical characteristics were assessed and parameters with p<0.10 were entered in a multiple Cox regression analysis. Results: A total of 15% died or had a cardiovascular event during a median follow-up period of 33 months (interquartile range 24, 51). Overall, 17% dropped out before finishing half of the program. Patients who withdrew prematurely had a risk twice as high for a cardiovascular event or death (hazard ratio 1.92, 95% confidence interval 1.28-2.90) than those who attended more than half of the sessions. Both ACS (2.36, 1.47-3.58) and PCI (2.20, 1.22-3.96), as primary indicators for CR, were associated with an adverse outcome and also a prior history of chronic heart failure (CHF) remained negatively associated with event-free survival (3.67, 1.24-10.91).Finally, the presence of hyperlipidemia was independently related to a worse outcome (1.48, 1.02-2.16). Conclusions: Drop-out for non-medical reasons was independently associated with a negative outcome in CAD. Therefore, underlying factors for drop-out should gain more attention in future research and should be taken into account when organizing CR

Hyperdynamic Myocardial Response to Beta-Adrenergic Stimulation in Patients With Chest Pain and Normal Coronary Arteries

ObjectivesThe goal of this study was to test the hypothesis that an abnormal response to beta-adrenergic stimulation may play a role in the pathophysiology of chest pain in patients with normal coronary arteries.BackgroundThe mechanism of angina-like (AL) chest pain in patients with angiographically normal coronary arteries remains controversial.MethodsFifty-eight patients with AL pain and a normal coronary angiogram underwent dobutamine echocardiography (DE) to evaluate regional wall motion and intraventricular flow velocities (IFV). Control patients consisted of 22 matched patients free of angina and coronary artery disease. Abnormal IFV were defined as dagger-shaped Doppler spectrum ≥3 m/s.ResultsDobutamine-induced regional wall motion abnormalities did not develop in any of the patients. An IFV ≥ 3 m/s was found in 28 patients (48%) with AL pain but in only 4 (18%) control patients (p < 0.05). In the subgroup of patients with AL pain and IFV ≥3 m/s, plasma renin concentration (PRC) was higher as compared with those with IFV <3 m/s (18 ± 17 pg/ml vs. 9 ± 6 pg/ml, p < 0.05). There were no differences in plasma ADR, NADR, or angiotensin-converting enzyme levels. Fourteen patients with angina and IFV ≥3 underwent control DE and blood sampling after 6 weeks treatment with 10 mg of bisoprolol. In these patients, a decrease in IFV (from 3.4 ± 0.35 m/s to 2.46 ± 0.64 m/s, p < 0.001) and a decrease in angina score (from 5.4 ± 1.5 to 0.6 ± 1.4, p < 0.001) were observed at follow-up.ConclusionsThe present data suggest that an exaggerated myocardial response to beta-adrenergic stimulation plays a role in the mechanisms of chest pain in some patients with normal coronary arteries

Left ventricular scar and the acute hemodynamic effects of multivein and multipolar pacing in cardiac resynchronization

Background We sought to determine whether presence, amount and distribution of scar impacts the degree of acute hemodynamic response (AHR) with multisite pacing. Multi-vein pacing (MVP) or multipolar pacing (MPP) with a multi-electrode left ventricular (LV) lead may offer benefits over conventional biventricular pacing in patients with myocardial scar. Methods In this multi-center study left bundle branch block patients underwent an hemodynamic pacing study measuring LV dP/dtmax. Patients had cardiac magnetic resonance scar imaging to assess the effect of scar presence, amount and distribution on AHR. Results 24 patients (QRS 171 ± 20 ms) completed the study (83% male). An ischemic etiology was present in 58% and the mean scar volume was 6.0 ± 7.0%. Overall discounting scar, MPP and MVP showed no significant AHR increase compared to an optimized “best BiV” (BestBiV) site. In a minority of patients (6/24) receiver-operator characteristic analysis of scar volume (cut off 8.48%) predicted a small AHR improvement with MPP (sensitivity 83%, specificity 94%) but not MVP. Patients with scar volume > 8.48% had a MPP-BestBiV of 3 ± 6.3% vs. −6.4 ± 7.7% for those below the cutoff. There was a significant correlation between the difference in AHR and scar volume for MPP-BestBiV (R = 0.49, p = 0.02) but not MVP-BestBiV(R = 0.111, p = 0.62). The multielectrode lead positioned in scar predicted MPP AHR improvement (p = 0.04). Conclusions Multisite pacing with MPP and MVP shows no AHR benefit in all-comers compared to optimized BestBiV pacing. There was a minority of patients with significant scar volume in relation to the LV site that exhibited a small AHR improvement with MPP

Применение активной молниезащиты, как способ повышения уровня безопасности промышленной площадки

В данной работе автором проводится разработка инженерно-технических мероприятий направленных на повышение уровня безопасности промышленной площадки эксплуатирующей природный газ действующего производства города Томск.In the paper author presents the development of measures aimed at the improving safety level of the Tomsk ongoing production gas operating industrial site