The nature of independent and interdependent self-construals: A focus on psychological relatedness.

Through the socialization of modes of thinking and behaving, ethnocultural background and gender can shape different orientations in one\u27s sense of self. These self-construals are conceptualized as independence (i.e., priority to the individual, stresses autonomy) and interdependence (i.e., priority to an in-group, stresses conformity; Markus & Kitayama, 1991; Singelis, 1994). Within these self-construals, connectedness with others is also possible. The psychology of relatedness was examined in the present study, operationalized as romanticism (orientation toward the welfare of one\u27s romantic relationship), and familism (orientation toward the welfare of one\u27s immediate and extended family). The study examined the relationships among these factors in a sample of 324 male and female undergraduate psychology students of diverse ethnocultural backgrounds. Participants completed measures of independent and interdependent self-construal (Singelis, 1994), familism (Gaines, Marelich et al., 1997), romantic beliefs (Sprecher & Metts, 1989), and an open-ended measure of self (Kuhn & McPartland, 1954). It was predicted that European Canadian males would have significantly higher independent selves than non-European Canadian males and females and European Canadian females, and that non-European Canadian females will score significantly higher on interdependent self-construal than non-European Canadian males and European Canadian males and females. It was also predicted that independent self-construal would be significantly and positively related to romanticism, and that interdependent self-construal would be significantly and positively related to familism. Results showed that none of the measures reliably differentiated between respondents of European versus non-European ethnocultural background. However, women did respond with more allocentric and small group responses than did men and men did respond with more idiocentric responses than did women when describing their self. Both familism and romanticism were significantly and positively related to an interdependent self-construal. These results call into question ethnocultural differences in self that are so often reported in the literature, and also call for future investigation of gender differences in relationality.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2001 .G73. Source: Dissertation Abstracts International, Volume: 63-04, Section: B, page: 2107. Adviser: Ken Cramer. Thesis (Ph.D.)--University of Windsor (Canada), 2001

Maintenance of Gains, Morbidity, and Mortality at 1 Year Following Cardiac Rehabilitation in a Middle‐Income Country: A Wait‐List Control Crossover Trial

Background-—Despite the epidemic of cardiovascular diseases in middle-income countries, few trials are testing the benefits of cardiac rehabilitation (CR). This trial assessed (1) maintenance of functional capacity, risk factor control, knowledge, and hearthealth behaviors and (2) mortality and morbidity at 6 months following CR in a middle-income country. Methods and Results-—Eligible Brazilian coronary patients were initially randomized (1:1:1 concealed) to 1 of 3 parallel arms (comprehensive CR [exercise plus education], exercise-only CR, or wait-list control). The CR programs were 6 months in duration, at which point follow-up assessments were performed. Mortality and morbidity were ascertained from chart and patient or family report (blinded). Controls were then offered CR (crossover). Outcomes were again assessed 6 months later (blinded). ANCOVA was performed for each outcome at 12 months. Overall, 115 (88.5%) patients were randomized, and 62 (53.9%) were retained at 1 year. At 6 months, 23 (58.9%) of those 39 initially randomized to the wait-list control elected to attend CR. Functional capacity, risk factors, knowledge, and heart-health behaviors were maintained from 6 to 12 months in participants from both CR arms (all P>0.05). At 1 year, knowledge was significantly greater with comprehensive CR at either time point (P<0.001). There were 2 deaths. Hospitalizations (P=0.03), nonfatal myocardial infarctions (P=0.04), and percutaneous coronary interventions (P=0.03) were significantly fewer with CR than control at 6 months. Conclusions-—CR participation is associated with lower morbidity, long-term maintenance of functional capacity, risk factors, and heart-health behaviors, as well as with greater cardiovascular knowledge compared with no CR. Clinical Trial Registration-—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02575976. (J Am Heart Assoc. 2019;8: e011228. DOI: 10.1161/JAHA.118.011228.) Key Words: cardiac rehabilitation • coronary disease • morbidity/mortality • rehabilitation • risk factorYork University Librarie

Depression

Health Issue: Depression causes significant distress or impairment in physical, social, occupational and other key areas of functioning. Women are approximately twice as likely as men to experience depression. Psychosocial factors likely mediate the risks for depression incurred by biological influences. Key Findings: Data from the 1999 National Population Health Survey show that depression is more common among Canadian women, with an annual self-reported incidence of 5.7 % compared with 2.9 % in men. The highest rates of depression are seen among women of reproductive age. Predictive factors for depression include previous depression, feeling out of control or overwhelmed, chronic health problems, traumatic events in childhood or young adulthood, lack of emotional support, lone parenthood, and low sense of mastery. Although depression is treatable, only 43 % of depressed women had consulted a health professional in 1998/99 and only 32.4 % wer

A Review of Cardiac Rehabilitation Delivery Around the World.

Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases. Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.non

Cardiovascular Disease

<p>Abstract</p> <p>Health Issue</p> <p>Cardiovascular disease (CVD) is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men.</p> <p>Key Findings</p> <p>In 1998, 78,964 Canadians died from CVD, almost half (39,197) were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women.</p> <p>Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women.</p> <p>Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension.</p> <p>Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men.</p> <p>Data Gaps and Recommendations</p> <p>CVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure). Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status.</p

The Relation Between Prescription Drug Usage and Cognitive Performance in Later Life

Older adults, the primary consumers of prescription medications in the United States, may be particularly prone to medication side effects. The present study examined the relation between change in prescriptions and change in cognitive performance (i.e., inductive reasoning and everyday problem solving), as well as how three common classes of medication (i.e., cardiovascular, hormone/synthetic substitutes, and central nervous system agents) were related to cognitive performance. Data were collected from 78 community-dwelling older adults (M = 71.14 years, SD = 5.35) over an 18-month period. Results indicated that types of drugs were differentially related to cognitive change and that the total number of prescriptions was related to change in cognitive performance. Clinical and research advantages of using specific cognitive and prescription assessments, rather than more global measures, are discussed

Ethnocultural Minorities in Cardiac Rehab

Background: Patients of diverse ethnocultural backgrounds are underrepresented among participants and, hence, little is known about their outcomes. The objectives of this study were to compare cardiac rehabilitation (CR) utilization, cardiovascular risk factor reduction (blood pressure, lipids, anthropometrics), and functional capacity between white and ethnocultural minority patients participating in CR across Canada. Methods: The study was a retrospective, observational cohort study using the Canadian Cardiac Rehab Registry (CCRR). Participants from an ethnocultural minority (n >= 25) were propensity-matched to white participants based on sociodemographic and clinical characteristics. CR outcomes were compared. Results: In the CCRR, 3848 (53.8%) participants had an ethnocultural background reported. Of those, whites (n = 3630) and South Asians (n = 26), Southeast Asians (n = 45), and Arab/West Asians (n = 37) minorities had sufficient representation in the registry to be analyzed. In the matched sample, 364 (97.1%) participants completed a discharge assessment. Southeast Asian participants adhered to (96.5%, P = .02) and completed (88.2%, P = .02) CR more often than white participants (90.2% and 55.6%, respectively). Southeast Asian participants had significantly lower diastolic blood pressure (P = .002) at CR discharge than matched white participants. No other differences in outcomes or functional capacity were observed. Conclusions: Ethnocultural minorities make up a small proportion of CR participants in Canada. However, when they do participate, they achieve similar CR outcomes compared with white participants. CR programs should seek to ensure ethnoculturally diverse patients are referred to their programs and ensure their programs are culturally sensitive to the needs of the preponderant ethnocultural groups in their catchment areas

Cardiac Rehabilitation: Under-utilized globally

Purpose of review: Cardiac rehabilitation (CR) is grossly under-utilized. This review summarizes current knowledge about degree of CR utilization, reasons for under-utilization, and strategies to increase use. Recent findings: ICCPR's global CR audit quantified for the first time the number of additional CR spots needed per year to treat indicated patients, so there are programs they may use. The first randomized trial of automatic/systematic CR referral has shown it results in significantly greater patient completion. Moreover, the recent update of the Cochrane review on interventions to increase use has provided unequivocal evidence on the significant impact of clinician CR encouragement at the bedside; a course is now available to train clinicians. The USA is leading the way in implementing automatic referral with inpatient-clinician CR discussions. Suggestions to triage patients based on risk to less resource-intensive, unsupervised program models could simultaneously expand capacity and support patient adherence.Dr. Whooley reports grants from United States Department of Veterans Affairs and the United States National Institutes of Health