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Rajagopalan A, Krishna A, Mukkadan JK. Effect of Om chanting and Yoga Nidra on depression anxiety stress, sleep quality and autonomic functions of hypertensive subjects - a randomized controlled trial. J Basic Clin Physiol Pharmacol 2023; 34:69-75. [PMID: 35689170 DOI: 10.1515/jbcpp-2022-0122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/09/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Hypertension (HTN) is a common and growing public health challenge with severe risk factors. Hence, this study aimed to assess the effect of Om chanting and Yoga Nidra on depression, anxiety, stress, sleep quality and autonomic functions on individuals with hypertension. METHODS This prospective randomized controlled study was conducted in patients with hypertension at Little Flower Medical Research Center. A total of 80 patients with diagnosed hypertension were recruited and randomized equally to either the experimental group or control group. The experimental group received a combination of Om chanting and Yoga Nidra for five days a week for two months. The control group participants continued with their regular conventional medications. Depression anxiety stress scale (DASS), Pittsburgh sleep quality index (PSQI) and heart rate variability (HRV) scores were assessed at baseline, 30 and 60 day for both the groups. RESULTS A total of 34 subjects in the experimental group and 31 subjects in the control group were included in the analysis. There was a significant (p<0.001) reduction in depression, anxiety, stress, and a significant (p<0.001) improvement in PSQI and HRV parameters in the experimental group was observed as compared to the control group. No adverse events were reported during the trial period. CONCLUSIONS The current study validates the effectiveness of Om chanting and Yoga Nidra in reducing depression, anxiety, stress and improving sleep quality and autonomic functions in hypertensive patients. These interventions could thus be considered a safer form of complementary therapy in managing stress and hypertension.
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Affiliation(s)
- Archana Rajagopalan
- Department of Physiology, Saveetha Medical College, Saveetha Institute of Technical And Medical Sciences (SIMATS), Tamil Nadu, India
| | - Anjana Krishna
- Department of Physiology, Little Flower Medical Research Center, Kerala, India
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Kim JS, Han BS, Kwon YH, Lim J. A 5-Year Analysis of Aviation Medical Examinations in South Korea. Aerosp Med Hum Perform 2022; 93:499-506. [DOI: 10.3357/amhp.5973.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: Little has been studied to promote aviation health in South Korea. The aim of this study was to analyze the results of aviation medical examinations conducted in South Korea over the past 5 yr and, in doing so, provide evidence for establishing a health promotion,
disease prevention plan.METHODS: Subjects of the study consisted of applicants who underwent aviation medical examinations from January 1, 2016, to December 31, 2020.RESULTS: Over the past 5 yr, the total number of aviation medical examinations in South Korea has shown
an annual increase of more than 10%. In the presence of the COVID-19 pandemic in 2020, the number of aviation medical examinations, both renewal and initial, for all types of licenses, except renewal aviation medical examinations for the ATCL, decreased. Disqualification rates were generally
higher in initial examinations than in renewal examinations. The examination results for license renewal showed the ATPL disqualification rate to be the highest at 3.5 per 1000 pilots per year in their 50s, with cardiology cases being the most common reason for disqualification, followed by
ophthalmology cases and psychiatry cases. Diagnostic categories for those disqualified after initial aviation medical examinations were similar, though ophthalmological causes were most common, followed by cases of psychiatry and neurology.CONCLUSION: Main causes of disqualification
in airmen and air traffic controllers were identified as the presence of cardiovascular, ophthalmic, and psychiatric diseases. The results of this study provide evidence for improving health promotion activity plans to manage risk factors of such diseases for aviation workers.Kim JS,
Han BS, Kwon YH, Lim J. A 5-yr analysis of aviation medical examinations in South Korea. Aerosp Med Hum Perform. 2022; 93(6):499–506.
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Levine GN, Cohen BE, Commodore-Mensah Y, Fleury J, Huffman JC, Khalid U, Labarthe DR, Lavretsky H, Michos ED, Spatz ES, Kubzansky LD. Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association. Circulation 2021; 143:e763-e783. [PMID: 33486973 DOI: 10.1161/cir.0000000000000947] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
As clinicians delivering health care, we are very good at treating disease but often not as good at treating the person. The focus of our attention has been on the specific physical condition rather than the patient as a whole. Less attention has been given to psychological health and how that can contribute to physical health and disease. However, there is now an increasing appreciation of how psychological health can contribute not only in a negative way to cardiovascular disease (CVD) but also in a positive way to better cardiovascular health and reduced cardiovascular risk. This American Heart Association scientific statement was commissioned to evaluate, synthesize, and summarize for the health care community knowledge to date on the relationship between psychological health and cardiovascular health and disease and to suggest simple steps to screen for, and ultimately improve, the psychological health of patients with and at risk for CVD. Based on current study data, the following statements can be made: There are good data showing clear associations between psychological health and CVD and risk; there is increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause CVD; the preponderance of data suggest that interventions to improve psychological health can have a beneficial impact on cardiovascular health; simple screening measures can be used by health care providers for patients with or at risk for CVD to assess psychological health status; and consideration of psychological health is advisable in the evaluation and management of patients with or at risk for CVD.
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Stevelink SAM, Opie E, Pernet D, Gao H, Elliott P, Wessely S, Fear NT, Hotopf M, Greenberg N. Probable PTSD, depression and anxiety in 40,299 UK police officers and staff: Prevalence, risk factors and associations with blood pressure. PLoS One 2020; 15:e0240902. [PMID: 33180769 PMCID: PMC7660485 DOI: 10.1371/journal.pone.0240902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 10/06/2020] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Police employees undertake challenging duties which may adversely impact their health. This study explored the prevalence of and risk factors for probable mental disorders amongst a representative sample of UK police employees. The association between mental illness and alterations in blood pressure was also explored. METHODS Data were used from the Airwave Health Monitoring Study which was established to monitor the possible physical health impacts of a new communication system on police employees. Data included sociodemographic characteristics, lifestyle habits, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms and blood pressure. Descriptive statistics were used to explore the prevalence of probable mental disorders and associated factors. Stepwise linear regression was conducted, controlling for confounding variables, to examine associations between mental disorders and blood pressure. RESULTS The sample included 40,299 police staff, police constable/sergeants and inspectors or above. Probable depression was most frequently reported (9.8%), followed by anxiety (8.5%) and PTSD (3.9%). Groups at risk for probable mental disorders included police staff, and police employees who reported drinking heavily. Police employees exposed to traumatic incidents in the past six months had a doubling in rates of anxiety or depression and a six-fold increase in PTSD compared to those with no recent trauma exposure. Adjusted logistic regression models did not reveal any significant association between probable mental disorders and systolic blood pressure but significantly elevated diastolic blood pressure (≈1mmHg) was found across mental disorders. CONCLUSIONS These results show lower rates of probable mental disorders, especially PTSD, than reported in other studies focusing on police employees. Although mental ill health was associated with increased diastolic blood pressure, this was unlikely to be clinically significant. These findings highlight the importance of continued health monitoring of members of the UK police forces, focusing on employees recently exposed to traumatic incidents, heavy drinkers and police staff.
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Affiliation(s)
- Sharon A. M. Stevelink
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
- Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Elena Opie
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - David Pernet
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - He Gao
- MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Paul Elliott
- MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
- NIHR Imperial College Biomedical Research Centre, Imperial College London, London, United Kingdom
- UK Dementia Research Institute at Imperial College London, Hammersmith Hospital Campus, London, United Kingdom
- Health Data Research UK London at Imperial College London, Faculty of Medicine, St Mary’s Campus, London, United Kingdom
| | - Simon Wessely
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Nicola T. Fear
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
- Academic Department of Military Mental Health, King’s College London, London, United Kingdom
| | - Matthew Hotopf
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Neil Greenberg
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
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Dong H, Zhang Q, Zhu C, Lv Q. Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: a cross-sectional study. Health Qual Life Outcomes 2020; 18:116. [PMID: 32349759 PMCID: PMC7191763 DOI: 10.1186/s12955-020-01374-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/23/2020] [Indexed: 12/20/2022] Open
Abstract
Background Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses’ sleep quality in public hospitals in Shandong, China and explored its influencing factors. Methods A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis. Results The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4–6 vs. never, ≥7 vs. never) and high occupational stress. Conclusions The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses’ sleep quality.
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Affiliation(s)
- Hongyun Dong
- Shouguang People's Hospital. Shouguang People's Hospital, NO. 3173 Jiankang Street, Shouguang, Weifang, 262700, Shandong Province, China. .,School of Nursing, Weifang University of Science and Technology, NO. 1299 Jinguang Street, Shouguang, Weifang, 262700, Shandong Province, China.
| | - Qiong Zhang
- Shouguang People's Hospital. Shouguang People's Hospital, NO. 3173 Jiankang Street, Shouguang, Weifang, 262700, Shandong Province, China
| | - Chunji Zhu
- Shouguang People's Hospital. Shouguang People's Hospital, NO. 3173 Jiankang Street, Shouguang, Weifang, 262700, Shandong Province, China
| | - Qian Lv
- Shouguang People's Hospital. Shouguang People's Hospital, NO. 3173 Jiankang Street, Shouguang, Weifang, 262700, Shandong Province, China
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Jackson KL, Head GA, Gueguen C, Stevenson ER, Lim K, Marques FZ. Mechanisms Responsible for Genetic Hypertension in Schlager BPH/2 Mice. Front Physiol 2019; 10:1311. [PMID: 31681017 PMCID: PMC6813185 DOI: 10.3389/fphys.2019.01311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/30/2019] [Indexed: 01/18/2023] Open
Abstract
It has been 45 years since Gunther Schlager used a cross breeding program in mice to develop inbred strains with high, normal, and low blood pressure (BPH/2, BPN/3, and BPL/1 respectively). Thus, it is timely to gather together the studies that have characterized and explored the mechanisms associated with the hypertension to take stock of exactly what is known and what remains to be determined. Growing evidence supports the notion that the mechanism of hypertension in BPH/2 mice is predominantly neurogenic with some of the early studies showing aberrant brain noradrenaline levels in BPH/2 compared with BPN/3. Analysis of the adrenal gland using microarray suggested an association with the activity of the sympathetic nervous system. Indeed, in support of this, there is a larger depressor response to ganglion blockade, which reduced blood pressure in BPH/2 mice to the same level as BPN/3 mice. Greater renal tyrosine hydroxylase staining and greater renal noradrenaline levels in BPH/2 mice suggest sympathetic hyperinnervation of the kidney. Renal denervation markedly reduced the blood pressure in BPH/2 but not BPN/3 mice, confirming the importance of renal sympathetic nervous activity contributing to the hypertension. Further, there is an important contribution to the hypertension from miR-181a and renal renin in this strain. BPH/2 mice also display greater neuronal activity of amygdalo-hypothalamic cardiovascular regulatory regions. Lesions of the medial nucleus of the amygdala reduced the hypertension in BPH/2 mice and abolished the strain difference in the effect of ganglion blockade, suggesting a sympathetic mechanism. Further studies suggest that aberrant GABAergic inhibition may play a role since BPH/2 mice have low GABAA receptor δ, α4 and β2 subunit mRNA expression in the hypothalamus, which are predominantly involved in promoting tonic neuronal inhibition. Allopregnanolone, an allosteric modulator of GABAA receptors, which increase the expression of these subunits in the amygdala and hypothalamus, is shown to reduce the hypertension and sympathetic nervous system contribution in BPH/2 mice. Thus far, evidence suggests that BPH/2 mice have aberrant GABAergic inhibition, which drives neuronal overactivity within amygdalo-hypothalamic brain regions. This overactivity is responsible for the greater sympathetic contribution to the hypertension in BPH/2 mice, thus making this an ideal model of neurogenic hypertension.
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Affiliation(s)
- Kristy L Jackson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Cindy Gueguen
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Emily R Stevenson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Kyungjoon Lim
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Francine Z Marques
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Hypertension Research Laboratory, School of Biological Sciences, Monash University, Clayton, VIC, Australia
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Rodríguez MB, León-Regal M, Morejón-Giraldoni A. [Risk of high blood pressure in hyperreactive cardiovascular individuals.]. SALUD PUBLICA DE MEXICO 2018; 60:414-422. [PMID: 30137943 DOI: 10.21149/8965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 01/26/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To determine the risk of high blood pressure in cardiovascular hyperreactive individuals identified by the isometric hand-held weight test. MATERIALS AND METHODS A prospective cohort study was conducted for 5 years, including a total of 419 individuals. Of them, 215 were normoreactive and 204 hyperreactive. The relative risk of hypertension in the hyperreactive individuals and the contribution of cardiovascular hyperreactivity to the development of high blood pressure were determined. The significance level was 0.05. RESULTS The frequency of new hypertension cases after five years was twice as high in the cohort of hyperreactive subjects compared to the cohort of normoreactive subjects (RR 2.23, 95%CI 1.42, 3.51). The cardiovascular hyperreactivity was the most important variable for predicting of the high blood pressure (OR: 2.73; 95%CI 1.59, 4.54). CONCLUSIONS Conclusions. Cardiovascular hyperreactive individuals have a higher risk of high blood pressure than normorreactive individuals.
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Dong H, Zhang Q, Sun Z, Sang F, Xu Y. Sleep problems among Chinese clinical nurses working in general hospitals. Occup Med (Lond) 2017; 67:534-539. [DOI: 10.1093/occmed/kqx124] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Dong H, Zhang Q, Sun Z, Sang F, Xu Y. Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. BMC Psychiatry 2017; 17:241. [PMID: 28673267 PMCID: PMC5496307 DOI: 10.1186/s12888-017-1402-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/27/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study aimed to determine the prevalence of sleep disturbances among clinical nurses in general hospitals in Mainland China, and identify its associate factors. METHODS Using a cross-sectional design, a total of 5012 clinical nurses selected by random cluster sampling completed the survey on the Pittsburgh Sleep Quality Index (PSQI), measures of quality of life indexed by the Medical Outcomes Study 12-item Short-Form Health Survey, occupational stress evaluated by the Job Content Questionnaire, lifestyle and sociodemographic details. RESULTS The average PSQI score of 4951 subjects was 7.32 ± 3.24, including 3163 subjects with PSQI ≥5, accounting for 63.9%. Multivariate Logistic regression analysis showed that the risk factors for sleep disturbances in nurses were female gender, the Emergency department and ICU, many years of service, high night shift frequency, professional status: primary and intermediate, employment status: temporary, poor quality of life: poor mental health, low perceived health, high occupational stress (high psychological demand, low job control and low workplace social support). CONCLUSIONS Sleep disturbances are highly prevalent among clinical nurses in general hospitals in Mainland China. Many of the factors listed above were associated with the prevalence of sleep disturbances in nurses, and occupational stress plays an important role in the development of sleep disturbances in Chinese clinical nurses.
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Affiliation(s)
- Hongyun Dong
- Shouguang People's Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province, China.
| | - Qiong Zhang
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
| | - Zihua Sun
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
| | - Fengxin Sang
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
| | - Yingzhi Xu
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
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Krause N, Ironson G, Pargament K, Hill P. Neighborhood conditions, religious coping, and uncontrolled hypertension. SOCIAL SCIENCE RESEARCH 2017; 62:161-174. [PMID: 28126096 DOI: 10.1016/j.ssresearch.2016.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/14/2016] [Accepted: 08/23/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this study is to see whether God-mediated control beliefs moderate the relationship between living in rundown neighborhoods and uncontrolled hypertension. God-mediated control refers to the belief that God will help people handle the stressors that arise in life. Data are provided by a nationwide survey of adults (N = 1919). Three ways of assessing uncontrolled hypertension are examined: a binary format contrasting people with and without uncontrolled hypertension, systolic and diastolic blood pressure scored continuously, and a four ordinal category scheme recommended by the American Heart Association. The data suggest that stronger God-mediated control beliefs moderate the relationship between neighborhood conditions and uncontrolled blood pressure when blood pressure is scored continuously and when the American Heart Association scheme are used as outcomes.
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Hu MX, Lamers F, Hiles SA, Penninx BWJH, de Geus EJC. Basal autonomic activity, stress reactivity, and increases in metabolic syndrome components over time. Psychoneuroendocrinology 2016; 71:119-26. [PMID: 27262344 DOI: 10.1016/j.psyneuen.2016.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/29/2016] [Accepted: 05/18/2016] [Indexed: 12/31/2022]
Abstract
CONTEXT Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to stress remains unclear. OBJECTIVE To examine cross-sectionally and longitudinally to what extent ANS basal level and stress reactivity are related to MetS. DESIGN 2-year and 6-year data from a prospective cohort: the Netherlands Study of Depression and Anxiety. SETTING Participants were recruited from the general community, primary care, and mental health care organizations. PARTICIPANTS 1922 respondents (mean age=43.7years). MAIN OUTCOME MEASURES Indicators of ANS functioning were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). ANS stress reactivity was measured during a cognitively challenging stressor and a personal-emotional stressor. MetS components included triglycerides, high-density lipoprotein cholesterol, blood pressure, glucose and waist circumference. RESULTS Cross-sectional analyses indicated that higher basal HR, lower basal values of RSA and PEP, and higher RSA reactivity during cognitive challenge were related to less favorable values of almost all individual MetS components. Longitudinal analyses showed that higher basal HR and shorter basal PEP predicted 4-year increase in many MetS abnormalities. Higher RSA stress reactivity during cognitive challenge predicted 4-year increase in number of MetS components. CONCLUSION Higher basal sympathetic, lower basal parasympathetic activity, and increased parasympathetic withdrawal during stress are associated with multiple MetS components, and higher basal sympathetic activity predicts an increase in metabolic abnormalities over time. These findings support a role for ANS dysregulation in the risk for MetS and, consequently, the development of cardiovascular disease.
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Affiliation(s)
- Mandy X Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Sarah A Hiles
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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Kuo WY, Huang CC, Weng SF, Lin HJ, Su SB, Wang JJ, Guo HR, Hsu CC. Higher migraine risk in healthcare professionals than in general population: a nationwide population-based cohort study in Taiwan. J Headache Pain 2015; 16:102. [PMID: 26631235 PMCID: PMC4668247 DOI: 10.1186/s10194-015-0585-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/27/2015] [Indexed: 11/21/2022] Open
Abstract
Background High stress levels and shift work probably trigger migraine in healthcare professionals (HCPs). However, the migraine risk differences between HCPs and the general population is unknown. Methods This nationwide population-based cohort study used Taiwan’s National Health Insurance Research Database. Physicians (50,226), nurses (122,357), and other HCPs (pharmacists, technicians, dietitians, rehabilitation therapists, social workers, etc.) (45,736) were enrolled for the study cohort, and randomly selected non-HCPs (218,319) were enrolled for the comparison cohort. Conditional logistical regression analysis was used to compare the migraine risks. Comparisons between HCPs and between physician specialties were also done. Results Physicians, nurses, and other HCPs had higher migraine risks than did the general population (adjusted odds ratio [AOR]: 1.672; 95 % confidence interval [CI]: 1.468–1.905, AOR: 1.621; 95 % CI: 1.532–1.714, and AOR: 1.254; 95 % CI: 1.124–1.399, respectively) after stroke, hypertension, epilepsy, anxiety, depression, and insomnia had been adjusted for. Nurses and physicians had higher migraine risks than did other HCPs (AOR: 1.303; 95 % CI: 1.206–1.408, and AOR: 1.193; 95 % CI: 1.069–1.332, respectively). Obstetricians and gynecologists had a lower migraine risk than did other physician specialists (AOR: 0.550; 95 % CI: 0.323–0.937). Conclusion HCPs in Taiwan had a higher migraine risk than did the general population. Heavy workloads, emotional stress, and rotating night shift sleep disturbances appear to be the most important risk factors. These findings should provide an important reference for promoting occupational health in HCPs in Taiwan.
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Affiliation(s)
- Wan-Yin Kuo
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.,Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.,Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Medical Research, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Jhi-Joung Wang
- Departments of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan. .,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
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Salman IM, Sarma Kandukuri D, Harrison JL, Hildreth CM, Phillips JK. Direct conscious telemetry recordings demonstrate increased renal sympathetic nerve activity in rats with chronic kidney disease. Front Physiol 2015; 6:218. [PMID: 26300784 PMCID: PMC4523722 DOI: 10.3389/fphys.2015.00218] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/20/2015] [Indexed: 01/05/2023] Open
Abstract
Chronic kidney disease (CKD) is associated with sympathetic hyperactivity and impaired blood pressure control reflex responses, yet direct evidence demonstrating these features of autonomic dysfunction in conscious animals is still lacking. Here we measured renal sympathetic nerve activity (RSNA) and mean arterial pressure (MAP) using telemetry-based recordings in a rat model of CKD, the Lewis Polycystic Kidney (LPK) rat, and assessed responses to chemoreflex activation and acute stress. Male LPK and Lewis control animals (total n = 16) were instrumented for telemetric recording of RSNA and MAP. At 12–13 weeks-of-age, resting RSNA and MAP, sympathetic and haemodynamic responses to both peripheral (hypoxia: 10% O2) and central chemoreflex (hypercapnia: 7% CO2) activation and acute stress (open-field exposure), were measured. As indicators of renal function, urinary protein (UPro) and creatinine (UCr) levels were assessed. LPK rats had higher resting RSNA (1.2 ± 0.1 vs. 0.6 ± 0.1 μV, p < 0.05) and MAP (151 ± 8 vs. 97 ± 2 mmHg, p < 0.05) compared to Lewis. MAP was negatively correlated with UCr (r = −0.80, p = 0.002) and positively correlated with RSNA (r = 0.66, p = 0.014), with multiple linear regression modeling indicating the strongest correlation was with Ucr. RSNA and MAP responses to activation of the central chemoreflex and open-field stress were reduced in the LPK relative to the Lewis (all p < 0.05). This is the first description of dual conscious telemetry recording of RSNA and MAP in a genetic rodent model of CKD. Elevated RSNA is likely a key contributor to the marked hypertension in this model, while attenuated RSNA and MAP responses to central chemoreflex activation and acute stress in the LPK indicate possible deficits in the neural processing of autonomic outflows evoked by these sympathoexcitatory pathways.
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Affiliation(s)
- Ibrahim M Salman
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University Sydney, NSW, Australia
| | - Divya Sarma Kandukuri
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University Sydney, NSW, Australia
| | - Joanne L Harrison
- School of Veterinary and Life Sciences, Murdoch University Murdoch, WA, Australia
| | - Cara M Hildreth
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University Sydney, NSW, Australia
| | - Jacqueline K Phillips
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University Sydney, NSW, Australia
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Uchino BN. Understanding the Links Between Social Support and Physical Health: A Life-Span Perspective With Emphasis on the Separability of Perceived and Received Support. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 4:236-55. [PMID: 26158961 DOI: 10.1111/j.1745-6924.2009.01122.x] [Citation(s) in RCA: 581] [Impact Index Per Article: 64.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Social support has been reliably related to physical health outcomes. However, the conceptual basis of such links needs greater development. In this article, I argue for a life-span perspective on social support and health that takes into account distinct antecedent processes and mechanisms that are related to measures of support over time. Such a view highlights the need to distinguish measures of perceived and received support and its links to more specific diseases (e.g., chronic, acute) and stages of disease development (e.g., incidence). I discuss both the novel implications of these theoretical arguments for research on social support and physical health, as well as the potential intervention approaches that are apparent from this perspective.
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Individual and work-unit measures of psychological demands and decision latitude and the use of antihypertensive medication. Int Arch Occup Environ Health 2014; 88:311-9. [DOI: 10.1007/s00420-014-0958-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 06/26/2014] [Indexed: 11/25/2022]
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Choi B, Schnall PL, Dobson M, Garcia-Rivas J, Kim H, Zaldivar F, Israel L, Baker D. Very Long (> 48 hours) Shifts and Cardiovascular Strain in Firefighters: a Theoretical Framework. Ann Occup Environ Med 2014; 26:5. [PMID: 24602344 PMCID: PMC3995990 DOI: 10.1186/2052-4374-26-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 02/23/2014] [Indexed: 11/10/2022] Open
Abstract
Shift work and overtime have been implicated as important work-related risk factors for cardiovascular disease (CVD). Many firefighters who contractually work on a 24-hr work schedule, often do overtime (additional 24-hr shifts) which can result in working multiple, consecutive 24-hr shifts. Very little research has been conducted on firefighters at work that examines the impact of performing consecutive 24-hr shifts on cardiovascular physiology. Also, there have been no standard field methods for assessing in firefighters the cardiovascular changes that result from 24-hr shifts, what we call “cardiovascular strain”. The objective of this study, as the first step toward elucidating the role of very long (> 48 hrs) shifts in the development of CVD in firefighters, is to develop and describe a theoretical framework for studying cardiovascular strain in firefighters on very long shifts (i.e., > 2 consecutive 24-hr shifts). The developed theoretical framework was built on an extensive literature review, our recently completed studies with firefighters in Southern California, e-mail and discussions with several firefighters on their experiences of consecutive shifts, and our recently conducted feasibility study in a small group of firefighters of several ambulatory cardiovascular strain biomarkers (heart rate, heart rate variability, blood pressure, salivary cortisol, and salivary C-reactive protein). The theoretical framework developed in this study will facilitate future field studies on consecutive 24-hr shifts and cardiovascular health in firefighters. Also it will increase our understanding of the mechanisms by which shift work or long work hours can affect CVD, particularly through CVD biological risk factors, and thereby inform policy about sustainable work and rest schedules for firefighters.
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Affiliation(s)
- Bongkyoo Choi
- Center for Occupational and Environmental Health, University of California, Irvine, USA.
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Piazza JR, Charles ST, Sliwinski MJ, Mogle J, Almeida DM. Affective reactivity to daily stressors and long-term risk of reporting a chronic physical health condition. Ann Behav Med 2013. [PMID: 23080393 DOI: 10.1007/s12160-012-9423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Daily stressors, such as an argument with a spouse or an impending deadline, are associated with short-term changes in physical health symptoms. Whether these minor hassles have long-term physical health ramifications, however, is largely unknown. PURPOSE The current study examined whether exposure and reactivity to daily stressors is associated with long-term risk of reporting a chronic physical health condition. METHODS Participants (N = 435) from the National Study of Daily Experiences completed a series of daily diary interviews between 1995 and 1996 and again 10 years later. RESULTS Greater affective (i.e., emotional) reactivity to daily stressors at time 1 was associated with an increased risk of reporting a chronic physical health condition at time 2. CONCLUSION Results indicate that how people respond to the daily stressors in their lives is predictive of future chronic health conditions.
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Affiliation(s)
- Jennifer R Piazza
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, USA.
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Piazza JR, Charles ST, Sliwinski MJ, Mogle J, Almeida DM. Affective reactivity to daily stressors and long-term risk of reporting a chronic physical health condition. Ann Behav Med 2013; 45:110-20. [PMID: 23080393 PMCID: PMC3626280 DOI: 10.1007/s12160-012-9423-0] [Citation(s) in RCA: 191] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Daily stressors, such as an argument with a spouse or an impending deadline, are associated with short-term changes in physical health symptoms. Whether these minor hassles have long-term physical health ramifications, however, is largely unknown. PURPOSE The current study examined whether exposure and reactivity to daily stressors is associated with long-term risk of reporting a chronic physical health condition. METHODS Participants (N = 435) from the National Study of Daily Experiences completed a series of daily diary interviews between 1995 and 1996 and again 10 years later. RESULTS Greater affective (i.e., emotional) reactivity to daily stressors at time 1 was associated with an increased risk of reporting a chronic physical health condition at time 2. CONCLUSION Results indicate that how people respond to the daily stressors in their lives is predictive of future chronic health conditions.
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Affiliation(s)
- Jennifer R Piazza
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, USA.
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Biologic Measures as Epidemiological Indicators of Risk for the Development of Hypertension in an African American Adolescent Population. J Cardiovasc Nurs 2012; 27:476-84. [DOI: 10.1097/jcn.0b013e31822f7971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Armitage JA, Burke SL, Prior LJ, Barzel B, Eikelis N, Lim K, Head GA. Rapid onset of renal sympathetic nerve activation in rabbits fed a high-fat diet. Hypertension 2012; 60:163-71. [PMID: 22647890 DOI: 10.1161/hypertensionaha.111.190413] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hypertension and elevated sympathetic drive result from consumption of a high-calorie diet and deposition of abdominal fat, but the etiology and temporal characteristics are unknown. Rabbits instrumented for telemetric recording of arterial pressure and renal sympathetic nerve activity (RSNA) were fed a high-fat diet for 3 weeks then control diet for 1 week or control diet for 4 weeks. Baroreflexes and responses to air-jet stress and hypoxia were determined weekly. After 1 week of high-fat diet, caloric intake increased by 62%, accompanied by elevated body weight, blood glucose, plasma insulin, and leptin (8%, 14%, 134%, and 252%, respectively). Mean arterial pressure, heart rate, and RSNA also increased after 1 week (6%, 11%, and 57%, respectively). Whereas mean arterial pressure and body weight continued to rise over 3 weeks of high-fat diet, heart rate and RSNA did not change further. The RSNA baroreflex was attenuated from the first week of the diet. Excitatory responses to air-jet stress diminished over 3 weeks of high-fat diet, but responses to hypoxia were invariant. Resumption of a normal diet returned glucose, insulin, leptin, and heart rate to control levels, but body weight, mean arterial pressure, and RSNA remained elevated. In conclusion, elevated sympathetic drive and impaired baroreflex function, which occur within 1 week of consumption of a high-fat, high-calorie diet, appear integral to the rapid development of obesity-related hypertension. Increased plasma leptin and insulin may contribute to the initiation of hypertension but are not required for maintenance of mean arterial pressure, which likely lies in alterations in the response of neurons in the hypothalamus.
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Affiliation(s)
- James A Armitage
- Departments of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
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Burke SL, Lambert E, Head GA. New Approaches to Quantifying Sympathetic Nerve Activity. Curr Hypertens Rep 2011; 13:249-57. [DOI: 10.1007/s11906-011-0196-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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22
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Davern PJ, Head GA. Role of the medial amygdala in mediating responses to aversive stimuli leading to hypertension. Clin Exp Pharmacol Physiol 2011; 38:136-43. [DOI: 10.1111/j.1440-1681.2010.05413.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Quartana PJ, Burns JW. Emotion suppression affects cardiovascular responses to initial and subsequent laboratory stressors. Br J Health Psychol 2010; 15:511-28. [DOI: 10.1348/135910709x474613] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Davern P, Jackson K, Nguyen-Huu T, La Greca L, Head G. Cardiovascular reactivity and neuronal activation to stress in Schlager genetically hypertensive mice. Neuroscience 2010; 170:551-8. [DOI: 10.1016/j.neuroscience.2010.07.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 07/16/2010] [Accepted: 07/18/2010] [Indexed: 11/17/2022]
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Abstract
Genetic and behavioral factors do not fully explain the development of hypertension, and there is increasing evidence suggesting that psychosocial factors may also play an important role. Exposure to chronic stress has been hypothesized as a risk factor for hypertension, and occupational stress, stressful aspects of the social environment, and low socioeconomic status have each been studied extensively. The study of discrimination is a more recent and rapidly growing area of investigation and may also help to explain the well-known racial disparities in hypertension. Research regarding mechanisms underlying stress effects on hypertension has largely focused on cardiovascular reactivity, but delayed recovery to the pre-stress level is increasingly being evaluated as another possible pathway. Recent findings in each of these areas are reviewed, and directions for future research are discussed.
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Affiliation(s)
- Tanya M Spruill
- Center for Behavioral Cardiovascular Health, Division of General Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA.
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Hilmert C, Kvasnicka L. Blood Pressure and Emotional Responses to Stress: Perspectives on Cardiovascular Reactivity. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2010. [DOI: 10.1111/j.1751-9004.2010.00275.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hilmert CJ, Ode S, Zielke DJ, Robinson MD. Blood pressure reactivity predicts somatic reactivity to stress in daily life. J Behav Med 2010; 33:282-92. [DOI: 10.1007/s10865-010-9256-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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Langan-Fox J, Sankey MJ, Canty JM. Human factors measurement for future air traffic control systems. HUMAN FACTORS 2009; 51:595-637. [PMID: 20196289 DOI: 10.1177/0018720809355278] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This article provides a critical review of research pertaining to the measurement of human factors (HF) issues in current and future air traffic control (ATC). BACKGROUND Growing worldwide air traffic demands call for a radical departure from current ATC systems. Future systems will have a fundamental impact on the roles and responsibilities of ATC officers (ATCOs). Valid and reliable methods of assessing HF issues associated with these changes, such as a potential increase (or decrease) in workload, are of utmost importance for advancing theory and for designing systems, procedures, and training. METHOD We outline major aviation changes and how these relate to five key HF issues in ATC. Measures are outlined, compared, and evaluated and are followed by guidelines for assessing these issues in the ATC domain. Recommendations for future research are presented. RESULTS A review of the literature suggests that situational awareness and workload have been widely researched and assessed using a variety of measures, but researchers have neglected the areas of trust, stress, and boredom. We make recommendations for use of particular measures and the construction of new measures. CONCLUSION It is predicted that, given the changing role of ATCOs and profound future airspace requirements and configurations, issues of stress, trust, and boredom will become more significant. Researchers should develop and/or refine existing measures of all five key HF issues to assess their impact on ATCO performance. Furthermore, these issues should be considered in a holistic manner. APPLICATION The current article provides an evaluation of research and measures used in HF research on ATC that will aid research and ATC measurement.
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Affiliation(s)
- Janice Langan-Fox
- Faculty of Business and Enterprise, Swinburne University of Technology, Melbourne, Victoria, Australia.
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Hayashi N, Someya N, Maruyama T, Hirooka Y, Endo MY, Fukuba Y. Vascular responses to fear-induced stress in humans. Physiol Behav 2009; 98:441-6. [DOI: 10.1016/j.physbeh.2009.07.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 06/25/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
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McCormick Covelli M. The Relationship of Low Birth Weight to Blood Pressure, Cortisol Levels, and Reactivity in African American Adolescents: A Pilot Study. ACTA ACUST UNITED AC 2009; 29:173-87. [PMID: 16923680 DOI: 10.1080/01460860600846941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Epidemiological studies show a relationship between low birth weight (LBW) and adult cardiovascular disease. Blood pressure and cortisol hyper-responsiveness during physiologic stress may function as biological markers for hypertension. The purpose of this study was to explore the relationship of blood pressure and cortisol levels with induced physiologic stress to LBW. Forty-eight adolescents, 14 to 16 years old, were tested for blood pressure and cortisol levels at rest and in response to a physiological stressor. A history of LBW was obtained. Multivariate repeated measures analysis and chi-square analyses were used to determine the changes in blood pressure and cortisol.Forty-eight African American adolescents, mean age 14.98 years (SD = 0.33), completed the study. Thirteen adolescents (27%) reported LBW. Although not statistically significant, systolic and diastolic pressures were 6 mmHg and 2 mmHg, respectively, higher in the LBW group when compared with the normal birth weight (NBW) group (p = 0.33 and p = 0.21, and 6 (46%) had elevated blood pressures (p = 0.005)). Blood pressure changes, cardiovascular reactivity, elevated blood, or all of these were significantly higher in LBW African American adolescents (p = 0.006). Cardiovascular reactivity was not significant (p = 0.208)). The mean average cortisol levels were (18.8 nmol/dL (SD = 11.0) but comparable (p = 0.72)). The number of LBW adolescents with cortisol reactivity was significantly higher that in the NBW group (p = 0.041). This study adds support to the association of LBW to biological markers of hypertension in childhood.
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Gianaros PJ, Sheu LK. A review of neuroimaging studies of stressor-evoked blood pressure reactivity: emerging evidence for a brain-body pathway to coronary heart disease risk. Neuroimage 2009; 47:922-36. [PMID: 19410652 DOI: 10.1016/j.neuroimage.2009.04.073] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 03/26/2009] [Accepted: 04/22/2009] [Indexed: 02/07/2023] Open
Abstract
An individual's tendency to show exaggerated or otherwise dysregulated cardiovascular reactions to acute stressors has long been associated with increased risk for clinical and preclinical endpoints of coronary heart disease (CHD). However, the 'brain-body' pathways that link stressor-evoked cardiovascular reactions to CHD risk remain uncertain. This review summarizes emerging neuroimaging research indicating that individual differences in stressor-evoked blood pressure reactivity (a particular form of cardiovascular reactivity) are associated with activation patterns in corticolimbic brain areas that are jointly involved in processing stressors and regulating the cardiovascular system. As supported empirically by activation likelihood estimates derived from a meta-analysis, these corticolimbic areas include divisions of the cingulate cortex, insula, and amygdala--as well as networked cortical and subcortical areas involved in mobilizing hemodynamic and metabolic support for stress-related behavioral responding. Contextually, the research reviewed here illustrates how behavioral medicine and health neuroscience methods can be integrated to help characterize the 'brain-body' pathways that mechanistically link stressful experiences with CHD risk.
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Affiliation(s)
- Peter J Gianaros
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Saleh KJ, Quick JC, Sime WE, Novicoff WM, Einhorn TA. Recognizing and preventing burnout among orthopaedic leaders. Clin Orthop Relat Res 2009; 467:558-65. [PMID: 19030943 PMCID: PMC2628510 DOI: 10.1007/s11999-008-0622-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Accepted: 11/03/2008] [Indexed: 01/31/2023]
Abstract
Stress, emotional exhaustion, and burnout are widespread in the medical profession in general and in orthopaedic surgery in particular. We attempted to identify variables associated with burnout as assessed by validated instruments. Surveys were sent to 282 leaders from orthopaedic surgery academic departments in the United States by e-mail and mail. Responses were received from 195 leaders for a response rate of 69%. The average surgeon worked 68.3 hours per week and more than (1/2) of this time was allocated to patient care. Highest stressors included excessive workload, increasing overhead, departmental budget deficits, tenure and promotion, disputes with the dean, and loss of key faculty. Personal-professional life imbalance was identified as an important risk factor for emotional exhaustion. Withdrawal, irritability, and family disagreements are early warning indicators of burnout and emotional exhaustion. Orthopaedic leaders can learn, and potentially model, ways to mitigate stress from other high-stress professions. Building on the strength of marital and family bonds, improving stress management skills and self-regulation, and improving efficiency and productivity can combine to assist the orthopaedic surgery leader in preventing burnout and emotional exhaustion.
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Affiliation(s)
- Khaled J. Saleh
- Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA
| | - James Campbell Quick
- The University of Texas at Arlington, Goolsby Leadership Academy, Arlington, TX USA ,Lancaster University School of Management, Lancaster, UK
| | - Wesley E. Sime
- Department of Health and Human Performance, University of Nebraska Lincoln, Lincoln, NE USA
| | - Wendy M. Novicoff
- Department of Orthopaedic Surgery, University of Virginia, PO Box 800159, Charlottesville, VA 22908-0159 USA
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Collet C, Averty P, Dittmar A. Autonomic nervous system and subjective ratings of strain in air-traffic control. APPLIED ERGONOMICS 2009; 40:23-32. [PMID: 18353277 DOI: 10.1016/j.apergo.2008.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2007] [Revised: 12/22/2007] [Accepted: 01/30/2008] [Indexed: 05/26/2023]
Abstract
The paper is aimed at studying the perceived strain in professional air-traffic controllers both through self-evaluation and physiological indicators from the autonomic nervous system (ANS). The number of aircraft to be monitored was the main independent variable and could evolve at random within 1 and 10. Five ANS variables were recorded continuously in 25 participants while they handled real traffic: skin potential, skin conductance, skin blood flow, skin temperature and instantaneous heart rate. The tonic level of each physiological variable was averaged to match the times spent monitoring a constant number of aircraft. After the session, participants reacted in compliance with the NASA-TLX rating scale. Subjective ratings and physiological values were closely correlated to the number of aircraft, especially when data were standardized thus reducing inter-subjects differences in baseline levels. Results provide objective information to prevent air-traffic controllers from overloaded situations as well as to improve passengers' safety.
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Affiliation(s)
- C Collet
- Université de Lyon, Université Claude Bernard Lyon 1, CRIS EA 647-Mental Processes and Performance, Villeurbanne Cedex, France.
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Trivedi R, Sherwood A, Strauman TJ, Blumenthal JA. Laboratory-based blood pressure recovery is a predictor of ambulatory blood pressure. Biol Psychol 2007; 77:317-23. [PMID: 18096293 DOI: 10.1016/j.biopsycho.2007.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Revised: 11/02/2007] [Accepted: 11/05/2007] [Indexed: 11/30/2022]
Abstract
The recovery phase of the stress response is an individual difference characteristic that may predict cardiovascular risk. The purpose of this study was to examine whether laboratory-based blood pressure (BP) recovery predicts ambulatory BP (ABP). One hundred and eighty-two participants underwent a standard laboratory stress protocol, involving a 20-min baseline rest period, and four stressors presented in a counterbalanced order, each followed by a 10-min recovery period. Participants also wore an ABP monitor for 24h during a typical workday. Hierarchical regression analyses showed that BP recovery accounted for significant additional variance for daytime SBP (p<0.001), nighttime SBP (p<0.001), daytime DBP (p<0.001), and nighttime DBP (p<0.001), after controlling for baseline and reactivity BP. Results suggest that persistence of the BP response following stress may be a more salient characteristic of the stress response in understanding its potential impact on longer term cardiovascular regulation.
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Affiliation(s)
- Ranak Trivedi
- Box 3119 Duke University Medical Center, Durham NC 27710, United States.
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Yamamoto K, Irie M, Sakamoto Y, Ohmori S, Yoshinari M. The relationship between IMPS-measured stress score and biomedical parameters regarding health status among public school workers. J Physiol Anthropol 2007; 26:149-58. [PMID: 17435358 DOI: 10.2114/jpa2.26.149] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The aim of this study was to examine the relationship between the stress score measured using the Inventory to Measure Psychosocial Stress (IMPS) and biomedical parameters regarding health status among apparently healthy subjects in order to evaluate the validity of the IMPS. Out of the 1,941 public school workers in Kyushu and Okinawa, Japan, who were admitted to a hospital for medical check-ups, 1,499 workers responded to questionnaires which assessed the degree of stress response (i.e., stress score) measured using the IMPS, and the degree of stress tolerance capacity (i.e., stress intolerance score) measured using the Inventory to Measure Stress Tolerance Capacity (IMST). One thousand two-hundred and one workers (684 men and 517 women) were analyzed, excluding 298 subjects who were taking medication for hypertension, hyperuricemia, hyperlipidemia and diabetes, or had a value for glycosylated hemoglobin (HbA1c)>or=6.0 percent. An increase in the stress score was positively associated with an increase in both body fat percentage and glycosylated hemoglobin values among men, while it was positively associated with an increase in plasma triglyceride concentrations among women. The stress score significantly correlated with the value for glycosylated hemoglobin even after controlling for age, body mass index, alcohol consumption, smoking, and exercise among men. An increase in the stress intolerance score was positively associated with an increase in body fat percentage among men, while it was positively associated with an increase in body weight, body mass index, and body fat percentage among women. Our result that the stress score measured using the IMPS was associated with obesity and unfavorable glycemic changes is in congruency with the model that psychosocial stress has a detrimental effect on humans by inducing obesity and insulin resistance, suggesting that the IMPS is a valid means to evaluate psychosocial stress levels among an otherwise healthy population.
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Affiliation(s)
- Kazuhiko Yamamoto
- Institute of Health Science, Kyushu University, and Kyushu Central Hospital, Fukuoka, Japan.
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Covelli MM. The relationship of blood pressure and cortisol reactivity to family history of hypertension of African American adolescents. J Cardiovasc Nurs 2006; 21:347-53. [PMID: 16966911 DOI: 10.1097/00005082-200609000-00004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Ethnicity and family history of hypertension (FHH) have been associated with the development of hypertension. Blood pressure and cortisol reactivity during physiologic stress are hypothesized to function as biologic markers for hypertension. The purpose of this study was to explore the relationship of blood pressure and cortisol reactivity physiologic to FHH in a selected sample of African American adolescents. METHODS Demographic data and physiologic measurements were obtained from 48 African American adolescents (14-17 years). Reactivity was induced by a cold pressor test of hand immersion in cold water. chi, t tests, and multivariate repeated-measures analysis were used to determine relationships. RESULTS Thirty-one (65%) subjects reported an FHH. Thirty (63%) subjects demonstrated cardiovascular reactivity. Although the mean systolic blood pressure was 4 mm Hg higher, t tests indicated no significance between group in systolic blood pressure (P = .32), diastolic pressure (P = .73), and cortisol (P =.81). Blood pressure reactivity of the FHH group was significantly different than the no family history group (P = .0338). Cortisol levels for the total group were markedly elevated (19 nmol/dL) and there was no significant difference in reactivity. CONCLUSION African American adolescents with FHH demonstrate increased blood pressure reactivity. Cortisol levels were elevated for all participants. This study adds support to the association of blood pressure reactivity, a biologic marker of HTN and FHH.
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Thomas KS, Nelesen RA, Malcarne VL, Ziegler MG, Dimsdale JE. Ethnicity, perceived discrimination, and vascular reactivity to phenylephrine. Psychosom Med 2006; 68:692-7. [PMID: 17012522 DOI: 10.1097/01.psy.0000238214.80871.e6] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study examined relationships among ethnicity, perceived discrimination, and vascular reactivity to phenylephrine (PE). METHODS Seventy-six white patients and 46 black patients were studied at an inpatient clinical research center in response to a bolus intravenous injection of 100 microg PE. Self-report questionnaires assessed perceived discrimination. RESULTS After controlling for body surface area, number of cigarettes smoked, and baseline blood pressure, black patients had greater vascular reactivity to PE than white patients (p = .01). There was also a significant relationship between perceived discrimination and diastolic blood pressure responsiveness to PE (p < .05). Path analyses revealed that perceived discrimination mediated the relationship between ethnicity and diastolic pressor responses. Individuals who perceived more discrimination had a larger increase in diastolic blood pressure in response to PE. CONCLUSION These data suggest perceived discrimination is associated with increased blood pressure responsiveness to PE.
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Affiliation(s)
- KaMala S Thomas
- San Diego State University & University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
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Melamed S, Shirom A, Toker S, Berliner S, Shapira I. Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions. Psychol Bull 2006; 132:327-53. [PMID: 16719565 DOI: 10.1037/0033-2909.132.3.327] [Citation(s) in RCA: 385] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the metabolic syndrome, dysregulation of the hypothalamic-pituitary-adrenal axis along with sympathetic nervous system activation, sleep disturbances, systemic inflammation, impaired immunity functions, blood coagulation and fibrinolysis, and poor health behaviors. The association of burnout and vital exhaustion with these disease mediators suggests that their impact on health may be more extensive than currently indicated.
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Affiliation(s)
- Samuel Melamed
- Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
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Clark R, Benkert RA, Flack JM. Violence exposure and optimism predict task-induced changes in blood pressure and pulse rate in a normotensive sample of inner-city black youth. Psychosom Med 2006; 68:73-9. [PMID: 16449414 DOI: 10.1097/01.psy.0000195744.13608.11] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This investigation examined the association of violence exposure (home and neighborhood) and optimism to task-induced changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR). METHODS Drawn from a larger investigation, the convenience sample for this study consisted of 172 normotensive black youth (mean age = 11.5 years, standard deviation = 1.3). Violence exposure and optimism were self-reported by participants, and task-induced changes in SBP, DBP, and PR were measured with an automated monitor during two sequentially administered digit-forward and digit-backward tasks. RESULTS Hierarchical regression analyses revealed that violence exposure was inversely related to task-induced changes in SBP (p = .010) and DBP (p = .005). Optimism was not an independent predictor of blood pressure or PR changes (p-s > .32). The final step of these hierarchical analyses indicated that the effects of violence exposure and optimism interacted to predict task-induced changes in SBP (p = .013) and PR (p = .003). Follow-up regression analyses indicated that violence exposure was inversely related to task-induced changes in SBP among participants high in optimism and was positively associated with PR reactivity in participants low in optimism. CONCLUSIONS The youth in this study have intact mechanisms for buffering blood pressure responses to violence exposure, especially those who are more optimistic about their future-a person factor whose moderating effects might wane with advancing age.
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Affiliation(s)
- Rodney Clark
- Department of Psychology, Wayne State University, Biobehavioral Research Laboratory, Program for the Advancement of Youth and Urban Health, Detroit, MI 48202, USA.
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Ottaviani C, Shapiro D, Goldstein IB, James JE, Weiss R. Hemodynamic profile, compensation deficit, and ambulatory blood pressure. Psychophysiology 2006; 43:46-56. [PMID: 16629685 DOI: 10.1111/j.1469-8986.2006.00378.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study hypothesized that physiologically grounded patterns of hemodynamic profile and compensation deficit would be superior to traditional blood pressure reactivity in the prediction of daily-life blood pressure. Impedance cardiography-derived measures and beat-to-beat blood pressure were monitored continuously in 45 subjects during baseline and four tasks. Ambulatory blood pressure measures were obtained combining data from one work day and one off day. The mediating effects of gender and family history of hypertension were considered. Only gender was significantly associated with hemodynamic profile. Regression analysis indicated that typical reactivity measures failed to predict everyday life blood pressure. After controlling for gender and baseline blood pressure, hemodynamic patterns during specific tasks proved to be strong predictors, overcoming limitations of previous reactivity models in predicting real-life blood pressure.
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Virués-Ortega J, Buela-Casal G. Psychophysiological effects of human-animal interaction: theoretical issues and long-term interaction effects. J Nerv Ment Dis 2006; 194:52-7. [PMID: 16462556 DOI: 10.1097/01.nmd.0000195354.03653.63] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper reviews literature published on the psychophysiological effects of long-term human-animal interaction (i.e., pet ownership, pet adoption). A literature search was conducted using PsycInfo and Medline databases. Although the available evidence is far from being consistent, it can be concluded that, in some cases, long-term relationships with animals may moderate baseline physiological variables, particularly blood pressure. Results proved more coherent in studies where animals were adopted by owners as part of the procedure. This paper examines existing hypotheses seeking to account for these effects and the supporting evidence. Two major hypotheses have been suggested to explain the psychophysiological effects of long-term interaction, namely (1) stress-buffering effects of noncritical social support provided by pets; and (2) classical conditioning of relaxation. These mechanisms may partially account for the long-term health outcomes observed in a number of human-animal interaction studies.
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MESH Headings
- Adaptation, Psychological/physiology
- Animals
- Animals, Domestic/physiology
- Blood Pressure/physiology
- Cardiovascular Physiological Phenomena
- Conditioning, Classical/physiology
- Heart Rate/physiology
- Human-Animal Bond
- Humans
- Models, Biological
- Psychophysiology
- Relaxation/physiology
- Social Support
- Stress Disorders, Traumatic, Acute/prevention & control
- Stress Disorders, Traumatic, Acute/psychology
- Stress, Psychological/prevention & control
- Stress, Psychological/psychology
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Unger T, Parati G. Acute stress and long-lasting blood pressure elevation: a possible cause of established hypertension? J Hypertens 2005; 23:261-3. [PMID: 15662210 DOI: 10.1097/00004872-200502000-00004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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