1
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Nazarov A, Forchuk CA, Houle SA, Hansen KT, Plouffe RA, Liu JJW, Dempster KS, Le T, Kocha I, Hosseiny F, Heesters A, Richardson JD. Exposure to moral stressors and associated outcomes in healthcare workers: prevalence, correlates, and impact on job attrition. Eur J Psychotraumatol 2024; 15:2306102. [PMID: 38334695 PMCID: PMC10860421 DOI: 10.1080/20008066.2024.2306102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/14/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction: Healthcare workers (HCWs) often experience morally challenging situations in their workplaces that may contribute to job turnover and compromised well-being. This study aimed to characterize the nature and frequency of moral stressors experienced by HCWs during the COVID-19 pandemic, examine their influence on psychosocial-spiritual factors, and capture the impact of such factors and related moral stressors on HCWs' self-reported job attrition intentions.Methods: A sample of 1204 Canadian HCWs were included in the analysis through a web-based survey platform whereby work-related factors (e.g. years spent working as HCW, providing care to COVID-19 patients), moral distress (captured by MMD-HP), moral injury (captured by MIOS), mental health symptomatology, and job turnover due to moral distress were assessed.Results: Moral stressors with the highest reported frequency and distress ratings included patient care requirements that exceeded the capacity HCWs felt safe/comfortable managing, reported lack of resource availability, and belief that administration was not addressing issues that compromised patient care. Participants who considered leaving their jobs (44%; N = 517) demonstrated greater moral distress and injury scores. Logistic regression highlighted burnout (AOR = 1.59; p < .001), moral distress (AOR = 1.83; p < .001), and moral injury due to trust violation (AOR = 1.30; p = .022) as significant predictors of the intention to leave one's job.Conclusion: While it is impossible to fully eliminate moral stressors from healthcare, especially during exceptional and critical scenarios like a global pandemic, it is crucial to recognize the detrimental impacts on HCWs. This underscores the urgent need for additional research to identify protective factors that can mitigate the impact of these stressors.
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Affiliation(s)
- Anthony Nazarov
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Callista A. Forchuk
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Stephanie A. Houle
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Research Directorate, Veteran Affairs Canada, Charlottetown, Canada
| | - Kevin T. Hansen
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Rachel A. Plouffe
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Jenny J. W. Liu
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Kylie S. Dempster
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Tri Le
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | - Ilyana Kocha
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
| | | | - Ann Heesters
- Department of Clinical and Organizational Ethics, University Health Network, Toronto, Canada
- The Institute for Education Research, University Health Network, Toronto, Canada
- Joint Centre for Bioethics, University of Toronto, Toronto, Canada
- The Michener Institute, University Health Network, Toronto, Canada
- The Wilson Centre, University Health Network, Toronto, Canada
| | - J. Don Richardson
- MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- St. Joseph’s Operational Stress Injury Clinic, St. Joseph’s Health Care London, London, Canada
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2
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Dempster KS, O'Leary DD, MacNeil AJ, Wade TJ. Childhood household dysfunction is associated with reduced left ventricular mass in young adulthood. Am J Physiol Heart Circ Physiol 2023; 324:H791-H803. [PMID: 36961488 DOI: 10.1152/ajpheart.00128.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
The effect of adverse childhood experiences (ACEs) on left ventricular mass (LVM) and left ventricular function remains largely unknown. This study investigated the influence of ACEs on LVM and left ventricular function and whether inflammation influences this relationship. 248 healthy young adults participated and a final sample of 217 (age = 22.6 ± 0.1 years; females = 114) had complete data. Echocardiographic assessment of LVM was indexed to height2.7 (LVMHT) and body surface area (LVMBSA). Ejection fraction (EF), and fractional shortening were assessed. Interleukin-6 (IL-6), C-reactive protein, tumour necrosis factor-α, and matrix metalloproteinase (MMP) 1 - 3 were measured and ACEs assessed based upon exposure and non-exposure to childhood household dysfunction and maltreatment, and quantity of adversity, (i.e., < 4 ACEs and ≥ 4 ACEs). Individuals who experienced household dysfunction demonstrated lower LVM, LVMHT, and LVMBSA (p < 0.01) and greater IL-6 (p < 0.05) than those who did not experience household dysfunction. Reduced MMP3 was present in individuals who experienced maltreatment (p < 0.05) and ≥ 4 ACEs (p < 0.01) compared to no maltreatment and < 4 ACEs, respectively. After controlling for covariates (i.e., sex, recent life stress, height, body mass index, smoking, physical activity, and inflammation), a significant negative effect of household dysfunction on LVM, LVMHT, and LVMBSA persisted. Likewise, a negative effect on EF independent of covariates was observed in individuals who experienced ≥ 4 ACEs. Alterations in LVM and EF may be perpetuated through a toxic home environment, promoting altered left ventricular development.
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Affiliation(s)
- Kylie S Dempster
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Brock Functional Inclusive Training Centre, St. Catharines, ON, Canada
| | - Deborah D O'Leary
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Brock Functional Inclusive Training Centre, St. Catharines, ON, Canada
| | - Adam J MacNeil
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Terrance J Wade
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Brock Functional Inclusive Training Centre, St. Catharines, ON, Canada
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3
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Dempster KS, Wade TJ, MacNeil AJ, O'Leary DD. Adverse childhood experiences are associated with altered cardiovascular reactivity to head-up tilt in young adults. Am J Physiol Regul Integr Comp Physiol 2023; 324:R425-R434. [PMID: 36693169 DOI: 10.1152/ajpregu.00148.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with greater prevalence of cardiovascular disease and altered acute stress reactivity. The current study investigated the effect of ACEs on hemodynamic and autonomic responses to orthostatic stress imposed by 60° head-up tilt (HUT) in young adults. Two-hundred twenty-six healthy young adults (age = 22.6 ± 1.5 yr; n = 116 females) without cardiovascular disease participated and had complete data. Participants underwent supine blood pressure (BP), R-R interval (RRI), cardiac output (CO), total peripheral resistance (TPR), and cardiovagal baroreflex sensitivity (cvBRS) testing followed by a transition to 60° HUT where measures were reassessed. Childhood adversity exposures were assessed based on categorical exposure and nonexposure to childhood household dysfunction and maltreatment, and <4 and ≥4 types of ACEs. Significantly greater increases in SBP (P < 0.05), DBP, MAP, and TPR (P < 0.01; all) following 60° HUT were observed in individuals with ≥4 compared with those with <4 types of ACEs. Attenuated decreases in RRI and cvBRS were observed in those with ≥4 types of ACEs (P < 0.05). Experiencing ≥4 types of ACEs was associated with augmented BP and TPR reactivity and a blunted decrease in cvBRS in response to 60° HUT in young adults. Results suggest that a reduced vagal response to orthostatic stress is present in those who have experienced ≥4 types of ACEs that may promote autonomic dysfunction. Future research examining the sympathetic and vagal baroreflex branches is warranted.
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Affiliation(s)
- Kylie S Dempster
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
| | - Terrane J Wade
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Brock-Niagara Centre for Health and Well-Being, St. Catharines, Ontario, Canada
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4
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Iannarelli NJ, Wade TJ, Dempster KS, Moore J, MacNeil AJ, O'Leary DD. No Mediation Effect of Telomere Length or Mitochondrial DNA Copy Number on the Association Between Adverse Childhood Experiences (ACEs) and Central Arterial Stiffness. J Am Heart Assoc 2022; 11:e026619. [DOI: 10.1161/jaha.122.026619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Adverse childhood experiences (ACEs) have been linked to increased cardiovascular disease (CVD) risk. Previous reports have suggested that accelerated biological aging—indexed by telomere length (TL) and mitochondrial DNA copy number (mtDNAcn)—may contribute to associations between ACEs and cardiovascular health outcomes. Here, we examine the potential mediating effects of TL and mtDNAcn on the association between ACEs and central arterial stiffness—an intermediate cardiovascular health outcome—as a novel pathway linking ACEs to CVD risk among young adults.
Methods and Results
One hundred and eighty‐five (n=102 women; mean age, 22.5±1.5 years) individuals provided information on ACEs. TL (kb per diploid cell) and mtDNAcn (copies per diploid cell) were quantified using quantitative polymerase chain reaction techniques. Central arterial stiffness was measured as carotid‐femoral pulse wave velocity (cfPWV; m/s). Multiple linear regression analyses were used to examine the associations between ACEs, TL, mtDNAcn, and cfPWV. ACEs were positively associated with cfPWV (
β
=0.147,
P
=0.035). TL (
β
=−0.170,
P
=0.011) and mtDNAcn (
β
=−0.159,
P
=0.019) were inversely associated with cfPWV. Neither TL (
β
=−0.027,
P
=0.726) nor mtDNAcn (
β
=0.038,
P
=0.620) was associated with ACEs. Neither marker mediated the association between ACEs and cfPWV.
Conclusions
An increasing number of ACEs were associated with a faster cfPWV and thus, a greater degree of central arterial stiffness. ACEs were not associated with either TL or mtDNAcn, suggesting that these markers do not represent a mediating pathway linking ACEs to central arterial stiffness.
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Affiliation(s)
- Nathaniel J. Iannarelli
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
| | - Terrance J. Wade
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
| | - Kylie S. Dempster
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
| | - Jessy Moore
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
| | - Adam J. MacNeil
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
| | - Deborah D. O'Leary
- Department of Health Sciences Faculty of Applied Health Sciences Brock University St. Catharines Ontario Canada
- Brock‐Niagara Centre for Health and Well‐Being Brock University St. Catharines Ontario Canada
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5
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Iannarelli NJ, MacNeil AJ, Dempster KS, Wade TJ, O’Leary DD. Serum MMP-3 and its association with central arterial stiffness among young adults is moderated by smoking and BMI. Physiol Rep 2021; 9:e14920. [PMID: 34110720 PMCID: PMC8191404 DOI: 10.14814/phy2.14920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/26/2021] [Accepted: 05/14/2021] [Indexed: 12/21/2022] Open
Abstract
Central arterial stiffness is an independent predictor of cardiovascular disease. It is characterized by a marked reduction in the elastin-collagen ratio of the arterial wall extracellular matrix (ECM), and is largely the result of degradation of various ECM components. Matrix metalloproteinase-3 (MMP-3) may contribute to central arterial stiffness via its involvement in ECM homeostasis and remodeling. This study examined the association between serum MMP-3 concentrations and central arterial stiffness and potential interactions of MMP-3 and traditional cardiovascular risk factors in a population of healthy young adults. A total of 206 participants (n = 109 females) aged 19-25 years were included in the current study. Central arterial stiffness was measured non-invasively as carotid-femoral pulse wave velocity (cfPWV) (m/s). MMP-3 concentrations (ng/ml) were measured using ELISA techniques. Regression analyses were used to examine the association between cfPWV and MMP-3, adjusting for age, sex, smoking status, body mass index (BMI), instantaneous mean arterial pressure (MAP) and heart rate, and serum C-reactive protein. Interactions between MMP-3 with smoking, BMI, sex, and MAP were analyzed in subsequent regression models. MMP-3 was an independent predictor of cfPWV (β = 0.187, p = 0.007), and significant interactions between MMP-3 and regular smoking (β = 0.291, p = 0.022), and MMP-3 and BMI (β = 0.210, p = 0.013) were observed. Higher serum MMP-3 concentrations were associated with a faster cfPWV and thus, greater central arterial stiffness. Interactions between MMP-3 and smoking, and MMP-3 and BMI may, in part, drive the association between MMP-3 and central arterial stiffness.
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Affiliation(s)
- Nathaniel J. Iannarelli
- Department of Health SciencesFaculty of Applied Health SciencesBrock UniversitySaint CatharinesONCanada
| | - Adam J. MacNeil
- Department of Health SciencesFaculty of Applied Health SciencesBrock UniversitySaint CatharinesONCanada
| | - Kylie S. Dempster
- Department of Health SciencesFaculty of Applied Health SciencesBrock UniversitySaint CatharinesONCanada
- Brock‐Niagara Centre for Health and Well‐BeingBrock UniversitySaint CatharinesONCanada
| | - Terrance J. Wade
- Department of Health SciencesFaculty of Applied Health SciencesBrock UniversitySaint CatharinesONCanada
- Brock‐Niagara Centre for Health and Well‐BeingBrock UniversitySaint CatharinesONCanada
| | - Deborah D. O’Leary
- Department of Health SciencesFaculty of Applied Health SciencesBrock UniversitySaint CatharinesONCanada
- Brock‐Niagara Centre for Health and Well‐BeingBrock UniversitySaint CatharinesONCanada
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6
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Dempster KS, O'Leary DD, MacNeil AJ, Hodges GJ, Wade TJ. Linking the hemodynamic consequences of adverse childhood experiences to an altered HPA axis and acute stress response. Brain Behav Immun 2021; 93:254-263. [PMID: 33358983 DOI: 10.1016/j.bbi.2020.12.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/02/2020] [Accepted: 12/16/2020] [Indexed: 01/07/2023] Open
Abstract
Adverse childhood experiences (ACEs), such as maltreatment and severe household dysfunction, represent a significant threat to public health as ACEs are associated with increased prevalence of several chronic diseases. Biological embedding, believed to be rooted in dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, is the prevailing theory by which chronic diseases become imprinted in individuals following childhood adversity. A shift towards HPA axis hypoactivity occurs in response to ACEs exposure and is proposed to contribute towards altered cortisol secretion, chronic low-grade inflammation, and dysregulated hemodynamic and autonomic function. This shift in HPA axis activity may be a long-term effect of glucocorticoid receptor methylation with downstream effects on hemodynamic and autonomic function. Emerging evidence suggests syncopal tendencies are increased among those with ACEs and coincides with altered neuroimmune function. Similarly, chronic low-grade inflammation may contribute towards arterial baroreceptor desensitization through increased arterial stiffness, negatively impacting autonomic regulation following posture change and increasing rates of syncope in later life, as has been previously highlighted in the literature. Although speculative, baroreceptor desensitization may be secondary to increased arterial stiffness and changes in expression of glucocorticoid receptors and arginine vasopressin, which are chronically altered by ACEs. Several research gaps and opportunities exist in this field and represent prospective areas for future investigation. Here, we synthesize current findings in the areas of acute psychosocial stress reactivity pertaining to HPA axis function, inflammation, and hemodynamic function while suggesting ideas for future research emphasizing systemic interactions and postural stress assessments among those with ACEs. This review aims to identify specific pathways which may contribute towards orthostatic intolerance in populations with history of childhood adversity.
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Affiliation(s)
- Kylie S Dempster
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, Canada
| | - Deborah D O'Leary
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, Canada.
| | - Adam J MacNeil
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Canada
| | - Gary J Hodges
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, Canada
| | - Terrance J Wade
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, Canada
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7
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Rafiq T, O’Leary DD, Dempster KS, Cairney J, Wade TJ. Adverse Childhood Experiences (ACEs) Predict Increased Arterial Stiffness from Childhood to Early Adulthood: Pilot Analysis of the Niagara Longitudinal Heart Study. J Child Adolesc Trauma 2020; 13:505-514. [PMID: 33269049 PMCID: PMC7683677 DOI: 10.1007/s40653-020-00311-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An association among adults between adverse childhood experiences (ACEs) and arterial stiffness and between arterial stiffness and cardiovascular disease has been established. Recent cross-sectional evidence suggests that ACEs is linked to the development and progression of arterial stiffness, but it remains unclear when these changes begin to manifest. We examine the relationship between ACEs and changes in arterial stiffness from childhood into adulthood using population-based longitudinal data. The Niagara Longitudinal Heart Study (NLHS) pilot data included 76 young adults (females = 44), with an average age of 21 years (SD = 1), and had a follow-up period of 9 years. Mixed effects modeling was used to examine the effect of ACEs on changes in arterial stiffness over time adjusting for sex, changes in heart rate, systolic blood pressure, body mass index, and physical activity. Individuals with four or more ACEs have a greater increase in arterial stiffness over time from childhood into young adulthood. This increase was similar for both males and females and independent of the effects of change in heart rate, systolic blood pressure, body mass index, and physical activity. Exposure to ACEs is associated with greater increase in arterial stiffness, a marker for cardiovascular disease among adults. This suggests that interventions targeted at individuals with high exposure to ACEs early on in life could lower the risk of arterial stiffness and in turn the cascade of events leading to cardiovascular disease.
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Affiliation(s)
- Talha Rafiq
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
| | - Deborah D. O’Leary
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
| | - Kylie S. Dempster
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
| | - John Cairney
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland Australia
| | - Terrance J. Wade
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
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8
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Dempster KS, Fajardo VA, Baranowski RW, Hamstra SI, Wade TJ, O'Leary DD. Low‐dose Lithium is Associated with Left Ventricular Ejection Fraction in Healthy Young Men but not Women. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.01845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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9
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Gagnon MK, Dempster KS, Wade TJ, O’Leary DD. Insomnia is Associated with an Increased Carotid‐Femoral Pulse Wave Velocity in Healthy Young Adults during Awake Hours. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.09725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Moore J, Maguire ARR, Dempster KS, Gagnon MK, Henry MA, O’Leary DD, MacNeil AJ, Wade TJ. Exploring the Role of Immunological Biomarkers in the Association Between Mental Health Status and Executive Function in Early Adulthood. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Iannarelli NJ, Dempster KS, Maguire ARR, Moore J, MacNeil AJ, Wade TJ, O'Leary DD. Serum MMP‐3 and its Association with Large Artery Stiffness. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.01878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Wade TJ, O'Leary DD, Dempster KS, MacNeil AJ, Molnar DS, McGrath J, Cairney J. Adverse childhood experiences (ACEs) and cardiovascular development from childhood to early adulthood: study protocol of the Niagara Longitudinal Heart Study. BMJ Open 2019; 9:e030339. [PMID: 31315878 PMCID: PMC6661634 DOI: 10.1136/bmjopen-2019-030339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Recent reviews have found substantial links between a toxic childhood environment including child abuse and severe household dysfunction and adult cardiovascular disease (CVD). Collectively referred to as adverse childhood experiences (ACEs), this toxic environment is prevalent among children, with recent Canadian estimates of child abuse at 27%-32%, and severe household dysfunction at 49%. Based on these prevalence rates, the potential effect of ACEs on CVD is more significant than previously thought. Yet, how ACEs amplify the risk for later CVD remains unclear. Lifestyle risk factors only partially account for this connection, instead directing attention to the interaction between psychosocial factors and physiological mechanisms such as inflammation. The Niagara Longitudinal Heart Study (NLHS) examines how ACEs influence cardiovascular health (CVH) from childhood to early adulthood. Integrating the stress process and biological embedding models, this study examines how psychosocial and physiological factors in addition to lifestyle factors explain the relationship between ACEs and CVH. METHODS This follow-up study combines three baseline studies from 2007 to 2012 that collected CVH measures including child blood pressure, heart rate, left ventricular structure and function, arterial stiffness indices and baroreflex sensitivity on 564 children. Baseline data also include anthropometric, biological, lifestyle, behavioural, and psychosocial measures that varied across primary studies. Now over 18 years of age, we will recruit and retest as many participants from the baseline studies as possible collecting data on ACEs, CVH, anthropometric, lifestyle and psychosocial measures as well as blood, saliva and hair for physiological biostress markers. ETHICS AND DISSEMINATION Ethics approval has been received for the NLHS follow-up. Written consent to participate in the follow-up study is obtained from each participant. Results testing all proposed hypotheses will be submitted for publication in peer-reviewed journals.
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Affiliation(s)
- Terrance J Wade
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
- Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
| | - Kylie S Dempster
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Danielle S Molnar
- Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Jennifer McGrath
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - John Cairney
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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13
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Klassen SA, Chirico D, Dempster KS, Shoemaker JK, O'Leary DD. Role of aortic arch vascular mechanics in cardiovagal baroreflex sensitivity. Am J Physiol Regul Integr Comp Physiol 2016; 311:R24-32. [PMID: 27122371 DOI: 10.1152/ajpregu.00491.2015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/26/2016] [Indexed: 01/06/2023]
Abstract
Cardiovagal baroreflex sensitivity (cvBRS) measures the efficiency of the cardiovagal baroreflex to modulate heart rate in response to increases or decreases in systolic blood pressure (SBP). Given that baroreceptors are located in the walls of the carotid sinuses (CS) and aortic arch (AA), the arterial mechanics of these sites are important contributors to cvBRS. However, the relative contribution of CS and AA mechanics to cvBRS remains unclear. This study employed sex differences as a model to test the hypothesis that differences in cvBRS between groups would be explained by the vascular mechanics of the AA but not the CS. Thirty-six young, healthy, normotensive individuals (18 females; 24 ± 2 yr) were recruited. cvBRS was measured using transfer function analysis of the low-frequency region (0.04-0.15 Hz). Ultrasonography was performed at the CS and AA to obtain arterial diameters for the measurement of distensibility. Local pulse pressure (PP) was taken at the CS using a hand-held tonometer, whereas AA PP was estimated using a transfer function of brachial PP. Both cvBRS (25 ± 11 vs. 19 ± 7 ms/mmHg, P = 0.04) and AA distensibility (16.5 ± 6.0 vs. 10.5 ± 3.8 mmHg(-1) × 10(-3), P = 0.02) were greater in females than males. Sex differences in cvBRS were eliminated after controlling for AA distensibility (P = 0.19). There were no sex differences in CS distensibility (5.32 ± 2.3 vs. 4.63 ± 1.3 mmHg(-1) × 10(-3), P = 0.32). The present data demonstrate that AA mechanics are an important contributor to differences in cvBRS.
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Affiliation(s)
- Stephen A Klassen
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada; and
| | - Daniele Chirico
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada; and
| | - Kylie S Dempster
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada; and
| | - J Kevin Shoemaker
- Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada
| | - Deborah D O'Leary
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada; and
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