This study aimed to investigate differences in transient endothelial dysfunction (TED) with mental stress in Black and non-Black individuals with coronary heart disease (CHD), and their potential ...impact on cardiovascular outcomes.
We examined 812 patients with stable CHD between June 2011 and March 2016 and followed through February 2020 at a university-affiliated hospital network. Flow-mediated vasodilation (FMD) was assessed before and 30 minutes after mental stress. TED was defined as a lower poststress FMD than prestress FMD. We compared prestress FMD, post-stress FMD, and TED between Black and non-Black participants. In both groups, we examined the association of TED with an adjudicated composite end point of cardiovascular death or nonfatal myocardial infarction (first and recurring events) after adjusting for demographic, clinical, and socioeconomic factors.
Prestress FMD was lower in Black than non-Black participants (3.7 2.8 versus 4.9 3.8, p < .001) and significantly declined with mental stress in both groups. TED occurred more often in Black (76%) than non-Black patients (67%; multivariable-adjusted odds ratio = 1.6, 95% confidence interval = 1.5-1.7). Over a median (interquartile range) follow-up period of 75 (65-82) months, 142 (18%) patients experienced either cardiovascular death or nonfatal myocardial infarction. Black participants had a 41.9% higher risk of the study outcome than non-Black participants (95% confidence interval = 1.01-1.95). TED with mental stress explained 69% of this excess risk.
Among CHD patients, Black individuals are more likely than non-Black individuals to develop endothelial dysfunction with mental stress, which in turn explains a substantial portion of their excess risk of adverse events.
Since the announcement of the World Health Organization of COVID-19 as a global pandemic, the probability of experiencing psychological disturbances and mental health problems among the frontline ...doctors who deal early with the suspected or confirmed patients is expected to increase, especially among anesthesia and ICU physicians.
The objective of this study was to assess the magnitude of mental stress among anesthesia and ICU physicians in Cairo university hospitals, Egypt, treating patients exposed to COVID-19.
This cross-sectional, survey-based study collected the demographic and mental health data from anesthesia and ICU physicians working in Cairo university hospitals from March 15 to April 15, 2020, in Egypt. The level of stress was assessed by the perceived stress scale (PSS-10).
A total of 193 out of 315 contacted physicians completed the survey. A significant proportion of participants (65%) experienced high levels of psychological distress during this acute situation, with the PSS-10 median score of 21 in the registrar group and 18 in the consultant group; the difference was statistically significant (P = 0.03). The most common causes of stress among the participants were the fears that they might transmit the disease to their loved people and the lack of a clear protocol on how to deal with COVID-19 cases, either suspected or confirmed.
In this survey study, anesthesia and ICU physicians responding to the spread of COVID-19 reported high rates of symptoms of mental stress.
Social disconnection has been associated with poor cardiometabolic health. This study sought to investigate the associations of social isolation and loneliness with diabetic microvascular ...complications (DMC) among individuals with type 2 diabetes mellitus (T2DM) and compare these associations to those related to traditional risk factors.
Prospective cohort study.
A total of 24,297 UK Biobank participants with T2DM and no DMC at baseline.
Social isolation and loneliness measured using self-reported questionnaires.
The incidence of DMC defined as a composite of diabetic kidney disease, diabetic retinopathy, or diabetic neuropathy.
Multivariable cause-specific hazards regression. To compare the relative importance of social disconnection with other established factors, the R2 values of the Cox models were calculated.
During a median follow-up of 12.6 years, 5,530 patients were documented to develop DMC (3,458 with diabetic kidney disease, 2,255 with diabetic retinopathy, and 1,146 with diabetic neuropathy). The highest level of social isolation was associated with an increased risk of any DMC component (most vs. least: HR: 1.13; 95% CI: 1.05-1.22), especially diabetic kidney disease (HR: 1.14, 95% CI: 1.04-1.25) and neuropathy (HR: 1.31, 95% CI: 1.11-1.53). Any level of loneliness was associated with an increased risk of any DMC component (HR: 1.12; 95% CI: 1.02-1.23) and diabetic kidney disease (HR: 1.16, 95% CI: 1.03-1.30). Social isolation and loneliness exhibited associations with DMC comparable to other conventional risk factors including smoking, blood pressure, and physical activity.
Limited generalizability related to the composition of participants in the UK Biobank Study.
Social isolation and loneliness were independently associated with a higher risk of incident DMC among individuals with T2DM, with comparable importance to other traditional risk factors. These findings underscore social isolation and loneliness as novel and potentially modifiable risk factors for DMC.
Getting to the “COR” Halbesleben, Jonathon R. B.; Neveu, Jean-Pierre; Paustian-Underdahl, Samantha C. ...
Journal of management,
07/2014, Letnik:
40, Številka:
5
Journal Article
Recenzirano
Proposed as a theory of motivation, the basic tenet of conservation of resources (COR) theory is that humans are motivated to protect their current resources and acquire new resources. Despite its ...recent popularity in the organizational behavior literature, several criticisms of the theory have emerged, primarily related to the central concept of resources. In this review, we address concerns regarding the conceptualization, conservation, acquisition, fluctuation, and measurement of resources. We highlight gaps in the COR literature that can be addressed by integrating research from other areas of psychology and management. In this manner, we hope to push the COR literature forward by resolving several concerns and providing suggestions for future research that might address other concerns.
Mental stress-induced myocardial ischemia (MSIMI), a transient myocardial ischemic response to mental stress, is associated with poorer outcomes among patients with coronary heart disease and is more ...likely to occur among women. However, predictors of MSIMI are not well explored. The current study investigated the association between experiences of everyday discrimination and MSIMI among patients with recent myocardial ischemia and contrasted the results with conventional stress-induced myocardial ischemia (CSIMI). We examined sex differences in associations.
We studied 295 post-MI patients (145 women, 150 men). Provocation of myocardial ischemia with mental stress (speech task) and conventional stress (exercise or pharmacologic) was assessed by myocardial perfusion imaging. Frequency of exposure to everyday discrimination was assessed via questionnaire using the Everyday Discrimination Scale (EDS).
The mean age was 51 years in both women and men, and the EDS score ranged from 10 to 38 (mean standard deviation = 17 6 years). After multivariable analysis, each standard deviation increase in the EDS score (more frequent exposure) was associated with an increased odds of MSIMI (odds ratio OR = 1.57 1.10-2.23). The EDS score was not associated with CSIMI (OR = 0.86 0.64-1.17). Women demonstrated a twofold increase (OR = 1.96 1.13-3.38, p = .02) in the adjusted odds of MSIMI, with each standard deviation increase in the EDS score compared with a 1.4-fold increase (OR = 1.40 0.80-2.44, p = .24) among men; however, interaction was not statistically significant.
Among post-MI patients, everyday discrimination was positively associated with occurrence of MSIMI, but not with CSIMI; associations were more pronounced among women.
This study examines the influence of online classes on the mental stress of Indian students amid the COVID-19 pandemic. Data from 428 respondents, spanning from class 10 to research scholars, was ...collected via a Google Form questionnaire. Parameters like excitement for online classes, class time gaps, teacher-centric lecture, competitive mindset, disruption of normal life, and health related issues were analysed using descriptive statistics. The findings offer insights into the potential causes of mental stress among students during online classes, with implications for improving mental health through screening strategies. These findings may also apply to offline classes.
•Mental stress significantly reduced variability and chaotic behaviour of HRV.•Stress causes sympathetic activation and parasympathetic withdrawal.•Pooled HRV power ratio changed significantly while ...did not in individual studies.•Studies investigating HRV non-linear measures and mental stress are required.•The method proposed to meta-analyze HRV features can be adopted for other studies investigating HRV.
Mental stress reduces performances, on the work place and in daily life, and is one of the first causes of cognitive dysfunctions, cardiovascular disorders and depression. This study systematically reviewed existing literature investigating, in healthy subjects, the associations between acute mental stress and short term Heart Rate Variability (HRV) measures in time, frequency and non-linear domain. The goal of this study was to provide reliable information about the trends and the pivot values of HRV measures during mental stress. A systematic review and meta-analysis of the evidence was conducted, performing an exhaustive research of electronic repositories and linear researching references of papers responding to the inclusion criteria. After removing duplicates and not pertinent papers, journal papers describing well-designed studies that analyzed rigorously HRV were included if analyzed the same population of healthy subjects at rest and during mental stress. 12 papers were shortlisted, enrolling overall 758 volunteers and investigating 22 different HRV measures, 9 of which reported by at least 2 studies and therefore meta-analyzed in this review. Four measures in time and non-linear domains, associated with a normal degree of HRV variations resulted significantly depressed during stress. The power of HRV fluctuations at high frequencies was significantly depressed during stress, while the ratio between low and high frequency resulted significantly increased, suggesting a sympathetic activation and a parasympathetic withdrawal during acute mental stress. Finally, among the 15 non-linear measures extracted, only 2 were reported by at least 2 studies, therefore pooled, and only one resulted significantly depressed, suggesting a reduced chaotic behaviour during mental stress. HRV resulted significantly depressed during mental stress, showing a reduced variability and less chaotic behaviour. The pooled frequency domain measures demonstrated a significant autonomic balance shift during acute mental stress towards the sympathetic activation and the parasympathetic withdrawal. Pivot values for the pooled mean differences of HRV measures are provided. Further studies investigating HRV non-linear measures during mental stress are still required. However, the method proposed to transform and then meta-analyze the HRV measures can be applied to other fields where HRV proved to be clinically significant.
Psychosocial stress can affect cardiovascular health through multiple pathways. Certain stressors, such as socioeconomic disadvantage, childhood adversity, intimate partner violence, and caregiving ...stress, are especially common among women. The consequences of stress begin at a young age and persist throughout the life course. This is especially true for women, among whom the burden of negative psychosocial experiences tends to be larger in young age and midlife. Menarche, pregnancy, and menopause can further exacerbate stress in vulnerable women. Not only is psychosocial adversity prevalent in women, but it could have more pronounced consequences for cardiovascular risk among women than among men. These differential effects could reside in sex differences in responses to stress, combined with women’s propensity toward vasomotor reactivity, microvascular dysfunction, and inflammation. The bulk of evidence suggests that targeting stress could be an important strategy for cardiovascular risk reduction in women.
•Psychosocial stress contributes to cardiovascular disease through multiple pathways, and young and midlife women, especially those from marginalized groups, are particularly vulnerable to the adverse effects of psychosocial stress.•A multipronged approach to psychosocial adversity at the individual and community levels is needed to reduce the impact of stress on women’s cardiovascular health.•Clinical trials should explore the benefits of targeting psychosocial stress to improve women’s cardiovascular health.
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