Psychological workload and body weight: is there an association? A review of the literature

BACKGROUND: According to Karasek's Demand/Control Model, workload can be conceptualized as job strain, a combination of psychological job demands and control in the job. High job strain may result from high job demands combined with low job control. Aim To give an overview of the literature on the association between obesity and psychological workload. METHOD: We carried out a review of the associations between psychological workload and body weight in men and women. In total, 10 cross-sectional studies were identified. RESULTS: The review showed little evidence of a general association between psychological workload and body mass index. Only weak positive associations were found, and only between elements of psychological workload and overall body weight. For body fat distribution, two out of three studies showed a positive association in men, but the associations became insignificant after adjustment for education. For women, there was no evidence of a consistent association. CONCLUSION: The reviewed articles were not supportive of any associations between psychological workload and either general or abdominal obesity. Future epidemiological studies in this field should be prospective or experimental, and should examine how chronic work stress affects eating and to what extent initial body weight is a predictor for individual differences in perceived psychological workload.     

How is Primary Health Care conceptualised in nursing in Australia? A review of the literature

Australia, in common with many other countries, is expanding the role of Primary Health Care (PHC) to manage the growing burden of chronic disease and prevent hospitalisation. Australia's First National Primary Health Care Strategy released in 2010 places general practice at the centre of care delivery, reflecting a constitutional division of labour in which the Commonwealth government's primary means of affecting care delivery in this sector is through rebates for services delivered from the universal healthcare system Medicare. A review of Australian nursing literature was undertaken for 2006–2011. This review explores three issues in relation to these changes: How PHC is conceptualised within Australian nursing literature; who is viewed as providing PHC; and barriers and enablers to the provision of comprehensive PHC. A review of the literature suggests that the terms ‘PHC’ and ‘primary care’ are used interchangeably and that PHC is now commonly associated with services provided by practice nurses. Four structural factors are identified for a shift away from comprehensive PHC, namely fiscal barriers, educational preparation for primary care practice, poor role definition and interprofessional relationships. The paper concludes that while moves towards increasing capacity in general practice have enhanced nursing roles, current policy and the nature of private business funding alongside some medical opposition limit opportunities for Australian nurses working in general practice.     

Progestogen-only pills and high blood pressure: is there an association? A literature review

The progestogen-only pill (POP) is a contraceptive option for women who have high blood pressure either induced by use of combined oral pills or due to other causes; as long as it is well controlled and monitored. Combined oral contraception (COC) and Depo-Provera have been implicated in increased cardiovascular risk following use. High blood pressure has been theorized to be the critical path that leads to this increased risk. POP is the recommended method for women who are at risk of coronary heart disease due to presence of risk factors like hypertension. In order to offer POP as a safe, alternative contraception to women who develop hypertension on COCs or those who are at increased cardiovascular risk, it is important to take into account evidence of no association of high blood pressure with POP use. A search of published medical literature (PUBMED and Cochrane database) was undertaken with this objective. A total of four articles were selected for final review after application of inclusion and exclusion criteria. Three of these were prospective control trials and one a cross-sectional survey. There was no randomized study to answer this question. The results of these studies consistently reported no significant association of high blood pressure with use of POPs for up to 2-3 years of follow-up.     

Is there another binge eating disorder? A review of the literature on overeating in the absence of bulimia nervosa

The current DSM-Ill-R psychiatric diagnostic system recognizes only one disorder of overeating, bulimia nervosa. Our clinical work has led us to believe that there are a number of individuals who believe that they have a serious overeating problem, but do not meet criteria for bulimia nervosa. We surveyed the literature for studies pertaining to overeating among individuals not meeting criteria for bulimia nervosa. Studies of obese binge eaters and of binge eating among young women suggest the existence of a significant proportion of obese and non-obese individuals with such a problem. However, the limitations in the existing data for addressing this question preclude definitive conclusions. Further work is needed to establish the defining features of an additional binge eating syndrome, to assess the reliability and validity of such a syndrome, and to determine its clinical utility.     

Why is teenage pregnancy conceptualized as a social problem? A review of quantitative research from the USA and UK

To explore why teenage pregnancy is regarded by researchers from the USA and UK as a major social problem, a systematic review was conducted of published research on the social influences on teenage pregnancy. Papers published in the USA and UK between 1981 and 2000 were examined with respect to samples, social influences and outcomes. UK studies often justified investigating teenage pregnancy in terms of health. Research from the USA more often viewed teenage pregnancy as problematic because of associated welfare expenditure. A few studies from the USA regarded teenage parenting as mediating the intergenerational transmission of poverty. Such studies often focused on Black and minority ethnic populations. Most research considered economic and cultural influences, with a bias in research from the USA on cultural factors, and in the UK on economic factors. Overall, there were significant differences between research in the USA and UK. These may have arisen from a combination of political, religious and research design factors.     

Play as a coping strategy?: A review of the relevant literature

Despite the fact that coping and play are both considered essential elements of child development, their relationship has seldom been investigated. The present review examines the assessment of children’s coping skills in general and the specific use of play as a coping skill in studies involving children aged 5–12 years. Forty studies published between 2000 and 2013 were analyzed. The review shows that play is not incorporated in 40% of the children’s coping skills instruments. Even when a coping instrument recognized play, it was classified as either an avoidant or distracting activity. Future research should investigate children’s play as a coping strategy for managing difficult and stressful situations. Overlooking play as a coping strategy may lead to underestimating its developmental and social potential in pediatric health care.     

Is there a problem with the problems in problem‐based learning?

OBJECTIVE: To determine the balance between acute and chronic medical problems in the PBL cases at 2 Australian medical schools. METHODS: Analysis of 162 PBL cases. RESULTS: Cases concentrate on acute problems in young people and neglect chronic disease in the old. CONCLUSION: This imbalance may contribute to negative attitudes towards elderly patients and people with chronic disease.     

The problem of obesity: is there a role for antagonists of the renin-angiotensin system?

Obesity is a major health problem worldwide; it is associated with more than 30 medical conditions and is a leading cause of unnecessary deaths. Adipose tissue not only acts as an energy store, but also behaves like an endocrine organ, synthesising and secreting numerous hormones and cytokines. Angiotensin II (ANG II) is the biologically active component of the renin-angiotensin system (RAS). The RAS is present in adipose tissue and evidence suggests that ANG II is intimately linked to obesity. Indeed, ANG II increases fat cell growth and differentiation, increases synthesis, uptake and storage of fatty acids and triglycerides and possibly inhibits lipolysis. Evidence obtained using genetically modified animals has shown that the amount of body fat is directly related to the amount of ANG II, i.e., animals with low levels of ANG II have reduced fat stores while animals with excessive ANG II have increased fat stores. In humans, epidemiological evidence has shown that body fat is correlated with angiotensinogen, a precursor of ANG II, or other components of the RAS. Furthermore, blocking the production and/or actions of ANG II with drugs or natural substances decreases body fat. The decrease in body fat caused by such treatments predominantly occurs in abdominal fat depots and appears to be independent of energy intake and digestibility. Clearly, ANG II has an important role in the accumulation of body fat and the possibility exists that treatment of obesity will be enhanced by the use of natural or synthetic substances that interfere with ANG II.