Psychosocial factors at home and at work and levels of salivary cortisol

BackgroundSalivary cortisol as a physiological measure of stress has attracted great interest in recent years.MethodA 55 women and 28 men, all healthy volunteers, were included in a study on psychosocial factors at work and at home and salivary cortisol. General linear models, univariate and repeated measures, respectively, were used to evaluate the associations between psychosocial factors and cortisol excretion measured six times during a working day. Age, physical activity, tobacco use and the time of the first saliva sample were used as covariates.ResultsIn the women, high degrees of time pressure, effort and effort reward imbalance were significantly associated with higher levels of cortisol. In the men, high degrees of effort, effort reward imbalance and overcommitment were significantly associated with higher levels of cortisol.ConclusionPsychosocial factors are of significance to the level of salivary cortisol. The study emphasises the benefits of taking physiological measurements of stress in epidemiological studies.     

Psychosocial factors at home and at work and levels of salivary cortisol

BACKGROUND: Salivary cortisol as a physiological measure of stress has attracted great interest in recent years. METHOD: A 55 women and 28 men, all healthy volunteers, were included in a study on psychosocial factors at work and at home and salivary cortisol. General linear models, univariate and repeated measures, respectively, were used to evaluate the associations between psychosocial factors and cortisol excretion measured six times during a working day. Age, physical activity, tobacco use and the time of the first saliva sample were used as covariates. RESULTS: In the women, high degrees of time pressure, effort and effort reward imbalance were significantly associated with higher levels of cortisol. In the men, high degrees of effort, effort reward imbalance and overcommitment were significantly associated with higher levels of cortisol. CONCLUSION: Psychosocial factors are of significance to the level of salivary cortisol. The study emphasises the benefits of taking physiological measurements of stress in epidemiological studies.     

Psychosocial factors at home and at work and four-year progression in intima media thickness

This study analyzed the relationship between psychosocial factors and progression in intima media thickness (IMT). In 1998 and 2002, 95 healthy participants underwent a clinical examination, including ultrasound of the arteria carotis communis (ACC). IMT progression in women was 0.033 mm/year (SD = 0.033) and in men 0.048 mm/ year (SD = 0.033). For cohabiting women as opposed to single women, the means for total IMT progression over the 4 years were, respectively, 0.137 (SE = 0.019) and 0.016 (SE = 0.048) mm. For women with above average as opposed to below average mean scores of effort, IMT progression were 0.149 (SE = 0.026) and 0.098 (SE = 0.024) mm, respectively. For men without children as opposed to men with children, mean scores for IMT progression were 0.231 (SE = 0.029) and 0.137 (SE = 0.028) mm, respectively. For men above average as opposed to those below average, scores of effort—reward imbalance IMT progression were 0.216 (SE = 0.030) and 0.155 (SE = 0.027) mm, respectively. Adjustment for confounders did not change the results significantly. We found that psychosocial factors were independent significant predictors of IMT progression. The associations were different between the genders.     

The influence of day and night work on the circadian variations of cardiovascular performance

Summary Circadian variations of the pre-ejection period, Q-T interval, heart rate and oral temperature at rest and in day and night shift work were investigated. At rest, pronounced circadian variation was found in heart rate, pre-ejection period and Q-T interval. The ratio between Q-T interval and heart rate also shows a distinct circadian variation. When working, the rest rhythms of the variables were obscured. The physiological implications for shift work are discussed.Supported by the National Swedish Board for Technical Development, Grants No. 76-7096 I and 78-4307     

The impact of task controllability on perceived control and cardiovascular processes

This article examines the impact of task control on perceived control and cardiovascular processes. Fifty‐eight undergraduates performed a computer task where the functionality of the computer mouse was used to manipulate task control. Results are consistent with the proposition that actual control triggers an initial physiological response which can be modified temporally later by perceived control and that male participants react psychologically faster to changes in task control than female participants.     

Caffeine affects cardiovascular and neuroendocrine activation at work and home

OBJECTIVE: This study investigated the effects of moderate doses of caffeine on ambulatory blood pressure and heart rate, urinary excretion of epinephrine, norepinephrine, and cortisol, and subjective measures of stress during normal activities at work and at home in the evening. METHODS: Healthy, nonsmoking, habitual coffee drinkers (N = 47) participated in 3 days of ambulatory study. After a day of ad lib caffeine consumption, caffeine (500 mg) and placebo were administered double-blind in counter-balanced order on separate workdays. Ambulatory blood pressure and heart rate were monitored from the start of the workday until bedtime. Urinary excretion of catecholamines and cortisol was assessed during the workday and evening. RESULTS: Caffeine administration significantly raised average ambulatory blood pressure during the workday and evening by 4/3 mm Hg and reduced average heart rate by 2 bpm. Caffeine also increased by 32% the levels of free epinephrine excreted during the workday and the evening. In addition, caffeine amplified the increases in blood pressure and heart rate associated with higher levels of self-reported stress during the activities of the day. Effects were undiminished through the evening until bedtime. CONCLUSIONS: Caffeine has significant hemodynamic and humoral effects in habitual coffee drinkers that persist for many hours during the activities of everyday life. Furthermore, caffeine may exaggerate sympathetic adrenal-medullary responses to the stressful events of normal daily life. Repeated daily blood pressure elevations and increases in stress reactivity caused by caffeine consumption could contribute to an increased risk of coronary heart disease in the adult population.     

Exposure to bright light and darkness to treat physiologic maladaptation to night work

Working at night results in a misalignment between the sleep-wake cycle and the output of the hypothalamic pacemaker that regulates the circadian rhythms of certain physiologic and behavioral variables. We evaluated whether such physiologic maladaptation to nighttime work could be prevented effectively by a treatment regimen of exposure to bright light during the night and darkness during the day. We assessed the functioning of the circadian pacemaker in five control and five treatment studies in order to assess the extent of adaptation in eight normal young men to a week of night work. In the control studies, on the sixth consecutive night of sedentary work in ordinary light (approximately 150 lux), the mean (+/- SEM) nadir of the endogenous temperature cycle continued to occur during the night (at 3:31 +/- 0:56 hours), indicating a lack of circadian adaptation to the nighttime work schedule. In contrast, the subjects in the treatment studies were exposed to bright light (7000 to 12,000 lux) at night and to nearly complete darkness during the day, and the temperature nadir shifted after four days of treatment to a significantly later, midafternoon hour (14:53 +/- 0:32; P less than 0.0001), indicating a successful circadian adaptation to daytime sleep and nighttime work. There were concomitant shifts in the 24-hour patterns of plasma cortisol concentration, urinary excretion rate, subjective assessment of alertness, and cognitive performance in the treatment studies. These shifts resulted in a significant improvement in both alertness and cognitive performance in the treatment group during the night-shift hours. We conclude that maladaptation of the human circadian system to night work, with its associated decline in alertness, performance, and quality of daytime sleep, can be treated effectively with scheduled exposure to bright light at night and darkness during the day.     

Psychosocial factors related to perceived compliance with cystic fibrosis treatment.

The present research was designed to investigate the adjustment of patients with cystic fibrosis (CF) and their families as well as the relationship between adjustment and physician perceptions of compliance with CF treatment. Patient and family adjustment was assessed by means of the Personality Inventory for Children as well as measures of marital adjustment, depression, and social isolation completed by mothers of CF patients. Results indicated no characteristic pattern of psychopathology or adjustment problems. However, higher levels of perceived compliance with CF treatment were found to be associated with less satisfactory marital relationships and with less frequent maternal social contacts. These findings are discussed in terms of achieving a balance between compliance and psychological adjustment.     

Dysthymic disorder: clinical characteristics in relation to age at onset

BACKGROUND: The variability in the clinical presentation of dysthymia has given rise to a rich debate in literature, and various hypotheses have been proposed. One is that the clinical presentation differs in relation to age at onset. The aim of the study was to evaluate differences in socio-demographic and clinical characteristics in a sample of patients with dysthymia (DSM-IV), in relation to age at onset. METHOD: 84 consecutive outpatients with a diagnosis of dysthymia (DSM-IV) were studied. All subjects were evaluated by a semistructured clinical interview and the following rating scales: HAM-A, HAM-D, MADRS, Paykel's Interview for Recent Life Events. RESULTS: 23.8% of the sample had early-onset (<21 yrs) dysthymia. Patients with early-onset disorder were significantly younger at the observation, more frequently female and single. They had a significantly longer duration of illness and in a significantly higher percentage had already received a specialist treatment before admission in the present trial. No differences in the frequency of symptoms were observed. A significantly higher percentage of patients with late-onset disease reported at least one stressful event in the year preceding the onset of dysthymia. A positive history of major depression was significantly more common among the early-onset group; social phobia, panic disorder and conversive disorder were also more frequent in this group. The late-onset patients frequently presented generalized anxiety disorder, substance abuse and somatization disorder. LIMITATION: The study is retrospective and enrolls a limited number of cases. CONCLUSIONS: The present study agrees with other reports on the differences in clinical presentation of dysthymia according to age at onset. Although they are not actually related to age at onset, some interesting findings emerged in the symptomatological characterization of the disorder, referring to the diagnostic criteria proposed in DSM-IV.     

Alterations of the cortisol quiescent period after experimental night work with enforced adaptation by bright light and its relation to morningness

A previous study where the delay of the circadian system was induced by bright light that was adjusted to the individual melatonin onset revealed concomitant alterations of the cortisol quiescent period that correlated inversely with morningness. This meta-analysis focuses on the question whether this applies to experimental shift work with fixed light schedules. The analysis bases on data from three laboratory studies where healthy young men [18 evening-, 20 neither-, 11 morning types (MT)] performed three consecutive day shifts and then three consecutive night shifts. Phase assessment procedures were performed after every three shifts to ascertain the diurnal melatonin profile for the quantification of the phase shift and the diurnal cortisol profile for the determination of the cortisol quiescent period. Work was done in 150–200 lx but phase delays were promoted by bright light (1,500–2,000 lx) either by 4-h pulses in the first part of the night or by continuous exposure during the whole night shifts. These different light scenarios caused similar phase delays. Morningness was inversely related to the phase delay and to the alteration of the cortisol quiescent period. The latter became shorter in morning and longer in evening types. Thus, MT are disadvantaged, even if treated with bright light. This suggests that morning-oriented career shift workers might have a higher health risk. These results need to be replicated by directed studies and verified by epidemiological studies.     

Psychosocial and demographic characteristics relating to vaccine attitudes in Australia

Objective

Distrust in vaccination is a public health concern. In responding to vaccination distrust, the psychosocial context it occurs in needs to be accounted for. But this psychosocial context is insufficiently understood. We examined how Australians’ attitudes to childhood vaccination relate to broader psychosocial characteristics pertaining to two key areas: health and government.

Psychosocial cardiovascular risks--on the double loads in women

The author discusses gender differences in the psychosocial correlates of cardiovascular risk. A moderate amount of overtime work was associated with a decreased risk of myocardial infarction in men but a corresponding increased risk in women. The reason for this difference may be the double role (home and paid work) of women. Emotional states in diaries differed between men and women in the same occupations, and these differences seemed to some extent to be occupation specific.     

Pace variation and control of work pace as related to cardiovascular, neuroendocrine, and subjective responses

Two studies of paced and self-paced arithmetic performance are reported. Heart rate and blood pressure were recorded and ratings of subjective arousal obtained. In one of the studies, plasma levels of catecholamines and cortisol were determined. Under externally paced experimental conditions pace variation was found to be quantitatively related to changes in systolic and diastolic blood pressure, as well as to ratings of stress and irritation. This was not the case for heart rate or positively evaluated aspects of subjective arousal. Performance was better and ratings of stress and irritation were lower during self-paced than during paced work at a comparable work pace. In one of the studies the diastolic blood pressure increased less when subjects controlled the pace. Plasma catecholamines did not increase significantly during either externally or self-paced work, but adrenaline tended to increase during paced work. Our findings give partial support to the suggestion that personal control may attenuate sympathoadrenal activation and cardiovascular reactivity.     

Psychosocial stress and cardiovascular disease: pathophysiological links

The remarkable decline in cardiovascular disease (CVD) experienced in developed countries over the last 40 years appears to have abated. Currently, many CVD patients continue to show cardiac events despite optimal treatment of traditional risk factors. This evidence suggests that additional interventions, particularly those aimed at nontraditional factors, might be useful for continuing the decline. Psychosocial stress is a newly recognized (nontraditional) risk factor that appears to contribute to all recognized mechanisms underlying cardiac events, specifically, (a) clustering of traditional cardiovascular risk factors, (b) endothelial dysfunction, (c) myocardial ischemia, (d) plaque rupture, (e) thrombosis, and (f) malignant arrhythmias. A better understanding of the behavioral and physiologic associations between psychosocial stress and CVD will assist researchers in identifying effective approaches for reducing or reversing the damaging effects of stress and may lead to further reductions of CVD morbidity and mortality.     

Maximal physical work performance with European standard based fire-protective clothing system and equipment in relation to individual characteristics

Every fire fighter needs to wear fire-protective clothing and a self-contained breathing apparatus (SCBA) several times a year while carrying out various fire-fighting and rescue operations in hazardous work environments. The aim of the present study was to quantify the effects of a multilayer turnout suit designed to fulfil European standard EN 469 used over standardized (Nordic) clothing and with SCBA (total mass 25.9 kg) on maximal physical work performance, and to evaluate the relationship between individual characteristics and power output with the fire-protective clothing system and SCBA. The subjects were 12 healthy firemen aged 26–46 years. The range of their body mass, body fat and maximal oxygen consumption was 69–101 kg, 10–20% and 2.70–5.86 1·min^–1, respectively. The maximal tests without (control) and with the fire-protective clothing system and SCBA were carried out on a treadmill in a thermoneutral environment. When compared to the control test, the decrease in the maximal power output in terms of maximal working time and walking speed averaged 25% (P < 0.001) varying from 18% to 34% with the fire-protective clothing system and SCBA. At maximum, no significant differences were found in pulmonary ventilation, absolute oxygen consumption, the respiratory exchange ratio, heart rate, systolic blood pressure, the rate-pressure product, mechanical efficiency, and the rating of perceived exertion between the tests with and without the fire-protective clothing system and SCBA. The reduction of the power output was related to the extra mass of the fire protective clothing and SCBA. In this study, robust build and parameters associated with good anaerobic capacity were the most powerful individual characteristics contributing to the smallest drop in the power output with the fire-protective clothing system and SCBA. All possible means to decrease the mass of both the fire-protective clothing system and SCBA for maintaining the sufficient power output in physically demanding fire-fighting and rescue tasks need to be considered.     

Psychosocial indexes and cardiovascular risk factors in a community sample

BACKGROUND: Psychosocial characteristics might contribute to a more comprehensive understanding of cardiovascular disease as it is increasingly recognised that biomedical risk factors do not fully explain its dynamics. This study aimed to describe psychometric indexes in a Portuguese community sample relating them to known cardiovascular disease risk factors. METHODS: Anthropometric, blood pressure, serum measurements and information on demographic, social, medical and behavioural characteristics were obtained for 215 women and 156 men. Self-administered questionnaires were used for the psychometric evaluation (Bortner scale, Beck Depression Inventory, Hopkins Symptom Distress Checklist 90-Revised, Psychological General Well-Being and the Nottingham Health Profile, NHP). RESULTS: There were significant differences according to gender regarding almost every psychometric dimension assessed. After adjusting for the presence of different biomedical risk factors, significant decreasing mean behaviour pattern scores were found with increasing age. Mean depression scores were significantly higher in women and in individuals with lower educational level. As to general psychological well-being, the highest scores were obtained for men and individuals with higher educational level. For the assessed dimensions of quality of life, as well as indexes of psychopathology, men scored better than women. No significant differences in mean scores of behaviour pattern, depression, psychological general well-being and dimensions of NHP were found according to the presence of an increasing number of cardiovascular risk factors. CONCLUSIONS: The study shows that the clustering of multiple biomedical risk factors does not result in additive deleterious psychological effects and that psychometric indexes are mainly dependent on gender and education, common confounders in most studies evaluating cardiovascular risk factors.     

Preterm infants prefer to be awake at night

Wakefulness distribution during a 24-h period was studied in ten low-risk preterm and near term infants through video-recording. The highest amount of wakefulness was found in the night-time period between 02:00 and 05:00 h. This result is different from what was observed in infants during the first year of life, and similar to what was found in the foetus.     

心肌素与心血管疾病的研究进展

 心肌素（myocardin）是2001年发现的在心血管组织特异表达的转录辅助因子,心肌素与血清效应因子（SRF）共同控制着心肌和平滑肌细胞特异基因的表达,其活性的改变与人类主要心血管疾病如动脉粥样硬化、心肌肥大、高血压的发生发展关系非常密切。本文就心肌素分子结构、表达调控以及与心血管疾病关系的研究进展作一综述。