摘要:

ObjectiveThe purpose of this study is to provide data on the prevalence of insomnia and hypersomnia among older persons, the stability of these sleep complaints over time, and factors associated with disturbed sleep, in particular age.MethodData on symptoms of insomnia and hypersomnia were examined for the 1994 to 1995 cohort of the Alameda County Study. In addition to age, the effects of gender, education, marital status, chronic medical conditions, functional impairment, life events, financial strain, and mood disturbance were examined using multiple logistic analyses.ResultsPrevalence in 1994 was 23.4% for insomnia and 6.8% for hypersomnia. There was moderate concordance between sleep complaints in 1994 and 1995 (kappa = .43). There was a tendency for insomnia and hypersomnia to increase with age in 1995, but not in 1994. Only gender, mood disturbance, and chronic health problems predicted insomnia. Life events, mood disturbance, and chronic conditions predicted hypersomnia. Age, net of the effects of other factors, was not associated with risk of either insomnia or hypersomnia.ConclusionsThe results contribute to the expanding body of evidence concerning the important roles of psychological and somatic dysfunction in sleep disturbance. Age in and of itself is not a risk factor for insomnia or hypersomnia. That is, after adjustment for an array of putative risk factors for sleep problems, it seems the association between sleep difficulties and age is primarily due to depressed mood and physical health problems.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe effects of burnout and perceived stress on early morning free cortisol levels after awakening were investigated in a group of teachers. Previous studies revealed that cortisol levels show a significant increase after awakening, with high intraindividual stability.MethodsSixty-six teachers from local public schools (42 women and 24 men, mean age 42 +/- 5 years) were asked to sample saliva for cortisol analysis on 3 consecutive days. On each day, cortisol levels were measured at the time of awakening and 15, 30, and 60 minutes thereafter. On the night before the third day, subjects took 0.5 mg dexamethasone orally for testing glucocorticoid feedback inhibition. Burnout and perceived stress were measured by three different questionnaires.ResultsPerceived stress correlated with increases of cortisol levels during the first hour after awakening after dexamethasone pretreatment. In addition, teachers scoring high on burnout showed lower overall cortisol secretion on all sampling days, and a higher suppression of cortisol secretion after dexamethasone administration. In the subgroup of teachers with both high levels of perceived stress and high levels of burnout, a lower overall cortisol secretion was observed on the first 2 days, with stronger increases during the first hour after awakening after dexamethasone suppression. This subgroup also showed the lowest self-esteem, the highest external locus of control, and the highest number of somatic complaints.ConclusionsThese results demonstrate differential effects of burnout and perceived stress on hypothalamic-pituitary-adrenal axis regulation.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThis study was conducted to determine whether large family responsibilities and their combination with high job strain were associated with an increase in ambulatory blood pressure (BP) among white-collar women.MethodsA cross-sectional study was conducted in a stratified random sample of 199 white-collar women with or without children who were employed full time in jobs involving high or low strain. These women were selected from a population of 3183 women of all ages, employed in eight organizations in Quebec City, Canada. Subjects wore an ambulatory BP monitor for 24 hours during a working day. Mean BPs were calculated. Different measures of family responsibilities were used, based on the number of children and their ages, and domestic work. Job strain was measured using the Job Content Questionnaire recommended by Karasek.ResultsFamily responsibility measures were significantly related to diurnal BP among women holding a university degree (N = 69). Indeed, women having large family responsibilities had increases in systolic and diastolic BPs of 2.7 to 5.7/1.8 to 4.0 mm Hg (p <or=to .05). Among women holding a university degree, increases in diurnal systolic and diastolic BPs reached 8.1 to 10.9/5.5 to 7.1 mm Hg (p <or=to .01) among women having both large family responsibilities and high job strain. These results were independent of confounders. There was no significant association among women without a university degree (N = 130).ConclusionsLarge family responsibilities were associated with significant increases in diurnal systolic and diastolic BPs among white-collar women holding a university degree. In these women, the combined exposure of large family responsibilities and high job strain tended to have a greater effect on BP than the exposure to only one of these factors.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThis study was conducted to determine whether an increase in salivary free cortisol would be reliably elicited by a midday meal, thus providing a convenient physiological challenge to the hypothalamic-pituitary-adrenal (HPA) axis, and whether this cortisol release depended on the protein content of the meal.MethodIn healthy men, free cortisol was measured in saliva samples taken before and after two identical protein-rich midday meals (39% energy as protein) and compared with a day on which no meal was eaten. Next, in healthy women in a nonclinical setting, salivary cortisol was measured before and after a protein-rich meal (32% energy as protein) on one day and a low-protein meal (5% energy as protein) on another day. Measures of mood, appetite, and psychological well-being were also taken.ResultsAn acute meal-dependent increase in salivary cortisol occurred, which was reliable over 2 test days. This increase in cortisol depended on the proportion of protein in the meal, increasing after the high-protein but not the low-protein meal. The extent of this increase in cortisol correlated significantly with poor psychological well-being in women. Some postmeal improvement of mood (positive affect) was associated with the high- but not the low-protein meal.ConclusionsThe cortisol response to meals may have implications for the effects of meal composition on mood, cognitive function, and food choice. The measurement of free cortisol in saliva provides a psychologically stress-free and reliable technique to assess the cortisol response to a standard protein-rich meal, ie, a physiological challenge to the HPA axis in men and women that could be investigated in naturalistic settings outside the laboratory.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectivesThis study evaluated the effectiveness of cardiac counseling and rehabilitation programs led by a nurse counselor, compared with normal care on outcomes for myocardial infarction (MI) patients and their partners.MethodsA randomized controlled trial with follow-up to 1 year was conducted with 100 patients recruited within 72 hours of a first MI and their partners: a Control group received normal care; an Inpatient group received cardiac rehabilitation from a nurse counselor while in hospital; and an Extended group received the same cardiac rehabilitation as the Inpatient group, but with additional sessions continuing up to 6 weeks after discharge from hospital. The scales for main outcome measures were 1) knowledge of heart disease and treatment (correct, misconceptions, and uncertainty); 2) mood (Hospital Anxiety and Depression Scale); 3) satisfaction; 4) disability (Functional Limitations Profile).ResultsInpatient cardiac counseling and rehabilitation resulted in more knowledge, less anxiety, less depression, and greater satisfaction with care in both patients and partners and in less disability in patients, with effects enduring to 1 year. There was some evidence of additional benefit from the Extended program. Both nurse counselors achieved benefits on all outcome variables.ConclusionsThis Inpatient cardiac counseling and rehabilitation program resulted in significant and enduring benefits of clinical value. It is likely that it would be acceptable to most post-MI patients, many of whom are not offered or are unable to accept outpatient cardiac rehabilitation.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveLaboratory research indicates that the presence of a supportive other can reduce physiological responses to a stressor. Whether there are gender differences, either on the part of the provider or the recipient, in this social support effect is explored. Such differences might shed some light on the frequent epidemiological reports of gender differences in social support and health.MethodsMale and female subjects gave an impromptu speech and received either standardized supportive or nonsupportive feedback from a male or female confederate. Blood pressure and heart rate were monitored continuously during baseline and speech periods.ResultsSpeakers with a supportive female audience showed a systolic increase of 25 mm Hg over baseline. Those with a nonsupportive female audience increased 36 mm Hg. A supportive male audience led to increases of 32 mm Hg, and a nonsupportive male audience 28 mm Hg. There was no significant effect of gender of subject.ConclusionsResults indicate that social support provided by women reduced cardiovascular changes for both male and female speakers compared with presence of a nonsupportive female audience. Social support from men did not. These findings suggest a possible mechanism that might help explain the epidemiological literature on the relationship between gender, social support, and health. The findings are consistent with the notion that married men are healthier because they marry women. Women do not profit as much from marriage or suffer as much from separation, in terms of health outcomes, because the support they gain or lose is the less effective support of a man. These findings render more plausible the possibility that differences in social support might contribute to health differences, through the dampening of cardiovascular responses to stress.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe longitudinal association between blood pressure (BP) reactivity to a video game and resting BP 3 to 4 years later was investigated in 83 Samoan adolescents from American and (Western) Samoa as part of a multidisciplinary study of cardiovascular disease (CVD) risk in modern Samoans.MethodsParticipants ranged in age from 11 to 14 years at baseline, in 1992 to 1993, and 14 to 18 years at follow-up in 1996. Video game BP reactivity was defined as the residual score of the regression of the maximum BP during the video game on the minimum resting BP before the video game. The predictive effect of baseline video game BP reactivity on follow-up resting BP was tested using regression models with baseline resting BP, baseline body mass index (BMI), and age as covariates.ResultsSystolic BP reactivity to the video game at baseline was significantly, p = .04, and independently associated with resting systolic BP 3 to 4 years later. Samoan adolescents who had higher systolic BP reactivity scores at baseline had significantly higher resting systolic BP at follow-up after adjustment for the significant effects of baseline resting systolic BP, age, and BMI. There were no interactions between sex and reactivity or between residence, American Samoa or (Western) Samoa, and reactivity in the models, indicating that the effects of systolic BP reactivity in early adolescence on later adolescent resting systolic BP were similar in the entire study sample.ConclusionsVideo game cardiovascular reactivity seems to assess aspects of psychophysiological arousal and prospective CVD risk in Samoan adolescents of both sexes residing in both Samoas, and may be useful for understanding the role of psychosocial stress and health in modernizing societies.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveAdministration of the muscle relaxant carisoprodol and placebo was crossed with information that was agonistic or antagonistic to the effect of carisoprodol. It was investigated whether information alone induced physiological and psychological responses, and whether information modified the response to the drug.MethodsHalf of the subjects received capsules containing 525 mg carisoprodol together with information that the drug acted in a specific way (Groups Relaxant/C, Stimulant/C, and No Information/C). The other half of the subjects received lactose (Groups Relaxant/L, Stimulant/L, and No Information/L). Dependent variables were blink reflexes and skin conductance responses, subjective measures of tension and sleepiness, and serum carisoprodol and meprobamate concentrations. Recordings were made between 15 and 130 minutes after administration of the capsules.ResultsThe Stimulant/L group reported more tension compared with the other two groups, and carisoprodol increased tension even more in the Stimulant/C group. The Relaxant/C group displayed higher levels of carisoprodol serum concentration compared with the other groups that received carisoprodol.ConclusionsReported tension was modulated in the direction suggested by the stimulant information. The effect of carisoprodol on tension was also modulated by stimulant information. Increased carisoprodol absorption in the group that received relaxant information could be a mechanism in the placebo response.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID