Biomedical subjects

A Steptoe

Publications and source records attributed to A Steptoe.

At least 91 records · Page 5Linked to original sources

PubMed1995

Tobacco smoking in young adults from 21 European countries: association with attitudes and risk awareness.

Information concerning tobacco smoking was obtained in a survey of 16,483 students aged 18-30 years from 21 European countries. Belief in the benefits to health of not smoking were also assessed. Risk awareness was measured in terms of knowledge of the links between smoking and disease. The overall age-adjusted prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations were observed across country samples. Significant sex differences were found in only a minority of cases. The inclusion of respondents who stated that they had sometimes smoked in the past substantially reduced variations in prevalence across country samples. Beliefs in the health benefits of not smoking were consistently associated with smoking behaviour. Awareness of the link between smoking and lung cancer was uniformly high, but awareness of the role of smoking in heart disease varied considerably across country samples, and averaged only 64.4% in men and 62.9% in women. In the majority of countries, risk awareness was greater among smokers than non-smokers. The results suggest that in this selected sector of the population of young adults in Europe, sex differences in smoking are relatively minor, robust associations between attitudes and smoking behaviour can be identified, and there are major gaps in risk awareness.

Adolescent↗

PubMed1995

Effects of academic examination stress on eating behavior and blood lipid levels.

The influence of academic examination stress on eating behavior and lipid profiles and the moderating effect of dietary restraint, trait anxiety, and social support availability was assessed in university students. One hundred and seventy-nine students were divided into exam-stress groups (51 women, 64 men) and control groups (48 women, 16 men) and were assessed at baseline and then within 2 weeks of exams or an equivalent point for the control group. Perceived stress, emotional well-being, and fasting lipid profiles were measured, and dietary information was collected by interview. The exam-stress group reported significant increases in perceived stress and deterioration in emotional well-being at the exam sessions compared with baseline sessions. No general effects of exam stress on food intake were observed, and there was no interaction between stress and dietary restraint. However, students in the exam-stress group with high trait anxiety and low social support showed significant increases in total energy intake between baseline and exam sessions, whereas individuals with low trait anxiety and high social support showed a reduction in energy intake. Students with high trait anxiety and low social support showed increases between baseline and exam sessions in the amount of fat and saturated fat consumed. Women in the exam-stress group taking oral contraceptives showed a significant increase in total cholesterol between baseline and exam sessions. The results are discussed in relation to the effects of naturally occurring episodic stress on health behavior and on lipid profiles.

Journal Article↗

PubMed1995

Cardiovascular stress reactivity and job strain as determinants of ambulatory blood pressure at work.

OBJECTIVE: To test the hypothesis that cardiovascular reactivity to laboratory mental stressors interacts with job strain in predicting blood pressure at work. DESIGN: Ambulatory monitoring of blood pressure and heart rate was carried out for an 8-h period on a work day and on an equivalent non-work day in 49 male firefighters. METHODS: Participants were recruited from a larger cohort (n = 90) on the basis of showing high or low systolic reactions to mental arithmetic 15-24 months previously, coupled with high or low ratings of perceived job strain (high demand-low control). Four groups were tested: low job strain-low systolic reactors (n = 12), low job strain-high systolic reactors (n = 12), high job strain-low systolic reactors (n = 12) and high job strain-high systolic reactors (n = 13). RESULTS: Systolic blood pressure (SBP) was higher on work than non-work days, and diastolic blood pressure and heart rate were higher at work in the morning but not in the afternoon. These effects were due partly to posture and physical activity differences between the two days. Neither job strain nor laboratory reactivity independently predicted ambulatory blood pressure. However, SBP was significantly higher during the afternoon at work in the high job strain-high systolic reactors than in the other groups. This was independent of baseline SBP, and was not due to differences in posture or activity at the time of recordings. Ambulatory SBP reactivity (difference between ambulatory values and workplace resting levels) in the afternoon at work was also elevated significantly in high job strain-high systolic reactors compared with in the other groups. CONCLUSIONS: The results support the hypothesis that individual differences in the appraisal of work stress modulate the relationship between stress reactivity and ambulatory blood pressure.

Adult↗

PubMed1995

Breast self-examination: attitudes and practices among young women in Europe.

Breast self examination (BSE) is recommended for the early detection of breast cancer in the European Code against Cancer. Evidence from North America suggests that there is reasonable public awareness of its importance, but compliance with regular BSE is reported by only a minority of young women. Attitudes to and practice of BSE has rarely been studied outside North America. In the present study, attitudes to BSE were evaluated by questionnaire in a sample of 16,486 students aged 17-30 from 20 European countries. Frequency of BSE practice was reported by the 9,181 women in the sample. Information on public recommendations concerning BSE was obtained from cancer organizations in each country. The data were collected as part of the European Health Behaviour Survey, an international study on health beliefs and health behaviour. The results showed that BSE was recommended in 16 countries and 'breast awareness' in two, while two countries did not recommend self-examination. 54% of women reported as never having practiced BSE. Regular practice (monthly) was reported by only 8% of the sample, with another 36% reporting occasional BSE. Significant differences emerged between centres in different countries ranging from 6% to 15% reporting regular BSE. Attitude towards BSE was a significant predictor of BSE practice within each centre and across all centres combined. Attitudes towards BSE were significantly less positive in the two centres from countries without BSE recommendations than in the others, but levels of practice were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

Weight concerns and eating patterns: a survey of university students in Europe.

OBJECTIVE: To assess a wide range of health-related behaviours, beliefs and knowledge in educated young adults. DESIGN: A standardized questionnaire was developed, translated, and administered in university classes. SUBJECTS: 16,486 university students in 21 European countries. DEPENDENT VARIABLES: Reported and self-perceived body size, eating practices and weight concerns. RESULTS: Body Mass Index (BMI; weight (kg)/height (m)2) was slightly different between countries, and rather low overall (20.5 in women and 22.0 in men). These low values can be attributed to the young age of respondents (21.4 years) and to their presumably high socio-economic status. Very few were overweight (8%) and less than 1% were obese. In spite of the low BMI, many perceived themselves as overweight, especially among women. Trying to lose weight (44% of women, 17% of men) and dieting (14% in women and 3% in men) were not uncommon, although large differences existed between countries. Dieting affected snack and meal patterns: dieters reported fewer snacks and female dieters also reported fewer meals than non-dieters. Breakfast was skipped by almost twice as many dieters as non-dieters. Some evidence of anorexia nervosa (dieting in very underweight individuals) appeared. CONCLUSION: The data suggest excessive responses to weight loss pressures and imperfect translation of nutritional advice into behaviours.

Adolescent↗

PubMed1994

Testicular self-examination: attitudes and practices among young men in Europe.

BACKGROUND: Testicular self examination (TSE) is recommended for the early detection of testicular cancer. Evidence from North America suggests there is only limited public awareness of its importance among the young male population. Compliance with regular TSE is found in only a small minority of young men. Attitudes toward and practice of TSE have rarely been studied outside North America. METHOD: Attitudes to TSE were evaluated by questionnaire in a sample of 16,486 students. Frequency of TSE practice was reported by the 7,304 men in the sample. The data were collected as part of the European Health Behavior Survey, an international study on health beliefs and health behavior. RESULTS: Eighty-seven percent of men reported never having practiced TSE. Regular practice (monthly) was reported by only 3% of the sample, with another 10% reporting occasional TSE. Significant differences emerged between countries, ranging from 76% of German men to 98% of Icelandic men reporting no TSE. Men rated TSE as less important to health than women. Attitude toward TSE among men was a significant predictor of TSE practice. CONCLUSION: Both the low levels of TSE and the low ratings of the importance of TSE suggest that young men in Europe are unaware of the value of this comparatively simple method of early detection of cancer. If a highly educated population group in the "at risk" age category is not carrying out the recommendations, it is unlikely that there are higher levels of compliance in other groups. These results suggest an important role for health education in the early detection of testicular cancer.

Adolescent↗

PubMed1994

What the experts think: a European survey of expert opinion about the influence of lifestyle on health.

This paper describes an assessment of expert medical and epidemiological opinion about the role of lifestyle in health, carried out by means of a questionnaire survey of senior members of academic departments of public health, epidemiology and social medicine in Western European universities. Estimates were made of the influence of eight lifestyle factors--smoking, alcohol consumption, exercise, stress, body weight, dietary fat, fibre and salt--on the aetiology or course of five disorders: heart disease, high blood pressure, lung cancer, breast cancer and diabetes. One hundred and fifty responses were received from scientists and clinicians from 16 countries. Respondents had an average of 17.8 years experience in their discipline (range 5-40 years). The only links to be endorsed as definite by over 90% of respondents were those between smoking and both heart disease and lung cancer. However, more than 70% considered alcohol consumption, exercise, stress body weight and dietary fat to be definite or probable influences on heart disease. Smoking, alcohol, exercise, stress, body weight and salt intake were endorsed as relevant to high blood pressure by more than 70%. Opinions differed widely about the influence of lifestyle on breast cancer and diabetes. Experts from the United Kingdom and Republic of Ireland were less positive than respondents from other countries about the influence of stress, dietary fat, fibre and salt on disease. The results indicate that comparatively few lifestyle factors were believed to be unequivocally related to any of the five disorders. Experts from the UK and Ireland were generally les likely to endorse lifestyle-disease links than those from other European countries.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗

PubMed1994

Stress management in cardiac patients: a preliminary study of the predictors of improvement in quality of life.

The effects on quality of life of a 12-wk relaxation-based stress management programme emphasizing improvements in self-confidence and control was assessed in seventy-eight patients following myocardial infarction, coronary artery bypass surgery or coronary angioplasty. Measures of psychological state, functional mobility level, social activity and chest pain were obtained before and after treatment and at 6 month follow-up. Fifty-one (66%) of patients completed the programme. Significant reductions in anxiety and depression and improvements in psychological general well-being, activities of daily living, social activity, quality of interactions and satisfaction with sexual relationships were observed posttreatment, and these were largely maintained at follow-up. Reductions in chest pain and improvements in spouse ratings of psychological state were also recorded. Similar responses were measured in myocardial infarction and surgery patients. Predictors of outcome in three aspects of quality of life, anxiety, activities of daily living and social activity, were assessed. Improvements in these three domains were independent of one another, and their predictors were also different. Reductions in anxiety were associated with neurotic dispositions and openness to new experience, while improvements in activities of daily living were predicted by work status, age and time since infarction or surgery. Implications for the use of stress management in cardiac rehabilitation are discussed.

Activities of Daily Living↗

PubMed1994

Association between smoking status and cardiovascular and cortisol stress responsivity in healthy young men.

Acutely, cigarette smoking stimulates increases in blood pressure (BP), heart rate (HR), and cortisol, but little evidence is available concerning the impact of habitual smoking status on cardiovascular stress responsivity. This relation was assessed in 86 healthy male firefighters, age 19 to 31. comprising 52 nonsmokers and 34 smokers. Measures of BP, HR, salivary free cortisol, breathing pattern, and self-reported stress and alertness were obtained while subjects performed nonverbal mental arithmetic and a socially evaluative speech task. Systolic and diastolic BP were higher at rest in nonsmokers than smokers, and a consistent difference in stress responsivity was also found. BP, HR, and cortisol responses to mental arithmetic were significantly smaller in smokers than nonsmokers, with mean changes in BP (adjusted for body weight) averaging 19.3/11.0 mmHg and 28.5/15.4 mmHg in smokers and nonsmokers, respectively. There were no effects of smoking status on task performance or subjective stress responses and no differences between groups in family health history, health-related behaviors, o r psychological characteristics that might account for the reactivity difference. Possible explanations of the results are discussed, and methodological implications for cardiovascular stress reactivity studies are outlined.

Journal Article↗

PubMed1993

Anger inhibition and family history as modulators of cardiovascular responses to mental stress in adolescent boys.

Sixty boys aged 12-16 took part in an experiment in which physiological and subjective measures were obtained at rest and in response to mental arithmetic and mirror drawing tasks. Blood pressure was recorded from biological parents, and subjects were subsequently categorized as being at high family risk for cardiovascular disease if either parent had a history of coronary heart disease or hypertension, or a resting blood pressure > or = 140/85 mmHg. Twenty boys were classified as high family risk and forty as low risk. A significant interaction between family risk and a disposition towards anger inhibition was observed, with the greatest systolic blood pressure responses to tasks being recorded in high risk boys who reported high levels of anger inhibition. This effect was maintained after controlling for initial blood pressure level, age and body mass. The cardiac baroreceptor reflex was inhibited during tasks, and was lower in high than low family risk subjects. The results suggest that the tendency to inhibit anger expression interacts with familial factors in determining reactivity patterns that may be indicative of raised risk of future cardiovascular disease.

Adolescent↗

PubMed1993

Control over work pace, job strain and cardiovascular responses in middle-aged men.

OBJECTIVE: To assess the effects of control over work pace on cardiovascular stress responses in healthy middle-aged men. DESIGN: The study involved administration in the laboratory of visual matrix and mirror drawing tasks, the pace of tasks being either under the control of the subject (self-paced) or determined externally (externally paced). The work demands in the two conditions were equated. METHOD: Forty men aged 55-65 years were randomly assigned to self-paced or externally paced conditions. Blood pressure (recorded continuously using the Finapres), heart rate, cardiac baroreflex sensitivity, salivary cortisol, skin conductance and breathing pattern were monitored at rest, during task performance and at recovery following tasks. RESULTS: Blood pressure and heart rate responses were significantly greater under the externally paced than self-paced conditions. The mean increase in blood pressure during the visual matrix task averaged 19.8/9.4 versus 34.1/15.5 mmHg for the self- and externally paced conditions, and 28.2/13.7 versus 41.8/19.5 mmHg in response to mirror drawing, respectively. Performance of the matrix task was less accurate under externally paced than self-paced conditions, but the two groups did not differ in mirror drawing. A reduction in baroreflex sensitivity and increases in cortisol, respiration rate, tidal volume and skin conductance responses were recorded during tasks, but these responses did not distinguish the two groups. Men were divided on the basis of reported job strain associated with their regular work, using the demand-control model. Blood pressure and heart rate responses were particularly pronounced among men reporting high job strain who were allocated to the externally paced condition. CONCLUSIONS: Middle-aged men showed greater stress-related cardiovascular responses when they performed tasks at a pace that they could not control. This pattern may be relevant to the mechanisms through which job strain (high demands associated with low control) influences cardiovascular disease risk.

Aged↗

PubMed1993

Cardiovascular activity during mental stress following vigorous exercise in sportsmen and inactive men.

Thirty-six competitive sportsmen and 36 inactive men participated in a two-session experiment. Session 1 involved exercise to exhaustion so as to assess maximal oxygen consumption (VO2 max). In Session 2, both groups were randomized into three experimental conditions: 20 min of exercise at high intensity (70% VO2max) or moderate intensity (50% VO2max) or a light exercise control. Following 30 min of recovery, all subjects performed mental arithmetic and public speech tasks in a counterbalanced order. Cardiovascular, electrodermal, respiratory, and subjective variables were recorded. Sportsmen had higher VO2max, lower body fat, and lower resting heart rate (HR) than inactive men. A postexercise hypotensive response was observed among subjects in the 70% and 50% VO2max conditions, accompanied by baroreceptor reflex inhibition in the 70% condition. Systolic pressure was lower during mental arithmetic and during recovery from the speech task in the high-intensity than in the control group. Diastolic pressure was lower following mental arithmetic in the high-intensity group. No differences in HR reactivity, electrodermal, or respiratory parameters were observed, but baroreceptor reflex sensitivity was inhibited during mental arithmetic. The results are discussed in relation to previous reports of suppressed cardiovascular reactivity to mental stress tests following vigorous exercise and the role of stress-related processes in the antihypertensive response to physical training.

Adult↗

PubMed1992

Individual differences in the perception of bodily sensations: the role of trait anxiety and coping style.

Thirty young women participated in an experiment in which heart rate, blood pressure, respiration rate, skin conductance level and palmar sweat index were monitored at rest and during the administration of mental arithmetic, mirror drawing and cold pressor tasks. The accuracy of perception of somatic states was estimated by calculating within-subject correlations between four bodily sensations (racing heart, high blood pressure, shortness of breath and sweaty hands) and corresponding physiological parameters, assessed on eight occasions during the experiment. The accuracy of heart rate perception was highest, with a mean correlation between actual heart rate and ratings of racing heart of 0.76 and 66% of participants showing significant within-subject effects. The mean accuracy was 0.55 for systolic blood pressure, 0.48 for respiration rate, 0.47 for skin conductance level, and 0.64 for palmar sweat index. Accurate perception across physiological parameters did not cluster within individuals, and was not dependent on the range either of physiological changes or sensation ratings. Trait anxiety was not significantly associated with accuracy of somatic perception. Subjects with high trait anxiety reported larger increases in shortness of breath during tasks than did low anxious subjects, but this was not reflected in objective physiological measures. Information-seeking coping style, indexed by the monitoring scale of the Miller Behavioral Style Scale, was related to the accuracy of perception of skin conductance level and heart rate. The use of within-subject correlational strategies for assessing individual differences in perception of bodily states is discussed.

Adaptation, Psychological↗

PubMed1992

Cognitive predictors of health behaviour in contrasting regions of Europe.

Four important health behaviours--dietary fat avoidance, regular exercise, smoking and alcohol consumption--were assessed by questionnaire, together with measures of risk awareness and beliefs about the importance of each behaviour for health, in comparable samples of young adults from eight countries: Belgium, England, Germany, Hungary, Ireland, Poland, Portugal and Spain. Results from 3223 men and 3930 women were analysed. Substantial differences in the prevalence of behaviours were identified, but no country consistently showed the most or least healthy profile across behaviours. Women tended to smoke and drink less than men and attempted to avoid dietary fat to a greater extent, while men exercised more than women. Ratings of the importance of behaviours for health were high, while risk awareness showed wide variations, with lower scores from samples in southern and eastern Europe. Across countries, few associations were observed between the prevalence of behaviour and either mean belief ratings or risk awareness. However, in comparisons of people who did and did not perform each behaviour, beliefs were consistently associated with practice. In multiple regression, beliefs about the importance of the behaviour for health independently accounted for 11.3 per cent of the variance in exercise, 18.9 per cent of the variance in smoking and 4.5 per cent of the variance in alcohol consumption. The association between beliefs and dietary fat avoidance was also substantial. In contrast, the relationships between risk awareness and behaviour were mixed. People who avoided dietary fat were more aware than others of the health risks of fat. But non-smokers were less aware than smokers of the risks of smoking, and people who drank regularly were more aware of the dangers of alcohol than were non-drinkers. The results are discussed in the context of the contribution of health psychology to European health promotion.

Adult↗

PubMed1992

Emotional coping and tonic blood pressure as determinants of cardiovascular responses to mental stress.

OBJECTIVES: The aim was to assess the combined influence of biological risk for hypertension and patterns of emotional control upon cardiovascular responses to mental stress tests. DESIGN: The study involved the administration of mental stress tests in the laboratory, designed to elicit substantial blood pressure and heart rate responses accompanied by suppression of cardiac baroreflex sensitivity. METHODS: Thirty-seven young men were selected as being at relatively high or low risk through having high or low normal blood pressure. Blood pressure, recorded continuously using the Finapres, heart rate, cardiac baroreflex sensitivity, skin conductance and respiration rate were monitored at rest and during mental arithmetic and mirror drawing tasks. RESULTS: Hypertension risk category had no overall effect upon cardiovascular reactions to mental stress. Two dimensions of emotional coping were identified through factor analysis of psychological questionnaires--anxious emotional inhibition (ratings of trait anxiety, anger in and self-concealment), and anger experience and expression (ratings of trait anger and anger out). Subjects with high and low scores on these dimensions were equally represented in the two blood pressure risk categories. Hypertensive risk interacted with anxious emotional inhibition, with the greatest systolic blood pressure and heart rate responses (accompanied by cardiac baroreflex inhibition) being recorded in subjects at high risk coupled with high anxious emotional inhibition. Anger experience and expression did not interact with hypertension risk, but had a direct effect upon cardiovascular responses to mental stress. No differences were seen in skin conductance or respiratory responses, suggesting specific disturbances of cardiovascular regulation. CONCLUSIONS: The results suggest that normotensives at risk for future hypertension are likely to show heightened stress-related cardiovascular responses if they also tend to inhibit the expression of negative emotions. This pattern may be relevant to the postulated links between hypertension and emotional inhibition.

Adaptation, Psychological↗

PubMed1991

Invited review. The links between stress and illness.

Evidence relating stress with illness has emerged from a variety of experimental, clinical and epidemiological research strategies. Psychobiological stress responses emerge through an imbalance between demands and psychosocial resources, and many factors relevant to this transaction have been identified, including the chronicity and predictability of stimulation, opportunities for control, psychological coping responses and the availability of social supports. By contrast, the mechanisms through which stress responses may increase risk of illness are poorly understood, and investigators are frequently obliged to fall back upon a poorly defined 'biological predisposition' to account for individual differences in susceptibility to disease or variations in clinical course. It is argued in this review that several distinct cognitive-behavioural and psychophysiological mediating processes may be postulated, and that these are relevant to different types of influence on health (acute and chronic effects, causal and facilitatory processes, impact on aetiology, maintenance, relapse or recurrence). It is through the recognition and identification of separate processes that questions concerning the specificity of illness outcome, personal resilience, the limits of the impact of psychosocial factors, and the appropriate forms of therapeutic intervention, may be resolved.

Adaptation, Psychological↗

PubMed1991

Satisfaction with communication, medical knowledge, and coping style in patients with metastatic cancer.

Interviews were conducted with 77 patients aged 19-84, admitted to a medical oncology ward for assessment and modification of treatment. Satisfaction with information provided about tests, symptoms and treatment was assessed, together with satisfaction with care in general, factual knowledge concerning cancer and other medical conditions, and anxiety. Habitual style of coping with stress by information-seeking vs avoidance was measured using the Miller Behavioral Style Scale. Satisfaction levels were generally high. Patients reporting the highest level of satisfaction with information were more avoidant in their coping style than the remainder, and were also less anxious. Factual knowledge about cancer was in contrast greater among patients who were less satisfied with communication. These patterns were not dependent on age or education. It is argued that satisfaction with communication in medical settings is not a simple function of communication skills and the provision of adequately structured information, but that patients' tendencies to cope with stress by seeking out or avoiding information need to be taken into account.

Adaptation, Psychological↗

PubMed1991

The European Health and Behaviour Survey: rationale, methods and initial results from the United Kingdom.

The aim of this study was to assess a wide range of health-related behaviours, beliefs concerning the importance of behaviours for health, and health knowledge, using a standardized protocol suitable for translation and administration in different countries of Europe. An inventory was developed from previous literature for the assessment of substance use, positive health practices, diet and eating habits, driving behaviour and preventive health care, beliefs concerning the importance of 25 activities for health, and knowledge about the influence of seven factors (including smoking, alcohol and diet) on major diseases. The first phase of the study involved administration of the inventory to approximately 200 male and 200 female university students aged 18-30 in 20 European countries. This report concerns data collected from 419 students in the U.K., together with analyses of short-term response stability. The inventory showed adequate short-term stability. Sex differences were observed in a number of behaviours, including consumption of fats and cholesterol, salt and fibre, dieting, exercise, sun-protection, driving speed, regular dental check-ups, frequency of brushing teeth, access to doctor and blood pressure measurement. Beliefs about the importance of behaviours for health were closely associated with the occurrence or frequency of the behaviours both within and between health behaviour categories. Little relationship was observed between health behaviour and awareness of the role of these same factors in disease. Important gaps in health knowledge were identified. Data concerning the frequency of health-related behaviours is crucial to the planning of health education and primary prevention programmes. The close association between beliefs and behaviour emphasises the importance of cognitive factors, while health knowledge appears to play a less direct role.

Adult↗