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PubMed2000

Risk of cardiovascular disease measured by carotid intima-media thickness at age 49-51: lifecourse study.

OBJECTIVE: To quantify the direct and indirect effects of fetal life, childhood, and adult life on risk of cardiovascular disease at age 49-51 years. DESIGN: Follow up study of the "Newcastle thousand families" birth cohort established in 1947. PARTICIPANTS: 154 men and 193 women who completed a health and lifestyle questionnaire and attended for clinical examination between October 1996 and December 1998. MAIN OUTCOME MEASURES: Correlations between mean intima-media thickness of the carotid artery (carotid intima-media thickness) and family history, birth weight, and socioeconomic position around birth; socioeconomic position, growth, illness, and adverse life events in childhood; and adult socioeconomic position, lifestyle, and biological risk markers. Proportions of variance in carotid intima-media thickness that were accounted for by each stage of the lifecourse. RESULTS: Socioeconomic position at birth and birth weight were negatively associated with carotid intima-media thickness, although only social class at birth in women was a statistically significant covariate independent of adult lifestyle. These early life variables accounted directly for 2.2% of total variance in men and 2.0% in women. More variation in carotid intima-media thickness was explained by adult socioeconomic position and lifestyle, which accounted directly and indirectly for 3.4% of variance in men (95% confidence interval 0.5% to 6.2%) and 7.6% in women (2.1% to 13.0%). Biological risk markers measured in adulthood independently accounted for a further 9.5% of variance in men (2.4% to 14.2%) and 4.9% in women (1.6% to 7.4%). CONCLUSIONS: Adult lifestyle and biological risk markers were the most important determinants of the cardiovascular health of the study members of the Newcastle thousand families cohort at age 49-51 years. The limited overall effect of early life factors may reflect the postwar birth year of this cohort.

Cardiovascular Diseases↗
PubMedDate not supplied

The roles of the pastor in the interdisciplinary rehabilitation team.

People with chronic illnesses and functional limitations may face a lifetime of changes and adjustments. Often, the onset of a long-term illness or disease requires a person to rethink values and develop new coping strategies in order to adapt to a life-changing event. At such times, people may draw on sources of spiritual support, finding comfort from a pastor or other clergy. This article describes key roles taken by the clergy who provide these services. Patients discharged from inpatient rehabilitation units have reported using faith and prayer as effective coping strategies. Religious faith can have a positive influence on emotions and may be directly related to improved functional ability. Disciplines of faith, such as solitude, silence, and meditation, may promote mental health. Although this article presents information from a Christian church perspective, readers should note that services should be considered from a wide range of spiritual representatives.

Adaptation, Psychological↗
PubMedDate not supplied

Transitions out of high school: time of increased cancer risk?

BACKGROUND: The effectiveness of lifestyle behavior interventions with children to reduce chronic disease risks in adulthood assumes stability in the lifestyle behaviors across time. The transition out of high school is a time when many changes occur in social roles, e.g., changing schools, leaving the parents' home, changing peers, finding employment, getting married, and becoming a parent. Cancer risk behaviors may increase as a result of some of these social role changes. METHODS: Concepts relevant to the stability or change in lifestyle behaviors through the transition out of high school are presented. Literature concerning diet, smoking, smokeless tobacco, alcohol, physical activity, sexual practices, and sun exposure behaviors through the transition is reviewed. RESULTS: Most lifestyle behaviors display increasing cancer risk around the transition out of high school. Different levels of change were associated with different pathways through the transition. Inconsistent findings were obtained in the pattern of co-occurrence of these behaviors. CONCLUSION: Priority research includes establishing the pattern of co-occurrence of lifestyle behaviors through the transition, identifying the pattern of tracking of each behavior through the transition, and identifying the primary influences on the group values and tracking of the behaviors. Longitudinal research is needed to control for preexisting differences between pathways through the transition.

Adolescent↗
PubMed1999

Posttraumatic stress and change in lifestyle among the Hanshin-Awaji earthquake victims.

BACKGROUND: In 1995, Japan's Hanshin-Awaji area was severely damaged by a major earthquake. Lifestyle factors, sometimes associated with physical health and mortality, have also been known to be associated with mental health status. This report examines the relationship between the subsequent change in lifestyle and the psychological stress induced by the earth quake. METHOD: An investigation was made of 108 male inhabitants of Awaji Island as to their individual lifestyle before and after the great earthquake, any posttraumatic stress disorder (PTSD) symptoms, and their demographic variables. RESULTS: The mean PTSD score was higher in the worse lifestyle group than in the no/better lifestyle change group. Category B or D of PTSD scores were higher in the worse lifestyle group than in the no/better lifestyle change group. The percentage of subjects who lived in temporary public housing was higher in the worse lifestyle group than in the no/better lifestyle change group. CONCLUSIONS: Worse change in lifestyle might be associated with high PTSD score in victims of Hanshin-Awaji earthquake.

Adult↗
PubMed1999

The Berne-Munich Lifestyle Panel. Background and baseline results from a longitudinal health lifestyle survey.

The Berne-Munich Lifestyle Panel (BMLP) studies health relevant lifestyles among some 2000 adults in Switzerland and Germany. This paper introduces the theoretical background and empirical concept of the BMLP. Sociological theory provided the guidelines for the development of an empirical model that measures structures and dynamics of health lifestyles. Health lifestyles are explained as the product of the complex interplay between health related behaviours, orientations and social resources. Residents of Berne (Switzerland) and Munich (Germany) in the age between 55 and 65 years were contacted in 12 months periods and interviewed by telephone (CATI). The questionnaire comprised some 200 questions on selected aspects of health lifestyles and health status. Interviews were conducted in two waves in Munich (1996 and 1997) and three waves in Berne (1996/97/98). The paper reports findings from baseline data analysis and explores cultural differentiations with respect to the distribution of 1. health relevant behaviours, orientations and social resources, 2. triggers of lifestyle change (life events), 3. mediating factors (Health Locus of Control, Sense of Coherence). Initial results from the search for patterns of health behaviours are also reported. The findings show considerable differences but also impressive similarities in health lifestyle elements across the two samples. There is also preliminary evidence for meaningful patterns of health behaviours in the cohort under investigation. Moreover, the findings clearly demonstrate the need for a gender specific approach in the analysis of cultural differences in health behaviours and lifestyles.

Adult↗
PubMed2005

Making sense of illness: late-in-life migration as point of departure for elderly Iranian immigrants' explanatory models of illness.

This article is based on data gathered through 60 qualitative interviews conducted within the realm of three research projects that have used "culture-appropriate lenses" to study the postmigration situation of late-in-life Iranian immigrants to Sweden. The findings gathered through these studies were interpreted against the backdrop that culturally appropriate nursing theories provide. This meant that it was, at times, these elders' backgrounds as cultural "others" that were implicitly used to make sense of the various issues that were brought to the fore by these studies. The particular issue with which this article is concerned is the "unusualness" of these elders' explanatory models of illness. Inspired by the concept "definition of situation" in the symbolic interactionist perspective and by the feeling that this perspective might bring about a different interpretation of the original findings regarding their understandings of illness and disease, we set out to conduct a secondary analysis of these elders' explanatory models of illness. The findings presented in this article will show how the elderly Iranian immigrants interviewed in these three studies utilize the process of "late in life migration" as a point of reference for their understandings of what has caused the illnesses from which they suffered. Hereby we will suggest that the "unusualness" of their explanatory models of illness might be best understood if we focus on what they shared as immigrants (i.e., the fact that the process of late-in-life migration has made their culture obsolete) as opposed to what they shared as Iranians (i.e., their culture of origin).

Adaptation, Psychological↗
PubMed1991

Disparities in psychological, neuroendocrine, and immunologic patterns in asymptomatic HIV-1 seropositive and seronegative gay men.

The present study concurrently measured psychological distress (state anxiety, depression, confusion, and intrusive thoughts), neuroendocrine (plasma cortisol concentrations), and immunologic [lymphocyte proliferative responses to phytohemagglutinin (PHA) and pokeweed mitogen (PWM)] changes in the 5-week periods preceding and following serostatus notification among asymptomatic Human Immunodeficiency Virus-type 1 (HIV-1) seropositive and seronegative gay men. Seropositives, as opposed to seronegatives, showed a disparity in predicted relationships among distress, cortisol, and immunologic measures across the prenotification to postnotification period. Individual difference analyses suggested that among seropositives, in contrast to seronegatives, plasma cortisol concentrations were negatively correlated with psychological distress and positively correlated with responses to PHA (assessed at study entry and after serostatus notification). This pattern in seropositives could not be explained by differences in prenotification perceived risk of infectivity, extraneous environmental stressors, or CD4 cell counts within the seropositive group.

AIDS Serodiagnosis↗
PubMed1994

Family dynamics during the third trimester of pregnancy in Denmark.

Family dynamics in Danish families during the third trimester of pregnancy were explored in relation to family structure, parity, mother-father differences, and normative versus delayed childbearing. There were differences between married and cohabiting families, first- and second-time expectant parents, mothers and fathers, and between normative and delayed first-time expectant parents. For married couples to have better family dynamics than cohabiting couples is surprising for Denmark where both marriage and cohabitation are examples of a nuclear family lifestyle. A dual-path model is conceptualized as a nursing strategy to support the couples' interrelationship during their role transition.

Adolescent↗
PubMed1986

Transitions of cardiovascular risk from adolescence to young adulthood--the Bogalusa Heart Study: I. Effects of alterations in lifestyle.

Adolescence and young adulthood represents a transition period for biologic and lifestyle characteristics. In a preliminary investigation of young adults (ages 18-20 years), the Bogalusa Heart Study documented patterns of alcohol, tobacco, and oral contraceptive use, as well as changes in education, occupational, marital and parenting status. Such behaviors accelerate the cardiovascular disease process and may differentially influence risk factor patterns of race and sex groups. Adverse levels of systolic blood pressure and alpha-lipoprotein cholesterol were more frequent in married vs single men; elevated triglyceride levels were more frequent in married vs single whites. However adverse levels of beta- and alpha-lipoprotein cholesterol were more frequent in nonparents than in parents. Cigarette smoking and oral contraceptive use were independently related to elevated beta-lipoprotein cholesterol and decreased alpha-lipoprotein cholesterol levels of young white women. Alcohol consumption was highest among white males, with 32% reporting daily consumption of the equivalent of two or more beers or one mixed drink. Alcohol consumption was negatively correlated with blood pressure in white males and positively correlated with alpha-lipoprotein cholesterol in black males. Since such lifestyle factors are related to physiologic risk factors that result in heart disease and adult cardiovascular morbidity and mortality in the older ages, early targeting during adolescence and young adulthood is important.

Adolescent↗
PubMed1992

Active coping style is associated with natural killer cell cytotoxicity in asymptomatic HIV-1 seropositive homosexual men.

The aim of this study was to examine the hypothesis that a psychosocial model was associated with natural killer cell cytotoxicity (NKCC) in HIV-1 infection. A sample of 62 HIV-1 seropositive homosexual men at CDC stages II and III were given a psychosocial battery assessing life stressors, social support, and coping style. A regression model quantifying these variables along with control variables for alcohol use, substance use and nutritional status was estimated. Active coping style was directly and positively associated with NKCC, and trends toward a negative relationship of life stressors and a buffering effect of social support on lives stressors were also observed. The results suggest that (1) control variables should be included with psychosocial models and that (2) psychosocial factors, especially active coping, may have a deterrent effect on loss of NK cell function. Active coping style may merit a specific focus in future research of life stressors and the immune system.

Adaptation, Psychological↗
PubMed1993

Influence of perceived psychological stress and distress on antibody response to low dose rDNA hepatitis B vaccine.

The present study focused on the relationship between psychological stress and immune reaction to a novel antigen. Participants completed questionnaires on daily hassles, psychoneurotic complaints, coping style, and loneliness, 2 and 6 months after the first of a series injections with a low dose recombinant DNA hepatitis B vaccine. Antibody response was determined 7 months after the first vaccination. Based on the psychological questionnaires two different stress measures were calculated: a Stress Index score-month-2 and a Stress Index score-month-6 indicating stress levels experienced at the beginning and at the end of the study respectively. Antibody levels were found to be negatively related with the Stress Index score-month-2. Although the influence of psychological stress reported on month 6 tended to be in the same direction, this effect was not significant. Coping styles and loneliness were not associated with antibody formation. These results suggest that antibody formation to rDNA hepatitis B vaccine is negatively influenced by psychological stress.

Adult↗
PubMed1993

The long-term outcome of facial pain treatment.

The long-term outcome of facial pain treatment is largely unknown. This study reports the results of a 4-yr review which indicated that conservative treatments including drug therapy and counselling are effective for 70% of patients. Refractory pain was associated with a long complex history of pain, a preoccupation with physical symptoms and poor psychosocial adjustment.

Adaptation, Psychological↗
PubMed1984

Life-style and health: some remarks on different viewpoints.

Within the framework of the medical model of health and disease the factor 'life-style' plays a central role in the genesis of important disorders such as myocardial infarction or lung cancer. Two central issues, however, have been left unconsidered by most of the research done by medical epidemiologists: Disease, as a rule, has not one single but several causes; it is multifactorial in its etiology. This means that alongside 'life-style' there are other factors influencing pathogenesis. In this way we can explain, for example, the empirical finding that the classical risk factors only explain a minor amount of the morbidity and mortality due to coronary disease. A number of social and psychological factors influence those types of human behavior, which are known to have an adverse effect on health. The influence of age, sex, social status and parental and peer-group models have been empirically demonstrated. Social epidemiological research could contribute to a clarification and supplementation of the above-mentioned relationships leading to an improvement in our knowledge upon which to found preventive intervention. Social epidemiologists view health-adverse behavior as the consequence of social stress, that the individual attempts to cope with via smoking, drinking, etc. In the individual's social environment there exist numerous models, as well as informal pressures leading to such behavior. We should know more about the acute and chronic strains in the transition to adolescence and in later stages of the life-cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1984

Life history model of adaptation to disability: the case of a 'congenital amputee'.

Life histories can be used to describe adaptation over time to disabling conditions and the context and meaning of disabilities. Data from the life history of Diane DeVries, a 33-year old woman born with quadralateral limb deficiencies (upper extremity hemimelia, lower extremity amelia) illustrate a model for eliciting, presenting and interpreting life histories of persons with disabilities. Substantively, the life history of Diane DeVries indicates, at this time, survival within a niche of institutional supports that include marriage, church membership, and government for the disabled. Her life history is also characterized by choices that support independent living in the community and a cognitive orientation toward her own cultural normality.

Adaptation, Psychological↗
PubMed1985

The association between health and retirement: self-health assessment of Israeli retirees.

Self-health evaluation and health behavior after retirement were compared with the retrospectively self-assessed health state of the pre-retirement period. The data of 310 former industrial and service workers were examined within the context of the 'Health, Stress and Coping' mechanism, with retirement representing the potential psychological stress. The findings negate the hypothesis that retirement is responsible for worsening health conditions leading to over-utilization of medical services. The decline in the perceived health state, that had already started 6 to 1 year before retirement is not ascribable to this life change event per se, but rather to the normal biological ageing processes.

Adaptation, Psychological↗