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At least 127 records · Page 7Linked to original sources
PubMed2004

Depression and 24-hour urinary cortisol in medical outpatients with coronary heart disease: The Heart and Soul Study.

BACKGROUND: In patients with coronary heart disease (CHD), depression leads to worse cardiovascular outcomes. Depression has been associated with increased cortisol in medically healthy patients, suggesting that cortisol may act as a mediator in the pathway between depression and cardiovascular events. However, it is not known whether depression is associated with elevated cortisol levels in patients with CHD. METHODS: We examined the association between depression (assessed by the Computerized Diagnostic Interview Schedule) and 24-hour urinary cortisol in 693 medical outpatients with known CHD. RESULTS: Of 693 participants, 138 (20%) had current depression. Depressed participants had greater mean cortisol levels than those without depression (42 +/- 25 vs. 36 +/- 20 microg/day, p <.01). With each increasing quartile of cortisol concentration the frequency of depression increased (p <.01). Participants in the highest quartile of cortisol had a twofold increased odds of having depression, compared with those in the lowest quartile (odds ratio [OR] 2.1, 95% confidence interval [CR] 1.2-3.6, p =.01). This association remained strong after adjusting for potential confounding variables (OR 2.4, 95% CI 1.3-4.4, p <.01). In this cross-sectional analysis, elevated cortisol was not associated with worse cardiac function. CONCLUSIONS: In patients with CHD,depression is associated with elevated cortisol levels.

Aged↗
PubMed2006

Cystatin C, left ventricular hypertrophy, and diastolic dysfunction: data from the Heart and Soul Study.

BACKGROUND: Impaired kidney function, as measured by serum cystatin C, is associated with risk of incident heart failure. Whether cystatin C is associated with preclinical cardiac structural abnormalities is unknown. We evaluate whether cystatin C is associated with left ventricular hypertrophy, diastolic dysfunction, and systolic dysfunction among 818 outpatients with coronary artery disease who were free of clinical heart failure. METHODS AND RESULTS: The 818 study participants were categorized into quartiles based on serum cystatin C concentrations, with < or =0.91 mg/L constituting the lowest quartile (I) and > or =1.28 mg/L constituting the highest (IV). Left ventricular hypertrophy (left ventricular mass index >90 g/m(2) by truncated ellipsoid method), diastolic dysfunction (impaired relaxation, pseudo-normal, or restrictive filling patterns) and systolic dysfunction (left ventricular ejection fraction < or =50%) were determined by echocardiography. Left ventricular hypertrophy was present in 68% of participants in quartile IV, compared with 44% of those in quartile I (adjusted odds ratio [OR] 2.17; 95% confidence interval [CI] 1.34 to 3.52; P = .002). Diastolic dysfunction was present in 52% of participants in quartile IV, compared with 24% of those in quartile I (adjusted OR 1.79; 95% CI 1.04 to 3.11; P = .04). Systolic dysfunction was present in 12% of those in quartile IV, compared with 6% of those in quartile I (adjusted OR 1.83; 95% CI 0.75 to 4.46; P = .15). CONCLUSION: Higher cystatin C concentrations are strongly associated with left ventricular hypertrophy and diastolic dysfunction in outpatients with coronary artery disease and without heart failure.

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PubMedDate not supplied

Case management: heart and soul.

Dear Colleagues: As a seasoned case manager, I have had the opportunity to serve our specialty practice in the development of the definition of case management, the creation of our standards of practice, the evolution of our professional code of conduct, and, of course, the process of certification. Yet it is the stories of our shared time with our clients that truly define what we do and who we are and clarify our contribution to health care. It is by the telling of the story that we understand our roles, our behavior, and the value of our activities.

Adult↗
PubMed2005

Interdisciplinary collaboration: the heart and soul of health care.

In a health care system in which patient complexity, outcome indicators, and informed families are representative of current reality, an interdisciplinary approach to care is crucial to successful navigation of a patient's experience in the ICU. To guide practitioners toward favorable patient progression, a thorough understanding of interdisciplinary collaboration is necessary. This article focuses on definitions of, benefits of, and barriers to interdisciplinary collaboration and provides practical solutions for implementation.

Attitude of Health Personnel↗
PubMed2003

Nursing abroad stirs the soul.

After establishing herself in her career as a perioperative nurse and ensuring her grown children were settled, this author pursued her dream of working abroad as a nurse. She chose to work in Pakistan, which is where her father was born. Her experiences there gave her a new appreciation for the help that perioperative nurses can offer to the citizens of developing countries.

Culture↗
PubMed2003

Relation of self-reported angina pectoris to inducible myocardial ischemia in patients with known coronary artery disease: the Heart and Soul Study.

To determine whether self-reported angina pectoris is associated with objective evidence of myocardial ischemia, we assessed angina symptoms, using the Seattle Angina Questionnaire, and measured ischemia using stress echocardiography in 933 patients with known coronary artery disease. We observed no association between self-reported angina pectoris and objective evidence of inducible ischemia.

Aged↗
PubMed2006

The "soul" of language does not use statistics: reflections on vowels and consonants.

This paper reviews studies of language processing with the aim of establishing whether any type of statistical information embedded in linguistic signals can be exploited by the language learner. The constraints as to the information that can be so used, we will argue, should be used to inform theories of language acquisition. We present two experiments with their respective controls. Both show that consonants (Cs) are much more suitable than vowels (Vs) to parse speech streams using statistical dependencies. These experiments use streams composed of items in which statistical information is carried either by the sequence of consonants or by the sequence of vowels. Both kinds of items are simultaneously present is the speech stream but, crucially, their overlap is only partial. Since the location of dips in transitional probabilities (TPs) between adjacent syllables differ for the first and the second type of sequences, we can explore whether consonants and vowels are equally efficient segments to parse signals. Our results show that "consonant words" (CW) are significantly preferred over "vowel words" (VW). We discuss the implication of our results for models of language acquisition.

Adult↗