Depressive Symptoms and Health Among Cardiovascular Disease Patients in Cardiac Rehabilitation Programs1

This study examined relations between depressive symptoms and health outcomes among 79 patients participating in cardiac rehabilitation. Results showed cross‐sectional negative associations between depressive symptoms and cardiac symptom appraisals at the beginning (Time 1) and end (Time 2) of rehabilitation. No longitudinal effects of depressive symptoms on cardiovascular functioning were found. Results also showed that improvements in depressive symptoms from Time 1 to Time 2 were related to improvements in cardiac symptom appraisals from Time 1 to Time 2. These results support the deleterious effects of depression on cardiovascular functioning. Findings such as these may help to understand the processes by which proximal health outcomes are affected by cardiac rehabilitation, thereby elucidating mechanisms linking depression to long‐term cardiovascular health.     

Religion and Cardiovascular Disease Risk

Objectives: To determine whether cardiovascular-disease risk-factor profiles of majority-church members differ from those of non-church members we examined a large population-based random sample. Methods: Data from the two cross-sectional surveys of the Pawtucket Heart Health Program conducted in 1981–82 (n = 2442) and 1983–84 (n = 2799) were evaluated. Trained interviewers collected physiological measures including height, weight, systolic and diastolic blood pressure, and a small blood sample (for total cholesterol and high-density lipoprotein). Smoking, exercise, sociodemographics, and church membership were determined by self-report. Results: Church members were older, more likely to be female, Portuguese, married, have more people living in their households, and were also more likely to be greater than 20% overweight. Forty-eight percent of church members reported never having smoked cigarettes compared to 35.4% of non-church members. Differences in systolic blood pressure and total cholesterol were attributable to age, sex, and ethnicity. Conclusions: Aside from cigarette-smoking status and body-mass index, the risk profile of the two groups was not different, indicating that health-promotion interventions geared to the general population may not need to be tailored too extensively for members of religious organizations based on health status. On the other hand, the demographic differences and easy access to entire families may require more attention.     

Promotion of Cancer Family History Awareness: Jameslink Cancer Risk Assessment Tool at Community Health Fairs

This article examines the impact of providing personalized familial cancer risk assessments with the Jameslink Cancer Risk Assessment Tool. Users of the Jameslink (N = 166) at eight community health fairs completed a survey including demographic, psychosocial and behavioral variables to better understand responses to the Jameslink. No differences were found between whites and those of other races for variables of interest, indicating suitability of the Jameslink for diverse populations. Those with higher Jameslink-assessed risk had higher perceived risk of cancer. Approximately half (53.8%) reported that they would speak to their physician about their Jameslink-assessed risk. A regression found Jameslink-assessed risk, cancer worry, and perceived risk of cancer predicted intentions to speak to a physician about their risk. In addition, open-ended data provided suggestions to improve the Jameslink. Changes in content and format were suggested; however most were happy with the program and encouraged its promotion. The lack of findings for differences as a function of race bolsters the use of computerized Cancer Risk Assessment Tools in diverse communities. The positive feedback of users and the close association between cancer risk assessment, perceived risk, and intention to speak to a physician are supportive of continued use and development of Cancer Risk Assessment Tools in the community to promote awareness of cancer risk.     

Faith-Based Organizations: Sexual Harassment and Health in Accra-Tema Metropolis

Sexual harassment occurs frequently in many faith-based organizations (FBOs). This study investigated whether sexual harassment in FBOs was a public health concern in Ghana. A cross-sectional exploratory approach was used to assess the prevalence and incidence of traditional or contrapower sexual harassment in FBOs. We also investigated the correlation between sexual harassment and health. Respondents completed a self-administered open-ended questionnaire in an anonymous survey about sexual harassment during the 12 months preceding the study. We hypothesized that both traditional and contrapower harassment were prevalent in FBOs of Ghana and also that the health effects were the same for both sexes in both forms of harassment. The two hypotheses were generally supported. We found that sexual harassment is a public health concern. Women were more likely to be sexually harassed (73%) than men were (27%). Sexual harassment negatively affects the victims’ health outcome. Secondly, both the traditional and contrapower forms of sexual harassment were prevalent in FBOs in Ghana. The health consequences of sexual harassment in Ghana are the same as in an industrialized country. The implications for policy and research are discussed.     

Psychosocial Factors and Disease Progression in Cancer

ABSTRACT— Psychosocial factors such as stress, personality, and social support relate to differences in disease progression in cancer patients. Neuroendocrine substances associated with psychosocial factors may regulate immune responses to cancer, as well as regulate the activity of oncogenic (cancer-causing) viruses, DNA-repair processes, and the expression in tumor cells of genes that may affect the tumor's growth and metastasis. Biobehavioral oncology research seeks to understand how these psychosocial factors, and interventions designed to modify them, become neurohormonal changes that alter cell signaling and tumor growth, viral oncogenesis, and immune responses. We review the empirical basis for psychosocial factors and biobehavioral processes in cancer progression and suggest future research.     

Faith-Based Sex Education Programs: What They Look Like and Who Uses Them

The purpose of this study was to explore the kinds of sex education programs for youth available in mainline churches. This research project sought to identify the kinds of programs developed, the ages of the youth involved, the reasons for implementing the programs, the goals of the programs, the topics covered, and the perceived youth response to these programs as identified by youth ministers and leaders. The sample included 92 churches/synagogues with memberships over 300 that were within a 25-mile radius of our small, urban area in southeast Michigan. Findings from this study lay the groundwork for exploring whether these programs have an impact on adolescents’ sexual behaviors.     

Associations Between Breast Cancer Risk Factors and Religiousness in American Women in a National Health Survey

Breast cancer is a leading cause of death in American women. Data are lacking from representative samples of total populations on the association of risk factors for breast cancer and religiousness. The sixth cycle of the National Survey of Family Growth (NSFG VI) included 3,766 women aged 30–44 years with complete data on self-reported religiousness, and selected breast cancer risk factors. Of women in the analysis, 1,008 reported having four or more breast cancer risk factors. Women who never attended services were over seven times more likely to report having four or more risk factors than those who attended more than weekly (P < 0.0001). After adjusting for age, race, Hispanic ethnicity, nativity, education and marital status by logistic regression, women who never attended services were still over six times more likely to report having four or more risk factors (P < 0.0001). The combination of frequent attendance at religious services, very high importance of religion in daily life, and self-identification as a Protestant evangelical was particularly protective. Multiple dimensions of religiousness are independently associated with multiple breast cancer risk factors.     

对疾病危险因素控制和癌症筛检的考量

目前各项疾病危险因素的“危险性”不够高, 所以通过药物控制单个危险因素来预防疾病的效益很低。癌症筛检虽然使检出的癌症病人增加, 但并不能降低死亡率。因此建议, 在控制慢性病危险因素时, 应首选安全、低成本的有效干预方式方法;采用药物控制手段时, 应优先在综合危险程度较高的人群使用;要努力寻找特异性更高的危险因素指标, 以缩小危险人群;要进一步加强临床研究, 根据国情确定我国自己的诊断与治疗标准。癌症筛检的目标是要检出真正可从治疗中受益的病人, 特别是鉴别出无需治疗的“停滞型”癌症。无论是对疾病危险因素的控制, 还是对癌症筛检, 在改进技术的同时, 更重要的是要从根本上树立正确的健康和医疗观念。     

抑制炎症因素在他汀类药物心血管疾病多效性中的作用

他汀类药物自1976年上市应用于临床治疗以来,其非调脂作用,即他汀类药物的多效性近些年来越来越引起人们的重视,尤其是抑制炎症因素方面。随着近些年来研究的不断深入,越来越多的证据表明C反应蛋白作为体内最敏感的炎性标志物之一参与了多种临床常见心血管疾病的发生发展过程。而他汀类药物随着REVERSAL、PROVEIT、MIR...     

A Methodological Review of Faith-Based Health Promotion Literature: Advancing the Science to Expand Delivery of Diabetes Education to Black Americans

Non-traditional avenues, such as faith-based organizations (FBOs), must be explored to expand delivery of diabetes self-management education (DSME) to benefit Black Americans with type 2 diabetes (T2D). The purpose of this study was to methodologically review the faith-based health promotion literature relevant to Blacks with T2D. A total of 14 intervention studies were identified for inclusion in the review. These studies detailed features of methods employed to affect health outcomes that DSME similarly targets. Analysis of the faith-based studies?? methodological features indicated most studies used (1) collaborative research approaches, (2) pre-experimental designs, (3) similar recruitment and retention strategies, and (4) culturally sensitive, behaviorally oriented interventions with incorporation of social support to achieve positive health outcomes in Black Americans. Findings indicate FBOs may be a promising avenue for delivering DSME to Black Americans. Informed by the findings, a focused discussion on advancing the science of faith-based interventions to expand delivery of DSME to Black Americans with diabetes is provided.     

脉压:心脑血管疾病的独立危险因子

脉压的大小是反映动脉粥样硬化的一个指标,因此,脉压增宽可以预测心脑血管疾病的发生,脉压预测的脑血管疾病危险的价值大于收缩压和舒张压,并有助于解释以往研究中舒张压与病死率关系不一致的现象。     

Empowerment,Leadership, and Sustainability in a Faith-Based Partnership to Improve Health

Community-based participatory research is a noted approach for improving community health and reducing health disparities. Community partnerships can serve as a catalyst for change in public health efforts. This article will apply empowerment theory and sustainability principles to an existing faith-based partnership. BRANCH Out is a partnership among 13 African American churches, the City of Milwaukee Health Department—Community Nutrition, and the Medical College of Wisconsin. The partnership goal was to change inaccurate perceptions, knowledge and negative attitudes, and behaviors about chronic disease and promote healthy youth leadership. Faith-based empowerment can occur at the individual, organizational, and community level. BRANCH Out demonstrates how partnerships can be sustained in multiple ways. The partnership also highlights the unique contributions of churches to community health outcomes.     

Spirituality and Cardiovascular Risk

This study extended current research linking spirituality to health by investigating the relationship between extrinsic and intrinsic spirituality and cardiovascular risk factors. Participants included 111 healthy males and females, ages 28 to 63. Measurements consisted of the Lifestyle Assessment Questionnaire (LAQ), a version of Kelly's Repertory Grid, hematological analysis, and blood pressure. A greater sense of spirituality was associated with lower cholesterol risk ratios (total cholesterol/HDL) and triglyceride levels. In addition, the structural or organizational characteristics of intrinsic spirituality were associated with several other hematological measures. Further research will help clarify the association between mechanisms underlying spirituality and health, including susceptibility to cardiovascular disorders.     

D型人格：心血管疾病的重要心理危险因素

D型人格（又称忧伤人格）是指经历消极情感与社会压抑的混合倾向。对于心血管疾病患者来说,这种心理危险因素与其生活质量下降、梗死复发甚至死亡等有着密切联系。作者总结了D型人格与心血管疾病关系的研究现状,阐述了D型人格对于识别早期高危患者的临床价值,探讨了神经内分泌学、免疫学及心理学等方面的机制,并评价了对D型人格进行心理干预的可行性。     

Developing Coordinated Technical Assistance and Training Programs

The design of a coordinated, multi-level technical assistance and training system is crucial to the delivery of manpower services under CETA. A framework for the development of such a system, together with tentative roles and responsibilities for its implementation are presented.