Assessing the relationship of Type A beliefs to cardiovascular disease risk and psychosocial distress

Investigators have begun to take a multimodal approach to the assessment and treatment of psychosocial risk factors for cardiovascular disease (CVD). For instance, cognitive responses have become the focus of contemporary research along with continued examination of overt Type A behaviors. Price (1982) has outlined a set of beliefs purportedly associated with Type A behavior and subsequent CVD risk. The current study examines the validity of this belief set as represented by a newly developed measure, the Type A Cognitive Questionnaire (TACQ). Subjects were 221 employed adults participating in a worksite CVD risk reduction program. They completed the TACQ as part of a pretreatment CVD risk screening protocol. As hypothesized, TACQ scores were significantly associated with Type A behavior, hostility, physiological mediators of CVD, and psychosocial distress. Discussion addresses continued refinement of the Type A belief construct.     

The Novacco Anger Scale and Jenkins Activity Survey as predictors of cardiovascular reactivity

This study investigated the relationship among anger, the Type A construct, and cardiovascular reactivity. The Novacco Anger Scale and the Jenkins Activity Survey (JAS) were used to measure anger proneness and Type A characteristics, respectively. Twenty-four college males were selected from the upper and lower quintiles of the JAS distribution. During the study, the subjects were exposed to varying levels of experimentally induced challenge, while measurements were taken of heart-rate and blood-pressure changes. The results showed a modest but significant correlation between scores on the Novacco Anger Scale and the JAS. More importantly, scores on the Novacco Anger Scale correlated significantly with heart rate and systolic blood pressure under all challenge conditions, while those on the JAS were unrelated to cardiovascular excitability. These results raise questions about the usefulness of the JAS as a predictor of CHD risk. They are also consistent with the beliefs of other investigators that anger and hostility are the most important Type A behaviors in predisposing patients to coronary heart disease. Additional implications of the study are discussed.     

Building cardiovascular disease competence in an urban poor Ghanaian community: A social psychology of participation approach

This paper describes conceptual, methodological, and practical insights from a longitudinal social psychological project that aims to build cardiovascular disease (CVD) competence in a poor community in Accra, Ghana's capital. Informed by a social psychology of participation approach, mixed method data included qualitative interviews and household surveys from over 500 community members, including people living with diabetes, hypertension, and stroke, their caregivers, health care providers, and GIS mapping of pluralistic health systems, food vending sites, bars, and physical activity spaces. Data analysis was informed by the diagnosis‐psychosocial intervention‐reflexivity framework proposed by Guareschi and Jovchelovitch. The community had a high prevalence of CVD and risk factors, and CVD knowledge was cognitive polyphasic. The environment was obesogenic, alcohol promoting, and medically pluralistic. These factors shaped CVD experiences and eclectic treatment seeking behaviours. Psychosocial interventions included establishing a self‐help group and community screening and education. Applying the “AIDS‐competent communities” model proposed by Campbell and colleagues, we outline the psychosocial features of CVD competence that are relatively easy to implement, albeit with funds and labour, and those that are difficult. We offer a reflexive analysis of four challenges that future activities will address: social protection, increasing men's participation, connecting national health policy to community needs, and sustaining the project.     

老年人群的韵律感知

老龄化导致听觉系统、认知功能有所衰退。老年人群的言语理解能力减弱, 韵律信息解析存在困难。老年人对重音、语调、语速等语言韵律感知能力退化, 对情感韵律的加工也出现问题, 特别是消极情绪韵律加工减退较快。老年疾病进一步加深韵律加工难度, 韵律感知呈现出与特定疾病的相关性。未来研究需考察不同语言背景老年人群的韵律感知表现与机制、复杂交流环境的影响、韵律感知障碍对老年疾病的预测、韵律感知的早期干预与复健等问题。     

抑郁和焦虑与心血管疾病

抑郁焦虑与心血管疾病的关系最能体现身与心两者相互影响、不可分割的特点。但临床上,心血管疾病患者抑郁焦虑的诊疗率不足1％。这说明现有的诊疗理念和方式没有将心血管疾病和精神障碍联系起来,给患者全面全程的干预和管理。这样的缺陷不仅增加患者的痛苦和功能障碍,也增加心血管疾病的发病率和病死率,还增加患者及社会的医疗负担。本文结合临床经验,从心身一体的诊疗理念,谈谈抑郁焦虑与心血管疾病。     

处理好心血管手术中体外循环的几个关系

随着医学技术的进步,近年来通过手术来解除患者心血管方面的疾患已成为一种有效的方法。开展心血管手术离不开体外循环,然而,体外循环是一门交叉学科,它涉及医学和非医学等多方面的知识,实施过程中还会对患者机体产生不同程度的影响。从非医学方面的哲学角度来看,体外循环的整个过程中都包含有丰富的唯物辩证法观点,用联系的、矛盾的、辩证的哲学思维去看待体外循环中的相关问题,有助于提高体外循环灌注技术的质量,减少对患者机体的损伤。     

布氏杆菌病诊治体会

加强对布氏杆菌病流行病学资料、临床特点、诊断、治疗、预后及本病误诊误治的前因后果等方面的认识,回顾性分析潍坊医学院附属医院近两年收治的28例布氏杆菌病病例,并总结布氏杆菌病在诊断、治疗等方面的特点.经查阅国内外资料分析所得,近20余年,布氏杆菌病发病率呈上升趋势,传播途径复杂,临床表现无特异性,易误诊误治;利福平、四环素及喹诺酮药物疗效肯定,治愈率高.临床医师须加强对本病的全面认识,提高诊断率并提供规范治疗、减轻患者心理及精神负担.     

Esfuerzo y decremento de vigilancia en tareas de discriminación sucesiva y simultánea

Resumen

El objetivo del experimento presentado en este artículo fue probar la hipótesis de que el decremento de sensibilidad en tareas de atención sostenida, ocurre porque los recursos atencionales o esfuerzo que demanda la tarea no pueden matenerse durante un tiempo prolongado. Comparamos dos tareas que diferían en carga de memoria y registramos tres grupos de índices de esfuerzo o gasto atencional: rendimiento en una tarea secundaria concurrente, esfuerzo subjetivo y actividad cardiovascular (IBI medio y amplitud espectral del componente 0.10 Hz). En ambas tareas observamos un declive significativo a lo largo del tiempo en eficiencia o ritmo de procesamiento, indicado por la razón entre la precisión y la velocidad. Los datos acerca del esfuerzo subjetivo y el rendimiento en la tarea secundaria no parecen apoyar la hipótesis original. El principal hallazgo fue que la actividad cardiovascular al comienzo de la tarea, medida por la amplitud del componente 0.1 Hz, era un predictor significativo del decremento de eficiencia en ambas tareas de vigilancia. Si esta amplitud es un índice fisiológico fiable de atención, nuestro resultado sugiere que un procesamiento controlado, con esfuerzo, al comienzo de la tarea previene el decremento de vigilancia.     

The relationship between mental vitality and cardiovascular health

Past measurement of vitality has included both emotional and physical components. Since aspects of physical vitality such as fatigue can be indicative of physical illness, the usefulness of existing measures of vitality to predict health is limited. This research was designed to examine the psychometric properties of a new Mental Vitality Scale and to test its associations with measures of cardiovascular health over the course of 2 years. The measure of mental vitality was administered in a two-part study using three different samples. In part 1, the reliability and validity of the scale was assessed with a student and a clinic sample. In part 2, medical data on mental and physical health were abstracted over a two-year period from 1041 patient records from a multi-specialty medical practice, and mental vitality assessed through a mailed questionnaire. The findings indicate that the Mental Vitality Scale is a valid and reliable questionnaire for measuring this construct. Mental vitality was also associated with reduced odds of several cardiovascular outcomes and prospective analyses suggest that mental vitality may serve a protective function in the development of cardiovascular disease. The results lend support for the importance of mental vitality as a construct that may be relevant for considering resilience in relation to cardiovascular disease.