Variances in Smoking Expectancies Predict Moment-to-Moment Smoking Behaviors in Everyday Life.

BACKGROUND: Many policy decisions about tobacco control are predicated on rational choice models, which posit (1) that smokers are aware of the risks of cigarettes and (2) that perceived risks have a consistent influence on continued smoking behavior. However, research shows that beliefs about smoking may be vulnerable to changes in internal and external contexts. METHODS: Using ecological momentary assessment, we tested this by measuring how smokers' (N = 52) beliefs about smoking varied over time. Four times per day over 1 week, participants responded to measures of smoking intentions, risk perceptions, mood and social outcome expectancies, and internal and external contextual factors. RESULTS: We analyzed this data using multilevel modeling, finding that both smoking intentions, risk perceptions, and expectancies differed between participants as well as between moments. CONCLUSION: Risk perceptions and mood expectancies were a significant predictor of intentions to smoke in the next 30 min, illustrating the importance of these beliefs in decisional processes. This study was preregistered at the Open Science Foundation: https://osf.io/wmv3s/?view_only=71ad66d3ce3845fcb3bf2b9860d820c9 . Our analytic plan was not preregistered.

Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study.

The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.

A novel approach to delivery of extracorporeal support using a modified continuous flow ventricular assist device in a mid-volume congenital heart program.

Extracorporeal life support (ECLS) is an essential component of a modern congenital cardiac surgery program. The circuit components and bedside management team may, however, vary among institutions. Here, we evaluate our initial experience with a modified ventricular assist device-based ECLS circuit primarily managed by the bedside nurse. We hypothesize that our outcomes are comparable to Extracorporeal Life Support Organization (ELSO) registry data. All patients who received ECLS from January 1, 2016 to December 31, 2019 at a single institution were included. Primary outcomes were survival to ECLS decannulation and discharge or transfer. Secondary outcomes included complications from ECLS. Data were compared to available ELSO registry data. Thirty-seven patients underwent 44 ECLS runs during the study period. Forty percent of patients had single ventricle physiology. Nearly 46% of patients received ECLS as part of extracorporeal cardiopulmonary resuscitation (eCPR). Survival to ECLS decannulation (68.2%) and survival to discharge or transfer (61.4%) did not differ from overall ELSO outcomes (69.7%, P = .870 and 50.7%, P = .136), as well as survival to discharge or transfer in a comparable cohort of ELSO centers (53.1%, P = .081). Patients with complications had a lower rate of survival to discharge or transfer but this did not reach statistical significance (47.7% vs. 75.0%, P = .455). Neurologic (50.0%), hemorrhagic (45.5%), and renal complications (31.8%) were most common in this cohort. A modified ventricular assist device-based ECLS circuit with primary management by the bedside nurse can provide comparable support in a neonatal and pediatric cardiac surgery population. Cost analyses and further delineation of the complication profile are necessary for a complete characterization of this system.

Everyday stress components and physical activity: examining reactivity, recovery and pileup.

The experience of naturally-occurring stress in daily life has been linked with lower physical activity levels. However, most of this evidence comes from general and static reports of stress. Less is known how different temporal components of everyday stress interfere with physical activity. In a coordinated secondary analysis of data from two studies of adults, we used intensive, micro-longitudinal assessments (ecological momentary assessments, EMA) to investigate how distinct components of everyday stress, that is, reactivity to stressor events, recovery from stressor events, and pileup of stressor events and responses predict physical activity. Results showed that components of everyday stress predicted subsequent physical activity especially for indicators of stress pileup. In both studies, the accumulation of stress responses over the previous 12 h was more predictive of subsequent physical activity than current stress reactivity or recovery responses. Results are compared to the effects of general measures of perceived stress that showed an opposite pattern of results. The novel everyday stress approach used here may be fruitful for generating new insights into physical activity specifically and health behaviors in general.

Self-focused and other-focused resiliency: Plausible mechanisms linking early family adversity to health problems in college women.

OBJECTIVES: This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. PARTICIPANTS: Female students (N = 795) participated between October 2009 and May 2010. METHODS: Participants completed self-report measures of early family adversity, self-focused (self-esteem, personal growth initiative) and other-focused (perceived social support, gratitude) resiliency, stress, subjective health, and health behaviors. RESULTS: Using structural equation modeling, self-focused resiliency associated with less stress, better subjective health, more sleep, less smoking, and less weekend alcohol consumption. Other-focused resiliency associated with more exercise, greater stress, and more weekend alcohol consumption. Early family adversity was indirectly related to all health outcomes, except smoking, via self-focused and other-focused resiliency. CONCLUSIONS: Self-focused and other-focused resiliency represent plausible mechanisms through which early family adversity relates to stress and health in college women. This highlights areas for future research in disease prevention and management.

Absorption in self-selected activities is associated with lower ambulatory blood pressure but not for high trait ruminators.

BACKGROUND: A range of nonpharmacological interventions (e.g., meditation) have positive effects on blood pressure (BP) but tend to have poor adherence. These interventions may lower BP partly by absorbing and directing attention away from one's negative thoughts. We hypothesized that recurring self-selected activities (SSAs) that are attentionally absorbing may similarly lower BP. We examined the effect of reported engagement in SSAs during the previous month prior to participation on ambulatory BP (ABP) and whether those prone to rumination were less likely to show these effects. METHODS: Participants (n = 38) reported engagement in SSAs and how absorbing they were, responded to trait rumination and perceived stress questionnaires, wore an ABP monitor for 24 hours, and at each ABP measurement answered electronic diary questions assessing activity levels, affect, social interactions, and caffeine and tobacco use. RESULTS: Regression analyses tested whether the reported absorption of SSAs, trait rumination, and their interaction predicted daytime and nighttime systolic and diastolic ABP. Greater absorption predicted lower daytime and nighttime ABP (bs = -18.83 to -8.79; Ps < .05), but this relationship was moderated by trait rumination (bs = 3.72 to 9.97; Ps < .05). Follow-up analyses revealed that absorption was unrelated to ABP for those with high trait rumination but that more absorption predicted lower ABP for those less prone to rumination. CONCLUSIONS: Our results suggest that regular engagement in absorbing SSAs is related to lower ABP. These findings have implications for the development of nonpharmacological interventions and suggest SSAs may serve as an adjuvant intervention strategy to lower BP.

Rumination and anxiety mediate the effect of loneliness on depressed mood and sleep quality in college students.

OBJECTIVE: We examined the mechanisms that underlie the observed relationships between loneliness and depressed mood and poor sleep quality in college students. This study was the first to investigate whether rumination and trait anxiety are psychological mechanisms that mediate this relationship. METHODS: In Study 1 (n = 1,244), using factor analysis with cross-sectional data, we established that loneliness and rumination are distinct constructs. We then collected survey data in two cross-sectional samples (ns = 300 and 218) and one prospective (n = 334) sample to test whether rumination and anxiety were mediators of the relationship between loneliness and depressed mood and poor sleep quality. Structural equation modeling was used to test the proposed relationships. Participants completed self-report measures of loneliness, rumination, trait anxiety, depressed mood, and sleep quality. In addition, measures of hostility, neuroticism, negative affect, and tobacco use were also assessed and tested as mediators, while social support was assessed and tested as a moderator. RESULTS: Consistent across the three studies, we found that rumination and trait anxiety fully mediated the associations between loneliness and depressed mood as well as poor sleep quality; these relationships held after testing all other factors. CONCLUSION: This study helps explain how loneliness dynamics relate to poor health and suggests specific points of departure for the development of interventions.