RESUMEN
Bereavement increases in prevalence as people age and is associated with multiple psychological and health risks, including cardiovascular risk. Religious and existential variables may play an important role in the health impacts of bereavement. Theorized pathways linking religious and existential variables with health have suggested these associations are due to intermediary psychosocial variables, but have not been tested in bereavement. This research empirically tested these pathways in a bereaved population. In N = 73 adults within 1 year of bereavement (mean age = 64.36), this study examined associations between (1) religious and existential characteristics (religious and spiritual struggles, intrinsic religiosity, and existential quest) and intermediary psychosocial variables (depression, loneliness, and difficulties in emotion regulation), and between (2) intermediary psychosocial variables and bereavement-relevant health outcomes (self-reported health, change in health since last year, grief severity, and cardiovascular biomarkers). Cardiovascular biomarkers (heart rate, heart rate variability, and blood pressure) were collected before, during, and after a laboratory grief recall emotion elicitation. Anticipated associations between self-reported religious and existential characteristics and intermediary variables, and between intermediary variables and self-reported bereavement-relevant outcomes, were consistently observed. However, associations between intermediary variables and cardiovascular biomarkers were largely unobserved. This study examined the role of religious and existential variables in whole-person health after bereavement and is among the first to include biomarkers of cardiovascular risk. Results suggest that although religious and existential variables are associated with important bereavement-related outcomes, these associations may be "skin-deep," and extensions to cardiovascular functioning should be re-examined.
Asunto(s)
Aflicción , Enfermedades Cardiovasculares , Adulto , Humanos , Persona de Mediana Edad , Espiritualidad , Adaptación Psicológica , Factores de Riesgo , Pesar , Factores de Riesgo de Enfermedad CardiacaRESUMEN
Importance: Neural tube defects are among the most common congenital malformations in the US, with an estimated 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folic acid supplementation. Population: Persons who are planning to or could become pregnant. Evidence Assessment: The USPSTF concludes that, for persons who are planning to or could become pregnant, there is high certainty that folic acid supplementation has a substantial net benefit to prevent neural tube defects in their offspring. Recommendation: The USPSTF recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid. (A recommendation).
Asunto(s)
Suplementos Dietéticos , Deficiencia de Ácido Fólico , Ácido Fólico , Defectos del Tubo Neural , Complicaciones del Embarazo , Femenino , Humanos , Embarazo , Comités Consultivos , Ácido Fólico/administración & dosificación , Ácido Fólico/uso terapéutico , Tamizaje Masivo , Defectos del Tubo Neural/etiología , Defectos del Tubo Neural/prevención & control , Servicios Preventivos de Salud , Deficiencia de Ácido Fólico/complicaciones , Deficiencia de Ácido Fólico/diagnóstico , Deficiencia de Ácido Fólico/tratamiento farmacológico , Complicaciones del Embarazo/etiología , Complicaciones del Embarazo/prevención & control , Atención Preconceptiva/normasRESUMEN
Importance: According to National Health and Nutrition Examination Survey data, 52% of surveyed US adults reported using at least 1 dietary supplement in the prior 30 days and 31% reported using a multivitamin-mineral supplement. The most commonly cited reason for using supplements is for overall health and wellness and to fill nutrient gaps in the diet. Cardiovascular disease and cancer are the 2 leading causes of death and combined account for approximately half of all deaths in the US annually. Inflammation and oxidative stress have been shown to have a role in both cardiovascular disease and cancer, and dietary supplements may have anti-inflammatory and antioxidative effects. Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the efficacy of supplementation with single nutrients, functionally related nutrient pairs, or multivitamins for reducing the risk of cardiovascular disease, cancer, and mortality in the general adult population, as well as the harms of supplementation. Population: Community-dwelling, nonpregnant adults. Evidence Assessment: The USPSTF concludes with moderate certainty that the harms of beta carotene supplementation outweigh the benefits for the prevention of cardiovascular disease or cancer. The USPSTF also concludes with moderate certainty that there is no net benefit of supplementation with vitamin E for the prevention of cardiovascular disease or cancer. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with multivitamins for the prevention of cardiovascular disease or cancer. Evidence is lacking and the balance of benefits and harms cannot be determined. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with single or paired nutrients (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. Evidence is lacking and the balance of benefits and harms cannot be determined. Recommendation: The USPSTF recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamin supplements for the prevention of cardiovascular disease or cancer. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement).
Asunto(s)
Enfermedades Cardiovasculares , Suplementos Dietéticos , Minerales , Neoplasias , Vitaminas , Adulto , Humanos , Comités Consultivos , beta Caroteno/efectos adversos , Enfermedades Cardiovasculares/prevención & control , Suplementos Dietéticos/efectos adversos , Tamizaje Masivo , Minerales/efectos adversos , Minerales/uso terapéutico , Neoplasias/prevención & control , Encuestas Nutricionales , Medición de Riesgo , Vitamina E/efectos adversos , Vitaminas/efectos adversos , Vitaminas/uso terapéuticoRESUMEN
OBJECTIVE: Research in psychosomatic medicine includes a long history of studying how responses to anger-provoking situations are associated with health. In the context of a marriage, spouses may differ in their anger-coping response style. Where one person may express anger in response to unfair, aggressive interpersonal interactions, his/her partner may instead suppress anger. Discordant response styles within couples may lead to increased relational conflict, which, in turn, may undermine long-term health. The current study sought to examine the association between spouses' anger-coping response styles and mortality status 32 years later. METHODS: The present study used data from a subsample of married couples (N = 192) drawn from the Life Change Event Study to create an actor-partner interdependence model. RESULTS: Neither husbands' nor wives' response styles predicted their own or their partners' mortality. Wives' anger-coping response style, however, significantly moderated the association of husbands' response style on mortality risk 32 years later, ß = -0.18, -0.35 to -0.01, p = .039. Similarly, husbands' response style significantly moderated the association of wives' response style and their later mortality, ß = -0.24, -0.38 to -0.10, p < .001. These effects were such that the greater the mismatch between spouses' anger-coping response style, the greater the risk of early death. CONCLUSIONS: For a three-decade follow-up, husbands and wives were at greater risk of early death when their anger-coping response styles differed. Degree of mismatch between spouses' response styles may be an important long-term predictor of spouses' early mortality risk.
Asunto(s)
Adaptación Psicológica/fisiología , Ira/fisiología , Mortalidad Prematura , Esposos/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , RiesgoRESUMEN
The interpersonal tradition (Horowitz & Strack, 2011) provides a rich conceptual and methodological framework for theory-driven research on mechanisms linking religiousness and spirituality (R/S) with health and well-being. In three studies, we illustrate this approach to R/S. In Studies 1 and 2, undergraduates completed various self-report measures of R/S, interpersonal style, and other aspects of interpersonal functioning. In Study 3, a community sample completed a wide variety of R/S measures and a measure of interpersonal style. Many, but not all, aspects of religiousness (e.g., overall religiousness, intrinsic religiousness) were associated with a warm interpersonal style, and most aspects and measures of spirituality were associated with a warm and somewhat dominant style. Spirituality and related constructs (i.e., gratitude, compassion) were associated with interpersonal goals that emphasize positive relationships with others, and with beneficial interpersonal outcomes (i.e., higher social support, less loneliness, and less conflict). However, some aspects of R/S (e.g., extrinsic religiousness, belief in a punishing God) were associated with a hostile interpersonal style. R/S have interpersonal correlates that may enhance or undermine health and emotional adjustment. This interpersonal perspective could help clarify why some aspects of religiousness and spirituality are beneficial and others are not.