Sex and Psychosocial Differences in Acute Stress Symptoms Prior to Open-Heart Surgery.

BACKGROUND: Acute stress symptoms can occur while cardiac patients await open-heart surgery (OHS). The distress leads to poor outcomes. This study aimed to investigate the association of sex and psychosocial factors (quality-of-life and character strengths). METHOD: Our study cohort included 481 pre-OHS patients (female 42%; mean age 62 years). Medical indices/factors were obtained from the Society of Thoracic Surgeon's national database. Multiple regression analyses were performed following pre-planned steps and adjusting medical factors. RESULTS: Our findings revealed that sex differences in trauma-related symptoms were associated with poor mental well-being, alongside comorbidities. Both mental well-being and comorbidity factors were directly related to acute stress symptoms, while dispositional optimism had an inverse association with this outcome. CONCLUSION: To improve OHS outcomes, our findings suggest healthcare providers be attentive to pre-OHS acute stress symptoms, pay greater attention to the emotional well-being of their female patients, and develop supportive interventions to enhance personality strengths.

Family Factors Related to Three Major Mental Health Issues Among Asian-Americans Nationwide.

Asian-Americans (AAs) constitute the fastest growing minority group in the USA. AAs share a common emphasis on collective cultural strengths, especially family values. Using the National Latino and Asian American Study (NLAAS) data, this study investigated the roles of family cohesiveness, along with other cultural strength factors and negative family interactions in three psychiatric disorders. Supporting the study's hypotheses, multivariate analyses showed that family cohesiveness was associated with a lower incidence of general anxiety disorder (GAD), while regular religious attendance was linked with a lower likelihood of having substance use disorder (SUD). Conversely, negative family interactions increased the likelihood of experiencing major depression disorder (MDD) and SUD. Whereas perceived discrimination was related to higher odds of all diagnoses, family cohesiveness moderated the relationship between discrimination and GAD. These findings suggest that family relationships play a critical role in AAs' mental health and should be further explored through a prospective design.

Acculturation Factors Related to Obesity of Latino American Men Nationwide.

Obesity is a public health epidemic, particularly among underrepresented populations. With a large proportion of immigrants, Latino Americans comprise the largest minority population in the United States. This study examined the association of acculturation factors with obesity among Latino American men ( n = 1,127) using the National Latino and Asian American Study. The result identified two acculturation-related factors (being U.S.-born and living in the United States for the longest period/5-10 years) as positive correlates. In contrast, a different study on obesity in Latino American women demonstrated discrimination, but not the above factors, as significant correlates. The men's pattern suggests that the Hispanic/Latino paradox might have greater implications for men with respect to weight issues. Furthermore, Mexican American and Other Latino American men presented a greater likelihood of being obese than Cuban and Puerto Rican men. The findings, if replicated in prospective research, suggest the need for gender- and ethnic-specific intervention for obesity in Latino American men, particularly for the largest subgroup, Mexican Americans.

Differential Associations of Religious Involvement with the Mental Health of Asian-American Subgroups: A Cultural Perspective.

In the USA, Asian-Americans (AA) constitute the fastest growing ethnic minority group, in which heterogeneous religious patterns and acculturation experiences can impose significant impacts on their mental health. Using national data, the present study examined the contributions of religious involvement and social support to self-rated mental health (SRMH) of Chinese, Vietnamese, and Filipinos. Findings demonstrated cross-group variations, with Filipinos reporting the highest levels of SRMH, acculturation, and discrimination. However, religious involvement was associated with better SRMH in the least religious Chinese subgroup but not in the most religious Filipino subgroup. Social support predicted SRMH for both Chinese and Vietnamese subgroups. The differential religious patterns in the more acculturated generations between the two AA subgroups suggest religious assimilation as part of their acculturation in the context of divergent immigration experiences.

Ethnic Identity and Major Depression in Asian American Subgroups Nationwide: Differential Findings in Relation to Subcultural Contexts.

OBJECTIVES: Asian Americans (AA) are the fastest growing minority population in the United States. Leading AA scholars have highlighted the unmet service needs and the necessity to investigate subgroup variations in the mental health of AAs. This study addressed a research gap of whether racial and ethnic identity (REI) in three AA subgroups (Chinese, Filipino, and Vietnamese) consistently protects against major depressive disorder (MDD), counteracting the deleterious role of discrimination. METHOD: Using the National Latino and Asian American Study (NLAAS), we explored the varying and incremental predictive values of REI, above and beyond the effects of known demographic and acculturation predictors, alongside other potentially protective factors. RESULTS: In three sets of two-step logistic regressions, REI had an inverse relationship with MDD in the Filipino subgroup only but a positive association in the Chinese subgroup. The damaging role of negative REI moderated the effect of discrimination. The longest stay in the United States and discrimination predicted a higher likelihood of a MDD diagnosis in the Filipino subgroup. Social support contributed to the lower odds of MDD in Chinese and Vietnamese subgroups, had lower odds of having MDD, and religious attendance may act as a protective factor in the Vietnamese subgroup. CONCLUSION: Our findings do not reinforce uniform protection of REI but lend partial support for two underlying rationales. Based on cultural psychologists' framework, inconsistent findings are interpreted within the sociocultural contexts of the 3 subgroups.

Starting the Conversation - A Childhood Obesity Knowledge Project Using an App.

PURPOSE: Starting the Conversation was a pilot project to test an intervention for childhood obesity, a major public health epidemic, using a free smartphone application (app). The primary aim was to assess students' knowledge of nutritional indicators, physical exercise and use of screen time before and after the intervention. METHODS: The study was conducted in 2011-2012. The sample, recruited from seven high schools in Snohomish County, Washington, was 65.3% minority participants. Of the 118 participants in the sample (n=118), 79 handwrote their responses (n=78) and 36 responded via the app (n=39). We compared the frequency and types of physical exercise, frequency of screen time, and nutritional variables of high school students. Participants used the cell phone app or a handwritten log to record their daily entries for 20 days. RESULTS: Both males (n=43) and females (n=75) grades 9-12 used the app or handwritten entries. Participants who used the app ate less fast food and exercised more, as compared with those who recorded their entries by hand. Screen time usage decreased over the course of the study, based on a comparison of the post-survey level and the pre-survey level. Knowledge of recommended daily consumption of vegetables increased post-test in the app group and knowledge of water consumption increased significantly in both groups. There was no significant difference in BMI pre and post-test. CONCLUSIONS: Patterns of nutritional intake, physical exercise and knowledge of these issues varied pre and post-test. It is critical to further examine factors associated with lack of physical activity and food intake patterns of youth using social media to further address the childhood obesity epidemic. Future research should focus on specific ethnic subgroups and an intervention at the school level aimed at the students with BMI ≥ 95th percentile.

Overall health and health care utilization among Latino American men in the United States.

Although the Latino American male population is increasing, the subgroup Latino men's health remains underinvestigated. This study examined the overall pattern of Latino male health and health care utilization in major subgroups, using a nationally representative sample (N = 1,127) from the National Latino and Asian American Study. The authors evaluated rates of chronic, behavioral, and mental health service utilization in this first nationally representative survey. The results identified significant cross-subgroup differences in most physical and chronic conditions with Puerto Rican American men having high rates in 8 of 15 physical ailments, including life-altering conditions such as cardiovascular diseases. Despite differences in racial/ethnic, socioeconomic, and cultural factors, Cuban American men shared similar rates of heart diseases and cancer with Puerto Rican American men. In addition, Puerto Rican American men had higher rates of substance abuse than other Latinos. For health providers, the authors' findings encourage awareness of subgroup differences regarding overall health issues of Latino American men to provide culturally appropriate care.

Chronic conditions, behavioral health, and use of health services among Asian American men: the first nationally representative sample.

Although the Asian American population is increasing, Asian American men's health remains underinvestigated. This study examined the overall pattern of their health and health care usage. Using a nationally representative sample (N = 998) from the National Latino and Asian American Study (2002-2003), the first comprehensive epidemiological survey, rates of chronic conditions, behavioral health, and mental health service utilization (e.g., general medical, specialty mental health, and any medical services) were computed. The ages ranged from 18 to 95 and the mean age was 41. Of the sample, there were no ethnic subgroup differences in most of the physical and chronic conditions, with the exception of allergies/hay fever, arthritis, asthma, and high blood pressure. Behavioral health problems and substance use varied among Asian American men with more Vietnamese American men reporting that they are current smokers and more Filipino American men reporting having ever used drugs and having higher rates of obesity. Levels of mental health status and health services-seeking behaviors also varied among Asian subgroups. Variations exist among the three subgroups of Asian American men with regard to chronic, behavioral, and mental health issues. The results provide greater understanding of the heterogeneity and relationships among the Asian American subgroups with respect to physical, behavioral, and mental health concerns. Similarities and differences in prevalence rates and use of health services must include examining the social context. Social factors such as immigration status, living environments, lifestyle, culture, and health insurance may help explain the variations among Asian American men.

Overall health and healthcare utilization among Latino American women in the United States.

PURPOSE: The purpose of this study was to examine the chronic conditions, behavioral-mental health and service utilization of Latino American women in the first epidemiologic survey in the United States. METHODS: Using a national sample (n=1427) from the National Latino and Asian American Study, we assessed and compared the prevalence of overall health and service use in three major subgroups, Cuban, Mexican, and Puerto Rican, and in other Latino American women. Service use included general medical, mental health, and subspecialists. RESULTS: In physical health, Puerto Rican American women reported the highest rate of asthma, whereas Mexican American women reported the highest rate of diabetes. Cuban American women reported the highest rate of hypertension and heart diseases. Body mass index (BMI) indicated that overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI≥30 kg/m(2)) were prevalent in all three subgroups: two thirds of Mexicans and Puerto Ricans, respectively, and >50% of Cuban Americans. Of the sample, 11.6% rated their mental health status as fair or poor, and 10.8% reported at least one major depressive disorder (MDD) in the past 12 months. Puerto Rican American women had the highest rates on depression, substance abuse, and seeking mental health service, and Cuban American women saw specialists most frequently. CONCLUSIONS: Patterns of overall health issues varied among Latino American subgroup women, yet they have low rates of healthcare use. It is critical to further examine factors associated with the sex-specific health issues and with their health services underuse.

Physical, behavioral, and mental health issues in Asian American women: results from the National Latino Asian American Study.

AIMS: Asian American women's health has been understudied while the Asian American population is increasing. The purpose of this study was to examine the physical, behavioral, and mental health of Asian American women. METHODS: Using a nationally representative sample (n=1097) from the National Latino Asian American Study (NLAAS), the first comprehensive epidemiologic survey in the United States, we examined the annual rates of behavioral, physical, and mental healthcare service use, including general medical, specialty mental health, and any medical services, in three major subgroups of Asian American women. RESULTS: Health problems varied with three major subgroups of Asian American women. In physical health, Chinese American women reported the highest rates of headache, other pain, hypertension, heart diseases, heart attacks, chronic lung diseases, and asthma. Vietnamese American women reported the highest rates of ulcer, stroke, and diabetes. Filipino American women had the highest rates of cancers and epilepsy. In behavioral health, Filipino women ranked highest on all types of drug use and cigarette smoking, compared with their counterparts. In mental health, Filipino American women reported significantly better mental health self-rating compared with their Chinese and Vietnamese American counterparts. Asian American women from each ethnic group sought health services at distinct rates. However, the help-seeking patterns of health services are similar. CONCLUSIONS: Asian American women encountered various physical, behavioral, and mental health problems, yet they had low rates of seeking healthcare services. Hence, it is critical to further examine factors associated with the underestimation of physical and mental health problems and underuse of health services by Asian American women.

Depression following open-heart surgery: a path model involving interleukin-6, spiritual struggle, and hope under preoperative distress.

Faith factors (i.e., factors pertaining to religion/spirituality) have been linked with well-being and adequate coping. Few studies have investigated negative aspects of religious coping, such as spiritual struggle. Based on the multidisciplinary literature and on previous findings, the study's analysis estimated parallel psychophysiological pathways from preoperative distress to postoperative depression in patients undergoing open heart surgery. Plasma samples for interleukin(IL)-6 were obtained before surgery. The results showed that a link between spiritual struggle and IL-6 mediated the indirect effects of preoperative anxiety on postoperative depression. Avoidant coping also mediated the influence of anxiety on postoperative maladjustment. Further, hope played a protective mediating role to moderate the undesirable influences of the spiritual struggle-IL-6 link and maladaptive coping on postoperative mental health attributes.