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1.
Int J Behav Med ; 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38570426

RESUMO

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.

2.
Stress Health ; 2023 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-37924512

RESUMO

Stress forecasting is the cognitive process of anticipating and preparing to respond to future stress experiences based on one's own perceived future stress. Though it may seem intuitive that stress forecasting predicts stress, competing theories exist that indicate the relationship is not so inherent. In this paper we conducted two studies which both examine the relationships between stress forecasting and day stress, examining two different stress domains (appraisal and coping). Participants in Study 1 (n = 143 working adults) and Study 2 (n = 60 undergraduate students) completed 4 and 14 days, respectively, of ecological momentary assessment reports of stress appraisal forecasting, stress coping forecasting, stress appraisal reports, and stress coping reports, for a combined total of 5280 completed assessments. Exploratory analysis in Study 2 examined the importance of morning forecast discrepancy in relation to evening recalls of day stress. Results indicate that within domain (e.g., stress appraisal to appraisal reports), or domain specific, stress forecasting is predictive of day stress, and that across domains (e.g., stress appraisal to coping reports), or domain crossover, was consistent between stress appraisal forecasting and stress coping reports. Results suggest that magnitude of bias and day outlook (i.e., being either optimistic or pessimistic) about one's coping ability matters for day stress outcomes. Findings have implications for developing challenge-based thinking interventions and further understanding cognitive processes for building stress management strategies.

3.
Cogn Emot ; 37(7): 1261-1271, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37675962

RESUMO

Theoretical work proposes that acceptance, attention monitoring, decentering, self-compassion, and nonreactivity are mechanisms that explain beneficial effects of mindfulness training. Yet, whether these mechanisms represent independent constructs and whether they naturally vary within person is unclear. This study examined whether mindfulness mechanisms represent independent constructs that naturally fluctuate within a person over time, and whether these fluctuations differentially relate to negative emotions. A sample of university staff employees (n = 143; 74.8% female; M ± SDage = 38.2 ± 10.9; 53.8% White) reported on mindfulness mechanisms and negative emotions five times a day for four days for a total of 2,122 assessments. Four distinct mechanisms emerged - acceptance-attention, decentering, self-compassion, nonreactivity - that exhibit substantial moment-to-moment variation. Greater acceptance-attention, self-compassion, and nonreactivity were associated with lower negative emotions; greater decentering was associated with higher negative emotions when examined concurrently with the other mechanisms. The unique associations of all mindfulness mechanisms with negative emotions, combined with their high levels of variability from moment to moment, suggest their potential as targets for mindfulness interventions to improve emotional well-being.


Assuntos
Atenção Plena , Humanos , Feminino , Masculino , Autocompaixão , Emoções , Atenção , Local de Trabalho
4.
Ann Behav Med ; 57(8): 630-639, 2023 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-37335887

RESUMO

BACKGROUND: Negative interpersonal interactions are associated with acute increases in ambulatory blood pressure (ABP). Yet, the mechanisms underlying this relationship are unclear. PURPOSE: This study tested whether negative interpersonal interactions predict higher ABP both in the moment and during subsequent observations, and whether increases in negative mood mediate these relations. These associations were tested among Black and Hispanic urban adults who may be at higher risk for negative interpersonal interactions as a function of discrimination. Race/ethnicity and lifetime discrimination were tested as moderators. METHODS: Using a 24-hr ecological momentary assessment (EMA) design, 565 Black and Hispanic participants (aged 23-65, M = 39.06, SD = 9.35; 51.68% men) had their ABP assessed every 20 min during daytime accompanied by an assessment of negative interpersonal interactions and mood. This produced 12,171 paired assessments of ABP and self-reports of participants' interpersonal interactions, including how much the interaction made them feel left out, harassed, and treated unfairly, as well as how angry, nervous, and sad they felt. RESULTS: Multilevel models revealed that more intense negative interpersonal interactions predicted higher momentary ABP. Mediation analyses revealed that increased negative mood explained the relationship between negative interpersonal interactions and ABP in concurrent and lagged analyses. Discrimination was associated with more negative interpersonal interactions, but neither race/ethnicity nor lifetime discrimination moderated findings. CONCLUSIONS: Results provide a clearer understanding of the psychobiological mechanisms through which interpersonal interactions influence cardiovascular health and may contribute to health disparities. Implications include the potential for just-in-time interventions to provide mood restoring resources after negative interactions.


Being mistreated by others has been shown to have negative impacts on cardiovascular health, including higher blood pressure (BP) levels. Yet, it is not clear why this mistreatment leads to increased and sustained influences on BP. In this paper, among a sample of Black and Hispanic urban adults, we studied whether changes in negative mood after being treated unfairly, excluded, or harassed explained the reason for higher BP levels. Participants completed reports of how they were treated in recent social interactions, and their levels of negative mood they were feeling at the current moment, every 20 min for 1 day. A BP measurement also occurred at each measurement. We found that negative mood was higher when a person reported being treated unfairly, excluded, and/or harassed, and that the negative mood that followed these negative interpersonal interactions accounted for increases in BP. These results have implications for how mistreatment can lead to chronic illness over time, and provides the potential for providing resources to restore mood and improve BP after mistreatment.


Assuntos
Afeto , Negro ou Afro-Americano , Hispânico ou Latino , Relações Interpessoais , Adulto , Feminino , Humanos , Masculino , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Hispânico ou Latino/psicologia , Negro ou Afro-Americano/psicologia , População Urbana , Racismo/etnologia , Racismo/psicologia , Avaliação Momentânea Ecológica , Adulto Jovem , Pessoa de Meia-Idade
5.
Artigo em Inglês | MEDLINE | ID: mdl-37047955

RESUMO

Previous research suggests that affectionate touch such as hugs might downregulate stress systems such as the hypothalamic pituitary adrenal (HPA) axis. However, the current literature lacks in generalizability beyond the laboratory setting and outside the context of romantic relationships. The cortisol awakening response (CAR) is a measure of the HPA axis and is responsive to daily fluctuations in stress and social information. However, associations between affectionate touch and the CAR have never been assessed. This study used ecological momentary assessment (EMA) to measure daily hugging behaviors in 104 first-year college students and salivary cortisol to assess the CAR. Participants who reported more daily hugs in their social interactions had significantly smaller CARs the next morning compared to days they reported fewer hugs. This study contributes to the literature on social interactions and stress responsive systems and emphasizes the importance of assessing affectionate touch behaviors such as hugs that can be exchanged outside the context of romantic relationships.


Assuntos
Ritmo Circadiano , Hidrocortisona , Humanos , Ritmo Circadiano/fisiologia , Sistema Hipotálamo-Hipofisário/fisiologia , Avaliação Momentânea Ecológica , Sistema Hipófise-Suprarrenal/fisiologia , Saliva , Vigília/fisiologia
6.
Psychosom Med ; 85(6): 535-544, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37097116

RESUMO

OBJECTIVE: Hostility is a risk factor for cardiovascular disease and mortality, but less is known about when hostility poses greatest risk. Work environments can be characterized by features that are reactive for high-hostile individuals. Using a person by environment approach, this article tested whether hostility interacted with work location to predict the cardiovascular disease risk factors of ambulatory blood pressure (ABP) and momentary affect. METHOD: Community participants ( n = 108; age, 20-68 years; mean [standard deviation] = 36.52 [11.96] years; 66.06% men; primarily 35.62% non-Hispanic Black, 31.51% non-Hispanic White, and 15.07% Latino/Hispanic) completed a measure of trait hostility followed by two 24-hour ABP monitoring sessions. After each ABP reading, ecological momentary assessment was used to capture participants' current location and ratings of anger, sadness, happiness, and anxiety. RESULTS: A total of 4321 observations were recorded. Multilevel models tested the relationship between work location, trait hostility, and their interaction on ABP and momentary affect. Participants higher on hostility had higher systolic ABP, diastolic ABP, anger, and sadness (but not happiness or anxiety) when at work compared with when not at work; no differences were observed for those lower on hostility. A more consistent pattern of results was found for the William hostility subscale than a traditional measure. CONCLUSIONS: Results suggest that mechanisms for how trait hostility can lead to cardiovascular disease and mortality and highlight the importance of studying traits like hostility within context. Future research should consider the role of social determinates of health like socioeconomic status and features of the work environment to better understand this relationship.


Assuntos
Doenças Cardiovasculares , Hostilidade , Masculino , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Pressão Sanguínea/fisiologia , Condições de Trabalho , Monitorização Ambulatorial da Pressão Arterial , Ira/fisiologia
7.
Perspect Psychol Sci ; 18(1): 110-124, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35904963

RESUMO

Repeated assessments in everyday life enables collecting ecologically valid data on dynamic, within-persons processes. These methods have widespread utility and application and have been extensively used for the study of stressors and stress responses. Enhanced conceptual sophistication of characterizing intraindividual stress responses in everyday life would help advance the field. This article provides a pragmatic overview of approaches, opportunities, and challenges when intensive ambulatory methods are applied to study everyday stress responses in "real time." We distinguish between three stress-response components (i.e., reactivity, recovery, and pileup) and focus on several fundamental questions: (a) What is the appropriate stress-free resting state (or "baseline") for an individual in everyday life? (b) How does one index the magnitude of the initial response to a stressor (reactivity)? (c) Following a stressor, how can recovery be identified (e.g., when the stress response has completed)? and (d) Because stressors may not occur in isolation, how can one capture the temporal clustering of stressors and/or stress responses (pileup)? We also present initial ideas on applying this approach to intervention research. Although we focus on stress responses, these issues may inform many other dynamic intraindividual constructs and behaviors (e.g., physical activity, physiological processes, other subjective states) captured in ambulatory assessment.


Assuntos
Exercício Físico , Estresse Psicológico , Humanos , Estresse Psicológico/psicologia , Exercício Físico/psicologia
8.
Ann Behav Med ; 57(1): 38-49, 2023 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-34894226

RESUMO

BACKGROUND: Anxiety, anger, and sadness are related to elevated ambulatory blood pressure (ABP), yet it is unclear whether each emotion exerts unique effects. Moreover, an understanding of who might be most susceptible to the negative effects of these emotions is limited, with the trait tendency to experience them or one's race as potential moderators. PURPOSE: The study examined the potential for differential effects of momentary anxiety, anger, and sadness on ABP. The study assessed whether a trait tendency to experience these negative emotions and/or race (Black vs. non-Black) would moderate these relationships. METHODS: Participants (n = 153) completed trait anxiety, anger, and depressive symptoms measures at baseline. ABP was collected over two 24-hour periods 3-4 months apart. Momentary measures of anxiety, anger, and sadness were assessed via ecological momentary assessment (EMA) after each ABP reading. RESULTS: Momentary anxiety consistently predicted diastolic blood pressure but not systolic blood pressure. Momentary anger and sadness did not predict blood pressure (BP). Conditional effects were found with momentary anxiety and anger predicting elevated BP in those individuals with trait anxiety/anger at its mean. Trait anxiety and depression consistently predicted heightened BP in Black participants. Trait anger did not moderate the relationships between negative emotions and ABP. CONCLUSIONS: Findings suggest that momentary anxiety and anger should be given attention as potential risk factors for hypertension and highlight the unique perspective of EMA methods. Black participants who were more anxious and depressed experienced heightened BP, with anxiety and depression providing possible intervention targets in improving racial disparities in cardiovascular health.


Assuntos
Hipertensão , Tristeza , Humanos , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Ira , Ansiedade/psicologia , Emoções
9.
J Am Coll Health ; 71(5): 1407-1416, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-34242538

RESUMO

OBJECTIVE: Changes in surroundings and social relationships may heighten feelings of loneliness, suggesting the need to measure as a state. This study tested whether loneliness fluctuates within and across days and the resultant associations with psychological distress. Further it tested familism as a moderator as endorsing this cultural value may buffer the negative effects of state loneliness. PARTICIPANTS: Participants (n = 220) were Latinx undergraduate students. METHODS: Students reported their loneliness levels and psychological distress twice a day for two weeks using an ecological momentary assessment approach. RESULTS: Results showed that experiencing a higher than usual level of loneliness predicted greater sadness, stress, and anxiety at both the moment-to-moment and day-to-day level. Familism, measured at baseline, only moderated the relationship between loneliness and sadness. CONCLUSIONS: The findings suggest being in a lonely moment may lead to the initiation or amplification of psychological distress immediately and the effects may linger over the day.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1927051.


Assuntos
Hispânico ou Latino , Solidão , Angústia Psicológica , Estudantes , Humanos , Solidão/psicologia , Estudantes/psicologia , Universidades
10.
JMIR Mhealth Uhealth ; 10(4): e33527, 2022 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-35377327

RESUMO

BACKGROUND: Mobile health (mHealth) apps targeting health behaviors using behavior change techniques (BCTs) have been successful in promoting healthy behaviors; however, their efficacy with sleep is unclear. Some work has shown success in promoting sleep through mHealth, whereas there have been reports that sleep apps can be adverse and lead to unhealthy obsessions with achieving perfect sleep. OBJECTIVE: This study aims to report and describe the use of BCTs in mHealth apps for sleep with the following research questions: How many BCTs are used on average in sleep apps, and does this relate to their effectiveness on sleep outcomes? Are there specific BCTs used more or less often in sleep apps, and does this relate to their effectiveness on sleep outcomes? Does the effect of mHealth app interventions on sleep change when distinguishing between dimension and measurement of sleep? METHODS: We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to review articles on mHealth app interventions for sleep published between 2010 and 2020. RESULTS: A total of 12 studies met the eligibility criteria. Most studies reported positive sleep outcomes, and there were no negative effects reported. Sleep quality was the most common dimension of sleep targeted. Subjective measures of sleep were used across all apps, whereas objective measures were often assessed but rarely reported as part of results. The average number of BCTs used was 7.67 (SD 2.32; range 3-11) of 16. Of the 12 studies, the most commonly used BCTs were feedback and monitoring (n=11, 92%), shaping knowledge (n=11, 92%), goals and planning (n=10, 83%), and antecedents (n=10, 83%), whereas the least common were scheduled consequences (n=0, 0%), self-belief (n=0, 0%), and covert learning (n=0, 0%). Most apps used a similar set of BCTs that unfortunately did not allow us to distinguish which BCTs were present when studies reported more positive outcomes. CONCLUSIONS: Our study describes the peer-reviewed literature on sleep apps and provides a foundation for further examination and optimization of BCTs used in mHealth apps for sleep. We found strong evidence that mHealth apps are effective in improving sleep, and the potential reasons for the lack of adverse sleep outcome reporting are discussed. We found evidence that the type of BCTs used in mHealth apps for sleep differed from other health outcomes, although more research is needed to understand how BCTs can be implemented effectively to improve sleep using mHealth and the mechanisms of action through which they are effective (eg, self-efficacy, social norms, and attitudes).


Assuntos
Aplicativos Móveis , Telemedicina , Terapia Comportamental/métodos , Comportamentos Relacionados com a Saúde , Humanos , Sono
11.
Stress Health ; 38(2): 375-387, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34494721

RESUMO

Stress is multidimensional, including exposure, subjective appraisals, perceived coping, rumination, and worry. Although research has shown each dimension can predict poor social, emotional, and subjective well-being, rarely have these dimensions of stress been compared as one is experiencing stress. This paper used ecological momentary assessment (EMA) to repeatedly measure stress dimensions and self-reported health to test whether each stress dimension has a unique relationship with well-being over time at the between-person and within-person levels. Participants (n = 165, 79.6% female) were Hispanic undergraduates, who completed EMAs twice a day for 14 consecutive days, resulting in 3,436 EMAs and 1,987 morning sleep observations. At each EMA, participants reported on the dimensions of stress, feelings of loneliness and belongingness (social well-being), levels of sadness, happiness, and anxiety (emotional well-being), and how healthy they felt (subjective well-being). Sleep quality and duration (subjective well-being) were assessed each morning. Multilevel models revealed few relationships at the between-person level. At the within-person level, appraisals, coping, rumination, and worry consistently predicted social, emotional, and subjective well-being. Lagged analyses suggested some relationships for appraisal, coping, and worry. Results suggest the importance of measuring stress in a multidimensional capacity and examining associations with well-being across multiple health facets.


Assuntos
Avaliação Momentânea Ecológica , Emoções , Adaptação Psicológica , Feminino , Hispânico ou Latino , Humanos , Masculino , Autorrelato
12.
Ann Behav Med ; 56(3): 305-310, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34156423

RESUMO

BACKGROUND: Research pairing ecological momentary assessment (EMA) methodology and ambulatory cortisol during daily life is still rare, as is careful testing of the within-person associations between stress, affect, and cortisol. Using a circumplex approach, we considered both valence and arousal components of affect. PURPOSE: To examine the within-person covariation of momentary cortisol with momentary perceived stress, affective valence, and affective arousal in everyday life. METHODS: 115 working adults (Mage = 41.2; 76% women; 76% white) completed six EMA surveys per day over 3 days. Each assessment included reports of perceived stress and affect (used to construct indicators of affective valence and arousal), followed by a saliva sample (from which cortisol was assessed). Multi-level models were used to examine the momentary associations between perceived stress, affective valence, affective arousal, and cortisol. RESULTS: Moments characterized by higher perceived stress were associated with higher cortisol (p = .036). Affective valence covaried with cortisol (p = .003) such that more positive valence was associated with lower cortisol and more negative valence with higher cortisol. Momentary affective arousal was not related to cortisol (p = .131). When all predictors were tested in the same model, only valence remained a significant predictor of cortisol (p = .047). CONCLUSION: Momentary perceived stress and affective valence, but not affective arousal, were associated with naturalistic cortisol. Cortisol was more robustly associated with affective valence than perceived stress or affective arousal. These findings extend our understanding of how moments of stress and particular characteristics of affective states (i.e., valence but not arousal) may "get under the skin" in daily life.


Assuntos
Afeto , Hidrocortisona , Adulto , Nível de Alerta , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Estresse Psicológico/psicologia
13.
PLoS One ; 16(10): e0257940, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618834

RESUMO

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.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Fatores de Risco de Doenças Cardíacas , Hipertensão/epidemiologia , Aculturação , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/psicologia , Criança , Colesterol/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Diabetes Mellitus/psicologia , Feminino , Hispânico ou Latino/psicologia , Humanos , Hipertensão/sangue , Hipertensão/patologia , Hipertensão/psicologia , Masculino , Americanos Mexicanos/psicologia , Características de Residência , Fumar , Estresse Psicológico/fisiopatologia
14.
J Clin Med ; 10(19)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34640499

RESUMO

INTRODUCTION: Children and youth under the age of 19 provide daily care for family members living with illness, including Amyotrophic Lateral Sclerosis (ALS). Caregiving affects school performance, social support, stress, and anxiety. Yet, little is known about potential disruptions in sleep. METHODS: A quasi-experimental matched comparison of age- and gender-matched young carers (n = 8) and non-carers (n = 12) was used in this study. Participants completed a pre/post survey, wore an actigraphy device, and journaled sleep/wake times for 5 days. RESULTS: Young carers had shorter sleep duration (t = 51.19 (11.99)), efficiency (t = 55.49 (14.00)), sleep quality (t = 51.32 (12.26)), and higher rates of utilizing sleep medications (t = 50.81 (11.49)). The case study sleep data showed that carers had lower total sleep time (CG = 6.75 ± 1.47, NCG = 7.08 ± 1.36) and sleep efficiency than non-caregivers (0.80 ± 0.23). Case examples were reported across groups. CONCLUSIONS: The study results demonstrate feasibility, while providing crucial initial case data on sleep quality in young carers. The findings underscore the need to better document the impact of caregiving on young carer's well-being across several areas, including sleep. This data has implications for larger scale studies examining how sleep disruption impacts well-being more broadly and in providing support and respite interventions for young carers across disorders.

15.
Int J Psychophysiol ; 167: 94-101, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34228984

RESUMO

OBJECTIVE: This study examined whether recalling a social stress that evoked lonely feelings produces greater affective and blood pressure responses than recalling non-social stress or a relaxing event. METHODS: Young adults (n = 114) underwent one of three inductions: recalling a social stressor in which one felt lonely, recalling a non-social non-lonely stressor, and relaxation. Negative affect was assessed during baseline, induction, and recovery. Blood pressure was assessed continuously using a finger cuff. RESULTS: Both the lonely and non-lonely stress conditions reported increased negative affect following the induction, with neither condition having fully recovered to baseline levels by the end of the study. For blood pressure, during recovery, blood pressure increased linearly for the lonely stress condition, but remained steady for the other conditions. CONCLUSIONS: Recalling a social stress evoking lonely feelings may be more harmful for cardiovascular health than recalling non-social stressors. Results extend work demonstrating that in vivo stressors involving social evaluation elicit larger stress responses compared to stressors without this component.


Assuntos
Sistema Cardiovascular , Solidão , Pressão Sanguínea , Emoções , Humanos , Estresse Psicológico , Adulto Jovem
16.
J Behav Med ; 44(4): 571-578, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33905032

RESUMO

Research implicates experiences of discrimination in exacerbating cardiometabolic disease (CMD) risk. Belongingness has been suggested as a buffer against the adverse effects of discrimination. However, when discrimination occurs in an environment to which one feels they belong, then the potential benefits of belongingness may dissipate or even exacerbate the effects of discrimination. In the present study, we examined these competing hypotheses on how campus belonging might moderate the relationship between discrimination experienced on campus and CMD risk. College students (n = 160, 60.9% Latino/a/x) reported the frequency of on-campus discrimination and campus belongingness, and then completed items assessing risk for CMD. More frequent discrimination related to higher comparative CMD risk among those who reported high campus belongingness, even after adjusting for relevant covariates. These findings highlight the complicated nature of belongingness in the context of physical health. Future research is needed to better understand the role of environment when considering morbidity among college students.


Assuntos
Doenças Cardiovasculares , Estudantes , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Universidades
17.
J Immigr Minor Health ; 23(5): 1001-1010, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33502662

RESUMO

Sleep problems and poorer well-being may be particularly salient for Latino/a college students as they tend to experience sociocultural adjustments during this transitory time. Social connections, a correlate of health, change moment-to-moment for college students and may be experienced differently for people who more strongly endorse horizontal collectivist cultural values. We used ecological momentary assessment (EMA) to examine how in-the-moment social connections influence in-the-moment health, and how horizontal collectivism moderates the moment-to-moment associations. Self-identified Latino/a college students (n = 221) completed a demographic information and cultural values questionnaire and then responded to EMA measures on their social connections, affective and subjective well-being, and sleep for 14 consecutive days. Better in-the-moment social connections associated with better health. Horizontal collectivism moderated some, but not all associations between social connections and health. Social connections are multidimensional and differently predict in-the-moment health among Latino/a college students who more strongly endorse horizontal collectivistic values. We discuss implications for identifying vulnerable well-being moments among this understudied population.


Assuntos
Hispânico ou Latino , Estudantes , Avaliação Momentânea Ecológica , Humanos , Inquéritos e Questionários
18.
Artif Organs ; 45(1): 55-62, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33029801

RESUMO

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.


Assuntos
Oxigenação por Membrana Extracorpórea/instrumentação , Cardiopatias Congênitas/cirurgia , Coração Auxiliar/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Adolescente , Criança , Pré-Escolar , Oxigenação por Membrana Extracorpórea/efeitos adversos , Oxigenação por Membrana Extracorpórea/métodos , Oxigenação por Membrana Extracorpórea/estatística & dados numéricos , Feminino , Cardiopatias Congênitas/mortalidade , Coração Auxiliar/efeitos adversos , Humanos , Lactente , Recém-Nascido , Masculino , Alta do Paciente/estatística & dados numéricos , Transferência de Pacientes/estatística & dados numéricos , Complicações Pós-Operatórias/etiologia , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
19.
J Behav Med ; 43(1): 108-120, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31140032

RESUMO

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.


Assuntos
Exercício Físico/psicologia , Estresse Psicológico/epidemiologia , Adulto , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Fumantes , Estresse Psicológico/complicações , Adulto Jovem
20.
Stigma Health ; 4(3): 264-281, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31517056

RESUMO

This study employed an intersectional approach (operationalized as the combination of more than one social identity) to examine the relationship between aspects of social identity (i.e., race, gender, age, SES), self-reported level of mistreatment, and attributions for discrimination. Self-reported discrimination has been researched extensively and there is substantial evidence of its association with adverse physical and psychological health outcomes. Few studies, however, have examined the relationship of multiple demographic variables (including social identities) to overall levels self-reported mistreatment as well the selection of attributions for discrimination. A diverse community sample (N = 292; 42.12% Black; 47.26% male) reported on experiences of discrimination using the Everyday Discrimination Scale. General linear models were used to test the effect of sociodemographic characteristics (i.e., race, gender, age, SES) on total discrimination score and on attributions for discrimination. To test for intersectional relationships, we tested the effect of two-way interactions of sociodemographic characteristics on total discrimination score and attributions for discrimination. We found preliminary support for intersectional effects, as indicated by a significant race by age interaction on the selection of the race attribution for discrimination; gender by SES on the age attribution; age by gender on the education attribution; and race by SES on the economic situation attribution. Our study extends prior work by highlighting the importance of testing more than one factor as contributing to discrimination, particularly when examining to what sources individuals attribute discrimination.

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