Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

Association of Trait Resilience With Peritraumatic and Posttraumatic Stress in Patients With Myocardial Infarction.

OBJECTIVE Acute myocardial infarction (MI) is a life-threatening condition, leading to immediate fear and distress in many patients. Approximately 18% of patients develop posttraumatic stress disorder in the aftermath of MI. Trait resilience has shown to be a protective factor for the development of posttraumatic stress disorder. However, whether this buffering effect has already an impact on peritraumatic distress and applies to patients with MI is elusive. METHODS We investigated 98 consecutive patients with acute MI within 48 hours after having reached stable circulatory conditions and 3 months thereafter. Peritraumatic distress was assessed retrospectively with three single-item questions about pain, fear, and helplessness during MI. All patients completed the Posttraumatic Diagnostic Scale (PDS) and the Resilience Scale to self-rate posttraumatic stress and trait resilience. RESULTS Multivariate models adjusting for sociodemographic and medical factors showed that trait resilience was not associated with peritraumatic distress, but significantly so with posttraumatic stress. Patients with greater trait resilience showed lower PDS scores (b = -0.06, p < .001). There was no significant relationship between peritraumatic distress scores and PDS scores; resilience did not emerge as a moderator of this relationship. CONCLUSIONS The findings suggest that trait resilience does not buffer the perception of acute MI as stressful per se but may enhance better coping with the traumatic experience in the longer term, thus preventing the development of MI-associated posttraumatic stress. Trait resilience may play an important role in posttraumatic stress symptoms triggered by medical diseases such as acute MI.

Cambios en la distribución minorista de alimentos y bebidas en Argentina 2001-2003 : Hacia nuevas horizontalidades territoriales

Se presentan en este trabajo los principales cambios en la distribución minorista de alimentos y bebidas en la Argentina iniciados con la crisis económica, política y social del año 2001. El territorio usado por parte de los actores sociales involucrados, como las empresas de diferentes tamaños (desde hipermercados a almacenes), y las personas (consumidores), ya no solo responderá a un orden global y a verticalidades territoriales, sino que muchas de estas nuevas tendencias estarán comandadas por normas locales relacionadas con la horizontalidad territorial. Entre estos cambios, son los más importantes: el consumo orientado a las ofertas; a empaques más chicos; a segundas y terceras marcas; a marcas propias de supermercados; a una nueva frecuencia en la realización de las compras; a la combinación de varios canales de distribución con el fenómeno denominado "vuelta al barrio", y a compras de productos sueltos.

Cambios en la distribución minorista de alimentos y bebidas en Argentina 2001-2003 : Hacia nuevas horizontalidades territoriales

Se presentan en este trabajo los principales cambios en la distribución minorista de alimentos y bebidas en la Argentina iniciados con la crisis económica, política y social del año 2001. El territorio usado por parte de los actores sociales involucrados, como las empresas de diferentes tamaños (desde hipermercados a almacenes), y las personas (consumidores), ya no solo responderá a un orden global y a verticalidades territoriales, sino que muchas de estas nuevas tendencias estarán comandadas por normas locales relacionadas con la horizontalidad territorial. Entre estos cambios, son los más importantes: el consumo orientado a las ofertas; a empaques más chicos; a segundas y terceras marcas; a marcas propias de supermercados; a una nueva frecuencia en la realización de las compras; a la combinación de varios canales de distribución con el fenómeno denominado "vuelta al barrio", y a compras de productos sueltos.

Cambios en la distribución minorista de alimentos y bebidas en Argentina 2001-2003 : Hacia nuevas horizontalidades territoriales

Se presentan en este trabajo los principales cambios en la distribución minorista de alimentos y bebidas en la Argentina iniciados con la crisis económica, política y social del año 2001. El territorio usado por parte de los actores sociales involucrados, como las empresas de diferentes tamaños (desde hipermercados a almacenes), y las personas (consumidores), ya no solo responderá a un orden global y a verticalidades territoriales, sino que muchas de estas nuevas tendencias estarán comandadas por normas locales relacionadas con la horizontalidad territorial. Entre estos cambios, son los más importantes: el consumo orientado a las ofertas; a empaques más chicos; a segundas y terceras marcas; a marcas propias de supermercados; a una nueva frecuencia en la realización de las compras; a la combinación de varios canales de distribución con el fenómeno denominado "vuelta al barrio", y a compras de productos sueltos.

Evaluación de la calidad de vida relacionada con la salud mediante las láminas Coop-Wonca en una población de hemodiálisis

Ante la necesidad de disponer de instrumentos que permitan medir calidad de vida relacionada con la salud (CVRS) de una manera ágil y rápida, nos planteamos estudiar, en un grupo de pacientes en hemodiálisis, las propiedades de medición de las láminas Coop-Wonca con el objetivo de establecer si reúnen las condiciones para su uso rutinario en este tipo de pacientes. Métodos: Estudio transversal en 163 pacientes de hemodiálisis (106 varones y 57 mujeres) procedentes de 3 centros. Para medir la CVRS de la población estudiada se ha utilizado la versión validada española de las láminas Coop-Wonca completa. Este cuestionario comprende nueve dimensiones de función y bienestar de un único ítem: 1.– Forma física; 2.–Sentimientos; 3.–Actividades cotidianas; 4.–Actividades sociales; 5.–Cambio en el estado de salud; 6.–Estado de salud; 7.–Dolor; 8.–Apoyo social; y 9.–Calidad de vida en general. Las posibles respuestas se puntúan de 1 a 5, siendo las puntuaciones mayores las que reflejan una peor salud percibida. El instrumento permite la obtención de un índice (Coop total) que es un sumatorio de las puntuaciones de todas las dimensiones salvo la 5 (Cambio en el estado de salud). Resultados: El tiempo medio de cumplimentación del cuestionario fue inferior a 5 minutos. Las láminas resultaron fácilmente comprensibles para los pacientes y la autoadministración de las mismas no planteó problemas. Las puntuaciones más altas (peor CVRS) se obtuvieron en las dimensiones «forma física» (3,66 ± 0,8) y «estado de salud» (3,43 ± 0,8), y la menor (mejor CVRS) en la dimensión «actividades sociales» (1,98 ± 1,3). Entre los principales factores asociados a un peor estado de salud percibida figuran el sexo (mujer), la comorbilidad (presencia de diabetes y/o hepatopatía), la situación laboral (pensionista) y el medio de transporte (taxi-ambulancia). Un mayor tiempo en hemodiálisis se asoció a peores puntuaciones en las dimensiones «calidad de vida en general» y «Dolor». Los pacientes que se trasladaban en taxi o ambulancia presentaban peores puntuaciones en las dimensiones «Forma física», «Actividades cotidianas» y «Estado de salud». Una mayor se asoció a peor puntuación en «Forma física». Un número elevado de fármacos prescritos (más de seis) se asoció a peor puntuación en las dimensiones «Forma física», «Actividades sociales» y «Apoyo social». Los varones, los viudos y los solteros puntuaron peor en «Apoyo social». Los pacientes con mayor nivel de estudios mostraron puntuaciones más altas (peor CVRS) en la dimensión «Forma física». Conclusiones: Las láminas Coop-Wonca podrían ser un buen instrumento de medida de CVRS en los pacientes de hemodiálisis, por la rapidez de su cumplimentación y por ser de fácil comprensión lo que favorece la autoadministración que evita el posible sesgo del entrevistador. Todo ello favorecería su uso rutinario como indicador par valorar la evolución en el tiempo de la CVRS de los pacientes en hemodiálisis. No obstante, se precisan estudios ulteriores que permitan evaluar en mayor profundidad las propiedades psicométricas del instrumento en este tipo de pacientes.

Is the effect of reading misspellings context dependent?

In 48 university students performing single-item spelling recognition, prior exposure to misspelled words improved slightly the accuracy on correctly spelled words and increased markedly the 'false alarm' rate (classifying a misspelling seen at study as correct). In a group given a dictation test (N = 24) the only effect of exposure to misspellings was a small increment in the number of misspellings that matched the misspelling seen at study. The two test groups showed no advantage of having the same display format at study and test (AA or BB vs AB or BA). Experiment 2 (in progress) investigated a format match at study and test against a condition with a new test context (AA or BB vs AC or BC). The results to date suggest an influence of memory of the study trial rather than simply an updating by the study exposures of abstract lexical representations. [ABSTRACT FROM AUTHOR]

Risk taking from the participant's perspective: The case of driving and accident risk

Although perceived health risk plays a prominent role in theories of health behavior. its empirical role in risk taking is less clear. In Study 1 (N = 129), 2 measures of drivers' risk-taking behavior were found to be unrelated to self-estimates of accident concern but to be related to self-ratings of driving skill and the perceived thrill of driving. In Study 2 (N = 405), out of a wide range of potential influences, accident concern had the weakest relationship with risk taking. The authors concluded that although health risk is a key feature in many theories of health behavior and a central focus for researchers and policy makers, it may not be such a prominent factor for those actually taking the risk.

On the use of likert-type scales in multilevel data:Influence on aggregate variables

In multilevel analyses, problems may arise when using Likert-type scales at the lowest level of analysis. Specifically, increases in variance should lead to greater censoring for the groups whose true scores fall at either end of the distribution. The current study used simulation methods to examine the influence of single-item Likert-type scale usage on ICC(1), ICC(2), and group-level correlations. Results revealed substantial underestimation of ICC(1) when using Likert-type scales with common response formats (e.g., 5 points). ICC(2) and group-level correlations were also underestimated, but to a lesser extent. Finally, the magnitude of underestimation was driven in large part to an interaction between Likert-type scale usage and the amounts of within- and between-group variance. © Sage Publications.

Axis-alignment affects perceptual grouping: evidence from simultanagnosia

We examined the effect of grouping by the alignment of implicit axes on the perception of multiple shapes, using a patient (GK) who shows simultanagnosia as part of Blint's syndrome. Five experiments demonstrated that: (1) GK was better able to judge the orientation of a global configuration if the constituent local shapes were aligned with their major axes than if they were aligned with their edges; (2) this axis information was used implicitly, since GK was unable to discriminate between configurations of axis-aligned and edge-aligned shapes; (3) GK's sensitivity to axis-alignment persisted even when the orientations of local shapes were kept constant, indicating some form of cooperative effect between the local elements; (4) axis-alignment of shapes also facilitated his ability to discriminate single-item from multi-item configurations; (5) the effect of axis-alignment could be attributed, at least partially, to the degree to which there was matching between the orientations of local shapes and the global configuration. Taken together, the results suggest that axis-based grouping can support the selection of multiple objects.

Design and implementation of production systems for high variety electronics assembly

Information technology companies are having to broaden their overall strategic view in deference to the premise that it is better to be market-driven than technology-led. Cost and technical performance are no longer the only considerations, as quality and service now demand equal recognition. The production of a high volume single item has given way to that of low volume multiple items, which in turn requires some modification of production systems and brings flexible manufacturing, Just-in-Time production and total quality control into sharper focus for the achievement of corporate objectives.

Student morningness-eveningness type and performance:does class timing matter?

Circadian rhythms have often been linked to people’s performance outcomes, although this link has not been examined within the context of University students. We therefore sought to test whether students’ perceptions of their morning-evening (ME) type had an influence on their performance on modules. We tested this hypothesis using students from a number of modules at two UK Universities. Results indicated that, contrary to our hypothesis, the further the discrepancy between a student’s ME type and the teaching time of the class, the better the student’s performance. These results have implications for teaching as student ME type could be taken into account for timetabling especially if modules need to be taught multiple times. We also provide implications for those seeking to measure ME, as our results are consistent with a 5-item ME scale, a 3-item ME scale, and a single-item ME scale.

What's in a broken promissory obligation? Developing and testing a multiple component form measure of psychological contract breach

While the literature has suggested the possibility of breach being composed of multiple facets, no previous study has investigated this possibility empirically. This study examined the factor structure of typical component forms in order to develop a multiple component form measure of breach. Two studies were conducted. In study 1 (N = 420) multi-item measures based on causal indicators representing promissory obligations were developed for the five potential component forms (delay, magnitude, type/form, inequity and reciprocal imbalance). Exploratory factor analysis showed that the five components loaded onto one higher order factor, namely psychological contract breach suggesting that breach is composed of different aspects rather than types of breach. Confirmatory factor analysis provided further evidence for the proposed model. In addition, the model achieved high construct reliability and showed good construct, convergent, discriminant and predictive validity. Study 2 data (N = 189), used to validate study 1 results, compared the multiple-component measure with an established multiple item measure of breach (rather than a single item as in study 1) and also tested for discriminant validity with an established multiple item measure of violation. Findings replicated those in study 1. The findings have important implications for considering alternative, more comprehensive and elaborate ways of assessing breach.

Stability of the Inventory-Backorder Process in the (R; S) Inventory/Production Model

2000 Mathematics Subject Classification: 60G52, 90B30.

Comparison of Objectively and Subjectively Measured Sedentary Behavior in Men with Prostate Cancer and a History of Androgen-Deprivation Therapy Use

Thesis (Master's)--University of Washington, 2016-08