Anhedonic Depression Is Not Associated With Risk of Recurrent Major Adverse Cardiac Events and All-Cause Mortality in Acute Coronary Syndrome Patients.

Background: Depression after acute coronary syndrome (ACS) is common and increases risks of adverse outcomes, but it remains unclear which depression features are most associated with major adverse cardiac events (MACE) and all-cause mortality (ACM).

Purpose: To examine whether a subtype of depression characterized by anhedonia and major depressive disorder (MDD) predicts 1-year MACE/ACM occurrence in ACS patients compared to no MDD history. We also consider other depression features in the literature as predictors.

Development and usability testing of the e-EXCELS tool to guide cancer survivorship follow-up care.

Objective: The aim of this study is to describe a user-centered (e.g., cancer survivors and clinicians) development process of an eHealth tool designed to facilitate self-management of cancer survivorship follow-up care.

Rationale and design of extended cancer education for longer term survivors (EXCELS): a randomized control trial of 'high touch' vs. 'high tech' cancer survivorship self-management tools in primary care.

Background: Breast, colorectal, and prostate cancer survivors are at increased risk for late and long-term effects post-treatment. The post-treatment phase of care is often poorly coordinated and survivors navigate follow-up care with minimal information or guidance from their healthcare team. This manuscript describes the Extended Cancer Education for Longer-term Survivors (EXCELS) in Primary Care protocol.

Stress management in the workplace for employees with hypertension: a randomized controlled trial.

While behavioral interventions can improve blood pressure (BP) in individuals with hypertension, getting such services to people who could benefit remains difficult. Workplace programs have potential as dissemination vehicles. The objective is to evaluate the effectiveness of a standardized stress management program delivered in groups at the workplace for reducing BP compared with enhanced usual care.

Impact of Perceived Weight Stigma among Underserved Women on Doctor-Patient Relationships.

Objective: To evaluate how perception of weight stigma among underserved women with obesity impacts doctor-patient relationships.

Methods: This study consisted of an interviewer-administered survey of 149 women with obesity (BMI ≥ 30 kg/m) immediately after their physician visit at four Federally Qualified Health Centers. Perceptions of weight stigma and physician empathy were measured using the Stigma Situations in Health Care instrument and Consultation and Relational Empathy (CARE) measure, respectively.

Hispanic residential ethnic density and depression in post-acute coronary syndrome patients: Re-thinking the role of social support.

Background: The ethnic density hypothesis suggests that ethnic density confers greater social support and consequently protects against depressive symptoms in ethnic minority individuals. However, the potential benefits of ethnic density have not been examined in individuals who are facing a specific and salient life stressor.

Aims: We examined the degree to which the effects of Hispanic ethnic density on depressive symptoms are explained by socioeconomic resources and social support.

Women weigh in: obese African American and White women's perspectives on physicians' roles in weight management.

Background: There is little qualitative research on the type of weight loss counseling patients prefer from their physicians and whether preferences differ by race.

Methods: This qualitative study used semistructured, in-depth interviews of 33 moderately to severely obese white and African American women to elucidate and compare their perceptions regarding their primary care physician's approach to weight loss counseling. Data were analyzed using a grounded theory approach and a series of immersion/crystallization cycles.

Association of acute coronary syndrome-induced posttraumatic stress disorder symptoms with self-reported sleep.

Background: Symptoms of posttraumatic stress disorder (PTSD) after acute coronary syndrome (ACS) are associated with recurrent ACS events and mortality. Poor sleep may be a mechanism, but the association between PTSD and sleep after ACS is unknown.

Purpose: This study aims to estimate the association between ACS-induced PTSD symptoms and self-reported sleep.

A randomized controlled trial of mindfulness-based stress reduction for women with early-stage breast cancer receiving radiotherapy.

Purpose: To testthe relative effectiveness of a mindfulness-based stress reduction program (MBSR) compared with a nutrition education intervention (NEP) and usual care (UC) in women with newly diagnosed early-stage breast cancer (BrCA)undergoing radiotherapy.

Methods: Datawere available from a randomized controlled trialof 172 women, 20 to 65 years old, with stage I or II BrCA. Data from women completing the 8-week MBSR program plus 3 additional sessions focuses on special needs associated with BrCA were compared to women receiving attention control NEP and UC.

Posttraumatic stress and myocardial infarction risk perceptions in hospitalized acute coronary syndrome patients.

Posttraumatic stress disorder (PTSD) is related to acute coronary syndrome (ACS; i.e., myocardial infarction or unstable angina) recurrence and poor post-ACS adherence to medical advice.

Widowhood and mortality: a meta-analysis and meta-regression.

The study of spousal bereavement and mortality has long been a major topic of interest for social scientists, but much remains unknown with respect to important moderating factors, such as age, follow-up duration, and geographic region. The present study examines these factors using meta-analysis. Keyword searches were conducted in multiple electronic databases, supplemented by extensive iterative hand searches.

Obese women's barriers to mammography and pap smear: the possible role of personality.

Obese women are at increased risk of developing and dying from cancer, but are less likely than nonobese women to receive cancer screening examinations. Our qualitative study explores obese women's barriers to Pap smears and mammograms in greater depth than previous research. We also seek to understand why some obese women undergo screening whereas others do not.

Music for surgical abortion care study: a randomized controlled pilot study.

Background: The study objective was to explore the effect of music as an adjunct to local anesthesia on pain and anxiety during first-trimester surgical abortion. Secondary outcomes included patient satisfaction and coping.

Study Design: We conducted a randomized controlled pilot study of 26 women comparing music and local anesthesia to local anesthesia alone.

The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial.

The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20-65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years.

Posttraumatic stress due to an acute coronary syndrome increases risk of 42-month major adverse cardiac events and all-cause mortality.

Approximately 15% of patients with acute coronary syndromes (ACS) develop posttraumatic stress disorder (PTSD) due to their ACS event. We assessed whether ACS-induced PTSD symptoms increase risk for major adverse cardiac events (MACE) and all-cause mortality (ACM) in an observational cohort study of 247 patients (aged 25-93 years; 45% women) hospitalized for an ACS at one of 3 academic medical centers in New York and Connecticut between November 2003 and June 2005. Within 1 week of admission, patient demographics, Global Registry of Acute Coronary Events risk score, Charlson comorbidity index, left ventricular ejection fraction, and depression status were obtained.

Association between social isolation and left ventricular mass.

Background: Social isolation is associated with progression of cardiovascular disease, with the most socially isolated patients being at increased risk. Increased left ventricular mass is a predictor of cardiovascular morbidity and mortality. It is not yet clear whether social isolation is a determinant of increased left ventricular mass.

Association of anhedonia with recurrent major adverse cardiac events and mortality 1 year after acute coronary syndrome.

Context: Depression consistently predicts recurrent events and mortality in patients with acute coronary syndrome (ACS), but it has 2 core diagnostic criteria with distinct biological correlates-depressed mood and anhedonia (loss of pleasure or interest).

Objective: To determine if depressed mood and/or anhedonia predict 1-year medical outcomes for patients with ACS.

Design: Observational cohort study of post-ACS patients hospitalized between May 2003 and June 2005.

Enhanced depression care for patients with acute coronary syndrome and persistent depressive symptoms: coronary psychosocial evaluation studies randomized controlled trial.

Background: Depressive symptoms are an established predictor of mortality and major adverse cardiac events (defined as nonfatal myocardial infarction or hospitalization for unstable angina or urgent/emergency revascularizations) in patients with acute coronary syndrome (ACS). This study was conducted to determine the acceptability and efficacy of enhanced depression treatment in patients with ACS.

Methods: A 3-month observation period to identify patients with ACS and persistent depressive symptoms was followed by a 6-month randomized controlled trial.

Rationale and design of a randomized clinical trial comparing stress reduction treatment to usual cardiac care: the Reducing Vulnerability to Implantable Cardioverter Defibrillator Shock-Treated Ventricular Arrhythmias (RISTA) trial.

Objective: To present the design of a multicenter, randomized trial testing the effects of stress reduction treatment (SRT) on the prevalence of shock-treated ventricular arrhythmias among patients with an implantable cardioverter defibrillator (ICD). Significant adjustment problems secondary to ICD shock can increase the likelihood of arrhythmias requiring shock for termination. Whether SRT can reduce arrhythmias requiring shock for termination in patients with ICDs has not been tested in clinical trials.

The misdiagnosis of hypertension: the role of patient anxiety.

Background: The white coat effect (defined as the difference between blood pressure [BP] measurements taken at the physician's office and those taken outside the office) is an important determinant of misdiagnosis of hypertension, but little is known about the mechanisms underlying this phenomenon. We tested the hypothesis that the white coat effect may be a conditioned response as opposed to a manifestation of general anxiety.

Methods: A total of 238 patients in a hypertension clinic wore ambulatory blood pressure monitors on 3 separate days 1 month apart.

Paroxysmal hypertension: the role of stress and psychological factors.

This paper reviews the limited literature on paroxysmal hypertension. A case report describes the clinical picture frequently seen in specialty hypertension practice, a patient with paroxysmal or intermittent hypertension who proves not to have a pheochromocytoma. The variety of diagnostic labels given to these patients is reviewed, including pseudopheochromocytoma, panic attacks, and hyperventilation syndrome.

Treating persistent depressive symptoms in post-ACS patients: the project COPES phase-I randomized controlled trial.

Depression and sub-syndromal depressive symptoms are important predictors of morbidity and mortality after acute coronary syndrome (ACS). Prior trials of depression treatment in post-ACS patients have demonstrated no improvement for event-free survival, and only modest improvement in depression symptoms. These trials have raised a number of important issues regarding timing of depression intervention, acceptability of depression treatment to ACS patients, and safety for subsets of the treated population.

The impact of perceived hypertension status on anxiety and the white coat effect.

Background: The white coat effect can lead to overdiagnosis of hypertension and unnecessary pharmacologic treatment. Mechanisms underlying the white coat effect remain poorly understood but are critical to improving the accuracy of clinic blood pressure measurement.

Purpose: This study investigated whether perceived hypertension status was associated with state anxiety levels during a clinic visit and the magnitude of the white coat effect, independent of true blood pressure status.

Using tailored telephone counseling to accelerate the adoption of colorectal cancer screening.

Background: Few interventions to increase colorectal cancer screening have used a stage of change model to promote screening adoption. None have used computer-assisted tailored telephone counseling calls. This study's purpose was to implement and evaluate stage-based computer-assisted tailored telephone counseling to promote colorectal cancer screening in a primary care population.