Simulation Use in Paramedic Education Research (SUPER): A Descriptive Study.

Objectives: The purpose of this research was to characterize the use of simulation in initial paramedic education programs in order assist stakeholders' efforts to target educational initiatives and resources. This group sought to provide a snapshot of what simulation resources programs have or have access to and how they are used; faculty perceptions about simulation; whether program characteristics, resources, or faculty training influence simulation use; and if simulation resources are uniform for patients of all ages.

Methods: This was a cross-sectional census survey of paramedic programs that were accredited or had a Letter of Review from the Committee on Accreditation of Educational Programs for the EMS Professions at the time of the study.

Psychosocial outcomes of an exercise maintenance intervention after phase II cardiac rehabilitation.

Purpose: Maintenance of exercise after completing phase II cardiac rehabilitation (CR) is challenging for many patients. We offered a telephone-based maintenance intervention and found improvement in exercise participation in the intervention group at 12 months post-CR discharge. We examined the effects of the intervention on psychosocial outcomes.

Maintenance of exercise after phase II cardiac rehabilitation: a randomized controlled trial.

Background: Patients who have completed Phase II cardiac rehabilitation have low rates of maintenance of exercise after program completion, despite the importance of sustaining regular exercise to prevent future cardiac events.

Purpose: The efficacy of a home-based intervention to support exercise maintenance among patients who had completed Phase II cardiac rehabilitation versus contact control was evaluated.

Design: An RCT was used to evaluate the intervention.

Prevalence and characteristics of multiple psychiatric disorders in cardiac rehabilitation patients.

Purpose: Anxiety and depressive disorders have been established as independent risk factors for the development of and recovery from coronary heart disease (CHD). However, few studies have reported on the prevalence and personal characteristics of comorbid psychiatric disorders (PD) among cardiac populations. This project examined the prevalence of comorbid depressive and anxiety disorders among men and women with CHD commencing cardiac rehabilitation (CR) and the demographic, medical, and psychosocial characteristics among those meeting multiple PD criteria.

Anxiety characteristics independently and prospectively predict myocardial infarction in men the unique contribution of anxiety among psychologic factors.

Objectives: This study investigated whether anxiety characteristics independently predicted the onset of myocardial infarction (MI) over an average of 12.4 years and whether this relationship was independent of other psychologic variables and risk factors.

Background: Although several psychosocial factors have been associated with risk for MI, anxiety has not been examined extensively.

Prevalence of anxiety disorders in men and women with established coronary heart disease.

Purpose: Anxiety has been associated with the development and recurrence of coronary heart disease (CHD). The objective of this study was to estimate the prevalence of anxiety disorders in men and women with established CHD.

Methods: One hundred fifty CHD patients were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of anxiety disorders.

Hostility and urine norepinephrine interact to predict insulin resistance: the VA Normative Aging Study.

Objective: Previous research has produced mixed results pertaining to the association between hostility and insulin resistance. These inconsistent findings may be the result of a lack of studies examining potential moderators of this relationship and inconsistent measures of insulin resistance and/or hostility. We hypothesized that hostility may interact with circulating norepinephrine (NEPI) levels, indexed by 24-hour urine concentrations, to affect insulin resistance.

Suppressed hostility predicted hypertension incidence among middle-aged men: the normative aging study.

This study tested whether suppressed hostility predicted incident hypertension (HTN) in initially nonhypertensive men, using prospective data from the Normative Aging Study. Six hundred twenty-seven men who completed the MMPI and participated in a subsequent laboratory assessment were included in the study. The Cook-Medley Hostility scale (Ho), a suppression factor, and other risk factors were used to predict incident HTN over a 3-year period.

Combined effect of the metabolic syndrome and hostility on the incidence of myocardial infarction (the Normative Aging Study).

A growing body of evidence suggests that the metabolic syndrome and hostility are independent risk factors for the development of coronary heart disease. However, few studies have examined the combined effect of the metabolic syndrome and hostility on the incidence of myocardial infarction (MI). We examined prospectively the relation among the metabolic syndrome, hostility, and the incidence of MI in healthy, older men (mean +/- SD 59.

Organ scarcity and the psychological pre-heart transplant evaluation: a simulation study using community residents.

Context: Although research examining medical outcomes in heart transplantation has progressed, there are few studies examining the impact of organ scarcity and wait list demand on the transplant candidate evaluation process.

Objective: To examine the influence of transplant knowledge pertaining to organ scarcity and wait list demand on simulated ratings of psychological distress provided by community residents participating in a simulated pre-heart transplant evaluation.

Design: A randomized, controlled design.

Prevalence of depressive disorders in men and women enrolled in cardiac rehabilitation.

Purpose: Epidemiological studies have demonstrated that depression is an independent risk factor for the development and recurrence of coronary heart disease (CHD). The prevalence of depressive disorders, however, is not well documented in CHD patients enrolled in cardiac rehabilitation (CR). The purpose of this study was to estimate the prevalence of current and lifetime depressive disorders in the CR setting.

Effect of negative emotions on frequency of coronary heart disease (The Normative Aging Study).

Negative emotions, such as depression and anxiety, have been associated with the development of coronary heart disease (CHD). In multivariate models, negative emotions have predicted CHD outcomes, such as nonfatal myocardial infarction and CHD mortality. Few studies, however, have investigated this relation while controlling for variables associated with the metabolic syndrome or those indicative of sympathetic nervous system activity.

Associations between repression, general maladjustment, body weight, and body shape in older males: the Normative Aging Study.

We examined relationships between repression, general maladjustment, body mass index (BMI), and waist-to-hip ratio (WHR). The participants were 1,081 healthy older men from the Normative Aging Study. Repression and General Maladjustment Scales of the Minnesota Multiphasic Personality Inventory were composite measures of personality.

Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute twin study.

Objective: To determine the extent to which depressive symptoms are associated with metabolic risk factors and whether genetic or environmental factors account for this association.

Method: Twin structural equation modeling was employed to estimate genetic and environmental contributions to the covariation of depressive symptoms, as indexed by the Centers for Epidemiological Studies-Depression Scale, and common variance among blood pressure, body mass index, waist-to-hip ratio, and serum triglycerides and glucose among 87 monozygotic and 86 dizygotic male twin pairs who participated in the NHLBI twin study.

Results: Depressive symptoms were associated with individual components of the metabolic syndrome and common variance among the risk factors.

Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X.

The metabolic syndrome, manifested by insulin resistance, obesity, dyslipidemia, and hypertension, is conceived to increase the risk for coronary heart disease and type II diabetes. Several studies have used factor analysis to explore its underlying structure among related risk variables but reported different results. Taking a hypothesis-testing approach, this study used confirmatory factor analysis to specify and test the factor structure of the metabolic syndrome.

Hostility, the metabolic syndrome, and incident coronary heart disease.

This invesgation examined the impact of hostility and the metabolic syndrome on coronary heart disease (CHD) using prospective data from the Normative Aging Study. Seven hundred seventy-four older, unmedicated men free of cardiovascular disease were included in the study. The total Cook-Medley Hostility (Ho) Scale score, anthropometric data, serum lipids, fasting insulin concentrations, blood pressure, cigarette smoking, alcohol consumption, and total dietary calories were used to predict incident CHD during a 3-year follow-up interval.