Mindfulness-Based Stress Reduction for Coronary Artery Disease Patients: Potential Improvements in Mastery and Depressive Symptoms.

Depressive symptoms after coronary events are associated with a worse prognosis. When changing the focus from psychopathology towards a resilience framework, treatments such as mindfulness meditation could offer novel ways to address psychological distress among coronary artery disease (CAD) patients. We studied the feasibility of mindfulness-based stress reduction (MBSR) for CAD patients with depressive symptoms.

Pentraxin-3 detected in human saliva shows limited correlation with biomarkers associated with systemic inflammation.

Pentraxin-3 (PTX3) is a conserved protein of the innate immune system which has been less studied than the pentraxin C-reactive protein (CRP), but it is of relevance in, for example, vascular pathology and pregnancy morbidities. Since the interest in salivary biomarkers in general is increasing, we asked whether PTX3 could be detected in saliva and if any substantial diurnal variation occurs. In addition, we evaluated association with biomarkers of systemic inflammation (interleukin (IL)-1β, IL-6, and IL-8 and CRP), body mass index (BMI), smoking, and age.

Measuring psychosocial factors in health surveys using fewer items.

The present study investigated the possibility of reducing length of psychosocial scales, while maintaining validity, using easily manageable techniques. Data were collected 2003-2004 in a Swedish general population; = 1007, ages 45-69, 50% women. Eight psychosocial scales were reduced from 6-20 to 3-7 items maintaining Cronbach's alpha >0.

Pronounced Diurnal Pattern of Salivary C-Reactive Protein (CRP) With Modest Associations to Circulating CRP Levels.

C-reactive protein (CRP), a humoral component of the innate immune system with important functions in host-defense, is extensively used as a sensitive biomarker of systemic inflammation. During inflammation, hepatocyte-derived CRP rises dramatically in the blood due to increased interleukin-6 (IL-6) levels. Reliable detection of CRP in saliva, instead of blood, would offer advantages regarding sampling procedure and availability but using saliva as a diagnostic body fluid comes with challenges.

A journey through chaos and calmness: experiences of mindfulness training in patients with depressive symptoms after a recent coronary event - a qualitative diary content analysis.

Background: Psychological distress with symptoms of depression and anxiety is common and unrecognized in patients with coronary artery disease (CAD). Efforts have been made to treat psychological distress in CAD with both conventional methods, such as antidepressant drugs and psychotherapy, and non-conventional methods, such as stress management courses. However, studies focusing on the experiences of mindfulness training in this population are still scarce.

Outpatient comprehensive geriatric assessment: effects on frailty and mortality in old people with multimorbidity and high health care utilization.

Background: Multimorbidity and frailty are often associated and Comprehensive Geriatric Assessment (CGA) is considered the gold standard of care for these patients.

Aims: This study aimed to evaluate the effect of outpatient Comprehensive Geriatric Assessment (CGA) on frailty in community-dwelling older people with multimorbidity and high health care utilization.

Methods: The Ambulatory Geriatric Assessment-Frailty Intervention Trial (AGe-FIT) was a randomized controlled trial (intervention group, n = 208, control group n = 174) with a follow-up period of 24 months.

Inverted items and validity: A psychobiological evaluation of two measures of psychological resources and one depression scale.

Psychological resources and risk factors influence risk of coronary heart disease. We evaluated whether inverted items in the Self-esteem, Mastery, and Center for Epidemiological Studies Depression scales compromise validity in the context of coronary heart disease. In a population-based sample, validity was investigated by calculating correlations with other scales ( = 1004) and interleukin-6 ( = 374), and by analyzing the relationship with 8-year coronary heart disease risk ( = 1000).

Patients requests and needs for culturally and individually adapted supportive care in type 2 diabetes patients: A comparative study between Nordic and non-Nordic patients in a social economical vulnerable area of Linköping, Sweden.

Aims: This study sought to determine and compare the metabolic control of type 2 diabetes mellitus (T2DM) in non-Nordic immigrants and native Nordics. The aim was also to describe and compare the request of supportive care between these two groups.

Methods: One hundred and eighty-four patients (n=184) coming to a routine check-up in a primary healthcare setting (PHC), were consecutively enrolled to the study during a period of one year.

Psychological Resources Are Independently Associated with Markers of Inflammation in a Middle-Aged Community Sample.

Purpose: To elucidate possible independent associations of psychological resources with inflammatory markers, all linked with coronary heart disease (CHD).

Method: In a middle-aged general population (n = 944), psychological resources (coping, self-esteem, and sense of coherence (SOC)), a global measure of quality of life (Cantril's self-anchoring ladder, also called "ladder of life"), and psychological risk factors (hopelessness, vital exhaustion, and depressive symptoms) were used in linear regression models to evaluate associations with the inflammatory markers interleukin (IL)-6, C-reactive protein (CRP), and matrix metalloproteinase (MMP)-9. Adjustments were done for age, sex, medical conditions, and cardiovascular risk factors.

Plasma Matrix Metalloproteinase-9 Levels Predict First-Time Coronary Heart Disease: An 8-Year Follow-Up of a Community-Based Middle Aged Population.

Background: The enzyme in matrix metalloproteinase (MMP)-9 has been suggested to be an important determinant of plaque degradation. While several studies have shown elevated levels in patients with coronary heart disease, results in prospective population based studies evaluating MMP-9 in relation to first time coronary events have been inconclusive. As of today, there are four published studies which have measured MMP-9 in serum and none using plasma.

The joint subclinical elevation of CRP and IL-6 is associated with lower health-related quality of life in comparison with no elevation or elevation of only one of the biomarkers.

Background: Measures of health-related quality of life (HRQoL), like the Short Form (SF)-36, have been suggested to correlate with inflammatory biomarkers. It is, however, unclear whether a joint measure of two inflammatory biomarkers would bring additional information in comparison with evaluation of one inflammatory biomarker.

Objective: To evaluate associations between SF-36 and low-grade inflammation in a Swedish population, with emphasis on a combined measure of C-reactive protein (CRP) and interleukin-6 (IL-6) as a proxy for low-grade inflammation.

Exploring trends in and determinants of educational inequalities in self-rated health.

Aims: Educational inequalities in self-rated health (SRH) in European welfare countries are documented, but recent trends in these inequalities are less well understood. We examined educational inequalities in SRH in different age groups, and the contribution of selected material, behavioural and psychosocial determinants from 2000 to 2008.

Methods: Data were derived from cross-sectional surveys conducted in 2000, 2004 and 2008 including 37,478, 34,876 and 32,982 respondents, respectively, aged 25-75 in mid-Sweden.

Psychological resources are associated with reduced incidence of coronary heart disease. An 8-year follow-up of a community-based Swedish sample.

Background: A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.

Purpose: The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.

Socioeconomic differences in outpatient healthcare utilisation are mainly seen for musculoskeletal problems in groups with poor self-rated health.

Aim: To assess whether there are socioeconomic (SES) differences in outpatient visits within groups of comparable morbidity (medical disease and self-rated health) and whether psychosocial factors can explain these differences.

Methods: Baseline data for SES, presence of disease, self-rated health (SRH), and psychosocial factors were collected during 2003-04 from 923 men and women aged 45-69 years in southeast Sweden. Outcome data were all registered outpatient healthcare visits to physicians during 2004-08.

Plasma levels of matrix metalloproteinase-9 are independently associated with psychosocial factors in a middle-aged normal population.

Objective: To test the association between psychosocial factors and circulating levels of matrix metalloproteinase-9 (MMP-9) in a normal population sample. Psychosocial factors have been associated with inflammatory markers and are of prognostic significance for coronary artery disease (CAD). The degrading enzyme MMP-9 is upregulated in inflammatory processes and hypothesized to play a role in the rupture of atherosclerotic plaques.

Parish classification or dwelling coordinate for exposure assessment in environmental epidemiology - a comparative study using Geographical Information System.

Background: Two previous epidemiological studies on the incidence of total malignancies in Sweden after the Chernobyl accident have shown consistently increased risks. The first study used an analogue map on (137)Cs from 1986 to classify individuals in terms of the parish they lived in. In the second study, dwelling coordinates were matched to a digital map from the year 2000 to assess the individual exposure.

Pooling ambulatory saliva cortisol samples over consecutive days - as reliable as arithmetic means.

Objective: When cortisol measurements are to be studied in large populations, cost-effective analyses are needed. This study aimed at testing whether one pooled cortisol value over three consecutive days is as reliable as using the arithmetic mean of the samples from the same measure points.

Material And Methods: Thirty participants aged between 45 and 69 collected saliva in salivettes immediately after awakening (t(1)), 30 min after awakening (t(2)) and in the evening (t(3)) during 3 consecutive days.

Circulating matrix metalloproteinase-9 is associated with cardiovascular risk factors in a middle-aged normal population.

Background: Elevated levels of circulating matrix metalloproteinase-9 (MMP-9) have been demonstrated in patients with established coronary artery disease (CAD). The aim of this study was to analyse levels of MMP-9 in a population free from symptomatic CAD and investigate their associations with cardiovascular (CV) risk factors, including C-reactive protein (CRP).

Methods: A cross-sectional study was performed in a population based random sample aged 45-69 (n = 345, 50% women).