scholarly journals Relationship Between Chronic Stress and Heart Rate Over Time Modulated by Gender in a Cohort of Office Workers: Cross-Sectional Study Using Wearable Technologies

10.2196/18253 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18253
Author(s):  
Alex Wilhelmus Jacobus van Kraaij ◽  
Giuseppina Schiavone ◽  
Erika Lutin ◽  
Stephan Claes ◽  
Chris Van Hoof
Keyword(s):  
Heart Rate ◽  
Chronic Stress ◽  
Acute Stress ◽  
Vital Signs ◽  
Cross Sectional Study ◽  
Energy Utilization ◽  
Cross Sectional ◽  
Stress Study ◽  
Stress Changes ◽  
Over Time

Background Chronic stress is increasing in prevalence and is associated with several physical and mental disorders. Although it is proven that acute stress changes physiology, much less is known about the relationship between physiology and long-term stress. Continuous measurement of vital signs in daily life and chronic stress detection algorithms could serve this purpose. For this, it is paramount to model the effects of chronic stress on human physiology and include other cofounders, such as demographics, enabling the enrichment of a population-wide approach with individual variations. Objective The main objectives of this study were to investigate the effect of chronic stress on heart rate (HR) over time while correcting for weekdays versus weekends and to test a possible modulation effect by gender and age in a healthy cohort. Methods Throughout 2016 and 2017, healthy employees of technology companies were asked to participate in a 5-day observation stress study. They were required to wear two wearables, of which one included an electrocardiogram sensor. The derived HR was averaged per hour and served as an output for a mixed design model including a trigonometric fit over time with four harmonics (periods of 24, 12, 8, and 6 hours), gender, age, whether it was a workday or weekend day, and a chronic stress score derived from the Perceived Stress Scale (PSS) as predictors. Results The study included 328 subjects, of which 142 were female and 186 were male participants, with a mean age of 38.9 (SD 10.2) years and a mean PSS score of 13.7 (SD 6.0). As main effects, gender (χ21=24.02, P<.001); the hour of the day (χ21=73.22, P<.001); the circadian harmonic (χ22=284.4, P<.001); and the harmonic over 12 hours (χ22=242.1, P<.001), over 8 hours (χ22=23.78, P<.001), and over 6 hours (χ22=82.96, P<.001) had a significant effect on HR. Two three-way interaction effects were found. The interaction of age, whether it was a workday or weekend day, and the circadian harmonic over time were significantly correlated with HR (χ22=7.13, P=.03), as well as the interaction of gender, PSS score, and the circadian harmonic over time (χ22=7.59, P=.02). Conclusions The results show a relationship between HR and the three-way interaction of chronic stress, gender, and the circadian harmonic. The modulation by gender might be related to evolution-based energy utilization strategies, as suggested in related literature studies. More research, including daily cortisol assessment, longer recordings, and a wider population, should be performed to confirm this interpretation. This would enable the development of more complete and personalized models of chronic stress.

scholarly journals Relationship Between Chronic Stress and Heart Rate Over Time Modulated by Gender in a Cohort of Office Workers: Cross-Sectional Study Using Wearable Technologies (Preprint)

2020 ◽  
Author(s):  
Alex Wilhelmus Jacobus van Kraaij ◽  
Giuseppina Schiavone ◽  
Erika Lutin ◽  
Stephan Claes ◽  
Chris Van Hoof
Keyword(s):  
Heart Rate ◽  
Chronic Stress ◽  
Acute Stress ◽  
Vital Signs ◽  
Cross Sectional Study ◽  
Energy Utilization ◽  
Cross Sectional ◽  
Stress Study ◽  
Stress Changes ◽  
Over Time

BACKGROUND Chronic stress is increasing in prevalence and is associated with several physical and mental disorders. Although it is proven that acute stress changes physiology, much less is known about the relationship between physiology and long-term stress. Continuous measurement of vital signs in daily life and chronic stress detection algorithms could serve this purpose. For this, it is paramount to model the effects of chronic stress on human physiology and include other cofounders, such as demographics, enabling the enrichment of a population-wide approach with individual variations. OBJECTIVE The main objectives of this study were to investigate the effect of chronic stress on heart rate (HR) over time while correcting for weekdays versus weekends and to test a possible modulation effect by gender and age in a healthy cohort. METHODS Throughout 2016 and 2017, healthy employees of technology companies were asked to participate in a 5-day observation stress study. They were required to wear two wearables, of which one included an electrocardiogram sensor. The derived HR was averaged per hour and served as an output for a mixed design model including a trigonometric fit over time with four harmonics (periods of 24, 12, 8, and 6 hours), gender, age, whether it was a workday or weekend day, and a chronic stress score derived from the Perceived Stress Scale (PSS) as predictors. RESULTS The study included 328 subjects, of which 142 were female and 186 were male participants, with a mean age of 38.9 (SD 10.2) years and a mean PSS score of 13.7 (SD 6.0). As main effects, gender (χ<sup>2</sup><sub>1</sub>=24.02, <i>P</i>&lt;.001); the hour of the day (χ<sup>2</sup><sub>1</sub>=73.22, <i>P</i>&lt;.001); the circadian harmonic (χ<sup>2</sup><sub>2</sub>=284.4, <i>P</i>&lt;.001); and the harmonic over 12 hours (χ<sup>2</sup><sub>2</sub>=242.1, <i>P</i>&lt;.001), over 8 hours (χ<sup>2</sup><sub>2</sub>=23.78, <i>P</i>&lt;.001), and over 6 hours (χ<sup>2</sup><sub>2</sub>=82.96, <i>P</i>&lt;.001) had a significant effect on HR. Two three-way interaction effects were found. The interaction of age, whether it was a workday or weekend day, and the circadian harmonic over time were significantly correlated with HR (χ<sup>2</sup><sub>2</sub>=7.13, <i>P</i>=.03), as well as the interaction of gender, PSS score, and the circadian harmonic over time (χ<sup>2</sup><sub>2</sub>=7.59, <i>P</i>=.02). CONCLUSIONS The results show a relationship between HR and the three-way interaction of chronic stress, gender, and the circadian harmonic. The modulation by gender might be related to evolution-based energy utilization strategies, as suggested in related literature studies. More research, including daily cortisol assessment, longer recordings, and a wider population, should be performed to confirm this interpretation. This would enable the development of more complete and personalized models of chronic stress.

scholarly journals Time trends of socioeconomic inequalities in adolescent smoking in Okinawa, Japan, 2008–2016: a repeated cross-sectional study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Minoru Takakura ◽  
Masaya Miyagi ◽  
Akira Kyan
Keyword(s):  
Time Trends ◽  
Parental Education ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
School Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
Japanese Adolescents ◽  
Index Of Inequality ◽  
Over Time

Abstract Background Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016. Methods We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated. Results Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time. Conclusions Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.

scholarly journals Heart rate variability and blood pressure among Japanese men and women: a community-based cross-sectional study

2014 ◽  
Vol 37 (8) ◽  
pp. 779-784 ◽  
Author(s):  
Hiromi Mori ◽  
Isao Saito ◽  
Eri Eguchi ◽  
Koutatsu Maruyama ◽  
Tadahiro Kato ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Japanese Men ◽  
Men And Women

scholarly journals Trend and status of out-of-pocket payments for healthcare in Iran: equity and catastrophic effect

2020 ◽  
Vol 95 (1) ◽  
Author(s):  
Satar Rezaei ◽  
Abraha Woldemichael ◽  
Mohammad Ebrahimi ◽  
Sina Ahmadi
Keyword(s):  
Household Income ◽  
Cross Sectional Study ◽  
Publicly Funded ◽  
Socioeconomically Disadvantaged ◽  
Time Series Regression ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Main Determinants ◽  
Over Time ◽  
Yearly Data

Abstract Background Equity in the distribution of health care resources and mitigating the risk of out-of-pocket (OOP) catastrophic healthcare expenditures (CHE) are the major objectives of the health system of a country. This study aims to measure equity in OOP payments for healthcare and the incidence of CHE among Iranian households over time. Methods This retrospective cross-sectional study utilized data extracted from the household income and expenditure survey (HIES) of Iran, collected by the Statistical Center of Iran. The analysis included a total of 174,341 households’ five yearly data of 6 years starting from 1991 to 2017. Kakwani progressivity index (KPI) was used to measure the equity in OOP payment for each year and examine the households’ incidence of CHE at 20%, 30%, and 40% of their capacities to pay (CTP). The trend series regression analysis was used to examine the trend in the KPI and the incidence of the CHE over time. Results The findings indicated that the households’ expenditure on health out of their monthly budgets for the years 1991 and 2017 were 2.1% and 10.1%, respectively. The KPI for the OOP payment was negative for all 6-year observations (1991 = − 0.680; 1996 = − 0.608; 2001 = − 0.554; 2006 = − 0.265; 2011 = − 0.225, and 2017 = − 0.207), indicating that the OOP payments for healthcare are regressive and more concentrated among the socioeconomically disadvantaged households. There was a statistically significant (p = 0.003) increase in the KPI (i.e., decline in the regressivity) over time. The incidence of the CHE (1.12, 1.93, and 3.71%) in 1991 at the CTP levels of 20%, 30%, and 40% was lower than the incidence at the corresponding levels of CTP (5.26, 10.88, and 22.16) in 2017. The findings of the time-series regression indicated a statistically significant (p < 0.05) increase in the incidence of the CHE at the 20%, 30%, and 40% levels of the households’ CTP. Conclusions The current study demonstrated that OOP payment as a source of healthcare funding in Iran is inequitable. While the use of interventions such as the prepaid and publicly funded programs may contribute to the reduction of CHE and improvement of equity in healthcare financing, further inequality analyses in the incidence of the CHE among households and its main determinants can contribute to evidence-informed planning to reduce the CHE in the context.

Temporal Trends in the Severity and Mortality of Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Hypothermia

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Cristina Vega-Del-Val ◽  
Juan Arnaez ◽  
Sonia Caserío ◽  
Elena Pilar Gutiérrez ◽  
Marta Benito ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Cross Sectional Study ◽  
Annual Incidence ◽  
Hypoxic Ischemic Encephalopathy ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Changes Over Time ◽  
Ischemic Encephalopathy ◽  
Annual Decline ◽  
Over Time

<b><i>Introduction:</i></b> There is a paucity of studies examining temporal trends in the incidence and mortality of moderate-to-severe hypoxic-ischemic encephalopathy (HIE) during the last decade of therapeutic hypothermia (TH). <b><i>Methods:</i></b> Multicenter cross-sectional study of all infants ≥35 weeks gestational age diagnosed with moderate-to-severe HIE within 6 h of birth in an extensive region of Spain between 2011 and 2019, in order to detect trend changes over time in the (1) annual incidence, (2) severity of neurological and systemic organ involvement, and (3) neonatal death from HIE. <b><i>Results:</i></b> Annual incidence rate of moderate-to-severe HIE was 0.84 (95% confidence interval [CI] 0.7–0.97) per 1,000 births, without trend changes over time (<i>p</i> = 0.8), although the proportion of severe HIE infants showed an average annual decline of 0.86 points (95% CI 0.75–0.98). There were 102 (70%) infants diagnosed with moderate HIE and 44 (30%) with severe HIE. TH was offered to 139/146 (95%) infants. Infants with clinical and/or electrical seizures showed a decreasing trend from 56 to 28% (<i>p</i> = 0.006). Mortality showed a nonstatistically significant decline (<i>p</i> = 0.4), and the severity of systemic damage showed no changes (<i>p</i> = 0.3). Obstetric characteristics remained unchanged, while higher perinatal pH values (<i>p</i> = 0.03) and Apgar scores (<i>p</i> = 0.05), and less need for resuscitation (<i>p</i> = 0.07), were found over time. <b><i>Conclusion:</i></b> The annual incidence of moderate-to-severe HIE has stabilized at around 1 per 1,000 births, with a temporal trend toward a decrease in severe HIE infants and a slight decline of mortality. No association was found between temporal trends and changes in perinatal/obstetric characteristics over time.

scholarly journals Health hazards and risks for musculoskeletal problems among child labourers in the brickfield sector of West Bengal, India

2018 ◽  
Vol 11 (4) ◽  
pp. 250-257 ◽  
Author(s):  
Banibrata Das
Keyword(s):  
Heart Rate ◽  
Occupational Health ◽  
Respiratory Health ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Health Hazards ◽  
Cross Sectional ◽  
Control Subjects ◽  
Strenuous Activity ◽  
Musculoskeletal Problems

Abstract Aims The purpose of this study was to describe the health hazards among child labourers in brickfields, and to assess occupational health problems, together with physiological and respiratory stress, compared with child control subjects. Methods A cross-sectional study was conducted on 112 child brickfield workers and 120 control subjects, and a modified Nordic Questionnaire was applied to assess the discomfort felt among both groups of workers. Physiological assessment of the workload was carried out by the measurement of heart rate, blood pressure and spirometry of the workers. Results Child brickfield workers suffer from pain, especially in the lower back (97%), shoulder (88%), hands (82%), wrist (76%), neck (73%) and ankle (71%). The post-activity heart rate of the child brickfield workers was 166.5 beats/min, whereas the systolic and diastolic blood pressures were 132.2 and 67.2 mm/Hg, respectively. The forced vital capacity value of child brickfield workers was 2.04, and in the case of the controls it was 2.18, which was significantly different. The forced expiratory volumes in 1 s of experimental and control subjects were 1.82 and 1.92, respectively. The peak expiratory flow rate was significantly different between the two groups. Conclusions Most of the brick-making activities were strenuous ones that affected the children. The cardiovascular and respiratory health of the child brickfield workers has changed markedly due to strenuous activity. The child brickfield workers also experienced other occupational health problems and severe musculoskeletal pain.

scholarly journals Hepatitis B antibody titers in Indonesian adolescents who received the primary hepatitis B vaccine during infancy

2013 ◽  
Vol 53 (3) ◽  
pp. 160
Author(s):  
Hartono Gunardi ◽  
Adra Firmansyah ◽  
Sri Rezeki S Harun ◽  
Sudigdo Sastroasmoro
Keyword(s):  
Hepatitis B ◽  
Booster Dose ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Blood Tests ◽  
Vaccination History ◽  
Antibody Titers ◽  
Hb Vaccine ◽  
Over Time

Backgi-ound Hepatitis B (HB) has been classified as moderate-tohighlyendemic in Indonesia. HB vaccination, the most effectivemethod to prevent HB viral transmission, induces protectiveantibodies against HB surface antigen (anti-HBs). However, theseantibodies decline in titer over time. Studies on the duration ofprotection and the prevalence of n on-responders in Indonesianadolescents have been limited.Objectives To determine anti-HBs titers in 15-17-year oldIndonesian adolescents given primary HB vaccine during infancyand the prevalence of non-responders after a HB vaccine boosterdosage.Methods This cross-sectional study was performed from Februaryto September 2008 on adolescents aged 15-17 years in threesenior high schools in Jakarta who received complete primary HBvaccines during infancy, based on parents' recall. Investigationsincluded HB vaccination history, anthropometric measurements,and blood tests for anti-HBs before and 4-6 weeks after a boosterdose ofHB vaccine.Results Of 94 subjects, 35 had protective anti-HBs and 59 hadundetectable anti-HBs. A booster dose was administered to 5 8 of then on-protected subjects, of which 33 showed anamnestic responses.However, 25 subjects failed to generate protective anti-HBs. Takinginto consideration the adolescents with protective anti-HBs beforeand after the booster dose, serologic protection was demonstratedin 73%. Non-responder prevalence was 27%. The high prevalenceof non-responders may indicate bias of parents' recall.Conclusion Protective anti-HBs is detected in less than half ofIndonesian adolescents given primary HB vaccine during infancy.Following booster dosage, anamnestic responses are n oted in onethirdof subjects. The prevalence of non-responders is 27%, butconfirmation with further study is needed.

scholarly journals Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Kersting ◽  
Lena Zimmer ◽  
Anika Thielmann ◽  
Birgitta Weltermann
Keyword(s):  
Regression Model ◽  
General Practitioners ◽  
Chronic Stress ◽  
Medical Records ◽  
High Strain ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Work Related

Abstract Background The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. Methods This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. Results Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29–19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. Conclusions This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

scholarly journals Experience of stigma among mental health service users in Hong Kong: Are there changes between 2001 and 2017?

2018 ◽  
Vol 65 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Ka-Fai Chung ◽  
Samson Tse ◽  
Chit-Tat Lee ◽  
Michael Ming-Cheuk Wong ◽  
Wing-Man Chan
Keyword(s):  
Mental Health ◽  
Hong Kong ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Cross Sectional Study ◽  
Baseline Survey ◽  
Service Users ◽  
Cross Sectional ◽  
Over Time

Background: Public expenditure on mental health education has grown exponentially in the past two decades. Does the experience of stigma among people with mental health problems improve over time? Our study aims to compare the levels of perceived stigmatization, rejection experiences and stigma–coping among mental health service users in Hong Kong between 2001 and 2017 using longitudinal and repeated cross-sectional study design. Method: The baseline survey was completed by 193 psychiatric outpatients in 2001. They were traced for re-assessment in 2017. Another sample of 193 outpatients matched in age, gender and psychiatric diagnosis was recruited in 2017 for cross-sectional comparison. Participants completed a 39-item questionnaire on stigma experiences, Beck Depression Inventory and Disability Assessment Schedule at both time points. Results: In total, 109 of 193 participants (56.5%) of the 2001 survey were re-assessed. No significant change in perceived stigmatization, rejection experiences and stigma–coping was found among the 109 participants interviewed in 2001 and 2017. For cross-sectional comparison, significant differences in two perceived stigma items were observed upon Bonferroni correction (chi-square test, p < .005) and remained significant after controlling for confounding factors by regression analysis. Improvements in perceived stigmatization were on marriage and friendship, while viewpoints on trustworthiness, dangerousness, devaluation, avoidance and personal failure remained unchanged, and there was no improvement in rejection experiences and stigma–coping. Conclusion: Positive attitude changes over time are unlikely to occur if there is no targeted intervention on stigma. Our findings highlight that evidence-based antistigma interventions are urgently needed.

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