Research suggests experiences of racial discrimination influence blood pressure outcomes among Black women, but little is known about how coping strategies may influence this relationship. Our study aimed to assess the moderating effects of coping strategies on perceived racial discrimination and blood pressure among young Black mothers. We conducted a secondary analysis on data from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study. Eligible participants were African American or Black women aged 21 and older, who did not present with any cognitive disorder that may obscure reporting data, and who had a biological child who was 3-5 years old at the time of study enrollment. In our analysis, systolic and diastolic blood pressure were the primary outcomes, and experiences of discrimination situations and frequency subscales were the primary predictors. We considered the three subscales of the Coping Strategy Indicator (problem-solving, seeking social support, and avoidance) as moderators. Linear regression models were used. Of the 246 female participants (mean age: 31.3 years; SD = 5.8), the mean systolic and diastolic blood pressures were 114 mmHg (SD = 13.8) and 73 mmHg (SD = 10.9), respectively. The frequency of experiences of perceived racial discrimination was significantly associated with higher systolic blood pressure, but this relationship was moderated among participants with greater seeking social support scores (p = 0.01). There were no significant moderation effects in models with diastolic blood pressure as the outcome. Future studies should examine this relationship longitudinally and further investigate specific coping strategies Black women use to manage perceived racial discrimination.

The salutary effects of a sense of control on health are well acknowledged; however, rigorous studies evaluating its effect on mortality remain scarce. This study aimed to study the association between a sense of control and mortality and to identify the effect of changes in this sense of control on mortality risk. This prospective cohort study included 22,793 participants over age 50 and their spouses, drawn from a nationally representative U.S. sample from 2006 to 2018. Cox proportional hazard regression analyses estimated the association between sense of control and all-cause mortality. Kaplan-Meier survival curves were compared using the log-rank test, and changes in sense of control levels associated with mortality risk were evaluated using the Cox proportional hazards model. Over the 12-year follow-up period, 5027 deaths were recorded. An increased sense of control was significantly associated with decreased mortality risk, as revealed by stratified analysis according to sex and age. Hazard ratios (HRs) for the second, third, and fourth quartiles of sense of control levels were 0.91 (95% CI, 0.84–0.98), 0.83 (95% CI, 0.77–0.92), and 0.79 (95% CI, 0.72–0.87), respectively, relative to the first quartile. Compared to individuals with stable sense of control scores from baseline to study conclusion, the HR was 0.58 (95% CI, 0.48–0.70) for those with increased scores and 1.81 (95% CI, 1.53–2.13) for those with decreased scores. High levels of sense of control were significantly associated with reduced mortality risk. These findings underscore the importance of a sense of control as a focus for public health interventions.

BackgroundFunctioning, recognized as the third health indicator and a key metric for rehabilitation, can be assessed by measuring capacity and performance.ObjectiveTo quantify the prevalence of disability and cognitive impairment in individuals aged 50+ and evaluate the reliability and clinical relevance of capacity and performance qualifiers in the activity and participation domains of the international classification of functioning checklist (ICF checklist).MethodsA cross-sectional study was conducted in a population from rural and urban areas of Aragón (Spain), including 1707 participants. Disability and cognitive impairment were assessed using the WHO Disability Assessment Schedule 12-item version (WHODAS 12) and mini-mental state examination. A randomly selected subsample (n = 129) underwent a detailed functional evaluation. The ICF checklist was used to compare capacity and performance, analyzing their agreement and differences.ResultsDisability was present in 50.6% of participants. Severe or total disability was most prevalent in general tasks/demands (10.1%) and domestic life (7.1%), reflecting significant daily functioning limitations. The largest capacity-performance discrepancies were in domestic life, self-care, and learning, indicating key intervention areas. Notably, 40.5% of participants had lower performance in domestic life, followed by learning/knowledge (28%) and mobility (17%). Conversely, performance exceeded capacity in community living (13.3%) and personal relationships (5.5%), highlighting the influence of environmental factors.ConclusionsDisability is highly prevalent in adults aged 50+, notably affecting daily functioning. Gaps between ability and performance indicate environmental barriers, especially at home and in learning contexts. Improved outcomes in social domains suggest enabling conditions. Findings support the ICF checklist's clinical value and advocate for integrating environmental factors into disability care.

This study examined gender differences in the association between recreational walking and indoor and outdoor fall rates among older adults. The Healthy Aging and Neighborhood Study is a prospective cohort that included 716 community-dwelling adults aged 65-95 years in central and northeastern Massachusetts, USA (2018-2023). Recreational walking at baseline was measured by the frequency of walking for exercise for at least 10 min in the participants' neighborhood. Falls were reported on monthly falls calendars, and the circumstances for reported falls were collected via subsequent telephone interviews. Mixed effects negative binomial models were used to estimate gender differences in the associations of recreational walking with rates of indoor and outdoor falls, separately. Models were adjusted for sociodemographic variables, physical health, functional status, lifestyle behaviors, mental health, and fear of falling. There were 394 (55%) female and 322 (45%) male participants enrolled in the study, and the mean (SD) age was 74.08 (6.29). About 61% of participants engaged in recreational walking at least once weekly. Women had lower outdoor fall rates than men (32 vs. 40 per 100 person-years), while indoor fall rates did not significantly differ by gender (31 vs. 34 per 100 person-years). Women engaging in recreational walking at least once weekly had a 62% lower indoor fall rate [IRR (95% CI): 0.38 (0.21, 0.71)] than those who did not. No significant associations were observed between recreational walking and outdoor falls for both women and men. Among community-dwelling older women, but not men, a higher frequency of recreational walking was associated with lower rates of indoor falls, while no changes were seen with outdoor falls. Increasing recreational walking may be a viable focus for fall prevention programs in the community, especially for older women.

BackgroundAssuming the care of a dependent family member can constitute a health risk factor that significantly reduces the productivity of family caregivers, compromising their future and quality of life.ObjectiveOur purpose of this study was to investigate the productivity activities that are altered in the caregivers of a dependent family member and the impact this has on their satisfaction and quality of life.MethodsAn analytical observational study was conducted for 500 caregivers of dependent family members. Sociodemographic data were collected for caregivers and their dependent family members. Carers' occupational performance and satisfaction were assessed using the Canadian Occupational Performance Measure (COPM), and quality of life was assessed using the World Health Organization - Quality of Life (WHOQOL-Bref). Comparison between groups was performed using the Chi-square test for qualitative variables. Pearson's correlation coefficient was used to assess the strength and direction of linear associations between numerical variables.ResultsMost caregivers were women (72.3%, n = 364), with an average age of 60.3 ± 13.64 years. These individuals were providing care for a family member with severe dependency (69.7%, n = 348), classified as Grade III. Up to 38.2% (n = 191) of caregivers struggled with maintaining punctuality and consistency in their paid employment, and 25.6% (n = 128) of caregivers stopped or had difficulty working. In addition, 28.4% (n = 142) of caregivers had problems with household cleaning and tidying, 20.4% (n = 102) perceived that they neglected their other family members, and 18.6% (n = 93) of caregivers encountered problems attending courses and furthering their education. Women were more affected in terms of productivity. Moreover, performance and quality of life worsened as the number of productivity activities affected increased.ConclusionsCaring for a dependent family member has a considerable impact on the caregiver's productive activities, affecting their work performance, household management, and professional development, with a particularly marked impact on women. This caregiving role is also associated with a decrease in quality of life, which highlights the need for interventions to support caregivers in these areas.

BackgroundOne of the primary challenges that hinders organizational effectiveness and prosperity is organizational cynicism. Organizational cynicism is defined as a general or specific attitude of disappointment, insecurity, burnout, and mistrust towards individuals or groups. Paradoxical leadership, as applied by nurse managers, involves acknowledging and navigating the inherent tensions and contradictions within healthcare organizations, which enables managers to sustain balance in the workplace.Aim of the StudyThis study aims to investigate the relation between organizational cynicism and a nurses' occupational burnout (testing nurse managers' paradoxical leadership moderation effects).Research designA non-experimental cross-sectional prospective design was employed for this study.SubjectsA stratified random sample of 314 nurses participated in the study.SettingThe study was conducted at Main Tanta University Hospital, which is affiliated with the Ministry of Higher Education and Scientific Research.MethodThree tools were used for data collection: the Organizational Cynicism Scale, the Nurse Managers' Paradoxical Leadership Scale, and the Maslach Burnout Inventory (MBI).ResultsA statistically significant positive correlation was found between organizational cynicism and occupational burnout. Additionally, a statistically significant negative correlation was observed between the nurse managers' paradoxical leadership and both organizational cynicism and occupational burnout.RecommendationsHealthcare leaders should take proactive measures to address organizational cynicism to mitigate a nurses' occupational burnout, which can contribute to the nursing shortage.

The transition of COVID-19 into the endemic phase in China has posed additional challenges to medical student's well-being, and increased the odds of mental distress. Although affective temperament traits and adult attachment styles accompany crisis-induced stress, whether this applies to medical students in the endemic phase has yet to be determined. The aim of present study is to test if temperament traits and adult attachment style can predict stress in Chinese medical students. Medical students (N = 402) enrolled in the undergraduate medical program at the Southern Medical University, Guangdong, China completed an online survey in May 2022. Most participants were female (62.4%), with a mean age of (21.3 ± 3.1). The individual temperament traits and adult attachment styles were assessed using the Chinese version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-auto-questionnaire short version (TEMPS-A), and the Attachment Style Questionnaire (ASQ). The participants showed significant distress as assessed with the K10: 19 (15-24) (median, Q1, Q3). Furthermore, a multiple linear regression analysis indicated that cyclothymic (β = 2.1, p = 0.048) and depressive (β = 1.2, p = 0.001) temperament traits and an insecure attachment (ASQ-anxious: β = 0.19, p = 0.006; ASQ-avoidant: β = 0.07, p < 0.001) predicted pandemic-related distress. Dimensions of both affective temperaments and attachment styles were associated with stress in the medical students during the transition to the endemic phase. The investigations of these psychological variables provided new information regarding risk factors for endemic-related distress, and pointed to potential targets for counseling and developing programs to support the medical students' mental health.

BackgroundSleep impairment and work-related stress are common issues that influence employee well-being and organizational outcomes. Impaired sleep depletes cognitive and emotional resources, increasing stress and the likelihood of counterproductive work behaviors directed toward the organization (CWB-O). This cross-sectional study, guided by the conservation of resources (COR) theory, explores the relationships between impaired sleep, work-related stress, and CWB-O, considering substance use as a dysfunctional coping strategy.MethodsA sample of 302 Italian employees completed an online survey. Sleep impairment was assessed using the Insomnia Severity Index, work-related stress was assessed with the Perceived Stress Scale, CWB-O was assessed with the Counterproductive Work Behavior Checklist, and substance use as a coping strategy was assessed using the Brief COPE. A moderated mediation model was tested to examine the indirect effects of sleep impairment on CWB-O via work-related stress, with substance use moderating both the sleep–stress and stress–CWB-O relationships.ResultsThe results supported the hypothesis that the relationship between sleep impairment and CWB-O is mediated by work-related stress. Sleep difficulties significantly increased work-related stress, which in turn led to higher levels of CWB-O. Substance use did not moderate the relationship between sleep and work-related stress. It did, however, significantly moderate the relationship between work-related stress and CWB-O, with higher levels of substance use amplifying the impact of stress on behavioral dysregulation.ConclusionThis study contributes to our understanding of how impaired sleep, work-related stress, and substance use interact to influence deviant behaviors at work. The findings align with COR theory, highlighting the role of resource depletion and dysfunctional coping in workplace behavior, and suggest that organizational interventions should also consider programs aimed at improving sleep quality and addressing substance use to reduce the likelihood of deviant behaviors at work.