Cardiovascular Health Problems Research Articles

Abstract Tu149: FDA-Approved Antidepressant Trazodone Potentially Increases the Risk of Dyslipidemia

Cardiovascular disease is the leading cause of death. Many cardiovascular health problems, such as atherosclerosis, are caused by dyslipidemia. One xenobiotic nuclear receptor, Pregnane X Receptor (PXR), plays a significant role in atherosclerosis and dyslipidemia, and is activated by various environmental chemicals, including endocrine-disrupting chemicals (EDCs). EDCs are found in common household items such as plastics, medications, and food. Trazodone is a clinically used medication to treat depression by aiding in restoring the balance of serotonin in the brain. But it is unclear if Trazodone has possible impacts on cardiovascular risk factors such as dyslipidemia. Our preliminary data suggested that Trazodone activated human PXR in both intestinal (LS180) and hepatic (HepG2) cells. We hypothesize that Trazodone could regulate the cholesterol uptake mediated by PXR signaling. In this study we use cell-based transfection assay to evaluate the underlying mechanisms by which Trazodone activates PXR. We found that Trazodone was a more potent agonist of human PXR than mouse PXR. Trazodone could activate PXR more intensely in human liver cells compared with human intestinal cells. Our data suggested that Trazodone was a selective PXR agonist and promoted the dissociation between PXR and its nuclear corepressors. Next, we are to identify the key amino acid residues within PXR ligand binding pocket that interact with Trazodone by using computational docking study along with site-mutagenesis assay. Furthermore, we plan to estimate if Trazodone altered cholesterol uptake by human intestinal cells using fluorescence-labeled cholesterol. In conclusion, we explore the potential molecular mechanisms of how FDA-approved antidepressant Trazodone activates human PXR and increases the possible risk of dyslipidemia, which provides potential evidence on future cardiovascular disease risk assessment for Trazodone as well as other antidepressant drugs.

The complexity of treatment-resistant depression: A data-driven approach

BackgroundRecent systematic reviews highlight great variability in defining and assessing treatment-resistant depression (TRD). A key problem is that definitions are consensus rather than data-led. This study seeks to offer a comprehensive socio-demographic and clinical description of a relevant sample. MethodsAs part of a pragmatic randomized controlled trial, patients (N = 129) were managed in primary care for persistent depression and diagnosed with TRD. Data included previous treatment attempts, characteristics of the depressive illness, functioning, quality of life, co-occurring problems including suicidality, psychiatric and personality disorders, physical health conditions, and adverse events. ResultsFindings show a severe and chronic course of depression with a duration of illness of 25+ years. Overall, 82.9 % had at least one other psychiatric diagnosis and 82.2 % at least one personality disorder; 69.8 % had significant musculoskeletal, gastrointestinal, genitourinary, or cardiovascular and respiratory physical health problems. All but 14 had severe difficulties in social and occupational functioning and reported severely impaired quality of life. Suicidal ideation was high: 44.9 % had made at least one serious suicide attempt and several reported multiple attempts with 17.8 % reporting a suicide attempt during childhood or adolescence. Of the patients, 79.8 % reported at least one adverse childhood experience. LimitationsPotential for recall bias, not examining possible interactions, and absence of a control group. ConclusionsOur findings reveal a complex and multifaceted condition and call for an urgent reconceptualization of TRD, which encompasses many interdependent variables and experiences. Individuals with TRD may be at a serious disadvantage in terms of receiving adequate treatment.

The Association of Desert Dust with the Risk of Acute Coronary Syndrome in Subjects of a Younger Age.

Objectives: Recently, desert dust in Europe has been recognized as a cardiovascular health problem. In Spain, desert dust inflows in recent years have been associated with worsening air quality. The present study examines whether desert dust events are related to the incidence of acute coronary syndrome (ACS) in patients under 55 years of age. Methods: Data from 2416 consecutive patients admitted to a tertiary hospital due to ACS were prospectively analyzed. A case-crossover time-stratified design using Poisson conditional regression models was applied to estimate the impact of desert dust events involving particulate matter concentrations of an aerodynamic diameter <10 μm (PM10) on the incidence of ACS in patients under 55 years of age. Results: Desert dust intrusion on days 0 to 5 before ACS onset showed no significant association with the incidence of ACS in patients under 55 years of age. The incidence rate ratios of PM10 concentrations 1, 2, 3, 3, 4, and 5 days before ACS onset (for changes of 10 µg/m3) were 1.02 (95% CI 0.97-1.1; p = 0.41), 1.01 (95% CI 0.96-1.07; p = 0.66), 0.99 (95% CI 0.94-1.05; p = 0.78), 0.96 (95% CI 0.9-1.02; p = 0.18), and 0.97 (95% CI 0.91-1.04; p = 0.41). Conclusions: Our findings suggest that desert dust is unlikely to be related to the incidence of ACS in patients under 55 years of age.

The mediating role of cardiac patients’ perception of nursing care on the relationship between kinesiophobia, anxiety and depression in rural hospitals: a cross-sectional study

BackgroundKinesiophobia could act as a significant barrier against physical activity following cardiac procedures worsening cardiovascular health problems and potentially leading to conditions like hospital-acquired anxiety and depression among patients with cardiovascular disease (CVD). Nurses are the vanguard health care team who can aid patients in taking proactive steps to overcome fear of movement following cardiac procedures.AimThe overarching aim is to investigate the relationship between kinesiophobia, anxiety and depression, and patients’ perception of nursing care.MethodA descriptive correlational research design in two rural hospitals, conducted at cardiac intensive care units of Kafr Eldawar Hospital and Damanhur Medical National Institute. Data were collected from 265 nurses, using the following patient-reported outcome measures, the Tampa Scale for Kinesiophobia (TSK), the Hospital Anxiety and Depression Scale (HADS), the Person-Centered Critical Care Nursing Questionnaire (PCCNP) and the patients’ demographic and clinical profile.ResultA significant negative correlation was found between HADS and PCCNP (r: -0.510, p < 0.001) however, Kinesiophobia was significantly and positively correlated (r: 0.271, p < 0.001). A direct effect of PCCNP in the presence of the mediator was found to be not statistically significant (-0.015, CR = 0.302, p = 0.763). Nonetheless, PCCNP indirectly affects kinesiophobia through HADS (p=-0.099).Implication for nursing practiceCustomizing individualized cardiac rehabilitation (CR) programs based on the emotional experience of cardiac patients will be conducive to rehabilitation and prognosis for patients, thereby lessening the physical burden and improving their quality of life.

Can flow proneness be protective against mental and cardiovascular health problems? A genetically informed prospective cohort study

Flow is a phenomenon where one experiences optimal challenge, marked by an intense, effortless, and rewarding concentration on a task. Past research shows that flow proneness is associated with good mental and cardiovascular health. However, this research has been primarily cross-sectional, based on self-report data, and has not controlled for potential confounding effects of neuroticism. In a large, longitudinal twin sample (N = 9361), we used nationwide patient registry data to test whether flow proneness predicted registry-based diagnoses of depression, anxiety, schizophrenia, bipolar disorder, stress-related disorders, or cardiovascular diseases. We used survival analyses taking time to diagnosis into account to test if (a) there is a relationship between flow proneness and health diagnoses over time, (b) neuroticism confounds this relationship, and (c) the relationship remains present within discordant monozygotic twin pairs (N = 952), thereby controlling for genetic and shared environmental confounding. Individuals with higher flow proneness had a decreased risk of receiving diagnoses for depression (16%; CI [14%, 18%]), anxiety (16%; CI [13%, 18%]), schizophrenia (15%; CI [4%, 25%]), bipolar (12%; CI [6%, 18%]), stress-related (9%; CI [9%, 12%]), and cardiovascular disorders (4%; CI [1%, 8%]). When controlling for neuroticism, higher flow proneness still decreased the risk of depression (6%; CI [3%, 9%]) and anxiety diagnoses (5%; CI [1%, 8%]). Monozygotic twins who experienced more flow than their co-twin had a lower risk for depression (16%; CI [5%, 26%]) and anxiety (13%; CI [1%, 24%]), though only the association with depression remained significant when also controlling for neuroticism (13%; CI [1%, 24%]). Findings are in line with a causal protective role of flow experiences on depression and potentially anxiety and highlight that neuroticism and familial factors are notable confounding factors in observed associations between flow proneness and health outcomes.

Shared genetic architecture and causal relationship between sleep behaviors and lifespan

Poor sleep health is associated with a wide array of increased risk for cardiovascular, metabolic and mental health problems as well as all-cause mortality in observational studies, suggesting potential links between sleep health and lifespan. However, it has yet to be determined whether sleep health is genetically or/and causally associated with lifespan. In this study, we firstly studied the genome-wide genetic association between four sleep behaviors (short sleep duration, long sleep duration, insomnia, and sleep chronotype) and lifespan using GWAS summary statistics, and both sleep duration time and insomnia were negatively correlated with lifespan. Then, two-sample Mendelian randomization (MR) and multivariable MR analyses were applied to explore the causal effects between sleep behaviors and lifespan. We found that genetically predicted short sleep duration was causally and negatively associated with lifespan in univariable and multivariable MR analyses, and this effect was partially mediated by coronary artery disease (CAD), type 2 diabetes (T2D) and depression. In contrast, we found that insomnia had no causal effects on lifespan. Our results further confirmed the negative effects of short sleep duration on lifespan and suggested that extension of sleep may benefit the physical health of individuals with sleep loss. Further attention should be given to such public health issues.

Treat Obesity to Treat Type 2 Diabetes Mellitus.

Obesity, a multifactorial, relapsing chronic disease, serves as a gateway to a spectrum of metabolic, cardiovascular, mechanical and mental health problems. Over the last few decades, the global prevalence of obesity has surged nearly threefold, mirroring the escalating rates of type 2 diabetes mellitus (T2DM). This parallel trajectory strongly suggests a cause-and-effect relationship between obesity and T2DM. Extensive research indicates that even modest weight gain elevates the risk of T2DM, favoring the notion of obesity being a root cause. This perspective finds robust support in numerous studies demonstrating the preventive effects of obesity management on the onset of T2DM. Beyond prevention, obesity management has been shown to enhance remission in individuals with T2DM and to decrease microvascular complications, cardiovascular risk factors, renal failure and heart failure. This evidence underpins the urgent need for global initiatives aimed at addressing obesity management as a key strategy in the prevention and management of T2DM and its complications.

Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention

BackgroundAbdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA size. Individuals in AAA surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance pathways.MethodsIntervention mapping methods were used to co-develop the intervention with individuals with AAA, families/carers, and healthcare staff. We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention.ResultsThe developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient’s AAA screening appointment for the duration that they are in surveillance.DiscussionThe developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population.Trial registrationInternational Clinical Trial Registration: ISRCTN93993995.

Global Public Health Implications of Traffic Related Air Pollution: Systematic Review.

Traffic-related air pollution (TRAP) has significant public health implications and a wide range of adverse health effects, including cardiovascular, respiratory, pulmonary, and other health problems. This study aimed to determine the public health impacts of traffic-related air pollution across the world that can be used as an input for protecting human health. This study considered studies conducted across the world and full-text articles written in English. The articles were searched using a combination of Boolean logic operators (AND, OR, and NOT), MeSH, and keywords from the included electronic databases (SCOPUS, PubMed, EMBASE, Web of Science, CINAHL, and Google Scholars). The quality assessment of the articles was done using JBI tools to determine the relevance of each included article to the study. In this study, 1 282 032 participants ranging from 19 to 452 735 were included in 30 articles published from 2010 to 2022. About 4 (13.3%), 9 (30.0%), 12 (40.0%), 8 (26.7%), 2 (6.7%), 15 (50.0%), 3 (10.0%), 3 (10.0%) 1 (3.3%), and 3 (10.0%) of articles reported the association between human health and exposure to CO, PM10, PM2.5, NOx, NO, NO2, black carbon, O3, PAH, and SO2, respectively. Respiratory diseases, cancer, cognitive function problems, preterm birth, blood pressure and hypertension, diabetes, allergies and sensitization, coronary heart disease, dementia incidence, and hemorrhagic stroke were associated with exposure to TRAP. Exposure to nitrogen dioxide, nitrogen oxide, sulfur dioxide, and fine particulate matter was associated with various health effects. This revealed that there is a need for the concerned organizations to respond appropriately.

Pulse wave analysis measurements: important, underestimated and undervalued parameters in cardiovascular health problems.

Central aortic stiffness is established as a reliable measure of cardiovascular disease. While pulse wave velocity (PWV) analysis measures arterial distensibility, risk profile of cardiovascular diseases can be expanded with following pulse wave analysis measurements: central aortic systolic blood pressure (CABPS), central aortic pulse pressure (CAPP), central aortic reflection magnitude (CARM), central aortic augmented pressure (CAAP) and central aortic augmentation index (CAAIx). The aim of this study is to evaluate the clinical usefulness and importance of pulse wave analysis measurements in specific cardiovascular conditions and diseases, both in term of diagnosis and therapeutic monitoring. One thousand sixty-six subjects were included. According to age bracket, four cohorts were investigated-healthy subjects (NL), hypertensive patients (HP), ischemic heart disease (IHD) and valvular heart disease (VHD) patients. Arterial stiffness was analyzed through Sphygmocor XCEL Central Blood Pressure Measurement System and Sphygmocor XCEL PWV Measurement System. Furthermore we observed the pulse wave analysis measurements of 14 patients with diagnose of ADHD who were referred by a child psychiatrist, in order to investigate the initiation of methylphenidate treatment. Statistically significant differences were found between NL and HP cohorts, across almost all age brackets, regarding pulse wave analysis measurements. In the risk stratification of arterial stiffness hypertension and especially central aortic blood pressure systolic (CABPS) seems a determining factor. Pulse wave analysis measurements for IHD and VHD cohort comparisons with NL counterparts, revealed non- statistically significant variations. Elevated CAAP, CAAIx and CARM within the youngest age group (0-10 years) in attention-deficit-hyperactivity-disorder (ADHD) patients warrant attention. Following such investigations, CABPS appears as a robust predominant factor in problems of arterial stiffness. Pulse wave analysis and PWV are important parameters in the evaluation and monitoring of arterial hypertension and cardiovascular diseases. There is a hypothesis that CAAP could be an important and even decisive parameter in the diagnosis of ADHD. Further investigation needed.

RELATIONS BETWEEN ERUPTION OF PERMANENT TEETH AND BODY MASS INDEX IN BULGARIAN CHILDREN

Introduction: Obesity and dental caries are diseases that have a strong social impact. Being overweight and obesity during childhood are a risk factor for cardiovascular, respiratory, skeletal diseases and other health problems in both children and adults. Aim: The aim of the study is to estimate the relationship between tooth eruption, tooth pathology and BMI in 7-8 year old Bulgarian children. Methods and Material: The present study observed 187 individuals. Oral and dental status were examined. The height was measured in a standing position with an anthropometer, weight was measured with an electric scale to the nearest 0.1 kg, and Body Mass Index (BMI) was calculated. The data was analyzed with the Statistical Package for Social Sciences (SPSS) version 16. The differences were considered statistically significant at p&lt;0.05. Results: A positive relation is found between the eruption of teeth and BMI. A statistically significant association is found between BMI and dental caries on the upper left first molar (26). Conclusion: A high percentage of the examined children were overweight and obese. A positive but low correlation between BMI, tooth eruption and dental caries is established. With the increase of the BMI, the number of erupted teeth also increases. Girls had more erupted teeth compared with boys. The caries of the first molar (26) correlate positively with the nutritional status of the 7-8 year old children studied.

Response Surface Modeling of the Steady-State Impedance Responses of Gas Sensor Arrays Comprising Functionalized Carbon Nanotubes to Detect Ozone and Nitrogen Dioxide.

Carbon nanotube (CNT) sensors provide a versatile chemical platform for ambient monitoring of ozone (O3) and nitrogen dioxide (NO2), two important airborne pollutants known to cause acute respiratory and cardiovascular health problems. CNTs have shown great potential for use as sensing layers due to their unique properties, including high surface to volume ratio, numerous active sites and crystal facets with high surface reactivity, and high thermal and electrical conductivity. With operational advantages such as compactness, low-power operation, and easy integration with electronics devices, nanotechnology is expected to have a significant impact on portable low-cost environmental sensors. Enhanced sensitivity is feasible by functionalizing the CNTs with polymers, metals, and metal oxides. This paper focuses on the design and performance of a two-element array of O3 and NO2 sensors comprising single-walled CNTs functionalized by covalent modification with organic functional groups. Unlike the conventional chemiresistor in which the change in DC resistance across the sensor terminals is measured, we characterize the sensor array response by measuring both the magnitude and phase of the AC impedance. Multivariate response provides higher degrees of freedom in sensor array data processing. The complex impedance of each sensor is measured at 5 kHz in a controlled gas-flow chamber using gas mixtures with O3 in the 60-120 ppb range and NO2 between 20 and 80 ppb. The measured data reveal response change in the 26-36% range for the O3 sensor and 5-31% for the NO2 sensor. Multivariate optimization is used to fit the laboratory measurements to a response surface mathematical model, from which sensitivity and selectivity are calculated. The ozone sensor exhibits high sensitivity (e.g., 5 to 6 MΩ/ppb for the impedance magnitude) and high selectivity (0.8 to 0.9) for interferent (NO2) levels below 30 ppb. However, the NO2 sensor is not selective.

Effectiveness of Structured Teaching Programme on Knowledge regarding selected Cardiovascular Health Problems and its Prevention among College Students

Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, It is associated with high mortality and morbidity. Adolescents are exposed to multiple risk factors which makes them highly prone towards CVD at a younger age. Objectives of the study are: To identify the existing knowledge of students regarding cardiovascular health problems and its prevention in selected College of Bhubaneswar, To administer structured teaching programme on knowledge regarding cardiovascular health problems and its prevention in College students, To compare the pre test and post test level of knowledge score of the students. To associate the post-test level of knowledge score of students with their selected demographic variable. A Pre experimental One group pre test post test design was used to conduct this study. A pre and post test frequency distribution of College students regarding selected cardiovascular health problems and its prevention was found by 3 point rating scale in which 80% of college students had poor knowledge in pre test and 58.33% of College students had good knowledge in post test. The pre test mean knowledge scores among college students was 12.08, whereas post test mean knowledge scores was 32.38. The p is 2.00 (p&gt;0.0.5). Hence the difference is statically non significance.

0748 Using daily wearable cardio fitness and sleep data to predict obesity in early adolescence

Abstract Introduction Obesity, and its co-morbidities, is a serious health risk currently facing adolescents in the US, with increased risk for adult obesity and cardiovascular health problems. Sleep is crucial for energy restorative processes and insufficient sleep influences food intake and appetite regulation. Adolescents are at risk for poor/insufficient sleep, which could, therefore, contribute to obesity risk. Given multifactorial risk factors, there is a need to identify the most salient predictors of adolescent obesity. Predicting adolescent obesity using objective Fitbit data has not previously been investigated and is the aim of the current study. Methods We used data collected with the Fitbit Charge 2 device from 2491 participants (Year 2, Mean-age=11.95 years, SD=0.65, 49.5% female) in the Adolescent Brain Cognitive Development (ABCD) Study®. We trained machine learning models (Gradient Boosted Trees and Regularized Logistic Regression) to identify the most important measures that predict obesity (&amp;gt;95 BMI percentile). In addition to sleep (timing, efficiency, duration, and regularity across the week) and cardio fitness (step counts, resting heart rate) Fitbit measures, averaged across seven days, we included socio-demographic characteristics. We ran a grid search embedded in a 2x5 fold cross-validation and we evaluated the performance based on the area under the curve-AUC and accuracy-ACC metrics. Results 15% percent of the sample were classified as having obesity. Both classification models performed acceptably high, with the LogReg having better performance (AUC-LogReg=0.76, ACC=85%) than the GBT model (AUC-GBT=0.75, ACC=0.69). Shorter sleep duration, more day-to-day variability in sleep measures, low number of steps with low variability over the week, and higher resting heart rate, with high day-to-day variability, were important predictors. Sociodemographic factors (Hispanic/Latinx ethnicity, African American race, low access to food) were also important predictors. Conclusion Results show that there are socio-economic disparities in obesity risk and that shorter sleep duration and more variable sleep patterns, as detected with a wearable, are important predictors of obesity risk. Results highlight the clinical utility of wearable measures and the importance of continuous monitoring of sleep, physical activity, and cardio fitness in adolescents. Support (if any) NIH U01DA041022

Task shifting roles, interventions and outcomes for kidney and cardiovascular health service delivery among African populations: a scoping review

BackgroundHuman resources for health (HRH) shortages are a major limitation to equitable access to healthcare. African countries have the most severe shortage of HRH in the world despite rising communicable and non-communicable disease (NCD) burden. Task shifting provides an opportunity to fill the gaps in HRH shortage in Africa. The aim of this scoping review is to evaluate task shifting roles, interventions and outcomes for addressing kidney and cardiovascular (CV) health problems in African populations.MethodsWe conducted this scoping review to answer the question: “what are the roles, interventions and outcomes of task shifting strategies for CV and kidney health in Africa?” Eligible studies were selected after searching MEDLINE (Ovid), Embase (Ovid), CINAHL, ISI Web of Science, and Africa journal online (AJOL). We analyzed the data descriptively.ResultsThirty-three studies, conducted in 10 African countries (South Africa, Nigeria, Ghana, Kenya, Cameroon, Democratic Republic of Congo, Ethiopia, Malawi, Rwanda, and Uganda) were eligible for inclusion. There were few randomized controlled trials (n = 6; 18.2%), and tasks were mostly shifted for hypertension (n = 27; 81.8%) than for diabetes (n = 16; 48.5%). More tasks were shifted to nurses (n = 19; 57.6%) than pharmacists (n = 6; 18.2%) or community health workers (n = 5; 15.2%). Across all studies, the most common role played by HRH in task shifting was for treatment and adherence (n = 28; 84.9%) followed by screening and detection (n = 24; 72.7%), education and counselling (n = 24; 72.7%), and triage (n = 13; 39.4%). Improved blood pressure levels were reported in 78.6%, 66.7%, and 80.0% for hypertension-related task shifting roles to nurses, pharmacists, and CHWs, respectively. Improved glycaemic indices were reported as 66.7%, 50.0%, and 66.7% for diabetes-related task shifting roles to nurses, pharmacists, and CHWs, respectively.ConclusionDespite the numerus HRH challenges that are present in Africa for CV and kidney health, this study suggests that task shifting initiatives can improve process of care measures (access and efficiency) as well as identification, awareness and treatment of CV and kidney disease in the region. The impact of task shifting on long-term outcomes of kidney and CV diseases and the sustainability of NCD programs based on task shifting remains to be determined.

Morbidity Pattern Among Elderly in an Urban Area of Burla, Odisha.

Population aging is an inevitable demographic reality that is associated with improvements in the health and medical care system. With longevity and declining fertility rates, the population of older persons is growing faster than the general population globally. The elderly population is more prone to various kinds of morbidity due to decreasing immunity and the risk of advancing age. To describe the morbidity pattern of the elderly in an urban area of Burla. Community-based cross-sectional study was carried out for one year from 1st July 2021 to 30th June 2022. A total of 385 individuals aged 60 years and above residing in Burla were included in the study. Patient-wise data collection was done by a predesigned, pretested structured questionnaire. The chi-square test for categorical variables at a 95% confidence interval and significance set at 0.05 were used as measures of association in the analysis of factors associated with morbidity. The most common health problem involved was musculoskeletal (68.6%), followed by cardiovascular (57.1%), eye (47.3%), endocrine (25.2%), respiratory (21.3%), digestive (20.5%), skin (16.1%), ear (15.3%), general and unspecified health problems (30.7%), and urological (5.5%) and 4.5% had neurological problems. Elderly population has a high frequency of numerous morbidities, so it is important to educate the elderly population about prevalent age-related health issues as well as preventive care.

Knowledge, attitude and practice behavior regarding blood pressure among physical therapists of twin cities

Background: Blood pressure (BP) monitoring has a very crucial role in physical therapy for accurate evaluation and re-evaluation of the patient, otherwise it can lead to inaccurate clinical decision making and the patient may be falsely diagnosed. It is an important cardinal sign that cannot be neglected in making clinical decision, may put the individual to a greater risk of cardiovascular and other health problems. Objective: to explore the knowledge, attitude, and practice behavior regarding BP among physical therapists (PT) of twin cities. Methods: A cross sectional study was conducted in 6 months, from January 2019 to June 2019 in different hospitals of Islamabad and Rawalpindi. The data was collected from n=296 PT of twin cities after obtaining the written consent. The data of knowledge, attitude and practice behaviors towards BP was collected by semi structured questionnaire. The results were presented in table and graph while description was given as Mean ± SD and f (%). Results: The mean age of study participants was 28.4±3.71 years. The overall mean score of knowledge (4.27±3.05) showed that n=159(53.72%) participants in the study have poor knowledge about the information related to BP. While attitude score (19.74±.2.29) showed that majority of the sample n=179(60.47%) have positive attitude towards the importance of BP evaluation during assessment, management and educating the patient. While observing the behaviour, mean score (14.55±4.78) showed that physical therapist has acceptable behaviour towards the BP measurement. But frequency distribution showed that n=160(54.05%) physical therapist has poor behaviour towards BP measurement during their practice. Conclusion: The knowledge and practice behavior regarding the BP assessment and evaluation among the physical therapist is very poor, while their attitude is positive towards the importance of BP evaluation during assessment, management and educating the patients. Keywords: Blood pressure, inpatient clinic, outpatient clinic, physical therapy.

Lighting color temperature impacts effort-related cardiovascular response to an auditory short-term memory task

To better understand the impact of environmental light on processes that underlie cognitive activity, Lasauskaite and Cajochen (2018) recently proposed a theoretical model that predicts how light's correlated color temperature (CCT) affects effort. Here we tested whether the effects of CCT of light on effort-related cardiovascular response also extend to another sensory input—hearing. In two experimental blocks, participants were exposed to either low (2800 K) or high correlated color temperature (6500 K) light with an illumination level of 500 lux for 15 min before and while they performed an auditory n-back task varying in difficulty level (low difficulty/1-back vs. moderate difficulty/2-back). Mental effort was indexed as sympathetic beta-adrenergic impact on the heart, measured via cardiac pre-ejection period and systolic blood pressure. Based on the theoretical model, we hypothesized that light with a high CCT should lead to lower mental effort compared to light with a low CCT in both the low and moderate task difficulty conditions. Moreover, moderate task difficulty should lead to stronger effort compared to an easy task. The results did not show expected differences in invested effort levels between the task difficulty conditions (1-back vs. 2-back task) measured by cardiac pre-ejection period and systolic blood pressure. However, in line with our prediction, the results indicated that higher CCT of light decreased effort during an auditory memory task. Task performance was higher in easy than moderate task difficulty but was not altered by lighting conditions. Furthermore, we found no significant associations between cardiovascular reactivity and changes in mood, sleepiness, light, task, or effort ratings. Taken together, our results provide first evidence that higher CCT of light reduces the amount of effort invested during cognitive tasks for which hearing is needed. Given that this study was conducted under controlled laboratory conditions and with healthy young participants, additional research is needed to demonstrate that our results generalize to real-life applications. Nevertheless, we recommend that lower CCT of light should be avoided in learning and work contexts, as it might lead to higher effort and cardiovascular reactivity that may contribute to the development of cardiovascular health problems. Instead, we recommend higher CCT of light during daytime for wellbeing and health.

Intimate Partner Violence and Health Outcomes Among Women Living With HIV/AIDS in Ghana: A Cross-Sectional Study.

Intimate partner violence (IPV) is known to have negative health consequences for victims. For women living with HIV/AIDS, whose health may be compromised, exposure to IPV can be devastating. Yet few (if any) studies have explored the health implications of exposure to IPV among HIV-positive women. We begin to fill this gap by examining the effects of various dimensions of IPV (physical, sexual, psychological/emotional, and economic) on the cardiovascular, psychosocial, and sexual reproductive health outcomes of HIV-positive women in Ghana. Data were collected from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern Region. We used logit models to explore relationships between IPV and health. The findings indicate high prevalence of IPV in our sample: physical violence (61%), sexual violence (50.9%), emotional/psychological violence (79.6%), and economic violence (66.8%). Generally, participants with experiences of IPV reported cardiovascular health problems, unwanted pregnancies and pregnancy loss, and poor psychosocial health. Our findings suggest the importance of screening for IPV as part of HIV care in Ghana.

What Possibilities, Problems and Barriers Do Patients, Suffering from Severe Mental Illness or Alcohol Use Disorder, Perceive Towards Lifestyle Changes or Treatment Seeking to Prevent Cardiovascular Health Problems

What Possibilities, Problems and Barriers Do Patients, Suffering from Severe Mental Illness or Alcohol Use Disorder, Perceive Towards Lifestyle Changes or Treatment Seeking to Prevent Cardiovascular Health Problems