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In INTERSTROKE, we explored the association of anger or emotional upset and heavy physical exertion with acute stroke, to determine the importance of triggers in a large, international population.INTERSTROKE was a case-control study of first stroke in 32 countries. Using 13 462 cases of acute stroke we adopted a case-crossover approach to determine whether a trigger within 1 hour of symptom onset (case period), vs. the same time on the previous day (control period), was associated with acute stroke. A total of 9.2% (n = 1233) were angry or emotional upset and 5.3% (n = 708) engaged in heavy physical exertion during the case period. Anger or emotional upset in the case period was associated with increased odds of all stroke [odds ratio (OR) 1.37, 99% confidence interval (CI), 1.15-1.64], ischaemic stroke (OR 1.22, 99% CI, 1.00-1.49), and intracerebral haemorrhage (ICH) (OR 2.05, 99% CI 1.40-2.99). Heavy physical exertion in the case period was associated with increased odds of ICH (OR 1.62, 99% CI 1.03-2.55) but not with all stroke or ischaemic stroke. There was no modifying effect by region, prior cardiovascular disease, risk factors, cardiovascular medications, time, or day of symptom onset. Compared with exposure to neither trigger during the control period, the odds of stroke associated with exposure to both triggers were not additive.Acute anger or emotional upset was associated with the onset of all stroke, ischaemic stroke, and ICH, while acute heavy physical exertion was associated with ICH only.

Ventricular free wall rupture (FWR) is a catastrophic complication of that occurs after acute myocardial infarction (AMI), and at present, its clinical characteristics are unclear. We analyzed a total of 6,712 consecutive patients who presented with ST-segment elevation myocardial infarction (STEMI), and 78 patients with FWR after STEMI were enrolled in the study. Patients' demographic data, clinical manifestation, laboratory test results, and angiographic features were then collected and analyzed. FWR occurred in 78 cases (1.16%), and the inhospital mortality of FWR was up to 92.3%. Among the 78 FWR patients, 72 obtained accurate rupture time. FWR typically occurred within the first week after the infarct. Compared to late-phase FWR (more than 48 hours after STEMI) patients, early-phase FWR (during 48 hours after STEMI) patients showed significantly higher random glucose and higher percentage of anterior myocardial infarction. Besides, dual antiplatelet therapy (DAPT), β-blockers, and angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (ACEI/ARB) were used less frequently in early-phase FWR patients. Moreover, we first reported the precipitating factors of FWR. Defecating, transporting, acute emotional upset, diets, and invasive treatment turned out to be the main triggers for FWR. Furthermore, we found that patients who survived from FWR were younger, had higher β-blocker coverage in the inhospital treatment, and had a higher frequency of primary PCI. FWR remains an infrequent but devastating complication of STEMI. We have found several factors related to the occurrence and prognosis of FWR. This study provides evidence for a better understanding of FWR.

Infidelity, actual or suspected, can trigger strong emotional reactions, such as jealousy, which could lead to the dissolution of the relationship. These reactions were predicted to vary with the severity of the infidelity, with the sex of the participant, with previous experience with unfaithful partners, and with the length of the relationship. We employed a sample of 447 Greek-speaking participants who were asked to indicate their reactions in different scenarios of infidelity. We found that more severe acts of infidelity were associated with higher emotional upset and jealousy and lower probability of forgiveness. Moreover, women indicated stronger emotional upset and jealousy than men, but they were more likely to forgive their partners. Furthermore, participants indicated more emotional upset and jealousy if they were in a long-term than in an early-stage relationship. Finally, participants who were older and who had experienced infidelity from their previous partners were more likely to forgive their partners’ infidelity than participants who were younger and who did not have such experience. Our results indicated that several factors determined the severityof the reactions to infidelity.

Background. Vitiligo is not a well-studied disease in Ethiopia. Therefore, this study assessed its clinico-epidemiological profile and treatment patterns. Methods. An institutional-based cross-sectional study was conducted in conveniently selected dermatologic clinics of Mekelle city, Ethiopia. A two-phased study was conducted, in which the first was to determine prevalence of vitiligo while the second phase was to describe the clinico-epidemiological profile and treatment pattern of vitiligo. Four-hundred three randomly selected dermatological patients were included in the first phase study. The second phase study included vitiligo cases from the first phase study and additional vitiligo cases found in a two months period prospective study. Results. Of the 403 randomly selected dermatological patients who presented in the year 2017 to 2019, the prevalence of vitiligo was 13.15%. Of the 79 cases with vitiligo, nearly two-thirds (50, 63.3%) were males with five years as the median age at onset of the disease. Positive family history of vitiligo was recorded in about one-third (25, 31.6%) of the cases. Limbs (48, 44.5%) followed by the head and neck (26, 24%) were the most commonly affected parts of the body at the onset of the disease. The most prevalent clinical form of vitiligo was vulgaris (39.2%) followed by the focal type (26.6%). Emotional upset (24, 33.8%) and physical traumas (23, 32.4%) were the frequently reported triggering factors of vitiligo. Three-fourths (75.5%) of the cases had prescriptions of topical corticosteroids, and 24.5% of them had prescriptions of sun screen lotion. Conclusion. The prevalence of vitiligo was found to be high. The clinico-epidemiological profile of vitiligo in Ethiopia was similar with that found globally. However, treatment options of vitiligo were very limited in Ethiopia.

Whether or not the source of aortic pathology is Marfan syndrome (MFS) or other processes leading to development of abdominal aorta aneurysms (AAA), the awareness of pathology may lead to an emotional upset and low assessment of satisfaction with life.To assess, in regard to MFS patients with aortic pathology and to abdominal aortic aneurysm patients: 1) whether or not self-efficacy (SE) and health locus of control (HLoC) affect the patients' satisfaction with life; 2) whether the two groups of patients differ in terms of mental dispositions.The study population consisted of 16 MFS patients with aortic pathology and 16 AAA patients, 9 men and 7 women in each group. The mean age of the MFS patients was 28.5 ±8.214, and of the AAA patients 64.25 ±7.019. The following scales were applied: Generalized Self-Efficacy Scale, Satisfaction With Life Scale, Multidimensional Health Locus of Control Scale.Abdominal aorta aneurysms patients compared to MFS patients gave a higher rating for SE (In patients with aortic diseases, special attention must be paid to the state of personal resources (PR). Interactions made by medical professionals should focus on enhancing PR supporting the patients' self-knowledge on their SE. This will help to improve their satisfaction with life and form a positive attitude to the illness.Niezależnie od tego, czy źródłem choroby aorty jest zespół Marfana (MFS) lub inne procesy prowadzące do rozwoju tętniaków aorty brzusznej (AAA), świadomość choroby może prowadzić do zaburzeń emocjonalnych oraz niskiej oceny satysfakcji z życia.Ocena pacjentów z MFS z patologią aorty oraz pacjentów z tętniakiem aorty brzusznej: 1) czy skuteczność własna (SE) i umiejscowienie kontroli zdrowia (HLBadaniem objęto 16 chorych z MFS z patologią aortalną oraz 16 pacjentów z AAA. W każdej grupie było 9 mężczyzn i 7 kobiet. Średni wiek pacjentów z MFS wynosił 28,5 ±8,214 roku, a pacjentów z AAA – 64,25 ±7,019. Zastosowano następujące skale: Skalę uogólnionej własnej skuteczności, Wielowymiarową skalę umiejscowienia kontroli zdrowia oraz Skalę satysfakcji z życia.Pacjenci z AAA oceniali swoją SE wyżej niż pacjenci z MFS (U pacjentów z chorobami aorty należy zwrócić szczególną uwagę na stan zasobów osobistych (PR). Działania prowadzone przez pracowników ochrony zdrowia powinny skupiać się na edukacji i wspieraniu pacjentów. Pomoże to zwiększyć satysfakcję pacjentów z życia oraz poprawi ich podejście do choroby.

Background: Healthy parent-child emotional connection (EC) enhances child development, reduces parenting stress, and is teachable. This study explored the feasibility and efficacy of a brief primary-care intervention to strengthen EC. Method: Together with the Nurture Science Program at Columbia, we created brief illustrated booklets titled “CUDDLE” and “CALM,” which are acronyms linked to simple rhyming couplets teaching parents how to strengthen EC and reduce emotional upset. Subjects comprised a convenience sample of mainly low-income parents of 2- to …

We thank Culic for his comments on our recent publication,1 but we wish to make 2 comments. First, we would like to clarify the assessment methods of physical exertion. Participants were asked about physical exertion in 2 ways: as a potential triggering event in the hour before acute myocardial infarction (AMI) and in the same hour on the previous day, and the usual level of physical activity. Therefore, we must clarify that we do not know whether mild to mderate physicial activity preceded AMI; instead we know that 24.6% of …

In their intriguing analysis of triggering events for acute myocardial infarction within the INTERHEART study population, Smyth et al1 found a relatively high percentage of physical activity and anger or emotional upset (13.6% and 14.4%, respectively) as an immediate precedent. Certainly, it is important to acknowledge the limitation that the INTERHEART …

A recent analysis of data from the INTERHEART study1 confirmed that physical exertion and anger or emotional upset can trigger acute myocardial infarction (AMI) and that those triggers have an additive effect when they come together. At the same time, the results confute some previous observations on effect modification by individual characteristics or cardiovascular prevention medication.1 However, 2 issues seem to be worth noting. In the INTERHEART study, physical exertion was reported by 13.6% of participants during the case period.1 The estimated population attributable risk (ie, number of AMIs that could have been avoided if there has been no …

This study was conducted with adolescent children from a probabilistic sample with national representation from both rural and urban areas, in Mexican households eligible for services from the federal social program known as Oportunidades and characterized by conditions of extreme poverty. Participating were 1,093 youth of whom 61 % live in urban localities and 56 % are males, with an average age of 14.92 (±1.29) years and an average number of completed years of schooling of 8.33 (±1.71). The results indicated that the subjective well-being of these adolescents was dependent on a positive self-concept (self-esteem and strength), positive interactions with their parents (respectful, understanding and close) and with their friends (supportive), with importance placed on their studies, and the absence of emotional upset (stress or depression). Among the population studied, males and those younger, as well as those who only study, reported greater subjective well-being.

We report tests of hypotheses derived from a theory of supportive communication outcomes that maintains the effects of supportive messages are moderated by factors influencing the motivation and ability to process these messages. Participants in two studies completed a measure of cognitive complexity, which provided an assessment of processing ability, and reported their degree of upset with a problem situation, which was hypothesized to impact both motivation and ability; they subsequently evaluated the helpfulness of comforting messages that varied in person centeredness. Consistent with predictions, an index of message processing depth—the degree to which participants discriminated between the helpfulness of better and worse supportive messages—was associated with the factors additively in both studies and interactively in one study. Los Efectos de la Complejidad Cognitiva y el Disgusto Emocional sobre el Procesamiento de Mensajes de Apoyo: Dos Pruebas de la Teoria de Proceso Doble de los Resultados de la Comunicacion de Apoyo Reportamos las pruebas de las hipotesis derivadas de una teoria de los resultados de la comunicacion de apoyo que sostiene que los efectos de los mensajes de apoyo son moderados por factores que influencian la motivacion y la habilidad de procesar estos mensajes. Los participantes en los dos estudios completaron una medida de la complejidad cognitiva, la cual proveyo de un asesoramiento de la habilidad de procesamiento, y reporto el grado de disgusto con una situacion problematica, la cual deberia impactar la motivacion y la habilidad; subsecuentemente ellos evaluaron cuan beneficioso eran los mensajes de apoyo que variaron en la centralidad de la persona. Consistente con las predicciones, un indice de la profundidad del procesamiento del mensaje–el grado en que los participantes discernieron entre el beneficio de los mensajes de apoyo mejores y peores–estuvo asociado con los factores aditivamente en ambos estudios e interactivamente en uno de los estudios. Palabras claves: complejidad cognitiva, modelos de proceso doble, apoyo emocional, recepcion de mensaje, apoyo social, escucha Die Wirkung von kognitiver Komplexitat und emotionaler Sensation auf die Verarbeitung von hilfreichen Botschaften: Zwei Tests einer Dualprozesstheorie zu Folgen unterstutzender Kommunikation Wir berichten uber den Test von Hypothesen, die aus der Theorie zu Folgen von unterstutzender Kommunikation extrahiert wurden und postulieren, dass die Wirkung von hilfreichen Botschaften durch Faktoren moderiert wird, die die Motivation und die Fahigkeit beeinflussen, diese Botschaften zu verarbeiten. Die Teilnehmer nahmen an zwei Studien teil. Sie vervollstandigten ein Messinstrument zur kognitiven Komplexitat, das zur Beurteilung der Verarbeitungsfahigkeit diente und gaben auserdem Auskunft daruber, wie sehr sich durch eine problematische Situation, die Motivation und Fahigkeit beeinflussen sollte, aus der Fassung gebracht wurden. Im Anschluss bewerteten sie den Nutzen beruhigender Botschaften, die bezuglich ihrer Fokussierung auf eine Person variierten. Im Einklang mit den Annahmen, war ein Index der Botschaftsverarbeitungstiefe (der Grad, zu welchem die Teilnehmer zwischen dem Nutzen von besseren und schlechteren hilfreichen Botschaften unterschieden) in beiden Studien additiv, in einer Studie interaktiv verknupft mit diesen Faktoren. Schlusselbegriffe: kognitive Komplexitat, Dualprozessmodelle, emotionale Unterstutzung, Botschaftsrezeption, soziale Unterstutzung, Zuhoren Les effets de la complexite cognitive et de la contrarieteemotive sur le traitement des messages de soutien : deux tests d’une theorie a deux temps des resultats de la communication de soutien Nous rendons compte de tests d’hypotheses derivees d’une theorie des resultats de la communication de soutien qui affirme que les effets des messages de soutien sont attenues par des facteurs influencant la motivation et la capacitea traiter ces messages. Les participants a deux etudes ont complete une mesure de la complexite cognitive (ce qui a fourni une evaluation de la capacite de traitement) et ont declare leur niveau de contrariete face a une situation problematique (ce qui devrait influencer la motivation et la capacite). Ils ont ensuite evalue l’utilite de messages de reconfort variant dans la centralite qu’ils donnaient a la personne. Conformement aux predictions, un indice de profondeur dans le traitement du message (le degre auquel les participants discriminaient entre l’utilite de meilleurs et de pires messages de soutien) etait associe aux facteurs de maniere additive dans les deux etudes et de maniere interactive dans une etude. Mots cles : complexite cognitive, modeles a deux temps, soutien emotionnel, reception des messages, soutien social, ecoute

This daily diary study followed, over a 2-week period, 252 beginning New York City public school teachers. Seventy percent were alternatively certified (New York City Teaching Fellows) and the rest, traditionally certified teachers. Alternatively certified teachers were more likely to experience stressors such as violent incidents and classroom management problems. No differences were found in exposure to stressors/difficulties such as problematic adults, student learning problems, and students experiencing emotional upset. Although differences in the rates of exposure to violent stressors could be explained by other factors (e.g., working in a low-performing school and years of experience), differences in the rates of occurrence of classroom management problems could not. Nevertheless, the high absolute rates of management problems and violence in both groups of teachers were striking and need to be addressed. The authors suggest measures to be taken to address the problem of retaining talented new teachers.

Objectives To test methods to optimize mail survey response and authorization rates (i.e., allowing one's survey to be linked to medical records) when the survey is sensitive and the targeted population has a mental disorder. Study Design and Setting Randomized controlled trial of 1,099 veterans treated for posttraumatic stress disorder (PTSD) at a Midwestern Veteran Affairs Medical Center. Subjects were randomized to one of three groups: (1) Health Insurance Portability and Accountability Act (HIPAA) authorization form embedded in the survey (checking “yes” for consent); (2) HIPAA form requiring signature for consent sent after the survey; or (3) HIPAA form requiring a signature and social security number (SSN) for consent sent after the survey. Results The “embedded” strategy yielded the lowest survey response rate (67.5%) but highest authorization rate (59.1%). Requiring respondents' signatures and SSNs after the survey was returned generated the highest survey response rate (74.2%) but lowest authorization rate (48.7%). However, the response rate difference was not statistically significant. Reported emotional upset was low (1.5%) and primarily directed to the survey, not the HIPAA form. Older age and greater trustfulness were associated with higher authorization rates. Conclusion Even with our most optimized strategy, authorization rates were disappointingly low.

As identified by quantitative electroencephalography, statistically abnormal brain wave patterns were observed when a person thought about a trauma when compared with thinking about a neutral (baseline) event. Reassessment of brain wave patterns (to the traumatic memory) immediately after thought field therapy diagnosis and treatment revealed that the previous abnormal pattern was altered and was no longer statistically abnormal. An 18-month follow-up indicated that the patient continued to be free of all emotional upset regarding the treated trauma. This case study supports the concept that trauma-based negative emotions do have a correlated and measurable abnormal energetic effect. In addition, this study objectively identified an immediate energetic change after thought field therapy in the direction of normalcy and health, which has persisted.

Japanese and U.S. sixth, eighth, and tenth graders ( N = 2141) responded to questionnaires asking whom they depended on in six contexts of need. These contexts were: morning awakening, physical illness, emotional upset, help with homework, causing a problem, and guidance in extracurricular activities. Findings indicated that, relative to culture, contextual effects exerted an equally if not more powerful effect on students' responses. In line with traditional cross-national theorizing, U.S. youth were, overall, more self-reliant than their Japanese peers. In contrast to such theorizing, U.S. students were more interdependent with family, and Japanese students were more interdependent with peers, than their counterparts in the other country. Furthermore, both Japanese and U.S. youth showed similar age-related decreases in interdependence with family and increases in interdependence with peers. Results are discussed in terms of active dyadic help-seeking versus conceptualized notions of social identity, and recent theories of development, culture, and the self.

Urticaria is a common dermatosis characterized by spontaneous recurrent bouts of hives. A common belief is that the tedious search for an underlying cause of spontaneous urticaria is fruitless, and even when successful an appropri- ately dealt with, is not necessarily followed by complete resolution of symptoms. In contrast, urticaria has a great impact on patients' quality of life. These patients suffer considerable loss of energy, sleep disturbance, and emotional upset. Urti- caria remains a big problem in term of etiology, pathogenetic mechanism, and pharmacologic treatment. Whereas text- books and reviews on the topic of urticaria devote limited space to investigations and optional trial therapies for the entity, this article is devoted to the subject. A three-step template for the treatment of urticaria is offered which may prove help- ful for you and your patients.

It has long since been suggested that people can suffer a ‘broken heart’ as a result of severe emotional upset. However, the phenomenon of ‘broken heart’ has only recently been subjected to rigorous scientific enquiry where it now formally recognized as acute stress cardiomyopathy. Acute stress cardiomyopathy, a distinct form of acute dilated cardiomyopathy, results in abrupt left ventricular dysfunction which can be acutely damaging and potentially fatal. However, the old adage ‘time mends a broken heart’ rings true with this condition as prognosis is very favorable with a period of time and appropriate nursing and medical care.

Aim. This paper reports a study to assess the interrelationships between physiological measures of children's heart rates and blood pressure, subjective measures of children's level of anxiety, and direct behavioural observations in children's emotional responses to surgery. Background. Psychological upset has been described as a multidimensional phenomenon which includes behavioural, subjective, and physiological components. However, a majority of previous studies have employed only one or two measures of psychological upset. Most importantly, the interrelationships among these three components of psychological upset have seldom been explored. Methods. A cross-sectional design was employed, and 106 Chinese children admitted for day surgery during the summer of 2004 were invited to participate in the study. They were asked to respond to the Chinese version of the State Anxiety Scale for Children. Their mean arterial blood pressure and heart rates were recorded in the operating theatre after being transferred to the operating table but before anaesthesia induction. A research nurse used the Children's Emotional Manifestation Scale to document the children's emotional behaviours during anaesthesia induction. The data were collected in 2004. Results. Children with high preoperative anxiety levels manifested more negative emotional behaviour during anaesthesia induction. Those with more negative emotional behaviour or high levels of state anxiety also had faster heart rates and higher mean arterial blood pressure. Conclusion. A child's response to stressful medical procedures can be varied. The emotional responses of children to surgery need to be understood as a multidimensional phenomenon. To gain a more comprehensive understanding of the effects of surgery on children, it is recommended that assessment strategies used should reflect the multidimensional phenomenon of the emotional upset.

鼠径ヘルニア根治術を受ける３～７歳の子どもと保護者を対象に，家庭でのVTR視聴をメインとしたプレパレーションの有効性をランダム化比較試験により検証した。入院前の時点で，２群への無作為割り付けを行い，対照群（n=31）には従来のケアすなわち「外来での術前オリエンテーションビデオ（以下，VTR）の１回のみの集団視聴」を行い，介入群（n=28）には従来のケアに加え「各家庭におけるVTRの反復視聴」を小冊子に沿って子どもに行うよう保護者に依頼した。経時的な子どもの心理的混乱を主要アウトカムとし，介入前１回，周手術期２回，退院時１回，退院後３回（退院後１ヶ月の時点まで）の計７回，測定した。周手術期のバイタルサインや，親の不安も評価した。 結果，「子どもの心理的混乱（代理評価）（p=0.01）」，「麻酔導入時の協力行動（p=0.04）」，「周手術期の体温（p=0.003）および心拍数（p=0.02）」において介入効果が得られた。 一方で，介入の有無に関わらず，退院後の子どもの退行行動は問題を呈したことから，医療者は，術前のみならず術後においても，子どもと保護者の精神面のアセスメントとフォローを行う必要性が示唆された。 今回，VTRの反復視聴をメインとする家庭でのプレパレーションによって，子どもの周手術期の心理的混乱や生理反応が緩和された一方で，子どもの退行行動および母親の不安に関しては介入の有効性が明らかにはならなかった。

The preference that incoming information be consistent with pre-existing attitudes, cognitions, and beliefs is referred to as the preference for consistency. Based on the assumption that inconsistency is emotionally upsetting, we expected a preference for consistency to be associated with the: (a) experience of emotional upset and (b) motivation to reduce emotional upset. In addition, we expected a preference for consistency to grow with age because avoiding emotional disruption becomes a more salient motivation with increasing age. A study of 269 individuals between 18 and over 80 years of age confirmed these predictions. We conclude that, because of a heightened motive for emotional harmony, older individuals are especially likely to prefer consistent activities, cognitions, and people.

BACKGROUND: Despite large numbers of blood donors being notified of abnormal infectious disease screening results, there has been little scientific study of the effects of this process. STUDY DESIGN AND METHODS: With a 28-item questionnaire, an anonymous mail survey was conducted of 4141 blood donors notified of 15 distinct categories of abnormal infectious disease screening and confirmatory test results. RESULTS: The survey had a 42 percent response rate, and 10 percent of the respondents did not recall being notified of their results. Of the 1556 respondents who recalled being notified, 27 percent contacted the blood center for further information, 60 percent discussed their results with a health care provider, and 73 percent of permanently or indefinitely deferred donors correctly understood their deferral status. Confusion and emotional upset were reported in 81 and 75 percent of notified donors, respectively. CONCLUSIONS: The notification process appears to achieve most of its aims in the majority of donors. Nevertheless, some donors did not understand that they were ineligible for future donation, and many donors were confused and upset. These data indicate that the adverse impact of notifying donors about abnormal test results needs to be considered when new blood donor screening tests and confirmatory algorithms are being licensed and implemented. Further studies of the effectiveness of newer revised donor notification materials are needed.

Computerized fitness tests are used in workplace settings to measure for impairment resulting from factors such as environmental fatigue, toxic chemicals, environmental stresses, sleep disorders, high workload, illness, emotional upset, and others. One obstacle in implementing these instruments has been resistance from organizations due to concerns with accuracy of the tests and how the scores apply to the tasks in the workplace. Organizations are also often reluctant to adopt this type of instrument due to the potential for false positives in impaired performance. in order to develop a scoring method which addresses these issues by achieving substantial Specificity (>97%), while maintaining high Sensitivity, we employed computerized fitness tests to evaluate subjects with graded alcohol doses. By implementing Multiple Regression and Multiple Cutoff Analyses, we were able to achieve the desired levels of Specificity, while maintaining high Sensitivity.

Using the empirical basis of the biographical work of Carmen Facal, Seeking my Memories, the social dynamics of youth in the Portos Pasajes, in Guipuzcoa, Spain, in 1960, is analyzed in the heat of an "emotional upset". The goal is to observe the characteristics of an emotional regime that prevailed in those years and to understand how it has been perceived by the new generation. The questions focus on the areas of leisure and behavioral norms. At the same time, it is noted that there has been an acceptance of some elements of the dominant emotional regime of that time, such as the behavior in the work environment. The biographical analysis is a tool that allows researchers theoretically advance in the study of emotions, and in this case, it has as a particularity the study of a biography in a given context.

Over 1,000 secondary school students (ages 11‐16) completed a closed‐form questionnaire about the nature, causes and consequences of asthma. The questionnaire contained items which related to conceptions about asthma which had emerged in previous work, and also items relating to the known scientific issues surrounding asthma. In general, most students knew about many of the triggers which can cause an asthma attack, although fewer recognised the allergenic properties of nuts and the possible role of emotional upset. More than half thought that people with asthma could not perform well at sport, and a fifth saw them as somehow “weaker”. A fifth thought of asthma as being simply inconvenient, but not serious. These ideas persisted in the oldest students, and it seems likely that they will exist in the adult population to a similar extent. In general, girls seemed to be better informed about asthma than boys.

In an effort to make unequivocal the boundaries of infidelity, the present study used three infidelity scenarios (sexual infidelity, emotional infidelity, and the combination of sexual and emotional infidelity). Two other variables, gender of the participants and the extent to which they reported either few or several jealous tendencies, were included to generate a 3 × 2 × 2 independent groups design. Reactions of 317 undergraduate college students (165 women and 152 men) to the scenarios were assessed using both Smith and Ellsworth's (1985) six cognitive dimensions of emotion and a measure of emotional upset. A multivariate analysis of variance yielded significance for two of the main effects, the nature of the infidelity scenario and the gender of the participant. Univariate analyses indicated that women experienced more emotional distress over all of the conditions of infidelity, and, for women and men alike, conditions of infidelity involving a sexual component, whether alone or together with emotiona...

A relational perspective on socialization explores how the distinctive parent-child relationship context affects the dynamics of parent-child interactions. Forty mothers responded to hypothetical transgressions involving short-term and long-term socialization issues in three different relationship contexts: their own child, their child's best friend, and an unfamiliar child. Mothers reported different affective reactions, socialization goals, and discipline strategies depending on the nature of the relationship and also depending on the nature of the socialization issue. Mothers reported that they would experience more emotional upset, have more future oriented goals, and employ more power assertion, teaching and reasoning strategies for their own child compared with unrelated children. They also used these strategies more frequently for transgressions involving long-term issues. The discussion explored how various dimensions of relationships (past history, future course, interdependence) are represented in how mothers handle disciplinary interactions with their children.

One hundred fourteen headache sufferers recorded their headaches, stressful events, appraisal processes, and coping responses over a 28 day period. Stressful events were found to precede headache attacks more often than periods of headache freedom. Primary appraisals (how much the event mattered), levels of affective regulation coping and ratings of emotional upset were all higher for stressful events that were not associated with subsequent headache. Stressful events occurring during headache were followed by increases in the intensity of the attack. In such instances, avoidance coping was associated with higher ratings of headache intensity following the event and direct coping with lower post-event ratings. It was concluded that stressful events may be causally related to headache and that the ways in which headache sufferers respond to these events may also have implications for the onset and intensity of attacks.

Cyanotic breath-holding spells are generally benign and resolve spontaneously by 4 to 5 years of age. Treatment with iron and other drugs has been employed in selected cases with very frequent and severe episodes. We describe a 10-year-old boy with recent-onset cyanotic breath-holding spells that were activity limiting. He was unable to participate in physical activities with his peers as any argument or emotional upset provoked these spells. Treatment with oral iron and piracetam was ineffective. However, treatment with oral theophylline produced dramatic amelioration of symptoms, and he was once again able to participate in play activities with his peers. We believe that general central nervous system stimulant and respirogenic effects of theophylline were instrumental in control of symptoms in our child.

The impact of the deaths of the last surviving elderly parent of 212 middle-aged children was studied. Daughters expressed more emotional upset, somatic response, and continuing tie with the deceased parent than sons; sons reported more acceptance of the death than daughters. The child's gender was not associated with a sense of personal finitude or control of grief. When we control in regressions for characteristics of the parent, the child, and the quality of their relationship, child's gender continued to add significantly to the bereavement outcomes above.

Cumulative risk assessment posits that multiple agents work together to induce disease and that multiple stressors therefore must be considered in order to gain a true understanding of why adverse health effects occur.1 Now a small but growing number of scientists are pushing the envelope by investigating whether chronic psychological stress might be one of those factors, enhancing a child’s vulnerability to certain chemical exposures and contributing to effects that later show up as asthma, neurodevelopmental disorders, cardiovascular disease, obesity, cancer, and other problems. These researchers are also starting to identify biomarkers that may shed light on the mechanisms by which psychological stress acts on a child’s developing immune system and brain to modify or enhance the response to certain pollution exposures such as traffic-related air pollutants and lead. “We really don’t know how broadly such interactions may occur across chemicals. They are much more likely to occur when the chemical itself acts directly upon stress systems,” says Deborah Cory-Slechta, a professor of environmental medicine at the University of Rochester School of Medicine & Dentistry. “We know some chemicals that interact with stress, such as lead exposure, but we don’t know which others do.” Observations of links between stress and disease date back to at least the twelfth century, when the philosopher Maimonides cited emotional upset as a factor in asthma.2 But proving such links poses a significant challenge, says Malcolm P. Cutchin, a professor at the School of Medicine of the University of North Carolina at Chapel Hill. “Much has been hypothesized about the linkages, but we are just now beginning to tease out relationships and understand the processes,” Cutchin says. As researchers have learned more about techniques that can identify chemical and stress exposures in the human body, they have begun to apply techniques to estimate how people respond to stress and how that response, if it goes awry, can facilitate the development of diseases.

Concurrent correlates of academic procrastination were investigated in Israeli college preparatory students (N = 113). Procrastination in one course of study was found to be moderately correlated with procrastination in another, but not to procrastination in the routine tasks of daily living. Evidence for the validity of self-report procrastination scales was the moderate correlation with instructors' ratings. Procrastination was weakly related to emotional upset about it and moderately related to the endorsement of reasons for it—students high in procrastination and emotional upset gave higher reason endorsements (i.e., cited suggested reasons as more reflective of the causes of their procrastination) than the others. Reasons that were judged a priori as less threatening to one's self-esteem received higher endorsements than threatening ones. Contrary to prediction, reasons considered nonthreatening to one's self-esteem were as strongly related to emotional upset and to procrastination as threatening reasons. That students vary in emotional upset about procrastination and in the reasons they give for it highlights the need for comprehensive assessment of students in planning and implementing treatment programs.

James Spence deserves great credit for his work with mothers and babies and his contributions to our understanding of “the purpose of the family”,1 but he was not the first to recognise the need for mothers to nurse their own infants. Perhaps the most remarkable of his predecessors never seems to have received credit for his vision and common sense. James H Nicoll, Surgeon of the Western Infirmary and the Royal Hospital for Sick Children, Glasgow, gave a paper to the Section of Surgery of the 77th Annual Meeting of the British Medical Association in July 1909.2 Drawing on his experience of some 9000 operations on children, he advocated that whenever possible children under 2 years of age should be treated as outpatients. After operation without a mother, he said a child was “all over the bed” and “if splinted his crying and struggling put fresh strain on his sutures”. He concluded that the small child would “do best in their mother’s arms, and nest there more quietly on the whole, than anywhere else”. Perhaps more surprising to the contemporary reader, however, is Nicoll’s statement: > “for seven years I have had a small house, near the Glasgow Children’s Hospital, for the accommodation of young infants and their mothers. The mothers are catered for, and themselves nurse their infants. My experience of the cases so treated has been such as to make me confident in the opinion that no children’s hospital can be considered complete which has not, in the hospital or hard by, accommodation for a certain number of nursing mothers whose infants require operation”. During World War I at the instigation of Miss Geeta Rowell, recently returned to Newcastle from Italy, an anonymous donor purchased a house on West Parade in Newcastle and gave £500 to equip …

As I wrote in Phase Two of the Magnetic Cure, the emotional irritation and exaltation Estelle feels following a spirited confrontation momentarily aggravates her problems. She sometimes goes into a rage. Her intellectual functioning is troubled. She makes no sense; it is as if she is having a fit. This state was foreseen by her in somnambulism. Her sensitivity becomes excessive and she suddenly develops a response to colors. The problem is at its worst. Then Estelle tells the entire story of her illness spontaneously in somnambulism, with a coherence and intelligibility of which she was incapable in the waking state.

While reflex sympathetic dystrophy syndrome (RSDS) research is lacking and the pathophysiology remains obscure, it is known that it affects all age groups with the common overriding complaint of severe, unrelenting, burning pain. It seems to be triggered by trauma (major or minor), including more central events such as myocardial infarction, cerebrovascular accident and tumours. Diagnostic characteristics of RSDS are: spontaneous burning pain, hyperalgesia, vasomotor disturbances, exacerbations by emotional upset, occurrence either spontaneously or after minor injury, occasional spontaneous resolution, extension to other body parts, and relief by sympathetic denervation. The problem may recur after earlier resolution. The problem for this author, and others, is the discrepancy between what appears in the literature and what is evidenced in clinical practice. What is being observed is a large number of individuals with RSDS who are not easily treated or cured. The problem for some clients becomes one of total body involvement, with severe incapacitation related to the constant and intense nature of the pain and the accompanying alterations in mobility. This author and two colleagues designed and conducted a study of clients registered with the RSDS Association to delineate the magnitude and long-term effects of RSDS in this sample.

The purpose of this study was to determine whether patient reporting of a relationship between seizure exacerbation and menses helps distinguish premenopausal women with epileptic seizures from those with nonepileptic seizures (NES). We reviewed the responses to the question "What tends to bring on your seizures?", administered during the initial evaluation of women ages 18–45 years with epileptic seizures ( n = 27) and NES ( n = 38) at our outpatient clinic. Only one out of 38 women with NES versus 13 of 27 women with epilepsy reported a relationship of seizures with the menstrual cycle ( p = .0001). Other precipitants identified for seizure exacerbation such as stress, or emotional upset, did not distinguish these two groups. Patient reporting of a relationship between seizure exacerbation and menses can help distinguish epileptic from NES in premenopausal women.

Ventricular arrhythmia exhibits considerable within-subject variability that cannot be attributed to clinical status alone. This investigation examined the extent to which cardiac arrhythmia was associated with psychological and physical factors assessed during the hour preceding arrhythmic or nonarrhythmic activity. Approximately twice hourly, 46 patients randomly completed a diary assessing mood and physical symptoms during 24-hr electrocardiographic monitoring. Greater negative emotion was associated with increased arrhythmia. Additionally, greater negative emotion was significantly associated with increased arrhythmia among participants in a low left ventricular ejection fraction group (LVEF). However, this relationship between negative emotion and arrhythmia was not observed among higher LVEF participants. These findings contribute to a larger body of evidence suggesting that negative moods may exacerbate cardiac conditions.

Hereditary trembling chin is an autosomal dominant condition characterized by recurrent bouts of tremor involving the chin. These episodes are precipitated by emotional upset. There has been considerable debate about the gravity of this condition. This may be a benign movement disorder; however, the rhythmic trembling of mentalis at rest or during times of stress in these patients is often misinterpreted as betraying an incipient emotional upset. For this reason, some patients with this condition may find it socially disabling. We have recently successfully treated one such family with regular botulinum toxin injections to the mentalis muscle. ( J Child Neurol 1992;7:154-156).

The aim of this article is to present a selective review of the research on children’s psychological responses to hospitalisation. Children vary in their capacities to cope with the stress of hospitalisation. A significant proportion of them, however, suffer from some degree of emotional disturbance due to the experience. Prolonged and repeated hospitalisation increases the chance of later problems. The separation of the child from familiar figures during admission may be the cause of some of the emotional upset. Younger children, especially those between the ages of 6 months and 4 years are most vulnerable. Individual factors such as the children’s temperament and intelligence contribute to their style of coping and thus may influence both the short term and long term effects of hospitalisation. Children who take an active coping role are more cooperative with hospital staff and show less disturbance after discharge. The preparation of children for the experience of hospitalisation has proven to be very effective in reducing their emotional distress during admission.

Aim This study is part of a larger cross-sectional study exploring the views of people affected by lung cancer about their experiences of discussing preferences and wishes for end of life care. Design and method 19 family members (16 women, 3 men) took part in single, joint and group interviews conducted between: 2006 and 2008. Participants were mainly from lower socio-economic classes in the north of England, UK. Findings The main findings were that family members supported the person with lung cancer to ‘carry on as normal’, which included continuing routine activities, planning holidays and special celebrations. They experienced emotional upset following disclosure of the person9s prognosis and expressed feelings of loneliness and isolation when their needs for information about the future were not fulfilled. They also expressed the fear of being seen as ‘disloyal’ by the person with lung cancer if they initiated the conversation about plans for end of life care. Family members supported the person with lung cancer in practical planning for the future such as planning funerals, wills and financial plans. They had their own needs for practical planning in relation to sourcing equipment and services for the future to support them in their caring role. Conclusion Health and social care professionals conducting advance care planning (ACP) need to consider the needs of family members about discussing preferences and wishes for end of life care, which may be different to those living with cancer. ACP interventions should be developed to meet the needs of both patients and their family members.