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Patients with heart failure with reduced ejection fraction (HFrEF) have exaggerated sympathoexcitation and impaired peripheral vascular conductance. Evidence demonstrating consequent impaired functional sympatholysis is limited in HFrEF. This study aimed to determine the magnitude of reduced limb vascular conductance during sympathoexcitation and whether functional sympatholysis would abolish such reductions in HFrEF. Twenty patients with HFrEF and 22 age-matched controls performed the cold pressor test (CPT) [left foot 2-min in −0.5 (1)°C water] alone and with right handgrip exercise (EX + CPT). Right forearm vascular conductance (FVC), forearm blood flow (FBF), and mean arterial pressure (MAP) were measured. Patients with HFrEF had greater decreases in %ΔFVC and %ΔFBF during CPT (both P < 0.0001) but not EX + CPT (P = 0.449, P = 0.199) compared with controls, respectively. %ΔFVC and %ΔFBF decreased from CPT to EX + CPT in patients with HFrEF (both P < 0.0001) and controls (P = 0.018, P = 0.015), respectively. MAP increased during CPT and EX + CPT in both groups (all P < 0.0001). MAP was greater in controls than in patients with HFrEF during EX + CPT (P = 0.025) but not CPT (P = 0.209). In conclusion, acute sympathoexcitation caused exaggerated peripheral vasoconstriction and reduced peripheral blood flow in patients with HFrEF. Handgrip exercise abolished sympathoexcitatory-mediated peripheral vasoconstriction and normalized peripheral blood flow in patients with HFrEF. These novel data reveal intact functional sympatholysis in the upper limb and suggest that exercise-mediated, local control of blood flow is preserved when cardiac limitations that are cardinal to HFrEF are evaded with dynamic handgrip exercise. NEW & NOTEWORTHY: Patients with HFrEF demonstrate impaired peripheral blood flow regulation, evidenced by heightened peripheral vasoconstriction that reduces limb blood flow in response to physiological sympathoexcitation (cold pressor test). Despite evidence of exaggerated sympathetic vasoconstriction, patients with HFrEF demonstrate a normal hyperemic response to moderate-intensity handgrip exercise. Most importantly, acute, simultaneous handgrip exercise restores normal limb vasomotor control and vascular conductance during acute sympathoexcitation (cold pressor test), suggesting intact functional sympatholysis in patients with HFrEF. [ABSTRACT FROM AUTHOR]

Through the use of indepth interviews, this study examines the impact of migration, from one social-economic milieu to another, on family dynamics among 20 immigrant Italian couples in Toronto. Specifically highlighting the effects of wives' wage employment on the division of family work and decision-making power, the authors question the argument that migration results in egalitarian gender dynamics within immigrant families. In doing so, they identify three distinct patterns of wife-husband relations among immigrant families: 1) Sex-segregated division of family work and unequal power relations; 2) Sex-segregated division of labour and greater sharing of power; 3) Sex-transcendent division of labour and shared power under extenuating circumstances. Based on these findings, the authors argue that changes taking place as a result of migration are reflective of adaptation to new demands within the context of a new social and economic environment., INTRODUCTION This paper presents the results of a case study of twenty working class Italian immigrant couples residing in Toronto. The investigation focuses on the subjective experiences of wives and […]

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The study presents empirical data, based on interviews with 117 immigrant fathers/husbands, about their involvement in family work. We found that their pattern of behaviour and participation in family work can be grouped into three types: (1) "Tradi tionalists" who refused to do more in compensation for their spouses' decrease in time availability for family chores due to employment; (2) "Situationalists' who did a minimal amount of domestic labour and believed that they had limited choice in the matter due to "situa tional constraints"; and (3) "Adaptors" or "prioritizors" who because of the presence of pre schoolers and/or their wives being employed fulltime did a fair number of domestic chores as a necessary strategy to maximize their family's well-being. The involvement of these husbands/fathers did not support the theoretical underpinnings of the Exchange/Resource Theory in explaining the family relation/interaction between husband and wife within the con text of family work. The analysis points to the need for a critical re-assessment of this theory. However, the findings suggest that changes in sex role attitudes and in the socio-economic and socio-cultural milieu as a result of their migration to Canada, and importantly, how they cope with these changes are important factors in explaining the division of labour in family work. [ABSTRACT FROM PUBLISHER]