Work Stress and Metabolic Syndrome in Police Officers. A Prospective Study

Objective

The aim of this longitudinal study was to evaluate the association between occupational stress and metabolic syndrome (MetS) in a rapid response police unit.

Method

Work-related stress was continuously monitored during the 5-year period with both the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models. Blood pressure, body mass index (BMI), waist circumference, triglycerides, HDL-cholesterol, and fasting blood glucose were measured at baseline in January 2009, and in January 2014. 234 out of 290 police officers (81%) completed the follow-up.

Results

The majority of police officers had high stress levels. At follow-up, police officers in the highest quartile of stress had significantly higher mean levels of triglycerides, and lower levels of HDL-cholesterol than their colleagues in the lowest quartile. Police officers with high stress had an increased adjusted risk of developing MetS (aOR = 2.68; CI95% = 1.08–6.70), and hypertriglyceridemia (aOR = 7.86; CI95 = 1.29–48.04). Demand and Effort were significant predictors of MetS.

Conclusion

Our study supports the hypothesis that work-related stress induces MetS, particularly through its effects on blood lipids. Future longitudinal studies with continuous monitoring of stress levels will definitively confirm this hypothesis.     

The Relationship of Metabolic Syndrome with Stress,Coronary Heart Disease and Pulmonary Function - An Occupational Cohort-Based Study

Background and Aims

Higher levels of stress impact the prevalence of metabolic syndrome (MetS) and coronary heart disease. The association between MetS, impaired pulmonary function and low level of physical activity is still pending assessment in the subjects exposed to stress. The study aimed to examine whether higher levels of stress might be related to MetS and the plaque presence, as well as whether MetS might affect pulmonary function.

Design and Methods

The study embraced 235 police officers (mean age 40.97 years) from the south of Poland. The anthropometrics and biochemical variables were measured; MetS was diagnosed using the International Diabetes Federation criteria. Computed tomography coronary angiography of coronary arteries, exercise ECG, measurements of brachial flow-mediated dilation, and carotid artery intima-media thickness were completed. In order to measure the self-perception of stress, 10-item Perceived Stress Scale (PSS-10) was applied. Pulmonary function and physical activity levels were also addressed. Multivariate logistic regression analyses were applied to determine the relationships between: 1/ incidence of coronary plaque and MetS per se, MetS components and the number of classical cardiovascular risk factors, 2/ perceived stress and MetS, 3/ MetS and pulmonary function parameters.

Results

Coronary artery atherosclerosis was less associated with MetS (OR = 2.62, 95%CI 1.24–5.52; p = 0.011) than with a co-existence of classical cardiovascular risk factors (OR = 5.67, 95% CI 1.07–29.85, p = 0.03; for 3 risk factors and OR = 9.05; 95% CI 1.24–66.23, p = 0.02; for 6 risk factors, respectively). Perceived stress increased MetS prevalence (OR = 1.07, 95% CI 1.03–1.13; p = 0.03), and impacted coronary plaque prevalence (OR = 1.05, 95% CI 1.001–1.10; p = 0.04). Leisure-time physical activity reduced the chances of developing MetS (OR = 0.98 95% CI 0.96–0.99; p = 0.02). MetS subjects had significantly lower values of certain pulmonary function parameters.

Conclusions

Exposure to job-specific stress among police officers increased the prevalence of MetS and impacted coronary plaque presence. MetS subjects had worse pulmonary function parameters. Early-stage, comprehensive therapeutic intervention may reduce overall risk of cardiovascular events and prevent pulmonary function impairment in this specific occupational population.     

个体化康复运动训练联合八段锦运动对冠心病PCI术后患者心功能、生活质量和心境状态的影响

目的:观察个体化康复运动训练联合八段锦运动对冠心病患者经皮冠状动脉介入术(PCI)术后心功能、心境状态和生活质量的影响。方法:选取2017年9月-2018年9月期间来我院接受治疗的100例冠心病PCI术后患者,根据随机数字表法分为对照组和研究组,各50例。对照组患者在常规治疗的基础上接受个体化康复运动训练,研究组患者在对照组的基础上联合八段锦运动。观察两组心功能、生活质量和心境状态变化情况。统计两组6个月内心血管不良事件发生率。结果:干预后,两组患者6 min步行试验(6MWT)距离、左心室射血分数(LVEF)均较干预前升高,且研究组的变化程度优于对照组(P<0.05)。干预后,两组患者紧张-焦虑、抑郁-沮丧、愤怒-敌意、疲乏-迟钝、迷惑-混乱评分均较干预前下降,精力-活力、与自我有关的情绪评分较干预前升高,且研究组的变化程度优于对照组(P<0.05)。研究组6个月内的心血管不良事件发生率低于对照组,但是两组组间对比无统计学差异(P>0.05)。干预后,两组总体/精神健康、精力、情感/生理职能、躯体疼痛、生理/社会功能各维度评分升高,且研究组较对照组高(P<0.05)。结论:八段锦运动联合个体化康复运动训练可促进冠心病PCI术后患者心功能、生活质量和心境状态改善,同时还可控制心血管不良事件发生风险。     

艾司西酞普兰联合心理疗法对焦虑症患者睡眠质量、生活质量和血清神经递质水平的影响

目的:探讨艾司西酞普兰联合心理疗法对焦虑症患者睡眠质量、生活质量和血清神经递质水平的影响.方法:选取2017年7月～2020年3月期间我院收治的焦虑症患者117例,随机分为对照组58例和研究组59例,对照组给予艾司西酞普兰治疗,研究组在对照组的基础上联合心理疗法,对比两组疗效、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠质...     

Infarct as a stress agent: life history and personality characteristics in improved versus not-improved patients after severe heart attack

Fifty-eight male subjects admitted to an intensive coronary care unit were interviewed and underwent psychometric testing on the second--third day after a severe heart attack (infarct). Seven-ten days following admission, the clinical condition of the patients was evaluated by the attending cardiological staff and rated on a three point scale. The patients were divided, on the basis of the clinical rating, into two groups: improved (N = 25) and non-improved (N = 33). Life history characteristics, MMPI personality profiles, and State-Trait anxiety scores were then compared for the two groups. The not-improved group showed the higher scores on almost all the MMPI scales, higher anxiety scores and more work-related problems than the improved group. Such data give some empirical support to the hypothesis that the physiological and hemodynamical conditon of the cardiac patient is in some way correlated with the patient's style of coping with stress, and his history of previous life stress situations.     

Stress of stoicism: Low emotionality and high control lead to increases in allostatic load

The present longitudinal study examined the combined effects of task persistence and negative emotionality (NE) on allostatic load (AL), a physiological indicator of chronic stress. In line with John Henryism theory, we hypothesized that high persistence combined with low NE may be indicative of a high-effort coping style, leading to high arousal of the nervous system and, as a consequence, increased AL. Mothers reported on children’s NE (N = 158, 72 females) at age 9. Persistence was measured at age 9 using a behavioral measure assessing persistence on an impossible task. AL was measured at ages 9 and 17. The AL measure captured hypothalamic pituitary adrenal axis, sympathetic adrenal medullary system, cardiovascular, and metabolic activity. Consistent with previous research, persistence protected against high AL in the context of high NE. However, combined with low NE, high behavioral persistence was associated with higher physiological stress. Our results have implications for both clinical and intervention contexts.     

Shaping adult phenotypes through early life environments

A major question in the biology of stress and environmental adaptation concerns the neurobiological basis of how neuroendocrine systems governing physiological regulatory mechanisms essential for life (metabolism, immune response, organ function) become harmful. The current view is that a switch from protection to damage occurs when vulnerable phenotypes are exposed to adverse environmental conditions. In accordance with this theory, sequelae of early life social and environmental stressors, such as childhood abuse, neglect, poverty, and poor nutrition, have been associated with the emergence of mental and physical illness (i.e., anxiety, mood disorders, poor impulse control, psychosis, and drug abuse) and an increased risk of common metabolic and cardiovascular diseases later in life. Evidence from animal and human studies investigating the associations between early life experiences (including parent‐infant bonding), hypothalamus‐pituitary‐adrenal axis activity, brain development, and health outcome provide important clues into the neurobiological mechanisms that mediate the contribution of stressful experiences to personality development and the manifestation of illness. This review summarizes our current molecular understanding of how early environment influences brain development in a manner that persists through life and highlights recent evidence from rodent studies suggesting that maternal care in the first week of postnatal life establishes diverse and stable phenotypes in the offspring through epigenetic modification of genes expressed in the brain that shape neuroendocrine and behavioral stress responsivity throughout life. Birth Defects Research (Part C) 87:314–326, 2009. © 2009 Wiley‐Liss, Inc.     

Arterial Stiffness,Carotid Intima-Media Thickness,Endocan, and A Disintegrin and Metalloproteinase With Thrombospondin Type I Motif 9 Levels and Their Relationship With Disease Activity in Patients With Acromegaly With and Without Cardiovascular Risk Factors

ObjectiveCardiovascular complications such as cardiomyopathy and endothelial dysfunction, which are frequently seen in patients with acromegaly, are among the most important causes of morbidity and mortality. In this study, we aimed to investigate arterial stiffness, carotid intima-media thickness, endocan level, and A disintegrin and metalloproteinase with thrombospondin type I motif 9 level and their relationship with disease activity in patients with acromegaly with and without cardiovascular risk factors.MethodsA total of 60 patients with acromegaly—25 with active disease, 26 with well-controlled disease, and 9 with newly diagnosed disease—and 60 age-, sex-, and body mass index (BMI)-matched healthy control subjects were enrolled in this study. All the subjects’ height, weight, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG) level, insulin, hemoglobin A1C (HbA1C), C-reactive protein , lipid, endocan, A disintegrin and metalloproteinase with thrombospondin type I motif 9 levels, pulse wave velocity (PWV), and carotid intima-media thickness were measured.ResultsThe SBP, DBP, FPG level, HbA1C level, and PWV of the acromegaly group were higher than those of the control group. In patients with acromegaly with cardiovascular disease (CVD) risk factors, the PWV was higher than that in the control group, and in patients with acromegaly without CVD risk factors, the PWV was similar to that in the control group. In a correlation analysis, a positive correlation was found between PWV and age, BMI, SBP, DBP, FPG level, and HbA1C level in the acromegaly group.ConclusionIn our study, we found that arterial stiffness increased in patients with acromegaly with CVD risk factors and that increased arterial stiffness was associated with hemodynamic (SBP and DBP) and metabolic (BMI, FPG level, and HbA1C level) parameters.     

Reduced Ventral Cingulum Integrity and Increased Behavioral Problems in Children with Isolated Optic Nerve Hypoplasia and Mild to Moderate or No Visual Impairment

Objectives

To assess the prevalence of behavioral problems in children with isolated optic nerve hypoplasia, mild to moderate or no visual impairment, and no developmental delay. To identify white matter abnormalities that may provide neural correlates for any behavioral abnormalities identified.

Patients and Methods

Eleven children with isolated optic nerve hypoplasia (mean age 5.9 years) underwent behavioral assessment and brain diffusion tensor imaging, Twenty four controls with isolated short stature (mean age 6.4 years) underwent MRI, 11 of whom also completed behavioral assessments. Fractional anisotropy images were processed using tract-based spatial statistics. Partial correlation between ventral cingulum, corpus callosum and optic radiation fractional anisotropy, and child behavioral checklist scores (controlled for age at scan and sex) was performed.

Results

Children with optic nerve hypoplasia had significantly higher scores on the child behavioral checklist (p<0.05) than controls (4 had scores in the clinically significant range). Ventral cingulum, corpus callosum and optic radiation fractional anisotropy were significantly reduced in children with optic nerve hypoplasia. Right ventral cingulum fractional anisotropy correlated with total and externalising child behavioral checklist scores (r = −0.52, p<0.02, r = −0.46, p<0.049 respectively). There were no significant correlations between left ventral cingulum, corpus callosum or optic radiation fractional anisotropy and behavioral scores.

Conclusions

Our findings suggest that children with optic nerve hypoplasia and mild to moderate or no visual impairment require behavioral assessment to determine the presence of clinically significant behavioral problems. Reduced structural integrity of the ventral cingulum correlated with behavioral scores, suggesting that these white matter abnormalities may be clinically significant. The presence of reduced fractional anisotropy in the optic radiations of children with mild to moderate or no visual impairment raises questions as to the pathogenesis of these changes which will need to be addressed by future studies.     

Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00545.x Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers Background and objective: The prevalence of malnutrition increases with age because of many factors. Edentulousness leads to the avoidance of many types of foods. The aim of this study was to determine whether elderly complete denture wearers have a higher risk of malnutrition than dentate controls. Material and methods: A Mini‐Nutritional Assessment (MNA) and a 3‐day dietary record were compiled for a group of fully dentates (21 women and 29 men; mean age 70.1 ± 6.1) and for a group of complete denture wearers (31 women and 16 men; mean age 70.1 ± 8.1). Socio‐demographic data and scores on the General Oral Health Assessment Index (GOHAI) questionnaire were collected. Results: Inter‐group comparison of MNA scores showed that more subjects in the edentulous group (21.3%) risked malnutrition than in the dentate group (0%). The variability of the MNA could be explained for 22% by dental status, 7% by loneliness and 4% by the GOHAI score (regression analysis). Both groups had insufficient energy intakes and deficits in vitamins and micronutrients; moreover, edentulous subjects had lower intakes than dentate subjects. Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly.     

Gain and loss learning differentially contribute to life financial outcomes

Emerging findings imply that distinct neurobehavioral systems process gains and losses. This study investigated whether individual differences in gain learning and loss learning might contribute to different life financial outcomes (i.e., assets versus debt). In a community sample of healthy adults (n = 75), rapid learners had smaller debt-to-asset ratios overall. More specific analyses, however, revealed that those who learned rapidly about gains had more assets, while those who learned rapidly about losses had less debt. These distinct associations remained strong even after controlling for potential cognitive (e.g., intelligence, memory, and risk preferences) and socioeconomic (e.g., age, sex, ethnicity, income, education) confounds. Self-reported measures of assets and debt were additionally validated with credit report data in a subset of subjects. These findings support the notion that different gain and loss learning systems may exert a cumulative influence on distinct life financial outcomes.     

个体化护理可干预糖尿病合并高血压患者脂联素、Cys-c水平及治疗依从性和生活质量

本研究回顾性选取2015年12月至2017年2月我院收治的糖尿病合并高血压患者142例,根据护理方法不同分为对照组和观察组。对照组患者采用常规护理,观察组患者采用个体化护理,分析两组患者护理后的效果,以探讨个体化护理对糖尿病合并高血压患者治疗依从性及生活质量的影响。研究结果显示:干预前,两组患者血压、血糖水平比较无统计学差异(p>0.05),干预后,观察组患者收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure, DBP)、空腹血糖(fasting plasma glucose, FPG)、餐后2 h血糖(2 hourspost prandial plasma, P2hPG)水平低于对照组(p<0.05);干预前,两组患者细胞一氧化氮(nitric oxide, NO)、脂联素(adiponectin)、基质金属蛋白酶-9 (matrix metalloproteinase-9, MMP-9)、细胞间黏附分子-1 (intercelluaradhension molecule-1, ICAM-1)、胱抑素C (cystatin C, Cys-c)水平比较无统计学差异(p>0.05),干预后,观察组患者NO、脂联素水平高于对照组,MMP-9、ICAM-1、Cys-c水平低于对照组(p<0.05);干预前,两组患者对饮食、运动、用药、心理方面的依从性评分比较无统计学差异(p>0.05),干预后,观察组患者各方面的依从性评分水平高于对照组(p<0.05);干预前,两组患者生活质量评分比较无统计学差异(p>0.05),干预后,观察组患者社会功能、生理职能、情感职能、躯体状况、心理状况评分水平高于对照组(p<0.05)。我们的研究初步得出结论:个体化护理干预可提高糖尿病合并高血压患者的依从性,控制患者血压、血糖、MMP-9、ICAM-1水平,提高患者生活质量。     

Phototherapy and Orange-Tinted Goggles for Night-Shift Adaptation of Police Officers on Patrol

The aim of the present combined field and laboratory study was to assess circadian entrainment in two groups of police officers working seven consecutive 8/8.5-h night shifts as part of a rotating schedule. Eight full-time police officers on patrol (mean age?±?SD: 29.8?±?6.5 yrs) were provided an intervention consisting of intermittent exposure to wide-spectrum bright light at night, orange-tinted goggles at sunrise, and maintenance of a regular sleep/darkness episode in the day. Orange-tinted goggles have been shown to block the melatonin-suppressing effect of light significantly more than neutral gray density goggles. Nine control group police officers (mean age?±?SD: 30.3?±?4.1 yrs) working the same schedule were enrolled. Police officers were studied before, after (in the laboratory), and during (ambulatory) a series of seven consecutive nights. Urine samples were collected at wake time and bedtime throughout the week of night work and during laboratory visits (1?×?/3?h) preceding and following the work week to measure urinary 6-sulfatoxymelatonin (UaMT6s) excretion rate. Subjective alertness was assessed at the start, middle, and end of night shifts. A 10-min psychomotor vigilance task was performed at the start and end of each shift. Both laboratory visits consisted of two 8-h sleep episodes based on the prior schedule. Saliva samples were collected 2?×?/h during waking episodes to assay their melatonin content. Subjective alertness (3?×?/h) and performance (1?×?/2?h) were assessed during wake periods in the laboratory. A mixed linear model was used to analyze the progression of UaMt6s excreted during daytime sleep episodes at home, as well as psychomotor performance and subjective alertness during night shifts. Two-way analysis of variance (ANOVA) (factors: laboratory visit and group) were used to compare peak salivary melatonin and UaMT6s excretion rate in the laboratory. In both groups of police officers, the excretion rate of UaMT6s at home was higher during daytime sleep episodes at the end compared to the start of the work week (p?<?.001). This rate increased significantly more in the intervention than control group (p?=?.032). A significant phase delay of salivary melatonin was observed in both groups at the end of study (p?=?.009), although no significant between-group difference was reached. Reaction speed dropped, and subjective alertness decreased throughout the night shift in both groups (p?<?.001). Reaction speed decreased throughout the work week in the control group (p?≤?.021), whereas no difference was observed in the intervention group. Median reaction time was increased as of the 5th and 6th nights compared to the 2nd night in controls (p?≤?.003), whereas it remained stable in the intervention group. These observations indicate better physiological adaptation in the intervention group compared to the controls. (Author correspondence: diane.boivin@douglas.mcgill.ca)     

基于Logistic回归模型分析维持性血液透析患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响

摘要 目的：基于Logistic回归模型分析维持性血液透析（MHD）患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响。方法：选取江苏省人民医院肾内科肾脏病重症病房于2019年2月-2021年2月期间收治的MHD患者289例,收集所有患者的一般资料,根据是否患有肌少症将患者分为肌少症组（n=71）及非肌少症组（n=218）。采用单因素和多因素Logistic回归模型分析MHD患者肌少症的危险因素,并观察两组生活质量、负性情绪及生存状况。结果：肌少症组、非肌少症组在年龄、透析时间、规律运动、体质量指数（BMI）、人体蛋白质含量（PM）、去脂体质量（FFM）、改良定量主观评估表（MQSGA）评分、血磷、超敏C反应蛋白（hs-CRP）、血肌酐、前白蛋白、白蛋白组间对比差异有统计学意义（P<0.05）。多因素Logistic回归分析,结果显示年龄偏大、透析时间偏长、BMI下降、MQSGA评分偏高、hs-CRP偏高、血肌酐偏高是MHD患者发生肌少症的危险因素,高血磷、规律运动则是其保护因素（P<0.05）。肌少症组患者的精神健康、生理职能、总体健康、生理功能、社会功能、活力、躯体疼痛、情感职能评分均低于非肌少症组（P<0.05）。肌少症组患者的抑郁自评量表（SDS）、焦虑自评量表（SAS）评分高于非肌少症组（P<0.05）。随访1年后,肌少症组的死亡率明显高于非肌少症组（P<0.05）。结论：MHD患者并发肌少症受到年龄、透析时间、BMI、MQSGA评分、hs-CRP、血肌酐、血磷、规律运动等因素的影响,且并发肌少症的患者其抑郁焦虑程度更重,生活质量更差,生存期缩短。     

Effects of early life adversity on cortisol/salivary alpha-amylase symmetry in free-ranging juvenile rhesus macaques

Early life adversity (ELA) affects physiological and behavioral development. One key component is the relationship between the developing Hypothalamic-Pituitary-Adrenal (HPA) axis and the Sympathetic Nervous System (SNS). Recent studies suggest a relationship between early life adversity and asymmetry in cortisol (a measure of HPA activation) and salivary alpha-amylase (sAA: a correlate of SNS activation) responses to stress among human children, but to our knowledge there have been no comparable studies in nonhumans. Here, we investigate the responses of these two analytes in “low stress” and “high stress” situations in free-ranging juvenile rhesus macaques (Macaca mulatta) on Cayo Santiago, Puerto Rico. Behavioral data on maternal maltreatment were collected during the first 3 months of life to determine individual rates of ELA, and saliva samples were collected from subjects noninvasively during juvenility. Irrespective of ELA, salivary alpha-amylase levels were lower in low stress situations and higher in high stress situations. For cortisol however, high ELA subjects exhibited higher low stress concentrations and blunted acute responses during high stress situations compared to moderate and low ELA subjects. Cortisol and sAA values were positively correlated among low ELA subjects, suggesting symmetry, but were uncorrelated or negatively correlated among moderate and high ELA subjects, suggesting asymmetry in these individuals. These findings indicate dysregulation of the stress response among juveniles maltreated during infancy: specifically, attenuated cortisol reactivity coupled with typical sAA reactivity characterize the stress response profiles of juveniles exposed to higher rates of ELA during the first 3 months of life.     

Phototherapy and orange-tinted goggles for night-shift adaptation of police officers on patrol

The aim of the present combined field and laboratory study was to assess circadian entrainment in two groups of police officers working seven consecutive 8/8.5-h night shifts as part of a rotating schedule. Eight full-time police officers on patrol (mean age ± SD: 29.8 ± 6.5 yrs) were provided an intervention consisting of intermittent exposure to wide-spectrum bright light at night, orange-tinted goggles at sunrise, and maintenance of a regular sleep/darkness episode in the day. Orange-tinted goggles have been shown to block the melatonin-suppressing effect of light significantly more than neutral gray density goggles. Nine control group police officers (mean age ± SD: 30.3 ± 4.1 yrs) working the same schedule were enrolled. Police officers were studied before, after (in the laboratory), and during (ambulatory) a series of seven consecutive nights. Urine samples were collected at wake time and bedtime throughout the week of night work and during laboratory visits (1 × /3 h) preceding and following the work week to measure urinary 6-sulfatoxymelatonin (UaMT6s) excretion rate. Subjective alertness was assessed at the start, middle, and end of night shifts. A 10-min psychomotor vigilance task was performed at the start and end of each shift. Both laboratory visits consisted of two 8-h sleep episodes based on the prior schedule. Saliva samples were collected 2 × /h during waking episodes to assay their melatonin content. Subjective alertness (3 × /h) and performance (1 × /2 h) were assessed during wake periods in the laboratory. A mixed linear model was used to analyze the progression of UaMt6s excreted during daytime sleep episodes at home, as well as psychomotor performance and subjective alertness during night shifts. Two-way analysis of variance (ANOVA) (factors: laboratory visit and group) were used to compare peak salivary melatonin and UaMT6s excretion rate in the laboratory. In both groups of police officers, the excretion rate of UaMT6s at home was higher during daytime sleep episodes at the end compared to the start of the work week (p 相似文献   

A 6-month supervised employer-based minimal exercise program for police officers improves fitness

The purpose of the study was to determine the effects of a 6-month supervised, job-specific moderate exercise program in police officers on body composition, cardiovascular and muscular fitness. Body weight (BW), body mass index (BMI), and cardiovascular and muscular fitness were assessed at baseline, after a 6-month supervised fitness program and at 12-month follow-up (18 months). One hundred sixty-five (n = 131 men and n = 34 women) young (mean ± SEM, 26.4 ± 1.9 years), overweight (BMI = 26.2 ± 1.2 kg·m) police officers participated. Aerobic exercise progressed from 3 d·wk, 20 minutes per session at 60% of the heart rate reserve (HRR) to 5 d·wk, 30 minutes per session at 75% of HRR at 3 months, and this level was maintained until 6 months. Muscular strength training progressed using 8 different calisthenics exercises from 3 d·wk, 2 sets of 5 repetitions using the participant's own BW to 5 d·wk, 3 sets of 15 repetitions of the participant's own BW at 3 months, and this level was maintained until 6 months. Cardiovascular and muscular fitness was measured using a 0.25-mile obstacle course incorporating various job-specific exercises and expressed as the physical abilities test (PAT) time. There was a significant reduction in BMI (-0.6 ± 0.2 kg·m, p < 0.001) and BW (-2.8 ± 2.3 kg) and reduction in PAT time (-11.9 ± 2.1%, p < 0.01) from baseline to 6 months. However, BMI (1.4 ± 1.1 kg·m, p < 0.001), BW (5.1 ± 3.0 kg, p < 0.01), and PAT time significantly increased (12.8 ± 2.2%, p < 0.01) from 6 to 18 months. There were no sex by time differences. The practical applications of this study indicate that a supervised, job-specific exercise program for police officers improves fitness and body composition after 6 months in both men and women, but continued supervision of exercise program may be necessary for maintenance of health benefits.     

A Multi-Level Bayesian Analysis of Racial Bias in Police Shootings at the County-Level in the United States, 2011–2014

A geographically-resolved, multi-level Bayesian model is used to analyze the data presented in the U.S. Police-Shooting Database (USPSD) in order to investigate the extent of racial bias in the shooting of American civilians by police officers in recent years. In contrast to previous work that relied on the FBI’s Supplemental Homicide Reports that were constructed from self-reported cases of police-involved homicide, this data set is less likely to be biased by police reporting practices. County-specific relative risk outcomes of being shot by police are estimated as a function of the interaction of: 1) whether suspects/civilians were armed or unarmed, and 2) the race/ethnicity of the suspects/civilians. The results provide evidence of a significant bias in the killing of unarmed black Americans relative to unarmed white Americans, in that the probability of being {black, unarmed, and shot by police} is about 3.49 times the probability of being {white, unarmed, and shot by police} on average. Furthermore, the results of multi-level modeling show that there exists significant heterogeneity across counties in the extent of racial bias in police shootings, with some counties showing relative risk ratios of 20 to 1 or more. Finally, analysis of police shooting data as a function of county-level predictors suggests that racial bias in police shootings is most likely to emerge in police departments in larger metropolitan counties with low median incomes and a sizable portion of black residents, especially when there is high financial inequality in that county. There is no relationship between county-level racial bias in police shootings and crime rates (even race-specific crime rates), meaning that the racial bias observed in police shootings in this data set is not explainable as a response to local-level crime rates.     

Ultradian rhythmic models of blood pressure variation in normal human daily life

To examine levels and variance structure of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR), we measured those 3 variables every 7.5 min for 24 h (approximately 192 samples each subject) by ambulatory monitoring in 2 nominated groups of normal volunteers: younger (Y; 8 men, 5 women, 24-44 years) and older (O; 13 men, 12 women, 50-95 years). Y and O did not differ in either sleep or wake means for HR and DBP. Mean SBP in O was 17 mm Hg higher than in Y during wakefulness. Thirty-four subjects had significant low frequency variations (presumably the circadian rhythm) in SBP, DBP and HR, regardless of age. A periodic model fitting the time series required a 9 h feature (rhythm) for Y and O in DBP for best reduction of mean square error. In addition, O regularly showed 3 h features in both SBP and DBP, a 6 h feature in DBP and a 9 h feature in SBP, which were absent in Y. Our results suggest that low-power ultradian rhythms may appear in both SBP and DBP after age 50, and possibly serve as dynamic markers of normal cardiovascular aging.