Literature suggests that occupational stress is associated with a higher risk of metabolic syndrome; yet less is known whether other sources of stress have similar effects. This review aims to examine whether the relationship between psychological stress and metabolic syndrome differs by sources of stress. Three databases (PubMed, Web of Science, and CINAHL) were searched for eligible articles; metaanalyses were conducted using the random effects model. After controlling for covariates, adults in the high-stress groups had 45% higher chance of having metabolic syndrome than adults in the low-stress groups (odds ratio [OR] = 1.450; 95% confidence interval [CI], 1.211-1.735; P < .001). The subsequent meta-analysis based on cross-sectional studies suggested that occupational stress showed the strongest effect (OR = 1.692; 95% CI, 1.182-2.424; P = .004), while perceived general stress showed the weakest effect (OR = 1.217; 95% CI, 1.017-1.457; P = .032).Unfortunately, there is a lack of longitudinal studies for subsequent meta-analysis based on sources of stress. There is a need for continued research to examine the long-term relationship between different sources of stress and the risk of metabolic syndrome. Traditional recommendations for preventing metabolic syndrome (eg, low-fat diet and exercise) may not achieve the best outcome if clinicians overlook patients' psychosocial stress. KEYWORDS metabolic syndrome, occupational stress, perceived stress, psychological stress 1 | INTRODUCTION About 30% of adults have metabolic syndrome worldwide. 1,2 The economic burden of metabolic syndrome is substantial. For instance, the annual medical costs for Americans with metabolic syndrome are 60% higher than those without metabolic syndrome. [3][4][5] The development of metabolic syndrome is a multifaceted continuum of metabolic dysregulation, including hyperglycemia, hypertension, visceral adiposity, and atherogenic dyslipidemia. 6 Psychological stress has been linked to metabolic syndrome for decades, but its underlying mechanism is not yet fully understood.Allostasis refers to a normal physiological process where the brain activates the sympathetic-adrenal-medullary (SAM) and hypothalamic-pituitary-adrenal (HPA) axes and stimulates adrenal glands to release stress hormones (eg, corticosteroids) and catecholamine (eg, epinephrine and norepinephrine) to combat against stressful environmental demands. 7 According to the allostatic load framework (ALF), the repeated cycles of activation and deactivation of allostasis over time, or a failure to disengage the stress response during and after each stressful life demand, could alter adults' diurnal cortisol rhythm and decrease the capacity of glucocorticoids to suppress endotoxin-stimulated cytokine production, resulting in a

Background Living with chronic condition(s) is difficult, due in part to the complexities of effective disease self‐care. Self‐care has been considered a challenging process according to the literature which describes multiple barriers patients with chronic conditions experience. Resilience has the potential to buffer the adversities of daily self‐care and maintain physical and emotional well‐being. No systematic review and meta‐analysis have been conducted to synthesise and quantify the relationship between resilience and self‐care across chronic conditions. Aims (1) To examine how the definitions and measurements of self‐care and resilience align with the middle‐range theory of self‐care of chronic illness (i.e. self‐care maintenance, self‐care monitoring, and self‐care management) and 3 Rs of resilience process from the society‐to‐cells framework (i.e. resistance, recovery and rebound) across different chronic conditions; and (2) to examine whether and the degree to which resilience is correlated with self‐care across different chronic conditions. Design Systematic review and meta‐analysis, following PRISMA guidelines. Methods PubMed, CINAHL, SocINDEX and PsychINFO were searched for quantitative studies published from January 2000 through July 2020. Descriptive data were summarised using numerical counting to provide an overview of the study characteristics. Definitions and measurements of self‐care and resilience were synthesised narratively based on self‐care and resilience theories. Numerical data with Pearson's product–moment correlation among observational studies were examined using meta‐analysis. Results This review included 20 articles, involving 9,269 individuals across 11 chronic conditions. Despite self‐care and resilience being defined and operationalised in a variety of ways, most definitions shared some underlying core constructs. Meta‐analysis showed a positive relationship between resilience and self‐care across chronic conditions. Findings from interventional studies indicated a bidirectional relationship between resilience and self‐care. Conclusions Overall, resilience was positively associated with self‐care in people with chronic conditions. Longitudinal and experimental studies are needed to better understand the causal relationship between resilience and self‐care. Relevant to clinical practice Resilience has the potential to buffer the adversities of daily self‐care and maintain physical and emotional well‐being. The positive relationship between resilience and self‐care found in this review provides preliminary evidence for clinicians to not only focus on reducing barriers and risk factors of self‐care but also to improve or increase patients’ resilience through various evidence‐based interventions.

In this study we sought to differentiate participants with amnestic mild cognitive impairment (a-MCI) from those with mild dementia of Alzheimer’s type (m-DAT) and normal controls by modifying an existing test of spatial context memory (SCMT) designed so as to evaluate the function of brain regions affected in early m-DAT. We found that participants with a-MCI had better total scores on our modified SCMT than those with m-DAT. Furthermore, the locational memory subtest was able to discriminate between those with a-MCI and m-DAT. Additionally, compared with other screening tests, our spatial context memory test showed high sensitivity and specificity in discerning those with a-MCI from the normal population but, was relatively ineffective in discriminating a-MCI patients from those with m-DAT. We conclude that our modified test of SCMT is an effective tool for discriminating a-MCI from m-DAT and does so by detecting differences in locational memory.

Introduction: The global prevalence of posttraumatic stress disorder (PTSD) continues to rise, the influence of culture and resilience remains unclear. This review and meta-analysis aimed to (a) examine the prevalence of PTSD among studies addressing culture and resilience, and (b) compare the PTSD prevalence rates across different trauma exposures and cultural contexts. Methodology: PubMed, CINAHL, and PsycINFO were searched for articles published between 01/01/2000 to 12/01/019 that defined PTSD, reported PTSD prevalence rates, and addressed culture and resilience. Meta-analysis of PTSD prevalence rates was performed using generalized linear mixed models. Results: Thirty articles met all search criteria. In the pooled sample of 20,138 participants, 3,403 met defined PTSD diagnostic criteria. The random-effects model showed PTSD cultural effects. Refugees displaced in similar cultures (0.44) had higher rates of PTSD. Discussion: Findings indicate that trauma-informed, practical assessments of health protective cultural determinants may promote individual resilience and reduce the risk of PTSD in displaced refugees.

Background Financial stress is associated with higher prevalence of metabolic abnormalities and cardiovascular disease, but the extent to which this association differs by type of metabolic abnormalities or gender is unclear. Objectives The study aims were (a) to examine the association between financial stress and the prevalence of common metabolic abnormalities and (b) to test the association for gender differences. Methods A cross-sectional secondary analysis was conducted using data from the Retirement and Sleep Trajectories study, an ancillary study of the Wisconsin Sleep Cohort study. Composite indicator structural equation alpha modeling with a stacking approach was applied in the data analysis. Results After controlling for covariates, financial stress was positively associated with the prevalence of abdominal obesity, metabolic syndrome, and dyslipidemia, with significant gender differences. Among men, financial stress was positively associated with the prevalence of hypertriglyceridemia. Among women, financial stress was positively associated with the prevalence of prediabetes, abdominal obesity, metabolic syndrome, and dyslipidemia. Conclusion Men living with financial stress are more likely to have hypertriglyceridemia, a specific metabolic abnormality and risk factor for acute cardiovascular events. However, financial stress in women is associated with a broader array of metabolic abnormalities (e.g., dyslipidemia, prediabetes, abdominal obesity, metabolic syndrome), highlighting a potential risk of multiple chronic conditions later in life.