http://diposit.ub.edu/dspace/bitstream/2445/122776/1/gbd2016riskfactorscollaborators2017_3028.pdf

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

1. Introduction and Overview. 2. Detecting Influential Observations and Outliers. 3. Detecting and Assessing Collinearity. 4. Applications and Remedies. 5. Research Issues and Directions for Extensions. Bibliography. Author Index. Subject Index.

Regression Diagnostics: Identifying Influential Data and Sources of Collinearity

The brain is the key organ of the response to stress because it determines what is threatening and, therefore, potentially stressful, as well as the physiological and behavioral responses which can be either adaptive or damaging. Stress involves two-way communication between the brain and the cardiovascular, immune, and other systems via neural and endocrine mechanisms. Beyond the "flight-or-fight" response to acute stress, there are events in daily life that produce a type of chronic stress and lead over time to wear and tear on the body ("allostatic load"). Yet, hormones associated with stress protect the body in the short-run and promote adaptation ("allostasis"). The brain is a target of stress, and the hippocampus was the first brain region, besides the hypothalamus, to be recognized as a target of glucocorticoids. Stress and stress hormones produce both adaptive and maladaptive effects on this brain region throughout the life course. Early life events influence life-long patterns of emotionality and stress responsiveness and alter the rate of brain and body aging. The hippocampus, amygdala, and prefrontal cortex undergo stress-induced structural remodeling, which alters behavioral and physiological responses. As an adjunct to pharmaceutical therapy, social and behavioral interventions such as regular physical activity and social support reduce the chronic stress burden and benefit brain and body health and resilience.

/pdf/physiology-and-neurobiology-of-stress-and-adaptation-central-2xtqi7pnfe.pdf

Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain

Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators

The mind involves the whole body, and two-way communication between the brain and the cardiovascular, immune, and other systems via neural and endocrine mechanisms Stress is a condition of the mind-body interaction, and a factor in the expression of disease that differs among individuals It is not just the dramatic stressful events that exact their toll, but rather the many events of daily life that elevate and sustain activities of physiological systems and cause sleep deprivation, overeating, and other health-damaging behaviors, producing the feeling of being “stressed out” Over time, this results in wear and tear on the body, which is called “allostatic load,” and it reflects not only the impact of life experiences but also of genetic load, individual lifestyle habits reflecting items such as diet, exercise, and substance abuse, and developmental experiences that set life-long patterns of behavior and physiological reactivity Hormones associated with stress and allostatic load protect the body in the short run and promote adaptation by the process known as allostasis, but in the long run allostatic load causes changes in the body that can lead to disease The brain is the key organ of stress, allostasis, and allostatic load, because it determines what is threatening and therefore stressful, and also determines the physiological and behavioral responses Brain regions such as the hippocampus, amygdala, and prefrontal cortex respond to acute and chronic stress by undergoing structural remodeling, which alters behavioral and physiological responses Translational studies in humans with structural and functional imaging reveal smaller hippocampal volume in stress-related conditions, such as mild cognitive impairment in aging and prolonged major depressive illness, as well as in individuals with low self-esteem Alterations in amygdala and prefrontal cortex are also reported Besides Pharmaceuticals, approaches to alleviate chronic stress and reduce allostatic load and the incidence of diseases of modern life include lifestyle change, and policies of government and business that would improve the ability of individuals to reduce their own chronic stress burden

Protective and damaging effects of stress mediators: central role of the brain.

Purpose. To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Design. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. Setting. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Subjects. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Measures. Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographi...

The Relationship between Modifiable Health Risks and Group-Level Health Care Expenditures:

The Relationship Between Modifiable Health Risks and Health Care Expenditures

The objective of this study is to identify the contribution that selected demographic characteristics, health behaviors, physical health outcomes, and workplace environmental factors have on presenteeism (on-the-job productivity loss attributed to poor health and other personal issues). Analyses are based on a cross-sectional survey administered to 3 geographically diverse US companies in 2010. Work-related factors had the greatest influence on presenteeism (eg, too much to do but not enough time to do it, insufficient technological support/resources). Personal problems and financial stress/concerns also contributed substantially to presenteeism. Factors with less contribution to presenteeism included physical limitations, depression or anxiety, inadequate job training, and problems with supervisors and coworkers. Presenteeism was greatest for those ages 30–49, women, separated/divorced/widowed employees, and those with a high school degree or some college. Clerical/office workers and service wor...

Presenteeism According to Healthy Behaviors, Physical Health, and Work Environment

Objective: To better understand the combined influence of employee engagement, health behavior, and physical health on job performance and absenteeism. Methods: Analyses were based on 20,114 employees who completedtheHealthwaysWell-BeingAssessmentfrom2008to2010.Employees represented three geographically dispersed companies in the United States. Results: Employee engagement, health behavior, and physical health indices were simultaneously significantly associated with job performance and also with absenteeism. Employee engagement had a greater association with job performance than did the health behavior or physical health indices, whereas the physical health index was more strongly associated with absenteeism. Specificelementsoftheindiceswereevaluatedforassociationwithself-rated job performance and absenteeism. Conclusion: Efforts to improve worker productivity should take a holistic approach encompassing employee health improvement and engagement strategies.

http://info.healthways.com/hubfs/Science_and_Research/Self-rated-job-performance.pdf?t=1441383706833

Self-Rated Job Performance and Absenteeism According to Employee Engagement, Health Behaviors, and Physical Health

Objective:To identify the need for worksite cultures of health, the organizational factors that support worksite cultures of health, the tools that have been used to measure worksite cultures of health, and the research needs related to healthy worksite culture.Methods:A cross-sectional survey invol

R. William Whitmer

Papers

The Relationship between Modifiable Health Risks and Group-Level Health Care Expenditures:

The Relationship Between Modifiable Health Risks and Health Care Expenditures

Presenteeism According to Healthy Behaviors, Physical Health, and Work Environment

Self-Rated Job Performance and Absenteeism According to Employee Engagement, Health Behaviors, and Physical Health

A review of the knowledge base on healthy worksite culture.