The effects of competition and competitiveness on cardiovascular activity.

Cardiovascular activity was measured at resting baseline and in response to a car racing game, undertaken in competition or in cooperation with an experimenter, or individually. Competitiveness and win and goal orientations were assessed by questionnaire. Competition provoked increases in blood pressure and heart rate, and a significant shortening of the preejection period, an index of enhanced beta-adrenergic influences on the heart. The cooperation task was largely without effect, and although the solo task affected cardiovascular activity, it did so to a lesser extent and much less consistently than did the competition task. The three task conditions, then, were largely distinguishable by their capacity to activate beta-adrenergic processes. Participants high in competitiveness and desire to win showed higher blood pressure reactions and greater shortening of the preejection period to competition than those low in these characteristics.

Secretory immunoglobulin A and cardiovascular reactions to mental arithmetic, cold pressor, and exercise: effects of alpha-adrenergic blockade.

The mechanism underlying acute changes in secretory immunoglobulin A (sIgA) remains to be determined. In this experiment, sIgA and cardiovascular activity were monitored at rest and while participants performed a mental arithmetic task, cold pressor, and submaximal cycle exercise following placebo or 1 mg of the alpha-adrenergic blocker, doxazosin. Under placebo, the tasks produced patterns of cardiovascular activity indicative of combined alpha- and beta-adrenergic, alpha-adrenergic, and beta-adrenergic activation, respectively. Doxazosin was associated with reduced blood pressure during cold pressor, but not during arithmetic or exercise. Mental arithmetic elicited increases in sIgA concentration and exercise produced increases in both sIgA concentration and secretion rate; these changes were unaffected by alpha blockade. In contrast, the cold pressor was associated with decreases in both sIgA concentration and secretion rate, which were blocked by doxazosin. These data suggest that acute decreases, but not increases, in sIgA are mediated by alpha-adrenergic mechanisms.

Cardiovascular and secretory immunoglobulin A reactions to humorous, exciting, and didactic film presentations.

Secretory immunoglobulin A (sIgA) in saliva and cardiovascular activity were measured at rest and in response to three film extracts varying in affective content. Subjective ratings of film impact confirmed a priori assumptions; the humorous film was rated as funnier than the other two films, the didactic film as more boring than the other two films, and the exciting film as more exciting and more stressful than the other two films. The films elicited distinct patterns of cardiovascular autonomic activity. The exciting film provoked changes characteristic of beta-adrenergic activation: increased systolic blood pressure (SBP); heart rate (HR); cardiac output (CO); and shortened pre-ejection period (PEP). The didactic film had little impact on cardiovascular activity. While an increase in total peripheral resistance (TPR) occurred, the humorous film was largely notable for a reduction in beta-adrenergic drive, as evidenced by reduced CO and a lengthening of PEP. In contrast to previous research reporting a rise in sIgA particular to humorous exposures, the sIgA secretion rate, although enhanced by exposure to the films, did not vary with film content.

The laws that affect abortion in the United States and their impact on women's health.

Abortion has been a hotly contested political issue since the mid 1960s, when states began liberalizing their abortion laws. Recent Supreme Court rulings, such as Rust vs. Sullivan, the retirement of two liberal Supreme Court justices and the battle over Louisiana's abortion legislation have created new fervor on both fronts of the battle. All health care providers who care for women need to be cognizant of the current abortion laws and the factors that influence the abortion decision. These factors include the different levels of health risk and financial implications posed by continued pregnancy or abortion. Historically, numerous court cases have influenced women's health care, and reviews of several significant cases are provided. The Webster vs. Reproductive Health Services decision was the first case that directly challenged the Roe vs. Wade decision. The Webster decision enables states to have greater authority in writing their own abortion laws. Individual state laws can vary greatly, so it is vitally important for providers to know and understand the laws of their state.

PIP: Changing abortion laws means changing medical practices. Roe v. Wade (1973) established and absolute constitutional protection against state regulation in 1st trimester abortions, increasing abortion safety by allowing professionals working in sterile environments to perform abortions. In Planned Parenthood of Central Missouri v. Danforth (1976) the Supreme Court invalidated a spousal/parental consent requirement. In Harris v. McRae (1980) the Court upheld the Hyde Amendment prohibiting the use of Medicaid funds for abortions. In City of Akron v. Akron Center for Reproductive Health Inc. (1983) the Court held as unconstitutional the requirement of hospitalization for all 2nd and 3rd trimester abortions, that unmarried minors under 15 obtain parental consent, that physicians give detailed lectures on fetal status, and that women wait 24 hours before an abortion. In Thornburgh v. American College of Obstetricians and Gynecologists (1986) the Court held as unconstitutional mandatory statements about alternatives to abortion, and particularized medical risks. Webster v. Reproductive Health Service (1989) upheld a state's right to protect life beginning at conception, withhold use of public employees, facilities, and funds for counseling a woman about, or performing, a nontherapeutic abortion, to encourage birth over abortion. Subsequent cases established a state's right to require parental notification for minor's abortion when a judicial hearing exists as an alternative. Rust v. Sullivan (1991) upheld regulations prohibiting medical staff from talking about abortion with family planning patients when the facility receives funding under Title X of the Public Health Service Act, and requires objective physical and financial separation of facilities from programs that offer abortion information. These regulations have been denounced by medical groups for compromising ethics. While the Senate passed a bill allowing such talk about abortion, President Bush promises a veto. Abortion is still legal in every state, but each state has its own laws.