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Background The association between psychosocial factors and atrial fibrillation (AF) is poorly understood. Methods and Results Postmenopausal women from the Womens Health Initiative were retrospectively analyzed to identify incident AF in relation to a panel of validated psychosocial exposure variables, as assessed by multivariable Cox proportional hazard regression and hierarchical cluster analysis. Among the 83 736 women included, the average age was 63.9±7.0 years. Over an average of 10.5±6.2 years follow-up, there were 23 954 cases of incident AF. Hierarchical cluster analysis generated 2 clusters of highly correlated psychosocial variables: the Stress Cluster included stressful life events, depressive symptoms, and insomnia, and the Strain Cluster included optimism, social support, social strain, cynical hostility, and emotional expressiveness. Incident AF was associated with higher values in the Stress Cluster (hazard ratio [HR], 1.07 per unit cluster score [95% CI, 1.05-1.09]) and the Strain Cluster (HR, 1.03 per unit cluster score [95% CI, 1.00-1.05]). Of the 8 individual psychosocial predictors that were tested, insomnia (HR, 1.04 [95% CI, 1.03-1.06]) and stressful life events (HR, 1.02 [95% CI, 1.01-1.04]) were most strongly associated with increased incidence of AF in Cox regression analysis after multivariate adjustment. Subgroup analyses showed that the Strain Cluster was more strongly associated with incident AF in those with lower traditional AF risks (P for interaction=0.02) as determined by the cohorts for heart and aging research in genomic epidemiology for atrial fibrillation score. Conclusions Among postmenopausal women, 2 clusters of psychosocial stressors were found to be significantly associated with incident AF. Further research is needed to validate these associations.

Edward Lear was in the vanguard of cultural assimilation of evolutionary theory. In what amounts to a gestalt relationship, some of his published "nonsense" figures against, and largely derives its meaning from, innovation in the natural sciences. Certain of his works, some not previously interpreted, are specific in their engagement with evolutionists, including Erasmus and Charles Darwin, Etienne Geoffroy Saint-Hilaire, and Robert Grant. Before and after the appearance of On the Origin of Species (1859), Lear backs one side against another in public debates sparked by evolutionary theory. His implicit engagement with the new biology becomes evident in close attention to the drawings, which are essential components of Lear's innovative hybridization of visual and literary artforms., Huxleyism and Darwinism may be true--but are uncomfortable. --Edward Lear, Diary (24 April 1870) Recent commentators have asserted, but mainly in general terms, that Edward Lear's published "nonsense" (1) reflects [...]