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Bender AE, Adhia A, Ross R, Gallagher A, Mustafa A, Kroshus E, Ellyson AM. Developing and implementing survivor-centred approaches for college student-athletes: perspectives from athletic department, Title IX, and campus advocacy personnel. Eur J Psychotraumatol 2024; 15:2334587. [PMID: 38590136 PMCID: PMC11005865 DOI: 10.1080/20008066.2024.2334587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/14/2024] [Indexed: 04/10/2024] Open
Abstract
ABSTRACTBackground: Sexual violence (SV) is a persistent issue on US college campuses, particularly among college student-athletes. Strategies to address SV are urgently needed. Yet, prior research shows that many university practices can be more harmful than helpful to SV survivors and necessitates a reimagination of how institutions support SV survivors. Survivor-centred approaches may be one way to effectively address SV for students, including student-athletes, across college campuses.Objective: This qualitative study explored campus personnel experiences with and perceptions of survivor-centred SV prevention and intervention policies and practices on college campuses and examined how these approaches serve SV survivors, including college student-athletes.Methods: As part of a larger study on campus SV and student-athletes across four institutions, semi-structured interviews with 22 representatives from athletic departments, campus advocacy, and Title IX were conducted. Guided by phenomenology, a thematic analysis approach was used to identify key patterns in survivor-centred SV prevention and intervention policies and practices. Participant demographic data were analysed descriptively.Results: Most participants identified as white (72.2%), heterosexual (63.6%), women (68.2%), and were an average of 41.8 years old (SD = 10.2). The majority were in positions associated with athletic departments (63.6%), and they had been in their role for an average of 5.6 years (SD = 6.6). Through thematic analysis, three main themes were identified: (1) education & accessibility; (2) interpersonal relationships & individual well-being; and (3) campus and societal norms.Conclusions: The findings from this study highlight clear policy and practice recommendations for survivor-centred SV prevention and intervention on college campuses, such as accessible, applicable SV training and the implementation of survivor-centred approaches. Further research is needed to understand existing survivor-centred practices and the facilitators and barriers to their implementation across institutions and within athletic departments.
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Affiliation(s)
- Anna E. Bender
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Avanti Adhia
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Rachel Ross
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Amy Gallagher
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ayah Mustafa
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emily Kroshus
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Alice M. Ellyson
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA
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Blackburn AM, Katz BW, Oesterle DW, Orchowski LM. Preventing sexual violence in sexual orientation and gender diverse communities: A call to action. Eur J Psychotraumatol 2024; 15:2297544. [PMID: 38197295 PMCID: PMC10783832 DOI: 10.1080/20008066.2023.2297544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024] Open
Abstract
Background: Members of the lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender diverse (SOGD) communities are at disproportionately higher risk for sexual violence compared to cisgender heterosexual people. Despite this elevated risk, relatively few sexual violence prevention efforts effectively reduce these victimization disparities based on sexual orientation or gender identity.Objective: This narrative review provides an overview of the prevalence of sexual violence in the SOGD communities, delineates risk factors for sexual victimization among SOGD community members, and reviews and evaluates existing prevention efforts for the SOGD communities. We outline specific recommendations for ensuring that prevention efforts meet the needs of the SOGD communities.Method: Drawing on ecological systems theory and public health approaches to sexual violence prevention, we outline current approaches and opportunities for preventionists and scholars to push the field forward.Results: There have been promising prevention programmes designed to be implemented within SOGD communities specifically; however, it is important that general primary prevention programmes endeavour to specifically address sexual violence perpetrated against SOGD people. While many packaged programmes that endeavour to prevent sexual violence across all gender identities and sexual orientations are inclusive of SOGD participants, more programming is needed that integrates anti-oppression training to target social norms that perpetuate SOGD-specific rape myths and normalize sexual violence against SOGD community members.Conclusion: Ecological prevention strategies in line with a public health approach for primary prevention may be particularly valuable for reducing victimization disparities based on SOGD status and identity. Comprehensive sexual education and anti-discrimination policies should be considered front-line prevention programming. To assess if these strategies are effective, the implementation of large-scale surveillance surveys that use comprehensive assessments of sexual orientation, gender identity, and sexual violence are needed. Using theoretically grounded implementation strategies for prevention programmes can ensure effective programme delivery.
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Affiliation(s)
- Allyson M. Blackburn
- Department of Psychology, Division of Clinical-Community Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Benjamin W. Katz
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Daniel W. Oesterle
- Department of Psychological Sciences, College of Health & Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Lindsay M. Orchowski
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Magnin C, Poulet E, Fanton L, Vignaud P, Brunelin J. A non-randomized pilot trial of the use of prazosin in the prevention of transition from acute stress disorder to post-traumatic stress disorder. Eur J Psychotraumatol 2023; 14:2251250. [PMID: 38154074 PMCID: PMC10484028 DOI: 10.1080/20008066.2023.2251250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/05/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Following a traumatic event, 40-80% of the patients with acute stress disorder (ASD) will develop post-traumatic stress disorder (PTSD), 67% at 6 months. Alpha1-blockers are effective in treating some symptoms of PTSD but their usefulness in acute stress situations remains unclear. We hypothesized that reducing noradrenergic hyperactivity with an alpha1-blocker during the acute phase after a traumatic event could prevent the transition to PTSD in patients with ASD. OBJECTIVE To investigate the efficacy and safety of a 1-month course of alpha1-blocker (prazosin) to prevent the transition to PTSD in patients with ASD at 6 months. METHOD In a monocentric open-label prospective pilot study, 15 patients with ASD were included within 3-7 days of exposure to a traumatic event. After enrolment, they received prazosin LP at home at bedtime at 2.5 mg/day for 7 days and then 5 mg/day for 21 days. Incidence of PTSD was assessed at 6 months using the Clinician Administrated PTSD Scale (CAPS). RESULTS At 6 months, 22% of patients who completed the study (2/9) met the diagnostic criteria for PTSD. This rate was significantly lower than that observed in previous studies (67%; p = .047). The treatment was well tolerated and there were no serious adverse events. CONCLUSIONS These preliminary findings indicating the safety of prazosin and suggesting its potential to prevent the development of PTSD in ASD require to be replicated in large-scale randomized placebo-controlled studies.Trial registration: The study was pre-registered on a public database (www.clinicalTrials.gov identifier: NCT03045016).
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Affiliation(s)
- Charline Magnin
- Psychiatric Emergency Service, Hospices civils de Lyon, Lyon, France
| | - Emmanuel Poulet
- Psychiatric Emergency Service, Hospices civils de Lyon, Lyon, France
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Université Claude Bernard Lyon 1, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Laurent Fanton
- Service of Legal Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
- Lyon-Est Medical School, Université de Lyon, Claude-Bernard Lyon 1 University, Lyon, France
| | - Philippe Vignaud
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Université Claude Bernard Lyon 1, Bron, France
- Regional Centre for Psychotraumatic Disorders, Edouard Herriot Hospital, Lyon, France
- Emergency medical service, cellule d’urgences medico-psychologiques, Edouard Herriot Hospital, Lyon, France
| | - Jerome Brunelin
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Université Claude Bernard Lyon 1, Bron, France
- Centre Hospitalier Le Vinatier, Bron, France
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Nourry N, Alsayed Obeid S, Rolling J, Lefebvre F, Baumlin S, Nasseri M, Berna F, Charbotel B, Gonzalez M, Vidailhet P, Mengin AC. Posttraumatic stress disorder and depression after the 2018 Strasbourg Christmas Market terrorist attack: a comparison of exposed and non-exposed police personnel. Eur J Psychotraumatol 2023; 14:2214872. [PMID: 37305952 PMCID: PMC10262818 DOI: 10.1080/20008066.2023.2214872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Background: Police personnel are among the first responders exposed to terrorist attacks, raising in number in the late decades. Due to their profession, they are also exposed to repetitive violence, increasing their vulnerability to PTSD and depression.Objective: Our study aims at comparing the prevalence of PTSD and depression, and the risk factors associated with these conditions among directly and indirectly exposed versus non-exposed police personnel during the Strasbourg Christmas Market terrorist attack.Method: Three months after the attack, participants completed a survey assessing their sociodemographic characteristics, occupational data, degree of exposure, sleep debt around the event, event centrality (CES), and three mental health conditions: PTSD (PCL-5), depression (PHQ-9), and suicide risk (yes/no questions).Results: A total of 475 police personnel responded to the questionnaire: 263 were exposed to the attack (182 of them directly) and 212 were non-exposed. Among directly exposed participants, the prevalences of partial and complete PTSD were 12.6 and 6.6%, and the prevalence of moderate-to-severe depression was 11.5%. Multivariate analysis revealed that direct exposure was associated with a higher risk of PTSD (OR = 2.98 [1.10-8.12], p = .03). Direct exposure was not associated with a higher risk of depression (OR = 0.40 [0.10-1.10], p = .08). A significant sleep debt after the event was not associated with a higher risk of later PTSD (OR = 2.18 [0.81-5.91], p = .13) but was associated with depression (OR = 7.92 [2.40-26.5], p < .001). A higher event centrality was associated with both PTSD and depression (p < .001).Conclusions: Police personnel directly exposed to the Strasbourg Christmas Market terrorist attack were at higher risk of PTSD but not depression. Efforts to prevent and treat PTSD should focus on directly exposed police personnel. However, general mental health should be monitored for every personnel member.
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Affiliation(s)
- Nathalie Nourry
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, Lyon Cedex, France
| | - Shadi Alsayed Obeid
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
| | - Julie Rolling
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- Centre National de la Recherche Scientifique Unité Propre de Recherche 3212 (CNRS UPR 3212), Institute for Cellular and Integrative Neurosciences (INCI), Strasbourg, France
| | - François Lefebvre
- Hôpitaux Universitaires de Strasbourg, Département de Santé Publique, GMRC, Strasbourg, France
- Université de Strasbourg, Laboratoire de Biostatistique et Informatique Médicale, Illkirch, France
| | - Sandra Baumlin
- Service de Soutien Psychologique opérationnel, Police Nationale, Ministère de l’Intérieur, Préfecture du Bas Rhin, Strasbourg, France
| | - Mohamed Nasseri
- Hôpitaux Universitaires de Strasbourg, Département de Santé Publique, GMRC, Strasbourg, France
- Université de Strasbourg, Laboratoire de Biostatistique et Informatique Médicale, Illkirch, France
| | - Fabrice Berna
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Barbara Charbotel
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, Lyon Cedex, France
| | - Maria Gonzalez
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
| | - Pierre Vidailhet
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Amaury C. Mengin
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
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Feinberg ME, Gedaly L, Mogle J, Hostetler ML, Cifelli JA, Tornello SL, Lee JK, Jones DE. Building long-term family resilience through universal prevention: 10-year parent and child outcomes during the COVID-19 pandemic. Fam Process 2022; 61:76-90. [PMID: 34927239 DOI: 10.1111/famp.12730] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 05/15/2023]
Abstract
As the COVID-19 pandemic has been highly stressful for parents and children, it is clear that strategies that promote long-term family resilience are needed to protect families in future crises. One such strategy, the Family Foundations program, is focused on promoting supportive coparenting at the transition to parenthood. In a randomized trial, we tested the long-term intervention effects of Family Foundations on parent, child, and family well-being one to two months after the imposition of a national shelter-in-place public health intervention in 2020. We used regression models to test intervention impact on outcomes reported on by parents in a standard questionnaire format and a series of 8 days of daily reports. We also tested moderation of intervention impact by parent depression and coparenting relationship quality. Relative to control families, intervention families demonstrated significantly lower levels of individual and family problems (general parent hostility, harsh and aggressive parenting, coparenting conflict, sibling relationship conflict, and children's negative mood and behavior problems), and higher levels of positive family relationship quality (positive parenting, couple relationship quality, sibling relations, and family cohesion). For some outcomes, including coparenting conflict, harsh parenting, and child behavior problems, intervention effects were larger for more vulnerable families-that is, families with higher pre-pandemic levels of parent depression or lower levels of coparenting relationship quality. We conclude that targeted family prevention programming is able to promote healthy parent and child functioning during unforeseen future periods of acute stress. The long-term benefits of a universal approach to family support at the transition to parenthood indicate the need for greater investment in the dissemination of effective approaches.
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Affiliation(s)
- Mark E Feinberg
- Prevention Research Center, Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Lindsey Gedaly
- Prevention Research Center, Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Jacqueline Mogle
- Prevention Research Center, Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Michelle L Hostetler
- Prevention Research Center, Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Joseph A Cifelli
- Prevention Research Center, Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Samantha L Tornello
- Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
| | - Jin-Kyung Lee
- Institute for Poverty Alleviation and International Development, Yonsei University
| | - Damon E Jones
- Prevention Research Center, Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University
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Perez‐Brena NJ, Toews ML, Feinberg ME, Anders KM. Adapting a Coparenting-Focused Prevention Program for Latinx Adolescent Parents in a School Context. Fam Process 2022; 61:91-107. [PMID: 33951202 PMCID: PMC9292999 DOI: 10.1111/famp.12651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The current study utilized a three-step cultural adaptation process to adapt a universal-coparenting program for Latinx adolescent parents in a school-based setting. First, focus groups were conducted with adolescent parents (n = 13; 100% Latinx; 69% female), their parents (n = 17; 94% Latinx; 82% female), and school staff (n = 7; 71% White; 100% female) to identify unique needs faced by this population. Second, the program was adapted to include new lesson modules (e.g., coparenting with grandparents, coparenting after breakups) and structural reformatting to fit a school schedule. Third, selected lessons from the adapted program were piloted in four schools with 32 Latinx adolescent parents (97% Latinx; 78% female). Lesson evaluation surveys and focus group data assessed the feasibility and acceptability of the service delivery method and content to show the program was well received. However, implementation challenges emerged when attempting to provide services to adolescent fathers and Spanish-speaking adolescents. This manuscript provides an example of how to use this cultural adaptation process to tailor prevention programs, highlights a new prevention program that can serve as a resource for adolescent parents, and provides several recommendations for working with Latinx adolescent parents.
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Affiliation(s)
| | - Michelle L. Toews
- College of Health and Human SciencesKansas State UniversityManhattanKSUSA
| | - Mark E. Feinberg
- Prevention Research CenterPennsylvania State UniversityUniversity ParkPAUSA
| | - Kristin M. Anders
- College of Health and Human SciencesKansas State UniversityManhattanKSUSA
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Martínez LM, Perpiñá JLE. Reflexiones para la reorganización de residencias en el contexto de la pandemia por COVID-19. FMC 2020; 27:390-397. [PMID: 33071540 PMCID: PMC7550109 DOI: 10.1016/j.fmc.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 07/18/2020] [Indexed: 11/24/2022]
Abstract
•Deberán revisarse las estrategias a todo nivel, para adaptar la atención residencial a los nuevos paradigmas de pirámides poblacionales y patologías. •En el futuro, el diseño de la estructura organizativa de los centros debería incluir la figura del profesional sanitario dentro del grupo directivo en los centros residenciales. •El contexto COVID-19 pone de manifiesto deficiencias que deben ser evaluadas y corregidas a todos los niveles: estructural, estratégico y de operativa en residencias. •La estructura no cooperativa de instituciones afecta a la salud de los usuarios. •Los centros que no reúnen mínimos cualitativos y estructurales son la consecuencia de una normativa previa que los ampara y permite su perpetuación.
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Affiliation(s)
- Laura Muñoz Martínez
- Enfermera de soporte residencial, Área derecha de Barcelona, CAP Sagrera, Institut Català de la Salut, Barcelona, España
| | - José Luis Estébanez Perpiñá
- Enfermero de soporte residencial, Área derecha de Barcelona, CAP Vila de Gràcia - Cibeles, Institut Català de la Salut, Barcelona, España
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Abstract
Recruiting diverse samples for prevention trials is challenging, but essential. This paper provides baseline data for four racial/ethnic groups from a randomized controlled trial of a mobile-based prevention intervention and systematically reviews recruitment trends in diversity across technology-based prevention studies. Female emerging adults completed measures of appearance esteem, body image flexibility, appearance comparison, and self-compassion. White participants reported lower body esteem and body image flexibility, and higher appearance comparison compared to Black and Asian participants. Latina participants evidenced higher appearance comparison compared to Black participants. The literature review revealed that while rates of diversity in previous trials vary, the majority of the participants were White. Efforts are needed to increase diversity in prevention trials.
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Affiliation(s)
- Rachel F Rodgers
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA.,b Department of Psychiatric Emergency & Acute Care , Lapeyronie Hospital, CHRU Montpellier , Montpellier , France
| | | | | | | | - Kayla Yates
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
| | - Elizabeth Cook
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
| | - Alice S Lowy
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
| | - Debra L Franko
- a APPEAR, Department of Applied Psychology , Northeastern University , Boston , MA , USA
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Winter L, Sanders MR, N Boyd R, Pritchard M, Gray PH, Whittingham K, Forrest K, Webb L, Marquart L, Colditz PB. PREDICTING ATTENDANCE OF A PREVENTIVE PARENTING INTERVENTION FOR VERY PRETERM INFANTS. Infant Ment Health J 2018; 39:699-706. [PMID: 30339722 DOI: 10.1002/imhj.21749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Preventive parenting interventions can experience challenges in maximizing dosage, or the amount of intervention received by parents. This study examined the associations of baseline mother, father, and very preterm infant (VPT; <32 weeks) characteristics with satisfactory intervention attendance of the family within a randomized controlled trial of Baby Triple P for Preterm Infants (Colditz et al., 2015). Mothers (n = 160) and fathers (n = 115) completed questionnaires prior to the randomization of family units (n = 160) to receive the intervention. Satisfactory session attendance (seven or eight sessions of eight in total) was achieved by 114 families (71.25%). In the logistic model for mothers, satisfactory attendance of the family was more likely when infants were extremely low birth weight (ELBW), odds ratio (OR) = 2.81, 95% confidence interval (CI) [1.16, 6.80], when the mother had a university, OR = 11.38, 95% CI [4.03, 32.19], or trade-certificate-level education, OR = 4.97, 95% CI [1.93, 12.84], or when she was not under financial stress, OR = 3.53, 95% CI [1.34, 9.28]. A similar pattern of results was found in the model for fathers. Session attendance of preventive parenting interventions for VPT infants may be improved by increasing the engagement of parents with infants not born ELBW, who have lower education, or are experiencing financial stress.
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Affiliation(s)
| | | | | | - Margo Pritchard
- University of Queensland, Mater Mothers' Hospital, and Australian Catholic University, Brisbane, Australia
| | - Peter H Gray
- Mater Mothers' Hospital, Brisbane and Mater Research Institute-University of Queensland
| | | | - Kylee Forrest
- University of Queensland and Mater Research Institute-University of Queensland
| | - Lachlan Webb
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Louise Marquart
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Paul B Colditz
- University of Queensland and Royal Brisbane and Women's Hospital
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Baucom KJW, Chen XS, Perry NS, Revolorio KY, Reina A, Christensen A. Recruitment and Retention of Low-SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood. Fam Process 2018; 57:308-323. [PMID: 28328086 PMCID: PMC7087449 DOI: 10.1111/famp.12287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Low-SES couples have limited resources to manage the chronic and acute stressors with which they are disproportionately faced. Although these couples are at greater risk for negative individual and relationship outcomes, evaluations of the impact of couple relationship education (CRE) in low-SES couples have been plagued by methodological problems, most notably challenges associated with recruitment and retention. We review the literature on challenges couples face associated with low-SES, as well as on recruitment, retention, and CRE in low-SES, ethnic minority populations. We illustrate some of these challenges in a case study of CRE for low-SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited from a community health clinic and randomized to either an experimental treatment condition (EXP; N = 11) or a treatment-as-usual control condition (TAU; N = 10). This study sought to mitigate documented challenges with recruitment and retention: We leveraged community partnerships, attempted to build and maintain strong relationships with study participants, provided incentives for assessments as well as intervention meetings, and attempted to reduce potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment and retention. We integrate these findings and experiences with our review of previous work in this area. We make recommendations for future CRE research and practice that have potential implications for public policy in this area.
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Affiliation(s)
| | - Xiao S Chen
- Graduate School of Education and Psychology, Pepperdine University, Malibu, CA
| | - Nicholas S Perry
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Kaddy Y Revolorio
- Graduate School of Education and Psychology, Pepperdine University, Malibu, CA
| | - Astrid Reina
- Department of Psychiatry, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Andrew Christensen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA
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11
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Abstract
Exposure to trauma is pervasive in societies worldwide and is associated with substantial costs to the individual and society, making it a significant global public health concern. We present evidence for trauma as a public health issue by highlighting the role of characteristics operating at multiple levels of influence - individual, relationship, community, and society - as explanatory factors in both the occurrence of trauma and its sequelae. Within the context of this multi-level framework, we highlight targets for prevention of trauma and its downstream consequences and provide examples of where public health approaches to prevention have met with success. Finally, we describe the essential role of public health policies in addressing trauma as a global public health issue, including key challenges for global mental health and next steps for developing and implementing a trauma-informed public health policy agenda. A public health framework is critical for understanding risk and protective factors for trauma and its aftermath operating at multiple levels of influence and generating opportunities for prevention.
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Affiliation(s)
- Kathryn M. Magruder
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, S.C, U.S.A
| | | | - Diane L. Elmore Borbon
- Department of Psychiatry and Behavioral Sciences, UCLA-Duke University National Center for Child Traumatic Stress, Washington, D.C, U.S.A
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Wieling E, Mehus C, Yumbul C, Möllerherm J, Ertl V, Laura A, Forgatch M, Neuner F, Catani C. Preparing the Field for Feasibility Testing of a Parenting Intervention for War-Affected Mothers in Northern Uganda. Fam Process 2017; 56:376-392. [PMID: 26503176 DOI: 10.1111/famp.12189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this article, we discuss the successful implementation of an adapted evidence-based parenting intervention for families affected by two decades of war in Northern Uganda. The adaptation and adoption of such interventions to support mental health and family functioning is widely endorsed by prevention scientists and considered a priority in global mental health. The preparation and early adoption phases of engaging with a highly vulnerable community affected by war trauma are documented in this paper along with a discussion of the steps taken to adapt a parenting intervention for cultural and contextual fit. This study is a component of an overall program of research aimed at reducing the long-term negative effects of war on parenting practices and childhood outcomes, which have considerable implications for preventing mental, neurological, and substance-use disorders. The processes described here cover a 4-year period culminating in the implementation of the nine-session Enhancing Family Connection intervention piloted with a group of 14 mothers. The lessons in cultural adaptation have been valuable and the feasibility results promising for further testing the intervention.
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Affiliation(s)
- Elizabeth Wieling
- Family Social Science, University of Minnesota, St. Paul, MN
- Victims Voice International (vivo.org), Gulu, Uganda
| | | | - Cigdem Yumbul
- Family Social Science, University of Minnesota, St. Paul, MN
| | - Julia Möllerherm
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Verena Ertl
- Victims Voice International (vivo.org), Gulu, Uganda
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Achan Laura
- Victims Voice International (vivo.org), Gulu, Uganda
| | - Marion Forgatch
- Oregon Social Learning Center, Implementation Sciences International Incorporated, Eugene, OR
| | - Frank Neuner
- Victims Voice International (vivo.org), Gulu, Uganda
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Claudia Catani
- Victims Voice International (vivo.org), Gulu, Uganda
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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Bakhurst MG, Loew B, McGuire ACL, Halford WK, Markman HJ. Relationship Education for Military Couples: Recommendations for Best Practice. Fam Process 2017; 56:302-316. [PMID: 26932356 DOI: 10.1111/famp.12211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Military couples have a number of distinctive strengths and challenges that are likely to influence their relationship adjustment. Military couples' strengths include stable employment, financial security, and subsidized health and counseling services. At the same time, military couples often experience long periods of separation and associated difficulties with emotional disconnect, trauma symptoms, and reintegrating the family. This paper describes best practice recommendations for working with military couples, including: addressing the distinctive challenges of the military lifestyle, ensuring program delivery is seen as relevant by military couples, and providing relationship education in formats that enhance the accessibility of programs.
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Affiliation(s)
- Melissa G Bakhurst
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Benjamin Loew
- Department of Psychology, University of Denver, Denver, CO
| | | | - W Kim Halford
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
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Perrino T, Pantin H, Huang S, Brincks A, Brown CH, Prado G. Reducing the Risk of Internalizing Symptoms among High-risk Hispanic Youth through a Family Intervention: A Randomized Controlled Trial. Fam Process 2016; 55:91-106. [PMID: 25683164 PMCID: PMC4534359 DOI: 10.1111/famp.12132] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Familias Unidas is an intervention that has been found to be efficacious in preventing and reducing substance use, sexual risk, and problem behaviors among Hispanic youth. While it does not specifically target youth internalizing symptoms, the intervention works to strengthen parenting and family factors associated with reduced risk of internalizing symptoms (i.e., depression, anxiety symptoms). This study examines the effects of Familias Unidas on internalizing symptoms among high-risk youth, as well as the role of family level factors in the intervention's effects. A total of 242 12-17-year-old Hispanic youth with a history of delinquency and their primary caregivers were recruited from the school and juvenile justice systems, and randomly assigned to the Familias Unidas intervention or community practice control. A linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms from baseline to 6 and 12 months post-baseline. Results show that the Familias Unidas intervention was more efficacious than control in reducing youth internalizing symptoms. Baseline youth externalizing and internalizing symptoms did not moderate the intervention's effects on the trajectory of youth internalizing symptoms. While parent-adolescent communication did not significantly moderate the intervention's effects, changes in parent-adolescent communication mediated the intervention's effects on internalizing symptoms, showing stronger intervention effects for youth starting with poorer communication. Findings indicate that the Familias Unidas intervention can reduce internalizing symptoms among high-risk Hispanic youth, and that improving parent-youth communication, a protective family factor, may be one of the mechanisms by which the intervention influences youth internalizing symptoms.
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Affiliation(s)
- Tatiana Perrino
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Hilda Pantin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Shi Huang
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Ahnalee Brincks
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - C Hendricks Brown
- Departments of Psychiatry & Behavioral Sciences and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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Alonzo J, Mann L, Simán F, Sun CJ, Andrade M, Villatoro G, Rhodes SD. [Perspectives to improve the sexual health of sexual and gender identity minorities in Guatemala]. EHQUIDAD 2016; 5:51-70. [PMID: 27494000 PMCID: PMC4970757 DOI: 10.15257/ehquidad.2016.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Sexual and gender identity minorities in Guatemala are disproportionally affected by HIV and other sexually transmitted infections (STI). However, little is known about the health determinants among these minorities that contribute to infection risk. Health researchers from the United States and Guatemala sought to explore sexual health needs and identify characteristics of HIV/STI prevention programs for these minorities.Our partnership conducted 8 focus groups with gay and bisexual men, men who have sex with men, and transgender women; and 10 in-depth interviews with community leaders. We analyzed transcripts of the focus groups and in-depth interviews using constant comparison.We identified 24 factors that influence sexual health which we organized into 5 ecological domains and 16 characteristics of potentially successful programs to reduce HIV/STI risk.The identification of sexual risk factors and characteristics of potentially successful programs offers great potential to develop interventions to help reduce the risk of HIV/STI infection among these minorities in Guatemala.
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Affiliation(s)
- Jorge Alonzo
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Division of Public Health Sciences, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Lilli Mann
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Division of Public Health Sciences, Medical Center Blvd., Winston-Salem, NC USA 27157
| | - Florence Simán
- El Pueblo, Inc., 2321 Crabtree Blvd., Suite 105, Raleigh NC USA 27604
| | - Christina J. Sun
- Portland State University, 1825 SW Broadway, Portland, OR USA 9720
| | - Mario Andrade
- APAES-Solidaridad, 2Ave. 11-40, zona 1, Guatemala, Guatemala
| | - Guillermo Villatoro
- Hospital Roosevelt, Unidad de Epidemiologia, Calzada Roosevelt, Zona 11, Guatemala City, Guatemala
| | - Scott D. Rhodes
- Wake Forest School of Medicine Department of Social Sciences and Health Policy, Division of Public Health Sciences, Medical Center Blvd., Winston-Salem, NC USA 27157
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Epstein K, Pruett MK, Cowan P, Cowan C, Pradhan L, Mah E, Pruett K. More than One Way to Get There: Pathways of Change in Coparenting Conflict after a Preventive Intervention. Fam Process 2015; 54:610-618. [PMID: 25676082 DOI: 10.1111/famp.12138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study explored pathways of change in the levels of conflict couples experienced after Supporting Father Involvement, an evidence-based, prevention-oriented couples and parenting intervention that included a diverse low-income and working class group of participants. Pathways of change were examined for couples with baseline conflict scores that were initially low, medium, and high. The growth mixture model analysis found that the best-fitting model for change in couples' conflict was represented by three distinctly different change patterns. The intervention was most successful for High-Conflict couples. This finding contributes to a growing literature examining variations in how relationships change over time and the process of change, especially for couples in distress. This study supports further investigation into the impact and costs associated with universal interventions versus those that target specific groups of higher risk families.
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Affiliation(s)
- Kenneth Epstein
- Psychiatry, University of California San Francisco, San Francisco, CA
| | | | - Philip Cowan
- Psychology, University of California Berkeley, Berkeley, CA
| | - Carolyn Cowan
- Psychology, University of California Berkeley, Berkeley, CA
| | - Lisa Pradhan
- School for Social Work, Smith College, Northampton, MA
| | - Elisabeth Mah
- School for Social Work, Smith College, Northampton, MA
| | - Kyle Pruett
- School of Medicine, Yale University, New Haven, CT
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Abstract
Biological invasions are a major concern in conservation, especially because global transport of species is still increasing rapidly. Conservationists hope to anticipate and thus prevent future invasions by identifying and regulating potentially invasive species through species risk assessments and international trade regulations. Among many introduction pathways of non-native species, horticulture is a particularly important driver of plant invasions. In recent decades, the horticultural industry expanded globally and changed structurally through the emergence of new distribution channels, including internet trade (e-commerce). Using an automated search algorithm, we surveyed, on a daily basis, e-commerce trade on 10 major online auction sites (including eBay) of approximately three-fifths of the world's spermatophyte flora. Many recognized invasive plant species (>500 species) (i.e., species associated with ecological or socio-economic problems) were traded daily worldwide on the internet. A markedly higher proportion of invasive than non-invasive species were available online. Typically, for a particular plant family, 30-80% of recognized invasive species were detected on an auction site, but only a few percentages of all species in the plant family were detected on a site. Families that were more traded had a higher proportion of invasive species than families that were less traded. For woody species, there was a significant positive relationship between the number of regions where a species was sold and the number of regions where it was invasive. Our results indicate that biosecurity is not effectively regulating online plant trade. In the future, automated monitoring of e-commerce may help prevent the spread of invasive species, provide information on emerging trade connectivity across national borders, and be used in horizon scanning exercises for early detection of new species and their geographic source areas in international trade.
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Affiliation(s)
- Franziska Humair
- Institute for Environmental Decisions-Consumer Behavior, ETH Zurich, Universitätstrasse 22, CH-8092, Zurich, Switzerland
| | - Luc Humair
- Department of Computer Science, ETH Zurich, Universitätstrasse 6, CH-8092, Zurich, Switzerland
| | - Fabian Kuhn
- Department of Computer Science, Albert-Ludwigs-Universität, Georges-Köhler-Allee 106, D-79110, Freiburg im Breisgau, Germany
| | - Christoph Kueffer
- Institute of Integrative Biology, ETH Zurich, Universitätstrasse 16, CH-8092, Zurich, Switzerland
- Centre for Invasion Biology, Department of Botany and Zoology, Stellenbosch University, Matieland, 7602, South Africa
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Abstract
This paper focuses on issues sparked by the Couples Relationship Education (CRE) field moving toward a more clinical model to meet the needs of an increasing number of distressed couples coming to CRE programs. We review the concerns raised and recommendations made by Bradford, Hawkins, and Acker (2015), most of which push CRE toward a more clinical model. We address these recommendations and make suggestions for best practices that preserve the prevention/education model underlying research-based CRE. The three main issues are couple screening, leader training, and service delivery models. Our suggested best practices include: conducting minimal screening including the assessment of dangerous levels of couple violence, training leaders with key skills to handle issues raised by distressed couples as well as other couples who may place additional burdens on leaders, providing referrals and choices of programs available to participants at intake and throughout the CRE program, and adding (rather than integrating) clinical services to CRE services for couples who desire additional intervention. Finally, throughout the paper, we review other key issues in the CRE field and make recommendations made for future research and practice.
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Hernández Holguín DM, Páez Zapata E, Múnera Restrepo LM, Duque Ramírez LF. Diseño de un programa basado en la promoción del desarrollo positivo en la infancia para la prevención temprana de la violencia en Colombia. Glob Health Promot 2015; 24:83-91. [PMID: 26187923 DOI: 10.1177/1757975915591683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aunque algunos informes identifiquen a Colombia como ejemplo de un país que ha logrado revertir los niveles crecientes de violencia, estos siguen siendo altos. Por este motivo se han convocado acciones de promoción de la convivencia y prevención de la violencia, a las cuales responde el programa que presentamos en este artículo. Este programa está basado en la perspectiva contextual-evolutiva del modelo ecológico y en la educación para la salud, tendiente al cuidado de sí en los padres o cuidadores, y al ejercicio de una crianza, centrada en los derechos de los niños, el desarrollo infantil y la promoción de la salud mental, con el fin de promover el desarrollo saludable y prevenir comportamientos agresivos en los niños; éste es presentado como una alternativa de orientación psicosocial para el fortalecimiento de estrategias y programas dirigidos a la primera infancia.
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Affiliation(s)
| | - Esteban Páez Zapata
- 1. Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | | | - Luis F Duque Ramírez
- 1. Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
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Vargas-Hernández VM, Acosta-Altamirano G, Moreno-Eutimio MA, Vargas-Aguilar VM. [New guidelines in regard to cervical cancer screening]. CIR CIR 2014; 82:453-459. [PMID: 25167359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.
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Affiliation(s)
- Víctor Manuel Vargas-Hernández
- Dirección de Investigación, Laboratorio de Inmunobiología, Hospital Juárez de México, Secretaría de Salud, México DF, Mexico.
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Abstract
The widespread roll-out of antiretroviral therapy (ART) has substantially changed the face of human immunodeficiency virus (HIV). Timely initiation of ART in HIV-infected individuals dramatically reduces mortality and improves employment rates to levels prior to HIV infection. Recent findings from several studies have shown that ART reduces HIV transmission risk even with modest ART coverage of the HIV-infected population and imperfect ART adherence. While condoms are highly effective in the prevention of HIV acquisition, they are compromised by low and inconsistent usage; male medical circumcision substantially reduces HIV transmission but uptake remains relatively low; ART during pregnancy, delivery and breastfeeding can virtually eliminate mother-to-child transmission but implementation is challenging, especially in resource-limited settings. The current HIV prevention recommendations focus on a combination of preventions approach, including ART as treatment or pre- or post-exposure prophylaxis together with condoms, circumcision and sexual behaviour modification. Improved survival in HIV-infected individuals and reduced HIV transmission risk is beginning to result in limited HIV incidence decline at population level and substantial increases in HIV prevalence. However, achievements in HIV treatment and prevention are threatened by the challenges of lifelong adherence to preventive and therapeutic methods and by the ageing of the HIV-infected cohorts potentially complicating HIV management. Although current thinking suggests prevention of HIV transmission through early detection of infection immediately followed by ART could eventually result in elimination of the HIV epidemic, controversies remain as to whether we can treat our way out of the HIV epidemic.
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Affiliation(s)
- Portia C Mutevedzi
- Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa
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Abstract
INTRODUCTION Family physicians, as leaders of primary healthcare teams, have demonstrated to be cost-effective in reducing infant mortality in developed nations, but their effect in developing nations is yet unknown. METHODS A descriptive study was conducted in 11 Latin American countries to observe their health indicators, and the possible association of the presence and actions of their family physicians regarding achieving a reduction in maternal and infant mortality. National scientific associations of family and community medicine in the region provided information for each country; a centralized statistical analysis was made. RESULTS There was a wide variation between the different countries, as regards their socio-demographic characteristics, inequalities, public investment in primary care, the proportion of family physicians within the medical profession, healthcare indicators, those relating to the level of development, and to the resources assigned to healthcare in each country. Maternal mortality was not associated to the presence and actions of family physicians in each country (R(2): 0.003) nor together with other medical specialties (R(2): 0.07); in contrast, infant mortality was associated with the presence and actions of family physicians (R(2): 0.37; 95% CI 0.04-0.95; P<0.05). CONCLUSION The presence and actions of family physicians in primary healthcare in Latin America was associated to a reduction of infant mortality, with the Millenium challenges contributing to this reduction.
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Orozco Beltrán D, de la Sen Fernández C, Guillén VG, Munuera CC, Pérez JN. [Diabetes mellitus and cardiovascular risk. Is integrated therapy of type 2 diabetes and cardiovascular risk factors necessary?]. Aten Primaria 2010; 42 Suppl 1:16-23. [PMID: 21074072 PMCID: PMC8171390 DOI: 10.1016/s0212-6567(10)70004-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Cardiovascular disease (CVD) is the first cause of death in the Spanish population among both diabetics and non-diabetics. In diabetes, CVD is between 2 and 4 times more frequent, earlier and more aggressive. With current measures, approximately 50% of CVD can be prevented. The risk factors for CVD in diabetes are hypertension, dyslipidemia, smoking, obesity and sedentariness. More than 80% of patient with type 2 diabetes have hypertension and dyslipidemia and approximately 15% continue to smoke. However, all these factors are controlled in at least 10%. Although dyslipidemia is the most influential and least treated factor, the greatest benefit for CVD prevention is obtained with integrated intervention on all risk factors, reducing blood pressure to below 140/80 mmHg, low-density lipoprotein cholesterol (LDL-c) to below 100 mg/dl, encouraging smoking cessation, regular physical activity and maintaining a healthy weight (BMI < 25 kg/m²). In secondary prevention or persons with microvascular disease, the targets may be stricter (blood pressure 130/80 mmHg and LDL-c 80 mg/dl). Drug treatment should always include an angiotensin converting-enzyme inhibitor or an angiotensin II receptor antagonist and a statin. Aspirin should be reserved for patients in secondary prevention or with very high CV risk. Consequently, interventions should be prioritized according to the foreseeable risk for each patient, which can be estimated through the SCORE scale or other scales such as Regicor or UKPDS, with a SCORE > 5% indicating high risk. These high-risk patients should receive personalized care.
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Affiliation(s)
- Domingo Orozco Beltrán
- Cátedra de Medicina de Familia, Departamento de Medicina, Universidad Miguel Hernández, San Juan, Alicante, España
| | - Carlos de la Sen Fernández
- Cátedra de Medicina de Familia, Departamento de Medicina, Universidad Miguel Hernández, San Juan, Alicante, España
| | - Vicente Gil Guillén
- Cátedra de Medicina de Familia, Departamento de Medicina, Universidad Miguel Hernández, San Juan, Alicante, España
| | - Concepción Carratalá Munuera
- Cátedra de Medicina de Familia, Departamento de Medicina, Universidad Miguel Hernández, San Juan, Alicante, España
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Miner S, Poupin L, Bernales M, Ferrer L, Cianelli R. [EFFECTIVE EDUCATIONAL INTERVENTIONS IN HIV FOR WOMEN]. Horiz Enferm 2010; 21:67-79. [PMID: 27667897 PMCID: PMC5033119 DOI: 10.7764/horiz_enferm.21.1.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED In Chile, it is estimated that over 38,000 people live with Human Immunodeficiency Virus [HIV]. In 2001, there were 1092 Chilean women living with HIV, and in 2006 there were 7,600, further affecting low income populations. These findings reveal the necessity to create prevention strategies directed towards Chilean women. OBJECTIVE the purpose of this revision is to analyze studies of prevention programs in HIV in order to determine what aspects should be included in successful HIV prevention programs with women. DESIGN AND METHOD a literature review was carried out using searches done in the databases Proquest and CINAHL, Pubmed and Scielo. The search was limited by the criteria of full text only, within the last ten years and free access, written in Spanish or English. Fifteen articles were selected for the following revision. RESULTS all of the selected articles measured the effect of an intervention on knowledge and behaviours related to HIV/AIDS. Fourteen articles produced significant changes in positive behaviours or knowledge related to the prevention of HIV. CONCLUSIONS prevention programs in HIV with socially disadvantaged women can be effective in provoking changes in behaviours and knowledge associated with HIV. Successful interventions were those based on prevention theories or models of behavior change and adapted to the culture of the sample.
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Affiliation(s)
| | | | | | - Lilian Ferrer
- Enfermera, PhD, Profesora Asociada Escuela de Enfermería UC., Chile
| | - Rosina Cianelli
- Enfermera-matrona, PhD, Profesora Titular Escuela de Enfermería, University of Miami, USA
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Casal ER, Velásquez EN, Mejía RM, Cuneo A, Pérez-Stable EJ. [Screening colorectal cancer. Perception and behavior of the population]. Medicina (B Aires) 2009; 69:135-142. [PMID: 19414294 PMCID: PMC4215950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
There is strong evidence favoring colorectal cancer screening. Preliminary data suggests that it is not included in routine practice with the adequate frequency. We intended to recognize in a Health Care System (HCS) that provides the needed resources, the facilitators and barriers related with the implementation of this preventive practice, how many individuals have carried out one procedure and what this preventive activity predicts. A telephone survey was administered to a sample of affiliates from an HCS that serves employees of the University of Buenos Aires; 132 completed the questionnaire (70% response rate). Facilitators obtained an affirmative response in a 64 to 97%, and barriers from 11 to 27%. In the latter category a special subgroup (39%) was afraid of adverse events, and there was a feeling of embarrassment in others (30%); 33% of respondents had carried out a screening procedure, mainly FOBT 27, sigmoidoscopy 11 and colonoscopy 20. A majority (95%) stated that they "would do the procedure if doctors recommend it", or "not do it unless my doctor advises to do it" (87%). Answering affirmatively that "physicians will do the best for their patients" was associated with having had a CRC screening test, OR 1.55 (95% CI: 1.02-2.37) p: 0.04. Studied individuals showed good predisposition for colorectal cancer screening, but to put it into practice, medical advice seems to be a prominent determinant.
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Affiliation(s)
- Enrique R Casal
- Programa de Medicina Interna General (PMIG), Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, 1120 Buenos Aires, Argentina
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Loreto Lara C, Rosina Cianelli A, Lilian Ferrer L, Margarita Bernales S, Natalia Villegas R. [Not Available]. Horiz Enferm 2008; 19:35-43. [PMID: 19936328 PMCID: PMC2779544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION: The HIV and AIDS epidemic has quickly spread over the world with a tendency towards feminization, pauperization, and heterosexualization. Partner communication around HIV has been described as one protective factor for the acquisition of this disease, favoring the adoption of safe sexual practices, such as couple negotiation and condom use. Considering this is fundamental in the incorporation of self-care practices among female sexuality. OBJECTIVE: Determine the level of partner communication around HIV among socially disadvantaged Chilean women. METHODOLOGY: Four hundred and six (406) women responded the baseline interview for the research project "Testing and HIV/AIDS Prevention Intervention for Chilean Women" (RO1 TW 006977, PI. Cianelli). The scale Health Protective Sexual Communication Scale (HPC) was used (range between 0-10 points). A descriptive analysis was done using SPSS, version 16.0. RESULTS: The mean level of partner communication with the main partner was 3,26 +2,7 points, of 2,52 +2,48 points with the second partner, and 0 points with the third partner. The themes related with less partner communication were the condom use and getting an HIV test before having sexual intercourse. CONCLUSION: Women in the sample had low levels of partner communication in relation with HIV with all their sexual partners. Strategies within HIV/AIDS prevention programs are needed to trigger this area, in order to strengthen the adoption of self care behaviors around this issue.
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Affiliation(s)
- C. Loreto Lara
- Candidata a Magíster en Enfermería, Asistente de investigación Iniciativa Mano a Mano, Pontificia Universidad Católica de Chile. Avda. Vicuña Mackenna 4860. Fono: 354 7268
| | - A. Rosina Cianelli
- Académico Universidad de Miami y Pontificia Universidad Católica de Chile
| | - L. Lilian Ferrer
- Profesor Adjunto, Escuela de Enfermería, Pontificia Universidad Católica de Chile
| | - S. Margarita Bernales
- Instructor Asociado, Escuela de Enfermería, Pontificia Universidad Católica de Chile
| | - R. Natalia Villegas
- Candidata a Magíster en Enfermería, Asistente de investigación Iniciativa Mano a Mano, Pontificia Universidad Católica de Chile
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Jurado J, Caula J, Pou i Torelló JM. [Selection of risk and diagnosis in diabetic polyneuropathy. Validation of method of new systems]. Aten Primaria 2006; 38:116-21. [PMID: 16828016 PMCID: PMC7679805 DOI: 10.1157/13090436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 11/28/2005] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION In a previous study we developed a specific algorithm, the polyneuropathy selection method (PSM) with 4 parameters (age, HDL-C, HbA1c, and retinopathy), to select patients at risk of diabetic polyneuropathy (DPN). We also developed a simplified method for DPN diagnosis: outpatient polyneuropathy diagnosis (OPD), with 4 variables (symptoms and 3 objective tests). OBJECTIVES To confirm the validity of conventional tests for DPN diagnosis; to validate the discriminatory power of the PSM and the diagnostic value of OPD by evaluating their relationship to electrodiagnosis studies and objective clinical neurological assessment; and to evaluate the correlation of DPN and pro-inflammatory status. DESIGN Cross-sectional, crossed association for PSM validation. Paired samples for OPD validation. SETTING Primary care in 3 counties. PARTICIPANTS Random sample of 75 subjects from the type-2 diabetes census for PSM evaluation. Thirty DPN patients and 30 non-DPN patients (from 2 DM2 sub-groups in our earlier study) for OPD evaluation. METHODS The gold standard for DPN diagnosis will be studied by means of a clinical neurological study (symptoms, physical examination, and sensitivity tests) and electrodiagnosis studies (sensitivity and motor EMG). Risks of neuropathy, macroangiopathy and pro-inflammatory status (PCR, TNF soluble fraction and total TGF-beta1) will be studied in every subject. EXPECTED RESULTS Electrodiagnosis studies should confirm the validity of conventional tests for DPN diagnosis. PSM and OPD will be valid methods for selecting patients at risk and diagnosing DPN. There will be a significant relationship between DPN and pro-inflammatory tests.
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Affiliation(s)
- Jerónimo Jurado
- Enfermería, Equipo de Atención Primaria, ABS Olot, Instituto Catalán de la Salud, Olot, Girona, España.
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Monzón Ballarín S, Venturini Díaz M, Nerín de la Puerta I, Colás Sanz C, Fraj Lázaro J, Duce Gracia F. [Prevalence of tobacco dependency and its prevention in patients with persistent asthma]. Aten Primaria 2005; 35:77-81. [PMID: 15727749 PMCID: PMC7684420 DOI: 10.1157/13071913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2003] [Accepted: 03/31/2004] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To analyse in patients with persistent bronchial asthma the prevalence of tobacco dependency and its degree; and to assess measures of prevention. DESIGN Cross-sectional, descriptive study. SETTING Allergy Service of the Lozano Blesa University Hospital, Zaragoza, Spain. PARTICIPANTS A total of 121 patients, from systematic selection of asthmatics attending for consultation. MAIN MEASUREMENTS Questionnaire filled out in the consulting room, recording social, demographic and clinical variables. RESULTS A sample of 121 patients was obtained, 62.7% women and 37.3% men. They had 5.87 +/- 4.99 years mean evolution of asthma. 21.5% were daily smokers, 4.1% occasional smokers, 27.3% ex-smokers, and 47.1% non-smokers. The ages of starting to smoke were < 10 years old, 1.7%; 10-15, 30%; 15-20, 56.7%; 20-25, 6.7%, and > 25, 5% (P > .05). There were significant differences between gender and tobacco dependency and between age and tobacco dependency (P < .01 and P < .014, respectively). 96.8% of smokers thought that tobacco was harmful to their health. This figure was 100% in daily smokers and 80% in occasional smokers (P < .02). 83.9% of smokers had the intention of giving up. Counselling to give up was received from the specialist (41.9%), the primary care doctor (12.9%), and both (9.7% of cases). 35.5% received no counselling. CONCLUSIONS The prevalence of tobacco dependency in patients with persistent asthma is lower than in the population as a whole; over a third receive no counselling about giving up. Interventions must be conducted in still healthy smokers and chronically ill patients in both primary and specialist care.
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Affiliation(s)
- S Monzón Ballarín
- Servicio de Alergología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Affiliation(s)
- M I Gil Canalda
- Especialista en Medicina de Familia. Máster en Nutrición Clínica. ABS Carles Ribas. Barcelona. España.
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Affiliation(s)
- M I Gil Canalda
- Máster en Nutrición Clínica. ABS Carles Riba. Barcelona. España
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Abstract
OBJECTIVES To asses the effectiveness of fissure sealants in a high risk infant population and to evaluate the criteria to determine when to apply them. DESIGN Prospective cohort study. SETTING Primary care. PARTICIPANTS 607 scholars that are included at the age of 6 years and followed for 4,5 years.Intervention. We have defined three groups. Groups I and II were included in a dental preventive program with and without fissure sealants in the first permanent molars, respectively, and group III received no preventive measures at all. MAIN MEASUREMENTS The dental explorations according to WHO recommendations were conducted before entering the study, at the age of six years, after the fissure sealant were applied, at the age of eight years and finally 4.5 years after the beginning. RESULTS After 4.5 years group I had a CAOD index of 0.59, group II 0.79 and group III 1.52 (P<.001). Group III has 2.57 times greater risk the group I of suffering caries in the permanent teeth. CONCLUSIONS The application of occlusive fissure sealant in the first permanent molar of an infant high risk population has a protective effect on dental caries. Therefore occlusive fissure sealant should be offered to all scholars because those without neither the preventive program nor occlusive fissure sealant had a significantly higher risk of caries.
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Affiliation(s)
- M A Tapias Ledesma
- Médico estomatólogo, Centro de Salud San Fernando, Móstoles (Madrid), Spain.
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Abstract
OBJECTIVES To identify the differences between the clinical practice (conduct) of male and female doctors and its determining factors; and to find the variability in the various conducts studied which is explained by a set of variables, gender among them. DESIGN Cross-sectional, multi-centre descriptive study. SETTING Andalusian health centres with populations of over 100000 inhabitants. PARTICIPANTS Selection of 159 primary care doctors with postgraduate training by means of simple randomised sampling. 56% were men, 44% women, with power of comparisons at 68%. MEASUREMENTS AND MAIN RESULTS Self-administered questionnaire to measure the dependent variable, overall conduct (clinical practice) and 11 dimensions of this conduct. Independent variables were: determinants of conduct identified by the theory of reasoned action (attitudes and subjective norm) and by the theory of social learning (self-efficacy and control locus), gender and other social and demographic variables and work conditions variables. Multiple linear regression models were constructed to explain each conduct analysed. Being a female doctor affects positively overall conduct and conduct in information, psycho-social guidance, prevention of obesity, active recruitment for family planning and collaboration with nurses. CONCLUSIONS In Andalusia women general practitioners have a more marked orientation towards the psycho-social sides of care than their male colleagues. They give more information to their patients and more frequently perform preventive activities linked to their gender. They also rely on the work of their nurses more than male doctors.
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Affiliation(s)
- A Delgado
- Unidad Docente de Medicina Familiar y Comunitaria de Granada,0 Escuela Andaluza de Salud Pública y Facultad de Medicina, Granada, Spain.
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González Villar M, Madoz Zubillaga MN, Calle Irastorza F, Jurío Burgui JJ, Arillo Crespo A, Fuertes Goñi MC. [Support intervention in grieving patients]. Aten Primaria 2001; 27:101-7. [PMID: 11256083 PMCID: PMC7683988 DOI: 10.1016/s0212-6567(01)78781-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2000] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES Principal: to describe the characteristics of grievers in an urban area. SECONDARY: To describe the risk factors for pathological grief, and the distribution of those cases of grief which are resolved and those tending to become chronic. DESIGN Descriptive study. SETTING Txantrea Health Centre, Pamplona. PATIENTS Consecutive sampling of all the family members of people who died between January and July 1999. In 4 basic care units, a grief-monitoring procedure was followed with 62 bereaved persons for 8 months. In the 8 other basic care units, the 21 bereaved people recruited formed a control group. INTERVENTION Initial interview with risk factors of pathological grief described in the PAPPS. Periodical consultations for help. Final interview with test from the Texas Revised Inventory of Grief Manual to determine the evolution of grief. MEASUREMENTS AND MAIN RESULTS Over 90% had some risk factor. Considerable numbers were self-aware of difficulty in overcoming earlier grief. Over 50% did not attend even half their appointments, which was related to low income (p < 0.005) and background of depression (p < 0.04). Low income was related to worse evolution of grief (p < 0.01). There were high proportions of prolonged and delayed grief, without any differences found between the intervention and control groups. CONCLUSIONS There were large numbers of bereaved people with risk factors, frequent failure to adhere to the proposed programme, and a high number of cases of lengthy and delayed grief.
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Affiliation(s)
- M González Villar
- Centro de Salud Txantrea (Pamplona), Osasunbidea-Servicio Navarro de Salud
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Antón García F, Guerola Lablanca JV, Catalán Macián JB, Barbas Galindo MJ, Durà Navarro R, Richart Rufino MJ. [Effectiveness of preventive activities at 8 years of their introduction in a general medicine practice in a health center]. Aten Primaria 2001; 27:38-42. [PMID: 11218974 PMCID: PMC7681382 DOI: 10.1016/s0212-6567(01)78771-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Main: to assess the change in coronary risk (CR) in adults after 8 years of their involvement in the Programme of Preventive Activities and Health Promotion (PAPPS). Secondary: to determine the level of anti-tetanus vaccination reached and patients' compliance with activities. DESIGN "Before and after" intervention study without random allocation. SETTING A general medical clinic at a health centre. PATIENTS 429 patients (204 men, 225 women) between 30 and 65 monitored for 8 years, recruited by active search for cases at daily consultations. INTERVENTIONS Blood pressure, cholesterol, weight, tobacco habit, alcohol intake, anti-tetanus vaccination state, CR calculation at 10 years on the Framingham scale, and degree of compliance with activities were all determined at the start, at 4 years and at 8 years. Data was obtained from the clinical notes. RESULTS Total population: a 0.8 drop in CR (CI difference: 0.4-1.2), equivalent to 8.5% of the initial figure. 64.4% increase in correct anti-tetanus vaccination (CI difference: 59.9-69). Compliance with activities at the start and after eight years: pressure 100%, 71%; tobacco consumption 99.5%, 71%; cholesterol determination 89%, 64%. Initially high CR sub-group: 6.7 drop of CR at 8 years (CI difference: 4.9-8.5), equivalent to 24.8% of the initial figure. CONCLUSIONS In the total population, the CR drop found was not clinically significant, whereas in the initially high CR sub-group the drop was. There should probably be an active search made for patients with high CR and action taken on them.
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Cameselle Teijeiro JF, Cortizo Torres ME, López Touza A, Gómez Cuñarro M, Pousa Estévez L, Senra Varela A. [The prevention of breast cancer in primary care]. Aten Primaria 2000; 26:419-27. [PMID: 11111316 PMCID: PMC7681466 DOI: 10.1016/s0212-6567(00)78693-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Olazábal Ulacia JC, García Paniagua R, Montero Luengo J, García Gutiérrez JF, Pastor Mateos F. [Care for the menopausal woman: an objective to be developed from primary care]. Aten Primaria 2000; 26:405-14. [PMID: 11111314 PMCID: PMC7681412 DOI: 10.1016/s0212-6567(00)78691-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- J C Olazábal Ulacia
- Departamento de Medicina, Universidad de Salamanca, Centro de Salud San Juan
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Hawkins Carranza F, López Alvarez MB. [Cost effectiveness analysis of alendronate versus placebo in the prevention of hip fractures]. Aten Primaria 2000; 26:274-5. [PMID: 11100590 PMCID: PMC7681436 DOI: 10.1016/s0212-6567(00)78659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Serna Arnáiz C, Montull Navarro L, Vázquez Torguet A, Gascó Eguíluz E, Peremiquel Lluch M, Ortega Bravo M. [How many patients need treatment for hypercholesterolemia?]. Aten Primaria 2000; 25:395-9. [PMID: 10857229 PMCID: PMC7675828 DOI: 10.1016/s0212-6567(00)78529-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/1999] [Accepted: 11/15/1999] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To find out the percentage of individuals from a population who need pharmacologic treatment for their hypercholesterolemia according to different guidelines. DESIGN Descriptive transversal study. SETTING Population from 6 areas of Lleida (province) including the city of Lleida. METHOD The study has been done on a randomized sample of 401 individuals. First the cardiovascular risk from the equation in the Framingham study was calculated, then the percentage of individuals who should be treated with lipid-lowering medication according to the US National Cholesterol Education Program, The European Society of Atherosclerosis and The Spanish Society of Atherosclerosis. RESULTS The prevalence of individuals with cholesterolemia > 250 mg/dl has been 16.3% among men and 22.4% in women. According to NCEP, 20.5% of men and 17.6% of women from 383 individuals older then 6 years old need pharmacologic treatment for hypercholesterolemia. The Framingham equation was applied to 281 individuals (over 30 and under 75 years old) estimating a risk higher than 20% in 10 years for 13.7% of the population under study (23.9% in men and 3.5% in women). CONCLUSIONS The percentage of patients who need pharmacologic treatment for hypercholesterolemia varies according to the different guidelines employed. We consider necessary the calculation of the cardiovascular risk with the Framingham equation to use lipid-lowering medication in order to achieve a better protection of the population at higher risk of developing a cardiovascular disease.
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Ruiz Lázaro PJ, Puebla del Prado R, Cano Carrascosa J, Ruiz Lázaro PM. [Health promotion project "Promoting the health adaptation in our adolescents"]. Aten Primaria 2000; 26:51-7. [PMID: 10916903 PMCID: PMC7681368 DOI: 10.1016/s0212-6567(00)78607-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Tapias Ledesma MA, Gil de Miguel A, Regidor E, Domínguez Rojas V. [Incidence of dental caries in a child population from Mostoles: evaluation of a preventive program after 2 years]. Aten Primaria 2000; 26:46-50. [PMID: 10916902 PMCID: PMC7681515 DOI: 10.1016/s0212-6567(00)78606-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To know the efficacy and effectivity od dental health program after 2 years. DESIGN The study of prospective cohorts not aleatorized. POPULATION AND METHODS The exposed cohort is composed of 583 school children, 296 girls and 287 boys, the non-exposed cohort is composed of 261 school children, 132 girls and 129 boys. We carried out and odontological exploration following the criteria of the WHO the preventive measures we carried out are health education, weekly mouthrinse of NaFl at 0.2%, occlusive sealant in the first permanent molar and external application fluorine gel. We measured and compared the different indexes of tooth decay and sociodemographic variables between both cohorts, the statistic meaning has been determined through the U est of Mann Whitney. RESULTS We have found statistically significant differences between both cohorts in the indexes of decay in the exposed cohorts. The indexes of decay in the exposed cohort being DMFT: 0.31; DMFM (first permanent molar): 0.31; DMFS: 0.4. And in the non-exposed cohort DMFT: 0.81; DMFM: 0.81; DMFS; 1.09. Existing an epidemiological association between the preventive program and the prevention of dental decay with a relative risk of 0.24 (95% CI, 0.17-0.33) and the prevention fraction of 76.3% (95% CI, 67-83). CONCLUSIONS The preventive program after two years elapsed is effective and has a clear protector effect.
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