Preventing violence by intimate partners in adolescence: an integrative review

Abstract OBJECTIVE To analyze the scientific literature on preventing intimate partner violence among adolescents in the field of health based on gender and generational categories. METHOD This was an integrative review. We searched for articles using LILACS, PubMed/MEDLINE, and SciELO databases. RESULTS Thirty articles were selected. The results indicate that most studies assessed interventions conducted by programs for intimate partner violence prevention. These studies adopted quantitative methods, and most were in the area of nursing, psychology, and medicine. Furthermore, most research contexts involved schools, followed by households, a hospital, a health center, and an indigenous tribe. CONCLUSION The analyses were not conducted from a gender- and generation-based perspective. Instead, the scientific literature was based on positivist research models, intimately connected to the classic public healthcare model and centered on a singular dimension

Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics

<p>Abstract</p> <p>Background</p> <p>Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital.</p> <p>Methods</p> <p>From among the 2,443 people who took part in the survey, 406 (17%) experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI)) in the 12 months pre-interview. These individuals were selected for cluster analysis.</p> <p>Results</p> <p>Analysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services.</p> <p>Conclusion</p> <p>The study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs for subgroups of individuals with mental and/or dependence disorders. Strategies aimed at changing low service users' attitude (youths and males) or instituting specialised programs for that particular clientele should be promoted. Finally, as concomitant disorders are frequent among individuals with mental disorder, psychological services and/or addiction programs must be prioritised as components of integrated services when planning treatment.</p

Low Levels of the Omega-3 Index are Associated with Sudden Cardiac Arrest and Remain Stable in Survivors in the Subacute Phase

In previous studies, low blood levels of n-3 fatty acids (FA) have been associated with increased risk of cardiac death, and the omega-3 index (red blood cell (RBC) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) expressed as weight percentage of total FA) has recently been proposed as a new risk factor for death from coronary artery disease, especially following sudden cardiac arrest (SCA). As blood samples often haven been harvested after the event, the aim of our study was to evaluate the stability of RBC fatty acids following SCA. The total FA profile, including the omega-3 index, was measured three times during the first 48 h in 25 survivors of out-of-hospital cardiac arrest (OHCA), in 15 patients with a myocardial infarction (MI) without SCA and in 5 healthy subjects. We could not demonstrate significant changes in the FA measurements in any of the groups, this also applied to the omega-6/omega-3 ratio and the arachidonic acid (AA)/EPA ratio. Furthermore, we compared the omega-3 index in 14 OHCA-patients suffering their first MI with that of 185 first-time MI-patients without SCA; mean values being 4.59% and 6.48%, respectively (p = 0.002). In a multivariate logistic regression analysis, a 1% increase of the omega-3 index was associated with a 58% (95% CI: 0.25–0.76%) reduction in risk of ventricular fibrillation (VF). In conclusion, the omega-3 index remained stable after an event of SCA and predicted the risk of VF

Omega-3 in Antiarrhythmic Therapy

The association between omega-3 (n-3 polyunsaturated fatty acids) and the clinical outcome of patients with cardiovascular diseases such as coronary heart disease is currently unclear, especially regarding its possible antiarrhythmic effects and the not quite understood mechanisms of action. In the last 15 years, several epidemiological studies have shown a lower incidence of sudden cardiac death with a diet rich in omega-3 or fish consumption. The antiarrhythmic properties related to omega-3 have been related to modulation of sodium-dependent ion channels or sodium-calcium exchangers of myocytes through a reduction of their excitability especially in ischaemic or damaged myocardial tissue. However, the results of experimental studies have not always been consistent. Although the role of omega-3 in preventing sudden cardiac death has been evaluated in several clinical trials that included patients with coronary artery disease (particularly in patients with post-myocardial infarction), the interpretation of such data must be treated with extreme caution. In particular, while a reduction in cardiac death was demonstrated by a meta-analysis of several randomized clinical trials, a reduced risk of sudden cardiac death has been described only in the GISSI-Prevenzione study, while in other studies the evidence that emerged is more controversial, with wide confidence intervals that support the possibility of heterogeneity in the distribution of the factors involved in the efficacy of treatment. Omega-3 is probably involved in the prevention of cardiovascular mortality through different mechanisms, and it is crucial to study its association with other drugs such as ACE inhibitors or calcium channel blockers. The study of antiarrhythmic drugs has been divided into prevention of supraventricular and ventricular arrhythmias. In these conditions, the role of omega-3 seems to be more pronounced in atrial tachyarrhythmias such as atrial fibrillation, but does not have a role in ventricular arrhythmias. In summary, the antiarrhythmic effect of omega-3 is not clearly evident and further studies are needed to investigate its beneficial effect in cardiac mortality compared with arrhythmic death