scholarly journals Childhood abuse and neglect and insecure attachment states of mind in adulthood: Prospective, longitudinal evidence from a high-risk sample

2017 ◽  
Vol 29 (2) ◽  
pp. 347-363 ◽  
Author(s):  
K. Lee Raby ◽  
Madelyn H. Labella ◽  
Jodi Martin ◽  
Elizabeth A. Carlson ◽  
Glenn I. Roisman
Keyword(s):  
High Risk ◽  
Childhood Abuse ◽  
Present Report ◽  
Romantic Partners ◽  
Insecure Attachment ◽  
States Of Mind ◽  
Increased Risk ◽  
Exploratory Factor Analyses ◽  
State Of Mind ◽  
Prospective Longitudinal

AbstractThe present report used data from the Minnesota Longitudinal Study of Risk and Adaptation to investigate the factor structure and childhood abuse and/or neglect related antecedents of adults’ attachment states of mind in a high-risk sample. Adult Attachment Interviews (AAIs) were collected when participants were age 26 years (N= 164) and Current Relationship Interviews (CRIs) were collected from participants (N= 116) and their romantic partners when target participants were between ages 20 and 28 years (M= 25.3 years). For both the AAI and the CRI, exploratory factor analyses revealed that (a) attachment state of mind scales loaded on two weakly correlated dimensions reflecting dismissing and preoccupied states of mind and (b) ratings of unresolved discourse loaded on the same factor as indicators of preoccupied states of mind. Experiencing any subtype of abuse and/or neglect, especially during multiple developmental periods, and experiencing multiple subtypes of abuse and/or neglect during childhood were associated with risk for preoccupied (but not dismissing) AAI states of mind regarding childhood relationships with caregivers. Analyses focused on the particular subtypes, and perpetrators indicated that the predictive significance of childhood abuse/neglect for adult's AAI preoccupied states of mind was specific to experiences of abuse (but not neglect) perpetrated by primary caregivers. In addition, experiencing chronic or multiple subtypes of childhood abuse and/or neglect increased risk for dismissing (but not preoccupied) CRI states of mind regarding adult romantic partners.

Preoccupied but not dismissing attachment states of mind are associated with nonsuicidal self-injury

2017 ◽  
Vol 29 (2) ◽  
pp. 379-388 ◽  
Author(s):  
Jodi Martin ◽  
Jean-François Bureau ◽  
Marie-France Lafontaine ◽  
Paula Cloutier ◽  
Celia Hsiao ◽  
...  
Keyword(s):  
Primary Caregivers ◽  
Adult Attachment Interview ◽  
States Of Mind ◽  
Factor Analyses ◽  
Self Injury ◽  
Regulatory Strategy ◽  
Exploratory Factor Analyses ◽  
State Of Mind ◽  
Age And Sex ◽  
Nonsuicidal Self Injury

AbstractIn this investigation the factor structure of the Adult Attachment Interview was studied in a partially at-risk sample of 120 young adults. More specifically, 60 participants had engaged in nonsuicidal self-injury (NSSI; 53 females, M age = 20.38 years), and 60 were non-self-injuring controls matched by age and sex. Theoretically anticipated differential associations between preoccupied (but not dismissing) states of mind and NSSI were then examined. Exploratory factor analyses identified evidence for two weakly correlated state of mind dimensions (i.e., dismissing and preoccupied) consistently identified in factor analyses of normative-risk samples. As hypothesized, results further showed that preoccupied (but not dismissing) states of mind were associated with NSSI behavior. Findings support existing arguments suggesting that the regulatory strategy adults adopt when discussing attachment-related experiences with primary caregivers, particularly passive, angry, or unresolved discourse patterns, is uniquely correlated with NSSI.

Defining the PrEP care continuum among recently incarcerated men at high risk for HIV infection (Preprint)

2021 ◽  
Author(s):  
Matthew Murphy ◽  
Colette Sosnowy ◽  
Brooke Rogers ◽  
Siena Napoleon ◽  
Drew Galipeau ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Hiv Infection ◽  
Care Continuum ◽  
Increased Risk ◽  
Biomedical Intervention ◽  
Prep Implementation ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Prospective Longitudinal

BACKGROUND HIV disproportionately impacts criminal justice (CJ)-involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in CJ-systems is limited. Little is known about effective PrEP implementation and use in this unique public health context. OBJECTIVE This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation. METHODS Men incarcerated in the Rhode Island Department of Corrections, a correctional system composed of all of the state's sentenced and awaiting trial population, are screened for HIV acquisition risk during the course of routine clinical care. Those identified at high risk for HIV acquisition are referred for evaluation for PrEP initiation and enrollment in this study. Individuals who express interest in initiating PrEP and consent to the study are then followed in a prospective longitudinal cohort. RESULTS The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to incarceration and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition. CONCLUSIONS Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the CJ-context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic.

Attachment states of mind and inferred childhood experiences in maltreated and comparison adolescents from low-income families

2017 ◽  
Vol 29 (2) ◽  
pp. 337-345 ◽  
Author(s):  
Glenn I. Roisman ◽  
Fred A. Rogosch ◽  
Dante Cicchetti ◽  
Ashley M. Groh ◽  
John D. Haltigan ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Caregivers ◽  
Adult Attachment Interview ◽  
States Of Mind ◽  
Childhood Experiences ◽  
Factor Analytic ◽  
Increased Risk ◽  
Abuse And Neglect ◽  
State Of Mind ◽  
Low Income Families

AbstractThis paper reports the first large-sample investigation of the maltreatment-related correlates of low-income adolescents’ narratives about their childhood experiences with primary caregivers, as assessed with a modified version of the Adult Attachment Interview (AAI) and based on official reports of abuse and neglect (maltreatedn= 214, nonmaltreatedn= 140;Mage = 16.7 years). Drawing on factor-analytic and taxometric evidence indicating that AAI narratives vary along two state of mind (i.e., dismissing and preoccupied) and two inferred childhood experience (i.e., maternal and paternal) dimensions, here we demonstrate that the experience of maltreatment, particularly when chronic, is associated with increased risk for dismissing and preoccupied states of mind and more negative inferred childhood experiences. Although such maltreatment-related associations were generally not specific to any of the four AAI dimensions, the experience of physical and/or sexual abuse was uniquely associated with preoccupied states of mind and negative inferred paternal experiences even after controlling for the other AAI dimensions. More extensive paternal perpetration of maltreatment also was uniquely related to more negative inferred paternal experiences.

Contraception and thrombophilia

2009 ◽  
Vol 29 (02) ◽  
pp. 193-196 ◽  
Author(s):  
H. Rott ◽  
A. Kruempel ◽  
G. Kappert ◽  
U. Nowak-Göttl ◽  
S. Halimeh
Keyword(s):  
Chronic Illness ◽  
High Risk ◽  
Children And Adolescents ◽  
Hormonal Contraception ◽  
Hormonal Contraceptives ◽  
Thromboembolic Events ◽  
Contraceptive Methods ◽  
Secondary Complications ◽  
Increased Risk ◽  
Coagulation Proteins

SummaryThe risk of thromboembolic events (TE) is increased by acquired or inherited thrombo -philias (IT). We know that some hormonal contraceptives also increase the risk of thrombosis, thus, the use of such contraceptives are discussed as contraindications in women with IT. TEs are infrequent events in children and adolescents and in the majority of cases are associated with secondary complications from underlying chronic illness. Although adolescents are not typically considered to be at high-risk for TE, this cohort is frequently using hormonal contraception, leading to an increased risk in cases with unknown IT. The risk of TE with pregnancy alone is higher than associated with combined hormonal contra -ception. Progestin-only methods have not been found to increase the risk of TE with only moderate changes of coagulation proteins compared to normal reference values. Conclusion: Thrombophilic women are good candidates for progestin-only contraceptive methods.

Markers of Hypercoagulability in Patients with Hemophilia B Given Repeated, Large Doses of Factor IX Concentrates during and after Surgery

1994 ◽  
Vol 71 (06) ◽  
pp. 737-740 ◽  
Author(s):  
E Santagostino ◽  
P M Mannucci ◽  
A Gringeri ◽  
G Tagariello ◽  
F Baudo ◽  
...  
Keyword(s):  
High Risk ◽  
Ex Vivo ◽  
Factor Ix ◽  
Hemophilia B ◽  
Coagulation System ◽  
Prolonged Treatment ◽  
Orthopedic Procedures ◽  
Factor X ◽  
Prothrombin Complex Concentrates ◽  
Increased Risk

SummaryPurer factor IX (FIX) concentrates have been produced for the treatment of hemophilia B in the attempt to reduce the risk of thrombotic complications associated with the use of prothrombin complex concentrates. To evaluate ex vivo whether or not FIX concentrates activate the coagulation system in conditions associated with a high risk for thrombosis, we measured markers of hypercoagulability in 10 patients with hemophilia B who underwent surgery, mainly orthopedic procedures, covered by multiple concentrate infusions (40-80 U/kg/day). Postinfusion plasma levels of prothrombin fragment 1+2 and factor X activation peptide did not differ significantly from the presurgical levels, neither before nor after each concentrate dose. Therefore, it appears that prolonged treatment of patients with hemophilia B undergoing high risk surgical procedures with high doses of FIX concentrate does not cause systemic activation of coagulation. This suggests that purified FIX concentrates are preferable to prothrombin complex concentrates for conditions associated with an increased risk of thrombosis.

scholarly journals Circulating Levels of Dephosphorylated-Uncarboxylated Matrix Gla Protein in Patients with Acute Coronary Syndrome

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 1108
Author(s):  
Admira Bilalic ◽  
Tina Ticinovic Kurir ◽  
Marko Kumric ◽  
Josip A. Borovac ◽  
Andrija Matetic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
High Risk ◽  
Hospital Mortality ◽  
Vascular Calcification ◽  
Matrix Gla Protein ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
St Elevation

Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI.

scholarly journals 491. Aerosol-Generating Medical Procedures: Transmission of SARS-CoV-2 and Emerging Viruses

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S312-S312
Author(s):  
Seth D Judson ◽  
Vincent J Munster
Keyword(s):  
High Risk ◽  
Severe Disease ◽  
Experimental Studies ◽  
Virus Transmission ◽  
Nosocomial Transmission ◽  
Medical Procedures ◽  
Emerging Viruses ◽  
Zoonotic Viruses ◽  
Increased Risk ◽  
Hospital Acquired

Abstract Background During the pandemic of coronavirus disease 2019 (COVID-19), many questions arose regarding risks for hospital-acquired or nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Aerosol generating medical procedures (AGMPs), techniques that can generate infectious, virus-laden aerosols, could potentially amplify transmission among healthcare workers (HCWs). Thus, it was widely recommended that HCWs use airborne precautions when performing AGMPs. However, in clinical settings it is often unclear what procedures constitute AGMPs and how the risk varies by procedure or pathogen. We set out to further define AGMPs and assess the risk for nosocomial transmission of SARS-CoV-2 and other high-risk viruses via AGMPs. Methods We identified potential AGMPs and emerging viruses that were high-risk for nosocomial transmission through reviewing experimental and clinical data. Potential AGMPs were those associated with previous virus transmission or mechanically capable of transmission. High-risk viruses were defined as those that cause severe disease in humans for which limited therapies or interventions exist, are infectious via aerosols in humans or non-human primates (NHPs), found in the respiratory tract of infected humans or NHPs, and had previous evidence of nosocomial transmission. Results We identified multiple potential AGMPs, which could be divided into those that generate aerosols or induce a patient to form aerosols, as well as eight families of high-risk viruses. All of the viruses were emerging zoonotic RNA viruses. In the family Coronaviridae, we identified potential evidence for SARS-CoV-1, MERS-CoV, and SARS-CoV-2 transmission via AGMPs. SARS-CoV-1 and SARS-CoV-2 were also found to be similarly stable when aerosolized. Conclusion Multiple emerging zoonotic viruses pose a high risk for nosocomial transmission through a variety of AGMPs. Given the similar stability of SARS-CoV-2 with SARS-CoV-1 when aerosolized and prior nosocomial transmission of SARS-CoV-1 via AGMPs, we suspect that certain AGMPs pose an increased risk for SARS-CoV-2 transmission. Additional experimental studies and on-site clinical sampling during AGMPs are necessary to further risk stratify AGMPs. Disclosures All Authors: No reported disclosures

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