Adversity in Childhood and Mental Health in Adulthood: The Role of Social Capital

2009 ◽  
Vol 8 (1) ◽  
pp. 99-113
Author(s):  
Francesca Borgonovi ◽  
M. Carmen Huerta
Keyword(s):  
Mental Health ◽  
Social Capital ◽  
High Risk ◽  
Mental Distress ◽  
Protective Role ◽  
Low Risk

The study examines whether social capital fosters resilience among individuals who are at a high risk of developing mental distress in adulthood. Results suggest that social capital is not associated with a reduction in the probability that high-risk individuals will experience mental distress, while one form of social capital, membership in groups and associations, appears to play a protective role among low-risk individuals. Overall, our research suggests that policies aimed at increasing social capital would not be able to reduce the gap in mental health between disadvantaged individuals and the rest of the population.

Abstract 19763: Role of HAS-BLED Score on Major Bleeding in Atrial Fibrillation Undergoing Percutaneous Coronary Intervention With Drug-eluting Stents

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoshitaka Ito ◽  
Kazuhiro Naito ◽  
Katsuhisa Waseda ◽  
Hiroaki Takashima ◽  
Akiyoshi Kurita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Stent Implantation ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk

Background: While anticoagulant therapy is standard management for atrial fibrillation (Af), dual antiplatelet therapy (DAPT) is needed after stent implantation for coronary artery disease. HAS-BLED score estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in Af care. However, it is little known about usefulness of HAS-BLED score in Af patient treated with coronary stents requiring DAPT or DAPT plus warfarin (triple therapy: TT). The aim of this study was to evaluate the role of HAS-BLED score on major bleeding in Af patients undergoing DAPT or TT. Methods: A total of 837 consecutive patients were received PCI in our hospital from Jan. 2007 to Dec. 2010, and 66 patients had Af or paroxysmal Af at the time of PCI. Clinical events including major bleeding (cerebral or gastrointestinal bleeding) were investigated up to 3 years. Patients were divided into 2 groups based on HAS-BLED score (High-risk group: HAS-BLED score≥4, n=19 and Low-risk group: HAS-BLED score<4, n=47). DAPT therapy was required for a minimum 12 months after stent implantation and warfarin was prescribed based on physicians’ discretion. Management/change of antiplatelet and anticoagulant therapy during follow-up periods were also up to physicians’ discretion. Results: Baseline characteristics were not different between High-risk and Low-risk group except for age. Overall incidence of major bleeding was observed in 8 cases (12.1%) at 3 years follow-up. Major bleeding event was significantly higher in High-risk group compared with Low-risk group (31.6% vs. 4.3%, p=0.002). However, management of DAPT and TT was not different between the 2 groups. Among component of HAS-BLED score, renal dysfunction and bleeding contributed with increased number of the score. Conclusion: High-risk group was more frequently observed major bleeding events compared with Low-risk group in patients with Af following DES implantation regardless of antiplatelet/anticoagulant therapy.

P4688Additional role of unmodifiable risk factors in pulmonary arterial hypertension risk stratification according to current ESC/ERS guidelines

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Zuffa ◽  
F Dardi ◽  
M Palazzini ◽  
E Gotti ◽  
A Rinaldi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Arterial Hypertension ◽  
High Risk ◽  
Risk Stratification ◽  
Arterial Hypertension ◽  
Specific Treatment ◽  
Low Risk ◽  
P Value ◽  
Pulmonary Arterial

Abstract Background Current pulmonary hypertension (PH) guidelines stratify the risk of patients with pulmonary arterial hypertension (PAH) using a multiparametric approach. Anyway, the role of unmodifiable risk factors is not taken into account. Purpose The aim of this study was to evaluate the role of unmodifiable risk factors (age, gender, PAH aetiology) in PAH risk stratification using the recently proposed simplified risk table and to test if these factors influence the response to PAH-specific treatment. Methods All patients with PAH referred to a single centre were included from 2003 to 2017. We applied a simplified risk assessment strategy using the following criteria: WHO functional class, 6-min walking distance, right atrial pressure or brain natriuretic peptide plasma levels and cardiac index (CI) or mixed venous oxygen saturation (SvO2). The last 2 criteria were based on which parameter was available; if both were available the worst was chosen. Risk strata were defined as: Low risk= at least 3 low risk and no high-risk criteria; High risk= at least 2 high risk criteria including CI or SvO2; Intermediate risk= definitions of low or high risk not fulfilled. Then we performed multivariate Cox analysis to evaluate what are the independent predictors of survival (age, gender, PAH aetiology together with the recently proposed simplified PAH risk table) and we tested if these factors influence the response to PAH specific therapy comparing the % improvement of hemodynamic parameters from baseline to 3–4 months after starting treatment. Wilcoxon-Mann-Whitney test was used for comparisons. Results Six hundreds and twenty-one treatment-naïve patients were enrolled. Age [HR (95% CI) = 1.022 (1.014–1.030); p-value <0.001], male gender [HR (95% CI) = 1.881 (1.479–2.392); p-value <0.001] and connective tissue disease (CTD)-PAH aetiology [HR (95% CI)= 2.278 (1.733–2.995); p-value <0.001] were all independent predictors of prognosis in patients with PAH together with the recently validated simplified PAH risk table [HR (95% CI) = 2.161 (1.783–2.618); p-value <0.001] but they didn't significantly influence the response to PAH specific treatment as shown in the Figure. Figure 1 Conclusions Age, gender and CTD-PAH aetiology significantly influence prognosis together with the recently validated simplified PAH risk table but don't significantly influence the response to PAH-specific treatment. Acknowledgement/Funding None

Immigration Stress among Recent Latino Immigrants: The Protective Role of Social Support and Religious Social Capital

2019 ◽  
Vol 34 (4) ◽  
pp. 279-292
Author(s):  
Mariana Sanchez ◽  
Stephanie Diez ◽  
Nicole M. Fava ◽  
Elena Cyrus ◽  
Gira Ravelo ◽  
...  
Keyword(s):  
Social Support ◽  
Social Capital ◽  
Protective Role ◽  
Latino Immigrants ◽  
Religious Social Capital ◽  
Immigration Stress

Restraint and the Question of Validity

2007 ◽  
Vol 14 (4) ◽  
pp. 535-545 ◽  
Author(s):  
Brodie Paterson ◽  
Joy Duxbury
Keyword(s):  
Mental Health ◽  
Current Literature ◽  
Mental Distress ◽  
Critical Examination ◽  
Ongoing Debate ◽  
Weak Support ◽  
Psychopolitical Validity

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy.

Social Capital and Mental Distress in an Impoverished Community

2002 ◽  
Vol 1 (2) ◽  
pp. 199-222 ◽  
Author(s):  
Carey Usher Mitchell ◽  
Mark LaGory
Keyword(s):  
Mental Health ◽  
Social Capital ◽  
Inner City ◽  
Mental Distress ◽  
Well Being ◽  
Environmental Stressors ◽  
Mediating Effect ◽  
Social Resource ◽  
High Poverty ◽  
Bonding Social Capital

According to recent investigations of social capital, this social resource represents a key ingredient in a community’s capacity to respond to environmental challenges and promote change. This article investigates the significance of social capital for the health and well‐being of inner‐city residents using data collected from a sample of household decisionmakers residing in a high‐poverty, racially segregated urban neighborhood in a mid‐sized southern city (N=222). A psychosocial resources model of distress is employed to explore the role of social capital as a critical social resource mediating the impact of poverty‐related economic and environmental stressors on residents’ mental health. Regression analyses show no mediating effect of social capital on the relationships between economic and environmental stressors and mental health. While bridging social capital displays a small inverse relationship with distress, bonding social capital is actually positively related to mental distress. Bonding social capital appears to increase individuals’ levels of mental distress in this impoverished community. On the other hand, a psychological resource, mastery, plays a significant role in mediating the harmful effects of poverty. These findings suggest the need for some modification of recent claims that social capital is a critical resource promoting individual and community well‐being. Apparently, in high‐poverty, high‐minority, inner‐city communities, active participation in the local area comes at some cost to the individual. This article demonstrates the importance of doing further research on the social capital of inner‐city areas.

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