Innovative Service Delivery for Secondary Prevention of PTSD in At-Risk OIF-OEF Service Men and Women

African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) “What works” in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.

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Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02087-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Javier Jiménez-Candil ◽

Olga Duran ◽

Armando Oterino ◽

Jendri Pérez ◽

Juan Carlos Castro ◽

...

Keyword(s):

At Risk ◽

Secondary Prevention ◽

Beta Blocker ◽

Cycle Length ◽

Close Relationship ◽

Appropriate Therapy ◽

The Mean ◽

Ventricular Tachycardias ◽

The Relationship

Abstract Background ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown. Methods 416 ICD patients with LVEF < 45% were studied. ICD programming was standardized. NSVT was defined as any VT of 5 or more beats at ≥ 150 bpm occurred in the first 6 months after implantation that terminated spontaneously and was not preceded by any appropriate therapy. The mean follow-up was 41 ± 27 months. Results We analyzed 2201 NSVTs (mean CL = 323 ms) that occurred in 250 patients; 111 of such episodes were fast (CL ≤ 300 ms). Secondary prevention (HR = 1.7; p < 0.001), number of NSVT episodes (HR = 1.05; 95% CI 1.04–1.07; p < 0.001) and beta-blocker treatment (HR = 0.7; p = 0.04) were independent predictors of appropriate interventions; however, the mean CL of NSVTs was not (p = 0.6). There was a correlation between the mean CL of NSVTs and the CL of the first monomorphic VT: r = 0.88; p < 0.001. This correlation was especially robust in individuals with > 5 NSVTs (r = 0.97; p < 0.001), with an agreement between both values greater than 95%. Patients with any fast NSVT experienced a higher incidence of VF episodes (26%) compared to those without NVSTs (3%) or with only slow NSVTs (7%); p < 0.001. Conclusions Unlike the burden, the CL of NSVTs is not a predictor of subsequent appropriate interventions. However, there is a close relationship between the CL of NSVTs and that of arrhythmias that will later lead to appropriate therapies.

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How does amiodarone compare with other antiarrhythmic drugs for the secondary prevention of sudden cardiac death in at-risk adults?

Cochrane Clinical Answers ◽

10.1002/cca.1276 ◽

2016 ◽

Author(s):

Jane Burch ◽

Dane Gruenebaum

Keyword(s):

At Risk ◽

Sudden Cardiac Death ◽

Secondary Prevention ◽

Cardiac Death ◽

Antiarrhythmic Drugs

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Depression: major problem for public health

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00001974 ◽

2006 ◽

Vol 15 (1) ◽

pp. 4-10 ◽

Cited By ~ 50

Author(s):

Eugene S. Paykel

Keyword(s):

Public Health ◽

Primary Prevention ◽

Secondary Prevention ◽

Service Delivery ◽

Professional Education ◽

Common Disorder ◽

Social Adversity ◽

Physical Disorders ◽

Public Health Programmes ◽

Health Programmes

AbstractThe aim of this Editorial is to discuss depression as an important disorder for public health. The literature regarding epidemiology, consequences, adequacy of service delivery and prevention of depression is reviewed. Depression is a common disorder with high lifetime rates, particularly in women, and those experiencing social adversity. It is a major cause of disability, and causes death both by suicide and due to raised rates of physical disorders. Many cases are undiagnosed and treatment is often inadequate. Primary prevention is not yet easily feasible but secondary prevention by earlier recognition, public and professional education, can produce benefits. There is a need for public health programmes aimed at improving recognition, treatment, and reducing consequences.

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