Exploring the complex links between childhood exposure to intimate partner violence, maltreatment, and self-regulation: A three-wave cross-lagged study.

BACKGROUND: Intimate partner violence (IPV) often co-occurs with childhood maltreatment and negatively impacts children's development. While previous research has shown a direct link between these experiences and children's self-regulation, less is known about the potential unique effect and bidirectional associations between them. OBJECTIVE: The present study aims to investigate the bidirectional effects among maternal IPV experiences, child maltreatment, and children's behavioral self-regulation. PARTICIPANTS AND SETTING: 4,402 participants from three waves of the longitudinal study of the Future of Families and Child Wellbeing Study (FFCWS) were included in the study. METHODS: Cross-lagged path analyses were conducted to examine the longitudinal reciprocal relationships among IPV, child maltreatment, and children's behavioral regulation when children were 3, 5, and 9 years old. RESULTS: IPV exposure at ages 3 and 5 was negatively associated with levels of behavioral self-regulation at ages 5 and 9, even after accounting for physical maltreatment, psychological maltreatment, or neglect. Neglect at ages 3 and 5 was found to be associated with lower levels of behavioral self-regulation at later ages, when IPV exposure was considered in the models. Lower levels of behavioral self-regulation at age 3 were found to be linked with higher levels of psychological maltreatment, physical maltreatment, neglect, and IPV exposure at age 5. CONCLUSION: This study revealed bidirectional effects between maternal IPV experiences, child maltreatment, and children's behavioral self-regulation. Furthermore, the study demonstrated that exposure to IPV during early childhood significantly predicts long-term behavioral self-regulation difficulties, even after controlling for the effects of child maltreatment.

Conductas de autocuidado en pacientes ambulatorios con insuficiencia cardíaca crónica / Self-care behaviors in outpatients with chronic heart failure

La insufciencia cardíaca (IC) es una patología compleja que se asocia con mala calidad de vida y una alta mortalidad. Las medidas autocuidado personal en los pacientes con IC son un aspecto importante y útil para mejorar su calidad de vida. Objetivo Determinar la frecuencia de las conductas de autocuidado en pacientes con IC. Diseño Estudio transversal Lugar y Sujetos Pacientes con IC atendidos en la consulta externa de cardiología y medicina interna de cuatro unidades de salud, durante los meses de marzo a mayo del 2018. Mediciones principales Datos demográfcos, comorbilidades, tratamientos farmacológicos y medidas de autocuidado evaluadas con la escala EHFScBS. Resultados Se encuestaron 69 pacientes (33.3% hombres, 66.6% mujeres) con una edad de 62 ± 12 años. El 76.8% de los pacientes tenían dos o más comorbilidades. Los pacientes recibían un promedio de 3.8 medicamentos y la frecuencia de polifarmacia fue del 34%. Se encontró conductas de autocuidado positivas (frecuencia de autocuidado Siempre + Casi siempre), para la toma de medicación acorde a indicaciones médicas (95.6%), consumo de dieta baja en sal (72.4%) y reposo durante el día (62.3%). Una falta o ausencia de medidas de autocuidado (frecuencia de autocuidado Casi nunca + Nunca), se observó en la búsqueda de atención medica si ocurría un aumento del peso en 2 kg en una semana (75.3%) o si se presentaba hinchazón de pies/piernas (53.6%), en la vacunación anual contra la gripe (44.9%) y el ejercicio semanal (42%). Conclusión La ausencia de conductas de autocuidado fue alta. El 75% de los pacientes no buscan atención médica cuando se presentas signos de congestión. Una mejor información sobre las medidas de autocuidado es esencial como parte el tratamiento no farmacológico en los pacientes con IC crónica(AU).

Heart failure (HF) is a complex pathology that is associated with poor quality of life and high mortality. Self-care measures in patients with HF are an important and useful aspect to improve their quality of life. Objective To determine the frequency of self-care behaviors in patients with HF. Design Cross-sectional study. Subjects and settings Patients with HF attended in the outpatient clinic of cardiology and internal medicine at four health care units, during the months of March to May of 2018. Main measurements Demographic data, comorbidities, pharmacological treatments and self-care measures evaluated with the EHFScBS scale. Results 69 patients were surveyed (33.3% men, 66.6% women) with an age of 62 ± 12 years. 76.8% of the patients had two or more comorbidities. The patients received an average of 3.8 medications and the frequency of polypharmacy was 34%. Positive self-care measures were found (selfcare Always + Frequently) for taking medication according to medical indications (95.6%), consumption of low salt diet (72.4%) and rest during the day (62.3%). A lack or absence of self-care measures (self-care Almost never + Never), was observed for the search for medical attention if there was a 2 kg/week weight gain (75.3%) or if there was swelling of feet / legs (53.6%), in the annual vaccination against influenza (44.9%) and weekly exercise (42%). Conclusion The absence of self-care measures was high. 75% of patients do not seek medical attention when they show signs of congestion. Better information on self-care measures is essential as part of non-pharmacological treatment in patients with chronic HF