Influence of Intimate Partner Violence (IPV) Exposure on Cardiovascular and Salivary Biosensors: Is There a Relationship?

BACKGROUND/PURPOSE: Intimate partner violence (IPV) is a global public health epidemic that initiates/exacerbates health consequences affecting a victim's lifespan. IPV can significantly predispose women to a lifetime risk of developing cardiovascular disease (CVD) due to the effects of stress and inflammation. This study investigates the correlation among IPV exposure, in-vivo CVD events, and inflammatory biomarkers as predictor indices(s) for CVD in female dental patients. METHODS: Of 37 women enrolled in this study, 19 were African-American (AA) and 18 non-African-American (non-AA) and their ages ranged from 19 to 63 years. IPV-exposure and stress-induced in-vivo CVD events such as Chest Pain (CP) and Heart palpitations were recorded from all enrolled subjects. Cardiovascular events were obtained through surveys by patient self-report. Saliva specimens were obtained from all women and were analyzed for CVD biomarkers using multiplex-ELISA. RESULTS: The prevalence of IPV was 51% (19/37) and statistically equivalent for AA and non-AA. The results show differences in experience of 1) CP (p < 0.01) and 2) heart palpitations (p < 0.02) when IPV + participants are compared with IPV- AA and non-AA cohorts. Of 10 CVD biomarkers analyzed, significant correlations between IPV+ and IPV- subjects were observed for biomarkers that include Interleukin-1ß/sCD40L; TNFα/sCD40L; Myoglobin/IL-1ß; CRP/sCD40L; CRP/IL-6; CRP/TNFα; TNFα/siCAM; CRP/MMP9; TNF-α/Adiponectin (p < 0.01). DISCUSSION/IMPLICATIONS: Analysis of in vivo CVD status showed that significant race/health disparities exist in IPV + cohorts, as well as increased expression of inflammatory mediators, specifically CRP, IL-1ß, IL-6, MMP9. Women who have experienced IPV may be a target cohort for primary prevention of CVD. The use of salivary biomarkers and our protocol may provide a less invasive method to help increase identification of victims at risk for IPV and CVD and potentially decrease other health injuries associated with IPV exposure.

Violence and abuse: core competencies for identification and access to care.

Violence and abuse (V/A) is recognized as a significant public health problem, especially in females. Injuries to the head, neck, and/or mouth are clearly visible to the dental team during examination. This article provides compelling evidence that supports the pivotal position occupied by oral health care professionals within the arena of detection, intervention, and prevention of V/A. This article reviews the epidemiology of orofacial risk factors for V/A, diagnostic tools and surveys for identifying victims of all ages, and suggests interdisciplinary educational curricula/specific algorithms to provide the necessary core competencies for identifying victims in the oral health care environment.

Leadership training for oral health professionals: a call to action.

With dramatic changes in the scope and mode of delivering oral health care on the horizon, a strategic approach to addressing the emerging opportunities and challenges is required. Such an approach will demand new and sustained initiatives to develop leaders with the skills, knowledge, and passion to guide oral health care into the future. The purpose of this position paper is to define the need for leadership training programs for dental and dental hygiene students to become future leaders. Whether these oral health professionals become leaders within a solo or group practice or at the local or national level of their profession, they must be given the mindset and tools to lead. This position paper will describe goals for leadership training and give examples of some programs that currently exist in dental education and other professional settings as the background for a call to action for dental education to provide leadership training opportunities for its students.

Program design considerations for leadership training for dental and dental hygiene students.

Since leadership is an essential part of the oral health professions, oral health educators can play an essential role in establishing a culture of leadership and in mentoring students to prepare them for future leadership roles within the profession. However, leadership training for oral health professionals is a relatively new concept and is frequently not found within dental and dental hygiene curricula. The purpose of this article is to propose several models for leadership training that are specific to the oral health professions. The authors hope that providing an overview of leadership programs in academic dental institutions will encourage all U.S. and Canadian dental schools to begin developing a culture that promotes leadership development.