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611.
This qualitative study examined female domestic violence offenders via structured interviews with 13 women referred for treatment in batterers' intervention programs in a major metropolitan area. The majority of women were victims of childhood abuse and/or witnessed violence between their parents. Most reported feeling cut-off from their mothers, left their childhood homes before the age of 18, and experienced violence at the hands of a prior partner. Women's motivations for current violence were primarily in self-defense or in retaliation for their partners' physical abuse, and secondarily in response to partner emotional abuse, control tactics, to get attention/be heard, or to express anger. A minority sought to control their partners. Differential treatment considerations and recommendations for women versus men batterers are included. 相似文献
612.
Effect of dialysate calcium concentrations on intradialytic blood pressure course in cardiac-compromised patients 总被引:1,自引:0,他引:1
FM van der Sande EC Cheriex WH van Kuijk KM Leunissen 《American journal of kidney diseases》1998,32(1):125-131
To prevent hypercalcemia in the treatment of secondary hyperparathyroidism, low calcium (L-Ca) dialysate is advocated. However, changes in ionized calcium (i-Ca) levels have a pivotal role in myocardial contraction and could influence blood pressure stability during dialysis. Recently, our group found in patients with normal cardiac function a significant decrease in blood pressure (decrease in systolic blood pressure [DSBP]: -13 mm Hg and decrease in mean arterial pressure [DMAP]: -7 mm Hg) during dialysis with L-Ca dialysate compared with high calcium (H-Ca) dialysate, and this was mainly related to a decreased left ventricular contractility with use of L-Ca dialysate. On the basis of these data, it could be expected that changes in i-Ca levels during dialysis are of more clinical importance in cardiac-compromised patients (CCpts), New York Heart Association classifications III and IV. In this study, the effects of L-Ca dialysate (1.25 mmol/L) and H-Ca dialysate (1.75 mmol/L) on arterial blood pressure parameters (systolic [SBP], diastolic [DBP], and mean arterial blood pressure [MAP]), heart rate, stroke distance (SDist), and minute distance (MDist) during 3 hours of a standardized ultrafiltration/hemodialysis (UF+HD) in nine CCpts was investigated. i-Ca levels increased significantly with H-Ca dialysate UF+HD, whereas there was no change with L-Ca dialysate. SBP, DBP, and MAP decreased statistically and clinically significantly during UF+HD with L-Ca dialysate and were significantly lower with the use of L-Ca dialysate compared with H-Ca dialysate. SDist and MDist decreased significantly with L-Ca dialysate, whereas there were no changes in SDist and MDist with H-Ca dialysate. The predialysis and postdialysis index of systemic vascular resistance (SVRI) was similar between L-Ca dialysate and H-Ca dialysate use. Between the two groups, there were no significant differences in changes in SVRI. From this study, we can conclude that changes in i-Ca levels are a very important determinant of the blood pressure response during UF+HD in CCpts, and this response is mediated by changes in myocardial contractility. 相似文献
613.