This prospective multicentre observational study investigated the risk of non-cardiac surgery in patients with moderate or severe aortic stenosis (AS). Patients with AS undergoing non-cardiac surgery in five New Zealand hospitals between August 2011 and September 2015 were studied. Preoperative variables were analysed for a significant association with postoperative major adverse cardiac events (MACE) and 30-day mortality. Of the 147 patients recruited, 13 (9%) died within 30 days and 33 (22%) had a MACE. Using univariate analysis, patients with severe AS had four times higher 30-day mortality than patients with moderate AS (16% versus 4%, P=0.007). Other factors associated with increased 30-day mortality included having a smaller aortic valve area, smaller dimensionless severity index, concomitant mitral regurgitation, and higher overall surgical risk. Patients with symptoms attributable to AS had a higher incidence of MACE compared to patients without symptoms (36% versus 16%, P=0.011). Variables significantly associated with both 30-day mortality and MACE were age, American Society of Anesthesiologists physical status, emergency surgery, New York Heart Association classification, preoperative albumin level, frailty, and history of congestive heart failure. Using multivariate analysis, emergency surgery, symptoms attributable to AS, preoperative albumin level, and AVA remained significantly associated with adverse outcome. While these findings should be interpreted with caution due to the observational nature of the study, limited power and multiple simultaneous comparisons, they suggest that patients with severe AS have a higher risk of adverse outcome after non-cardiac surgery than patients with moderate AS.

PURPOSE: We sought to examine the relation between childhood family violence and intimate partner violence (IPV).METHODS: We surveyed 1615 couples from the U.S. household Population by using multistage cluster sampling. Childhood family violence measures included moderate and severe child physical abuse and witnessing interparental threats or physical violence. IPV was categorized as nonreciprocal male-to-female partner violence (MFPV), nonreciprocal female-to-male partner violence (FMPV), reciprocal IPV (MFPV and FMPV), and no IPV. We used multinomial logistic regression to estimate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) between childhood family violence and IPV.RESULTS: Men who experienced moderate (adjusted OR [AOR] 3.9,95% CI, 1.3-11.8) or severe (AOR 4.5, 95% CI: 1.1-19.3) child physical abuse were at increased risk of nonreciprocal MFPV; a male history of severe childhood physical abuse or witnessing interparental violence was associated with a twofold increased risk of reciprocal IPV. Women who witnessed interparental threats of violence (AOR 1.9, 95% CI, 0.8-4.6) or interparental physical violence (AOR 3.4, 95% CI, 1.5-7.9) in childhood were at increased risk of nonreciprocal FMPV. Women exposed to any type of childhood family violence were more than 1.5 times as likely to engage in reciprocal IPV. Many strong positive ORs had CIs compatible with no association.CONCLUSION: We provide new evidence that childhood family violence is associated with an increased risk of nonreciprocal and reciprocal IPV. Treatment providers and policy makers should consider childhood family violence history in both men and women in the context of IPV.

The primary aim of this study is to determine the association between alcohol, violence related cognitive risk factors, and impulsivity with the perpetration of partner violence among current drinkers. A probability sample (n = 1468) of White, Black, and Hispanic couples 18 years of age or older in the United States household population was interviewed in 1995 with a response rate of 85%. The risk factors of interest included the alcohol and violence related cognitions of approval of marital aggression, alcohol as an excuse for misbehavior, and aggressive expectations following alcohol consumption as well as impulsivity. In all, 15% (216/1468) of the respondents reported perpetration of domestic violence. In addition, 24% (7/29) of those who approved of marital violence, 11% (126/1163) of those who reported alcohol use as an excuse for misbehavior, 10% (128/1257) of those who reported aggressive expectations following alcohol consumption, and 14% (99/716) of those who reported impulsivity also reported perpetration of domestic violence. Bivariate analysis indicated that all of the cognitive risk factors were significantly more common in those who reported perpetration of intimate partner violence (IPV) (p < 0.05). However, multivariate analysis controlling for ethnicity, education, income, age, gender, and impulsivity indicated that those who reported strong or very strong expectations of aggressive behavior following alcohol consumption were 3.2 (95% CI = 1.3–7.9) times more likely to perpetrate IPV. Although all of the alcohol and violence related cognitive risk factors were associated with the perpetration of domestic violence, expectations of aggressive behavior following alcohol consumption appeared to be the strongest predictor of the perpetration of IPV among current drinkers. Therefore, alcohol expectancy may be an important factor to assess when attempting to identify and treat perpetrators of domestic violence who are also current drinkers.

This article examines the association of exposure to parental violence during childhood and childhood physical abuse with the development of alcohol-related problems in adulthood among Whites, Blacks, and Hispanics. A multistage area household probability sample of White, Black, and Hispanic couples (married or cohabiting), 18 or older, in the U.S. household population was interviewed in 1995. Analyses show an association between childhood physical abuse and exposure to parental violence and alcohol problems among White, Black, and Hispanic females and Hispanic males and an association between parental violence and alcohol problems among Black males. In sum, childhood physical abuse and exposure to parental violence are associated with the development of alcohol-related problems in adulthood. However, this association is ethnic and gender specific. Therefore, these violence-related experiences during childhood and adolescence have both immediate and long-term health consequences and should be addressed by health professionals in a variety of settings.

Objectives: The primary aim of this study is to determine the association between intimate partner violence, alcohol problems, and help seeking behaviors for alcohol problems. In addition, the study was conducted to examine ethnic differences in the reporting of intimate partner violence, alcohol problems and treatment or help seeking for alcohol problems. Methods: A probability sample (n = 1468) of White, Black and Hispanic couples 18 years of age or older in the U.S. household population was interviewed in 1995 with a response rate of 85%. Help seeking was defined as talking to someone or seeking treatment for an alcohol problem; therefore, the bivariate and multivariate analyses exclude lifetime abstainers. Results: Multivariate analysis controlling for ethnicity, gender, age, education, and income indicated that those with alcohol problems and intimate partner violence together were 1.5 (95% CI = 0.8-2.6) times more likely to seek help than those reporting alcohol problems alone. Conclusions: The coexistence of intimate partner violence and alcohol problems may prompt individuals to seek help for alcohol problems. However, a majority of people who report intimate partner violence and alcohol problems or alcohol problems alone do not seek help.