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Abstract Objective To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings. Design Systematic review of published quantitative studies. Search strategy Three [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2007.12.038 Byline: Blair J. Wylie (a), Leslie L. Davidson (b), Maneesh Batra (c), Susan D. Reed (d) Keywords: cesarean delivery; neonatal survival; prematurity; very low-birthweight Abstract: This study was undertaken to compare neonatal outcome by method of delivery in very low-birthweight less than 1500 g vertex-presenting fetuses. Author Affiliation: (a) Department of Obstetrics and Gynecology, New York-Presbyterian Medical Center, New York, NY (b) Department of Clinical Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (c) Department of Pediatrics, University of Washington Medical Center, Seattle, WA (d) Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, WA. Article History: Received 16 June 2007; Revised 10 November 2007; Accepted 31 December 2007 Article Note: (footnote) Cite this article as: Wylie BJ, Davidson LL, Batra M, et al. Method of delivery and neonatal outcome in very low-birthweight vertex-presenting fetuses. Am J Obstet Gynecol 2008;198:640.e1-640.e7. , Reprints not available from authors.

OBJECTIVES To describe the receipt of controlling behaviors in young women's dating relationships and the association with physical and sexual relationship violence (RV) and to ascertain whether young women experiencing controlling from partners support RV screening and respond honestly. DESIGN Anonymous audio computer-assisted self-interview. SETTING Reproductive health center. PARTICIPANTS A total of 603 women aged 15 to 24 years seeking reproductive care. MAIN OUTCOME MEASURES Self-reported victimization (controlling behaviors and physical and sexual aggression) by a partner in the past year. RESULTS Sixty-eight percent of participants reported receiving 1 or more episodes of controlling behavior by a partner: 38.1% reported experiencing only controlling behaviors; 11.4% and 10.0% reported receiving controlling behaviors plus physical or sexual victimization, respectively; and 8.6% reported all forms of RV. Adjusted Poisson regression found that age 15 to 18 years (relative risk, 1.40), Hispanic ethnicity (1.29), childhood exposure to domestic violence (1.11), ever pregnant (1.21), older partner (1.28), recent physical (1.89) or sexual (1.93) victimization, and uncomfortable asking for condom use (1.39) were significantly associated with increased episodes of controlling behavior by a partner. Younger women and those who reported being victimized by controlling behaviors were more than twice as likely to object to screening by a health care provider, and those who reported receiving these behaviors were 2.5 times more likely to report that they might not honestly disclose RV. CONCLUSIONS Controlling behaviors are strongly associated with physical and sexual RV. Young women experiencing controlling behaviors are more reticent about screening for RV and may not feel that they can answer honestly.Arch Pediatr Adolesc Med. 2011;165(4):313-319--

Objective: Individuals' recollections of the number and type of health service encounters are frequently required for health economic studies. We sought to establish whether the accuracy of self-reported healthcare resource utilization is a function of the duration of the recall period and the saliency of the health service encounter. Methods: Patient recollections of a range of community services (general practitioner visits, community midwifery visits) and hospital services (accident and emergency attendances, hospital outpatient attendances, inpatient admissions) over 4-month and 8-month time periods were obtained from women participating in a randomized controlled trial. Comparisons were made with healthcare resource utilization data extracted from medical records. Where significant differences were identified between the self-reported and medically recorded data, a multivariate linear regression model was constructed to identify the factors associated with underreporting and overreporting of healthcare resource utilization. Results: The study revealed a tendency to underreport community service utilization, which appears to be exacerbated when the recall period is extended. A number of sociodemographic and clinical factors significantly associated with this tendency to underreport community service utilization were identified. The self-reporting of hospital service utilization over varying periods of recall was found to be more accurate. Conclusion: It is important that economic analysts establish optimal methods for estimating resource utilization quantities within health economic analytical designs. In particular, greater emphasis should be placed on extracting information on community service utilization from medical records or routine health service information systems.

Objective:to explore current policies and practices in maternity units that aim to identify, assess and support women experiencing domestic violence.

Children with conditions requiring neonatal intensive care impose a financial burden on health services, on families and carers, and on society generally. A systematic review of the literature identified 81 studies that conducted primary research on the cost of services as a result of conditions requiring neonatal intensive care. The majority of studies estimated costs incurred during the initial hospital stay. Relatively few studies considered health service costs following discharge from the neonatal intensive care unit, costs to other sectors of the economy or costs to families and carers. It is important that these costs are considered more fully.

• The weights and heights of 1670 Harlem children aged 5 to 11 years (879 boys, 791 girls) were compared with the National Center for Health Statistics standards. The median height for age and weight for age were greater by 1.4 cm and 2.2 kg in boys and 2.7 cm and 2.8 kg in girls. Weight distribution was skewed to the right and showed a bimodal pattern. "Height-ages" were advanced by an average of 0.24 years in boys and 0.47 years in girls. Weight for height in 13.9% of girls and 13.6% of boys were above the 95th percentile. The results are consistent with early maturation. However, even after adjusting for height, shift to the right of the weight distribution persists with a large subgroup of boys and girls who are overweight.(AJDC. 1993;147:155-159)

An international study to validate the Ten Questions screen for serious childhood disability was undertaken in communities in Bangladesh, Jamaica, and Pakistan, where community workers screened more than 22,000 children ages 2–9 years. All children who screened positive, as well as random samples of those who screened negative, were referred for clinical evaluations. Applying comparable diagnostic criteria, the sensitivity of the screen for serious cognitive, motor, and seizure disabilities is acceptable (80–100) in all three populations, whereas the positive predictive values range from 3 to 15. These results confirm the usefulness of the Ten Questions as a low-cost and rapid screen for these disabilities, although not for vision and hearing disabilities, in populations where few affected children have previously been identified and treated. They also show that the value of the Ten Questions for identifying disability in underserved populations is limited to that of a screen; more thorough evaluations of children screened positive are necessary to distinguish true- from false-positive results and to identify the nature of the disability if present.

ObjectiveTo examine the effectiveness of screening for intimate partner violence conducted within healthcare settings to determine whether or not screening increases identification and referral to support agencies, improves women’s wellbeing, decreases further violence, or causes harm.DesignSystematic review and meta-analysis of trials assessing effectiveness of screening. Study assessment, data abstraction, and quality assessment were conducted independently by two of the authors. Standardised estimations of the risk ratios and 95% confidence intervals were calculated.Data sourcesNine databases searched up to July 2012 (CENTRAL, Medline, Medline(R), Embase, DARE, CINAHL, PsycINFO, Sociological Abstracts, and ASSIA), and five trials registers searched up to 2010.Eligibility criteria for selecting studiesRandomised or quasi-randomised trials of screening programmes for intimate partner violence involving all women aged ≥16 attending a healthcare setting. We included only studies in which clinicians in the intervention arm personally conducted the screening, or were informed of the screening result at the time of the consultation, compared with usual care (or no screening). Studies of screening programmes that were followed by structured interventions such as advocacy or therapeutic intervention were excluded.Results11 eligible trials (n=13 027) were identified. In six pooled studies (n=3564), screening increased the identification of intimate partner violence (risk ratio 2.33, 95% confidence interval 1.39 to 3.89), particularly in antenatal settings (4.26, 1.76 to 10.31). Based on three studies (n=1400), we detected no evidence that screening increases referrals to domestic violence support services (2.67, 0.99 to 7.20). Only two studies measured women’s experience of violence after screening (three to 18 months after screening) and found no reduction in intimate partner violence. One study reported that screening does not cause harm.ConclusionsThough screening is likely to increase identification of intimate partner violence in healthcare settings, rates of identification from screening interventions were low relative to best estimates of prevalence of such violence. It is uncertain whether screening increases effective referral to supportive agencies. Screening does not seem to cause harm in the short term, but harm was measured in only one study. As the primary studies did not detect improved outcomes for women screened for intimate partner violence, there is insufficient evidence for screening in healthcare settings. Studies comparing screening versus case finding, or screening in combination with therapeutic intervention for women’s long term wellbeing, are needed to inform the implementation of identification policies in healthcare settings.

Objective: To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings. Design: Systematic review of published quantitative studies. Search strategy: Three electronic databases (Medline, Embase, and CINAHL) were searched for articles published in the English language up to February 2001. Included studies: Surveys that elicited the attitudes of women and health professionals on the screening of women in health settings; comparative studies conducted in healthcare settings that measured rates of identification of domestic violence in the presence and absence of screening; studies measuring outcomes of interventions for women identified in health settings who experience abuse from a male partner or ex-partner compared with abused women not receiving an intervention. Results: 20 papers met the inclusion criteria. In four surveys, 43-85% of women respondents found screening in healthcare settings acceptable. Two surveys of health professionals' views found that two thirds of physicians and almost half of emergency department nurses were not in favour of screening. In nine studies of screening compared with no screening, most detected a greater proportion of abused women identified by healthcare professionals. Six studies of interventions used weak study designs and gave inconsistent results. Other than increased referral to outside agencies, little evidence exists for changes in important outcomes such as decreased exposure to violence. No studies measured quality of life, mental health outcomes, or potential harm to women from screening programmes. Conclusion: Although domestic violence is a common problem with major health consequences for women, implementation of screening programmes in healthcare settings cannot be justified. Evidence of the benefit of specific interventions and lack of harm from screening is needed.