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Background: Abusive relationships are associated with several demographic factors and many clinical problems in women. However, practices often do not screen for abuse., Methods: This is a descriptive study of 1526 women aged 19 to 69 years who completed a health survey in 31 office practices. The 53-item survey included a question designed to screen for an abusive relationship. Our analysis compared self-reported measures of symptoms (N = 13) and functional limitations (n = 6) of women who had abusive relationships with those who did not. We also examined the utility of using a constellation of clinical problems to identify risk for abuse., Results: Women in abusive relationships were more likely to be poor (37% vs 14%; P < .001) and young (87% were younger than 51 years versus 69% of those who were not in such relationships; P < .001). They had twice as many bothersome symptoms (3.1 vs 1.7; P < .001) and functional problems (1.6 vs 0.8; P < .001). Approximately 40% (36/89) of low-income women with emotional problems were at risk for abuse versus only 6% (64/1025) of women with adequate financial resources and no emotional problems. However, because so many women were at low risk, almost twice as many in this group (n = 64) reported abusive relationships than in the high-risk group (n = 36)., Conclusions: Women in abusive relationships have many symptoms and functional limitations. However, symptoms and clinical problems provide insufficient clues for abuse. It is better just to ask. A single-item screening question appears adequate for this purpose.

Background: Many significant problems of adolescents are undetected and untreated. To aid in the discovery of these problems, we have developed and tested picture-and-word charts for use in the classroom or the physician's office. This report presents the results of these tests and describes how the charts may be used., Methods: We assessed test-retest reliability of the picture-and-word charts. We also compared picture-and-word chart scores with corresponding multi-item questionnaires. Six charts were determined to be the most effective in measuring mutually exclusive dimensions of health and social problems. We used these six charts to examine factors that might affect the distribution of chart scores., Results: We administered the picture-and-word charts to a diverse population of 658 adolescents whose median age was 15 years. Compared with multi-item questionnaires, respondents found the charts easier to understand and less likely to induce dishonest replies. Girls scored significantly worse (P < .001) than boys on the Physical Fitness and Emotional Feelings charts but better on the (at-risk) Health Habits chart (P < .001). The scores of teenagers known to have behavioral problems were worse on the Health Habits chart than were those of other adolescents (P < .001)., Conclusions: The charts are an efficient and acceptable method for detecting health and social problems of adolescents.

Many of the obstacles inherent in the conduct of primary care research have been overcome by an experimental program in northern New England, the Primary Care Cooperative Information Project. This project uses a medical information network in 44 rural medical practices to carry out both clinical and management research. This paper describes the developmental problems encountered and the results of some initial clinical, quality assurance, and practice management studies conducted by the network and presents observations on its future research directions.

This is the first of two papers describing the Primary Care Cooperative Information Project (COOP Project), a program that integrates the interests of community physicians, medical school faculty, and health policymakers. This integration has been accomplished through the uniting of 44 rural medical practices in Maine, New Hampshire, and Vermont with faculty at Dartmouth Medical School in clinical research, quality assurance, practice management, and continuing medical education activities. This paper describes the structure, goals, and history of the COOP Project, together with the design, cost, and output of its computerized medical information system.

In order to estimate the proportion of women who have urinary tract infection, 23 rural primary care private practices agreed to obtain information according to a standard protocol on women over 12 years of age with urinary tract symptoms. Women excluded were those with vaginitis, chronic urinary tract infection, or concurrent confounding diagnoses. The results of the study on 213 women showed that the proportion of ambulatory women with urinary symptoms diagnosed as having urinary tract infection ranged from 31 percent to 71 percent, depending on the diagnostic criteria used. The type of urinary symptoms experienced by the women were not sensitive for cultures of 10(5) or more organisms per milliliter.