Screening for intimate partner violence in orthopedic patients: a comparison of three screening tools

Accurately identifying victims of intimate partner violence (IPV) can be a challenge for clinicians and clinical researchers. Multiple instruments have been developed and validated to identify IPV in patients presenting to health care practitioners, including the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS). The purpose of the current study is to determine if female patients attending an outpatient orthopaedic fracture clinic who screen positive for IPV using three direct questions (direct questioning) also screen positive on the WAST and PVS. We conducted a prevalence study at two Level I trauma centres to determine the prevalence of IPV in female patients presenting to orthopaedic fracture clinics for treatment of injuries. We used three methods to determine the prevalence of IPV; 1) direct questioning, 2) WAST, and 3) PVS. We compared the prevalence rates across the three screening tools. Ninety-four women screened positive for IPV using any method. The prevalence of IPV was 30.5% when a direct questioning approach was utilized, 12.4% using the WAST, and 9.2% using the PVS. The WAST identified 37.2% (35/94) of the IPV victims detected and the PVS identified 27.7% (53/94) of the IPV victims detected, whereas direct questioning identified 89.4% of the IPV victims. Identification of IPV may be under-estimated by the WAST and PVS screening tools. Our findings suggest direct questioning may increase the frequency of disclosure of IPV among women attending outpatient orthopaedic clinics.     

Congress and the political expansion of the U.S. districts courts

Expanding the number of U.S. district judgeships is often justifiedas a response to expanding caseloads. Increasing judgeshipsduring unified government, however, allows Congress and thePresident to engage in political (patronage and ideological)control of the federal district courts. This paper examinesempirically the relative importance of caseload pressure andpolitical motives for Congress to expand the number of federaldistrict judgeships. We demonstrate that politics dominatesthe timing of judgeship expansion in the U.S. District Courts.We also show that both politics and caseload affect the actualsize of those timed expansions. In particular, we find thatbefore 1970, Congress seemed to have strong political motivationsfor the size of an expansion. After 1970, Congress became muchmore attentive to caseload considerations.