Optimal methods to screen men and women for intimate partner violence: results from an internal medicine residency continuity clinic

Contradictory data exist regarding optimal methods and instruments for intimate partner violence (IPV) screening in primary care settings. The purpose of this study was to determine the optimal method and screening instrument for IPV among men and women in a primary-care resident clinic. We conducted a cross-sectional study at an urban, academic, internal medicine residency continuity clinic in Connecticut among English or Spanish speaking adult patients. One group of patients ( n = 340) received a self-administered questionnaire (SAQ) containing the partner violence screen (PVS) and the Hurt, Insulted, Threatened or Screamed at Questionnaire (HITS). A second group (n = 126) was screened with PVS and HITS by their primary care providers during face-to-face (FTF) clinical encounters. Multivariable logistic regression models were used to determine the association between IPV prevalence and screening method (SAQ or FTF) after adjusting for socio-demographic effects. The overall IPV prevalence was 17.3% using the SAQ and 9.0% with FTF screening (p = .008). Patients receiving the SAQ were more likely to report IPV than those who were screened FTF (adjusted odds ratio [AOR]: 2.6, 95% confidence interval [CI]: 1.2-5.6). This effect persisted for women, who had a higher odds of IPV when screened through a SAQ than when screened FTF (AOR: 3.5, 95% CI: 1.4-8.6). Men did not differ in reporting IPV between methods: 11% with SAQ versus 9.4% FTF (p = .69). In internal medicine residency continuity clinics, a SAQ for IPV may result in higher disclosure and completion rates among female patients compared to FTF screening. Unique screening instruments and methods may be needed for men.     

One Step at a Time: A Latent Transitional Analysis on Changes in Substance Use,Exposure to Violence,and HIV/AIDS Risk Behaviors among Female Offenders

The aim of this analysis is to identify latent subgroups of women based on substance use, exposure to violence, and risky sexual behaviors and quantify discrete stages of behavior change over time. Data comes from 317 women recruited from a Municipal Drug Court System in the Midwest. All participants were interviewed regarding their substance use and sexual behaviors, as well as their exposure to violence at baseline, a 4th-month follow-up, and an 8th-month follow-up. A latent transitional analysis (LTA), a longitudinal extension of a latent class analysis (LCA), was used to quantify discrete stages of behavior change. The results of our analyses revealed 4 distinct behavioral profiles in our sample: 1) women with high probabilities of risky sexual behaviors, exposure to violence, and crack/cocaine use, 2) women with a high probability of exposure to violence, and moderate sexual risk taking, 3) women characterized solely by a high probability of crack/cocaine use, 4) women with low probabilities of all factors. The proportion of women in latent statuses characterized by a high probability of crack/cocaine use did not substantially decrease over time. Women who experienced child sexual abuse, had a greater number of lifetime arrests, were older, and believed they had risky drug using behavior that needed changing at baseline were significantly more likely to be in higher-risk latent statuses. Targeted interventions tailored to crack/cocaine users, as well as a wide-spread need for trauma-informed interventions among females involved in the criminal justice system, are needed.     

Citizen Activism in the Russian Transition

Two American specialists on Russia report the results of two nationwide surveys conducted in that country in 1992 (N = 1,393) and 1993 (N = 1,598). Focus was on rates and types of political activism and their correlation with attitudes toward economic and political reform. Conclusions are that different types of political activism attract different constituencies. People with higher income and occupational status participate in a wide range of activities but are significantly less likely than others to vote. Those with less to gain from the transition are more likely to vote—perhaps a legacy of communism—but take part less in activities which demand high levels of commitment and resources. Journal of Economic Literature Classification Numbers: P29, Jl8.     

Small State Discourses in the International Political Economy

Abstract

This article supports growing calls to ‘take small states seriously’ in the international political economy but questions prevailing interpretations that ‘smallness’ entails inherent qualities that create unique constraints on, and opportunities for, small states. Instead, we argue that discourses surrounding the ‘inherent vulnerability’ of small states, especially developing and less-developed states, may produce the very outcomes that are attributed to state size itself. By presenting small states as a problem to be solved, vulnerability discourses divert attention away from the existence of unequal power structures that, far from being the natural result of smallness, are in fact contingent and politically contested. The article then explores these themes empirically through discussion of small developing and less-developed states in the Commonwealth and the World Trade Organization (WTO), considering in particular how smallness has variously been articulated in terms of what small states either cannot or will not do.     

The Efficacy of Ideographic Models for Geographical Offender Profiling

Objectives

Current ‘geographical offender profiling’ methods that predict an offender’s base location from information about where he commits his crimes have been limited by being based on aggregate distributions across a number of offenders, restricting their responsiveness to variations between individuals as well as the possibility of axially distorted distributions. The efficacy of five ideographic models (derived only from individual crime series) was therefore tested.

Methods

A dataset of 63 burglary series from the UK was analysed using five different ideographic models to make predictions of the likely location of an offenders home/base: (1) a Gaussian-based density analysis (kernel density estimation); (2) a regression-based analysis; (3) an application of the ‘Circle Hypothesis’; (4) a mixed Gaussian method; and (5) a Minimum Spanning Tree (MST) analysis. These tests were carried out by incorporating the models into a new version of the widely utilised Dragnet geographical profiling system DragNetP. The efficacy of the models was determined using both distance and area measures.

Results

Results were compared between the different models and with previously reported findings employing nomothetic algorithms, Bayesian approaches and human judges. Overall the ideographic models performed better than alternate strategies and human judges. Each model was optimal for some crime series, no one model producing the best results for all series.

Conclusions

Although restricted to one limited sample the current study does show that these offenders vary considerably in the spatial distribution of offence location choice. This points to important differences between offenders in the morphology of their crime location choice. Mathematical models therefore need to take this into account. Such models, which do not draw on any aggregate distributions, will improve geographically based investigative decision support systems.     

Perpetration of intimate partner aggression by men and women in the Philippines: prevalence and associated factors

This study uses data from the 2002 Cebu Longitudinal Health and Nutrition Survey to examine the prevalence of and factors associated with intimate partner violence perpetration by husbands and wives in Cebu, Philippines. Multinomial logistic regression was used to identify the factors associated with wife-only, husband-only, and reciprocal perpetration. About 26% of women reported that either they or their partner perpetrated at least one physically aggressive act during the past year, whereas 22% reported sexual coercion by their husband during their relationship. The most common reason cited for hurting the partner was his or her alcohol use, partner nagging, the wife fighting back, and jealousy. In the regression analysis, the wife's alcohol use and violence between the wife's parents were predictors of all three perpetrator groups. The importance of regular church attendance and husband control and dominance varied for the groups. Research and prevention implications are discussed.     

Diesel fumes do kill: a case of fatal carbon monoxide poisoning directly attributed to diesel fuel exhaust with a 10-year retrospective case and literature review*

While it is known that diesel fuel combustion engines produce much lower concentrations of carbon monoxide (CO) than gasoline engines, these emissions could certainly generate lethal ambient concentrations given a sufficient amount of time in an enclosed space and under suitable environmental conditions. The authors report a case of CO poisoning which was initially referred for autopsy as a presumed natural death of a truck driver found in the secure cab of a running diesel tractor trailer truck. Completion of the preliminary investigation ascribed death to complications of ischemic heart disease (IHD), pending toxicological analysis that included quantification of CO. When the toxicology results showed lethal blood COHbg, the cause of death was re-certified as CO intoxication secondary to inhalation of (diesel) vehicular exhaust fumes. Because of the unique source of fatal CO intoxication in this case, the contributory IHD and the possible contaminants in the putrefied blood, a 10-year retrospective review was conducted on all nonfire related CO deaths autopsied (n = 94) at the Office of the Chief Medical Examiner in Louisville, KY from 1994 to 2003. For validation of the COHbg detection method used by the Kentucky Office of Forensic Toxicology (KYOFT), blood samples from these cases along with controls were submitted to three laboratories using various analytical methods yielding no statistically significant differences. Lastly, an extensive literature review produced no scientifically reported cases of fatal CO poisoning attributed to diesel fuel exhaust.     

Examining the effects of paper type, pen type, writing pressure and angle of intersection on white and dark dominance in ESDA impressions of sequenced strokes--an application of the likelihood ratio

Questioned document casework can occasionally involve the sequencing of impressions. Although some conclusions can be drawn from looking at ESDA traces of intersections there is currently no way of assessing the strength of the observations made in any given case. Using a range of paper and pen types this work examines points of intersection and evaluates the results statistically in order judge the value of the results obtained.