RESUMEN

OBJECTIVES: To determine the type and severity of discipline practices in rural India and to identify risk and protective factors related to these practices. METHODS: Five hundred mothers, ages 18-50, participated in face-to-face interviews as part of a cross-sectional, population-based survey. One of the mother's children was randomly selected as the referent child. The interview focused primarily on discipline practices and spousal violence. Sociodemographic characteristics, neighbor support, residential stability, and husband's drinking behavior were also assessed. RESULTS: Nearly half of the mothers reported using severe verbal discipline and 42% reported using severe physical discipline. While common, severe discipline practices occurred less frequently than moderate practices and had different risk factors, notably low maternal education and spousal violence. CONCLUSIONS: Results suggest that increased formal education for rural women in India may have the added benefit of reducing family violence, including spouse and child abuse.

Asunto(s)

RESUMEN

This study examined the proportion of women inmates who accepted HIV testing and the sociodemographic, criminal, and HIV-related risk characteristics associated with accepting such testing in a state prison offering voluntary HIV testing. A consecutive sample of 805 women felons admitted to the North Carolina Correctional Institution for Women between July 1991 and November 1992 was interviewed. Of these inmates, 680 (84%) granted permission to access their medical records and had complete information on relevant characteristics. Seventy-one percent of the women inmates accepted HIV testing. In multivariate analysis, the exchange of sex for money or drugs and the conviction for a drug crime were significantly associated with accepting HIV testing. Injection drug use, drug-injecting sex partners, and a history of a sexually transmitted disease were not significantly associated with accepting HIV testing. A prison-based voluntary HIV testing program appears to be reaching a substantial proportion of women inmates potentially at risk for HIV, especially women inmates who exchanged sex for money or drugs.

Asunto(s)

RESUMEN

OBJECTIVE: To measure the incidence of fatal and nonfatal firearm injuries in a rural setting. DESIGN: A prospective, population-based surveillance system using information from medical and legal records, newspapers, and members of the community. SETTING: A rural county in North Carolina. MAIN OUTCOME MEASURES: Incidence rates and case-fatality ratios (fatal:non-fatal). RESULTS: Of the 114 firearm injuries detected by the surveillance system from January 1, 1990, through December 31, 1991, nearly two thirds were nonfatal. The overall age-adjusted annual incidence of firearm injuries was 66.4 per 100 000 population, and the incidence of nonfatal firearm injuries was 41.2 per 100 000 population. Subgroup annual incidence rates were greatest for African Americans. The overall case-fatality ratio was 1:1.8 (fatal:nonfatal). CONCLUSIONS: Incidence rates and case-fatality ratios for firearm injury in this rural setting were greater than expected, based on national estimates, perhaps because of greater proportions of rifle injuries and self-inflicted injuries.

Asunto(s)

RESUMEN

This study examined adolescents' perceptions concerning the presence of guns in their school and the adolescents' emotional and behavioral responses associated with these perceptions. Survey data from 376 African-American sixth, seventh, and eighth grade students of a low-income area of a North Carolina city were studied. Twenty-eight percent of adolescents reported that other students brought guns to school, 36% felt afraid that someone would hurt or attack them while at school, 15% avoided school (or places in school) because of fear that a student would hurt or attack them, and 20% carried weapons to school for self-protection. Logistic regression analyses found that, compared to their peers, adolescents who perceived that their school mates brought guns to school were almost twice as likely to experience fear while at school, were more than three times more likely to exhibit school avoidance behavior, and were more than twice as likely to bring a weapon to school themselves for self-protection. Educators and school health professionals are urged to work together to address these problems concerning school safety.

Asunto(s)

RESUMEN

Although much has been written about the importance of collaboration among physicians in practice-based research, the relationship between the clinical investigator and nonphysician professionals in this setting has received less attention. Nurses, physician assistants, and other office support staff can provide valuable insights pertinent to research design and project implementation. Because nonphysician professionals frequently play a large part in implementing a research project, how well the investigator collaborates with them often determines the success or failure of the project. We suggest the following guidelines: 1. Consider the research interests of the nonphysician collaborators. 2. Adapt the project to office routine. 3. Limit the demands on staff. 4. Use detailed protocols. 5. Orient all collaborators. 6. Be available and visible. 7. Provide feedback and reward to all collaborators.

Asunto(s)

Asunto(s)

RESUMEN

Firearm injury is the second leading cause of death among teenagers. In this study we examined firearm acquisition and ownership in a biracial cohort of 664 teenagers (313 male and 351 female). Ownership was prevalent among male adolescents (48%) and rare among female adolescents (4%). Among these suburban and rural teenagers, the ownership rate was highest for white male adolescents (56%). Handgun ownership was more frequent among male school dropouts (22%) than enrollees (7%). The first firearm was typically acquired by late childhood or early adolescence (median age, 12.5 years). An adult male family member (eg, father, grandfather, uncle) was the primary source. The prevalence, developmental timing, and sociodemographic correlates of firearm acquisition should be useful for informing preventive clinical practice and interventions.

Asunto(s)