Domestic violence begets other problems which physicians must be aware to be effective

Article Abstract:

In addition to the physical damage that women receive in violent relationships, they also experience severe attacks on their emotional health. Violence can lead to physical illness and various psychologic problems. Escalating violence often makes the victim feel isolated from the resources that could help relieve the problem. Physicians historically have dealt only with the wounds and injuries that these women suffer, and have tended to turn away from the underlying problem of domestic abuse. Physicians excuse this behavior by claiming it is not deferring action to the police or to psychiatric specialties. It is only recently that the enormous number of individuals affected by violence have been carefully assessed. In a 1981 national survey, 26 percent of respondents admitted to being involved in violence the previous year, and up to 60 percent of couples reported being exposed to violence from their spouse at some time. Another study estimated that 50 percent of all adult women experience violence from their spouse or other men with whom they live. A projection of the size of the problem in the United States would indicate that as many as 12 million couples are at risk for abuse, and 20 million adult married woman are at risk for abuse. Some studies have indicated that 22 to 35 percent of all women seeking treatment for injuries are victims of spouse abuse. In addition, approximately 33 percent of abused woman suffer from depression, 26 percent of women who attempt suicide are victims of violence; 10 percent of battered woman are drug abusers, and 16 percent are abusers of alcohol. Physicians are advised to acknowledge the violence and assure the patient that many women are in the same situation. Education on resources and protective measures provided by the community is important. While it is difficult, and perhaps painful, for both patient and physician to confront domestic violence, discussion can actually bring significant relief. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Health aspects, Care and treatment, Injuries, Abused women, Family violence, Domestic violence, Wife abuse, Conjugal violence

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National morbidity data have their beginnings in offices of private practice physicians

Article Abstract:

The Public Health Service needs accurate, rapid reporting of infectious diseases by physicians, but the Service finds compliance with its needs highly variable. All states and territories of the US participate in a morbidity surveillance program, which tracks 49 infectious diseases and reports them to the Centers for Disease Control (CDC) in Georgia. The CDC is totally dependent on front-line physicians for data. However, many physicians do not know the reporting requirements or methods for their states, as revealed in a 1984 study of New York physicians. Severe or newly emerging diseases are best reported, as are those for which primary prevention (vaccination) is available. Other diseases may not be reported, and some, such as cases of mild food poisoning from Salmonella, never even reach the physician for treatment. While this may not matter for such illnesses, it is important for some. Chickenpox is an under-reported disease, which should be reported. Since a chicken pox vaccine may soon be approved, knowledge of the incidence of the disease will be important to assess the vaccine's effectiveness. Under-reporting also leads to inaccurate estimate's of disease prevalence among certain groups, such as AIDS (acquired immunodeficiency syndrome) among hispanics. Techniques of reporting now include a computer-based telecommunication system and the compilation of the CDC's Morbidity and Mortality Weekly Report. Standardized definitions for reportable diseases have also been formulated. Accurate data are essential to monitor and eradicate infectious diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Reports, Diseases, Demographic aspects, Information services, Communicable diseases, United States. Centers for Disease Control and Prevention, Public health records

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Cholesterol 'war': dietitians, physicians team up

Article Abstract:

Since the release of recommendations from the National Cholesterol Education Project advocating dietary changes that would reduce the amount of fat and cholesterol consumed by Americans, dietitians have been increasingly sought out by physicians to help with patient care. The Project's 1988 report suggests that a registered dietitian become involved if patients cannot reduce their cholesterol levels after three months of trying to improve their diets. As many as 84 million people have cholesterol levels higher than 200 milligrams per deciliter, the point above which the level is considered elevated. Dietitians have noticed a pronounced increase in the number of patients and physicians who consult them; the old approach, in which a physician hands a patient a printed diet, is simply not effective, according to professionals. Linda Van Horn, an Associate Professor of Community Health and Preventive Medicine, believes that change has already occurred. Few people have dramatically elevated cholesterol (above 500 milligrams per deciliter). Medical students are more aware of diet than in previous generations. Most of the country's 50,000 dietitians work in hospitals, while approximately one-fifth have private practices. Their total number is expected to increase by one-third during the 1990s. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Employment, Control, Blood cholesterol, Diet therapy, Hypercholesterolemia, Dietitians

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