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A JAMA THEME ISSUE
Edited by Thomas B. Cole, MD, MPH, and Annette Flanagin, RN, MA
Although clinicians are encouraged to screen women for intimate partner violence (IPV), whether screening reduces violence or improves health outcomes is unclear. To investigate these questions, MacMillan and colleagues Article from the McMaster Violence Against Women Research Group randomly assigned women who presented for primary care to receive screening for IPV before seeing a clinician (who would be informed of a positive screen result) or to receive screening after their clinician visit. At an 18-month follow-up, no significant differences in subsequent IPV or quality-of-life scores between groups was found. In an editorial, Moracco and Cole Article discuss the effectiveness of screening and intervention to prevent IPV.
In an analysis of data from the World Trade Center (WTC) Health Registry, a longitudinal cohort study of persons exposed to the September 11, 2001, terrorist attack on the WTC, Brackbill and colleagues found that acute and prolonged exposures were associated with new diagnoses of asthma and symptoms of posttraumatic stress—5 to 6 years after the attack.
In a prospective population-based cohort study of community-dwelling elderly individuals, Dong and colleagues Article examined the relationship between suspected self-neglect or elder abuse reported to a social service agency and all-cause mortality. They found that a report of either condition was associated with an increased risk of mortality. In an editorial, Gill Article discusses the challenges posed by elder self-neglect for the health care system and social service agencies.
Millions of Cambodians experienced profound trauma during the Khmer Rouge era and efforts to prosecute Khmer Rouge leaders through a joint United Nations—Cambodian tribunal (the “Khmer Rouge trials”) are under way. In a national probability survey of adult Cambodians, Sonis and colleagues determined the prevalence of probable posttraumatic stress disorder (PTSD) and associations with perceived justice, desire for revenge, and attitudes toward the trials. They report that probable PTSD is common among Cambodian adults. Most respondents expressed positive attitudes toward the trials, but many feared the trials would conjure painful memories.
Estimates of the mental health needs of those exposed to mass conflict and displacement vary. In a meta-analysis of epidemiologic surveys, Steel and colleagues found that methodological factors of surveys, such as nonrandom sampling, small sample sizes, and use of self-report measures, and substantive risk factors, including exposure to torture and other potentially traumatic events, are associated with higher rates of reported prevalence of posttraumatic stress disorder and depression.
In a meta-analysis of longitudinal data from 23 case-control and cohort studies, Paras and colleagues found a significant association between a history of sexual abuse and lifetime diagnosis of functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain.
“[The load master] told me that Germany was our final stop but that we were dropping equipment in Balid, Iraq, and picking up some ‘fresh meat’ first.” From “Answering the Call of the Wounded Warrior.”
Three featured articles explore this issue's theme of violence and human rights.
PTSD and male-perpetrated intimate partner violence
Hospital surge capacity for mass casualty events
Join John Forman, MD, MSc, Wednesday, August 19, from 2 to 3 PM eastern time to discuss diet and lifestyle risk factors and incident hypertension in women. Register at http://www.ihi.org/AuthorintheRoom. Send questions to firstname.lastname@example.org.
How would you manage a woman with skin cancer who experienced wrong-site surgery? Go to www.jama.com to read the case, and submit a response by August 9 for possible online publication.
For your patients: Information about elder abuse.
This Week in JAMA . JAMA. 2009;302(5):465. doi:10.1001/jama.2009.1134