Biomedical subjects

David Fine

Publications and source records attributed to David Fine.

4 recordsLinked to original sources

PubMed2003

Legal outcomes of sexual assault.

OBJECTIVE: The study was undertaken to better describe the assault characteristics and examination findings in sexual assault victims who pursue legal action. STUDY DESIGN: A case-control study of consecutive women older than 15 years who came to an urban hospital after sexual assault over a 32-month period was conducted. All the women underwent a standardized history and physical examination by a resident in obstetrics and gynecology. Cases were those in which charges were filed against an assailant by the prosecutors' office. The controls were the women assaulted immediately preceding and after each case. RESULTS: Of the 888 women undergoing evaluation in the emergency department, 132 (15%) had charges filed by the prosecutor. Characteristics positively associated with a legal outcome included being examined within 24 hours after assault, partner/spouse as an assailant, oral assault, and anogenital trauma (P <.05,.01,.05,.05, respectively). Amnesia at the time of assault and/or friend/acquaintance as assailant were negatively associated with a legal outcome (P <.01,.05, respectively). CONCLUSION: Although only 15% of sexual assault cases were resolved with a legal outcome, the data support the importance of a physical examination within 24 hours of the assault. Anogenital trauma is associated with, but not a prerequisite for, a successful legal outcome.

Adolescent↗

PubMed2003

Developing leaders in the real world.

Leatt and Porter present an excellent and timely review of the current leadership challenge in the field of healthcare administration. Their case is assembled through a review of relevant management literature and an adept summarization of current thinking and contemporary needs in the leadership zone of healthcare organizations. This commentator views the authors' thesis through the filters of a 30-year career as a healthcare administration practitioner and educator, the last 20 of which have been as a chief executive officer and concurrent professorial appointee at four universities in the United States. A leadership development paradigm at the UAB Health System is used to demonstrate an application of the lead authors' proposed, career-long development process encompassing graduate, postgraduate, mid-career and senior-executive levels.

Administrative Personnel↗

PubMed2002

Characteristics of sexual assault in women with a major psychiatric diagnosis.

OBJECTIVE: In a previous study of women who had been sexually assaulted, we reported a 26% prevalence of a major psychiatric diagnosis. The purpose of this study was to better characterize sexual assaults in women with a major psychiatric diagnosis. STUDY DESIGN: All female patients >or=15 years old with a complaint of sexual assault underwent a standardized history and physical examination by an upper-level resident in obstetrics and gynecology. Data were abstracted and verified. A psychiatric diagnosis was determined by history and by use of computer-linked medical records. Chi-square or Fisher exact test was used for categoric analysis. RESULTS: Of the 819 women who were examined, 211 women (26%) had a major psychiatric diagnosis. In these 211 women, the prevalence of solely mood, thought, or substance use disorders were 26%, 14%, and 16%, respectively, whereas 44% had >or=2 diagnoses. Having a psychiatric diagnosis was associated with increasing age (P =.001), homelessness (P =.001), and incarceration (P =.001). In comparison with women with no psychiatric diagnosis, sexual assaults in these 211 women occurred more frequently outdoors (P =.007), by a stranger (P <.001), or by >or=2 assailants (P =.02). Being assaulted with a weapon (P =.04) and being hit (P =.01) were more prevalent in assaults against women with a psychiatric diagnosis, as was anal contact (P =.03), contact to >or=2 body orifices (P =.001), and body trauma (P =.01). CONCLUSION: Sexual assaults in women with a major psychiatric diagnosis are common. These assaults are more violent and result in body trauma more frequently than do sexual assaults in women without a psychiatric diagnosis. Prevention and treatment strategies should target this vulnerable population.

Adult↗

PubMed2002

Abnormal vitamin A cytology and mortality in infants aged 9 months and less with measles.

We investigated the relationship between abnormal vitamin A cytology and mortality in infants less than 9 months of age with measles. In a 12-month period, 116 children of this age with measles consecutively admitted to Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi were enrolled in the study. All guardians of patients were interviewed and clinical information and consent were obtained in a standardised fashion. Conjunctival impression cytology (CIC) was attempted on all and collected from 93 (80%) children. The overall mortality was 16%. The proportional hazards model revealed that the presence of pneumonia on admission (hazard ratio 9.58, p = 0.0002) and an abnormal vitamin A CIC on admission (hazard ratio 6.40, p = 0.003) were independently associated with mortality. Our findings suggest a relationship between abnormal vitamin A CIC and fatality in infants under 9 months of age.

Conjunctiva↗