PubMed Health⌕ Search

Biomedical subjects

E De Vos

Publications and source records attributed to E De Vos.

16 recordsLinked to original sources
PubMed1997

Barriers to physician identification and treatment of family violence: lessons from five communities.

Since the Surgeon General's Workshop on Violence and Public Health (Leesburg, Virginia, October 27-29, 1985), a substantial literature has developed about the limitations of the health care response to family violence. Many contributions have reflected experiences in limited numbers of practice settings (e.g., a single emergency department or hospital). Until 1990, however, there had been no community-based studies. The Robert Wood Johnson Foundation asked a multidisciplinary team from Education Development Center, Inc. and Children's Hospital (Boston) to investigate the health care responses to family violence in five diverse communities. This qualitative study, comprising more than 480 interviews, provided a vivid picture of the barriers facing physicians and other health care providers in identifying, treating, and referring victims of family violence. It also illuminated the relations of the health care systems in these communities with other key sectors, including agencies and the judiciary. The key findings from the five-city study remain relevant because (1) it is the only large-scale, multi-community-based assessment of the barriers facing physicians; (2) it identified, or in some cases confirmed, both institutional and educational barriers limiting the effectiveness of even the most committed physicians; (3) it identified, or in some cases confirmed, specific areas of knowledge, attitudes, and skills development that should be incorporated in medical education; and (4) its conclusions continue to be reflected in subsequent contributions to the literature. In each of these ways, therefore, it informs the other articles in this supplement.

Aged↗
PubMed1995

Criminal justice outcomes of prosecution of child sexual abuse: a case flow analysis.

This study examined the progress and disposition of child sexual abuse cases referred for prosecution in four urban jurisdictions. Most cases were accepted for prosecution. The vast majority of cases carried forward for prosecution resulted in guilty pleas. Only 9% of the total sample went to trial. A majority of the small number that went to trial were convicted. Over 3/4 of those convicted were incarcerated. The rate at which cases were carried forward for prosecution and convicted was comparable to that of a national sample of felony arrests overall, but child sexual abuse cases were more likely to go to trial (p < .005) and received more severe sentences (p < .005). Our results are strikingly consistent with those from previous studies of prosecution of child sexual abuse. A new understanding of prosecution of child sexual abuse is recommended that takes into account the large proportion of cases that do not go to trial.

Adolescent↗
PubMed1994

Prosecution of child sexual abuse: which cases are accepted?

This study examined the relationship of case characteristics, maternal support, and child psychopathology to acceptance of child sexual abuse cases for prosecution. Cases referred to prosecutors' offices over a 1-year period in four urban jurisdictions (N = 431) were examined, and a smaller sample of mothers and children (N = 289) were interviewed as well. Background characteristics of the perpetrator and victim, severity of abuse, and nature of available evidence were all significantly related to acceptance for prosecution. Specific independent predictors of acceptance were victim age, presence of oral-genital abuse, use or threat of force, duration of abuse, and presence of physical or eyewitness evidence. With other variables controlled, maternal support was higher and child internalizing psychopathology lower in accepted cases. The results are interpreted in terms of prosecutors' concern for serving justice and protecting children and their perceptions of their ability to prosecute cases successfully.

Adolescent↗
PubMed1994

The Intervention Stressors Inventory: a measure of the stress of intervention for sexually abused children.

This paper describes the development and initial validation of the Intervention Stressors Inventory (ISI), a new scale designed to measure the level of stress sexually abused children experience as a result of societal intervention. Estimates of the relative stress level of various interventions were obtained from 98 professionals; a police interview was the designated anchor with a score of 50 points. Resulting scores from the survey included 35 points for social worker interview, 100 points for placement in foster care, and 111 points for testimony in criminal court. Factors that could potentially modify the stress of any given event were also considered. Interviews with 254 sexually abused children and their parents, 9 months after their cases were reported, provided an opportunity to examine the validity of the instrument. Weighted scores for each child were generated based on their experiences. Validity was supported by higher scores for older children, varying patterns of scores in different jurisdictions and a decline in scores over the one-year period in which jurisdictions were actively seeking to reduce the intrusiveness of intervention. Early results suggest that the ISI is useful as a research tool and as a guide in our efforts to reduce the trauma of intervention.

Adolescent↗
PubMed1993

Molecular cytogenetic analysis of a familial pericentric inversion of chromosome 12.

We describe the application of multi-color fluorescence in situ hybridization (FISH) in the characterization of a familial pericentric inversion. Using chromosome 12 short- and long-arm specific DNA probes, fast and reliable discrimination between normal and inversion chromosome 12 or recombinant inversion chromosome 12 was possible. FISH thus provides a reliable means for prenatal detection of balanced or unbalanced chromosome 12 rearrangements in this family. This approach is possible for identification of similar chromosome rearrangements provided that probes for the putatively involved chromosome region are available.

Adult↗
PubMed1992

Asymmetric action in the human newborn: sex differences in patterns of organization.

We developed a procedure and scale to quantify movement asymmetry in 36 full-term newborns from several normal newborn nurseries (Measure of Behavioral Laterality, MOBL). The majority of newborns had elicited reflexes and spontaneous movements that were stronger and more coordinated on the right than on the left side of the body; there was no asymmetry in the latency, threshold, or habituation of these behaviors. Although asymmetry of different movements was associated if they relied on the same motor pool, there was little association of movement asymmetries among different body regions, indicating that multiple subsystems, rather than a single asymmetric system, controls asymmetric action in the newborn. Finally, there was a sex difference in asymmetry of all 3 distal lower-body elicited reflexes: females were right biased, but the majority of males were left biased. These sex differences are discussed in terms of alternative mechanisms for the development of asymmetric action and the role of newborn reflexes in adult voluntary movement.

Female↗
PubMed1989

Victimization of mothers of abused children: a controlled study.

To search for indicators of violence against mothers of child abuse victims by husbands or boyfriends, the women's medical records were reviewed and compared to records of mothers of a nontraumatized child comparison group. Of the 32 children ascertained in a 6-month interval, the records of mothers of 19 (59.4%) were diagnostic or highly suggestive of current or previous victimization. Although the prevalence of documented violence against the mothers of children in the comparison group was an unexpectedly high 16%, the case-control difference was highly significant (P less than .001). Although differences were found in the (younger) ages and (higher) parity of mothers of abused children, these differences did not predict risk of mothers' exposures to violence in a multivariate analysis. The rate of violence against single mothers of child abuse victims, however, was four times the rate against mothers who were married (P = .022). These findings suggest a need to broaden the diagnostic conceptualization of child abuse to include maternal victimization and argue for including data concerning maternal risk in formulating diagnoses and disposition plans for abused children.

Adolescent↗
PubMed1988

What residents know about child abuse. Implications of a survey of knowledge and attitudes.

Residency training programs are the appropriate milieu in which physicians should receive specialized training in the diagnosis and management of child abuse. The purposes of the present study were to assess and compare residents' knowledge of child abuse and their attitudes toward the propriety of different forms of childhood discipline. We surveyed 192 residents from seven different training programs with questionnaires probing their knowledge of child abuse and their attitudes toward childhood disciplinary measures; 161 (84%) of the questionnaires were satisfactorily completed by residents in pediatrics (n = 87), family medicine (n = 51), and surgery (n = 23). Both pediatric residents and family medicine residents outperformed surgery residents in one subscale and the total score on the test. Scores were not related to year of training or attitudes toward childhood discipline but were correlated with self-reports of previous child abuse teaching. Residents' performance on a childhood disciplinary measure demonstrated wide latitude in their rating of the acceptability of 23 different modes of childhood discipline. Our findings indicate a need for a more systematic approach to residents' education in childhood intentional injuries and some value clarification of their attitudes toward various forms of childhood discipline.

Attitude of Health Personnel↗
PubMed1988

Abuse and victimization: a life-span developmental perspective.

A conceptualization of coping and adaptation following victimization is presented from a life-span developmental perspective. Recovery is characterized as an evolving process of interaction among three dimensions: social cognition, environmental sensitivity, and emotional-behavioral functioning. The model is illustrated through an individual case study and through an approach to research on outcomes of sexual victimization.

Adaptation, Psychological↗
PubMedDate not supplied

Evaluation of a hospital-based youth violence intervention.

To decrease adolescent morbidity and mortality and improve the quality of life, a violence-prevention consultation is offered to hospitalized victims of nondomestic violence. The context is a violence-prevention team approach to patient assessment, treatment, and follow-up. Psychoeducational counseling emphasizes the individual through a cognitive behavioral approach and also recognizes the individual in the proximal social setting through referrals to community resources. The in-hospital component draws on the health beliefs model, self-efficacy, the theory of reasoned action and their synergy with cognitive mediation theory as expressed in developmental psychology. The target group for the intervention is adolescents (12-17 years of age) who have been victims of violent assaults severe enough to warrant treatment at a Level One trauma center. The six steps in the intervention are to (1) review and assess the incident, (2) review the patient's conflict-resolution strategies and introduce nonviolent alternatives, (3) provide information on the prevalence of violence/homicide and determine the patient's risk status, (4) explore the patient's coping skills and support system, (5) develop a plan to stay safe, and (6) refer patient to services for follow-up activities. Approximately 15 study participants are identified each month, half of whom are randomly assigned to receive the intervention. Over the 12-month recruitment interval, approximately 180 adolescent patients will be identified. Baseline data are collected through hospital intake procedures and chart reviews. A battery of standardized measures supplemented by a brief structured, closed-ended interview is collected four months after the youths leave the hospital. Preliminary baseline data for 39 youths are reported. The "typical" youth is a 16-year-old African-American male. Even though nearly one third of victims had been shot, the typical patient was injured in a fight during which he was kicked, bitten, or beaten with or without a blunt instrument. The majority of incidents involved only one attacker who was known to the victim. Nearly half the injuries were precipitated by an argument or fight. No statistically significant differences between intervention subjects and nonintervention controls in terms of baseline variables have been observed. For inner-city adolescent victims of violent assaults, a hospital-based intervention offers a unique opportunity for reduction of the incidence of reinjury. We describe the elements of the intervention, including the theoretical basis and implementation; detail the overall evaluation design including modifications; and present preliminary analyses of baseline data.

Adolescent↗