Sexual victimization in adolescent girls (age 15–20 years) enrolled in post-mandatory schools or professional training programmes in Switzerland

An analysis of data from the Swiss Multicenter Adolescent Survey on Health was conducted to assess the prevalence of a history of sexual victimization among a national sample of adolescent girls enrolled in schools or professional training, to estimate the number of associated psychosocial health problems, and to gain information on the effects of disclosure of the experience. A representative sample of 9268 adolescents answered a written questionnaire on health and lifestyle. Of the 3993 participating girls, 18.6% reported an experience of sexual victimization. The burden of associated psychosocial health problems was considerable, notably as regards depression, suicidal behaviour and substance misuse. Preliminary findings on the relation of disclosure and mechanisms of learned helplessness stress the need for more research on this issue. The results stress the importance of prevention programmes for adolescents and preadolescents, of physicians' awareness and training for screening and appropriate counselling, and of easy access to professional support.     

Clinical outcomes and maternal perceptions of an updated model of perinatal care

BACKGROUND: Postpartum hospital stays seem likely to remain limited even under new laws which mandate that insurers cover 48-hour hospitalization after uncomplicated delivery. Clinicians, who are increasingly practicing in capitated arrangements, need better information to maximize clinical benefit to mothers and newborns using finite resources. OBJECTIVE AND INTERVENTIONS: This study's aim was to evaluate the clinical outcomes, patient perceptions, and costs of a revised model of perinatal care services. In this model, a new postpartum care center was established for routine follow-up of newborns within 48 hours after hospital discharge, educational efforts were shifted from the postpartum hospitalization to the prenatal period, and lactation consultant hours were increased. DESIGN AND PARTICIPANTS: Controlled, nonrandomized (double cohort) study that compared mothers and newborns with hospital stays of 48 hours or less during the Baseline Care (preintervention) study period (N = 344) with those under the Revised Care (postintervention) study period (N = 456). SETTING: The Hayward, California, medical center of Kaiser Permanente, a nonprofit health maintenance organization. DATA COLLECTION: Telephone interviews were attempted with all mothers 3 weeks after delivery. Data on rehospitalizations, emergency department (ED) and clinic visits, and costs during the first 14 postpartum days were collected from computerized databases and chart review. OUTCOME MEASURES: The combined clinical outcome was defined as any undesirable health event, including rehospitalization, an ED visit, or an urgent clinic visit by either the mother or newborn within the first 14 days postpartum, or breastfeeding discontinuation within the first 21 days postpartum. Maternal satisfaction and costs were also studied. RESULTS: Of 876 attempted interviews, 800 were completed (91%). Analyses were adjusted for age, race, education, parity, breastfeeding experience, and other relevant variables. Among the interviewed mother-newborn pairs, 45% in the Revised Care group experienced the combined clinical outcome, compared with 52% in the Baseline Care group. Newborns in the Revised Care group (29%) were significantly less likely to make urgent clinic visits during the first 14 days of life than those in the Baseline Care group (36%). There were no differences between groups in newborn ED visits or rehospitalizations, maternal clinical outcomes, or breastfeeding continuation. Mothers in the Revised Care group expressed higher satisfaction with the newborn's care, the amount of information they received about newborn care and breastfeeding, and the amount of help they received with breastfeeding. Planned hospital care, planned follow-up visits, and unplanned care costs decreased by $149 per delivery, while the new prenatal class and increased lactation consultant services cost $58 per delivery, for an estimated overall reduction in cost. CONCLUSIONS: We conclude that the revised model of perinatal care in this health maintenance organization medical center improved clinical outcomes and maternal satisfaction for low-risk mothers and newborns without increasing costs.     

The preliminary study on HMBA-induced differentiation of the drug-pretreated murine erythroleukemia cells

Several drug-resistant variants have been developed by growing the parental MEL cells in presence of colchicine, adriamycin and vincristine respectively with stepwise increasing concentration. Both the colchicine-resistant Sc9(Co10) and vincristine-resistant Sc9(VCR5) cells displayed an accelerated HMBA-induced commitment to terminal cell differentiation, whereas the adriamycin-resistant SC9 (A120) showed no acceleration but rather a substantial delay in HMBA-induced differentiation. The studies provide more clues as well as experimental models for further study on the mechanism of induced differentiation of MEL cells.