Does parenting mediate the effects of exposure to violence on violent behavior? An ecological–transactional model of community violence

Three waves of longitudinal data from a high poverty sample of 1544 African American youth were used to test an ecological–transactional model of violence. SEM analyses were conducted to determine whether parenting (Time 2) mediated the effects of exposure to violence (Time 1) on violent behaviors (Time 3). Findings supported the specified model. Multigroup SEM analyses indicated that neither family structure nor developmental stage (early versus middle/late adolescence) moderated these effects. However, exposure to violence had a larger effect on violent behaviors in female versus male youth, although the difference was simply in magnitude, not direction. A final model that predicted change scores also provided support for the hypothesized ecological–transactional model of violence.     

Inner-City Child Mental Health Service Use: The Real Question Is Why Youth and Families Do Not Use Services

OBJECTIVE: This study examines pathways to urban child mental health care as well as explores reasons why care was not received. METHODS: A single group longitudinal design was used to study initial attendance rates at an outpatient child mental health clinic and identify factors associated with initial service use for urban children and their families. RESULTS: Approximately one-third of families (n = 82) do not follow up with care despite their child being referred and an initial appointment scheduled. Yet, three-quarters of those who did not attend a first session still wanted services when interviewed. Factors most significantly related to service use were social support and parental skill efficacy. Miscommunication between adult caregiver and provider was the most often cited reason for non-attendance. CONCLUSIONS: There is a significant unmet need for care along with identification of significant barriers to access. Empirical findings can serve as the basis for modifying urban child mental health service delivery systems.     

中国北方城乡两地居民自杀意念、自杀未遂的调查

目的:了解中国北方城乡两地居民自杀意念、自杀未遂的发生率,以及性别之间、城乡之间的差异。方法:采用分层抽样的方法随机抽取北京市区10个居委会和河北武安农村10个村、年龄≥18岁人群共1 000人(城市和农村各500人),实际调查1 007人(城市503人,农村504人);采用自制"公众对自杀的态度问卷"对被试逐项进行调查。结果:被调查的1 007人中,有36人近1年出现过自杀意念,在性别、城乡之间差异无统计学意义(χ2=0.07,χ2=0.11;P均0.05);92人曾经有过自杀意念,在性别之间差异无统计学意义(χ2=0.11,P0.05),但农村显著多于城市(χ2=7.88,P0.05);有6人近1年出现过自杀未遂,18人曾经有过自杀未遂,在性别(χ2=0.72,χ2=0.27)、城乡之间(χ2=0.00,χ2=2.20)差异无统计学意义(P均0.05)。1 007人中有49人的亲属在过去任何时候有过自杀意念,城市显著多于农村(χ2=6.24,P0.05);20人的亲属有过自杀未遂,25人的亲属自杀死亡,城乡之间差异无统计学意义(χ2=0.82,χ2=0.38;P均0.05)。结论:中国北方城乡两地居民自杀意念、自杀未遂的发生率均相对较高,制定相应的自杀预防计划是亟待解决的问题。     

76例无痛性上消化道出血相关因素分析

目的探讨黔东南地区无痛性上消化道出血与病因、性别、年龄、城乡地域差别等相关因素的关系。方法对2004年1月-2006年12月间收治的623例UGB中76例无痛者临床资料进行统计学分析。结果1．胃溃疡、十二指肠球部溃疡、急性胃粘膜病变、慢性胃炎等为无痛性上消化道出血主要病因，消化性溃疡居首位，在活动性出血病因中也占绝大多数。2．男性上消化道出血及无痛者较女性多见，男性中无痛者占12．58％，女性中无痛者占11．29％，P〉0．05。3．青年组上消化道出血中无痛者占8．33％，中年组占10．11％，老年组占20．12％，P〈0．05。4．乡村病员上消化道出血中无痛者占15．62％，城镇病员中占6．19％，P〈0．05。结论消化性溃疡是无痛性上消化道出血的最主要病因。病因、性别、年龄、城乡差别等为无痛性上消化道出血的相关因素。     

Menstrual regulation and contraception in Bangladesh: Competing or complementary?

To examine the relationship between menstrual regulation (MR) and subsequent use of contraception in Bangladesh, we studied the birth control practices of a 6-month cohort of 4359 family-planning acceptors in a family-planning clinic in Dacca. We compared their use of birth control measures before and after MR. We attempted to examine the subsequent pregnancy and induced-abortion rates of 1671 of these women through a 3-year non-concurrent prospective study. Of those 1172 made their first visit to the clinic to obtain an MR and the remaining 499 women, who served as a comparison group, made their first visit to obtain contraceptive services not associated with MR. Three years' followup data were available for 558 women in the MR group and 228 women in the comparison group. Based on these data, the 3-year pregnancy rate for the MR group was 37.6/100 women and the induced abortion rate was 4.3/100 women. The 3-year pregnancy rate for the comparison group was 39/100 women and the induced abortion rate was 3.5/100 pregnancies. Thus, during a 3-year period women in the MR group did not obtain abortions significantly more often than women in the comparison group.     

'Opportunity structures': urban landscape,social capital and health promotion in Australia

This paper presents data from 40 in-depth interviews that were conducted as part of a study of social capital and health in relation to people's perceptions of the influence of 'place' on their participation levels and health. These data were used to examine features of the western suburbs of Adelaide that were perceived as health damaging and health promoting. The paper demonstrates that our Australian suburban respondents expressed a considerable concern about these features and the impact they have on their perception of community and their ability to participate in it. Safety, connectedness to the area, the reputation of an area and the extent and nature of community facilities are all seen as important to a healthy community. The research found that in the more deprived socioeconomic areas within the study area, there was a significant degree of dissatisfaction with features of the urban environment, such as availability of amenities, provision of public transport, and proximity of industry to private dwellings. The paper concludes by considering certain features of urban environments that might make them more supportive of health through encouraging contact between people. We conclude that these environments could be improved using the following measures: a subsidy scheme to support the viability of local shops and cafés (thereby providing meeting places and employment); parks with facilitators (who could play a role in increasing safety in the park but also encouraging community development); attractive places to walk; and a general environmental improvement program.     

Risk factors for deaths in under-age-five children attending a diarrhoea treatment centre

Few case-control studies have examined possible risk factors for diarrhoeal deaths in under-age-five children in the developing countries. We analysed data from the surveillance system of our diarrhoea treatment centre/hospital for the period 1990-94 on 928 children less than 5 years of age. In univariate analysis, 11 factors were significantly associated with death: lack of breastfeeding, severe malnutrition, complicated diarrhoea, pneumonia, xerophthalmia, duration of diarrhoea 7-14 days, moderate or severe dehydration, recent history of measles, Shigella flexneri infection, maternal illiteracy, and very low household income. Rotavirus diarrhoea was negatively associated with fatal outcome. In the assessment of severe malnutrition, weight-for-height measurement discriminated mortality risk better than weight-for-age or height-for-age indices. Only two factors retained their significance, severe malnutrition and non-breastfeeding in the multivariate analysis with adjusted odds ratio (95% confidence interval) of 84.2 (9.1, 775.9) and 4.2 (1.3, 13.2) respectively.     

Pelvic infections following gynecologic procedures in Bangladesh

Data were collected to establish the rate of pelvic infection following various gynecologic procedures, including postpartum intrauterine device (IUD) insertions, IUD insertion following menstrual regulation procecures, IUD insertion in women who were not recently pregnant, and induced and spontaneous abortions. The pelvic infection rate was only 1% in 97 women who underwent postpartum IUD insertions. The infection rate was related to the timing of IUD insertion and the type of IUD used. Finally, the pelvic infection rate was unacceptably high (10.3%) in women undergoing induced abortions vs. women having spontaneous abortions (1.1%).     

Mood disorders and urban/rural settings

Background A review of the main large-scale mental health surveys does not give full support to the idea of urbanicity as a risk factor in mood disorders. Lack of agreement between findings can be attributed, at least in part, to heterogeneous operationalisation of urbanicity, as different ways to define urban and rural areas are likely to lead to different morbidity rates and to have an effect on the respective weight of other risk factors.Methods A total of 2,638 subjects sampled from two French regions (Basse-Normandie and Ile-de-France) were interviewed using face-to-face parts of the Composite International Diagnostic Interview covering demographic and certain life event questions. Urbanicity was defined according to (1) official index based on population density or (2) type of dwelling. Participation rates were 85 and 79%.Results When gender, age, marital status and certain early life events, such as being placed in an institution, as well as events concerning close family members are entered into a logistic regression, the urbanicity association with DSM-IV MDE and especially severe forms disappeared. This finding tends to support the theory that what happens to individuals is more relevant to depression than the place where they live.Conclusion It may be wiser to rely on social indicators than on a rural/urban component for planning for mental health care in the various areas; this remark should not prevent to evaluate the topographic situations of the diverse settings to take them into account to provide appropriate resources.