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PubMed1995

Interaction of socioeconomic status and provider practices as predictors of immunization coverage in Virginia children.

OBJECTIVE: To describe the pattern of immunization in the cohort of children who entered public schools in Virginia in 1992. DESIGN: This was a historic cohort study using stratified cluster sampling. Three strata were created based on the socioeconomic status (SES) of the children in the catchment area of each public school in Virginia. SETTING: The random sample included public elementary schools throughout Virginia. PARTICIPANTS: Immunization records were obtained for a randomly selected cohort of 2519 first-grade children in Virginia. OUTCOME MEASURES: Age at completion of recommended childhood vaccines was determined from birth to school entry by SES, race, and population density. Provider practices were assessed by ascertaining missed opportunities for simultaneous administration of vaccinations according to recommended schedules. RESULTS: Although immunization completion rates were high at school entry, low levels of immunization coverage were found in all areas of Virginia at 24 months of age regardless of SES (as measured by per capita income), population density, or race. However, under-immunization was more severe for poor children in urban areas (42.3% of children in low-SES urban areas were age-appropriately immunized at 24 months of age versus 64.0% in children in high-SES rural areas). By multivariate logistic regression, race and gender were not predictors of which children were appropriately immunized at 2 years of age after adjusting for the following: SES, population density, receiving the first DTP (diphtheria, tetanus, and pertussis) or OPV (oral polio) vaccination after 3 months of age, and failure to have the first DTP administered simultaneously with the first OPV or the second DTP administered simultaneously with the second OPV. Receiving the first DTP or OPV vaccination after 3 months of age and failure to have the first and second DTP and OPV administered simultaneously were the strongest predictors of not being age-appropriately immunized at 2 years of age. The effect of failure to vaccinate simultaneously on predicting vaccination coverage at 2 years of age was strongly modified by SES. Children who attended schools located in census tracts with per capita incomes less than $10,600 and who did not have the first and second doses of DTP and OPV administered simultaneously were 33.19 times more likely not to be age-appropriately immunized at 2 years of age compared with children who attended schools located in census tracts with per capita incomes greater than $18,800 and who received the first and second doses of DTP and OPV simultaneously (95% confidence interval: 18.29 to 60.22). CONCLUSIONS: Although beginning the immunization schedule at the recommended age was crucial to appropriate vaccination later in life, provider practices were important predictors of under-immunization. Failure to administer vaccinations simultaneously strongly influenced poorer children in Virginia. Serious delays in vaccine administration were observed not only for poor children in urban areas, but also in all areas of Virginia before school entry.

Child↗
PubMed1985

Virginia Woolf: manic-depressive psychosis and genius. An illustration of separation-individuation theory.

Virginia Stephen was a member of one of England's great literary families, many of whom were also mentally ill. An exquisitely endowed infant, she was beautifully matched with her mother during the symbiotic state of development, and later called this period "the base upon which life stands." Difficulties presumably began as early as the differentiation subphase of separation. Mrs. Stephen appeared to be a narcissistic woman, who required constant affirmation, and thus was unable to respond to the needs of a developing child. Virginia probably was rescued from engulfment by a powerful biologically determined practicing period of separation-individuation. This great organismic surge, in all likelihood, is as characteristic of toddlers who are incipient manics as of children of future genius. Because of the strong regressive pull, it is probable that Virginia experienced a particularly high-powered glee in evading the field of her mother. This "economic condition," according to Freud, is a given that is felt by the manic as he overthrows the imprisoning restraints of the superego. Deflated by events beyond her control, such as the sadism of her siblings, Virginia probably attempted to return to her mother. But it appears that Mrs. Stephen was not available. Hence Virginia was forced to split off her anger and turn it against herself, keeping her aggression unavailable for neutralization. As a result she was unable to proceed to an age-adequate level of development. The raw rage lay smoldering within until many years later, when it burst forth to power her manic attacks. This failure of rapprochement presumably deflated Virginia, and resulted in a basic mood of depression already apparent in the nursery. Virginia also experienced a second basic mood, elation, which appears to have been characteristic of her even in well periods, and resembles the description of the typical manic victim given by Beck.

Bipolar Disorder↗
PubMed1986

Virginia Woolf and Leslie Stephen: a father's contribution to psychosis and genius.

Leslie Stephen, the father of Virginia Woolf, was a cacophony of contradictions. From all accounts, he was a bully, a manipulator, and a blustering, pessimistic, emotionally dishonest man. Although he could be lovable, charming, whimsical, encouraging, and deeply devoted to his family, he subjugated the adult women in his household and at least one son to exploitation and abuse, demanding (and receiving from his wife and step-daughter) almost total abnegation of self. Julia Stephen, in contrast, was an optimistic, seemingly selfless person, who characteristically presented herself in an "up" mood to the world. Virginia incorporated both parental moods into her character structure, as have a number of the author's cyclothymic patients. Therefore, it is postulated that pessimism and habitual deflating affronts on the part of one parent, in combination with a compulsive "good mood" on the part of the second parent, are a particularly lethal combination of character traits, which in their offspring may contribute to the rapid mood shifting characteristic of manic depression. In contrast to Julie, Stephen was a presence who could not be side-stepped. This combination of sweet and monstrous attributes in her father's nature, and again in the contrasting temperaments of the parental couple, must have been impossible to integrate for the small Virginia, who already was desperately engaged in the struggle for selfhood. She could not complete her development on the oedipal level, although she loved her father dearly, because identification with her mother meant further threat to an identity already weakened at the separation-individuation phase of development. Virginia's solution was to identify with her father in his character, his sexual identity, and his profession. Stephen, who was particularly devoted to Virginia, whom he regarded as an extension of himself, encouraged this identification, and served as her teacher and mentor. In that sense, he truly was the captain of the ship in her voyage To the Lighthouse, master of the currents that swept her onward to the grand light of her genius. A four-fold comparison of Virginia Woolf and Leslie Stephen is made concerning their respective ages of weaning, success in navigating both the rapproachment phase of separation-individuation and the oedipal period, and the ages at which their mothers died. It appears that Virginia lost her mother at those four critical periods when Leslie did not.(ABSTRACT TRUNCATED AT 400 WORDS)

Creativity↗
PubMed2006

Assessment of pharmacy manpower and services in West Virginia.

BACKGROUND: The shortage of pharmacists across the nation has been much publicized and has been identified as one of the reasons for new schools of pharmacy to open or for existing colleges and schools of pharmacy to increase their class sizes. This article represents the assessment of a new school of pharmacy's evaluation of staffing and practice in its geographic area. OBJECTIVE: This survey represents the first data point within the School of Pharmacy assessment plan and will be repeated at several intervals after the program opens to longitudinally evaluate its impact on pharmacy staffing and services within West Virginia. METHODS: Using a modified Dillman survey methodology a random sample of 548 pharmacists in West Virginia, approximately one-third the active roster, were surveyed regarding staffing and services in West Virginia. RESULTS: A response rate of 32.78% was achieved and findings indicated that there is a staffing shortage of pharmacists within West Virginia, that staffing impacts the services pharmacists provide, and that more pharmacists would be willing to offer disease management services if staffing levels were at appropriate levels. CONCLUSIONS: A shortage of pharmacists does exist in West Virginia and it has implications on patient care. Longitudinal evaluation of the impact of a new pharmacy program will be conducted and the staffing and services within West Virginia should be continued to be studied.

Female↗
PubMed1999

The Virginia generalist initiative: lessons learned in a statewide consortium.

In response to Virginia's need for an increased supply of generalist physicians, the state's three medical schools--Eastern Virginia Medical School, Virginia Commonwealth University School of Medicine, and the University of Virginia School of Medicine--have formed a partnership with key governmental stakeholders in the Virginia Generalist Initiative funded by The Robert Wood Johnson Foundation's Generalist Physician Initiative. These state-supported medical schools historically have functioned independently, with little cooperative effort. This paper describes the consortium, its activities, its successes, and its unmet objectives, and uses a series of cases in point to illustrate relevant lessons learned. Some of these lessons are that (1) stakeholders must be involved from the beginning of planning to identify mutual goals and establish consortium protocols; (2) all partners must share a philosophical commitment to the consortium's mission, as well as the time and resources needed; (3) an atmosphere that enables risk-taking behavior must be created; (4) stakeholders must be willing to revise goals and sustain an environment conductive to change; and (5) trust is essential and must be vigilantly maintained. The paper concludes that the Virginia Generalist Initiative has dramatically altered the goals, objectives and programs of the three schools and has succeeded in aligning the schools' strategic objectives with the state's priorities.

Databases as Topic↗
PubMed2005

The need for an organized approach for Government Medical Insurance Programs in the Commonwealth of Virginia.

The Commonwealth of Virginia has a disorganized approach to enrolling their retired faculty in Medicare Supplement Insurance Programs. An organized approach to establishing Medicare Supplemental Insurance for retired University faculty should include the following administrative changes to correct this potential health-care crisis for retired state faculty members. First, the ombudsman for human resources for the state universities must receive educational programs that prepare the retired faculty members over the age of 65 to select the corporate insurance policy from Anthem Blue Cross/Blue Shield Insurance Company. Included in this educational program should be a review of the Advantage 65 Member Handbook. Second, they must point out to the faculty member that they are receiving a CORPORATE insurance policy rather than an individual insurance policy from Anthem Blue Cross/Blue Shield Insurance Company. They must provide the telephone numbers of the Anthem Blue Cross/Blue Shield offices in Roanoke, Virginia. Concomitantly, they must send the name and address of the faculty member to the Commonwealth of Virginia Department of Human Resource Management. They should inform the faculty member that the Commonwealth of Virginia Department of Human Resource Management will be sending them newsletters that outline any changes in the corporate insurance policy that they coordinate with the Anthem Blue Cross/Blue Shield Insurance Company. The Commonwealth of Virginia Department of Human Resource Management must take on some new responsibilities in their efforts to coordinate health-care coverage of the retired faculty over the age of 65. First, they must have a computer registry of all corporate health-care policies of the individual faculty members to ensure that newsletters are being sent to them. Ideally, this agency should have a computerized system that allows it to send out its newsletter update by email to those retired faculty members who have computers. They should urge the faculty members to initiate an automatic check payment withdrawal from their bank so that the premiums from their corporate insurance policy can be paid promptly to Anthem Blue Cross/Blue Shield Insurance Company. Whereas the universities and the Commonwealth of Virginia Department of Human Resource Management are making these responsible changes, Anthem Blue Cross/Blue Shield Insurance Company must undertake innovative changes in their corporate health-care policy to assist the retired faculty member. For instance, they must list on the insurance card that the faculty member has a corporate policy. Like the United Health Insurance Company, it would be advisable to offer a 2-5% reduction in the cost of the corporate insurance policy if the faculty member begins an automatic premium payment agreement through their bank. This insurance discount would be an added incentive for the faculty member to do automatic payments through their bank.

Aged↗
PubMed1998

Prevalence and distribution of QPX, Quahog Parasite Unknown, in hard clams Mercenaria mercenaria in Virginia, USA.

In July 1996, the Virginia Institute of Marine Science initiated a sampling program to examine wild and cultured hard clams Mercenaria mercenaria for QPX, Quahog Parasite Unknown, a protistan parasite associated with severe mortalities of hard clams in localized areas in maritime Canada and Massachusetts, USA. The sampling program set out to seasonally monitor wild clams from one site, James River, Virginia, and cultured clams from 2 sites, Chincoteague Bay and Mattawoman Creek, Virginia. Histological examination of initial samples revealed 8% prevalence of the parasite in 1-2 yr old cultured clams in Chincoteague Bay. This is the first documentation of QPX in Virginia. To ascertain the distribution of the parasite in Virginia, the survey was expanded between August 1996 and July 1997 to include 16 additional sites. A total of 1305 wild and cultured clams was sampled from Chesapeake Bay tributaries and coastal areas where harvest and culture occur. QPX was not found in Chesapeake Bay, but was present in cultured clams from 3 coastal embayments--the original Chincoteague Bay site, Burton Bay and Quinby Inlet. The parasite was found in Chincoteague Bay at each sample period at prevalences ranging from 8 to 48%. Infections were generally light to moderate intensity and were most often observed in mantle and gill tissues. The maximum prevalence was observed in May 1997 and coincided with notable clam mortalities. QPX prevalences at the other sites were low, ranging from 4 to 15%. To date QPX has not had a significant impact on Virginia's hard clam fishery and aquaculture industry; however, the presence of the pathogen in 3 of the state's most productive hard clam growout areas warrants continued monitoring and research.

Animals↗
PubMed2000

Evaluating provider prescribing practices for the treatment of tuberculosis in Virginia, 1995 to 1998: an assessment of educational need.

BACKGROUND: Although the use of epidemiologic studies to demonstrate learning needs appears to be infrequent, this study addressed the discrepancies in the prescribing practices for the initial treatment of tuberculosis in Virginia between public and private clinicians, comparing them with the treatment regimens recommended by the Centers for Disease Control and Prevention and the American Thoracic Society (CDC-ATS). METHODS: Data examined were the 1995 to 1998 reported cases of tuberculosis within the Commonwealth of Virginia. The study population consisted of 770 laboratory-confirmed tuberculosis cases, living in Virginia, whose isolates were tested for isoniazid susceptibility and were prescribed an initial drug regimen. Prevalence rates, prevalence odds ratios, and logistic regression were used to determine the estimated risk for receipt of the CDC-ATS treatment regimen. RESULTS: Of the 770 cases, 28.7% did not receive the CDC-ATS recommended drug regimen. Prevalence rates and odds for not receiving the recommended regimen were highest among persons of United States origin, Caucasians, females, persons under age 15, and persons from the southwest region of Virginia. Logistic regression indicated a slight increase in the estimated risk of not receiving the CDC-ATS regimen from a private physician (OR: 1.40; CI: 0.97, 2.04) when compared to a public physician. FINDINGS: Private tuberculosis care providers were less compliant with CDC-ATS guidelines than public tuberculosis care providers. Because providers did not follow the recommended treatment guidelines universally, it is advised that all tuberculosis care providers in Virginia would benefit from increased education regarding adequate treatment regimens for tuberculosis and the prevention of multidrug-resistant tuberculosis.

Adolescent↗
PubMedDate not supplied

Sexual assault in Virginia: A population-based study.

PURPOSE: Sexual assault is a serious social problem that affects the lives of many women, men, and children. Most sexual assaults are not reported to authorities and most victims do not seek services. As a result, accurate statistics on the prevalence and incidence of this problem are difficult to obtain. As in many states, the magnitude of sexual assault in Virginia is not known. This study was conducted to estimate the prevalence and determine the correlates of sexual assault among women in Virginia. METHODS: A cross-sectional telephone survey was conducted among adult female residents of Virginia between November 2002 and February 2003. A total of 1,769 women aged 18 and older were interviewed using a random digit dialing method. RESULTS: The lifetime prevalence of sexual assault in Virginia was 27.6%. The majority (65%) were rape victims with a prevalence of 17.8%. Approximately 78% of the victims reported that the sexual assault occurred for the first time when they were children or adolescents. Women who reported sexual assault were more likely to be between 35 and 44 years old (OR = 3.57; 95% CI = 2.06-6.15), divorced/separated/widowed (OR = 1.61; 95% CI = 1.13-2.30), consume alcohol four or more times a week (OR = 1.80; 95% CI = 1.01-3.21), ideate suicide (OR = 4.48; 95% CI = 3.23-6.23), and perceive their health status to be poorer (OR = 2.74; 95% CI = 1.30-5.83). CONCLUSION: Sexual assault is a major public health problem in the Commonwealth of Virginia and children are disproportionately affected by the problem. Interventions and prevention programs should focus on children and adolescents.

Adolescent↗
PubMedDate not supplied

Changes in number and distribution of community and ambulatory pharmacies in Virginia from 1994 to 1999.

OBJECTIVE: To determine whether market changes have resulted in a decrease in the number or geographic distribution of pharmacies available to ambulatory patients in Virginia. DESIGN: Retrospective review of Virginia Board of Pharmacy records of pharmacy registrations in 1994 and 1999. SETTING: The Commonwealth of Virginia. PARTICIPANTS: All pharmacies classified as outpatient pharmacies (including community and other types of ambulatory pharmacies) and operating in Virginia in 1994 and 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Changes in the total number, geographic distribution, and metropolitan/nonmetropolitan distribution of outpatient pharmacies between 1994 and 1999. RESULTS: The total number of outpatient pharmacies increased from 1,290 to 1,337 between 1994 and 1999. Chain pharmacies, mass merchandiser, and grocery pharmacies increased in number while independent pharmacies declined. There was little change in the geographic or metropolitan/nonmetropolitan distribution of pharmacies. CONCLUSION: Changes in the number and distribution of community and other ambulatory pharmacies in Virginia have not diminished their availability to consumers.

Pharmacies↗
PubMed1990

Epidemiology of Lyme disease in Virginia.

Prior to January 1986, only one case of Lyme disease was reported from Virginia. In 1986-87, however, the Virginia Department of Health observed an increase in reports of suspected Lyme disease by physicians, despite the fact that Ixodes dammini is not highly prevalent in the Virginia tick population. Twenty-eight cases of Lyme disease were identified in Virginia, of which eight cases occurred in 1986 and 20 in 1987. Lyme disease appears to be increasing in frequency in Virginia and moving southward along the Eastern Atlantic Seaboard.

Adolescent↗
PubMedDate not supplied

Hurricane Isabel-related mortality--virginia, 2003.

BACKGROUND: Hurricane Isabel had a massive negative environmental, public health, and economic impact; Virginia bore the highest death toll (32) among nine states affected by this storm. A descriptive mortality analysis was conducted to identify modifiable risk factors and corresponding injury prevention measures that might mitigate future natural disaster-related morbidity and mortality in Virginia. METHODS: Information for the decedents, including demographic data, health status, and injury circumstances, was collected from the records of the Virginia Office of the Chief Medical Examiner and Office of Vital Records/Health Statistics. Criteria from the National Hurricane Center were used to classify deaths as direct or indirect. Storm assessments and emergency-response reports were also reviewed. RESULTS: A total of 32 deaths associated with Hurricane Isabel occurred in several densely populated localities in southeastern and central Virginia. The median age of decedents was 48 years (range: 7-85 years). A disproportionately higher mortality (21 [66%] of 32) occurred among persons older than 45 years (Virginia 2000 Census data). Twelve deaths were directly caused by environmental factors related to the storm (eg, seven drowning deaths and five traumatic head injuries from falling trees). Twenty deaths were indirectly associated with the storm and its effects: six fatal motor vehicle crashes, five related to clean-up operations, seven associated with power outages, and two stress-related (ie, myocardial infarction and suicide). The presence of alcohol or drugs was observed in 9 (28%) of 32 deaths. CONCLUSIONS: Classifying deaths as direct or indirect facilitates better target interventions on the basis of the identification of modifiable risk factors underlying hurricane-associated fatal injuries. Public education messages that reinforce avoidance of use of alcohol and drugs during natural disaster situations might reduce risk for injury.

Adolescent↗
PubMedDate not supplied

Developing a web-based data mining application to impact community health improvement initiatives: the Virginia Atlas of Community Health.

This article describes how a team from the Virginia Department of Health (VDH) and the Virginia Center for Healthy Communities (VCHC) attended the UNC Management Academy for Public Health to learn skills to address Virginia's commitment to using technology to improve the public's health. After creating a business plan for a food-safety information Web site, team members used that experience as well as Management Academy training in information technology, the management of data and finances, and strategic partnering to create a comprehensive tool with which to place customizable population data in the hands of anyone interested in pursuing population health improvement. The Virginia Atlas of Community Health, launched through the VCHC in 2003, places clear, compelling data in the hands of those who can influence decisions at the local level and create the most impact for health. Since the program's inception, more than 2,000 individuals have registered as ongoing users of the Virginia Atlas. Initially funded by a Turning Point grant from the Robert Wood Johnson Foundation, the program is sustained through a series of smaller grants and funding from the VDH.

Atlases as Topic↗
PubMed1998

A common DLX3 gene mutation is responsible for tricho-dento-osseous syndrome in Virginia and North Carolina families.

Tricho-dento-osseous syndrome (TDO) is characterised by a variable clinical phenotype primarily affecting the hair, teeth, and bone. Different clinical features are observed between and within TDO families. It is not known whether the variable clinical features are the result of genetic heterogeneity or clinical variability. A gene for TDO was localised recently to chromosome 17q21 in four North Carolina families, and a 4 bp deletion in the human distal-less 3 gene (DLX3) was identified in all affected members. A previous genetic linkage study in a large Virginia kindred with TDO indicated possible linkage to the ABO, Gc, and Kell blood group loci. To examine whether TDO exhibits genetic heterogeneity, we have performed molecular genetic analysis to determine whether affected members of this Virginia kindred have the DLX3 gene deletion identified in North Carolina families. Results show that affected subjects (n=3) from the Virginia family have the same four nucleotide deletion previously identified in the North Carolina families. A common haplotype for three genetic markers surrounding the DLX3 gene was identified in all affected subjects in the North Carolina and Virginia families. These findings suggest that all people with TDO who have been evaluated have inherited the same DLX3 gene deletion mutation from a common ancestor. The variable clinical phenotype observed in these North Carolina and Virginia families, which share a common gene mutation, suggests that clinical variability is not the result of genetic heterogeneity at the major locus, but may reflect genetic heterogeneity at other epigenetic loci or contributing environmental factors or both.

Abnormalities, Multiple↗
PubMedDate not supplied

A study of the future practice location intent of family medicine residents in West Virginia.

Recruitment of graduating family medicine residents into practice in rural West Virginia has been hampered by many factors. A cross-sectional survey was done to obtain the opinions of family medicine residents in West Virginia in 1996 in order to characterize their perceptions regarding certain aspects of their rural training and the relative importance of various factors influencing their future practice location intent. There was a positive association between cumulative resident experience and intent to practice in West Virginia and in rural areas. Perceived preparation for rural practice varied with educational area. There was significant variation in the relative importance of recruiting factors for likelihood of practice in West Virginia and in rural areas. Some recruiting factors tended to be positive or negative discriminators for intent to practice in West Virginia and in rural areas. Enhanced recruitment may be aided by an active community involvement which addresses the identified relevant factors.

Choice Behavior↗
PubMed2000

The effectiveness of resource allocation methods used by RWCA Title II Consortia in Virginia.

The authors sought to determine the following: (1) How rigorous are the current resource allocation methods used by Virginia's five regional Ryan White CARE (Comprehensive AIDS Resources Emergency) Act Title II consortia? (2) How useful are existing databases in allocating resources? (3) Is it feasible to introduce a standardized performance measurement approach for state-level assessment of consortia effectiveness? The authors reviewed proposals and progress reports from each of the consortia to the Virginia public health agency; they then visited each of the consortia to solicit information to refine the study questions and to review the consortia's databases. The authors reviewed the literature on existing models used to allocate resources, and surveyed members of the Virginia consortia about how they used various resource allocation tools, how effective these tools were, and how ready the consortia were to be evaluated regarding resource allocation. The authors found no uniform process for the allocation of Title II funds in Virginia. Consortia members who felt connected and involved with their consortium were significantly more knowledgeable about its operations and more likely to consider it effective. A consortium's use of a continuous quality improvement (CQI) approach to allocating resources was strongly associated with its members' perception that the consortium was effective. Statewide performance and/or outcome measures cannot be set without some standardized expectations for performance. To do this, some expectations for basic resource allocation procedures must be established. Three of Virginia's five consortia will make use of this study's instrumentation in their next resource allocation processes, and, if their experiences are useful, a statewide process may be established. If a statewide process is established, regional consortia must continue to be able to determine local needs and to respond with locally appropriate service planning.

Adult↗
PubMedDate not supplied

ATV-related deaths in West Virginia: 1990-2003.

During the 14-year period from 1990-2003, West Virginia experienced 220 deaths related to All Terrain Vehicles (ATVs). Death rates in West Virginia however, were significantly higher than the national rate or those of any of the its five surrounding states. About 25% of the West Virginia deaths occurred in children less than 18 years of age. Ninety-five percent of the victims were not wearing helmets and 15% were passengers. Nearly one-third of the ATV crashes occurred on public roads, streets, and highways--surfaces on which ATVs are not designed nor recommended to be used. The cost of ATV-related deaths is estimated to be over dollar 100 million annually. The number of non-fatal injuries resulting from ATV crashes is difficult to ascertain because of a lack of a centralized and standardized state-based surveillance mechanism. The 44 states that have some level of ATV safety requirements have a collective death rate half that of states, like West Virginia, who do not have ATV safety requirements. Due to the continuing public health burden caused by ATV deaths and injuries, as well as their associated costs, it is important that West Virginia policymakers pass strong ATV safety legislation during the current session.

Accidents, Traffic↗
PubMed1996

Family violence education in medical school-based residency programs--Virginia, 1995.

In the United States, family violence (e.g., intimate partner violence, child abuse, and elder abuse) is a well-documented social and public health problem that physicians are uniquely positioned to play a crucial role in addressing. However, few schools of medicine or residency training programs provide substantial attention to family violence in their curricula. To assess the status of graduate medical education regarding family violence at Virginia's three medical schools (eastern Virginia Medical School [EVMS], Medical College of Virginia [MCV], and the University of Virginia [UVA]), the Task Force on Violence Education and Awareness for Physicians, established by the Virginia Commission on Family Violence, conducted a survey of these medical schools in 1995. This report summarizes the results of the survey, which identified variations in the formal programs to address family violence at these schools.

Curriculum↗