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PubMed1995

The association between weapon carrying and the use of violence among adolescents living in and around public housing.

PURPOSE: To test the hypothesis that adolescents who carry lethal weapons are more likely to engage in violent behavior than adolescents who do not carry weapons. DESIGN: Cross-sectional Survey. SUBJECTS: Black adolescents (N = 225) from a lower socioeconomic (SES) background living in or around nine Housing and Urban Development housing projects. MEASUREMENTS: An anonymous questionnaire containing scales from the CDC Youth Risk Behavior Survey and Self-Reported Delinquency Questionnaire was administered. Data were analyzed with Spearman rho correlation coefficients (r), followed by partial correlation coefficients controlling for age and gender. RESULTS: Thirty-five percent of males and 16% of females reported carrying a weapon during the previous 30 days. Frequency of weapon-carrying was correlated (r = .33, p < or = 0.0001). with the frequency of physical fights in the last month, but the relationship was stronger among males than females. Weapon-carrying was also associated (r = .20, p < or = 0.003) with frequency of receiving a serious injury during a fight and the frequency of attacking someone with a weapon with the idea of seriously hurting or killing them (r = .48, p < or = 0.0001). Although males were more likely to carry a hidden weapon than females, the frequency of weapon-carrying was more highly correlated with the frequency of carrying a hidden weapon by females (r = .63, p < or = 0.0001) than males (r = .49, p < or = 0.0001). Females who carried weapons were more likely than males to be involved in gang fights. Among males (r = .27, p < or = 0.008), frequency of weapon-carrying was correlated with frequency of attacking someone with whom they lived. This was not so among females (r = .02). CONCLUSION: These data support the hypothesis that the lower SES black adolescents in this sample who carried weapons were more likely to engage in violent behaviors than those who did not carry weapons.

Adolescent↗

PubMed2004

Surgeon workhours in the era of limited resident workhours.

BACKGROUND: Resident workhours have received much attention, yet there is little information concerning faculty workhours. In addition, the perspectives of surgical faculty on the anticipated effects of reducing resident hours have not been studied. STUDY DESIGN: An anonymous survey was distributed to all clinical faculty in the Departments of Surgery, Neurosurgery, Orthopaedics, and Otolaryngology at a single, large academic institution. Surgeons completed a detailed retrospective report of hours worked during a 1-week period. Opinions regarding resident workhour restrictions were also elicited. Chi-square or Student's t-tests were used to determine p values as appropriate, with p </= 0.05 considered significant. RESULTS: Of 120 surveys distributed, 102 (85%) were returned. Subspecialty departments comprised 51% of respondents with 49% from general surgeons. The mean number of hours worked per week by faculty was 70.4 +/- 12.5 (SD) (73.8 +/- 14.1 for general surgeons versus 67.1 +/- 9.9 for subspecialists, p = 0.006), with only 44.1% having at least 1 day per week free from clinical duties. Up to 95% of general surgeons are paged overnight at least once per week (mean 13.6 +/- 11.2 calls/week), with 73% returning from home at least once during the week (mean 1.8 +/- 1.1 returns/week). Importantly, 84% of general surgeons believe reducing resident workhours will increase faculty hours, compared with 57% of subspecialists (p = 0.004). In addition, 87% predict that reducing resident hours will compromise surgical education, with only 11% believing the benefits of hour reduction will outweigh the negatives. CONCLUSIONS: The recommended limit for resident workhours closely approximates the average number of hours worked by surgical faculty in an academic center. Despite this, significant concern exists among the majority of surgical faculty regarding the impact of resident workhour restriction, both on faculty workhours and on resident education.

Attitude of Health Personnel↗

PubMed2004

Stress and coping among orthopaedic surgery residents and faculty.

BACKGROUND: Evaluations of physicians and residents have revealed concerning levels of psychosocial dysfunction. The purposes of this study were to determine the quality of life of orthopaedic residents and faculty and to identify the risk factors for decompensation. METHODS: Twenty-one orthopaedic residents and twenty-five full-time orthopaedic faculty completed a 102-question voluntary, anonymous survey. The survey consisted of three validated instruments, i.e., the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale; and three novel question sets addressing background and demographic information, stress reaction and management, and the balance between work and home life. Descriptive statistics, pairwise correlations, simple t tests, and Pearson and nonparametric Spearman correlations were calculated. The simple correlation coefficient was used to assess bivariate relationships. RESULTS: The mean overall quality-of-life score, on a scale of 0 to 4 points, was 2.5 points for residents compared with 3.6 points for faculty members. Residents reported considerable burnout, showing a high level of emotional exhaustion and depersonalization and an average level of personal achievement, whereas faculty reported minimal burnout, showing a low level of emotional exhaustion (p < 0.0003), an average level of depersonalization (p < 0.0001), and a high level of personal achievement (p < 0.0001). Only two of twenty-five faculty members (compared with seven of twenty-one residents) scored over 4 points on the General Health Questionnaire-12, indicating significant symptomatology (p < 0.01). The majority of subjects reported that a partner or spouse showed nondistressed levels of marital adjustment and satisfaction. All residents and nine of the twenty-five faculty members had mentors but judged the resource to be minimally beneficial. Resident burnout and psychiatric morbidity correlated with weekly work hours; conflict between the commitments of work and home life; discord with faculty, nursing staff, and senior residents; debt load; and work-related stress. Protective factors included being a parent, spending time with a spouse, having a physician father, and deriving satisfaction from discussing concerns with colleagues, friends, and family. CONCLUSIONS: In pursuit of our goal of determining the quality of life of orthopaedic residents and faculty, we identified a large disparity between the two groups. The resident group reported much greater levels of dysfunction particularly with regard to burnout and psychiatric morbidity. Furthermore, with regard to our second goal; our data revealed a number of risk factors for resident decompensation, most notably, increased workload, high debt levels, and discord with superiors. In addition, our research revealed that the current support interventions by the residency program, including mentoring and facilitation of spousal adjustment, are viewed as being of little help.

Adaptation, Psychological↗

PubMed2004

Living with HIV in New Zealand: balancing health and quality of life.

AIM: This paper characterises the health and wellbeing of HIV-positive people in New Zealand. METHODS: The HIV Futures New Zealand Survey is a self-complete anonymous questionnaire distributed in a variety of ways. Data were collected on health, clinical, and social variables. RESULTS: There were 226 responses, estimated to be approximately 25% of the HIV positive population. Respondents were aged between 18 and 68, and 56% were homosexual men. Most (68%) reported a viral load on most recent test of below 500 copies/mL and 59% had a CD4 lymphocyte count on most recent test of over 250 cells/mcL. However, 28% reported a major health condition in addition to HIV and 21% had a mental health condition. Most respondents (64%) were currently using antiretroviral therapy. Many (84%) knew other people with HIV and had contact with an HIV/AIDS organisation (77%). Forty-two percent of respondents had stopped working because of HIV, and 47% reported their main source of income as a Government benefit. CONCLUSIONS: This research has demonstrated that, while the HIV-positive population of New Zealand generally has improved health as a result of antiretroviral therapy, there are still significant social and economic barriers to their quality of life.

Anti-Retroviral Agents↗

PubMed1995

HIV infection among women undergoing abortion in Montreal.

OBJECTIVE: To determine the seroprevalence and correlates of HIV infection in a subpopulation of women of childbearing age in Montreal. DESIGN: Anonymous unlinked seroprevalence study. SETTING: Pregnancy termination unit in a teaching hospital in Montreal. PARTICIPANTS: Women presenting for abortion from July 1989 to June 1993 who resided in Quebec and were not known to have HIV infection; 12,017 (99.6%) of 12,068 eligible women were included in the study. INTERVENTION: HIV antibody testing of serum left over from samples obtained for routine Rh typing; the same algorithm as for serodiagnostic testing, namely enzyme immunoassay (EIA) followed by confirmatory testing of repeatedly EIA-reactive samples, was used. OUTCOME MEASURES: HIV serostatus by age, marital status, region of residence (metropolitan Montreal versus other), country of birth and number of living children. RESULTS: Most (84.7%) of the subjects resided in metropolitan Montreal. The median age was 27.0 (range 13 to 50) years. The serum samples of 22 women were confirmed to be HIV positive, for an overall seroprevalence rate of 1.8 per 1000 (95% confidence interval 1.1 to 2.8). The seroprevalence rate did not vary significantly by age, marital status, region of residence or study year. However, it was strongly correlated with country of birth: Canada 0.16, Haiti 23.5, HIV-endemic countries other than Haiti 5.3 and non-HIV-endemic countries other than Canada 0.0 per 1000. The seroprevalence rate among women born in Haiti was 147 times higher than that among women born in Canada (p < 0.0001). Of the women born in Haiti the rate was 3.0 times greater among those who immigrated to Canada in 1985 or later than among those who immigrated earlier (p = 0.047). CONCLUSIONS: The results of this study indicate that the HIV seroprevalence rate among women in Montreal is strongly associated with country of birth, women born in HIV-endemic countries, especially Haiti, having the highest rate. These results will help in the development of policies regarding HIV antibody testing and prevention of HIV transmission in Quebec.

Abortion, Legal↗

PubMed1994

Desire to treat HIV-infected patients: similarities and differences across health-care professions.

OBJECTIVES: To determine attitudinal predictors of health-care providers' willingness to treat HIV-infected patients. We also tested the hypothesis that differences between dental and medical students in their expressed desire to treat HIV-infected patients result from differences in their clinical exposure to bloodborne pathogens and their clinical training. DESIGN: A cross-sectional design was used to administer a self-report questionnaire format to preserve subject anonymity. METHODS: A questionnaire was used to assess attitudes, knowledge, and behavior associated with the care of HIV-infected patients. Both bivariate statistics and logistic regression techniques were used to determine factors related to the desire to treat HIV-infected patients. RESULTS: Compared with dental students, medical students expressed a greater desire to treat HIV-infected patients. However, the attitudinal predictors of a desire to treat were similar across both groups. The two most important predictors were the degree to which respondents perceived a personal risk of HIV exposure and their sense of professional obligation to treat all patients. Furthermore, knowledge levels were unrelated to desire to treat. CONCLUSIONS: These results suggest that educational interventions aimed simply at increasing a provider's knowledge of HIV may not be effective in changing behavior.

Adult↗

PubMed1993

[Possibilities of quality assurance in ambulatory rehabilitation].

Formal, structurally determined quality requirements (for medical and non-medical staff, space and equipment, respectively) are supplemented by guidelines that are able to inform about the actual course of rehabilitation. Not only externally controlled medical reports on the treatment are suited for this, but also inquiries of patients comparisons between sickness insurances (for example on duration of inability to work, need for hospital measures of rehabilitation) and the comparison with patients who did not take part in ambulant rehabilitation. A report system has to be built up that pictures the clientele of the "reha"-institution, measures changes and documents results a long-term basis. The proposed periodical tests and final test serve not only for the control of patient progress in each single case with information for the practitioner, but also give financial committees hints on the efficiency of the work of the institutions for rehabilitation. Continuous attendance is proposed with a report system and scientific evaluation, whose results are sent concisely but anonymous by to the contract partners on a quarterly basis. A committee for quality assurance discusses new developments and improves ambulant rehabilitation.

Ambulatory Care↗

PubMed1993

Rapid assessment of human immunodeficiency virus seroprevalence in a community-based hospital.

BACKGROUND: To aid in development of patient testing policy, in-service education, and resource planning, it is necessary to have a useful and meaningful tool for determining the population-specific HIV seroprevalence rate for our hospital patients. We were offered by the Centers for Disease Control a newly developed survey tool: "Rapid Assessment of HIV Seroprevalence in Hospital Patients." We subsequently served as one pilot site for this tool. METHODS: A population-based sample of 1000 patients (500 inpatients, 500 outpatients) was stratified into age and sex groups on the basis of admission statistics from the previous year in a general community hospital system in southeastern Pennsylvania that consists of two clinical campuses: an urban site with 343 beds and a suburban site with 506 beds. The study was conducted as an anonymous, unlinked screening for HIV antibody in 1000 serum samples. RESULTS: We found our overall seroprevalence rate to be 2.60% (Poisson 95% confidence interval, 1.77% to 3.81%), or 1 in 38 patient specimens. The highest rates for both sexes were found in the age range 25 to 44 years. CONCLUSIONS: This protocol is a useful survey tool for community hospitals to determine the HIV seroprevalence rate in patient populations, a practical necessity for planning and education. Survey results would aid in implementation of current Centers for Disease Control guidelines for HIV testing of inpatients and outpatients in the acute care hospital setting.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Pathogenesis and prevalence of variant Creutzfeldt-Jakob disease.

In the late 1980s and early 1990s, there was widespread exposure of the UK population to bovine spongiform encephalopathy (BSE)-contaminated food products, which has led to over 150 deaths from variant Creutzfeldt-Jakob disease (vCJD). Although the pathogenesis in humans is not fully understood, data from animal models and, to a lesser extent, patients with vCJD suggest that oral exposure to BSE is rapidly followed by accumulation of PrP(res) in gut-associated lymphoid tissue, then, after haematogenous spread, throughout the lymphoreticular system. Spread to the central nervous system may not occur for several years, but blood from individuals in the pre-clinical phase appears to be able to transmit disease. The incidence of vCJD has remained low and is in decline, but it is known from iatrogenic CJD and kuru that human prion disease can have incubation periods of up to 40 years. Cases of vCJD are therefore likely to occur for many more years and alternative phenotypes may develop in individuals with different PRNP genotypes to those seen to date. Studies in transgenic mice have shown that sub-clinical infection is frequent following oral exposure to BSE and a study looking at the accumulation of PrP in anonymized human lymphoid tissue samples found positive cases. There are likely to be a number of asymptomatic 'carriers' of disease within the UK and although it is unclear whether these individuals will develop clinical disease, there is a potential for iatrogenic spread to others. These uncertainties highlight the importance of developing a reliable blood test for vCJD and the continued need for surveillance.

Animals↗

PubMed2000

Absence of linkage for bone mineral density to chromosome 12q12-14 in the region of the vitamin D receptor gene.

Polymorphisms in the region of the gene for the vitamin D receptor (VDR) (chromosome 12q12-14) have been associated with differences in bone mineral density (BMD) in some studies but not in others. Because linkage analysis assesses allele sharing identical-by-descent among relatives instead of the association of a particular allele of an anonymous marker, we have performed a linkage study for bone BMD using microsatellite markers flanking the VDR locus. The present study explores whether or not relatives who share the chromosomal region containing the VDR gene have more similar bone density. Participants in the Framingham Osteoporosis Study (aged 37-89 years) who had undergone BMD testing were used to test for concordance of genotype with phenotype in the hip (femoral neck, Ward's area, trochanter) and lumbar spine (L2-L4) with adjustment for covariates. Multipoint quantitative trait linkage analysis using variance components methods was conducted with microsatellite markers flanking the VDR locus (GATA91H06, GATA5A09, GGAT2G06) in 332 extended families containing 1062 individuals with both bone density measures and marker data. In addition, quantitative trait sib-pair linkage analysis, with a marker (AFM345xf1) in close proximity to the VDR locus, was performed in a second sample of 169 sibships (n = 413), comprising 284 full-sib pairs. Neither analysis revealed evidence for linkage of this region to femoral neck, Ward's area, lumbar spine, and trochanter in age or sex BMI, and height-adjusted bone density measures. Additional adjustment for alcohol intake, caffeine consumption, smoking status, and estrogen supplement (female only) did not alter the results. The present study could not demonstrate linkage of BMD to chromosome 12q12-14. These findings suggest that neither the VDR gene nor other genes at this locus are likely to have a substantial impact upon bone density.

Absorptiometry, Photon↗

PubMed2006

Evaluation of a school-based HIV/AIDS educational intervention in Ukraine.

PURPOSE: To assess changes observed in knowledge, attitudes toward people living with human immunodeficiency virus (HIV), self-efficacy and behavioral intentions of senior secondary school students after an HIV/AIDS (acquired immune deficiency syndrome) educational intervention in Vinnitsa, Ukraine. METHODS: A quasi-experimental, nonequivalent control group design with pretest-posttest components was employed. Two secondary schools (intervention and control) were randomly assigned to the study. A random sample of the 15-16-year-old students (100 participants in each school) completed anonymous self-reported pre- and postintervention questionnaires. In addition, a three-month follow-up questionnaire was administrated in both schools to assess the longevity of the intervention outcomes. Outcome scale scores were compared between the two groups on baseline, first, and second posttests separately. We used the Pearson chi-square test for categorical data and a t-test for difference in mean scores. RESULTS: After intervention we observed significantly higher knowledge, attitudes, and self-efficacy scores among students in the intervention school than in the control school (96.2 +/- 6.2 [SD] vs. 82.6 +/- 8.3, respectively, p < .01; 24.4 +/- 4.4 vs. 21.7 +/- 4.8, respectively, p < .01; 21.9 +/- 2.6 vs. 20 +/- 3.8, respectively, p < .01). As a result of the intervention, we also report significantly higher proportions of students in the intervention school than in the control school who would not intend to use alcohol and narcotics and who intend to use condoms (p < .01). CONCLUSIONS: Our AIDS education program was able to considerably improve students' knowledge, attitudes and self-efficacy, and promoted positive changes in participants' behavior intentions; it should therefore be extended to more schools to multiply its effects. However, in the context of evaluation, studies with actual HIV-risk behavior outcomes are urgent for Ukraine.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Emergency medicine residency applicant educational debt: relationship with attitude toward training and moonlighting.

OBJECTIVES: Heated debate persists regarding the role of resident moonlighting in emergency medicine (EM). The attitudes of EM residency applicants have not been assessed. The objectives of this study were to assess: 1) the level of educational debt among EM residency applicants, 2) their perception of increased risk potential to patients from unsupervised EM resident practice, and 3) their opposition to laws restricting moonlighting. The authors then report the relationship between the degree of indebtedness and these stated positions. METHODS: Fifty-four EM residency programs returned 393 responses to a 1996 anonymous survey. Applicants recorded: 1) their indebtedness, 2) whether they believed that EDs should hire only physicians who have completed full training in an EM residency, and 3) whether they believed that unsupervised EM practice prior to completing EM training carries a higher risk of adverse patient outcomes. The authors used a t-test and logistic regression to determine whether there was any significant difference in debt between responders who answered yes and those who answered no to the various questions. A p-value < 0.05 was considered significant. RESULTS: The mean +/- SD debt was $72,290 +/- 48,683 (median $70,000). Most EM applicants (84.8%) agreed that unsupervised medical care by EM residents carries a higher risk of adverse patient outcomes. Paradoxically, only half the applicants opposed a moonlighting ban. Responses did not statistically correlate with educational debt. CONCLUSIONS: Emergency medicine residency applicant debt is large. The EM applicants' opposition to laws that would restrict moonlighting was mixed. This was inconsistent with the majority acknowledging an increased risk potential to patients. Nearly all EM applicants would still select EM as a career, even if moonlighting were to be banned.

Adult↗

PubMed1999

Postmarketing surveillance based on electronic patient records: the IPCI project.

Researchers claim that data in electronic patient records can be used for a variety of purposes including individual patient care, management, and resource planning for scientific research. Our objective in the project Integrated Primary Care Information (IPCI) was to assess whether the electronic patient records of Dutch general practitioners contain sufficient data to perform studies in the area of postmarketing surveillance studies. We determined the data requirements for postmarketing surveillance studies, implemented additional software in the electronic patient records of the general practitioner, developed an organization to monitor the use of data, and performed validation studies to test the quality of the data. Analysis of the data requirements showed that additional software had to be installed to collect data that is not recorded in routine practice. To avoid having to obtain informed consent from each enrolled patient, we developed IPCI as a semianonymous system: both patients and participating general practitioners are anonymous for the researchers. Under specific circumstances, the researcher can contact indirectly (through a trusted third party) the physician that made the data available. Only the treating general practitioner is able to decode the identity of his patients. A Board of Supervisors predominantly consisting of participating general practitioners monitors the use of data. Validation studies show the data can be used for postmarketing surveillance. With additional software to collect data not normally recorded in routine practice, data from electronic patient record of general practitioners can be used for postmarketing surveillance.

Family Practice↗

PubMed1991

Benzoylecgonine (cocaine metabolite) detection in hair samples of jail detainees using radioimmunoassay (RIA) and gas chromatography/mass spectrometry (GC/MS).

Benzoylecgonine (BE) was detected in hair samples using nonproprietary extraction methodology and modifications of well-established radioimmunoassay (RIA) screening/quantitative gas chromatography/mass spectrometry (GC/MS) confirmation procedures. Samples collected anonymously from a population of 48 jail detainees weighed between 5.3 and 61.2 mg. All of the 22 hair samples which had RIA results indicating the presence of BE or immunologically similar substances above a cutoff amount of 1.25 ng/sample (50 ng/mL) were confirmed by GC/MS. Several varieties of hair color and texture were tested, although in each general category there were samples which contained BE as well as other samples which did not reveal detectable amounts of BE. The range of concentrations in 22 hair extracts that screened positive were 0.26 to 18 ng/mg hair as determined by GC/MS. In comparison with other reports of cocaine-related substances in hair, these data show consistent concentrations.

Cocaine↗

PubMed2000

[Reproducibility of cytologic diagnosis: study of CRISAP Ile-de-France].

The cervical Pap smear is the method of choice for early detection of precancerous cervical lesions. However, the sensitivity of the Pap smear is not perfect, nor is the specificity, in particular for minor atypia; quality control is the best method to improve the efficiency of the test. The "Centre de regroupement informatique et statistique des données en anatomie pathologique" (CRISAP) Ile-de-France has initiated an external quality control with a protocol aimed at assessing diagnosis reproducibility among observers. Thirteen pathologists agreed to participate on a voluntary basis fur this protocol, which consisted of the rereading of 650 slides chosen at random. Each participant reread 50 cases and sent 50 cases to be reread anonymously. The diagnosis was given according to the Bethesda classification. The reproducibility was assessed using the percentage of agreement and kappa statistics. The percentage of agreement for the whole group was 65% and the weighted kappa 0.66. When normal and unsatisfactory cases were combined as negative and atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LGSIL) and high-grade squamous intraepithelial lesion (HGSIL) as positive, the percentage of agreement was 83% and Kappa 0.66. When normal, unsatisfactory and ASCUS were combined as negative and LGSIL and HGSIL as positive, the percentage agreement raised to 90% and kappa to 0.76. This attempt at assessing the reproducibility of cytologic diagnosis using an informal method had led to good participation among participants. A fairly good agreement for overall cytologic diagnosis was found, though some variability remained concerning the diagnosis of unsatisfactory and those labelled as ASCUS. These results should lead the participants to reflect upon and eventually reassess their criteria on these specific cases.

Female↗

PubMed1996

Diagnostic assessments in patients with invasive cancer of the cervix: a national patterns of care study of the American College of Surgeons.

Using a standard collection form designed by a multidisciplinary committee of specialists, cancer registrars at 703 hospitals submitted anonymous data on 11,721 patients with cervical cancer diagnosed during 2 study years, 1984 and 1990. Information concerning the initial use of diagnostic assessments was analyzed with respect to the potential influences of clinical stage, patient age, race/ethnicity, insurance status, and modalities of therapy employed. Estimates of the yield of diagnostic information for each test were correlated with clinical stage and patient age. Judged by the number of procedures performed, the intensity of pretreatment assessment declined between 1984 and 1990. Substantially increased use of the newer body imaging modalities (computerized axial tomography and magnetic resonance imaging) with high probabilities of revealing abnormalities attributed to cancer, balanced major declines in utilization of procedures historically important in staging and assessment (cystoscopy, proctoscopy, barium enema, excretory urography (intravenous pyelogram), bone scintography, and lymphangiography). Race/ethnicity and insurance status had no discernible independent impact on the intensity of diagnostic evaluation. Patients with more advanced clinical stages underwent more extensive testing, as did patients treated initially with radiation compared to surgery. Periodic review of assessment strategies would seem prudent to avoid widening discrepancies between sanctioned staging formalisms with endorsed and authorized appraisals and actual clinical practice.

Adult↗

PubMed2002

A social learning theory comparison of the sexual victimization of adolescent sexual offenders and nonsexual offending male delinquents.

OBJECTIVE: This paper tests hypotheses based on Garland and Dougher's (1990) formulation of the "victim to victimizer" relationship which is a social learning theory etiological approach to adolescent sexual offending. METHOD: Two hundred sixteen adolescent sexually victimized sexual offenders and 93 adolescent sexually victimized nonsexual offending delinquents from three Michigan sexual offender treatment facilities participated in an anonymous cross-sectional survey regarding their sexual victimization and offending as well as a social desirability measure. RESULTS: When comparing the two groups, nonsexually offending delinquents and sexually offending delinquents, the latter were found to have: closer relationships with their perpetrators; a higher chance of having a male perpetrator(s); a longer duration of sexual victimization; more forceful sexual victimization; and the experience of penetration as part of their sexual victimization. Logistic regression showed that the gender of the perpetrators being both male and female and the forcefulness of the perpetrators were the best predictors of being in the sexual offender group. CONCLUSIONS: The social learning theory hypotheses were generally supported. Further multivariate research on this theory is warranted.

Adolescent↗

PubMedDate not supplied

Predictive and prenatal diagnosis of Huntington's disease: attitudes of Mexican neurologists, psychiatrists, and psychologists.

BACKGROUND: Huntington's disease (HD) is a hereditary disease of the central nervous system. Its molecular diagnosis has allowed predictive and prenatal diagnosis to be done, and it is now a model for the study of the ethical, legal, and social problems arising from the diagnosis of such diseases. METHODS: This study explores the knowledge and attitudes of a group of Mexican specialists regarding the disease and its diagnosis. A self-administered, 30-item multiple-choice questionnaire was completed anonymously by neurologists, psychiatrists, and psychologists. RESULTS: Fifty-five percent of the professionals had experience with HD patients, 59% claimed to know the hereditary risks, and 20% answered incorrectly concerning the risks. Neurologists had the most exposure to HD; 74% acknowledged the existence of predictive diagnosis, although only 10% knew the international guidelines for testing. Eighty-six percent of the participants recommended predictive diagnosis, the reasons being: 55%, if the patients considered having offspring; 41%, for the patient's professional reasons; 6%, if a treatment was available, and 12% did not answer. In cases in which the patient wanted to have offspring, 38% thought that this should be avoided. Thirty-six percent of the subjects considered prenatal diagnosis justified in a couple with a carrier, and 51% justified abortion for affected fetuses. CONCLUSIONS: Genetic counseling and predictive diagnosis in Mexico must be the responsibility of genetics units and specialists who are aware of inheritance risks and of guidelines for HD programs. The number of patients requiring such attention is increasing rapidly.

Adult↗