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This study examined how being abused by a current partner versus an ex-partner might affect psychological well-being and social support in a community sample of 398 women, half of whom had experienced abuse in the past 6 months. The impact of emotional and physical abuse was influenced by partner status, with emotional abuse being more detrimental to women abused by current partners and physical abuse being more detrimental to women abused by ex-partners. Emotional support was negatively related to depression in women abused by current partners, whereas practical support was negatively related to depression in women abused by ex-partners. The implications for interventions with abused women are discussed. [ABSTRACT FROM AUTHOR]

Objective: Population-level strategies to organize and deliver care may improve diabetes management. We conducted a multiclinic controlled trial of population management in patients with type 2 diabetes.Research Design and Methods: We created diabetic patient registries (n = 3,079) for four primary care clinics within a single academic health center. In the intervention clinic (n = 898), a nurse practitioner used novel clinical software (PopMan) to identify patients on a weekly basis with outlying values for visit and testing intervals and last measured levels of HbA1c, LDL cholesterol, and blood pressure. For these patients, the nurse practitioner e-mailed a concise patient-specific summary of evidence-based management suggestions directly to primary care providers (PCPs). Population changes in risk factor testing, medication prescription, and risk factor levels from baseline (1 January 2000 to 31 August 2001) to follow-up (1 December 2001 to 31 July 2003) were compared with the three usual-care control clinics (n = 2,181).Results: Patients had a mean age of 65 years, were mostly white (81%), and the majority were insured by Medicare/Medicaid (62%). From baseline to follow-up, the increase in proportion of patients tested for HbA1c (P = 0.004) and LDL cholesterol (P < 0.001) was greater in the intervention than control sites. Improvements in diabetes-related medication prescription and levels of HbA1c, LDL cholesterol, and blood pressure in the intervention clinic were balanced by similar improvements in the control sites.Conclusions: Population-level clinical registries combined with summarized recommendations to PCPs had a modest effect on management. The intervention was limited by good overall quality of care at baseline and temporal improvements in all control clinics. It is unknown whether this intervention would have had greater impact in clinical settings with lower overall quality. Further research into more effective methods of translating population registry information into action is required. [ABSTRACT FROM AUTHOR]

To better illuminate the elements of an effective community response to domestic violence, this study examined how survivors prioritized their help-seeking activities and what their priorities revealed about their patterns of need. This study expanded on Sullivan and Bybee's findings regarding the utility of community-based advocacy by examining whether the extent to which such advocacy was effective was dependent on the types of needs that survivors presented. Cluster analysis revealed five distinct subgroups of survivors: one focused primarily on activities to acquire housing, a second worked more on education and employment, a third focused heavily on legal issues, and two groups were characterized by survivors' level of activity across a variety of needs (high and low). Despite the varied constellations of needs survivors presented, broad-based advocacy enhanced survivors' effectiveness in mobilizing needed community resources. These findings suggest that comprehensive and individualized approaches to advocacy for battered women are essential. [ABSTRACT FROM AUTHOR]

OBJECTIVE. To determine the effects of large doses of aspartame on behavior, cognition, and monoamine metabolism in children with attention deficit disorder. DESIGN. A randomized, double-blind, placebo-controlled crossover study of unmedicated children meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed) criteria for attention deficit disorder. SETTING. Behavioral assessments were performed in the child's home by their parents and in the classroom by a teacher. Cognitive tests were administered and blood drawing was performed during a 2-day inpatient admission to our Children's Study Center. INTERVENTIONS. Administration of aspartame (single morning dose, 34 mg/kg) or placebo for alternate 2-week periods. MAIN OUTCOME MEASURES. Behavioral and cognitive tests included the Matching Familiar Figures Test (MFFT), Children's Checking Task (CCT), the Airplane Test, the Wisconsin Card Sorting Test (WCST), the Subjects Treatment Emergent Symptom Scale (STESS), the Multigrade Inventory for Teachers (MIT), and the Conners Behavior Rating Scale. Blood was drawn for complete blood cell count and liver function tests, as well as amino acid, methanol, formate, serotonin, and monoamine metabolite analyses, and urine was collected for measurement of catecholamine and monoamine metabolite excretion. RESULTS. No clinically significant differences between aspartame and placebo were found for the STESS, MIT, or Conners ratings, or for the MFFT, CCT, WCST, or Airplane cognition tests. Also, no differences were noted for any of the biochemical measures, except for the expected increase in plasma phenylalanine and tyrosine following aspartame. CONCLUSIONS. The findings indicate that aspartame at greater than 10 times usual consumption has no effect on the cognitive and behavioral status of children with attention deficit disorder. In addition, aspartame does not appear to affect urinary excretion rates of monoamines and metabolites. [ABSTRACT FROM AUTHOR]

We assessed the incidence of sexual violence, physical violence, physical health symptoms, gynecological symptoms, and risk behaviors for contracting an STD or HIV infection in women who had used a shelter for women with abusive partners. In addition, we investigated the relationships between sexual violence and the frequency of physical health symptoms, including specific gynecological symptoms. Results indicated that one fourth of the women interviewed had experienced sexual violence and nearly two thirds of the women had experienced physical violence in the past 6 months. The incidence of physical health symptoms, gynecological symptoms, and risk behaviors for exposure to STDs and HIV infection are presented. The correlations among sexual violence, physical violence, and experiences of physical health symptoms are also reported. This study is particularly valuable because previous research has not documented the relationship between sexual violence and physical health symptoms. [ABSTRACT FROM AUTHOR]