Should health professionals screen women for domestic violence? : systematic review

Objective To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings. Design Systematic review of published quantitative studies. Search strategy Three electronic databases (Medline, Embase, and CINAHL) were searched for articles published in the English language up to February 2001. Included studies Surveys that elicited the attitudes of women and health professionals on the screening of women in health settings; comparative studies conducted in healthcare settings that measured rates of identification of domestic violence in the presence and absence of screening; studies measuring outcomes of interventions for women identified in health settings who experience abuse from a male partner or ex­partner compared with abused women not receiving an intervention. Results 20 papers met the inclusion criteria. In four surveys, 43­85% of women respondents found screening in healthcare settings acceptable. Two surveys of health professionals' views found that two thirds of physicians and almost half of emergency department nurses were not in favour of screening. In nine studies of screening compared with no screening, most detected a greater proportion of abused women identified by healthcare professionals. Six studies of interventions used weak study designs and gave inconsistent results. Other than increased referral to outside agencies, little evidence exists for changes in important outcomes such as decreased exposure to violence. No studies measured quality of life, mental health outcomes, or potential harm to women from screening programmes. Conclusion Although domestic violence is a common problem with major health consequences for women, implementation of screening programmes in healthcare settings cannot be justified. Evidence of the benefit of specific interventions and lack of harm from screening is needed

State Indicators for Early Childhood

Virtually all State Early Childhood Comprehensive System Initiatives have adopted or identified indicators for monitoring program performance and child outcomes related to early childhood systems. These are primarily based on nationally recommended indicators or on state initiatives. However, although a functional set of indicators is needed to monitor progress of ECCS initiatives across the states, there is no one overarching set of indicators consistently being used. The challenge for states' ECCS leadership is to select an indicator set that is both comprehensive enough to monitor system developments and specific and limited enough to be useful and manageable. This Short Take reviews the characteristics of good indicators and proposes 36 indicators, based on a review of the literature, an analysis of key national indicator sets, and a comparative review of indicators set out in State ECCS reports and plans

State-level Indicators for Social-emotional Development: Building Better Systems

Research repeatedly suggests that experiences and skills acquired early in life have a long lasting effect. Many interventions that promote social-emotional well-being and preventing mental health problems in children and their caregivers are clinically sound and cost effective. Social-emotional well-being is also seen as a crucial determinant of school readiness, while school readiness is critical to educational and health outcomes. Research evaluating appropriate interventions and investigating the importance of school readiness makes a strong case for creating a system to monitor social-emotional development in the effort to improve the well-being of young children. Indicators are a key part of this monitoring system and promote accountability by providing decision-makers and researchers with information they need to understand and meet local and state needs, to assess the provision and quality of interventions, and to address gaps in services to young children and families. The ability to track and assess social-emotional development of young children in a community poses a special challenge to policymakers. For many other areas within early childhood it is possible to understand the status and trends for child well-being at the population level. For instance, data on infant mortality, immunizations, and child welfare at the local, state and national level can be accessed to inform health promotion and prevention efforts. Currently, such multi-level data on social-emotional development for young children is not easily available. The challenge to quantify social-emotional wellness at a population level stems in part from the lack of universally accepted indicators and infrastructure for collecting information in this domain of child development. This report addresses the process of creating a system of indicators for social-emotional wellness, examines recent state experiences in this area, and describes a framework for moving forward in the development of social-emotional indicators for state policymakers

Indicators for Social-emotional Development in Early Childhood: A Guide for Local Stakeholders

Social-emotional development in young children encompasses how young children feel about themselves, how they behave and how they relate to people close to them, such as caregivers, teachers, and peers. Although infant and early childhood mental health are often used in the same way, the term social-emotional development illustrates the importance of prevention and early intervention. There is strong evidence linking social-emotional health in the early childhood years (birth to 6) to subsequent school success and health in preteen and teen years, and to long term health and wellbeing in adulthood. However, research also shows that effective programs that address social-emotional health early in life can promote resilience and actually prevent mental health problems later in life

Does breastfeeding account for the association between maternal sensitivity and infant cognitive development in a large, nationally representative cohort?

Background Previous research has established that exposure to high maternal sensitivity is positively associated with advances in infant cognitive development. However, there are many fixed and modifiable factors that influence this association. This study investigates whether the association between maternal sensitivity and infant cognitive development in the first year of life is accounted for by other factors, such as breastfeeding, maternal depressive symptoms, maternal alcohol use, infant birth weight or demographic covariates. Methods Using data from the Early Childhood Longitudinal Study-Birth (ECLS-B) Cohort, a nationally representative sample of U.S. born children, multi-variable regression analyses was used to examine whether breastfeeding, maternal depressive symptoms and alcohol use were associated with maternal sensitivity, as measured by the Nursing Child Assessment Teaching Scale (NCATS), and with infant cognitive development, as measured by the Bayley Scales of Infant Development, Short Form, Research Edition, after controlling for demographic covariates (infant sex, maternal age, education, race/ethnicity, income, parity, family structure) and infant birth weight. Results Breastfeeding, depressive symptoms and alcohol use were not associated with maternal sensitivity scores after controlling for demographic covariates and infant birth weight. However, breastfeeding (β = .079, p < .001), depressive symptoms (β = −.035, p < .05), and maternal sensitivity (β = .175, p < .001) were each significantly associated with infant cognitive development scores, even after controlling for demographic covariates and birthweight (R2 = .053, p < .001). The association between maternal sensitivity and infant cognitive development did not attenuate after adjusting for breastfeeding. Instead, both sensitivity and breastfeeding independently contributed to higher infant cognitive development scores. Conclusion Maternal sensitivity and breastfeeding are separate means to advancing infant cognitive development. This study is significant because it is the first to examine breastfeeding, maternal depressive symptoms and alcohol use together, upon the association between maternal sensitivity and infant cognitive development, after adjusting for demographic covariates and infant birthweight. Maternal sensitivity, a measurable quality, advances infants’ cognitive development. Moreover, sensitivity and breastfeeding had independent effects upon cognitive development after controlling for multiple fixed and modifiable covariates. Understanding factors impacting the association between sensitivity and infant cognitive development provide avenues for developing more effective parenting interventions

THE MAGNETIC FIELD MORPHOLOGY OF THE CLASS 0 PROTOSTAR L1157-mm

We present the first detection of polarization around the Class 0 low-mass protostar L1157-mm at two different wavelengths. We show polarimetric maps at large scales (10 '' resolution at 350 mu m) from the SHARC-II Polarimeter and at smaller scales (1.'' 2-4.'' 5 at 1.3 mm) from the Combined Array for Research in Millimeter-wave Astronomy (CARMA). The observations are consistent with each other and show inferred magnetic field lines aligned with the outflow. The CARMA observations suggest a full hourglass magnetic field morphology centered about the core; this is only the second well-defined hourglass detected around a low-mass protostar to date. We apply two different methods to CARMA polarimetric observations to estimate the plane-of-sky magnetic field magnitude, finding values of 1.4 and 3.4 mG.</p

Compliance with referrals for non-acute child health conditions: evidence from the longitudinal ASENZE study in KwaZulu Natal, South Africa

Background: Caregiver compliance with referrals for child health services is essential to child health outcomes. Many studies in sub-Saharan Africa have examined compliance patterns for children referred for acute, life-threatening conditions but few for children referred for non-acute conditions. The aims of this analysis were to determine the rate of referral compliance and investigate factors associated with referral compliance in KwaZulu Natal, South Africa. Methods: From September 2008–2010, a door-to-door household survey was conducted to identify children aged 4–6 years in outer-west eThekwini District, KwaZulu-Natal, South Africa. Of 2,049 identified, informed consent was obtained for 1787 (89%) children who were then invited for baseline assessments. 1581 children received standardized medical and developmental assessments at the study facility (Phase 1). Children with anemia, suspected disorders of vision, hearing, behavior and/or development and positive HIV testing were referred to local health facilities. Caregiver-reported compliance with referrals was assessed 18–24 months later (Phase 2). Relationships between socio-demographic factors and referral compliance were evaluated using chi-square tests. Results: Of 1581 children, 516 received referrals for ≥1 non-acute conditions. At the time of analysis, 68% (1078 /1581) returned for Phase 2. Analysis was limited to children assessed in Phase 2 who received a referral in Phase 1 (n = 303). Common referral reasons were suspected disorders of hearing/middle ear (22%), visual acuity (12%) and anemia (14%). Additionally, children testing positive for HIV (6.6%) were also referred. Of 303 children referred, only 45% completed referrals. Referral compliance was low for suspected disorders of vision, hearing and development. Referral compliance was significantly lower for children with younger caregivers, those living in households with low educational attainment and for those with unstable caregiving. Conclusions: Compliance with referrals for children with non-acute conditions is low within this population and appears to be influenced by caregiver age, household education level and stability of caregiving. Lack of treatment for hearing, vision and developmental problems can contribute to long-term cognitive difficulties. Further research is underway by this group to examine caregiver knowledge and attitudes about referral conditions and health system characteristics as potential determinants of referral compliance

The opposites task: Using general rules to test cognitive flexibility in preschoolers

A brief narrative description of the journal article, document, or resource. Executive functions play an important role in cognitive development, and during the preschool years especially, children's performance is limited in tasks that demand flexibility in their behavior. We asked whether preschoolers would exhibit limitations when they are required to apply a general rule in the context of novel stimuli on every trial (the "opposites" task). Two types of inhibitory processing were measured: response interference (resistance to interference from a competing response) and proactive interference (resistance to interference from a previously relevant rule). Group data show 3-year-olds have difficulty inhibiting prepotent tendencies under these conditions, whereas 5-year-olds' accuracy is near ceiling in the task. (Contains 4 footnotes and 1 table.

Alignment between Flattened Protostellar Infall Envelopes and Ambient Magnetic Fields

We present 350 μm polarization observations of four low-mass cores containing Class 0 protostars: L483, L1157, L1448-IRS2, and Serp-FIR1. This is the second paper in a larger survey aimed at testing magnetically regulated models for core-collapse. One key prediction of these models is that the mean magnetic field in a core should be aligned with the symmetry axis (minor axis) of the flattened young stellar object inner envelope (aka pseudodisk). Furthermore, the field should exhibit a pinched or hourglass-shaped morphology as gravity drags the field inward toward the central protostar. We combine our results for the four cores with results for three similar cores that were published in the first paper from our survey. An analysis of the 350 μm polarization data for the seven cores yields evidence of a positive correlation between mean field direction and pseudodisk symmetry axis. Our rough estimate for the probability of obtaining by pure chance a correlation as strong as the one we found is about 5%. In addition, we combine together data for multiple cores to create a source-averaged magnetic field map having improved signal-to-noise ratio, and this map shows good agreement between mean field direction and pseudodisk axis (they are within 15°). We also see hints of a magnetic pinch in the source-averaged map. We conclude that core-scale magnetic fields appear to be strong enough to guide gas infall, as predicted by the magnetically regulated models. Finally, we find evidence of a positive correlation between core magnetic field direction and bipolar outflow axis