STABILITY AND CHANGE IN PATTERNS OF WIFE-BEATING: A SYSTEMS THEORY APPROACH

This research is a longitudinal study of wife battering using a system\u27s theory approach. Two types of longitudinal analyses are presented. The first is the analysis of retrospective data of histories of violent relationships. The second type of longitudinal analysis is the comparison of the number and the frequency of men\u27s and women\u27s violent acts at two points: in the year prior to entering a shelter for battered women and six months later. In-depth interviews with 31 battered women who had voluntarily sought help at a shelter provide histories of violence as well as information on their own early family background, that of their spouses, and the history of their relationship. Three life histories are presented in the form of edited transcripts of interviews with the women. In addition 24 of the women were reinterviewed six months after they came to the shelter. This research is unique in the presentation of longitudinal data, and in the integration of quantitative and qualitative data. Quantitative data are presented on number of violent acts and frequency of violent acts at the two interview points; data are presented on the women\u27s responses to three incidents of violence, the first, the most important and the most recent, and qualitative data are presented in the form of three life histories. The quantitative and qualitative data form the basis for a six stage model of the wife battering process, and a flow chart which illustrates the system\u27s processes that lead to stabilization and change in the patterns of wife battering. Important findings include the following: (1) the sample of battered women differed from a random sample on number of marriages, percent cohabiting, exposure to violence as a child, incidence of alcohol abuse, and skewed marital power; (2) men were both more likely to be violent than the women, and more frequently violent; (3) over three incidents of violence the women\u27s reaction changed from denial to seeking intervention, and the processes that led to change were governed by the systems principles of positive and negative feedback; (4) violence of both men and women was reduced between the two interviews, but 50% of the women had been hit in the six month follow-up period; (5) the highest rates of violence in the six month follow-up period were among women who had returned to their husbands and never left again. Finally, the most significant contribution of the research may be the development of an analytical model to explain wife battering using the concepts of system\u27s theory. This model incorporates dynamic processes of feedback control and the cybernetic processes of system maintenance

Spankers and Nonspankers: Where They Get Information on Spanking

Because spanking is common, puts children at risk for harmful side effects, and is ineffective as a positive behavior management tool, it is important to identify the kind of advice families receive about the appropriateness of spanking. Using the health belief model, I examined spankers and nonspankers on the spanking messages they received from eight sources of discipline information and how important they perceived these messages to be. Data from telephone interviews with 998 mothers with children aged 2 to 14 years showed that 33% of mothers rated advice from workshops, pediatricians, newspapers and magazines, and books as ‘‘very important.’’ Less than 15% rated parents and relatives and friends as such. Spankers perceived sources as recommending spanking, whereas nonspankers perceived sources as opposing spanking. Mothers were more likely to spank when they perceived more intense messages to spank, less intense messages opposing spanking, had younger children, and were of lower socioeconomic status

RApid Primary care Initiation of Drug treatment for Transient Ischaemic Attack (RAPID-TIA): study protocol for a pilot randomised controlled trial.

BACKGROUND: People who have a transient ischaemic attack (TIA) or minor stroke are at high risk of a recurrent stroke, particularly in the first week after the event. Early initiation of secondary prevention drugs is associated with an 80% reduction in risk of stroke recurrence. This raises the question as to whether these drugs should be given before being seen by a specialist--that is, in primary care or in the emergency department. The aims of the RAPID-TIA pilot trial are to determine the feasibility of a randomised controlled trial, to analyse cost effectiveness and to ask: Should general practitioners and emergency doctors (primary care physicians) initiate secondary preventative measures in addition to aspirin in people they see with suspected TIA or minor stroke at the time of referral to a specialist? METHODS/DESIGN: This is a pilot randomised controlled trial with a sub-study of accuracy of primary care physician diagnosis of TIA. In the pilot trial, we aim to recruit 100 patients from 30 general practices (including out-of-hours general practice centres) and 1 emergency department whom the primary care physician diagnoses with TIA or minor stroke and randomly assign them to usual care (that is, initiation of aspirin and referral to a TIA clinic) or usual care plus additional early initiation of secondary prevention drugs (a blood-pressure lowering protocol, simvastatin 40 mg and dipyridamole 200 mg m/r bd). The primary outcome of the main study will be the number of strokes at 90 days. The diagnostic accuracy sub-study will include these 100 patients and an additional 70 patients in whom the primary care physician thinks the diagnosis of TIA is possible, rather than probable. For the pilot trial, we will report recruitment rate, follow-up rate, a preliminary estimate of the primary event rate and occurrence of any adverse events. For the diagnostic study, we will calculate sensitivity and specificity of primary care physician diagnosis using the final TIA clinic diagnosis as the reference standard. DISCUSSION: This pilot study will be used to estimate key parameters that are needed to design the main study and to estimate the accuracy of primary care diagnosis of TIA. The planned follow-on trial will have important implications for the initial management of people with suspected TIA. TRIAL REGISTRATION: ISRCTN62019087.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

The listening talker: A review of human and algorithmic context-induced modifications of speech

International audienceSpeech output technology is finding widespread application, including in scenarios where intelligibility might be compromised - at least for some listeners - by adverse conditions. Unlike most current algorithms, talkers continually adapt their speech patterns as a response to the immediate context of spoken communication, where the type of interlocutor and the environment are the dominant situational factors influencing speech production. Observations of talker behaviour can motivate the design of more robust speech output algorithms. Starting with a listener-oriented categorisation of possible goals for speech modification, this review article summarises the extensive set of behavioural findings related to human speech modification, identifies which factors appear to be beneficial, and goes on to examine previous computational attempts to improve intelligibility in noise. The review concludes by tabulating 46 speech modifications, many of which have yet to be perceptually or algorithmically evaluated. Consequently, the review provides a roadmap for future work in improving the robustness of speech output

Spirit, mind and body: the archaeology of monastic healing

Archaeology and material culture are used in this chapter to consider how monastic experience responded to illness, ageing and disability. The approach taken is influenced by the material study of religion, which interrogates how bodies and things engage to construct the sensory experience of religion, and by practice-based approaches in archaeology, which examine the active role of space and material culture in shaping religious agency and embodiment. The archaeology of monastic healing focuses on the full spectrum of healing technologies, from managing the body in order to prevent illness, through to the treatment of the sick and preparation of the corpse for burial

Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study

Purpose: To improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA). Methods: In a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS.2. Strokes were classified as ‘‘major’ ’ by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was#7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores.10. Results: Of 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p,0.0001). Combining NIHSS with BASIS was highly predictive: 77.6 % (114/147) classified as NIHSS.10/BASIS+ had poor outcomes, versus 21.5 % (77/358) with NIHSS#10/BASIS2 (p,0.0001), regardless of treatment. The odds ratios for poor outcome is 12.6 (95 % CI: 7.9 to 20.0

The nosological significance of Folie à Deux: a review of the literature

BACKGROUND: Folie à Deux is a rare syndrome that has attracted much clinical attention. There is increasing doubt over the essence of the condition and the validity of the original description, such that it remains an elusive entity difficult to define. METHOD: We conducted a systematic review of the literature of all cases reporting the phenomenon of Folie à Deux, from the years 1993–2005. RESULTS: 64 cases were identified of which 42 met the inclusion criteria. The diagnoses in the primary and secondary were more heterogeneous than current diagnostic criteria suggest. There exists a high degree of similarity between the primary and secondary in terms of susceptibility to psychiatric illness, family and past psychiatric history, than previously thought. CONCLUSION: Folie à Deux can occur in many situations outside the confines of the current classification systems and is not as rare as believed, and should alert the clinician to unrecognized psychiatric problems in the secondary