Added Cost and Time Spent by Patients With History of Abuse in Florida Emergency Departments

2020 ◽  
Vol 35 (5) ◽  
pp. 741-750
Author(s):  
Natasha Kurji ◽  
Etienne E. Pracht ◽  
Barbara Langland-Orban ◽  
Kathleen Pracht
Keyword(s):  
Sexual Abuse ◽  
Interpersonal Violence ◽  
Healthcare Costs ◽  
Negative Binomial ◽  
Linear Regression Analysis ◽  
Physical And Mental Health ◽  
For Profit ◽  
Visit Duration ◽  
History Of ◽  
Log Linear

Interpersonal violence is known to lead to both short- and long-term health effects. Victims of sexual abuse tend to have higher healthcare costs and higher rates of physical and mental health issues than nonvictims. In this study, we investigate whether the comorbidity of mental illness and a personal history of adult physical and sexual abuse (HAPSA) results in higher healthcare costs and length of emergency department (ED) stay among Florida residents. A Negative Binomial and Log-Linear Regression Analysis suggest increased ED visit duration for those with a history of abuse, Hispanics, the uninsured, and those with multiple comorbidities. In addition, increased costs were found to be associated with White race, the uninsured, those with multiple comorbidities, and the facility type (for-profit hospitals).

Analysis of count data in the setting of cervical cancer detection

2020 ◽  
Vol 68 (6) ◽  
pp. 1196-1198
Author(s):  
Christina G Bracamontes ◽  
Thelma Carrillo ◽  
Jane Montealegre ◽  
Leonid Fradkin ◽  
Michele Follen ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Count Data ◽  
Pap Smear ◽  
Negative Binomial ◽  
El Paso ◽  
Language Preference ◽  
A Value ◽  
History Of ◽  
Zip Model ◽  
Endocervical Canal

Women with an abnormal Pap smear are often referred to colposcopy, a procedure during which endocervical curettage (ECC) may be performed. ECC is a scraping of the endocervical canal lining. Our goal was to compare the performance of a naïve Poisson (NP) regression model with that of a zero-inflated Poisson (ZIP) model when identifying predictors of the number of distress/pain vocalizations made by women undergoing ECC. Data on women seen in the colposcopy clinic at a medical school in El Paso, Texas, were analyzed. The outcome was the number of pain vocalizations made by the patient during ECC. Six dichotomous predictors were evaluated. Initially, NP regression was used to model the data. A high proportion of patients did not make any vocalizations, and hence a ZIP model was also fit and relative rates (RRs) and 95% CIs were calculated. AIC was used to identify the best model (NP or ZIP). Of the 210 women, 154 (73.3%) had a value of 0 for the number of ECC vocalizations. NP identified three statistically significant predictors (language preference of the subject, sexual abuse history and length of the colposcopy), while ZIP identified one: history of sexual abuse (yes vs no; adjusted RR=2.70, 95% CI 1.47 to 4.97). ZIP was preferred over NP. ZIP performed better than NP regression. Clinicians and epidemiologists should consider using the ZIP model (or the zero-inflated negative binomial model) for zero-inflated count data.

scholarly journals Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders

2018 ◽  
Vol 64 (3) ◽  
pp. 180-189
Author(s):  
Laura M. Heath ◽  
Jill Torrie ◽  
Kathryn J. Gill
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Psychological Distress ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Emotional Abuse ◽  
Substance Dependence ◽  
Physical And Mental Health ◽  
Parental History ◽  
History Of

Objective: This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. Methods: Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. Results: Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. Conclusions: This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.

Child Physical and Sexual Abuse and Eating Disorders: A Review of the Links and Personal Comments on the Treatment Process

1997 ◽  
Vol 31 (2) ◽  
pp. 194-199 ◽  
Author(s):  
Lisa Brown
Keyword(s):  
Eating Disorders ◽  
Sexual Abuse ◽  
Eating Disorder ◽  
Interpersonal Violence ◽  
Theoretical Basis ◽  
Treatment Process ◽  
Causal Relation ◽  
Case Reports ◽  
History Of ◽  
Physical And Sexual Abuse

Objective: The aim of the present paper is to review the available literature on abusive experiences and the development of eating disorders, with particular reference to the theoretical basis of the possible links between them. Method: The review covers the literature of both interpersonal violence and eating disorders, with special reference to that linking the two fields. Brief case reports and clinical experience from a specialised eating disorders unit are also described. Results: Despite much theoretical speculation of a causal relation between abuse and eating dysfunction there is a lack of empirical research to confirm such theories, and a dearth of treatment suggestions to deal with the comorbid problems of the patient with an eating disorder and a history of abuse. Conclusions: There is a need for more clinical and experimental focus in this area, particularly in the study of aetiology and the management of dually affected individuals.

History of Sexual Abuse Negatively Impacts Resilience to Suicide

2008 ◽  
Author(s):  
William J. Meyer ◽  
Meghan Marty ◽  
Andrea June ◽  
Daniel L. Segal
Keyword(s):  
Sexual Abuse ◽  
History Of

Religion and Medicine

2020 ◽  
Author(s):  
Jeff Levin ◽  
Stephen G. Post
Keyword(s):  
Clinical Decision Making ◽  
Well Being ◽  
Clinical Decision ◽  
Religion And Medicine ◽  
Physical And Mental Health ◽  
Faith Based ◽  
Baylor University ◽  
Wide Range ◽  
History Of ◽  
The Impact

In Religion and Medicine, Dr. Jeff Levin, distinguished Baylor University epidemiologist, outlines the longstanding history of multifaceted interconnections between the institutions of religion and medicine. He traces the history of the encounter between these two institutions from antiquity through to the present day, highlighting a myriad of contemporary alliances between the faith-based and medical sectors. Religion and Medicine tells the story of: religious healers and religiously branded hospitals and healthcare institutions; pastoral professionals involved in medical missions, healthcare chaplaincy, and psychological counseling; congregational health promotion and disease prevention programs and global health initiatives; research studies on the impact of religious and spiritual beliefs and practices on physical and mental health, well-being, and healing; programs and centers for medical research and education within major universities and academic institutions; religiously informed bioethics and clinical decision-making; and faith-based health policy initiatives and advocacy for healthcare reform. Religion and Medicine is the first book to cover the full breadth of this subject. It documents religion-medicine alliances across religious traditions, throughout the world, and over the course of history. It summarizes a wide range of material of relevance to historians, medical professionals, pastors and theologians, bioethicists, scientists, public health educators, and policymakers. The product of decades of rigorous and focused research, Dr. Levin has produced the most comprehensive history of these developments and the finest introduction to this emerging field of scholarship.

scholarly journals Role of Narrative and Social Networks in Thwarting Violence and Sexual Abuse in Young People’s Lives

2019 ◽  
Vol 50 (7) ◽  
pp. 2172-2190
Author(s):  
Margareta Hydén ◽  
David Gadd ◽  
Thomas Grund
Keyword(s):  
Social Networks ◽  
Sexual Abuse ◽  
Social Work ◽  
Young People ◽  
Narrative Analysis ◽  
Interpersonal Violence ◽  
Sexually Abused ◽  
Her Family ◽  
The Social ◽  
Work Intervention

Abstract Combining narrative analysis with social network analysis, this article analyses the case of a young Swedish female who had been physically and sexually abused. We show how she became trapped in an abusive relationship at the age of fourteen years following social work intervention in her family home, and how she ultimately escaped from this abuse aged nineteen years. The analysis illustrates the significance of responses to interpersonal violence from the social networks that surround young people; responses that can both entrap them in abusive relationships by blaming them for their problems and enable them to escape abuse by recognising their strengths and facilitating their choices. The article argues that the case for social work approaches that envision young people’s social networks after protective interventions have been implemented. The article explains that such an approach has the potential to reconcile the competing challenges of being responsive to young people’s needs while anticipating the heightened risk of being exposed to sexual abuse young people face when estranged from their families or after their trust in professionals has been eroded.

scholarly journals Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health

2021 ◽  
pp. 088626052110139
Author(s):  
Rachel Langevin ◽  
Martine Hébert ◽  
Audrey Kern
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Psychological Distress ◽  
Sexually Abused ◽  
Maternal Mental Health ◽  
Ptsd Symptoms ◽  
Abused Children ◽  
Maternal History ◽  
History Of ◽  
Sexually Abused Children

The effects of child sexual abuse (CSA) have been found to surpass generations as maternal history of CSA is associated with increased difficulties in sexually abused children. However, little is known about the mechanisms underlying this association. The present study aimed to test maternal mental health symptoms including psychological distress, post-traumatic stress disorder (PTSD) symptoms, and dissociation as mediators of the relationship between maternal CSA and children’s internalizing, externalizing, and dissociation symptoms in a large sample of sexually abused children. A total of 997 sexually abused children aged 3-14 years old and their mothers were recruited at five specialized intervention centers offering services to sexually abused children and their families. The children were divided into two groups depending on their mothers’ self-reported history of CSA. Mothers completed a series of questionnaires assessing their mental health and children’s functioning. Maternal history of CSA was associated with increased maternal psychological distress, PTSD symptoms, and dissociation following children’s disclosure of CSA. In turn, maternal psychological distress and maternal dissociation were associated with increased child internalizing, externalizing, and dissociation symptoms. Maternal PTSD symptoms were associated with child internalizing symptoms. Maternal mental health difficulties mediated the association between maternal CSA and sexually abused children’s maladaptive outcomes. Clinicians should assess for possible history of CSA in mothers of sexually abused children and determine how best to support them to cope with the aftermaths of their child’s disclosure and with their own traumatic past.

Sign in / Sign up

Export Citation Format

Share Document