Our purpose was to measure the beliefs of physicians about victims of spouse abuse and to examine factors related to holding positive (e.g., supportive) and negative beliefs about providing services to victims of domestic violence. This was a total site sample of 150 physicians (76 responded; RR 51%), surveyed at one time, practicing in a large general hospital and the surrounding urban/periurban area. Four specialities are represented: emergency medicine, family practice, obstetrics-gynecology, and psychiatry. Three aspects of beliefs are measured: beliefs toward physician role in assisting victims of spouse abuse, beliefs about victims of spouse abuse, and beliefs about resources available to physicians to assist victims of spouse abuse. Almost all (97%) physicians believe it is part of their role to assist victims of domestic violence. Almost one third (30%) hold victim-blaming attitudes toward victims of spouse abuse, and the majority (70%) do not believe that they have the resources available to them to assist victims of domestic violence. Being female, younger, practicing obstetrics-gynecology, and having fewer years in practice are all significantly related to holding supportive (positive) beliefs. The majority of negative beliefs held are about resource availability. Hence, training programs may need to be developed locally for physicians and tailored to individual community characteristics. Training programs should also emphasize the importance of understanding the victims of spouse abuse and of not blaming the victims for the violence.

This study examines models of SANE service in the ED and quality of care. Nurse nicinagers of all 82 Ens in Virginia were surveyed ( K K 76%). Five models emerged: I ) No SANE services (27.4%); 2) Victinis transferred off-site for services (14.5%); 3) Partial coverage of services by ED SANEs (16.1%); 4 ) SANEs called in jrom off-site (6.5%); and 5) Full-coverage of services by ED SANEs (35.5%). Models 4 and 5 consistently provided a higher qualio of care.

The underimmunization of children younger than 2 years old is a major health problem in U.S. cities. Innovative methods to increase immunization rates are being researched and implemented. In 1993, six focus groups were conducted with 41 mothers (25 African Americans and 16 Caucasians) to discuss their views regarding immunizations and the services they received from health care providers in the public health (n = 27), military (n = 4), and private (n = 10) sectors. Participants viewed immunizations positively, but perceived many barriers to immunization. They suggested the following ways to improve the immunization process: enhancing knowledge acquisition, improving reminder and appointment systems, providing transportation and child care, decreasing waiting times, improving the clinic environment, and making the immunizations less traumatic. According to mothers in this study, obtaining an immunization on time is a complex task that requires planning and resources. The fewer resources that are available to mothers, the more difficult it is to succeeded. Health care providers must help mothers identify and remove barriers if immunization rates are to be increased.

The experience of death and dying is very different in the 21st century than it was in the 19th. A number of societal changes in the latter part of the 19th and early part of the 20th centuries served to remove contact with the dying and the dead from everyday experience. This article examines four of these changes: 1) falling death rates, 2) the rise of hospitals, 3) the rise of funeral directing as a profession, and 4) the rural cemetery movement. It is proposed that these changes produced an unjustified optimism with regard to the prolongation of life.