Interventions to help battered women seek and receive optimal health care must be informed by battered women's experiences in health care settings. In this study, we used a Systems Model to categorize the barriers battered women encounter in health care settings into patient, provider, and organizational levels. We conducted in-depth, face-to-face interviews with 31 battered women recruited by random digit dialing of households and by a publicity recruitment campaign. The data revealed that at the patient level, many women chose to conceal their abuse from their health care professionals, some fearing retaliation from their partners if they revealed the source of their injuries. At the provider level, the women perceived health care professionals to be disinterested or unsympathetic toward the needs of battered women, causing the women to feel ignored or trivialized. And at an organizational level, battered women believed that the structure of the health care system did not allow health care professionals enough time to deal with issues beyond treating their immediate presenting injuries. To ensure that battered women seek and receive optimal health care, multicomponent interventions should be designed to address the complex barriers at the three levels. We conclude by suggesting possible ways to help battered women get the tools they need to raise the issue of domestic violence with their health care professional. We also suggest ways to enable these professionals to identify battered women, validate their experiences, and provide appropriate referrals.
Abnormal results from neurologic examination are the best clinical parameters to predict structural intracranial pathology; however, in patients 55 years or older with headache of acute onset located in the occipitonuchal region that has associated symptoms, computed tomographic scan of the head is justified as part of their clinical evaluation independently of the findings of the neurologic examination.
Should music be a priority in public education? One argument for teaching music in school is that private music instruction relates to enhanced language abilities and neural function. However, the directionality of this relationship is unclear and it is unknown whether schoolbased music training can produce these enhancements. Here we show that 2 years of group music classes in high school enhance the neural encoding of speech. To tease apart the relationships between music and neural function, we tested high school students participating in either music or fitness-based training. These groups were matched at the onset of training on neural timing, reading ability, and IQ. Auditory brainstem responses were collected to a synthesized speech sound presented in background noise. After 2 years of training, the neural responses of the music training group were earlier than at pretraining, while the neural timing of students in the fitness training group was unchanged. These results represent the strongest evidence to date that in-school music education can cause enhanced speech encoding. The neural benefits of musical training are, therefore, not limited to expensive private instruction early in childhood but can be elicited by costeffective group instruction during adolescence.
A time-compressed version of the PB-K 50 speech discrimination measure was administered to 20 children diagnosed as displaying auditory perceptual disorders. Results indicated that these children performed equally well at both 0 and 30% time compression. Performance decreased significantly at 60% time compression. Comparison of the results with normative data indicated that performance of the two groups of children was similar at the 30% time compression condition but that children with auditory perceptual disorders performed poorer at both 0 and 60% time compression. The results were discussed relative to short-term memory abilities.
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