CONTEXT: Domestic violence has an estimated 30% lifetime prevalence among women, yet physicians detect as few as 1 in 20 victims of abuse. OBJECTIVE:To identify factors associated with physicians' low screening rates for domestic violence and perceived barriers to screening. DESIGN:Cross-sectional postal survey. PARTICIPANTS:A national systematic sample of 2,400 physicians in 4 specialties likely to initially encounter abused women. The overall response rate was 53%.MAIN OUTCOME MEASURE: Self-reported percentage of female patients screened for domestic violence; logistic models identified factors associated with screening less than 10%. RESULTS:Respondent physicians screened a median of only 10% (interquartile range, 2 to 25) of female patients. Ten percent reported they never screen for domestic violence; only 6% screen all their patients. Higher screening rates were associated with obstetrics-gynecology specialty (odds ratio Lower screening rates were associated with emergency medicine specialty (OR, 1.72; CI, 1.13 to 2.63), agreement that patients would volunteer a history of abuse (per Likertscale point, OR, 1.60; CI, 1.25 to 2.05), and forgetting to ask about domestic violence (OR, 1.69; CI, 1.42 to 2.02).CONCLUSIONS: Physicians screen few female patients for domestic violence. Further study should address whether domestic violence training can correct misperceptions and improve physician self-confidence in caring for victims and whether the use of specific intervention strategies can enhance screening rates.
Seven patients with chronic moderate to severe generalized periodontitis requiring periodontal flap surgery were selected for study. Internally beveled full thickness, apically positioned flaps with osseous recontouring were performed in 20 quadrants. Half the quadrants received a noneugenol dressing, and the other half were left undressed. Fluid Index, Gingival Index, inflammatory index, pocket depth and patient comfort were studied up to 16 weeks postoperatively. Results showed no difference in these parameters between quadrants where periodontal dressings were or were not used following surgery. The patients reported more pain and discomfort and the pain and discomfort was more severe postoperatively when the dressing was used. The results of this study suggest that a surgical dressing serves no useful purpose when periodontal flap surgery is performed.
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