Clinical Briefs

Am Fam Physician. 2002 Dec 1;66(11):2168.

Recommendations on Screening for Domestic Violence

The Family Violence Prevention Fund has developed a resource booklet for primary care physicians on screening for and responding to cases of domestic violence. “Identifying and Responding to Domestic Violence: Consensus Recommendations for Child and Adolescent Health” is available online at www.endabuse.org/health or by calling 888-RX-ABUSE (792-2873).

The booklet provides specific recommendations on screening for, and responding to, domestic violence in child health settings; tips to help family physicians talk to children and their parents about abuse; strategies to use when talking to parents, care-givers, and adolescent patients about domestic violence; guidance on helping children and adolescents who experience or witness abuse; and recommendations on how to proceed in sensitive situations. Sample questions for screening adults who accompany children to medical appointments are also included.

If abuse is disclosed, the booklet tells physicians how to support victims and provide referrals; how to assess and address a victim's safety issues; how to develop a safety plan for the victim; how to document abuse; and how to report child maltreatment or domestic violence if there are mandatory reporting laws. It also provides information on how to help a victim of domestic violence who denies or refuses to discuss abuse.

According to the authors of the booklet, too many health care professionals do not see their role in screening for domestic violence and do not know how to screen caregivers or adolescent patients for violence, or how to talk to caregivers about how abuse affects children.

The booklet was developed in partnership with the American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, Child Witness to Violence Project at Boston Medical Center, and the National Association of Pediatric Nurse Practitioners.

FDA Advisory

Undercooked Sprouts. The U.S. Food and Drug Administration (FDA) has updated its advisory about risks of undercooked sprouts, prompted by several outbreaks in the previous two years of serious food-borne illness linked to eating raw or lightly cooked sprouts. Children, elderly persons, and those with reduced immune function should avoid sprouts entirely. Others are urged to take certain steps to reduce their risk of illness if they eat alfalfa, mung bean, or other kinds of sprouts. The advisory is available online at www.fda.gov.

Updated Recommendations to Prevent Hypertension

The National High Blood Pressure Education Program (NHBPEP) has updated its recommendations to prevent hypertension. The recommendations appear in the October 16, 2002 issue of JAMA.

New recommendations include adequate intake of potassium and an eating pattern rich in fruits, vegetables, and low-fat dairy products. The update also reinforces earlier recommendations to limit consumption of sodium and alcohol, reduce excess body weight, and increase levels of physical activity.

The recommendations caution that some widely publicized approaches have less proven or uncertain efficacy. Fish oil (omega-3 poly-unsaturated fatty acids) and calcium supplements lower blood pressure only slightly in persons with hypertension. The ability of herbal and botanical supplements to safely lower blood pressure is unproven, and these unregulated products can interact adversely with medications.

Fifty million adults in the United States—including more than one of every two adults over the age of 60—have hypertension, according to the National Center for Health Statistics. Data from the National Heart, Lung, and Blood Institute's Framingham Heart Study suggest that middle-aged and elderly persons face a 90 percent risk of developing hypertension during their remaining years. Proven behavior changes can lower blood pressure and reduce the risk of a cardiovascular event.


Copyright © 2002 by the American Academy of Family Physicians.
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