Tri-county comprehensive assessment of risk factors for sporadic reportable bacterial enteric infection in children.

BACKGROUND: The aim of this study was to determine risk factors for childhood sporadic reportable enteric infection (REI) caused by bacteria, specifically Campylobacter, Salmonella, Escherichia coli O157, or Shigella (REI-B). METHODS: Matched case-control study. Case patients aged <19 years who were reported to 3 Washington State county health departments and matched control subjects were interviewed from November 2003-November 2005. Matched odds ratios (ORs) were calculated by using conditional logistic regression. Population attributable risk percentages were calculated for exposures associated with infection. RESULTS: Two hundred ninety-six case patients were matched to 580 control subjects. Aquatic recreation was the most important factor associated with all REI-Bs studied (beach water exposure [OR for Salmonella infection, 28.3 {CI, 7.2-112.2}; OR for Shigella infection, 14.5 {CI 1.5-141.0} or any recreational water exposure [OR for Campylobacter infection, 2.7 {CI, 1.5-4.8}; OR for Escherichia coli O157 infection, 7.4 {CI, 2.1-26.1}]). Suboptimal kitchen hygiene after preparation of raw meat or chicken (OR, 7.1 [CI, 2.1-24.1]) and consumption of food from restaurants were additional risks for Campylobacter infection. Infection with Salmonella was associated with the use of private wells as sources of drinking water (OR, 6.5 [CI, 1.4-29.7]), and the use of residential septic systems was a risk for both Salmonella (OR, 3.2 [CI, 1.3-7.8]) and E. coli (OR, 5.7 [CI, 1.2-27.2]) O157 infection. CONCLUSIONS: Overall, non-food exposures were as important as food-related exposures with regard to their contributions to the proportion of cases. Infection prevention efforts should address kitchen hygiene practices and non-food exposures, such as recreational water exposure, in addition to food-consumption risks.

Factors that influence battered women to leave their abusive relationships.

This study examines factors associated with leaving an abusive relationship, including relationship characteristics, external support, and health status of the abused subjects. The subjects included 448 Seattle women whose abuse resulted in police involvement or filing for a civil protection order against their male partner. Women were followed longitudinally for 9 months. Stepwise logistic regression analyses assessed factors independently predictive of leave taking. Predictors of leaving the abusive relationship were young age, leaving the relationship previously, and having a protection order, an abuse-related physician visit, and a high score of psychological vulnerability to abuse. Seeking but not receiving external support was negatively associated with leave taking.

Children in the crossfire: child custody determinations among couples with a history of intimate partner violence.

Although most states mandate considerations of intimate partner violence (IPV) in child custody proceedings, little is known about how often a preexisting history of IPV is effectively presented to the courts in dissolution cases and, when it is, what effect it has on child custody and visitation outcomes. This retrospective cohort study examined the effects of a history of IPV, further categorized by whether substantiation of that history existed and whether the court handling the custody proceedings knew of that history, on child custody and visitation outcomes. The findings from this study highlight several issues of concern regarding the reality of child custody among families with a history of IPV. These include two primary concerns: a lack of identification of IPV even among cases with a documented, substantiated history, and a lack of strong protections being ordered even among cases in which a history of substantiated IPV is known to exist.