The impact of domestic violence on individuals.

There is extensive evidence of the adverse effects of domestic violence across all age groups and cultural backgrounds. The impact of domestic violence may be long-term, affecting emotional adjustment, physical health and subsequent relationships. Health professionals should be aware of the confounding effect of youth, age and cultural diversity on presentation. Shame and isolation militate against disclosure. Specific, sensitive questioning that incorporates awareness of cultural and social issues is essential to detect domestic violence and initiate appropriate assistance.

Cesarean section or vaginal delivery at 24 to 28 weeks' gestation: comparison of survival and neonatal and two-year morbidity.

A large cohort of consecutive live births with gestational ages assessed antenatally from 24 to 28 weeks from one tertiary center was studied to determine the association between mode of delivery and in-hospital mortality and morbidity and morbidity at two years of age. Between 1 January 1977 and 31 March 1982, 52.8% (172 of 326) of such infants survived their primary hospitalization. Obstetric factors independently associated with improved survival were increasing gestational age (P less than .0001), the absence of maternal hypertension (P = .007), singleton pregnancy (P = .007), and antenatal steroid therapy (P = .018). Although 62.7% (32 of 51) of infants delivered by cesarean section survived compared with 50.9% (140 of 275) of infants delivered vaginally, the increased survival was not statistically significant (X 2 = 1.97). Moreover, the trend favoring cesarean section disappeared after adjustment for confounding obstetric factors. In univariate analyses cesarean births more frequently required ventilatory support and there was a trend toward a lower incidence of cerebroventricular hemorrhage; again, however, when adjusted for extraneous factors these associations disappeared. Of the 172 in-hospital survivors, five died at home unexpectedly; 162 of the remaining 167 were traced; 18 (11.1%) had cerebral palsy and two (1.2%) were deaf. Of the 111 children who were fully assessed, 13.5% had major handicaps, 23.4% were suspect, and 63.1% were free of handicap at two years' corrected age. There was no association between mode of delivery and frequency of handicap. Little evidence was found from mortality or morbidity data to support routine delivery of infants of borderline viability by cesarean section.

Concordant monozygotic twins with bilateral renal agenesis.

We report the unique observation of monozygotic twins concordant for bilateral renal agenesis.

Effects of selected vocal disguises upon speaker identification by listening.

This research was designed to investigate the effects of selected vocal disguises upon speaker identification by listening. The experiment consisted of 360 pair discriminations presented in a fixed-sequence mode. The listeners were asked to decide whether two sentences were uttered by the same or different speakers and to rate their degree of confidence in each decision. The speakers produced two sentence sets utilizing their normal speaking mode and five selected disguises. One member of each stimulus pair in the listening task was always an undisguised speech sample; the other member was either disguised or undisguised. Two listener groups were trained for the task: a naive group of 24 undergraduate students, and a sophisticated group of three doctoral students and three professors of Speech and Hearing Sciences. Both groups of listeners were able to discriminate speakers with a moderately high degree of accuracy (92% correct) when both members of the stimulus pair were undisguised. The inclusion of a disguised speech sample in the stimulus pair significantly interfered with listener performance (59%--81% correct depending upon the particular disguise). These results present a similar pattern to this authors' previous results utilizing spectrographic speaker-identification tasks (Reich et al., 1976).