Who Is at High Risk for Child Abuse and Neglect: Risk Assessment among Battered Women Using Shelter Services.

BACKGROUND: The intersections between intimate partner violence (IPV) and child abuse and neglect (CAN) have received growing attention from the research community. However, there is limited research examining the risk factors for CAN among children of battered women who have experienced severe IPV and seek refuge in shelters. OBJECTIVE: In the current study, we examined the co-occurrence of IPV and CAN and the risk factors for CAN in a sample of battered women. PARTICIPANTS AND SETTING: We recruited 260 battered women who were staying in women's shelters in Hong Kong. METHODS: We analyzed the data collected from the risk assessment reports of battered women and focused on IPV against women, CAN, and risk assessment. RESULTS: Nearly half of the battered women had reported both IPV against themselves and CAN against their children. These women were, in general, younger, unemployed, and had been living in Hong Kong for less than seven years as new immigrants. Other risk factors for CAN in violent families included women's conflicts with their partner and abusers with higher levels of stress and approval of violence. CONCLUSIONS: This exploratory study of risk factors for the co-occurrence of IPV and CAN advances our understanding of the causes of violence against women and children in families with violence. Our findings suggest that additional integrated services should be offered to both battered women and their children during their stay in shelters and after shelter departure. Addressing IPV and CAN and reducing adverse consequences needs greater collaboration among the various stakeholders across the social services, health, educational, and legal sectors.

[Replacement of insulin by fasting C-peptide in modified homeostasis model assessment to evaluate insulin resistance and islet beta cell function].

OBJECTIVE: To investigate the possibility of using C-peptide to replace insulin in homeostasis model assessment (Homa) to evaluate insulin resistance and islet beta cell function. METHODS: Oral glucose tolerance test (OGTT) was performed in 21 normal subjects, whose venous blood was drawn before taking glucose and 30, 60, 120 minutes after taking glucose. Insulin and C-peptide were determined with radioimmune assay. Homa indices of insulin resistance and islet beta cell function were calculated. Multiple stepwise linear regression model of insulin resistance was measured using C-peptide x blood glucose as independent variables and Homa-IR was used as the dependent variable, while the model of islet beta cell function was determined using C-peptide/(fasting blood glucose - 3.5) as the independent variable and Homaislet as the dependent variable. RESULTS: The modified Homa formula were: Homa-IR (CP) = 1.5 + fasting blood glucose x fasting C-peptide/2800 (F = 5. 511, P = 0.029), Homa-islet (CP-Normal) = 0.27 x fasting C-peptide /(fasting blood glucose - 3.5) + 50, and Homa-islet (CP-DM) = 0.27 x fasting C-Peptide/(fasting blood glucose - 3.5) (F = 212.961, P = 0.000), respectively. The modified Homa-IR (CP) and Homa-IR, Homa-islet (CP) and Homa-islet were highly correlated (r =0.689 and r = 0.788; all P = 0.000). Using Homa and modified Homa formula to evaluate the insulin resistance and islet beta cell function both in the normal and diabetic subjects was similar. CONCLUSION: Fasting C-peptide can substitute insulin in Homa model to assess insulin resistance and islet beta cell function. The modified homeostasis model assessment may be applied in the diabetics using exogenous insulin.