Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress-related, or central nervous system complaints are needed to support disclosure of domestic violence.

Although theories of glacier movement ge n erally assume that glaciers flow over rigid rock beds, there are many places where glacie rs r est on beds of d eforma ble sedim e nt, a nd the great Pleistocene ice sheets which extend ed from time to time over much of Northern Europe a nd N orth America were largely underlain by such b eds. Observations sh ow that a large proportion of the forward movement ofa glacier lying on such a bed may be contributed by d eformation of the bed ra ther than the gl acier. A theory is d eveloped in which the glacier surface profile is rela ted to the hydraulic and strength prope rti es of potentially deform-able bed materials. If these have a high hydraulic transmiss ibility, melt wa te r is readily discharged sub-glacially, the bed is stable, and the profile is a normal p a ra boli c one, governed by the rheologica l properties of ice. If bed transmissibility is low, wa ter pressures build up, the bed begins to d eform, and a lower equilibrium profile will develop, so tha t in a n extreme case the gl acier a pproxim a tes to a thin flat sheet, similar to an ice shelf. It is suggested tha t su ch behaviour may h ave occurred a t the m a rgins of large Pleistocene ice sheets over North America and Europ e, a nd evidence in support of this is dra wn from the reconstructed shapes of these ice margins, a nomalo usly sm all a mounts of isostatic rebound, a n o ma lously high retreat-rates, and the presence of glaciotectonic structures. R easons a re suggested to expl a in why this behaviour should have been important for Pleistocene glaciers which p en etra ted into currently te mperate latitudes but does not appear to be important in la rge m od ern glaciers. REsuME. Stabiliti de calottes de glace tempi ree reposant sur des lits de sidiments diformables. Bien que les theories sur le mouvem e nt d es glaciers supposent en general que les glaciers s'ecoule nt sur d es lits rocheux rigides, il arrive souvent que les glaciers reposent e n fait sur des sed iments deforma bles et la grande calotte glaciaire pleistocene qui s' es t pa rfois etendue sur la plus grande pa rti e de l'Europe du N o rd et de l'Amerique du Nord etait en gran de partie supportee p a r d e tels lits. Des o bservati ons montre nt qu'une fort e proportion des avancees de glacie rs r eposant sur un tellit peut et re le res ultat de la deform atio n du lit plus que d e glacier. On a developpe un e theorie selon laquell e le profil de la surface du gl acier es t mis en relation avec les pro-prietes hydrauliques et plastiques d es m a te ria ux d'un lit d e fo rma ble. S' ils o nt un e forte permeabilite, I'eau d e fonte est rapid ement tra nsmise so us le glacier, le lit est sta ble et le profil est normalement parabolique, conformement aux lois rheologiques d e la glace. Si la pe rm eabili te a I'eau est fa ible, la pression hydrosta tique croit, le lit commence a se deforme r et un profil d'equilibre plus bas en a ltitude se developpe d e sorte que, e n d es cas extre m es, le glacier ressembl e a un e feuille min ce pl...

Satellite imagery and data from ground surveys are used to reconstruct the integrated pattern of the principal longitudinal and transverse features produced on a continent-wide scale by the last ice sheets in Europe and North America. From modern analogues, it is argued that most longitudinal features reflect flow in the outer zone of the ice sheet, and that most major transverse features reflect relatively stable ice-sheet margins. These principles are tested and, using them alone, detailed patterns for the decay of the last ice sheets in North America, Europe and the British Isles are produced, and periods during which they attained near steady-states identified. These patterns can be calibrated by dated sequences to yield deglaciation isochrons. Application of glaciological models to these geological reconstructions generates detailed prediction of net ablation for the period of ice-sheet decay and, by using evidence of last glaciation stratigraphy, models of the dynamic behaviour of the ice sheets throughout the last glacial period are constructed. These enable volumetric changes, oceanic isotopic changes and erratic dispersal pathways to be reconstructed. Erratic dispersal patterns give a good indication of the long-term distribution of centres of ice sheet mass. Discrepancies between predicted and empirical oceanic isotopic records indicate ways in which the conventional continental timescale of glacial change must be altered to fit the better-dated deep ocean record. In addition discrepancies between predicted and empirical erratic dispersal patterns suggest that conventional views of ice-sheet behaviour based on high latitude models may be inappropriate to the dynamically more active mid-latitude ice sheets based in large part on deformable sediment beds.

These estimates add support to previous conclusions that efforts to improve the rate of successful reconstructions have merit. Not only is reconstruction a reasonable goal at an experienced level-I trauma center, it results in lower lifetime costs.

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