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International Journal of Gynaecology... Jun 2024Within Europe, Roma, Gypsy, and Traveller groups have been marginalized and discriminated against by larger society. Persecution and displacement have resulted in high... (Review)
Review
BACKGROUND
Within Europe, Roma, Gypsy, and Traveller groups have been marginalized and discriminated against by larger society. Persecution and displacement have resulted in high rates of unemployment, reduced access to education, and poorer health, with significantly increased risk of poverty compared with the general population. In pregnancy, there appears to be a gap in the literature surrounding the experiences and outcomes of pregnant people within these ethnic groups.
OBJECTIVES
The aim of this study was therefore to scope published research, specifically questioning "What is the experience of Roma Gypsy and Traveller pregnant people who access maternity care?" and "What are the obstetric outcomes within these groups?"
SEARCH STRATEGY
This review followed frameworks proposed by Arksey and O'Malley, Levac, and the Joanna Brigg's Institute. The PRISMA extension for Scoping Reviews (PRISMA-ScR) tool was used. The search strategy and specific terms were chosen using the population-concepts-context framework.
SELECTION CRITERIA
Titles and abstracts were reviewed independently by two reviewers. Inclusion and exclusion criteria were defined to set clear guidance for reviewers to identify appropriate studies.
DATA COLLECTION AND ANALYSIS
Five electronic databases were searched (CINAHL, EMBASE, MEDLINE [OVID] Web of Science and SCOPUS). A charting form was developed to record key characteristics systematically and uniformly from the studies.
MAIN RESULTS
Five themes were identified: systemic issues, antenatal care, complications of pregnancy, birth experience, and postnatal care. Systemic issues included racism, barriers to care, and adapted antenatal care. Antenatal issues included teenage pregnancy, smoking, risk of venous thrombus embolism, dietary issues, risk of communicable diseases, domestic violence, and mental health concerns. Increased risks of congenital abnormalities, growth restriction, premature labor, and perinatal and early childhood mortality were identified. For Roma women, negative birth experiences were reported, whereas the experiences of Traveller women varied.
CONCLUSIONS
The findings identified in this study serve to create a framework upon which healthcare providers can tailor the way in which pregnant people from a Roma, Gypsy, or Irish Traveller background are cared for. Using such a framework would hopefully begin to reduce the systematic marginalization and discrimination of these minorities.
PubMed: 38887905
DOI: 10.1002/ijgo.15723 -
Frontiers in Public Health 2024The maternal mortality indicator serves as a crucial reflection of a nation's overall healthcare, economic, and social standing. It is necessary to identify the...
INTRODUCTION
The maternal mortality indicator serves as a crucial reflection of a nation's overall healthcare, economic, and social standing. It is necessary to identify the variations in its impacts across diverse populations, especially those at higher risk, to effectively reduce maternal mortality and enhance maternal health. The global healthcare landscape has been significantly reshaped by the COVID-19 pandemic, pressing disparities and stalling progress toward achieving Sustainable Development Goals, particularly in maternal mortality reduction.
METHODS
This study investigates the determinants of maternal mortality in Kazakhstan from 2019 to 2020 and maternal mortality trends in 17 regions from 2000 to 2020, employing data extracted from national statistical reports. Stepwise linear regression analysis is utilized to explore trends in maternal mortality ratios in relation to socioeconomic factors and healthcare service indicators.
RESULTS
The national maternal mortality ratio in Kazakhstan nearly tripled from 13.7 in 2019 to 36.5 per 100,000 live births in 2020. A remarkable decrease was observed from 2000 until around 2015 with rates spiked by 2020. Significant factors associated with maternal mortality include antenatal care coverage and the number of primary healthcare units. Additionally, socioeconomic factors such as secondary education enrollment and cases of domestic violence against women emerged as predictors of MMR. Moreover, the impact of the pandemic was evident in the shift of coefficients for certain predictors, such as antenatal care coverage in our case. In 2020, predictors of MMR continued to include secondary education enrollment and reported cases of domestic violence.
CONCLUSION
Despite Kazakhstan's efforts and commitment toward achieving Sustainable Development Goals, particularly in maternal mortality reduction, the impact of the COVID-19 pandemic poses alarming challenges. Addressing these challenges and strengthening efforts to mitigate maternal mortality remains imperative for advancing maternal health outcomes in Kazakhstan.
Topics: Humans; Kazakhstan; Maternal Mortality; COVID-19; Female; Pregnancy; Adult; Socioeconomic Factors; SARS-CoV-2; Pandemics
PubMed: 38887251
DOI: 10.3389/fpubh.2024.1337564 -
BMC Women's Health Jun 2024As global immigration from countries with a high prevalence of female genital mutilation and cutting (FGM/C) has grown in the United States (US), there is need for...
BACKGROUND
As global immigration from countries with a high prevalence of female genital mutilation and cutting (FGM/C) has grown in the United States (US), there is need for pediatricians to have adequate training to care for these patients. The objective of this study is to determine the level of knowledge and attitudes of child abuse pediatricians (CAPs) towards FGM/C in the US.
METHODS
This cross-sectional study distributed a peer-reviewed survey to US CAPs-members of the Helfer Society-to assess their attitudes, knowledge, clinical practice, and education about FGM/C. Data was analyzed using descriptive statistics, Kruskal-Wallis tests, and Fisher's exact test.
RESULTS
Most of the 65 respondents were aware that FGM/C is illegal (92%) and agreed that it violated human rights (99%). Individuals reporting previous training related to FGM/C were significantly more likely to correctly identify World Health Organization types of FGM/C (p < 0.05) and report confidence in doing so (p < 0.05). Only 21% of respondents felt comfortable discussing FGM/C with parents from countries with a high prevalence of FGM/C. Sixty-three percent were not aware of the federal law, and 74% were not aware of their own state's laws about FGM/C.
CONCLUSIONS
US CAPs have high rates of training related to FGM/C; however, they need additional training to increase confidence and ability to identify FGM/C. FGM/C remains a topic that CAPs find difficult to discuss with families. With culturally sensitive training, CAPs have the opportunity to help manage and prevent the practice by serving as educators and experts for general pediatricians.
Topics: Humans; Circumcision, Female; Female; Cross-Sectional Studies; Child Abuse; Pediatricians; United States; Health Knowledge, Attitudes, Practice; Child; Male; Adult; Surveys and Questionnaires; Attitude of Health Personnel; Middle Aged
PubMed: 38886697
DOI: 10.1186/s12905-024-03119-7 -
Behavioral Sciences & the Law Jun 2024Sexual homicides (SHs) demand nuanced research for effective prevention, treatment, risk assessment and theoretical insights. Intimate-partner sexual homicides (IPSHs),...
Sexual homicides (SHs) demand nuanced research for effective prevention, treatment, risk assessment and theoretical insights. Intimate-partner sexual homicides (IPSHs), comprising approximately 20% of SHs, have received limited attention. This study compares IPSHs (n = 56) and non-intimate partner sexual homicides (NIPSHs) (n = 236) in Australia and New Zealand by investigating offender, victim, and crime-scene characteristics. While IPSH perpetrators were typically older, separated, and had prior domestic violence convictions, victims were more often non-white with histories of domestic violence and substance use. Although crime-scene locations and post-offence behaviours differed, similar crime scene behaviours were displayed across offender groups, which seemed to be routed in different underlying motives. Whereas drivers of IPSH commonly were grievance and anger, associated with offences occurring after arguments, drivers for NIPSH were more often sexual deviance and sadism. Overall, IPSH encompasses aspects of domestic violence, homicide, and sexual violence, distinguishing it from SH.
PubMed: 38885340
DOI: 10.1002/bsl.2680 -
Heliyon Jun 2024Intimate partner violence is a major public health concern around the world. While its degrading effects on maternal health are well documented, it is not clear...
Intimate partner violence is a major public health concern around the world. While its degrading effects on maternal health are well documented, it is not clear establishing a link with child health outcomes, especially on breastfeeding practices. Therefore, this paper aims to analyze the association between Intimate partner violence and breastfeeding practices in Cameroon using data from the 2018 demographic and health survey. Intimate partner violence is apprehended from its three dimensions (physical, emotional and sexual violence), and the two key breastfeeding practices are considered: early initiation to breastfeeding within an hour of delivery for children under 24 months of age, and exclusive breastfeeding during 24 h preceding the mother's interview for children under 6 months. The results of descriptive statistics suggest that 51.91 % (n = 1704) of mothers whose infants between 0 and 23 months of age who acquired early initiation to breastfeeding and 39.61 % (n = 484) of mothers whose infants between 0 and 5 months of age practiced exclusive breastfeeding. The estimated results of the logistic regression model suggest that emotional violence and sexual violence were significantly associated with low chances of early initiation to breastfeeding (OR: 0.675; 95 % CI: 0.528, 0.864; p < 0.05; OR: 0.741; 95 % CI: 0.525, 1.046; p < 0.1), which is not the case with physical violence which has no significant association. No dimension of Intimate partner violence was associated with exclusive breastfeeding, independently or with control for infant, maternal and household characteristics. We further performed robustness analysis, and the findings suggest that the associations are robust to consider another measure of Intimate partner violence and the duration of maternity leave. Thus, to improve breastfeeding practices, in particular early initiation to breastfeeding, public decision-makers should strengthen the fight against domestic violence by emphasizing sexual and emotional violence. This paper provides a benchmark for several future investigations that could discuss other breastfeeding practices and the policy challenges towards the length of maternity leave.
PubMed: 38882319
DOI: 10.1016/j.heliyon.2024.e32062 -
Responsivity to Interviewer during Interview-Based Assessment of Physical Intimate Partner Violence.Psychology of Violence Sep 2023Interview assessments of intimate partner violence (IPV) may provide more accurate behavior frequency estimates than self-report questionnaires. However, concerns have...
OBJECTIVE
Interview assessments of intimate partner violence (IPV) may provide more accurate behavior frequency estimates than self-report questionnaires. However, concerns have been raised about whether participants underreport IPV during interviews due to an emotional response to the interviewer.
METHOD
Participants were 42 mixed gender community couples (83 individuals) in which at least one partner endorsed physical IPV perpetration or victimization in their relationship. We examined whether participants were emotionally responsive to the interviewer during an interview about physical IPV. Responsivity was defined as the extent to which participants' emotional arousal, indexed by vocal fundamental frequency (f), was predicted by interviewers' emotional arousal at the previous talk turn on a moment-by-moment basis. We then examined whether participants' responsivity predicted interview-based reporting of IPV relative to their own self-report on an IPV measure and to the highest other available report (including partner report).
RESULTS
Repeated measures actor-partner interdependence models conducted in a multi-level modeling framework indicated that, on average, participants were responsive to interviewers' emotional arousal, even when controlling for responsivity to their own arousal, and that responsivity varied across participants. However, participants' responsivity to interviewer arousal did not significantly predict reporting of IPV perpetration or victimization during the interview relative to their own self-report or to the highest other available report.
CONCLUSIONS
Participants are emotionally responsive to interviewer arousal, but this responsivity does not appear to reduce interview-based reporting of IPV relative to self-report, supporting the utility of IPV interviews in clinical and research settings.
PubMed: 38882041
DOI: 10.1037/vio0000482 -
International Health Jun 2024In Somalia, despite its prohibition, female circumcision persists alongside significant intimate partner violence. This study examines the prevalence of wife-beating...
Attitudes towards wife-beating justification and its association with female genital mutilation - analysis of ever-married Somali women in the 2020 Somali Health and Demographic Survey.
BACKGROUND
In Somalia, despite its prohibition, female circumcision persists alongside significant intimate partner violence. This study examines the prevalence of wife-beating justification among Somali women and its link to the perception that female genital mutilation/cutting (FGM/C) is a religious obligation.
METHODS
We studied 7726 married Somali women 15-49 y of age from the 2020 Somali Health and Demographic Survey. Using χ2 tests and logistic regression, we examined wife-beating justification by covariates and its connection to the perception that FGM/C is a religious obligation.
RESULTS
The prevalence of women justifying wife-beating for any of six reasons was 56.5% (95% confidence interval [CI] 55.3 to 57.6). A higher prevalence of wife-beating justification was found among women 35-49 y of age (59.9% [95% CI 57.8 to 61.9]), without education (57.7% [95% CI 56.5 to 59.0]), rural residents (57.8% [95% CI 56.3 to 59.2]), with lower socio-economic status (60.4% [95% CI 58.7 to 62.1]) and married before age 18 y (58.4% [95% CI 56.7 to 60.1]). Adjusted for covariates, logistic regression analyses indicated a significant association between wife-beating justification and the belief that FGM/C is mandated by religion (adjusted odds ratio 1.40 [95% CI 1.17 to 1.68], p<0.001).
CONCLUSIONS
Wife-beating justification is alarmingly common among Somali women and significantly associated with the belief that FGM/C is mandated by religion. Further research is necessary to investigate the drivers behind the acceptance of domestic violence, its impact on women's mental health and well-being and its association with FGM/C acceptance.
PubMed: 38881416
DOI: 10.1093/inthealth/ihae047 -
BMC Primary Care Jun 2024Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important...
BACKGROUND
Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment.
OBJECTIVE
The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment.
DESIGN
A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0-5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion.
RESULTS
The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence.
CONCLUSIONS
This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection.
Topics: Humans; Child Abuse; Cross-Sectional Studies; Norway; Female; Primary Health Care; Male; Child, Preschool; Adult; Infant; Nurse's Role; Middle Aged; Guideline Adherence; Surveys and Questionnaires; Infant, Newborn; Public Health Nursing; Nurses, Public Health
PubMed: 38879472
DOI: 10.1186/s12875-024-02445-x -
Swiss Medical Weekly Jun 2024The mistreatment of older adults is a global and complex problem with varying prevalence. As there are no data on the prevalence of elder mistreatment in European...
AIM OF THE STUDY
The mistreatment of older adults is a global and complex problem with varying prevalence. As there are no data on the prevalence of elder mistreatment in European emergency department populations, we aimed to translate and culturally adapt the Emergency Department Senior Abuse Identification (ED Senior AID) tool for German use, assess the positive screen rate for elder mistreatment with the German version, and compare characteristics of patients who screened positive and negative.
METHODS
To assess the prevalence of elder mistreatment, we created a German version of the ED Senior AID tool. This tool identifies intentional or negligent actions by a caregiver or trusted person that cause harm or risk to an older adult. Then, the German ED Senior AID tool was applied to all consecutively presenting patients aged ≥65 years at our academic emergency department in the Northwest of Switzerland from 25 April to 30 May 2022. Usability was defined as the percentage of patients with completed assessments using the German ED Senior AID tool.
RESULTS
We included 1010 patients aged ≥65 years, of whom 29 (2.9%) screened positive with the ED Senior AID tool. The patients who screened positive were older, more severely cognitively impaired, hospitalised more frequently, and presented with higher frailty scores than those who screened negative. Mortality up to 100 days after presentation was comparable in all patients (p = 0.861), regardless of their screening result. The tool showed good usability, with 73% of assessments completed.
CONCLUSION
This is the first prospective investigation on the prevalence of elder mistreatment in a European emergency department setting. Overall, 2.9% of patients screened positive using a validated screening tool translated into German.
TRIAL REGISTRATION
This study was registered with the National Institute of Health on ClinicalTrials.gov with the registration number NCT05400707.
Topics: Humans; Elder Abuse; Switzerland; Aged; Emergency Service, Hospital; Male; Female; Prospective Studies; Aged, 80 and over; Mass Screening; Prevalence; Geriatric Assessment
PubMed: 38875501
DOI: 10.57187/s.3775 -
Health Sociology Review : the Journal... Jun 2024As trauma survivors, women and girls from refugee backgrounds face significant challenges when settling in host countries; the risk of domestic and family violence (DFV)...
Listening deeply to refugee background women to understand experiences of domestic and family violence in their communities to foster engagement with global support systems.
As trauma survivors, women and girls from refugee backgrounds face significant challenges when settling in host countries; the risk of domestic and family violence (DFV) accentuates these difficulties. Reflecting on findings from a seven-year university and industry research partnership, this article explores the etiology of DFV in women from refugee backgrounds living in non-metropolitan Australia. Drawing on action research principles and intersectional and social ecological theoretical frameworks, this study captured diverse women's views about experiences and strategies for addressing DFV in refugee communities. Having developed trusting relationships with participants over the different study phases, the first author conducted in-depth interviews with women of refugee backgrounds, listening deeply and confirming findings with participants as they emerged. Interviews were also conducted with staff from settlement, health and specialist domestic violence services to offer a broad perspective on how best to support refugee women experiencing DFV. Key findings revealed stressors and support that impact violence, such as employment status and acculturation, and identification of who the women would trust if experiencing violence. By understanding the interweaving factors influencing women's risk of DFV and strategies to address it, global healthcare providers will be better positioned to collaborate with refugee communities and specialist services.
PubMed: 38875352
DOI: 10.1080/14461242.2024.2357193