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Comprehensive Psychiatry Aug 2024To explore the occurrence, demographics, and circumstances of homicides of physicians.
OBJECTIVE
To explore the occurrence, demographics, and circumstances of homicides of physicians.
METHOD
Authors interrogated the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention's surveillance system tracking violent deaths between 2003 and 2018 which integrates data from law enforcement and coroner/medical examiner reports. Authors identified cases of homicide decedents whose profession was physician, surgeon, or psychiatrist. Data collected included decedents' demographics as well as circumstances of death.
RESULTS
Data were provided by 7-41 states as participating states increased over time. Fifty-six homicides were reported, most were male (73.2%) and white (76.8%). Most (67.9%) identified assailants reportedly knew decedents: 23.2% were perpetrated by partners/ex-partners; 10.7% by patients/patients' family members. Deaths were mainly due to gunshot wounds (44.6%), stabbing (16.1%), and blunt force trauma (16.1%). More (58.9%) homicides occurred at victims' homes than work (16.1%).
CONCLUSIONS
Physician homicides are relatively rare and occur at lower rates than in the general population. Physicians were more frequently killed by partners or ex-partners than by patients. Most homicides occurred away from the workplace. Broader efforts are needed to promote interventions throughout America's violent society to reduce domestic/partner violence and gun violence.
Topics: Humans; Homicide; Male; Female; United States; Adult; Physicians; Middle Aged; Aged; Cause of Death; Wounds, Gunshot
PubMed: 38788614
DOI: 10.1016/j.comppsych.2024.152503 -
PloS One 2024Childhood abuse can have long-term adverse outcomes in adulthood. These outcomes may pose a particular threat to the health and well-being of perinatal women; however,...
Childhood abuse can have long-term adverse outcomes in adulthood. These outcomes may pose a particular threat to the health and well-being of perinatal women; however, to date, this body of knowledge has not been systematically collated and synthesized. This systematic review examined the child abuse literature and a broad range of perinatal outcomes using a comprehensive search strategy. The aim of this review was to provide a clearer understanding of the distinct effect of different abuse types and areas where there may be gaps in our knowledge. Following PRISMA guidelines, EBSCO, PsychInfo, Scopus, Medline, CINAHL, PubMed, and Google Scholar databases and gray literature including preprints, dissertations and theses were searched for literature where childhood abuse was associated with any adverse perinatal outcome between 1969 and 2022. Exclusion criteria included adolescent samples, abuse examined as a composite variable, editorials, letters to the editor, qualitative studies, reviews, meta-analyses, or book chapters. Using an assessment tool, two reviewers extracted and assessed the methodological quality and risk of bias of each study. From an initial 12,384 articles, 95 studies were selected, and the outcomes were categorized as pregnancy, childbirth, postnatal for the mother, and perinatal for mother and child. The prevalence of childhood abuse ranged from 5-25% with wide variability (physical 2-78%, sexual 2-47%, and emotional/psychological 2-69%). Despite some consistent findings relating to psychological outcomes (i.e., depression and PTSD), most evidence was inconclusive, effect sizes were small, or the findings based on a limited number of studies. Inconsistencies in findings stem from small sample sizes and differing methodologies, and their diversity meant studies were not suitable for a meta-analysis. Research implication include the need for more rigorous methodology and research in countries where the prevalence of abuse may be high. Policy implications include the need for trauma-informed care with the Multi-level Determinants of Perinatal Wellbeing for Child Abuse Survivors model a useful framework. This review highlights the possible impacts of childhood abuse on perinatal women and their offspring and areas of further investigation. This review was registered with PROSPERO in 2021 and funded by an internal grant from Charles Sturt University.
Topics: Humans; Pregnancy; Female; Child Abuse; Child; Mothers; Pregnancy Outcome; Adult
PubMed: 38787894
DOI: 10.1371/journal.pone.0302354 -
Women's Health (London, England) 2024Survivors of sexual assault and intimate partner violence often face many challenges in seeking/receiving healthcare and are often lost to follow up.
BACKGROUND
Survivors of sexual assault and intimate partner violence often face many challenges in seeking/receiving healthcare and are often lost to follow up.
OBJECTIVES
Our study objectives are to evaluate the feasibility, acceptability, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence patients who present to a Canadian Emergency Department.
DESIGN
Qualitative research was conducted using a thematic approach.
METHODS
Patients were identified from a case registry of all sexual assault and intimate partner violence cases seen between 1 April 2020 and 31 March 2022 from an emergency department of a large Canadian hospital. Qualitative trauma-informed interviews were conducted with consenting participants. Thematic qualitative analyses were performed to investigate barriers and drivers of telemedicine for follow-up care.
RESULTS
Of the 1007 sexual assault and intimate partner violence patients seen during the study timeframe, 180 (8%) consented to be contacted for future research, and 10 completed an interview regarding telemedicine for follow-up care. All participants were cisgendered women, 5 (50%) experienced sexual assault, 6 (60%) physical assault, and 3 (30%) verbal assault. All knew their assailant, and 6 (60%) were assaulted by a current or former intimate partner. Three themes emerged as drivers of telemedicine use: increased comfort, increased convenience, and less time required for the appointment. Three thematic barriers to telemedicine use included lack of privacy from others, lack of safety from their assailant, and pressure to balance competing tasks during the appointment.
CONCLUSION
This study illustrated that telemedicine for sexual assault and intimate partner violence follow-up care is feasible, acceptable, and can improve patient satisfaction with follow-up care. Ensuring safety and privacy are key considerations when offering telemedicine as an appropriate option for survivors.
Topics: Humans; Telemedicine; Female; Qualitative Research; Intimate Partner Violence; Adult; Survivors; Canada; Sex Offenses; Middle Aged; Emergency Service, Hospital; Patient Satisfaction
PubMed: 38783826
DOI: 10.1177/17455057241252958 -
Violence Against Women May 2024This article explores the theological drivers of domestic and family violence (DFV)-specifically intimate partner violence-by engaging with ecclesiastical beliefs and...
This article explores the theological drivers of domestic and family violence (DFV)-specifically intimate partner violence-by engaging with ecclesiastical beliefs and practices of the Lutheran Church of Australia (LCA). Key theological, policy, and public documents were analyzed to understand gender relations, gender roles, marriage, ordination, ethical behavior, and responses to DFV. Findings from the document analysis demonstrate church practice and policy reforms underway in addressing violence against women and supporting safety. Simultaneously, the documents show contested and troubled positions regarding gender relations, the theological context to gender roles and responsibilities and the church's journey of debating (re)configuration of its organizational structure and responsibilities.
PubMed: 38783771
DOI: 10.1177/10778012241254849 -
JPMA. the Journal of the Pakistan... May 2024To review available medical literature to elucidate the association between childhood sexual abuse and the development of irritable bowel syndrome later in life. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To review available medical literature to elucidate the association between childhood sexual abuse and the development of irritable bowel syndrome later in life.
METHODS
This systematic review was conducted from January to August 2022 and comprised a literature search on Medline (via PubMed), Scopus, Embase, Web of Science, and Google Scholar databases for relevant studies published between 2001 and 2021. The Newcastle-Ottawa scale was used to determine the quality of the studies. Data on the prevalence of irritable bowel syndrome were meta-analysed using a Mantel-Haenszel random-effects model in RevMan 5.4.1.
RESULTS
Of the 7 observational studies analyzed in detail, 5 (71.4%) had a case-control design, and 2 (28.6%) were crosssectional studies. Overall, there were 3156 subjects. The prevalence of irritable bowel syndrome in the childhood sexual abuse group was 51.86% (334/644), while it was 36.74% (923/2512) in the non-childhood sexual abuse group. The pooled odds ratio, indicating the association between childhood sexual abuse and irritable bowel syndrome, was 1.87 (95% confidence interval: 1.56-2.26). The study quality was rated as good in 3 (42.8%) cases, fair in 3 (42.8%), and poor in 1 (14.3%).
CONCLUSION
Childhood sexual abuse was found to be significantly associated with the development of irritable bowel syndrome later in life, further strengthening the argument that childhood sexual abuse can lead to long-term detriments extending into adulthood. However, there was no existing literature found that stratified other aspects of irritable bowel syndrome, including symptom severity and childhood sexual abuse being the exclusive cause of irritable bowel syndrome.
Topics: Irritable Bowel Syndrome; Humans; Child Abuse, Sexual; Prevalence; Child
PubMed: 38783444
DOI: 10.47391/JPMA.9542 -
BMC Public Health May 2024Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health....
Multi-level analysis of intimate partner violence and its determinants among reproductive age group women in Ethiopia: evidence from Ethiopian Demographic Health Survey, 2016.
BACKGROUND
Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia.
METHODS
A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15-49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test.
RESULT
The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20-24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25-29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30-34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35-39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40-44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45-49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42-3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV.
CONCLUSION AND RECOMMENDATION
This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences.
Topics: Humans; Female; Ethiopia; Adult; Adolescent; Intimate Partner Violence; Middle Aged; Young Adult; Retrospective Studies; Health Surveys; Prevalence; Risk Factors; Multilevel Analysis; Socioeconomic Factors
PubMed: 38783247
DOI: 10.1186/s12889-024-18781-7 -
Heliyon May 2024This paper seeks to gain insights into complex and multiple influences which may behind the different components of intimate partner violence (IPV) against Jordanian...
This paper seeks to gain insights into complex and multiple influences which may behind the different components of intimate partner violence (IPV) against Jordanian wives. Drawing on a quantitative approach, the paper explores and presents findings of the determinants of domestic violence sustained by female partners during the year preceding a nationally representative survey. The survey is based on national multi-stage random sampling data from the 2012 Jordan Demographic Health Survey (JDHS). The paper applies the social-ecological framework. A method of Leastwise deletion techniques is used to remove missing data. Doing this resulted in 6213 married women used in the data analysis. Logistic regression models are used to estimate/predict different forms of IPV against domestic female partners. The findings of the study suggest that wives are victimized at all levels of the framework. Specifically, family, community, and social levels were the most vital factors affecting victims experiencing IPV. More specifically, wives witnessing their fathers beat their mothers and wives who are scared of their husbands are more prone to sustain violence inflicted by their partners. Furthermore, wives' education, working status, and age at marriage do not predict IPV. Another key finding is that wife empowerment in family relationships is a protective factor against domestic violence against her. The implication is that the patriarchal explanation of domestic violence against wives is valid in the Jordanian cultural context. This study underscores the need to reevaluate the effectiveness of Jordan's general human development programs and women empowerment programs as an essential measure for alleviating IPV inflicted on married women in Jordan.
PubMed: 38778956
DOI: 10.1016/j.heliyon.2024.e30364 -
European Journal of Paediatric Dentistry Jun 2024Orofacial trauma (OFT) occurs frequently in children and requires thorough evaluation not only by paediatric dentists but also by all specialists involved in emergency...
Orofacial trauma (OFT) occurs frequently in children and requires thorough evaluation not only by paediatric dentists but also by all specialists involved in emergency services, particularly in cases involving children under 3 years of age, given their inability to directly participate in clinical-anamnestic evaluations. Addressing early childhood orofacial trauma resulting from maltreatment, this study explores the key role played by various healthcare professionals, including paediatric dentists, general dentists, maxillofacial surgeons, dental hygienists, and paediatricians, in the optimal management of these cases. In the event of trauma due to suspected or confirmed mistreatment, it is essential that all healthcare workers involved have precise knowledge of the appropriate course of action from both a clinical and legal point of view, guaranteeing maximum protection for the young patient. This is particularly significant as cases of mistreatment with apparently minor consequences can degenerate into situations of irreparable severity. The latest guidelines from the International Association of Dental Traumatology (IADT) in 2020 continue to emphasise the potential correlation between OFT and cases of abuse or violence. Recent recommendations in the literature highlight the importance of facilitating mandatory reporting of incidents to relevant authorities and improving information sharing between dental healthcare professionals and child welfare services. A new flow diagram, called Paediatric Orofacial Trauma Alert (P.O.T.A.), has been proposed at the University of Verona. This tool is specifically designed to assist specialists dealing with early childhood orofacial trauma cases by assisting them in identifying potential cases of maltreatment. In this innovative approach, the collaborative efforts of general dentists, paediatric dentists, maxillofacial surgeons, dental hygienists and paediatricians play a vital role in cases of abuse. In addition to restoring the oral health of young patients, these professionals can activate a vast network of contacts, ensuring not only optimal oral health care but also providing comprehensive support to victims. The objective is to safeguard not only the physical but also the psychological well-being of these vulnerable subjects.
Topics: Humans; Child, Preschool; Child Abuse; Facial Injuries; Italy; Patient Care Team; Infant
PubMed: 38778771
DOI: 10.23804/ejpd.2024.2141 -
Trials May 2024Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not...
BACKGROUND
Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse.
METHODS
This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses.
DISCUSSION
This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral.
TRIAL REGISTRATION
ANZCTR, ACTRN12623000676617p . Registered 22 June 2023.
Topics: Humans; Elder Abuse; Aged; Single-Blind Method; Health Personnel; Pragmatic Clinical Trials as Topic; Australia; Multicenter Studies as Topic; Health Knowledge, Attitudes, Practice; Quality of Life; Inservice Training; Time Factors; Middle Aged; Attitude of Health Personnel
PubMed: 38778386
DOI: 10.1186/s13063-024-08160-3 -
Journal of Affective Disorders Sep 2024In the 1990s, the concepts of hikikomori and modern-type depression (MTD) emerged in Japan. Hikikomori is a condition of social avoidance or isolation, characterized by...
BACKGROUND
In the 1990s, the concepts of hikikomori and modern-type depression (MTD) emerged in Japan. Hikikomori is a condition of social avoidance or isolation, characterized by staying at home and being physically isolated for at least six months. MTD is characterized by depressive symptoms-mainly in stressful work or school situations during adolescence and early adulthood-which tend to rapidly reduce or disappear after leaving the stressful situation. We hypothesized that childhood maltreatment can form MTD traits that lead to hikikomori.
METHODS
As a first step, we conducted a multigroup path analysis between childhood maltreatment, MTD traits, and physical isolation in the hikikomori group. This study utilized the nine-item Patient Health Questionnaire (PHQ-9), Home Environment Questionnaire (HEQ), 22-item Tarumi Modern-Type Depressive Trait Scale (TACS-22), 25-item Hikikomori Questionnaire (HQ-25), and Hamilton Depression Rating Scale (HDRS). The HQ-25 contains three factors: physical isolation, lack of socialization, and lack of emotional support.
RESULTS
The hikikomori group included 92 patients and the control group comprised 137 healthy individuals. All total and subscale scores of PHQ-9, HEQ, TACS-22, HQ-25, and HDRS were significantly higher in the hikikomori group than in the control group. The risk model of childhood maltreatment for physical isolation via MTD traits obtained good fit with a goodness-of-fit index of.982.
LIMITATIONS
The study's limitations were its sample selection bias, cross-sectional design, and use of self-report scales.
CONCLUSIONS
Our findings support the hypothesis that childhood maltreatment is an important risk factor for hikikomori via MTD traits.
Topics: Humans; Male; Female; Adult; Social Isolation; Middle Aged; Japan; Depression; Adult Survivors of Child Abuse; Surveys and Questionnaires; Psychiatric Status Rating Scales; Child Abuse
PubMed: 38777275
DOI: 10.1016/j.jad.2024.05.094