What have adolescents in Rio de Janeiro city, Brazil, done to reduce their community violence exposure? / O que os adolescentes do município do Rio de Janeiro, Brasil, têm feito para reduzir sua exposição à violência comunitária?

This study aims to identify the individual community strategies to avoid violence exposure most used by adolescents from public and private schools in the IX Administrative Region of Rio de Janeiro and investigate the profile of co-occurrence and its prevalence in specific population subgroups. This is a cross-sectional study with 693 individuals. A multidimensional questionnaire collected information regarding strategies to avoid community violence exposure and was self-completed in the classroom. The most used strategies were avoiding walking close to armed people (55.5%), avoiding walking alone (30.5%), and avoiding returning home at dawn (24.7%). Girls adopt more of all (concurrently) the four limiting behaviors to reduce their community violence exposure (53% vs. 32%). Notably, the adoption of such strategies differed by socioeconomic indicators and was higher among adolescents from lower-income households. These findings point to the high frequency of use of such strategies by adolescents, which may hinder and limit the full development of their social and cultural skills.

O objetivo do estudo é conhecer as estratégias individuais mais utilizadas por adolescentes de escolas públicas e privadas da IX Região Administrativa do município do Rio de Janeiro para evitar a exposição à violência comunitária, bem como investigar o perfil de coocorrência e sua prevalência em subgrupos populacionais específicos. Trata-se de um estudo seccional com 693 indivíduos. As informações referentes às estratégias para evitar a exposição à violência comunitária foram coletadas por meio de questionário multidimensional autopreenchido em sala de aula. As estratégias mais utilizadas foram: evitar passar onde há pessoas armadas (55,5%), evitar andar sozinho (30,5%) e evitar voltar para casa de madrugada (24,7%). Observou-se que as meninas adotam mais todos (concomitantemente) os quatro tipos de comportamento limitantes para reduzir sua exposição à violência comunitária (53% vs. 32%). Ressalta-se que a adoção de tais estratégias diferiu segundo os indicadores socioeconômicos, sendo maior entre os adolescentes oriundos de família de estratos de renda mais baixos. Tais achados chamam a atenção para a alta frequência de utilização de tais estratégias por adolescentes, o que pode cercear e limitar o pleno desenvolvimento de suas habilidades sociais e culturais.

Education and training for preventing and minimizing workplace aggression directed toward healthcare workers.

BACKGROUND: Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression.  OBJECTIVES: To assess the effectiveness of education and training interventions that aim to prevent and minimize workplace aggression directed toward healthcare workers by patients and patient advocates. SEARCH METHODS: CENTRAL, MEDLINE, Embase, six other databases and five trial registers were searched from their inception to June 2020 together with reference checking, citation searching and contact with study authors to identify additional studies. SELECTION CRITERIA: Randomized controlled trials (RCTs), cluster-randomized controlled trials (CRCTs), and controlled before and after studies (CBAs) that investigated the effectiveness of education and training interventions targeting aggression prevention for healthcare workers. DATA COLLECTION AND ANALYSIS: Four review authors evaluated and selected the studies resulting from the search. We used standard methodological procedures expected by Cochrane. We assessed the certainty of evidence using the GRADE approach. MAIN RESULTS: We included nine studies-four CRCTs, three RCTs, and two CBAs-with a total of 1688 participants. Five studies reported episodes of aggression, and six studies reported secondary outcomes. Seven studies were conducted among nurses or nurse aides, and two studies among healthcare workers in general. Three studies took place in long-term care, two in the psychiatric ward, and four in hospitals or health centers. Studies were reported from the United States, Switzerland, the United Kingdom, Taiwan, and Sweden. All included studies reported on education combined with training interventions. Four studies evaluated online programs, and five evaluated face-to-face programs. Five studies were of long duration (up to 52 weeks), and four studies were of short duration. Eight studies had short-term follow-up (< 3 months), and one study long-term follow-up (> 1 year). Seven studies were rated as being at "high" risk of bias in multiple domains, and all had "unclear" risk of bias in a single domain or in multiple domains. Effects on aggression Short-term follow-up The evidence is very uncertain about effects of education and training on aggression at short-term follow-up compared to no intervention (standardized mean difference [SMD] -0.33, 95% confidence interval [CI] -1.27 to 0.61, 2 CRCTs; risk ratio [RR] 2.30, 95% CI 0.97 to 5.42, 1 CBA; SMD -1.24, 95% CI -2.16 to -0.33, 1 CBA; very low-certainty evidence). Long-term follow-up Education may not reduce aggression compared to no intervention in the long term (RR 1.14, 95% CI 0.95 to 1.37, 1 CRCT; low-certainty evidence). Effects on knowledge, attitudes, skills, and adverse outcomes Education may increase personal knowledge about workplace aggression at short-term follow-up (SMD 0.86, 95% CI 0.34 to 1.38, 1 RCT; low-certainty evidence). The evidence is very uncertain about effects of education on personal knowledge in the long term (RR 1.26, 95% CI 0.90 to 1.75, 1 RCT; very low-certainty evidence). Education may improve attitudes among healthcare workers at short-term follow-up, but the evidence is very uncertain (SMD 0.59, 95% CI 0.24 to 0.94, 2 CRCTs and 3 RCTs; very low-certainty evidence). The type and duration of interventions resulted in different sizes of effects. Education may not have an effect on skills related to workplace aggression (SMD 0.21, 95% CI -0.07 to 0.49, 1 RCT and 1 CRCT; very low-certainty evidence) nor on adverse personal outcomes, but the evidence is very uncertain (SMD -0.31, 95% CI -1.02 to 0.40, 1 RCT; very low-certainty evidence). Measurements of these concepts showed high heterogeneity. AUTHORS' CONCLUSIONS: Education combined with training may not have an effect on workplace aggression directed toward healthcare workers, even though education and training may increase personal knowledge and positive attitudes. Better quality studies that focus on specific settings of healthcare work where exposure to patient aggression is high are needed. Moreover, as most studies have assessed episodes of aggression toward nurses, future studies should include other types of healthcare workers who are also victims of aggression in the same settings, such as orderlies (healthcare assistants). Studies should especially use reports of aggression at an institutional level and should rely on multi-source data while relying on validated measures. Studies should also include days lost to sick leave and employee turnover and should measure outcomes at one-year follow-up. Studies should specify the duration and type of delivery of education and should use an active comparison to prevent raising awareness and reporting in the intervention group only.

At-a-glance - The Child Maltreatment Surveillance Indicator Framework. / Aperçu - Cadre des indicateurs de surveillance de la maltraitance envers les enfants.

The federal health portfolio has conducted surveillance on child maltreatment as a public health issue since the 1990s. The Public Health Agency of Canada (PHAC) is now releasing the Child Maltreatment Indicator Framework, to take its place alongside other PHAC frameworks, such as the Suicide Surveillance Indicator Framework. Based on a scoping review of existing reviews and meta-analyses, this Framework, along with the online interactive data tool, presents child maltreatment outcome indicators and risk and protective factors at the individual, family, community and societal levels, disaggregated by sex, age and other sociodemographic variables. This Framework will function as a valuable resource pertaining to an issue that affects at least one in three Canadian adults.

The Child Maltreatment Surveillance Indicator Framework complements other indicator frameworks released by the Public Health Agency of Canada and presents available data on child maltreatment outcomes and risk and protective factors at the individual, family, community and societal level. One-third (34.1%) of the Canadian population aged 15 years and older have experienced at least one type of childhood maltreatment. Physical abuse was experienced most often (27.4%), followed by exposure to intimate partner violence (10.6%) and sexual abuse (8.1%). Factors such as parental mental illness, substance use and past experience of family violence can put children at higher risk of child maltreatment.

Le Cadre d'indicateurs de la maltraitance envers les enfants vient compléter d'autres cadres d'indicateurs publiés par l'Agence de la santé publique du Canada et présente des données sur les résultats et les facteurs de risque et de protection de la violence envers les enfants, aux échelles individuelle, familiale, communautaire et sociétale. Le tiers (34,1 %) de la population canadienne âgée de 15 ans et plus a été victime d'au moins un type de maltraitance durant l'enfance. La violence physique est le type de maltraitance le plus répandu (27,4 %), suivie de l'exposition à la violence entre partenaires intimes (10,6 %) et de l'abus sexuel (8,1 %). Des facteurs présents chez les parents tels que la maladie mentale, la consommation de substances et le fait d'avoir été victime de violence familiale peut exposer les enfants à un risque plus élevé de maltraitance.

Enhancing the Identification of Commercial Sexual Exploitation Among a Population of High-Risk Youths Using Predictive Regularization Models.

Despite an increasing awareness about the existence and harms of commercial sexual exploitation of children (CSEC), the identification of victims remains a challenge for practitioners, hindering their ability to provide appropriate services. Tools that gauge risk of CSEC support the identification of victims but are underdeveloped because most tools assess risk of CSEC within a general youth population. An understanding of what predicts actual CSEC victimizations among youths at higher risk of CSEC due to experiences of childhood adversities has been left unassessed. Research in this area is limited in part because traditional methods do not allow for an assessment of the unique impact of childhood adversities that tend to co-occur. To address these difficulties, the current study applied predictive regularization methods to identify the most decisive risk items for CSEC. Proximal risk of CSEC was assessed among 317 youths who were referred to a specialized program in the Northeast of the United States due to suspicion of CSEC. With an innovative methodological approach, this study seeks to prompt other scholars to examine risk utilizing novel techniques and provides a foundation for the development of concise tools that assess risk of CSEC among populations of youths at higher levels of risk.

Interventions to prevent aggression against doctors: a systematic review.

OBJECTIVE: To find out if there is evidence on interventions to prevent aggression against doctors. DESIGN: This systematic review searched the literature and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: Pubmed, Embase, Turning Research into Practice (TRIP), Cochrane and Psycharticle, GoogleScholar and www.guideline.gov were consulted. ELIGIBILITY CRITERIA: Abstracts published in English between January 2000 and January 2018 were screened. Eligible studies focused on prevention and risk factors of type II workplace violence in general healthcare, psychiatric departments, emergency departments, emergency primary care, general practice. DATA EXTRACTION AND SYNTHESIS: The selected intervention studies were grouped into quantitative and qualitative studies. Systematic reviews were reported separately. For each study, the design, type of intervention and key findings were analysed. Quality rating was based on Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and GRADE-Confidence in the Evidence from Reviews of Qualitative Research (CERQUAL). RESULTS: 44 studies are included. One randomised controlled trial (RCT) provided moderate evidence that a violence prevention programme was effective in decreasing risks of violence. Major risk factors are long waiting times, discrepancy between patients' expectations and services, substance abuse by the patient and psychiatric conditions. Appropriate workplace design and policies aim to reduce risk factors but there is no hard evidence on the effectiveness. One RCT provided evidence that a patient risk assessment combined with tailored actions decreased severe aggression events in psychiatric wards. Applying de-escalation techniques during an aggressive event is highly recommended. Postincident reporting followed by root cause analysis of the incident provides the basic input for review and optimisation of violence prevention programmes. CONCLUSIONS: This review documented interventions to prevent and de-escalate aggression against doctors. Aggression against physicians is a serious occupational hazard. There is moderate evidence that an integrated violence prevention programme decreases the risks of patient-to-worker violence. The review failed to gather sufficient numerical data to perform a meta-analysis. A large-scale cohort study would add to a better understanding of the effectiveness of interventions.

American Association for the Surgery of Trauma Prevention Committee topical update: Impact of community violence exposure, intimate partner violence, hospital-based violence intervention, building community coalitions and injury prevention program evaluation.

An effective injury prevention program is an important component of a successful trauma system. Maintaining support for a hospital-based injury prevention program is challenging, given competing institutional and trauma program priorities and limited resources. In light of those pressures, the American College of Surgeons Committee on Trauma mandates that trauma centers demonstrate financial support for an injury prevention program as part of the verification process, recognizing that hospital administrators might see such support as discretionary and ripe as a target for expense reduction efforts. This Topical Update from the American Association for the Surgery of Trauma Injury Prevention Committee focuses on strategies to be more effective with the limited resources that are allocated to hospital-based injury prevention programs. First, this review tackles two of the many social determinates of violence, including activities aimed at mitigating the impact of both community violence exposure and intimate partner/domestic violence. Developing or participating in coalitions for injury prevention, both in general with any injury prevention initiative, and specifically while developing a hospital-based violence intervention program, efficiently extends the hospital's efforts by gaining access to expertise, resources, and influence over the target population that the hospital might otherwise have difficulty impacting. Finally, the importance of systematic program evaluation is explored. In an era of dwindling resources for injury prevention, both at the national level and the institutional level, it is important to measure the effectiveness of injury prevention efforts on the target population, and when necessary, make changes to programs to both improve their effectiveness and to assist organizations in making wise choices in the use of their limited resources.

Effects of cartoon violence on aggressive thoughts and aggressive behaviors.

This article reports on an experiment designed to test whether the cartoon manipulation leads to significant increases in aggressive thoughts and aggressive behaviors among Chinese children (n = 3,000). Results indicated that brief exposure to a violent cartoon triggered higher aggressive thoughts and aggressive behaviors than a nonviolent cartoon. Females displayed higher aggressive thoughts and aggressive behaviors than males in a nonviolent cartoon condition, while males displayed higher aggressive behaviors than females in a violent cartoon condition. Mediation analysis suggested that the effect on aggressive behaviors was mediated by aggressive thoughts. The findings imply that cartoon developers, parents, and teachers should develop cartoons that inhibit children's aggressive thoughts to avoid aggressive behaviors. Females are the key group for the prevention and intervention of aggression in a nonviolent cartoon context, while males are the key group for the prevention and intervention of aggression in a violent cartoon context.

Proteção e desgaste: a dialética da violência contra jovens no estado do Paraná / Protection and wear: the dialectic of violence against young people in the state of Paraná

Resumo: Trata-se de um estudo descritivo e exploratório com abordagem qualiquantitativa, baseado na epidemiologia crítica, que objetivou elaborar a Matriz de Processos Críticos das violências contra e entre jovens universitários no estado do Paraná, explicitando os processos de proteção e desgaste envolvidos no fenômeno. Para tanto, desenvolveu-se três fases de pesquisa. Na primeira fase utilizou-se dados dos casos de violências ocorridos contra e entre jovens com idade de 18 a 29 anos, com nível superior incompleto, por meio de dados secundários obtidos do Sistema de Informação de Agravos de Notificação (SINAN-Net). Na segunda fase, os dados foram coletados junto a jovens universitários, regularmente matriculados nos diferentes cursos da UFPR, em seus vários campi - com idade entre 18 e 29 anos, por meio de questionário eletrônico. Na terceira e última fase, a construção da Matriz de Processos Críticos. Identificou-se na primeira fase (quantitativa) que, o maior número de notificações de violência ocorreram com o sexo feminino, de raça branca, solteiras, em suas residências ou vias públicas. A tipologia das violências com maior notificação foram física, psicológica e autoprovocadas, tendo como motivação sexismo ou conflito geracional. Já a segunda fase da pesquisa (qualitativa), obtevese 68 questionários e a análise foi realizada com apoio do software WebQDA. Emergiram três categorias e seis subcategorias. Dentre elas, se destacam a dimensão particular, onde houve maior especificidade das respostas frente ao tema da pesquisa. Os participantes apontaram a categoria de proteção às violências, relações de amizade; cuidados e horários para sair nas ruas e na universidade; necessidade de apoio institucional e segurança, dentro e fora da universidade, e de desgaste às violências, como fragilidade socioeconômica; raça e relações de poder. Na terceira fase, foi realizada a construção de uma matriz de processos críticos, reconhecida como modelo de organização do trabalho de investigação e intervenção em epidemiologia. Como conclusão, percebe-se que as violências contra e entre jovens universitários são fenômenos socialmente determinados, sendo possível a obtenção de informações diferenciadas acerca das tipologias das violências e da implantação de políticas públicas para a prevenção e enfrentamento das violências. Desta forma, se faz necessário, que a universidade realize ações junto à sociedade organizada e Estado, para além da criação dos coletivos, realizando atividades de ensino, pesquisa e extensão que discutam as violências dentro das universidades, bem como o empoderamento dos jovens para que ocorra a denúncia dos casos. A construção de uma matriz de processos críticos, possibilitou o reconhecimento da realidade objetiva do fenômeno "violências" contra e entre jovens universitários no estado do Paraná e, acredita-se que servirá como guia para a orientação de ação, organização e capacitação participativa dos profissionais de saúde no que tange ao enfrentamento do fenômeno violências contra e entre jovens universitários.

Abstract: This is a descriptive and exploratory study with a quantitative and qualitative approach, based on critical epidemiology, which aimed to elaborate the Matrix of Critical Processes of violence against and among university students in the state of Paraná, explaining the processes of protection and attrition involved in the phenomenon. Therefore, three phases of research were developed. In the first phase, data from cases of violence against and among young people aged 18 to 29 years, with incomplete upper level, were used, using secondary data obtained from the SINAN-Net Information System. In the second phase, the data were collected from university students, regularly enrolled in the different UFPR courses, in their various campuses - aged 18 to 29 years, by means of an electronic questionnaire. In the third and last phase, the construction of the Matrix of Critical Processes. It was identified in the first phase (quantitative) that, the largest number of reports of violence occurred with female, white, single, in their homes or public ways. The typology of violence with greater notification were physical, psychological and selfinflicted, motivated by sexism or generational conflict. In the second phase of the research (qualitative), 68 questionnaires were obtained and the analysis was performed with the support of WebQDA software. Three categories and six subcategories emerged. Among them, the particular dimension is highlighted, where there was a greater specificity of the answers to the research theme. Participants pointed to the category of protection against violence, friendship relations; care and times to go out on the streets and in the university; need for institutional support and security, inside and outside the university, and attrition to violence, such as socioeconomic fragility; race and power relations. In the third phase, the construction of a matrix of critical processes, recognized as a model for the organization of research and intervention in epidemiology, was carried out. As a conclusion, it can be seen that violence against and among university students are socially determined phenomena, and it is possible to obtain differentiated information about the typologies of violence and the implementation of public policies for the prevention and confrontation of violence. In this way, it is necessary for the university to carry out actions with organized society and the State, in addition to creating the collective, carrying out teaching, research and extension activities that discuss violence within universities, as well as the empowerment of young people to cases are reported. The construction of an array of critical processes enabled the recognition of the objective reality of the phenomenon "violence" against and among university students in the state of Paraná and is believed to serve as a guide for action orientation, organization and participatory training of professionals of health in relation to the confrontation of the violence phenomenon against and among university students.

Violent Lives: Pathways Linking Exposure to Violence To Suicidal Behavior in a National Sample.

This study explored the extent to which depression, somatic symptoms, and substance use mediated the effects of exposure to violence on suicidal ideation and attempted suicide, and whether these pathways varied across gender, age, and race/ethnicity. Path analysis was conducted on 12,272 adolescents (mean = 15.3 years) from the National Longitudinal Study of Adolescent to Adult Health. The impact of exposure to violence on suicidal ideation was fully mediated, and the impact of exposure to violence on attempted suicide was partially mediated by depression, somatic symptoms, and substance use. Mediating pathways were stronger for females and for younger adolescents. Understanding the impact of exposure to violence on adolescent suicidal behavior requires the consideration of direct, indirect, and conditional indirect effects.

Maternal violence experiences and risk of postpartum depression: A meta-analysis of cohort studies.

BACKGROUND: Most of original studies indicated maternal violence experiences is associated with adverse obstetric outcomes, to date, but it is not clear that the association of maternal violence experiences and the risk of postpartum depression (PPD). We aimed to assess the association between maternal violence experiences and risk of developing PPD by performing a meta-analysis of cohort studies. METHODS: PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through December 2017 to identify studies that assessed the association between violence and PPD. Meta-analysis was conducted by the RevMan software and Stata software. Potential heterogeneity source was explored by subgroup analysis and potential publication bias was assessed by Begg's funnel plots and Egger's linear regression test. RESULTS: Overall, women experiencing any violence events compared with the reference group were at a higher risk of developing PPD (odds ratio [OR] = 2.04; 95% confidence interval [CI]: 1.72-2.41). Additionally, different types of violence events such as sexual (OR = 1.56; 95%CI: 1.35-1.81), emotional (OR = 1.75; 95%CI: 1.61-1.89), and physical violence (OR = 1.90; 95%CI: 1.36-2.67), as well as domestic (OR = 2.05; 95%CI: 1.50-2.80) or childhood violence (OR = 1.59; 95%CI: 1.34-1.88) also increased the risk of developing PPD. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. CONCLUSIONS: Maternal violence experiences are significantly associated with risk of developing PPD. These finding highlight the necessary to protect women from any types of violence and formulate preventive strategies to promote the maternal mental health.

Lifetime Experience of Violence in Early Adulthood Female.

INTRODUCTION: Despite political commitment and a supportive legal and policy framework, violence against women remains a significant problem in Nepal. Nepal Demographic and Health Survey reported more than one in five women experience violence in lifetime. Three fourth of women who had experienced physical or sexual violence had not sought any help. The aim of the study is to find out the status of early adult hood experience of violence in female. METHODS: Descriptive cross-sectional study was carried out in an Institute in Lalitpur. Accessibility sampling was used to find out the experience of violence from their childhood to this date. The data were collected by self-administered questionnaire was distributed to the female students. Data were analyzed using SPSS. Frequency, mean, percentage and standard deviation were calculated. RESULTS: More than three fourth 71 (79.8%) of the female students were victim of violence and among them most 67 (75.3%) were at age of 11 to 19 years. Majority 63 (70.8%) were victimized from strangers followed by friends 11 (12.4%). Teasing 55 (61.8%) and unwanted touching 35 (39.3%) were the most common type of violence. Most 51 (57.3%) were the victim while traveling by public vehicle and walking on road 47 (52.8%). More than half (57.7%) were suffered <5 times. One third 34 (38.2%) told strict punishment to the offenders followed by awareness program 32 (36%) for the prevention of violence. CONCLUSIONS: Majority of the female students were victim of violence and offenders were young adult. Awareness program, strict rules and punishment to offenders should be implemented to prevent the violence among girls.

Violência contra o idoso no município de João Pessoa: análise das notificações entre os anos de 2009 e 2015 / Violence against the elderly in the municipality of João Pessoa: analysis of notifications between the years of 2009 and 2015

A apresentação do projeto na disciplina procurou socializar a pesquisa retrospectiva, do tipo estudo ecológico, e fomentar a importância da notificação da violência contra a pessoa idosa que é recente no Brasil. A discussão dos docentes com o grupo foi bastante importante no sentido de potencializarmos esta discussão no âmbito da gestão dos Distritos Sanitários e desta forma espera-se que o estudo após pesquisa proporcione uma maior atenção dos gestores e profissionais de saúde no que concerne a notificação, no sentido de intensificá-las e com isso, impactar a redução dos casos de violência contra idosos

Pre- and postnatal exposure to intimate partner violence among South African HIV-infected mothers and infant developmental functioning at 12 months of age.

In rural South Africa, pregnant HIV-infected women report high rates of psychological (55%) and physical (20%) intimate partner violence (IPV). IPV increases the risk of infant developmental delays. Such delays may have negative socioemotional and cognitive outcomes throughout the lifespan. This paper assesses the relationship between IPV and infant development in rural South Africa. The present investigation was a cross-sectional add-on follow-up designed retrospectively. A randomly selected sub-sample of mothers from the main randomized controlled trial (n = 72) were asked to participate with their infants at 12 months of age; all women invited agreed to participate. Women were 18.35 ± 5.47 weeks pregnant; demographics, HIV disclosure status, and pre- and postnatal IPV measured via the Conflict Tactics Scale during pregnancy at baseline and 12 months post-partum were assessed. Infant HIV serostatus and developmental functioning at 12 months of age were assessed. Women were a mean age of 29 ± 2 years. One third had completed at least 12 years of education and had a monthly income of ~ US$76. At 12 months post-partum, 6% of infants tested HIV seropositive. Postnatal physical IPV was associated with delays in cognitive and receptive language development p < 0.05, but only in unadjusted analyses. This study identified an association between early IPV exposure and infant cognitive and receptive communication delays. Given the small sample size, findings support replication. Longitudinal studies are needed to confirm temporal order and identify appropriate timing for interventions in HIV-exposed infants.

Uneven progress in reducing exposure to violence at home for New Zealand adolescents 2001-2012: a nationally representative cross-sectional survey series.

OBJECTIVE: To explore trends, and identify risk factors, that may explain changes in adolescent exposure to family violence over time. METHODS: Data for this study was drawn from the Youth 2000 series of cross-sectional surveys, carried out with New Zealand high school students in 2001, 2007 and 2012. Latent class analysis was used to understand different patterns of exposure to multiple risks for witnessing violence at home among adolescents. RESULTS: Across all time periods, there was no change in witnessing emotional violence and a slight decline in witnessing physical violence at home. However, significant differences were noted between 2001 and 2007, and 2007 and 2012, in the proportion of adolescents who reported witnessing emotional and physical violence. Four latent classes were identified in the study sample; these were characterised by respondents' ethnicity, concerns about family relationships, food security and alcohol consumption. For two groups (characterised by food security, positive relationships and lower exposure to physical violence), there was a reduction in the proportion of respondents who witnessed physical violence but an increase in the proportion who witnessed emotional violence between 2001 and 2012. For the two groups characterised by poorer food security and higher exposure to physical violence, there were no changes in witnessing of physical violence in the home. Implications for public health: In addition to strategies directly aimed at violence, policies are needed to address key predictors of violence exposure such as social disparities, financial stress and alcohol use. These social determinants of health cannot be ignored.

Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence.

Witnessing violence toward a caregiver during childhood is associated with negative impact on children's health and development, and there is a need for effective interventions for children exposed to intimate partner violence in clinical as well as in community settings. The current effectiveness study investigated symptom reduction after participation in two established group interventions (one community-based psychoeducative intervention; one psychotherapeutic treatment intervention) for children exposed to intimate partner violence and for their non-offending parent. The study included 50 children-24 girls and 26 boys-aged 4-13 years and their mothers. Child and maternal mental health problems and trauma symptoms were assessed pre- and post-treatment. The results indicate that although children showed benefits from both interventions, symptom reduction was larger in the psychotherapeutic intervention, and children with initially high levels of trauma symptoms benefited the most. Despite these improvements, a majority of the children's mothers still reported child trauma symptoms at clinical levels post-treatment. Both interventions substantially reduced maternal post-traumatic stress. The results indicate a need for routine follow-up of children's symptoms after interventions.

Enhancing Risk Detection Among Homeless Youth: A Randomized Clinical Trial of a Promising Pilot Intervention.

Homeless youth frequently experience victimization, and youth with histories of trauma often fail to detect danger risks, making them vulnerable to subsequent victimization. The current study describes a pilot test of a skills-based intervention designed to improve risk detection among homeless youth through focusing attention to internal, interpersonal, and environmental cues. Youth aged 18 to 21 years ( N = 74) were recruited from a shelter and randomly assigned to receive usual case management services or usual services plus a 3-day manualized risk detection intervention. Pretest and posttest interviews assessed youths' risk detection abilities through vignettes describing risky situations and asking youth to identify risk cues present. Separate 2 (intervention vs. control) × 2 (pretest vs. posttest) mixed ANOVAs found significant interaction effects, as intervention youth significantly improved in overall risk detection compared with control youth. Post hoc subgroup analyses found the intervention had a greater effect for youth without previous experiences of indirect victimization than those with previous indirect victimization experiences.

Risk and Protective Factors for Family Violence among Low-Income Fathers: Implications for Violence Prevention and Fatherhood Programs.

Over the last decade there has been an increased focus on improving father engagement to improve child and family outcomes. Recent research suggests that child and family outcomes improve with increased fatherhood engagement. This exploratory study examined risk and protective factors associated with approval of family violence among a sample of low-income fathers (N = 686) enrolled in a responsible fatherhood program. The program goals include increasing father involvement and economic stability and encouraging healthy relationships-with a focus on preventing intimate partner violence. Toward these aims, this study explored factors associated with fathers' self-reported approval of family violence. Understanding the prevalence of risk and protective factors in this population and factors associated with fathers' potential for family violence is important in developing programs to address responsible fatherhood and healthy relationships.