Drought and intimate partner violence towards women in 19 countries in sub-Saharan Africa during 2011-2018: A population-based study.

BACKGROUND: Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intimate partner violence (IPV). We aimed to evaluate this relationship and to assess effect heterogeneity between population subgroups among women in 19 sub-Saharan African countries. METHODS AND FINDINGS: We used data from 19 Demographic and Health Surveys from 2011 to 2018 including 83,990 partnered women aged 15-49 years. Deviations in rainfall in the year before the survey date were measured relative to the 29 previous years using Climate Hazards Group InfraRed Precipitation with Station data, with recent drought classified as ordinal categorical variable (severe: ≤10th percentile; mild/moderate: >10th percentile to ≤30th percentile; none: >30th percentile). We considered 4 IPV-related outcomes: reporting a controlling partner (a risk factor for IPV) and experiencing emotional violence, physical violence, or sexual violence in the 12 months prior to survey. Logistic regression was used to estimate marginal risk differences (RDs). We evaluated the presence of effect heterogeneity by age group and employment status. Of the 83,990 women included in the analytic sample, 10.7% (9,019) experienced severe drought and 23.4% (19,639) experienced mild/moderate drought in the year prior to the survey, with substantial heterogeneity across countries. The mean age of respondents was 30.8 years (standard deviation 8.2). The majority of women lived in rural areas (66.3%) and were married (73.3%), while less than half (42.6%) were literate. Women living in severe drought had higher risk of reporting a controlling partner (marginal RD in percentage points = 3.0, 95% CI 1.3, 4.6; p < 0.001), experiencing physical violence (marginal RD = 0.8, 95% CI 0.1, 1.5; p = 0.019), and experiencing sexual violence (marginal RD = 1.2, 95% CI 0.4, 2.0; p = 0.001) compared with women not experiencing drought. Women living in mild/moderate drought had higher risk of reporting physical (marginal RD = 0.7, 95% CI 0.2, 1.1; p = 0.003) and sexual violence (marginal RD = 0.7, 95% CI 0.3, 1.2; p = 0.001) compared with those not living in drought. We did not find evidence for an association between drought and emotional violence. In analyses stratified by country, we found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemployed women. This study is limited by its lack of measured hypothesized mediating variables linking drought and IPV, prohibiting a formal mediation analysis. Additional limitations include the potential for bias due to residual confounding and potential non-differential misclassification of the outcome measures leading to an attenuation of observed associations. CONCLUSIONS: Our findings indicate that drought was associated with measures of IPV towards women, with larger positive associations among adolescent girls and unemployed women. There was heterogeneity in these associations across countries. Weather shocks may exacerbate vulnerabilities among women in sub-Saharan Africa. Future work should further evaluate potential mechanisms driving these relationships.

Physical violence and violent threats reported by Aboriginal and Torres Strait Islander people with a disability: cross sectional evidence from a nationally representative survey.

BACKGROUND: A recent Royal Commission into the treatment of Australians living with disabilities has underscored the considerable exposure to violence and harm in this population. Yet, little is known about exposure to violence among Aboriginal and Torres Strait Islander people living with disabilities. The objective of this paper was to examine the prevalence, disability correlates and aspects of violence and threats reported by Aboriginal and Torres Strait Islander people living with disabilities. METHODS: Data from the 2014-15 National Aboriginal and Torres Strait Islander Social Survey were used to measure physical violence, violent threats and disability. Multivariable logistic and ordinal logistic regression models adjusted for complex survey design were used to examine the association between measures of disability and exposure to violence and violent threats. RESULTS: In 2014-15, 17% of Aboriginal and Torres Strait Islander people aged 15-64 with disability experienced an instance of physical violence compared with 13% of those with no disability. Approximately 22% of those with a profound or severe disability reported experiencing the threat of physical violence. After adjusting for a comprehensive set of confounding factors and accounting for complex survey design, presence of a disability was associated with a 1.5 odds increase in exposure to physical violence (OR = 1.54 p < 0.001), violence with harm (OR = 1.55 p < 0.001), more frequent experience of violence (OR = 1.55 p < 0.001) and a 2.1 odds increase (OR = 2.13 p < 0.001) in exposure to violent threats. Severity of disability, higher numbers of disabling conditions as well as specific disability types (e.g., psychological or intellectual) were associated with increased odds of both physical violence and threats beyond this level. Independent of these effects, removal from one's natural family was strongly associated with experiences of physical violence and violent threats. Aboriginal and Torres Strait Islander women, regardless of disability status, were more likely to report partner or family violence, whereas men were more likely to report violence from other known individuals. CONCLUSION: Aboriginal and Torres Strait Islander people with disability are at heightened risk of physical violence and threats compared to Aboriginal and Torres Strait Islander people without disability, with increased exposure for people with multiple, severe or specific disabilities.

The link between hearing impairment and child maltreatment among Aboriginal children in the Northern Territory of Australia: is there an opportunity for a public health approach in child protection?

BACKGROUND: International studies provide evidence of an association between child disabilities, including hearing impairment (HI), and child maltreatment. There are high prevalences of ear disease with associated HI, and child maltreatment among Australian Aboriginal children, but the link between HI and child maltreatment is unknown. This study investigates the association between HI and child maltreatment for Aboriginal children living in the Northern Territory (NT) of Australia. METHODS: This was a retrospective cohort study of 3895 Aboriginal school-aged children (born between 1999 and 2008) living in remote NT communities. The study used linked individual-level information from health, education and child protection services. The outcome variables were child maltreatment notifications and substantiations. The key explanatory variable, HI, was based on audiometric assessment. The Kaplan-Meier estimator method was used in univariate analysis; Cox proportional hazards regression was used in multivariable analysis. RESULTS: A majority of the study cohort lived in very remote (94.5%) and most disadvantaged (93.1%) regions. Among all children in the study cohort, 56.1% had a record of either HI or unilateral hearing loss (UHL), and for those with a history of contact with child protection services (n = 2757), 56.7% had a record of HI/UHL (n = 1564). In the 1999-2003 birth cohort, by age 12 years, 53.5% of children with a record of moderate or worse HI had at least one maltreatment notification, compared to 47.3% of children with normal hearing. In the 2004-2008 cohort, the corresponding results were 83.4 and 71.7% respectively. In multivariable analysis, using the full cohort, children with moderate or worse HI had higher risk of any child maltreatment notification (adjusted Hazard Ratios (adjHR): 1.16, 95% CI:1.04-1.30), notification for neglect (adjHR:1.17, 95% CI:1.04-1.31) and substantiation (adjHR:1.20, 95% CI:1.04-1.40), than children with normal hearing. In the 2004-2008 birth cohort, children with moderate or worse HI had higher risk of a substantiated episode of physical abuse (adjHR:1.47, 95% CI:1.07-2.03) than children with normal hearing. CONCLUSION: Our findings demonstrate the urgent need for HI and child maltreatment prevention strategies through raised community awareness and inter-agency collaboration. Effective information-sharing between service providers is a critical first step to a public health approach in child protection.

Urban-Rural Residence and Child Physical Abuse Hospitalizations: A National Incidence Study.

OBJECTIVE: To determine if child physical abuse hospitalization rates vary across urban-rural regions overall and after accounting for race/ethnicity and poverty demographics. STUDY DESIGN: This was a retrospective cross-sectional study of black, Hispanic, and non-Hispanic white children <5 years of age living in all US counties. US counties were classified as central metro, fringe/small metro, and rural. Incidence rates were calculated using child physical abuse hospitalization counts from the 2012 Kids' Inpatient Database and population statistics from the 2012 American Community Survey. Counties' race/ethnicity demographics and percent of children living in poverty were used to adjust rates. RESULTS: We identified 3082 child physical abuse hospitalizations occurring among 18.2 million children. Neither crude nor adjusted overall rates of child physical abuse hospitalizations varied significantly across the urban-rural spectrum. When stratified by race/ethnicity, crude child physical abuse hospitalization rates decreased among black children 29.1% (P = .004) and increased among white children 25.6% (P = .001) from central metro to rural counties. After adjusting for poverty, only rates among black children continued to vary significantly, decreasing 34.8% (P = .001) from central metro to rural counties. Rates were disproportionately higher among black children compared with white children and their disproportionality increased with population density, even after poverty adjustment. Rates among Hispanic children were disproportionately lower compared with white children in nearly all urban-rural categories. CONCLUSIONS: Our results suggest that urban black children have unique exposures, outside of poverty, increasing their risk for child physical abuse hospitalization. Identifying and addressing these unique urban exposures may aid in reducing black-white disproportionalities in child physical abuse.

Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders.

OBJECTIVE: This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. METHODS: Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. RESULTS: Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. CONCLUSIONS: This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.

Physical and Psychological Abuse among Seropositive African American MSM 50 Aged Years and Older.

Little is known about abuse experienced among African American men who have sex with men (MSM) who are 50 years and older. A series of focus groups were conducted to examine perspectives of seropositive African American MSM age 50 years and older who reported experiencing some form of psychological or physical abuse. Thirty African American MSM were divided into four focus groups and four themes emerged: "Fear Being Gay," "No One Else to Love Me," "Nowhere to Turn," and "Sexual Risk & Control." The data suggest there is a need to develop culturally tailored interventions for this population.

Applying a participatory approach to the promotion of a culture of respect during childbirth.

Disrespect and abuse (D&A) during facility-based childbirth is a topic of growing concern and attention globally. Several recent studies have sought to quantify the prevalence of D&A, however little evidence exists about effective interventions to mitigate disrespect and abuse, and promote respectful maternity care. In an accompanying article, we describe the process of selecting, implementing, and evaluating a package of interventions designed to prevent and reduce disrespect and abuse in a large urban hospital in Tanzania. Though that study was not powered to detect a definitive impact on reducing D&A, the results showed important changes in intermediate outcomes associated with this goal. In this commentary, we describe the factors that enabled this effect, especially the participatory approach we adopted to engage key stakeholders throughout the planning and implementation of the program. Based on our experience and findings, we conclude that a visible, sustained, and participatory intervention process; committed facility leadership; management support; and staff engagement throughout the project contributed to a marked change in the culture of the hospital to one that values and promotes respectful maternity care. For these changes to translate into dignified care during childbirth for all women in a sustainable fashion, institutional commitment to providing the necessary resources and staff will be needed.

Mitigating disrespect and abuse during childbirth in Tanzania: an exploratory study of the effects of two facility-based interventions in a large public hospital.

BACKGROUND: There is emerging evidence that disrespect and abuse (D&A) during facility-based childbirth is prevalent in countries throughout the world and a barrier to achieving good maternal health outcomes. However, much work remains in the identification of effective interventions to prevent and eliminate D&A during facility-based childbirth. This paper describes an exploratory study conducted in a large referral hospital in Dar es Salaam, Tanzania that sought to measure D&A, introduce a package of interventions to reduce its incidence, and evaluate their effectiveness. METHODS: After extensive consultation with critical constituencies, two discrete interventions were implemented: (1) Open Birth Days (OBD), a birth preparedness and antenatal care education program, and (2) a workshop for healthcare providers based on the Health Workers for Change curriculum. Each intervention was designed to increase knowledge of patient rights and birth preparedness; increase and improve patient-provider and provider-administrator communication; and improve women's experience and provider attitudes. The effects of the interventions were assessed using a pre-post design and a range of tools: pre-post questionnaires for OBD participants and pre-post questionnaires for workshop participants; structured interviews with healthcare providers and administrators; structured interviews with women who gave birth at the study facility; and direct observations of patient-provider interactions during labor and delivery. RESULTS: Comparisons before and after the interventions showed an increase in patient and provider knowledge of user rights across multiple dimensions, as well as women's knowledge of the labor and delivery process. Women reported feeling better prepared for delivery and provider attitudes towards them improved, with providers reporting higher levels of empathy for the women they serve and better interpersonal relationships. Patients and providers reported improved communication, which direct observations confirmed. Additionally, women reported feeling more empowered and confident during delivery. Provider job satisfaction increased substantially from baseline levels, as did user reports of satisfaction and perceptions of care quality. CONCLUSIONS: Collectively, the outcomes of this study indicate that the tested interventions have the potential to be successful in promoting outcomes that are prerequisite to reducing disrespect and abuse. However, a more rigorous evaluation is needed to determine the full impact of these interventions.

Public Health Information Delivery in the Emergency Department: Analysis of a Kiosk-Based Program.

BACKGROUND: Because more than one-third of the U.S. population visits an emergency department (ED) any given year, public health interventions in the ED can have major population-level impacts. OBJECTIVES: We determined ED patients' interest in receiving information via kiosk on common, chronic conditions for which education and preventive screening could offer public health benefit and to assess what topical information patients are interested in receiving. METHODS: This is a secondary analysis of survey data from an ED pilot program December 2011 to April 2012. Main outcome measures were patients' interests in receiving information on health topics via kiosk module. RESULTS: More than half of the 4351 patients indicated interest in receiving information on at least one health topic, including high blood pressure (30%), depression (21%), diabetes (18%), sexually transmitted diseases (11%), drug abuse (6%), and physical abuse (3%). African-American patients were more likely to be interested in receiving information on high blood pressure (odds ratio [OR] 2.7, 95% confidence interval [95% CI] 2.2-3.2]), depression (OR 1.3, 95% CI 1.1-1.6), diabetes/sugar (OR 2.2, 95% CI 1.8-2.8), drug abuse (OR 1.4, 95% CI 1.0-1.9), and sexually transmitted diseases (OR 2.6, 95% CI 1.9-3.7). Participants >55 years of age were more likely to desire information on high blood pressure and diabetes (age 55-64 years: OR 4.0, 95% CI 3.1-5.1; age >64 years: OR 4.4, 95% CI 3.2-6.2). Patients who were interested in receiving public health information were more likely to be older, African American, and male (p < 0.05). CONCLUSIONS: Interest in obtaining kiosk-delivered education on hypertension predominated. Kiosks are versatile tools that could be used in ED settings to provide health education services.

Individual, family, and culture level contributions to child physical abuse and neglect: A longitudinal study in nine countries.

This study advances understanding of predictors of child abuse and neglect at multiple levels of influence. Mothers, fathers, and children (N = 1,418 families, M age of children = 8.29 years) were interviewed annually in three waves in 13 cultural groups in nine countries (China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, and the United States). Multilevel models were estimated to examine predictors of (a) within-family differences across the three time points, (b) between-family within-culture differences, and (c) between-cultural group differences in mothers' and fathers' reports of corporal punishment and children's reports of their parents' neglect. These analyses addressed to what extent mothers' and fathers' use of corporal punishment and children's perceptions of their parents' neglect were predicted by parents' belief in the necessity of using corporal punishment, parents' perception of the normativeness of corporal punishment in their community, parents' progressive parenting attitudes, parents' endorsement of aggression, parents' education, children's externalizing problems, and children's internalizing problems at each of the three levels. Individual-level predictors (especially child externalizing behaviors) as well as cultural-level predictors (especially normativeness of corporal punishment in the community) predicted corporal punishment and neglect. Findings are framed in an international context that considers how abuse and neglect are defined by the global community and how countries have attempted to prevent abuse and neglect.

Emotional, physical and sexual violence among Sami and non-Sami populations in Norway: The SAMINOR 2 questionnaire study.

AIMS: To assess the prevalence and investigate ethnic differences of emotional, physical and sexual violence among a population of both Sami and non-Sami in Norway. METHODS: Our study was based on the SAMINOR 2 study, a population-based survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Central and Northern Norway. Our study includes a total of 11,296 participants: 2197 (19.4%) Sami respondents and 9099 (80.6 %) non-Sami respondents. RESULTS: Almost half of the Sami female respondents and one-third of the non-Sami female respondents reported any violence (any lifetime experience of violence). Sami women were more likely to report emotional, physical and sexual violence than non-Sami women. More than one-third of the Sami men compared with less than a quarter of non-Sami men reported having experienced any violence in their life. Sami men were more likely to report emotional and physical violence than non-Sami men. However, ethnicity was not significantly different regarding sexual violence experienced among men. Violence was typically reported to have occurred in childhood. Sami participants were more likely to report having experienced violence in the past 12 months. For all types of violence, the perpetrator was typically known to the victim. CONCLUSIONS: Regardless of gender, Sami respondents were more likely to report interpersonal violence. The prevalence of any violence was substantial in both ethnic groups and for both genders; it was highest among Sami women.

Re-examining Norms of Disrespect and Abuse in the Second Stage of Labor in Tanzanian Maternity Care.

Globally, the widespread occurrence of disrespect and abuse (D&A) on maternity wards is well-documented. Using ethnography and cultural consensus analysis we explore how the practice of midwives hitting women who are in the second stage of labor (pushing) has become a locally accepted form of care in Tanzania if a baby's life appears to be at risk. This analysis interrogates the deep uncertainty of birth outcomes in this setting that may motivate abuse during this time. Seriously engaging with local discourses on abuse and care sheds light on hegemonic norms and power dynamics and is critical for improving maternity services.

"His body is human, but he has a tiracchana heart": An ethnographic study of the epigenesis of child abuse in Cambodia.

In Cambodia, more than half of all children experience physical, emotional, or sexual abuse. This article examines how Cambodians view the causes and effects of child abuse and analyses its underlying cultural forces. Adopting a conceptual framework originally developed for the cultural context of violence against women, 110 cases of child abuse were ethnographically studied, comprising 61 cases of sexual abuse (50 girls and 11 boys), 26 cases of physical abuse (13 girls and 13 boys), and 23 cases of emotional abuse or neglect (13 girls and 10 boys). The perpetrators included fathers and other close relatives, lay Buddhist officiants and monks, and neighbors. Most informants viewed the sexual or physical abuse of children as stemming from "cultural attractors," including blighted endowment caused by deeds in a previous life, a bad character starting early in life, astrological vulnerability to abuse, preordained entanglement between the child and the abuser (they are "fated" to meet), sexual craving, "entering the road to ruin," and a moral blindness that portrays the abuser as blameless. Although these traits are similar to those identified in the explanations of violence against women, there were notable differences such as the role of the tiracchana in explaining sexual abuse, including incest. Using these findings, this article identifies a cultural epigenesis of child sexual abuse, and provides a blueprint for developing a culturally responsive plan to prevent child abuse.

The overrepresentation of First Nations children and families involved with child welfare: Findings from the Ontario incidence study of reported child abuse and neglect 2013.

BACKGROUND: While there are national studies on the overrepresentation of First Nations children in the Canadian child protection system, there is a dearth of provincial/territorial studies. OBJECTIVE: The objectives are to: 1) estimate the rate of overrepresentation of First Nations children and youth involved in child welfare investigations in the Ontario child welfare system and, 2) determine which factors drive the overrepresentation of First Nations children in child welfare at the investigation stage compared to White children. PARTICIPANTS AND SETTING: Child welfare workers completed a three-page data collection form at the conclusion of a child protection investigation. METHODS: A secondary analysis of the Ontario Incidence Study 2013 was conducted. Incidence rates were calculated and bivariate analyses were conducted, comparing investigations involving First Nations children to investigations involving White children. RESULTS: First Nations children represent 2.5% of the child population; however, they represent 7.4% of child maltreatment related investigations in Ontario. The rate of investigations for First Nations children was approximately three times higher than the rate for White children. Overrepresentation was most pronounced for investigations of neglect and exposure to intimate partner violence. Rates of substantiation, ongoing child welfare services, child welfare court, and placement in care were higher for the First Nations child population. CONCLUSIONS: The findings provide a foundation for further research and analyses examining the compounding of disparities across the investigation process. Research is needed to disentangle factors that influence decision-making in the child welfare system and how these vary based on a child's race.

Attitudes of Turkish Academics Regarding Violence Against Women in the Name of Honor.

Honor is an important concept that has a vital value in Turkey and affects many women's lives and even causes death. It is of utmost importance to know and scientifically demonstrate the value judgments of the academics that lead and pioneer the society in our country where honor culture is adopted. Therefore, in Turkey, where thousands of women are exposed to violence every year, 877 academics participated in this descriptive study to determine the attitudes of academics toward violence against women in the name of honor. The data were collected using "The Scale for Attitudes Towards Violence Against Women in the Name of Honor (SAVWNH)" in the form of electronic questionnaires through email addresses of the academics working at different faculties of the university in the official website of the university in September 1 to October 1, 2015. In our study, academics' "attitudes towards violence against women in the name of honor" were found low. That is, academics had negative attitudes toward the verbal or physical violence against women in the name of honor and opposed to the punishment of women for this reason. Nevertheless, the attitudes of those who were males; those who were not professors, associate professors, and assistant professors; those who were single; those who had lived in the district/village for a long time; those who had arranged marriages; those who used any kind of violence; and those who considered violence as a solution were found somewhat more conventional. These results showed that, for some academics, the traditional beliefs of the Turkish patriarchal society continued to be valid although they were included in university academic cultures. In fact, it is revealed here that social values, traditions, and customs are very effective and important on the formation of personality in socialization process.

Physical and Sexual Dating Violence and Nonmedical Use of Prescription Drugs.

BACKGROUND: Little information is available on the associations between nonmedical use of prescription drugs (NMUPD) and dating violence victimization (DVV) among high school students and how associations vary by sex. METHODS: We used data from the 2015 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of students in grades 9 to 12. The sample was restricted to students who dated during the 12 months before the survey, resulting in a sample of 5136 boys and 5307 girls. Sex-stratified logistic regression models estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between lifetime NMUPD and DVV. In our analyses, we examined a 4-level DVV measure: no DVV, physical only, sexual only, and both physical and sexual. RESULTS: Male students had a significantly lower prevalence of DVV compared with female students. By using the 4-level measure of DVV, after adjusting for covariates, sexual DVV only (aPR = 1.61, 95% CI: 1.21-2.12) and both physical and sexual DVV (aPR = 1.65, 95% CI: 1.26-2.17) were positively associated with NUMPD among boys, whereas among girls, physical DVV only (aPR = 1.42, 95% CI: 1.16-1.75) and both physical and sexual DVV (aPR = 1.43, 95% CI: 1.03-1.99) were positively associated with NMUPD. CONCLUSIONS: NMUPD was associated with experiences of DVV among both male and female students. Community- or school-based adolescent violence and substance use prevention efforts would be enhanced by considering the association between DVV and substance use, particularly NMUPD among both male and female adolescents, to address these public health problems.

Workplace violence against medical staff of Chinese children's hospitals: A cross-sectional study.

BACKGROUND: In China, medical staff of children's hospitals are commonly exposed to violence. However, few studies on medical violence are conducted in the settings of children's hospitals. The aim of this study is to assess the incidence, magnitude, consequences, and potential risk factors of workplace violence (WPV) against medical staff of children's hospitals. METHODS: A retrospective cross-sectional design was used. A self-administered questionnaire was utilized to collect data on 12 children's hospitals. The questionnaires were distributed to a stratified proportional random sample of 2,400 medical staff; 1,932 valid questionnaires were collected. A chi-square test and multiple logistic regression analysis were conducted. RESULTS: A total of 68.6% of respondents had experienced at least one WPV incident involving non-physical and/or physical violence in the past year. The perpetrators were mainly family members of patients (94.9%). Most of the WPV occurred during the day shift (70.7%) and in wards (41.8%). Males were 1.979 times (95% CI, 1.378 to 2.841) more likely than females to experience physical violence. Emergency departments were more exposed to physical violence than other departments. Oncology was 2.733 times (95% CI, 1.126 to 6.633) more exposed to non-physical violence than the emergency department. As a result of WPV, victims felt aggrieved and angry, work enthusiasm declined, and work efficiency was reduced. However, only 5.6% of the victims received psychological counseling. CONCLUSION: Medical staff are at high risk of violence in China's children's hospitals. Hospital administrators and related departments should pay attention to the consequences of these incidents. There is a need for preventive measures to protect medical staff and provide a safer workplace environment. Our results can provide reference information for intervention strategies and safety measures.

Transnational Motherhood: Health of Hispanic Mothers in the United States Who Are Separated From Children.

Immigration often results in the separation of families, and in particular transnational parenting, which is the separation of mothers from children. Transnational mothers may have greater risks for poor mental health and behavioral conditions such as substance abuse, violence, sexual risk, and depression. This study was a secondary analysis of self-reported data from 425 Hispanic mothers (328 with no separations, 60 separated from an adult child, and 37 separated from a minor child) enrolled in a randomized trial of a sexual health group intervention in South Florida (USA). Separations were related to mother's age, years in the United States, family income, number of people living on income, acculturation to the United States, occupational/economic stress, immigration stress, and lifetime exposure to abuse. A follow-up analysis described the types of childhood or adulthood abuse experienced by mothers with separations. These findings provide new information for nurses about the experience of immigrant mothers.

The Reactive-Proactive Aggression Questionnaire: Validation Among a Portuguese Sample of Incarcerated Juvenile Delinquents.

The aim of the present study was to examine the psychometric properties of the Reactive-Proactive Aggression Questionnaire (RPQ) among a forensic sample of incarcerated male juvenile offenders ( N = 221). The Portuguese version of the RPQ demonstrated promising psychometric properties, namely, in terms of factor structure, internal consistency, convergent validity, discriminant validity, and concurrent validity that generally justifies its use among this population. Statistically significant associations were found with conduct disorder, age of criminal onset, age of first problem with the law, crime seriousness, physical violence use in committing crimes, alcohol use, cannabis use, cocaine/heroin use, and having unprotected sex. The findings provide additional support for the extension of the RPQ across different cultures, ethnic groups, and samples.

Child maltreatment experience among primary school children: a large scale survey in Selangor state, Malaysia.

Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10-12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.