Lagged and simultaneous effects of exposure to violence at home on child-to-parent violence: gender differences.

Introduction: Numerous studies have found that exposure to violence at home is a risk factor for child-to-parent violence. However, most of the available studies do not delimit a time frame for exposure to violence. This aspect is fundamental to differentiating lagged effects (compensation) from simultaneous effects (reciprocal). The purpose of this study is to clarify the relationship between lagged (before the age of 10) and simultaneous (last year) exposure to violence at home (direct victimization: parent-to-child violence and vicarious victimization: exposure to violence between parents) and child-to-parent violence, the possible differential reactive or instrumental motivation of these relationships and whether they differ based on the gender of children and parents. Method: The sample comprised 1,734 Spanish adolescents who lived with both parents (57.3% girls), aged between 13 and 17 years. The instruments used were the Child-to-Parent Violence Questionnaire and the Violence Exposure Scale. Results: Positive and significant relationships were found between child-to-parent violence and exposure to violence at home both during childhood and during the last year; however, the relationships were stronger in the latter. The most important predictors were direct parental victimization during the last year. Boys exerted more reactive violence toward the father concerning exposure to violence by the father toward the mother during the last year. In the case of girls, violence toward both father and mother is more reactive to most victimization experiences. Conclusions: The findings highlight the need to intervene in family contexts of violence to prevent child-to-parent violence.

[Knowledge and implementation of institutional safeguarding measures in German hospitals as part of medical child protection]. / Wissen zu und Umsetzung von institutionellen Schutzkonzepten in deutschen Krankenhäusern als Teil des medizinischen Kinderschutzes.

BACKGROUND: Recent studies show the high prevalence of child maltreatment in Germany and that assaults by hospital staff also pose a problem. Since 2020, the Joint Federal Committee has been calling for institutional safeguarding measures (ISM) to protect and support those affected in hospitals. The aim of this study is to analyze the level of knowledge and action competencies regarding child maltreatment among hospital staff and the extent to which ISM are implemented in hospitals. METHODS: A survey was administered to 1011 participants before they took part in two online courses on child protection and protection measures in hospitals, with questions regarding self-assessed level of knowledge and competence on child protection and the occurrence of cases of maltreatment and protective measures in their own institution. Data were analyzed using descriptive methods. RESULTS: It becomes apparent that the knowledge and competencies of hospital staff regarding child protection are in the middle range. In hospitals, cases of maltreatment that occur outside the institution are particularly common, but violence by staff or other patients of the same age also plays a significant role. Of the respondents, 93.6% stated that their institution had already developed at least one element of an ISM, but only 1.0% of respondents reported that all the elements surveyed had already been fully developed. DISCUSSION: Hospitals in Germany seem to be largely on the path to better protect children and adolescents from maltreatment and to support those affected. However, there are still deficits in the competencies of employees and the implementation of the ISM elements. More resources need to be made available by hospital operators and the public sector for this purpose.

Ecological approach to the characteristics and determinants of sexual violence against adolescents in Perú / Aproximación ecológica a las características y factores determinantes de la violencia sexual contra adolescentes en Perú.

Introduction. Sexual violence against adolescents is a global problem that affects young people around the world. The ecological model examines its forms and determinants through interconnected levels. Objective. To determine the frequency, characteristics, and predictors of sexual violence in adolescents attending school in Perú. Materials and methods. This was a cross-sectional study that secondarily analyzed data from the Encuesta Nacional de Relaciones Sociales (2019). A stratified probabilistic sample involved 1,579 youth aged 12-17 from 93 schools. The questionnaire evaluated physical, psychological, and sexual violence in the family and at school. Models were estimated using logistic regression analysis, calculating odds ratio (OR). Results. Eighteen point sixty eight per cent (95% CI: 16.80-20.60) suffered some type of sexual assault. In addition, 9.75% (95% CI: 8.28-11.21) reported having been touched in some part of the body and 1.84% (95% CI: 1.17-2.50) reported that was a victim of rape. Age was identified as a risk factor in the microsystem (OR = 1.48) (95% CI: 1.26-1.74), while the age of the first experienced sexual violence acted as a protective factor (OR = 0.61) (95% CI: 0.54-0.69). In addition, in the macrosystem, the perception that violence occurs mainly outside the home increased the risk (OR = 2.06) (95% CI: 1.01-4.19). Conclusions. Approximately two out of ten respondents reported having experienced some type of sexual violence, with verbal harassment and invasive personal contact being the most common. No single level or factor can fully explain adolescent sexual violence without considering its ecological interconnectedness.

Introducción. La violencia sexual contra los adolescentes es un problema global que afecta a jóvenes de todo el mundo. El modelo ecológico examina sus formas y factores determinantes a través de niveles interconectados. Objetivo. Determinar la frecuencia, las características y los predictores de la violencia sexual contra adolescentes escolarizados en Perú. Materiales y métodos. Se llevó a cabo un estudio transversal en el cual se analizaron de manera secundaria los datos de la Encuesta Nacional de Relaciones Sociales (2019). Una muestra probabilística estratificada incluyó a 1.579 jóvenes de 12 a 17 años de 93 escuelas. Con el cuestionario se evaluó la violencia sexual en la familia y en la escuela. Se estimaron modelos mediante análisis de regresión logística, calculando la razón de momios (odds ratio, OR). Resultados. El 18,68 % (IC95%: 16,80-20,60) sufrió algún tipo de agresión sexual. Además, el 9,75 % (IC95%: 8,28-11,21) informó haber sido tocado en alguna parte del cuerpo y el 1,84 % (IC95%: 1,17-2,50) informó que fue víctima de violación. La edad se identificó como factor de riesgo en el microsistema (OR=1,48) (IC95%: 1,26-1,74), mientras que la edad de la primera violencia sexual actuó como factor protector (OR=0,61) (IC95%: 0,54-0,69). Además, en el macrosistema, la percepción de que la violencia ocurre principalmente fuera del hogar incrementó el riesgo (OR=2,06) (IC95%: 1,01-4,19). Conclusión. Aproximadamente, dos de cada diez encuestados informaron haber experimentado algún tipo de violencia sexual, siendo el acoso verbal y el contacto personal invasivo los más comunes. Ningún nivel del modelo ecológico o factor único puede explicar completamente la violencia sexual contra los adolescentes sin considerar su interconexión ecológica.

Dual Systems Imbalance as a Mediator of the Relationship Between Exposure to Violence and Violent Offending Risk: Delineating Direct Victimization and Witnessed Violence.

Exposure to violence is a robust risk factor associated with violent offending. Furthermore, exposure to violence can lead to dysfunctional cognitive development, and this may underpin the relationship between exposure to violence and violent offending risk. However, there is a dearth of research that has examined the independent effects of direct victimization and witnessed violence in this regard, particularly as it pertains to dual systems imbalance as a cognitive mediator of either or both forms of exposure to violence. This study sought to address this gap in the literature by examining the effects of direct victimization and witnessed violence on violent offending risk and examining dual systems imbalance as a mediator of these relationships. The Pathways to Desistance data were analyzed. Generalized structural equation modeling was used to assess the direct and indirect effects of interest. The results indicated that only experiencing direct victimization was associated with an increased risk of violent offending at follow-up but not witnessed violence. Furthermore, dual systems imbalance significantly mediated the relationship between direct victimization and violent offending risk. The results indicate that justice-involved youth who have experienced direct victimization should be prioritized for intervention in order to reduce violent recidivism risk and that treatment should focus on improving cognitive processes pertaining to impulse control and risk-seeking.

Correlates of dangerous firearm storage among a representative sample of firearm owners across nine states.

OBJECTIVE: To identify demographic and behavioral correlates of dangerous firearm storage (i.e., unlocked and loaded) among firearm owners in nine states. METHODS: Online survey data from the probability-based sample were collected using Ipsos Knowledge Panel. Participants were adults residing in nine states across the United States (n = 7785). RESULTS: Nearly one third of the firearm owners within the sample stored at least one of their firearms unlocked and loaded. Greater threat sensitivity was associated with dangerous firearm storage. Established firearm owners who purchased an additional firearm during the firearm purchasing surge (2020-2021) had increased odds of storing at least one firearm unlocked and loaded. Those who had direct exposure to firearm violence and those whose primary reason for having a firearm at home was protection also had increased odds of storing at least one firearm unlocked and loaded. CONCLUSIONS: The results contribute to the literature on firearm storage tendencies, highlighting correlates of dangerous firearm storage within the home related to perceptions of threat and direct experiences with firearm violence. Implications include the need for broad public education on the value of secure storage targeted toward to those who have an elevated perception of danger and have been personally exposed to firearm violence.

Social capital as a moderator of the relationship between violent community environment and psychological distress.

OBJECTIVE: To evaluate the modifying effect of social capital on the relationship between living in violent communities and the presence of psychological distress in adolescents and youth in Mexico. METHOD: The analysis of the Social Cohesion Survey for the Prevention of Violence and Crime (ECOPRED, by its acronym in Spanish) was conducted. The analytic sample consisted of 39,639 participants aged 12 to 29 years. Community violence and social capital were measured at the census tract level using the average answers of a household's head sample. These environmental variables were independent of the experiences of the participants. Social capital variables included structural (social ties, recreational participation, collaborative participation, and social cohesion), and cognitive (trust in neighbors) dimensions. Multilevel structural equation models were used. RESULTS: Recreational participation, collaborative participation, and social cohesion modified the relationship between community environments and psychological distress. In females who lived in places with less recreational participation or less social cohesion, the higher the social disorder, the higher the psychological distress. A similar relationship between vandalism and psychological distress was identified, but only in males who lived in places with less collaborative participation, and in females with less social cohesion. CONCLUSIONS: Our results suggest that dimensions of the structural social capital (organization and interest in the community and its members) were the ones that had the buffering effect of the exposure to disordered community environments on psychological distress.

The link between exposure to violence and psychological distress among middle-aged Muslims in Israel: the role of gender.

Introduction: To date, it is still unclear if exposure to violence affects psychological distress in middle-aged adults and if the effects are gender specific. This age group is of special interest as it is at the onset of the aging process and is often overlooked or understudied in scholarly research. Specifically, targeted research on middle-aged Muslims living in Israel, a unique population exposed to increasing violence, is lacking. Methods: We examined the relationship between exposure to violence and psychological distress in a cohort of 363 middle-aged adults (223 women) from three Muslim villages in northern Israel, collecting data on violence exposure (Screen for Adolescent Violence Exposure (SAVE) questionnaire), psychological distress (Kessler 6 Psychological Distress questionnaire), and other demographic characteristics including education level and socioeconomic status. We used this data to answer two questions: (1) is exposure to violence a predictor of psychological distress in middle-aged Muslims, and (2) does the relationship between exposure and distress differ between men and women? Results: We revealed a positive link between exposure to violence and psychological distress (ß = 0.145, p = 0.017) when controlling for gender, age, education level, and socioeconomic level. Discussion: Despite previous evidence of gender-based differences in this interplay in younger cohorts, we did not find a significant interaction between gender and the violence exposure-psychological distress interplay. Our findings are some of the first to focus on middle-aged individuals and show that both men and women exhibit connections between exposure to violence and psychological distress when considering covariates. This research provides insights that can be used when planning community-wide interventions and treatment schemes to support healthy aging.

Estratégias adotadas pelos profissionais de enfermagem a partir da violência sofrida na urgência e emergência / Strategies adopted by nursing professionals based on the violence suffered in urgency and emergency / Estrategias adoptadas por los profesionales de enfermería basadas en la violencia sufrida en urgencia y emergencia

Objetivo: identificar os significados e estratégias adotadas pelos profissionais de enfermagem em situações de violência em uma unidade de urgência e emergência. Método: estudo descritivo, qualitativo, tendo como suporte teórico-conceitual o interacionismo simbólico, que utilizou um grupo focal de oito profissionais da equipe de enfermagem de um serviço de urgência e emergência hospitalar. Resultados: os significados foram complexos e as estratégias adotadas foram tolerância à violência para manter o controle no ambiente de trabalho, gerenciamento de conflito, tentando aplacar a situação de violência, buscar a segurança de terceiros e adotar um posicionamento de afastamento do atendimento ao paciente/acompanhante agressor. Conclusão: a violência significou diversas concepções frequentemente negativas, e as estratégias adotadas pelos profissionais de enfermagem evidenciam a tentativa de evitar o sofrimento perpetuado pelos pacientes no serviço de urgência e emergência hospitalar. Os diversos atores sociais devem sinergicamente propiciar meios para a proteção dos profissionais.

Objective: To identify the strategies adopted and meanings constructed by nursing professionals exposed to violence in an urgency and emergency unit. Method:A descriptive, qualitative study based on symbolic interactionism was conducted with eight nursing professionals from a hospital urgency and emergency service by means of a focus group. Results: The meanings were complex and the strategies adopted were tolerance towards violence to maintain control in the workplace, conflict management seeking to placate the situation, seek the safety of third parties and withdrawal from caring for the offending patient/companion. Conclusion: Violence was often conceptualized negatively and the strategies adopted by nursing professionals show an attempt to avoid the harm perpetrated by emergency patients. The various social actors implicated should synergistically provide means for protecting professionals

Objetivo: identificar los significados y estrategias adoptadas por los profesionales de enfermería en situación de violencia en una unidad de urgencia y emergencia. Método:estudio descriptivo, cualitativo, con interaccionismo simbólico como marco teórico y conceptual, que utilizó un grupo focal formado por ocho profesionales del equipo de enfermería de un servicio de urgencia y emergencia hospitalaria. Resultados: los significados fueron complejos, y las estrategias adoptadas se centraron en la tolerancia a la violencia para mantener el control en el ambiente de trabajo, el manejo de conflictos buscando aplacar la situación de violencia, la búsqueda de seguridad de terceros y la adopción de una posición de retiro de la atención al paciente/acompañante infractor. Conclusión: la violencia significó varias concepciones que muchas veces son negativas, y las estrategias adoptadas por los profesionales de enfermería muestran el intento de evitar el sufrimiento perpetuado por los pacientes en el servicio de emergencia hospitalaria. Los diversos actores sociales deben proporcionar sinérgicamente medios para la protección de los profesionales

Exploring staff experiences and perceptions of patient-perpetrated violence in hospital settings: A qualitative study.

AIMS: To explore hospital staff experiences and perceptions of patient-perpetrated violence. DESIGN: Descriptive qualitative study. METHODS: Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens. RESULTS: Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different 'types' of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of 'resilience' and reflecting on its role in their responses to escalating situations. CONCLUSIONS: Many hospital staff are resigned to the inevitability of violence. The concept of staff 'resilience' following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK. IMPLICATIONS FOR THE PROFESSION: Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels. REPORTING METHOD: This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Nursing students' exposure to violence in clinical practice and violence management competence levels.

INTRODUCTION: The violence nursing students experience in the clinic may affect their attitudes towards the profession. AIM: This study was conducted to determine nursing students' exposure to violence during their clinical practice and their violence management competence levels. DESIGN: This was a two-centred, descriptive, and correlational study. PARTICIPANTS: A total of 512 nursing students from two universities in Türkiye participated in this study. METHODS: The study data was collected between March and April 2023 with the Student Information Form, Violence Exposure Form, and Management of Workplace Violence Competence Scale for Nursing Students. Institutional permission and ethics committee approval were obtained before starting the study (Date: 05/01/2023, No: 50). Descriptive statistics, Mann-Whitney U test, Kruskal Wallis test and linear regression analysis were used to evaluate the data. Statistical significance was accepted as p < 0.05. RESULTS: It was determined that 17.4 % (n = 89) of the participant students felt competent in managing violence, and 94.3 % (n= 483) were concerned about being exposed to violence at various levels. In these results, 20.5 % (n = 105) of them were exposed to violence during clinical practice, 60.9 % (n = 64) of whom experienced verbal violence and 52.3 % (n = 55) psychological violence. The total mean score from the violence management competence scale was 103.29 ± 16.64. No statistically significant difference was found between the scale total and subscale scores according to gender (p > 0.05). The scale total scores of fourth-grade students with a good perceived academic success and who received training on coping with violence were statistically significantly higher (p˂0.05). The regression model created between the scale score and students' perceived academic success and receiving white code training (Training on the use of the alarm system that will enable security guards to reach the scene as soon as possible in cases where healthcare workers are exposed to all kinds of violence.) was statistically significant (F = 23.108, p < 0.001). CONCLUSION: Some of the students participating in the study experienced violence in clinical practices. Their violence management competence levels were good. It can be said that academic success, coping with violence, and white code training are useful in increasing competence levels.

Exploring Firearm Access, Carriage, and Possession among Justice-Involved Youth.

Firearm carriage and possession predicts youth firearm violence victimization and perpetration. This study describes self-reported factors associated with firearm access, carriage, and possession among justice-involved youth. We conducted an exploratory, mixed-methods study. Participants were recruited from May 2022 to February 2023 from the Juvenile Justice Collaborative, a diversion program for justice-involved youth. We used online anonymous surveys to investigate exposures related to firearm access, carriage, and possession. We performed semi-structured interviews using the phenomenology framework. We used descriptive statistics to examine firearm exposures by participant demographics. We performed qualitative analyses using an iterative approach with constant comparison to identify key themes. We completed 28 surveys and 5 interviews. Most survey participants identified as male (57%) and Black (61%) with a median age of 18 years. Interview participants described the socialization and cultural normalization of firearms, most prominently among peers. Survey participants reported whether they had ever carried (25%) or possessed (21%) a firearm. Survey and interview participants endorsed protection in the context of increasing violence exposure over time as the primary motivation for firearm possession. Interview participants describe accessing firearms primarily through social networks while survey participants also reported access from strangers (25%) and licensed sellers/gun dealers (18%). In conclusion, justice-involved youth believe firearm carriage and possession may be needed for protection due to increasing violence exposure. Further investigation is necessary to determine interventions that may decrease firearm access, carriage, and possession among justice-involved youth.

Guardians of health under fire: Understanding and combating violence against doctors.

Violence against physicians is not a newly emerged but an increasingly serious problem. Various studies have reported a prevalence of up to 90%. If not prevented, it not only causes physical and mental harm to physicians who are dedicated to serving humanity but also affects the entire healthcare system and, consequently, the whole community with its direct and indirect effects. Some interventions have a positive outcome when effectively managed. However, for these interventions to be permanent and effective, they need to be multidisciplinary, legally backed and adopted as public policy. In this article, the prevalence of violence against physicians in the literature, its causes, practices worldwide, and suggestions for solving this problem are compiled.

Development and validation of an intervention for childhood trauma and exposure to violence in Vhembe District, South Africa.

Most strategies are implemented; however, South Africa needs to evaluate and develop trauma interventions. The study aims to develop, test and validate childhood trauma exposure intervention in the Vhembe district, Limpopo province. Donabedian's structure-process-outcome model will guide the study. The study will employ multiphase mixed methods with five phases. Phase 1 will be a thorough systematic evaluation of literature on childhood trauma and exposure to violence interventions to describe existing interventions. Phase 2, stage 1: Will explore the experiences of children exposed to trauma and violence regarding their experiences of the treatment they received, using semi-structured qualitative interviews. Non-probability purposeful sampling techniques will be used to select participants. The Thoyondou Victim Empowerment's database will select participants. The researchers will conduct semi-structured and unstructured interviews with youngsters exposed to violence and trauma. Stage 2 will be a qualitative study of trauma centre managers and personnel sampled from the contact record. IPA will analyze data. Phase 3 will conceptualize Phase 1 and the empirical phase into Donabedian's SPO framework for Phase 4. Phase 4 develops the intervention using Phase 3's conceptual framework and tests and validates it.

Examining the causal effects of exposure to violence on crime among youth involved in the justice system: Experienced, witnessed, and experienced-witnessed violence.

Previous studies on exposure to violence lack a nuanced understanding of the causal effects of different exposure types on offending behaviors. This study, drawing on Pathways to Desistance Study (PDS) data tracking 1354 adjudicated youths aged 14-18 over 7 years, explores the contemporaneous (cross-sectional), acute (after 1 year), enduring (after 3 years), and long-term (after 6 years) causal effects of violence exposure on property and violent offending. The sample, predominantly male (86%), consisted of White (20%), Black (42%), and other (38%) individuals. The generalized propensity score is used to match unbalanced covariates across multiple exposure types, namely noninvolved (n = 392), witnessed (n = 577), experienced (n = 31), and experienced-witnessed violence (n = 305). Results demonstrate the contemporaneous, acute, enduring, and long-term effects of violence exposure on both violent and property offending, with varying durations and strengths across exposure types. The most pronounced risk effects are immediate, diminishing over time and potentially reversing in the long term as youth transition into adulthood. Among exposure types, experienced-witnessed violence exhibits the most potent effects on offending, followed by witnessed violence and then experienced violence-a pattern consistent across the observed time points. Noteworthy is the finding that the impact of violence exposure is more pronounced for violent offending, diminishing more rapidly compared to the effects on property offending.

Childbirth experiences of women with a history of physical, sexual, and child abuse: a cross-sectional study of 2,575 Russian women.

BACKGROUND: A substantial number of women who subsequently become pregnant and give birth have a history of physical, sexual, and/or child abuse. This study investigated the associations of these types of traumas and their cumulative effect with childbirth experiences, namely, mode of birth, maternal and child complications during pregnancy/childbirth, preterm birth, medical procedures, and obstetric violence during labour. METHODS: A group of Russian women (n = 2,575) who gave birth within the previous 12 months, completed a web-based survey, where they provided demographic information, details about their childbirth experiences, and a history of trauma. RESULTS: Women with any type of past abuse were at higher risk for maternal complications during pregnancy/childbirth (exp(ß) < 0.73, p < 0.010 for all). More specific to the type of trauma were associations of physical abuse with caesarean birth, child abuse with complications during pregnancy/childbirth for the baby, and physical and child abuse with obstetric violence (exp(ß) < 0.54, p < 0.022 for all). There was a cumulative effect of trauma for all the outcomes except for medical procedures during childbirth and preterm birth. CONCLUSION: This study provides insights into potential different individual effects of physical, sexual, and/or child abuse as well as their cumulative impact on the childbirth experiences. The robust findings about maternal complications during pregnancy/childbirth and obstetric violence highlight the importance of trauma-informed care, supportive policies, and interventions to create safe and empowering birthing environments that prioritise patient autonomy, dignity, and respectful communication.

The Association of Teen Pregnancy and Violence: A Multilevel Study in Colombia.

Background: Colombia has a high teen pregnancy (TP) rate. In 2018, one in five pregnancies was from teen mothers between 10 and 19 years of age. While TP rates are declining globally, Colombia's TP rate decline has been particularly low, despite sexual education and contraception campaigns. Other factors must be studied to prevent TP. Colombia has a long history of violence. We aim to assess whether there is a relationship between TP and exposure to violence in Colombia. Methods: Data from the Colombian Demographic and Health Survey 2015 and the Colombian National Department of Statistics were analyzed for association between TP and sexual violence, physical violence, physical punishment as a child, and community violence. Univariate, bivariate, multivariate, and multilevel binary logistic regression models were calculated using SPSS v.25 and HLM v.7. Results: Fifteen percent of teens were pregnant. Emotional violence was reported by 47%, sexual harassment by 27%, physical violence by 17%, physical punishment as a child by 7%, and unwanted sex by 2%. Unwanted sex (odds ratio [OR]: 3.18, 95% confidence interval [95% CI]: 1.96-5.16), sexual harassment (OR: 2.43, 95% CI: 1.89-3.14), and physical punishment (OR: 20.30, 95% CI: 7.96-22.81) were associated with adolescent pregnancy. In unadjusted models, emotional violence was associated (OR: 1.22, 95% CI 1.06-1.40) and community violence showed a tendency (OR: 1.24, 95% CI: 0.99-1.55). Physical violence was not associated. Conclusions: Violence exposure and particularly physical punishment, unwanted sex and sexual harassment were associated with TP incidence and should be considered risk factors for TP.

Interpersonal Violence, Racial Discrimination, and Mental Health Symptoms Among Adolescents of Color in the Juvenile-Justice System.

The current study examined how interpersonal racial discrimination experiences operate together with other forms of interpersonal violence to contribute to mental health symptoms among justice-involved adolescents of color. Participants were 118 justice-involved adolescents of color aged 14 to 17 (M = 15.77, SD = 1.08; 52.5% male; 77.1% Black/African American) and their mothers. At baseline, adolescents reported on experiences of interpersonal racial discrimination, harsh parenting, teen dating violence, and exposure to interparental physical intimate partner violence. At baseline and the 3-month follow-up assessment, adolescents reported on trauma symptoms, and adolescents and their mothers reported on the adolescents' externalizing and internalizing symptoms. Multivariate multilevel modeling results indicated that interpersonal racial discrimination experiences contributed additively to adolescent mental health symptoms at both the baseline and 3-month follow-up assessments, after accounting for exposure to other forms of interpersonal violence. The current findings highlight the importance of considering adolescents' experiences of interpersonal racial discrimination, together with other forms of interpersonal violence, in work focused on understanding the mental health symptoms of justice-involved adolescents of color.

Association between witnessing domestic violence against the mother in childhood and intimate partner violence in adulthood: A population-based analysis of Peru.

Objective: To assess the association between witnessing domestic violence against the mother in childhood and intimate partner violence (IPV) in adulthood. Study design: An analytical cross-sectional study was conducted using data from the 2019 Peruvian Demographic and Family Health Survey (ENDES). The independent variable was the condition of witnessing physical violence by the father against the mother during childhood. The dependent variable was IPV, defined by the presence of some subtype of violence (physical, psychological, and sexual) against the respondent in the last year by her husband or partner. To assess this association, generalized linear models of the Poisson Family with a logarithmic link function were performed to estimate crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI). Results: Data from 17,911 Peruvian women between 15 and 59 years of age were analyzed. Most women were between 30 and 49 years old (71.4%), were cohabiting (65.0%), and had secondary education (43.2%). The prevalence of IPV in the last year was 16.0%, and the history of witnessing domestic violence against the mother during childhood was 42.0%. In the regression models, those with the studied exposure showed a higher prevalence of experiencing an episode of IPV in the last year (any IPV [aPR: 1.69; 95% CI: 1.50-1.91]; physical IPV [aPR: 1.70; 95% CI: 1.43-2.02], psychological IPV [aPR: 1.64; 95% CI:1.42-1.88], and sexual IPV [aPR: 1.68; 95% CI: 1.22-2.32]). Conclusions: Women with a history of domestic violence towards their mothers were likelier to have had IPV in the last year than women who did not report violence towards their mothers during childhood. Approximately two in ten Peruvian women reported having had IPV in the past year, and nearly half reported witnessing domestic violence against their mother as a child.

Change Laboratory intervention for promoting learning about causes and prevention of workplace aggressions in a mental health facility.

AIM: To assess a Change Laboratory (CL) intervention concerning the promotion of learning about the causes and prevention of workplace aggression in a Healthcare Service for Drug and Alcohol Users. BACKGROUND: It is estimated that one fourth of all healthcare professionals worldwide have already experienced some kind of workplace violence. In mental health facilities, aggressions have multiple origins, including moments when physical restraint is applied or situations when the patients' demands are not met. This problem is aggravated in facilities known for their practice of imposing disciplinary measures. Several studies have shown the need to reduce disciplinary means, as well as the importance of health service teams and user participation in designing strategies to prevent aggression. DESIGN: This study employed a qualitative approach with an exploratory and descriptive design. An intervention was conducted in a Healthcare Service for Drug and Alcohol Users, in Brazil. The COREQ guidelines were followed for reporting. METHODS: This study is a qualitative analysis of nine sessions of a CL, which was conducted in 2022 with 12 healthcare professionals, mainly women from the nursing staff. RESULTS: These workers identified the main causes of aggression after a historical and empirical analysis of the nature of the work performed and the contradictions inherent within it. They also recognized the need for cooperative teams prepared to recognize potentially aggressive situations beforehand. CONCLUSIONS: This article brings practical contributions by showing a detailed analysis of how the CL intervention method, using the principle of Transformative Agency Double Stimulation, promotes a sequence of learning actions. The method helped participants to systematically understand the causes of the situations that give rise to workplace violence, examining the goal of the activity as something socially and historically constructed. Likewise, this method helped the professionals to collectively build the key components of a potential prevention program against aggression in the workplace.

Alteraciones de la salud humana por artefactos explosivos improvisados. Revisión sistemática exploratoria / Alterations of human health due to improvised explosive devices. Exploratory systematic review / Mudanças na saúde humana devido a dispositivos explosivos improvisados. Revisão sistemática exploratória

Objetivo: revisar la literatura existente indagando por los tipos de lesión o enfermedad que se han identificado en supervivientes de artefactos explosivos improvisados (AEI), así como aspectos individuales y colectivos relacionados con la protección o destrucción de la salud humana enfrentada a los AEI. Metodología: revisión sistemática exploratoria de literatura publicada en bases de datos, como PubMed, SciELO, LILACS, JSTOR, OpenGrey y Google Scholar, entre 2001 a 2021 en cualquier localización geográfica. Se incluyeron artículos de investigación, de revisión o reflexión, libros o capítulos de libro de investigación e informes técnicos, en inglés, español, francés y portugués. Resultados: cumplieron con los criterios de inclusión y fueron revisados 76 documentos. Se han reportado múltiples lesiones asociadas al uso de los AEI, sin que exista un patrón característico de lesión o enfermedad; no obstante, la lesión más común es la amputación bilateral de miembros inferiores. En supervivientes se ha encontrado que el personal militar afectado suele mostrar una mayor capacidad de resiliencia, calidad de vida, tratamiento oportuno y capacidad física funcional más alta, comparado con civiles. El apoyo social genera efectos positivos en la salud y bienestar de los afectados. Conclusiones: los AEI generan múltiples afectaciones a la salud humana, físicas y psicosociales, los cuales requieren una atención integral y multidisciplinaria para el tratamiento, rehabilitación y reintegración de los supervivientes. Los aspectos protectores y destructivos identificados se encuentran asociados a mejores o peores resultados en la salud, existe una representación desigual entre civiles y militares.

Objective: to review the existing literature where we inquired for injury types or illness identified in victims of improvised explosive devices (IED), and also to look for individual and collective processes described in literature in relation with the protection or destruction of human's health and IEDs. Methodology: exploratory systematic review of the literature published on PubMed, SciELO, LILACS, JSTOR, OpenGrey and Google Scholar databases between 2001 and 2022, in any geographic location. We included research, review and opinion articles, books and book chapters reporting research results, and final technical reports in English, Spanish, French and Portuguese. Results: 76 documents met the inclusion criteria and were reviewed. Multiple types of injuries have been reported in relation with the use of IEDs, without a characteristic pattern of injury or disease reported; however, the most common injury is bilateral lower limb amputation. In survivors it has been found that affected military personnel tend to show greater resilience capacity, better quality of life, timely treatment, and higher functional physical capacity, compared to civilians. Social support generates positive health effects and wellness of people affected by IED. Conclusion: IEDs generate multiple effects on human health, both physical and psychosocial, which is why comprehensive and multidisciplinary care is required for the treatment, rehabilitation, and reintegration of their victims. The protective and destructive processes identified are associated with better or worse health outcomes, with unequal representation between civilians and military personnel.

Objetivo: Revisar a literatura existente investigando os tipos de lesão ou doença que foram identificados em sobreviventes de artefatos explosivos improvisados ​​(IED), bem como aspectos individuais e coletivos relacionados à proteção ou destruição da saúde humana diante de IEDs. Metodologia: Revisão sistemática exploratória da literatura publicada nas bases de dados Pubmed, Scielo, Lilacs, JSTORE, Open Gray e Google Acadêmico, entre 2001 e 2021 em qualquer localidade geográfica. Foram incluídos artigos de pesquisa, revisão ou reflexão, livros ou capítulos de livros de pesquisa, relatórios técnicos, em inglês, espanhol, francês e português. Resultados: Atenderam aos critérios de inclusão e foram revisados ​​76 documentos. Múltiplas lesões associadas ao uso de IEDs foram relatadas, sem um padrão característico de lesão ou doença; entretanto, a lesão mais comum é a amputação bilateral de membros inferiores. Nos sobreviventes, verificou-se que os militares acometidos tendem a apresentar maior resiliência, qualidade de vida, tratamento oportuno e maior capacidade física funcional, em comparação aos civis. O apoio social gera efeitos positivos na saúde e bem-estar das pessoas afetadas. Conclusões: Os IEDs geram múltiplos efeitos na saúde humana, física e psicossocial, que requerem atenção integral e multidisciplinar para o tratamento, reabilitação e reintegração dos sobreviventes. Os aspectos protetores e destrutivos identificados estão associados a melhores ou piores resultados de saúde, com representação desigual entre civis e militares.