Assessing risk for severe domestic violence and related homicides perpetrated by partners and in-laws: adapted danger assessments for women in abusive relationships in India.

Despite domestic violence and related homicides perpetrated by partners and/or in-laws being a significant public health problem in India, there are no reliable and valid instruments to identify and intervene with women in domestic violence relationships. Continued domestic violence can escalate to severe, near-lethal, or lethal violence or homicide. The Danger Assessment (DA) is a risk assessment instrument designed to assess the likelihood of severe, near-lethal, or lethal violence in abusive relationships. However, the DA is not designed to determine the risk of future severe, near-lethal, or lethal violence by in-laws. In-law abuse plays a significant role in domestic violence-related homicides in India and other countries with similar cultural norms. This study addressed this gap by developing the Danger Assessment for in-laws (DA-L) to assess risk from in-laws, alongside the Danger Assessment for Women in India (DA-WI) to assess risk from partners. The study also examined the psychometric properties of the DA-L and DA-WI. Longitudinal data from 150 women in India were used to measure the reliability and validity of the two versions of the DA. The original DA items and additional risk items were examined using relative risk ratios for their relationship with severe violence at three-month follow-ups. Predictive validity was tested with the receiver operating characteristic curve. The study resulted in reliable and valid measures (11 items DA-L and 26-items DA-WI) of risk. The versions of the DA can be useful for practitioners in India and those working with Indian women in the US and other countries. The DAs can be used for identifying women in domestic violence relationships who are at risk for future severe domestic violence and guide the provision of tailored safety plans.

The Labor Market Integration of Women Having Suffered Gender Violence: Some Critical Questions.

The integration of women victims of gender-based violence (WVGBV) in the labor market is key to women's autonomy and empowerment. After pursuing some personal stability in different domains (emotional, physical, relational, etc.), these women require a further step toward recovery, which is often related to financial independence and, therefore, to their integration in the labor market. In this article, we describe the results of a study that focused on the actions aimed at integrating WVGBV into the labor market in the region of Andalusia (Spain). Based on a qualitative methodology, we collected the narratives and perspectives of the different actors involved in these processes (public administrations, nongovernmental organizations, the business world, and the WVGBV). The results revealed a series of deficiencies in social intervention methodologies that can sometimes lead to greater social exclusion. In conclusion, we believe that more participatory methodologies in their design, incorporating the views of woman themselves, are necessary.

Bodily Autonomy and Trauma: Understanding the Nature of the Association Between Sexual Trauma, an External Locus of Control, and Depressive Symptoms.

There is growing evidence suggesting an increased perception of control is associated with reduced psychological distress among survivors of sexual trauma. The current study advances the extant literature by investigating the association between depressive symptoms, sexual trauma, and an external locus of control or the perception life events are outside one's own control. To do so, we analyze data from the New Family Structures Study, a nationally representative survey of U.S. adults ages 18-39. Results from ordinary least square regression analyses suggest sexual trauma and an external locus of control are associated with significantly greater depressive symptoms and that external control exacerbates the association between sexual trauma and depression. Such findings suggest future research should investigate environmental control for sexual trauma survivors in areas such as prenatal care and the justice system.

Development and Evaluation of a Community Advisory Board for Family Violence.

Although intimate partner violence (IPV) is an important risk factor for child physical abuse, most IPV-exposed children are not evaluated for abusive injuries. A Community Advisory Board (CAB) was formed to (a) optimize a program to evaluate IPV-exposed children for abusive injuries and (b) inform research methods to engage IPV victims and their children. The objectives of this study were to implement and to evaluate the family violence CAB. Following best practices on CAB formation, we recruited local stakeholders with key roles as service providers, community leaders, and knowledge experts in IPV, child abuse, and emergency care. Fourteen members met bimonthly to develop a family-centered intervention and to inform research and advocacy activities. A shared memorandum of understanding outlined goals and objectives. One year after the CAB's implementation, a research assistant interviewed CAB members to understand their experiences, perceived benefits of participation, and desired improvements. Eleven CAB members, including an IPV survivor, participated. Emerging categories included (a) motivations to join the CAB (victim advocacy), (b) benefits of participation (development of relationships among members and increased acceptability of research methods), (c) facilitators of sustainability (program adaptability and development of trust), and (d) desired improvements (case-based follow-up). The CAB was successfully implemented and facilitated the development of collaborative relationships among stakeholders with key roles in IPV and child abuse. The CAB led to community member-proposed changes in research activities and clinical care for victims of IPV.

Protective factors for the risk of suffering intimate partner violence in help-seeking women survivors from a social organization in Chile.

Objective: Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV. Methods: We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study. Results: Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication. Conclusion: To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.

Violence in the emergency department: a quantitative survey study of healthcare providers in India.

BACKGROUND: Workplace violence (WPV) in Emergency Departments (EDs) is an increasingly recognized challenge healthcare providers face in low-resource settings. While studies have highlighted the increased prevalence of WPV in healthcare, most of the existing research has been conducted in developed countries with established laws and repercussions for violence against healthcare providers. More data on WPV against ED providers practicing in low-resource settings is necessary to understand these providers' unique challenges. OBJECTIVE: This study aims to gain insight into the incidence and characteristics of WPV among ED healthcare providers in India. METHODS: This study was conducted at two EDs in geographically distinct regions of India. A survey was designed to assess violence in EDs among healthcare providers. Surveys were distributed to ED workplace providers, completed by hand, and returned anonymously. Data was entered and stored in the RedCAP database to facilitate analysis. RESULTS: Two hundred surveys were completed by physicians, nurses, and paramedics in Indian EDs. Most reported events involved verbal abuse (68%), followed by physical abuse (26%), outside confrontation (17%), and stalking (5%). By far, the most common perpetrators of violence against healthcare workers were bystanders including patient family members or other accompanying individuals. Notably, reporting was limited, with most cases conveyed to ED or hospital administration. CONCLUSION: These results underscore the prevalence of WPV among Indian ED healthcare providers. High rates of verbal abuse followed by physical abuse are of concern. Most perpetrators of WPV against healthcare providers in this study were patient family members or bystanders rather than the patients themselves. It is imperative to prioritize implementing prevention strategies to create safer work environments for healthcare workers.

The mediating role of psychological well-being on the effect of fear of future violent events at work on nurses' intention to migration.

AIM: To evaluate the effect of the fear of violence of nurses working in Turkey on their intention to migrate and to examine the mediating role of psychological well-being on this effect. BACKGROUND: Many countries are concerned about nurses' fear of violence and their intention to migrate. The fear of violence at work may influence nurses' intention to migrate. Additionally, psychological well-being may impact this process. However, the impact of the fear of violence at work on the intention to migrate, as well as the moderating effect of psychological well-being in a nursing context, is not well understood. METHODS: We conducted this cross-sectional study on a sample of 221 nurses from two public hospitals. We collected survey data between November 2022 and January 2023 using three scales. We analyzed the data using SPSS, AMOS, and HAYES. We followed the STROBE statement guidelines for cross-sectional studies. RESULTS: Nurses reported a moderate intention to migrate and a moderate to high level of fear of violence and psychological well-being. Fear of violence is positively associated with the intention to migrate. Mediation analyses indicated that the association between fear of violence and intention to migration was mediated by psychological well-being. DISCUSSION AND CONCLUSION: The fear among nurses of being exposed to violence increases their intention to migrate. However, high psychological well-being can reduce this intention. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing managers, policymakers, and decision-makers need to take serious precautions against the fear of violence in the future and make necessary improvements for nurses who witness violence. To achieve this, it can begin by paying attention to the high psychological well-being of each nurse.

Challenging Pennsylvania's Firearm Preemption Law as a Public Health Danger: The Case of Philadelphia.

Firearm violence has soared in American cities, but most states statutorily preempt municipal firearm regulation. This article describes a unique collaboration in Philadelphia among elected officials, public health researchers, and attorneys that has led to litigation based on original quantitative analyses and grounded in innovative constitutional theories and statutory interpretation.

Using the Preparation Phase of the Multiphase Optimization Strategy to Design an Antiextremism Program in Bahrain: Formative and Pilot Research.

BACKGROUND: Extremism continues to raise concerns about conflict and violent attacks that can lead to deaths, injuries, trauma, and stress. Adolescents are especially vulnerable to radicalization by extremists. Given its location in a region that often experiences extremism, Bahrain developed 4 peaceful coexistence lessons and 4 antiextremism lessons to be implemented as part of their Drug Abuse Resistance Education (D.A.R.E.) program. OBJECTIVE: The aim of this study is to report the results of the preparation phase of the multiphase optimization strategy (MOST) to develop a peaceful coexistence program and an antiextremism program implemented by D.A.R.E. officers in Bahrain. METHODS: We developed conceptual models for the peaceful coexistence and antiextremism programs, indicating which mediators each lesson should target, the proximal outcomes that should be shaped by these mediators, and the distal and ultimate outcomes that the intervention should change. We recruited 20 middle schools to pilot test our research protocol, survey measures, and the existing intervention lessons. A total of 854 seventh and ninth grade students completed a pretest survey, 4 peaceful coexistence intervention lessons, and an immediate posttest survey; and a total of 495 ninth grade students completed the pretest survey, 4 antiextremism lessons, and an immediate posttest survey. A series of 3-level models, nesting students within classrooms within schools, tested mean differences from pretest to posttest. RESULTS: Pilot test results indicated that most measures had adequate reliability and provided promising evidence that the existing lessons could change some of the targeted mediators and proximal outcomes. Specifically, students who completed the peaceful coexistence lessons reported significant changes in 5 targeted mediating variables (eg, injunctive norms about intolerance, P<.001) and 3 proximal outcomes [eg, social skills empathy (P=.008); tolerance beliefs (P=.041)]. Students who completed the antiextremism lessons reported significant changes in 3 targeted mediators [eg, self-efficacy to use resistance skills themselves (P<.001)], and 1 proximal outcome (ie, social skills empathy, P<.001). CONCLUSIONS: An effective antiextremism program has the potential to protect youth from radicalization and increase peaceful coexistence. We used the preparation phase of MOST to (1) develop a conceptual model, (2) identify the 4 lessons in each program as the components we will evaluate in the optimization phase of MOST, (3) pilot test the existing lessons, our newly developed measures, and research protocol, and (4) determine that our optimization objective will be all effective components. We will use these results to revise the existing lessons and conduct optimization trials to evaluate the efficacy of the individual lessons.

The Antecedent of Nurses' Revenge and Gossiping Behaviors: Gender Microaggression Experiences.

Background and Purpose: Microaggressions that are not intended to cause deliberate harm to the target are frequently encountered in health communications. Individuals who are the targets of microaggressions may develop emotional and behavioral responses as coping strategies. This study seeks to provide needed clarity on the relationship between microaggression, gossip, and revenge. Methods: A quantitative method was used to collect data. Nurses working in public hospitals in Turkey participated in this study and provided valuable data for the final analysis and the acquisition of conclusion. Results: The findings indicated that the increasing effect of gender microaggressions on organizational gossip occurred both directly and indirectly through vengeful feelings. Moreover, the indirect impact of gender microaggression through revenge was moderated by gender. Implication for Practice: Given the subtle and ambiguous nature of microaggression, this study develops the implications of gender microaggression within emotional and behavioral constructs and has explanatory contributions through the development of direct and indirect relationships.

LGBTQIA+ Individuals' Experiences with Intimate Partner Violence and Perceptions of Victim Services.

This study explored lived experiences of LGBTQIA+ survivors of intimate partner violence (IPV). Seven participants completed a one-on-one, in-depth interview to share their experiences of IPV and any internal or external factors that influenced whether they sought support services or reported victimization. Thematic analysis revealed four overarching themes: (a) health complications, (b) coping mechanisms, (c) barriers to seeking professional help, and (d) suggestions for professionals. Results contribute insight into internal and external barriers LGBTQIA+ IPV survivors face when accessing support services and outline practical approaches for professionals providing support to LGBTQIA+ IPV survivors.

Assessing the feasibility, acceptability, and initial efficacy of a multiple behavior change intervention addressing alcohol use, sexual risk taking, and bystander intervention.

OBJECTIVE: Prevention programs that address the intersecting health problems of risky alcohol use, unsafe sexual behaviors, and sexual violence are needed. This pilot project assessed the feasibility, acceptability, and preliminary efficacy of a two-session group-based intervention, Sex Positive Lifestyles: Addressing Alcohol & Sexual Health (SPLASH), targeting these highly interconnected risks for college students across genders. METHOD: A total of 217 participants (51.6% male, ages 18-24) took part in the SPLASH intervention or a nutrition/exercise control condition. SPLASH included three approaches aimed at reducing the incidence of alcohol problems, unsafe sex, and sexual victimization: normative feedback to modify misperceptions around peers' drinking, sexual behaviors, and support of bystander intervention; drinking and sexual-related protective behavioral strategy training to enhance safer drinking and sex-risk behaviors; and bystander intervention skills training to promote bystander efficacy and engagement. Participants completed baseline and follow-up (1-month and 6-month) online assessments. RESULTS: SPLASH demonstrated high acceptability and feasibility, as well as preliminary efficacy. SPLASH participants reported strong acceptability of the intervention, particularly its integrated content and interactive, in-person group format. Successful enrollment (70% randomized) and retainment point to the feasibility of recruiting students to this two-session in-person intervention. Results showed sustained trends toward more accurate perceived sex-related norms and indications of increasing bystander norms among intervention but not control participants. CONCLUSIONS: Results demonstrate the potential for SPLASH to effectively address the interrelated health risks of risky alcohol use, unsafe sex, and sexual violence on college campuses and point to the need for larger-scale studies.

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.

"We don't know how to talk": Adolescent meaning making and experiences of participating in research on violence in Romania, South Africa, and the Philippines.

BACKGROUND: Current evidence on adolescent participation in violence research has primarily measured distress, harm or upset using quantitative methods. There are relatively few studies which have employed qualitative methods to understand adolescent emotional experiences, and to articulate the experiences of participation from their own perspective. OBJECTIVE: This study aimed to assess adolescents' experiences of participating in research on violence in different contexts, namely Romania, South Africa, and the Philippines. METHODS: A purposive sample of adolescents (N = 53, 51 % female) were recruited from rural, urban, and peri-urban areas in Romania, the Eastern Cape Province of South Africa, and Metro Manila, Philippines. Semi-structured one-on-one in-depth interviews and drawings sought adolescent perspectives on their experiences of participation, including the emotions they felt, and their perceptions of research on violence. RESULTS: Drawing on analysis of interviews and drawings, adolescents reported a layered emotional experience, ranging from sadness, anger, apprehension, and upset, to joy, relief, and laughter. Their emotional experiences were driven by participation as a relational encounter, both with the researchers involved, as well as with other children and young people they encountered. Adolescents emphasized participation as enabling disclosure of difficult experiences, and the creation of awareness of violence. CONCLUSIONS: Adolescent perspectives of participation in research on violence are nuanced and encompass their lived experience as well as the fundamentally relational nature of participation. Adolescents experienced increased awareness of topics in violence and perceived research participation as enabling disclosure and possible help-seeking. Measures of participation impact developed along with adolescents, which reflect this complexity, are needed.

"They should ask me so that they can help me": Patterns of young children's expressed feelings and beliefs when interviewed about violence and difficult experiences.

BACKGROUND: Children's participation in research is a rights-based principle. However, young children are often excluded from research on sensitive topics, due to gatekeepers concerns that participation would cause distress/re-traumatization and conflict with the principle of providing adequate protection from harm. OBJECTIVE: To provide evidence around young children's feelings, including potential distress, and beliefs in mixed-method interviews about violence and difficult experiences. PARTICIPANTS AND SETTING: Data were collected from South African interviewer focus group discussions and young child (age 6-10) interviews, along with observations and fieldnotes from young child (age 6-17) interviews. METHODS: We collected and analyzed qualitative data focused on children's displayed and reported emotions and beliefs in violence-focused interviews. RESULTS: Findings showed the quantitative interview was frequently a positive experience for young children, and children who became upset or emotional stated their feelings were due to violence they experienced. The interviewer seemed to represent a safe person to whom the child could disclose. The play- and arts-based methods of the interview were useful in building this safety and providing space for children to regulate difficult emotions. CONCLUSIONS: In a carefully managed interview environment using developmentally appropriate methods, young children are enthusiastic participants and do not appear to experience undue distress or trauma when asked about violence and other sensitive topics. Findings demonstrate that young children can be safely included in research about violence and issues that impact them and can exercise their right to participation when research methods, environments, and safeguards are appropriately adapted to their needs.

Prevalence and factors associated with workplace violence in a tertiary healthcare facility in Nigeria.

Background: Healthcare workers globally are at an increased risk of workplace violence. Adverse effects such as physical injury, reduced quality of care to patients and lower productivity with associated costs to employers occur. Non-reporting hinders the implementation of effective prevention. This study aimed to assess the prevalence, reasons for non-reporting of workplace violence, and knowledge of prevention prior to designing intervention strategies in the study location where there is a paucity of research on this issue. Methodology: This cross-sectional study was conducted at a Teaching Hospital in Abakaliki, Ebonyi State, for 4 weeks in 2020 among 205 employees. The hospital was stratified into Clinical, Nursing Services, Pharmacy, Laboratory, and administrative divisions; proportionate allocation and random sampling were used to select the allocated samples. A structured questionnaire was used to collect data. Descriptive statistics determined the measures of central tendencies and dispersion, while bivariate analysis of the variables was done using Pearson's Chi-Square test. Statistical significance was set at p ≤ 0.05 with a confidence level of 95%. Results: The mean age of the participants was 39.1 ± 7.8 years. The prevalence of workplace violence was 70%. The most common reason for non-reporting was complexities and time-consuming reporting procedures (26.5%) followed by fear of reprisal on career (22.4%). The proportion of respondents with good knowledge of workplace violence prevention strategies was high (69.8%). Gender (p = 0.03), work setting (p = 0.006), previous workplace violence training (p = 0.005) and knowledge of workplace violence preventive strategies (p = 0.04) had statistically significant associations with experience of workplace violence. Conclusion: The high prevalence of workplace violence suggests a need for a workplace violence prevention program which should include a simple process of reporting and training. The improved awareness from previous training may account for the significant association with workplace violence.

The Impact of Intimate Partner Violence on Homelessness and Returns to Housing: A Qualitative Analysis From the California Statewide Study of People Experiencing Homelessness.

Homelessness is a public health concern in California and throughout the United States. Intimate partner violence (IPV) is a risk factor for experiencing homelessness. Few studies have examined the interplay between IPV, homelessness, and housing. Qualitative methods can provide a greater understanding of the lived experience of IPV and homelessness to identify potential solutions. We purposefully sampled 104 adults who reported experiencing IPV in the California Statewide Study of People Experiencing Homelessness (CASPEH), a representative, mixed-methods study. We administered semi-structured interviews focusing on IPV and six other topic areas pertaining to homelessness from October 2021 to May 2022. We created and applied a codebook with a multidisciplinary team using a hybrid of deductive and inductive logic. Our analysis included all participants who discussed IPV and homelessness across the seven studies. We conducted a thematic analysis using an interpretivist approach and informed by grounded theory. We found that violence within a partnership was multidimensional (physical, sexual, emotional, and financial) and bidirectional. We identified six themes: (1) IPV precipitated and prolonged homelessness; (2) Need for housing, financial stability, and material resources influenced staying in abusive relationships; (3) Alcohol and illicit substance use exacerbated violence between partners; (4) Participants struggled to find resources in domestic violence (DV) shelters; (5) The healthcare system did not provide substantial support; and (6) discrimination and stigma influenced equitable access to housing and DV resources. Experiencing IPV contributed to homelessness and impeded returns to housing. Limitations in current IPV resources impede care. We propose equitable expansion of survivor-centered services that improve access to long-term subsidized housing, prevent IPV and homelessness with flexible funding options, and facilitate rapid exits from homelessness through trauma-informed, non-congregate shelter that transitions to permanent housing.

Femicide Circumstances and Harmfulness: Case Report and Focusing Review.

(1) Background: Femicide is an increasing phenomenon consisting of the murder of a woman for gender-related reasons. Despite the enactment of new laws aimed at controlling the phenomenon by toughening the penalties and introducing aggravating circumstances, there is an increasing trend that testifies to the persistence of a flaw in the actual measures. (2) Case Presentation. We report the case of the murder of a 32-year-old woman-perpetrated by an ex-husband who refused to accept the end of the marriage-the analysis of which allowed us to frame the case as femicide. (3) Discussion. Despite global awareness of this phenomenon, the identification of risk factors to predict and prevent femicide is of utmost importance. This can be achieved by a multidisciplinary approach involving police officers, legal professionals, hospitals, governmental and nongovernmental organizations, and medico-legal departments aimed at promoting standardized methodologies. (4) Conclusions. We evaluate the contribution of forensic investigations to the identification of key elements that can help frame the murder of a woman as a femicide. Considering the devastating consequences for children who witness this kind of violence within the domestic setting, the planning of more impactful preventive actions is, thus, mandatory to minimize effects on public health.