Sexual violence against ever-married reproductive-age women in East Africa: further analysis of recent demographic and health surveys.

BACKGROUND: Sexual violence is a violation of women's rights, resulting in significant physical and psychological challenges and adverse reproductive health outcomes. Addressing these issues demands urgent public health interventions and support systems to mitigate the profound impact on individuals and societies. Thus, this study aimed to assess sexual violence against ever-married reproductive-age women in East Africa. METHODS: Data retrieved from the recent Demographic and Health Survey (DHS) of East African countries was used, and a weighted sample of 40,740 ever-married reproductive-age women was included. To identify factors associated with sexual violence, multilevel mixed-effects models utilizing robust Poisson regression were applied. Akaike's and Bayesian information criteria, as well as deviance, were utilized to compare the models. In the multivariable regression model, adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were used to estimate the strength of association, with statistical significance set at a p-value < 0.05. RESULT: The pooled proportion of sexual violence among ever-married reproductive-age women in East Africa was 13.05% (95% CI: 12.74-13.36). The multivariable multilevel robust Poisson regression revealed that age at first cohabitation/marriage, having a primary educational level, being employed, residing in a female-headed household, having a husband/partner who drinks alcohol, and living in rural areas were positively associated with sexual violence. On the contrary, having secondary and higher educational levels and living in communities with a high proportion of uneducated women were negatively associated with sexual violence. CONCLUSION: Empowering girls and women through education reduces their vulnerability. Effective programs should prioritize workplace safety, financial independence, and robust legal protections against harassment and abuse. Raising awareness about the impact of alcohol abuse on relationships and the heightened risk of sexual violence is crucial. Moreover, enhancing access to support services and community networks, especially in rural areas, is essential for preventing and responding to sexual violence.

The effect of solution-focused approach on attitudes to violence against women in high school students.

PURPOSE: This study was conducted to examine the Effect of Solution-Oriented Approach on Attitudes of Violence Against Women in High School Students. MATERIALS AND METHODS: The research was designed as a pretest-posttest and repeated-measurement randomized controlled experimental study. The population of the research consisted of 1473 students studying at 5 high schools randomly selected from a city center. Out of these students, 166 students who did not accept the study or did not meet the research criteria were excluded, and the school numbers of the remaining 1307 students were numbered separately for girls and boys, and 90 (45 girls and 45 boys) students were included in the study by simple randomization method. Personal Information Form and Violence Against Women Attitude Scale (ISKEBE) were used to collect data. RESULTS: Before the program, the personal characteristics of the control and experimental group students were similar in terms of ISKEBE and subscale scores. Significant differences were found between the groups in the Attitude Toward Identity, Attitude Toward Body sub-dimensions, and the total scores of ISKEBE of the scale used to collect data in the post-program and follow-up test (p < 0.05). CONCLUSION: It was seen that the solution-oriented approach applied to high school students had positive effects on the students' attitudes toward violence against women. In this context, it is thought that this study will develop a new perspective in breaking the cycle of violence against women.

Learning from a gender transformative intervention among faith-leaders in Woliso, Ethiopia: A qualitative study.

Violence against women and girls (VAWG) continues to be a pervasive issue globally, and in Ethiopia, that harms women and challenges progress towards a more gender-equal society. Many interrelated social, economic, and cultural factors impact VAWG. Religion is a complex factor that can contribute to and act as a preventative measure against VAWG. Thus, faith-leaders have been identified as key actors in VAWG prevention. This study examines Ethiopian Evangelical faith-leaders transformative knowledge change following a Channels of Hope for Gender training intervention. Focus group discussions were conducted with faith-leaders from five different Evangelical Church groups. The results show that the faith-leaders' experience of the Channels of Hope training challenged their gender norms and allowed them to enact relationship and community-level changes. Additionally, they demonstrated efforts and interest in generating change at the level of the Church. However, barriers remained to fully addressing VAWG and implement gender transformative learning more widely. Thus, we conclude that the Channels for Hope training is useful in generating mindset changes and improving relationship-level interactions, but that it requires a longer implementation timeframe and further support from other structures and interventions to achieve sustainable change to prevent VAWG.

Development of Trinidad and Tobago's first National Clinical and Policy Guidelines on Intimate Partner Violence and Sexual Violence.

This Special Report aims to outline the development process of the first National Clinical and Policy guidelines on Intimate Partner Violence and Sexual Violence in Trinidad and Tobago and to support the implementation of quality standards for survivors. The study used an implementation science approach to identify key evidence-based practice recommendations from guidance documents on health care for women who are subjected to violence and from relevant national legislation, policy, and practices. The process engaged stakeholders in discussions on the appropriateness, implementation, and use of these recommendations in the context of local health care delivery. Multidisciplinary teams of frontline health workers were consulted in groups in each of the five Regional Health Authorities. Interviews were held with senior government stakeholders responsible for health policy and with representatives of four civil society agencies. Participants provided recommendations to integrate quality standards into routine practice. These were incorporated into the guidelines, which include human rights principles and pathways of care for identifying violence, providing psychosocial and clinical care, safety planning, referrals, care during emergencies, and prevention of intimate partner violence and sexual violence. The guidelines were approved by the Ministry of Health of Trinidad and Tobago on 15 August 2022. Training of trainers has been undertaken to support implementation.

El objetivo de este informe especial es describir el proceso de elaboración de las primeras directrices políticas y clínicas nacionales sobre violencia de pareja y violencia sexual en Trinidad y Tabago, así como brindar apoyo para la aplicación de normas de calidad dirigidas a las personas supervivientes. El estudio utilizó un enfoque de ciencia de implementación para hallar recomendaciones prácticas clave basadas en la evidencia a partir de documentos de orientación sobre atención de salud para mujeres víctimas de violencia, así como de las leyes, políticas y prácticas nacionales pertinentes. El proceso involucró a las partes interesadas en las deliberaciones sobre la idoneidad, la puesta en práctica y el uso de estas recomendaciones en el contexto de la prestación de servicios de salud locales. Se realizaron consultas grupales a equipos multidisciplinarios de trabajadores de salud de primera línea de cada una de las cinco autoridades regionales de salud. Se mantuvieron entrevistas con funcionarios gubernamentales con cargos de responsabilidad en materia de políticas de salud y con representantes de cuatro organizaciones de la sociedad civil. Los participantes proporcionaron recomendaciones para integrar las normas de calidad en la práctica habitual. Estas recomendaciones se incorporaron a las directrices, que incluyen principios de derechos humanos y protocolos asistenciales para detectar la violencia, prestación de atención psicosocial y clínica, diseño de planes de seguridad, derivación de los casos, atención durante emergencias y prevención de la violencia de pareja y la violencia sexual. Las directrices fueron aprobadas por el Ministerio de Salud de Trinidad y Tabago el 15 de agosto del 2022. Se ha llevado a cabo la capacitación de formadores a fin de brindar apoyo para su puesta en práctica.

O objetivo deste relatório especial é resumir o processo de elaboração das primeiras diretrizes clínicas e orientações sobre políticas de âmbito nacional para violência por parceiro íntimo e violência sexual de Trinidad e Tobago, bem como apoiar a implementação de padrões de qualidade para sobreviventes. O estudo utilizou uma abordagem científica de implementação para identificar as principais recomendações de práticas baseadas em evidências, derivadas de documentos de orientação sobre atenção à saúde para mulheres vítimas de violência e de leis, políticas e práticas nacionais pertinentes. O processo envolveu as partes interessadas em discussões sobre adequação, implementação e uso dessas recomendações no contexto da prestação de serviços de saúde em nível local. Em cada uma das cinco autoridades regionais de saúde, equipes multidisciplinares de profissionais de saúde na linha de frente foram consultadas em grupo. Foram entrevistadas partes interessadas da alta administração do governo que eram responsáveis pela política de saúde e representantes de quatro organizações da sociedade civil. Os participantes fizeram recomendações para integrar padrões de qualidade à prática de rotina. Tais recomendações foram incorporadas às diretrizes, que incluem princípios de direitos humanos e percursos assistenciais para identificação de violência, oferta de atenção psicossocial e clínica, planejamento da segurança, encaminhamentos, cuidados durante emergências e prevenção de violência por parceiro íntimo e violência sexual. As diretrizes foram aprovadas pelo Ministério da Saúde de Trinidad e Tobago em 15 de agosto de 2022. Realizou-se capacitação de instrutores para apoiar a implementação.

How do young men narrate the redemption story of a sexual assault perpetrator?

Background: Little is known about how young men who have committed sexual assault might acknowledge wrongdoing and eventually change and make amends. There are practical barriers to seeking the real redemption stories of perpetrators.Objective: To explore hypothetical pathways to young men's accountability-taking and amends (i.e. redemption) after perpetration of sexual assault.Method: In a pre-registered, qualitative story completion study, we presented heterosexual, cisgender college men (N = 54) with a date-based sexual assault story written by a fictional male perpetrator. Participants were prompted to complete the story so that the protagonist, who initially denies wrongdoing, eventually changes and becomes a violence prevention advocate.Results: A thematic analysis of the redemption stories revealed that this study's speculative task was a challenging one. Half of the stories did not provide an explanation for how the perpetrator was able to acknowledge wrongdoing. Overall, individualistic themes (e.g. he introspected) were more common than relational, community, or societal facilitators of redemption.Conclusions: Without infrastructure for accountability-taking and repair, or narrative exemplars to draw from in public life, it is difficult to envision redemption from violence. Rare gender-based, structurally attuned analyses of sexual violence in the stories point the way towards a more transformative vision of redemption.

In this qualitative story completion study, college men wrote the redemption story of a fictional sexual assault perpetrator.Men had difficulty explaining how the perpetrator would acknowledge wrongdoing.Redemption themes tended to be individualistic versus rooted in community.

Decolonising the field of violence against women and girls: A scoping review and recommendations for research and programming.

In response to continuing legacies of colonialism, there is increasing recognition of the need to decolonise various fields of research and practice, including within work on violence against women and girls (VAWG). An emerging body of literature critiques how VAWG is framed, how prevention and response interventions may be imposed on communities as part of White Saviourism, and the existence of hierarchical approaches to data collection, analysis and interpretation. This scoping review is the first known attempt to describe global published and grey literature on colonialism and decolonisation within VAWG research and programming. We conducted an extensive search across databases and search engines including research studies, reports, commentaries and blogs, and identified 55 sources that focused on VAWG and related to the legacy of colonialism and/or decolonial approaches within the field. Included literature discussed the role of colonialism in shaping VAWG, referenced decolonial approaches to respond to VAWG and identified five key recommendations for VAWG research and practice: 1. Consider the context and power hierarchies within which VAWG occurs; 2. Incorporate community resources and perspectives into efforts to end VAWG; 3. Use methods and approaches to researching VAWG that centre perspectives and lived experience of communities; 4. Shift VAWG funding to local actors and ensure VAWG funding streams are more responsive to local needs and realities; and 5. Ensure local, contextually-relevant framings of feminisms inform decolonising of VAWG. We conclude that shifting towards a bottom-up approach to decolonising VAWG research and programming is essential to prevent decolonisation from being reduced to a buzzword. While literature explored the use of specific methods to decolonise research on VAWG, researchers need broader strategies to embed a decolonial perspective throughout the research process, transcending mere methodological adaptations. There is a need for VAWG research and programming to scrutinise structural inequities, particularly acknowledging how colonial practices entrenched within wider societal power structures impact the field of VAWG.

Suspicion of needle pricking/spiking in 2022 in Paris, France, an observational study from the Department of Forensic Medicine.

BACKGROUND: Needle pricking, the act of being intentionally pricked by an assailant, and needle spiking, the covert injection of substances using a needle, have historical precedents and recently resurfaced in Europe in 2022. This resurgence presented a challenge for emergency and forensic medicine departments. METHODS: We conducted a retrospective study in the forensic medicine department of Paris, France, including all patients who consulted for suspected needle pricking/spiking in 2022, following a police report. The study aimed to provide epidemiological data on victims, circumstances, and the results of toxicologic and serological analyses. FINDINGS: Of all assault victims in 2022, patients reporting or suspecting needle pricking/spiking represented 1.2 % of the total (171 cases). Most cases involved women (81.9 %) with a median age of 21.75 years. Incidents often occurred in festive contexts (84.8 %). Over a third of the patients didn't report any symptoms (37.5 %). Amnesia, nausea, and dizziness were common symptoms among those who did. Patients reporting alcohol consumption were more likely to experience symptoms (p < 0.05). Over half of the patients displayed physical examinations consistent with needle pricking, with pricks mostly on their arms. Not all patients underwent toxicologic analyses (30.6 %), but all results were negative. Despite most patients not providing follow-up serology results, all received results were negative. INTERPRETATION: Overall, our data are more suggestive of needle pricking than spiking. Although women were overrepresented, there was no evidence of sexual motivation on the part of the perpetrators. It's possible that the perpetrators wanted to instill fear in the population without a specific goal. This form of violence necessitates preventive measures in festive venues and enhanced efforts to detect psychoactive substance.

Formal help-seeking in intimate partner violence among Spanish-born and immigrant women in Spain: A focus group study.

Intimate partner violence (IPV) is a public health problem. In Spain, although the prevalence of IPV is greater in immigrant women than in Spanish-born women, immigrant women seem to access services to a lesser extent. This study aimed to explore and compare perceptions of barriers to and strategies for seeking formal help among Spanish-born and immigrant women IPV survivors. A qualitative study was conducted based on three focus groups with women of Spanish (n = 9), Romanian (n = 4), and Latin American (n = 4) origin. The thematic analysis was supported by Atlas.ti. Three categories and 12 subcategories were identified: general characteristics of help-seeking behavior (e.g., children as the main motivating factor), barriers (e.g., immigrant status, fear of the perpetrator), and strategies for accessing services (e.g., increasing education). Differences in help-seeking behavior were found between groups. Relevant information for professionals to improve women's access to IPV support services is provided.

Profile of female survivors of sexual violence in the first 6 months of the COVID-19 quarantine in the city of Campinas, Brazil: A cross-sectional retrospective study.

OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

The mental health of staff at violence against women organizations during the COVID-19 pandemic: Findings from a mixed-methods study of service providers in Canada's largest city.

OBJECTIVES: Staff at violence against women (VAW) organizations provide essential services for survivors of violence. The increase in VAW during the COVID-19 pandemic placed additional pressures on VAW staff. We investigated the impacts of the pandemic on the mental health of VAW staff in the Greater Toronto Area to inform recommendations for policy and practice. METHODS: We conducted a community-based, mixed-methods study on the processes, experiences, and outcomes of adapting VAW programming during the pandemic using a sequential explanatory approach. Throughout 2021, we conducted a survey of direct support and leadership staff who worked on VAW services ("VAW staff") followed by semi-structured interviews with VAW staff purposively sampled from the survey. We descriptively analyzed quantitative survey data on the mental health of 127 VAW staff. We then applied thematic analysis to qualitative data from 18 interviews with VAW staff. We used the qualitative data to support interpretation and enrich the quantitative findings regarding staff mental health. RESULTS: In the survey, 81% of leadership and 61% of direct support staff indicated that their work was more distressing during the pandemic. Participants reported moderate symptoms of vicarious trauma and mild symptoms of anxiety and depression. We generated three themes from the qualitative data to help explain these findings: (1) challenges related to changing work environments; (2) distress over not meeting client needs; and (3) difficulties in adapting self-care strategies in response to pandemic stressors. CONCLUSION: VAW organizations require increased resources and flexible funding to hire and retain more staff to respond to higher and more complex caseloads during public health emergencies. With more structural supports in place, VAW organizations could create more time and space to develop their trauma-informed organizational practices: for example, establishing a culture of connection and learning among staff virtually and in-person and facilitating a range of self-care opportunities.

RéSUMé: OBJECTIFS: Le personnel des organisations de lutte contre la violence envers les femmes (VEF) fournit des services essentiels aux survivantes de la violence. L'augmentation de la VEF pendant la pandémie de COVID-19 a exercé des pressions supplémentaires sur le personnel de la VEF. Nous avons étudié les impacts de la pandémie sur la santé mentale du personnel de la VEF dans la région du Grand Toronto afin de formuler des recommandations pour les politiques et les pratiques. MéTHODES: Nous avons mené une étude communautaire basée sur des méthodes mixtes sur les processus, les expériences et les résultats de l'adaptation des programmes de VEF pendant la pandémie, en utilisant une approche explicative séquentielle. Tout au long de l'année 2021, nous avons mené une enquête auprès personnel de première ligne et des cadres travaillant sur les services de VEF (personnel de VEF), suivie d'entretiens semi-structurés avec un échantillon intentionnel de ce personnel tiré de l'enquête. Nous avons analysé de manière descriptive les données quantitatives de l'enquête sur la santé mentale de 127 membres du personnel de VEF. Nous avons ensuite appliqué une analyse thématique aux données qualitatives provenant de 18 entretiens avec le personnel de VEF. Nous avons utilisé les données qualitatives pour soutenir l'interprétation et enrichir les résultats quantitatifs concernant la santé mentale du personnel. RéSULTATS: Dans l'enquête, 81 % des cadres et 61 % du personnel de première ligne ont indiqué que leur travail était plus stressant pendant la pandémie. Les participants ont signalé des symptômes modérés de traumatisme indirect et des symptômes légers d'anxiété et de dépression. Nous avons dégagé trois thèmes à partir des données qualitatives pour aider à expliquer ces résultats : (1) défis liés aux environnements de travail changeants; (2) détresse liée à l'incapacité de répondre aux besoins des clients; et (3) difficultés à adapter les stratégies de soins personnels en réponse aux facteurs de stress de la pandémie. CONCLUSION: Les organisations de VEF ont besoin de ressources accrues et de financements flexibles pour recruter et retenir plus de personnel afin de répondre à des charges de travail plus élevées et plus complexes pendant les urgences de santé publique. Avec davantage de soutiens structurels en place, les organisations de VEF pourraient dégager plus de temps et d'espace pour développer leurs pratiques organisationnelles tenant compte des traumatismes. Par exemple, établir une culture de connexion et d'apprentissage entre le personnel, à la fois virtuellement et en personne, et faciliter une gamme d'opportunités de soins personnels.

Hope Groups: a protocol for a cluster randomized controlled trial of psychosocial, mental health, and parenting support groups for Ukrainian caregivers during war and conflict.

BACKGROUND: In 2021, more than two-thirds of the world's children lived in a conflict-affected country. In 2022, 13 million Ukrainians were forced to flee their homes after Russia's full-scale invasion. Hope Groups are a 12-session psychosocial, mental health, and parenting support intervention designed to strengthen parents, caregivers, and children affected by war and crisis. The primary objective of this study is to evaluate the effectiveness of Hope Groups among Ukrainians affected by war, compared to a wait-list control group. This protocol describes a promising decentralized intervention delivery model and an innovative research design, which estimates the causal effect of Hope Groups while prioritizing prompt delivery of beneficial services to war-affected participants. METHODS: This protocol describes a pragmatic cluster randomized controlled trial (RCT) among Ukrainians externally displaced, internally displaced within Ukraine, and living at home in war-affected areas. This study consists of 90 clusters with 4-7 participants per cluster, totaling approximately n = 450 participants. Intervention clusters will receive 12-session Hope Groups led by peer facilitators, and control clusters will be wait-listed to receive the intervention after the RCT concludes. Clusters will be matched on the facilitator performing recruitment and intervention delivery. Primary outcomes are caregiver mental health, violence against children, and positive parenting practices. Secondary outcomes include prevention of violence against women and caregiver and child well-being. Outcomes will be based on caregiver report and collected at baseline and endline (1-week post-intervention). Follow-up data will be collected among the intervention group at 6-8 weeks post-intervention, with aims for quasi-experimental follow-ups after 6 and 12 months, pending war circumstances and funding. Analyses will utilize matching techniques, Bayesian interim analyses, and multi-level modeling to estimate the causal effect of Hope Groups in comparison to wait-list controls. DISCUSSION: This study is the first known randomized trial of a psychosocial, mental health, and parenting intervention among Ukrainians affected by war. If results demonstrate effectiveness, Hope Groups hold the potential to be adapted and scaled to other populations affected by war and crisis worldwide. Additionally, methodologies described in this protocol could be utilized in crisis-setting research to simultaneously prioritize the estimation of causal effects and prompt delivery of beneficial interventions to crisis-affected populations. TRIAL REGISTRATION: This trial was registered on Open Science Framework on November 9, 2023. REGISTRATION: OSF.IO/UVJ67 .

Men's perspectives on public-space sexual harassment of women in South Asia.

The ubiquity of public-space sexual harassment (PSH) of women in the global South, particularly in South Asia, is both a public health and gender equity issue. This study examined men's experiences with and perspectives on PSH of women in three countries with shared cultural norms and considerable gender inequalities - Bangladesh, India, and Pakistan. The three-country survey in 2021-2022 was completed by 237 men who were generally young, urban, single, well-educated, and middle-/high-income. Among the 53.3% who witnessed PSH, 80% reported intervening to stop it or help the victim. A substantial share of men worried about PSH, and bore emotional, time, and financial costs as they took precautionary or restorative measures to help women in their families avoid PSH or deal with its consequences. Most respondents articulated potential gains for men, women, and society if PSH no longer existed. However, a non-negligible share of participants held patriarchal gender attitudes that are often used to justify harassment, and a small share did not favour legal and community sanctions. Many called for stricter legal sanctions and enforcement, culture change, and education. Men's perspectives offer insights for prevention of harassment and mitigation of its consequences.

Gender Gap in academic medicine: a narrative review and the Italian forensic context.

Background: Gender gap is a neologism that identifies the disparity between social and professional conditions experienced by females compared to males. The disparity increases as one ascends the academic hierarchy. In recent years, the debate has expanded, and more options have been planned for the elimination of the current gender gap. Methods: This research was conducted by examining the landscape of the gender gap, particularly in the academic forensic medicine field. Our analysis involved reviewing papers published between 2006 and 2024, identified through electronic database searches (PubMed). The search terms used were: "gender gap" AND "academic" AND "medicine" AND "leadership." In total, we analyzed 85 papers. Additionally, we examined data from forensic medicine residency programs. Conclusions: The representation of women in medicine is well-known. Despite the increasing number of women in leadership positions in medicine, they still lag significantly behind men. These data highlight a situation that could be seen as grounds for an accusation of "academic abuse". In the Italian forensic residency programs, less than 20% are led by women, and among these, not all hold the rank of full professor. Although a certain rebalancing is already underway, the gap is still significant. There are already regulations obliging local authorities to promote gender equality in councils, companies, and institutions under their jurisdiction. It would be desirable to consider minimum quotas for female participation in university competitions. This would be a first step toward eliminating the gender gap in academic and forensic medical fields.

Couples, alcohol use and experience of intimate partner violence among young women in urban informal settlements in Durban, South Africa: A mixed methods study.

Alcohol is recognized as a driver of intimate partner violence (IPV) perpetration and experience, but relatively little research has focused on the role of couples' drinking patterns, nor pathways between alcohol and violence. We draw on data collected among young (18-30 year old) people living in informal settlements who self-selected to enroll in an intervention trial to reduce IPV in Durban, South Africa to understand these dynamics. Between September 2015 and September 2016 quantitative data were collected from women, who reported on their own experiences of IPV and alcohol use, as well as their partner's own alcohol use. To contextualise and interpret the quantitative results, we use qualitative data from women and men (who were not in relationships with one another) to understand potential pathways through which alcohol use may shape conflict in relationships. All forms of IPV (physical and/or sexual, emotional and economic) were more common among women where either, they alone had problematic drinking levels, their partner was frequently drunk but they did not have problematic alcohol use, or they had problematic alcohol use and their partner was drunk frequently. Qualitative data suggested women and men in relationships rarely drank together. Three potential ways in which alcohol use increased conflict and IPV: disinhibition, with women and men more likely to get into arguments and speak 'badly' to one another; the impact of men's drinking on relationships, including economic provision and providing emotional support; and, the close association between alcohol consumption and infidelity, with women's public drinking being particularly stigmatized and male partner's seeing this as a challenge to their authority and control. Interventions addressing the alcohol-IPV nexus need to also address male patriarchal control and alcohol's close association with infidelity and the impact on finances, as well as reducing alcohol use.

New perspectives on fighting violence against women.

Gender-based violence (GBV) and, more specifically, violence against women (VAW) are commonly considered a consequence of a patriarchal structure-a social system granting the senior male absolute authority over the family and the community as a whole. Anthropologists have documented that human male dominance is rooted in evolution, with male violent behavior observed among the great apes. Given that evolution is a continuous process, human progress over millennia has modified pre-existing behavior, demonstrating that humans can move beyond ancestral ways of life over time. Precisely because of the imperative to change and improve, at the global international level as well as in individual countries, strong movements are in action to eliminate GBV/VAW. FIGO has been and continues to be at the forefront of the battle for equality, with initiatives that cover many aspects of this, including the imperative to involve men, who-in the majority of cases-are the perpetrators. Since men are often the root of the problem, they must also be at the forefront of the battle to eradicate it. GBV/VAW comprises many facets, including selective female abortion, infanticide, femicide, honor killing, female genital mutilation, and child marriage. These deeply rooted forms of violence continue to perpetuate gender inequalities, remain major obstacles to health and societal progress, and violate the most basic human rights.

Plantocratic patriarchal culture, violence against women and girls and the failures of the global health system: an interview with Marsha Hinds Myrie and Anya A. A. Lorde.

Like other parts of the world, women and girls in the Commonwealth Caribbean (CC) experience high and escalating rates of physical and sexual violence. The interview presented outlines some factors that underscore the gendered disparities of violence against women in the Caribbean as well as how healthcare responses are not developed for marginalised women and girls. The interview explores the invisibility of women and girls within healthcare and broader national healthcare structures responses through case details analysis of a Barbadian strategic litigation case. The interview calls for transdisciplinary approaches to analysing the effectiveness of the global health system that make space for not just traditional research approaches but also lived experiences 'from below' and input of advocates and activists. Despite Barbados being a signatory to a range of global health initiatives to improve healthcare responses to gender-based violence, the country does not have a formalised, comprehensive national plan to inform prevention and intervention measures. The interview shows the connections between plantocratic patriarchal culture (PPC) and the existing gaps that cause harm to women and girls who experience various types of gendered violence.

'Important, but difficult': Swedish primary care professionals' perceptions and experiences of dealing with violence against women: an interview study.

BACKGROUND: Men's violence against women is a global health problem causing physical, mental, sexual and reproductive ill-health. The World Health Organisation has estimated that every third woman in the world has been exposed to physical and/or sexual violence. Swedish primary care is central for victims of violence, as it is normally the first port of call for seeking healthcare. This requires professional competence on violence, and its causes. It also requires resources for working with violence prevention, disclosure and supportive actions. The aim of this study is to deepen the understanding of how primary care professionals in Sweden deal with violence against women. We analyse their viewpoints, experiences and practices of working with violence as a health problem, and especially if, and if so how, they ask patients about violence. METHODS: A qualitative, explorative research design was adopted. Research interviews were conducted with 18 health professionals at eight primary care clinics. These clinics were located in four different regions, from the south to the north, in large urban areas, middle-size cities and rural areas. The interviews were voice recorded and transcribed verbatim. Thematic analysis was used to analyse the interviews. RESULTS: Three themes, with a total of ten related sub-themes, were developed. These themes are: (a) Varying understandings and explanations of violence against women; (b) The tricky question of asking about violence; and (c) Multiple suggestions for improving primary care's work with violence against women. The awareness of violence varied considerably, with some practitioners being highly knowledgeable and having integrated violence into their everyday practice, whereas others were less knowledgeable and had not paid much attention to violence. The very naming of violence seemed to be problematic. Several suggestions for improvements at professional, managerial and organisational levels were articulated. CONCLUSIONS: The results shed important light on the professionals' problems and struggles when dealing with violence against women in primary care. Better support and resources from the healthcare organisation, clearer leadership and more detailed policy would improve and facilitate everyday practice. All of these factors are indispensable for primary care's work with victims of men's violence against women.

Clinical validation of the ineffective social support network nursing diagnosis in violence-victimized women.

PURPOSE: To verify clinical validity evidence for the ineffective social support network nursing diagnosis. METHOD: A quantitative, descriptive, cross-sectional study was performed with 98 violence-victimized women treated in two reference centers for violence in the city of Recife, Pernambuco, Brazil. The women were interviewed from August 2021 to June 2022. FINDINGS: The clinical indicators that best predicted the nursing diagnosis were as follows: Frustration with unmet support expectations, negative social interaction, perceived neglect of support demands, feeling of abandonment, low reciprocity, and encouragement of negative behaviors. Etiological factors that showed greater association were excessive demand for support, limited social network, social isolation, the fragility of institutional service networked organizations, and inadequate appreciation of available social support. CONCLUSIONS: The clinical validity evidence for the ineffective social support network nursing diagnosis has been verified. Thus, the validated clinical indicators and etiological factors can accurately diagnose and predict the emergence of this phenomenon in violence-victimized women. IMPLICATIONS FOR NURSING PRACTICE: The results contribute to advancing scientific knowledge in nursing teaching, research, and practice and support the nursing process in violence-victimized women.

OBJETIVO: Verificar evidências de validade clínica para o diagnóstico de enfermagem Rede de Apoio Social Ineficaz. MÉTODO: Estudo quantitativo, descritivo e transversal realizado com 98 mulheres vítimas de violência atendidas em dois centros de referência em violência na cidade do Recife, Pernambuco, Brasil. As mulheres foram entrevistadas no período de agosto de 2021 a junho de 2022. RESULTADOS: Os indicadores clínicos que melhor predisseram o diagnóstico de enfermagem foram: Frustração com Expectativas de Apoio Não Atendidas, Interação Social Negativa, Negligência Percebida nas Demandas de Apoio, Sentimento de Abandono, Baixa Reciprocidade e Incentivo a Comportamentos Negativos. Os fatores etiológicos que apresentaram maior associação foram Demanda Excessiva de Apoio, Rede Social Limitada, Isolamento Social, Fragilidade das Organizações em Rede de Serviços Institucionais e Valorização Inadequada do Apoio Social Disponível. CONCLUSÕES: Foram verificadas evidências de validade clínica para o diagnóstico de enfermagem Rede de Apoio Social Ineficaz. Assim, os indicadores clínicos e fatores etiológicos validados têm a capacidade de diagnosticar e prever com precisão o surgimento deste fenômeno em mulheres vítimas de violência. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: A validação clínica do diagnóstico fundamenta as intervenções de enfermagem direcionadas às mulheres vítimas de violência e à sua rede de apoio social. PALAVRAS­CHAVE: Apoio social; Educação saudável; diagnóstico de enfermagem; rede social; violência contra as mulheres.

Burn-related Violence Against Women in the US: Findings from the ABA Burn Registry.

Violence against women is a global public health problem. CDC data shows 41% of US women have experienced intimate partner violence. Burn-related violence against women is an extremely confronting form of physical violence. The aim of this study was to describe the frequency, demographics, injury characteristics and outcomes of women admitted to US burn centers who have experienced burn violence compared to those with accidental burn injuries. 2008-2018 data was queried from the ABA Burn Quality Care Platform registry for patients that were women and ≥18 years old. Women who experienced an assault or accidental burn injury were included. Women who experienced self-harm were excluded. Descriptive/simple comparative statistics were used to describe/compare groups. 54,523 women met study inclusion criteria. 956 (2%) experienced burn violence. Women who experienced burn violence had a younger median [IQR] age (36 [27,48] vs 47 [32,61],p<0.0001), were Black/African American (44.5% vs. 22.4%,p< 0.0001), were covered by Medicaid (38.8% vs. 21.6%,p< 0.0001), had a higher median [IQR] %TBSA extent (6.0% [3,15.2] vs. 3.0% [1,7.3],p< 0.0001), a higher proportion with 3rd degree burns (35.4% vs. 28.9%,p<0.0001), and a higher proportion with TBSA >20% (18.2% vs. 6.7%,p<0.0001). Scald/flame injuries were the most frequent mechanism of injury. Women who experienced violence had a higher median [IQR] length of hospital stay (7.0 [2,18] vs. 4.0 [1,11] days, p< 0.0001), ICU stay (8.5 [2,27] vs. 4 [2,13] days,p< 0.0001), and mortality rate (5.7% vs 4.3%,p<0.04). The frequency of women who sustained burn violence appears small yet experience worse outcomes. Clinicians should be aware of these demographic/clinical characteristics to provide optimal care to this vulnerable population.

Constructing, Deconstructing or Abolishing? Discourses on Masculinities in Violence Against Women Prevention by Stakeholders in Spain.

In the field of violence against women (VAW) prevention, one of the current questions at stake is how to address men's role and masculinities, but it is still an emerging field in Spain. The aim of this study was to analyze the up-to-date discourses on masculinity among stakeholders in the field of VAW prevention and gender equity in Spain. We used a qualitative methodology with semi-structured interviews, conducted between October 2019 and February 2020 in Madrid and Alicante (Spain), with 23 key stakeholders from different areas: in governmental (public health and VAW prevention/intervention, and institutional and policy positioning) and nongovernmental organizations (anti-violence masculinities workers, youth education workers, and feminist and LGBT associations). A discourse analysis was performed with the data collected. Our findings showed that discourses around masculinities among Spanish stakeholders in VAW prevention and gender equity were diverse and presented different layers of critique. Despite a general agreement on the importance of transforming sexist men's practices toward more gender equitable relations, three main interpretive repertoires were identified: "Constructing positive/new masculinities" discourse, focused on promoting men's engagement and egalitarian practices; "Deconstructing hegemonic masculinity" discourse, intended to critically identify and question harmful masculinities norms; and "Abolishing gender" discourse, which aims at dismantling masculinity, and gender in general, as a social structure that generates oppression in itself, advocating for its abolition. Those interpretive repertoires were not mutually exclusive and sometimes stakeholders incorporate in their work more than one approach. The study findings shed light on this current emerging and urgent debate and contributes more broadly to the critical assessment of the concepts used and their implications for VAW prevention.