Prevalência e fatores associados à violência por parceiro íntimo na gestação em Caxias, Maranhão, 2019-2020 / Prevalencia y factores asociados con la violencia por la pareja durante el embarazo en Caxias, en el estado de Maranhão, Brasil, 2019-2020 / Prevalence and factors associated with intimate partner violence during pregnancy in Caxias, state of Maranhão, Brazil, 2019-2020

Objetivo: Analisar a prevalência e fatores associados à violência por parceiro íntimo na gestação. Métodos: Estudo transversal, com dados obtidos de entrevistas com grávidas de 10 a 49 anos de idade, no terceiro trimestre gestacional, residentes em Caxias, Maranhão, Brasil (2019-2020). Utilizou-se o instrumento World Health Organization Violence Against Women Study para identificação da forma de violência. Realizou-se análise hierarquizada por regressão logística múltipla. Resultados: Foram entrevistadas 233 gestantes. A violência na gestação apresentou prevalência de 33,0%, com predomínio da violência psicológica (18,9%). No modelo hierarquizado final, a faixa etária da mulher <20 anos (ORaj=2,09 - IC95% 1,17;3,54) e o consumo de drogas ilícitas pelo parceiro (ORaj=8,78 - IC95% 2,13;28,92) mantiveram-se associados ao desfecho de violência. Conclusão: A violência na gestação apresentou elevada prevalência, sendo a idade jovem da mulher e o uso de substâncias ilícitas pelo parceiro fatores associados a sua ocorrência.

Objetivo: Analizar la prevalencia y los factores asociados de la violencia de pareja durante el embarazo. Métodos: Estudio transversal, con datos obtenidos mediante entrevistas a mujeres embarazadas de 10 a 49 años en el tercer trimestre de gestación, residentes en Caxias, Maranhão, Brasil (2019-2020). Para identificar la violencia se utilizó el instrumento del Estudio sobre la Violencia contra la Mujer de la Organización Mundial de la Salud. Se realizó análisis jerárquico mediante mediante regresión logística múltiple. Resultados: Se entrevistaron 233 mujeres. La violencia durante la gestación tuvo prevalencia de 33,0%, con predominio de violencia psicológica (18,9%). En el modelo jerárquico final, la edad de la mujer <20 años (ORaj=2,09 - IC95% 1,17;3,54) y el consumo de drogas ilícitas por la pareja (ORaj=8,78 - IC95% 2,13;28,92) se mantuvieron asociadas al desenlace violento. Conclusión: La violencia durante el embarazo tuvo alta prevalencia, siendo la baja edad de la mujer y el consumo de sustancias ilegales por la pareja, factores asociados con su ocurrencia.

Objective: To analyze prevalence and factors associated with intimate partner violence during pregnancy. Methods: This was a cross-sectional study, with data obtained through interviews conducted with pregnant women aged 10 to 49 years during the third trimester of pregnancy, living in Caxias, state of Maranhão, Brazil (2019-2020). The instrument of the World Health Organization Violence Against Women Study was used to identify violence. A hierarchical analysis was performed using multiple logistic regression. Results: foram entrevistadas 233 gestantes. A prevalência de violência na gestação foi de 33,0%, com predomínio da violência psicológica (18,9%). No modelo hierárquico final, mulheres com idade <20 anos (ORadj=2,09 - IC95% 1,17;3,54) e uso de drogas ilícitas por parceiro íntimo (ORadj=8,78 - IC95% 2,13;28,92) permaneceram como fatores associados ao desfecho .Conclusion: Prevalence of violence during pregnancy was high, with illegal drug use by young women and their partners being factors associated with its occurrence.

Intimate partner violence during pregnancy: prevalence and associated factors.

OBJECTIVE: To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS: Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS: Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS: Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.

Marital violence precipitating/intensifying elements during the Covid-19 pandemic. / Elementos precipitadores/intensificadores da violência conjugal em tempo da Covid-19.

The study aims to identify marital violence precipitating/intensifying elements during the COVID-19 pandemic. This is a narrative review of the literature, and the search was carried out in May 2020. We employed the PubCovid-19 platform, which is indexed in the United States National Library of Medicine (PubMed) and the Excerpta Medica (EMBASE) database. English descriptors "Domestic violence", "COVID-19", and "Intimate Partner Violence" were used in the search, and nine papers were selected for full-text reading. Three empirical categories were elaborated from the exploration of the selected material: Economic instability, Alcohol and other drugs use/abuse, and Weaker women's support network. Support networks for women in situations of marital violence should be expanded in this pandemic context, with emphasis on the use of digital technologies as possible tools for screening pandemic-related violence cases.

Impact of gender-based violence on psychological distress and happiness in León (Nicaragua).

The researchers' aim for the current study is to analyze the impact of gender-based violence on mental health and happiness. The sample is composed of 136 women victims of intimate partner violence, who were living in poverty. The participants contacted through the country's Commissariat for Women and Children and other associations working with the National Police from Nicaragua, a country with low levels of development. The results of our structural equation model show that the frequency of abuse has a direct effect on psychological distress and an indirect effect on overall happiness. The deterioration of mental health and social support have a direct effect on overall happiness. Consequently, emotional recovery and social support play an important role in the future of women victims of gender-based violence. This information can be useful to reduce psychological distress and improve care for women in specialized services.

Intimate partner violence during pregnancy: prevalence and associated factors / Violências por parceiro íntimo na gestação: prevalências e fatores associados

ABSTRACT OBJECTIVE To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.

RESUMO OBJETIVO Identificar a prevalência das violências durante a gestação e verificar a associação com as características socioeconômicas, comportamentais e clínicas da gestante. MÉTODOS Estudo transversal em uma maternidade de baixo risco do município de Cariacica, Espírito Santo. Foram entrevistadas 330 puérperas de agosto a outubro de 2017. Informações sobre as características socioeconômicas, comportamentais, reprodutivas e clínicas, assim como experiências de vida, foram coletadas por meio de questionário. Para identificar os tipos de violência, foi utilizado o instrumento da Organização Mundial da Saúde. Foi realizada análise bivariada e multivariada bruta e ajustada por regressão de Poisson com variância robusta. RESULTADOS As prevalências foram 16,1% (IC95% 2,5-20,4) para violência psicológica, 7,6% (IC95% 5,1-11,0) para a física e 2,7% (IC95% 1,4-5,2) para a sexual. A violência psicológica manteve-se associada a idade, renda familiar, início da vida sexual, doença na gravidez, desejo de interromper a gestação e número de parceiros. A violência física esteve associada a escolaridade, início da vida sexual e doença na gravidez. Já a violência sexual manteve-se associada a situação conjugal e desejo de interromper a gestação (p < 0,05). CONCLUSÕES A violência psicológica perpetrada pelo parceiro íntimo foi a de maior prevalência entre as gestantes. Mulheres mais jovens, com menor renda e escolaridade, que iniciaram a vida sexual até os 14 anos e que desejaram interromper a gravidez vivenciaram com maior frequência a violência durante a gestação.

Elementos precipitadores/intensificadores da violência conjugal em tempo da Covid-19 / Marital violence precipitating/intensifying elements during the Covid-19 pandemic

Resumo O estudo tem por objetivo identificar elementos precipitadores/intensificadores da violência conjugal em tempos de pandemia da Covid-19. Trata-se de uma revisão narrativa da literatura, tendo a busca sido realizada no mês de maio de 2020. Utilizou-se a plataforma PubCovid-19, a qual está indexada na Biblioteca Nacional de Medicina dos Estados Unidos (PubMed) e no Banco de dados Excerpta Medica (EMBASE). Para a realização da busca foram utilizados os seguintes descritores em inglês: "Domestic violente"; "Covid-19" e "Intimate Partner Violence". Foram selecionados nove artigos para leitura na íntegra. A partir da exploração do material selecionado, foram elaboradas três categorias empíricas a saber: Instabilidade econômica, Uso/abuso de álcool e outras drogas e Enfraquecimento da rede de apoio da mulher. É importante que nesse contexto de pandemia, sejam ampliadas as redes de apoio à mulher em situação de violência conjugal, com destaque para o uso de tecnologias digitais como possíveis ferramentas para a triagem de casos de violência em tempos de pandemia.

Abstract The study aims to identify marital violence precipitating/intensifying elements during the COVID-19 pandemic. This is a narrative review of the literature, and the search was carried out in May 2020. We employed the PubCovid-19 platform, which is indexed in the United States National Library of Medicine (PubMed) and the Excerpta Medica (EMBASE) database. English descriptors "Domestic violence", "COVID-19", and "Intimate Partner Violence" were used in the search, and nine papers were selected for full-text reading. Three empirical categories were elaborated from the exploration of the selected material: Economic instability, Alcohol and other drugs use/abuse, and Weaker women's support network. Support networks for women in situations of marital violence should be expanded in this pandemic context, with emphasis on the use of digital technologies as possible tools for screening pandemic-related violence cases.

Violence against women and its association with the intimate partner's profile: a study with primary care users. / Violência contra a mulher e sua associação com o perfil do parceiro íntimo: estudo com usuárias da atenção primária.

OBJECTIVE: To verify the association between the history of violence against women and the socio-demographic and behavioral characteristics of intimate partners. METHODS: A cross-sectional study was carried out with 938 women using basic health care, aged between 20 and 59 years, who at the time of the interview had an intimate partner. Information about the sociodemographic and behavioral characteristics of the intimate partner were collected, as well as the WHO VAW Study instrument for tracking the psychological, physical and sexual violence experienced in the past year. A bivariate analysis was performed using the Pearson c2 test and multivariate analysis using Poisson regression with robust variance. RESULTS: The highest prevalences of psychological, physical and sexual violence were significantly associated with partners who had no occupation and who refused to use condoms in sexual relationships. Men who were considered controllers and who consumed alcoholic beverages were associated with greater perpetration of psychological and physical violence (p < 0.05). Partners with up to eight years of schooling present a higher frequency of psychological violence (PR = 1.32, 95%CI 1.05 - 1.66), while sexual violence was significantly higher among women whose partners smoked: 1.94, 95%CI 1.11 - 3.38). CONCLUSIONS: These data highlight the importance of health professionals, work together in other sectors such as education and safety, dealing with alcohol and other drugs, as well as addressing issues of gender.

OBJETIVO: Verificar associação entre a história de violência contra a mulher e características sociodemográficas e comportamentais do parceiro íntimo. MÉTODOS: Estudo transversal realizado com 938 mulheres usuárias da atenção básica de saúde, com idade entre 20 e 59 anos e que no momento da entrevista possuíam parceiro íntimo. Foram coletadas informações sobre as características sociodemográficas e comportamentais, do parceiro íntimo, bem como foi aplicado o instrumento World Health Organization Violence Against Woman (WHO VAW Study) para o rastreamento da violência psicológica, física e sexual vivenciada no último ano. Foi realizada análise bivariada, por meio do teste do c2 de Pearson, e multivariada usando regressão de Poisson com variância robusta. RESULTADOS: As maiores prevalências de violência psicológica, física e sexual estiveram significativamente associadas aos parceiros que não possuíam ocupação e que recusaram o uso do preservativo nas relações sexuais. Homens que foram considerados controladores e que ingeriam bebida alcoólica estiveram associados a maior perpetração de violência psicológica e física (p < 0,05). Parceiros com até 8 anos de escolaridade apresentam maior frequência de prática de violência psicológica (RP = 1,32; IC95% 1,05 - 1,66), enquanto a violência sexual foi significativamente maior entre as mulheres cujos parceiros fumavam (RP = 1,94; IC95% 1,11 - 3,38). CONCLUSÕES: Esses dados evidenciam a importância de os profissionais de saúde atuarem juntamente a outros setores, tais como educação e segurança, no enfrentamento ao álcool e outras drogas, bem como na abordagem das questões de gênero.

Understanding marital violence: a study in grounded theory.

OBJECTIVE: to understand the phenomenon of marital violence based on the experience of women in judicial process and network professionals. METHOD: a qualitative study, with theoretical-methodological support in grounded theory. Data collection took place in two regional Courts for Peace in the Home in a municipality of the Brazilian Northeast. Interviews were conducted with 38 participants, who composed two sample groups: women in situations of violence and network professionals. RESULTS: the understanding of marital violence emerged for the phenomenon "Experiencing marital violence as a progressive and cyclical process, with repercussions for health and implications for social relations". CONCLUSION: in recognizing marital violence as a recurring problem in the life of women, with implications for their own health and that of their children, the study points to the relevance of coping strategies based on institutional and social support.

Exposure to domestic violence in women living in Istanbul and Aegean regions: a Turkish sample.

Domestic violence (DV) is a serious public health problem in the world. DV against women is also a global problem without cultural, geographic, religious, social, economic or national boundaries. This descriptive cross-sectional study was carried out to determine the situations of DV in women living in Istanbul and the Aegean Region in Turkey. The study population included outpatient clinics of state hospitals both regions. A stratified sampling by age was performed and 1100 women were included into the sample. Data were collected at face-to-face interviews with Domestic Violence Against Women Determination Scale. The mean age of the women living in Istanbul was 41.81 ± 9.75 years and Aegean Region was 33.72 ± 11.38 years. The prevalence of emotional and financial violence were higher in Istanbul and the Aegean Region. The women living in Istanbul got higher scores for Domestic Violence Against Women Determination Scale. The prevalence of the women reporting to suffer from violence from their spouses was 15.4% in Istanbul and 14% in the Aegean Region. While the prevalence of the women suffering from violence was higher in Istanbul, the women in Aegean Region suffered from more severe violence. The violence prevalence was lower among the wives and the husbands with high education levels, employed women and high-income families.

Exposure to domestic violence in women living in Istanbul and Aegean regions: a Turkish sample / Exposição à violência doméstica em mulheres que vivem em Istambul e nas regiões do Egeu: uma amostra turca

Abstract Domestic violence (DV) is a serious public health problem in the world. DV against women is also a global problem without cultural, geographic, religious, social, economic or national boundaries. This descriptive cross-sectional study was carried out to determine the situations of DV in women living in Istanbul and the Aegean Region in Turkey. The study population included outpatient clinics of state hospitals both regions. A stratified sampling by age was performed and 1100 women were included into the sample. Data were collected at face-to-face interviews with Domestic Violence Against Women Determination Scale. The mean age of the women living in Istanbul was 41.81 ± 9.75 years and Aegean Region was 33.72 ± 11.38 years. The prevalence of emotional and financial violence were higher in Istanbul and the Aegean Region. The women living in Istanbul got higher scores for Domestic Violence Against Women Determination Scale. The prevalence of the women reporting to suffer from violence from their spouses was 15.4% in Istanbul and 14% in the Aegean Region. While the prevalence of the women suffering from violence was higher in Istanbul, the women in Aegean Region suffered from more severe violence. The violence prevalence was lower among the wives and the husbands with high education levels, employed women and high-income families.

Resumo A violência doméstica (VD) é um grave problema de saúde pública no mundo. VD contra as mulheres também é um problema global sem fronteiras culturais, geográficas, religiosas, sociais, econômicas ou nacionais. Este estudo descritivo transversal foi realizado para determinar as situações de VD em mulheres que vivem em Istambul e na região do Egeu, na Turquia. Foi realizada uma amostragem estratificada por idade e 1.100 mulheres foram incluídas na amostra. Os dados foram coletados em entrevistas presenciais com a Escala de Determinação de Violência Doméstica Contra a Mulher. A idade média das mulheres que vivem em Istambul foi de 41.81 ± 9.75 anos e a região do Egeu foi de 33.72 ± 11.38 anos. As prevalências de violência emocional e financeira foram maiores em Istambul e na região do Egeu. A pontuação na Escala de Determinação de Violência Doméstica Contra a Mulher foi mais elevada entre as mulheres que vivem em Istambul. A prevalência das mulheres que relatam sofrer violência de seus cônjuges foi de 15.4% em Istambul e 14% na região do Egeu. Embora a prevalência das mulheres que sofrem de violência tenha sido maior em Istambul, as da região do Egeu sofreram de violência mais grave. A prevalência da violência foi menor entre as esposas e os maridos com altos níveis de escolaridade, mulheres empregadas e famílias de alta renda.

Elements which precipitate conjugal violence: the discourse of men in criminal prosecution.

OBJECTIVE: Unveiling the precipitating elements of conjugal violence based on the discourse of men undergoing criminal prosecution. METHOD: This is a qualitative study developed in a Domestic Violence and Family Violence Campaign against Women from Salvador, Bahia, Brazil. RESULTS: We interviewed 23 men. The following central ideas emerged: children and family interference; change in woman's behavior; feeling of ownership; discovery of extramarital affairs of women; absence of marital sexual intercourse; and use of alcohol and other drugs by men. CONCLUSION: Several elements precipitate marital violence according to the mens' discourse. Knowing these elements can subsidize actions for preventing the phenomenon, especially from implementing peaceful conflict resolution strategies.

Childhood abuse, intimate partner violence, and placental abruption among Peruvian women.

PURPOSE: Experiencing childhood abuse (CA) or intimate partner violence (IPV) has been linked to adverse pregnancy outcomes. We examined whether CA history and current IPV are independently and jointly associated with placental abruption (PA). METHODS: We recruited 662 PA cases and 665 controls in Lima, Peru. We used multivariate logistic regression to calculate odds ratios (OR), adjusting for age, education, and parity. RESULTS: Approximately 42% of cases and controls reported CA; 50% of cases and 49% of controls reported IPV. History of any CA was not associated with PA, but history of severe CA was associated with 38% increased odds of PA (adjusted OR [aOR], 1.38; 95% confidence interval (CI), 1.07-1.80), adjusting for IPV. There was a statistically nonsignificant association between severe IPV and odds of PA (aOR, 1.22; 95% CI, 0.92-1.62), adjusting for CA. Women who experienced severe CA and severe IPV had 2.06-fold (95% CI, 1.25-3.40) increased odds of PA compared with women who did not experience severe abuse. The joint effect of CA and IPV was positive but statistically nonsignificant on the multiplicative (aOR, 1.48; 95% CI, 0.79-2.80) and additive scale (relative excess risk due to interaction, 0.70; 95% CI, -0.39 to 1.78). CONCLUSIONS: Preventing exposure to violence may improve maternal outcomes.

Disseminating the Community Advocacy Project in Mexico: A Feasibility Study.

The Community Advocacy Project is an evidence-based practice that has been shown to lead to numerous positive changes in the lives of intimate partner violence (IPV) survivors. Prior research conducted in the Midwest United States, and with primarily African American and Anglo American survivors, has shown that this short-term, community-based advocacy intervention results in increased safety and quality of life even 2 years after the intervention ends. The current study describes the process of culturally adapting and disseminating this program in Monterrey, Mexico, with a sample of low-income Mexican IPV survivors exposed to a variety of considerable contextual stressors. Interviews were conducted with advocates, advocate supervisors, and survivors to examine the acceptability and utility of the intervention. Twenty-seven IPV survivors, seven advocates, and four advocate supervisors participated in the intervention research. Advocates and their supervisors were highly laudatory, believing the intervention to be culturally relevant and effective. Encouraging changes were found for survivors as well, with positive changes over time being found on safety, quality of life, social support, and depression.

Prevalência de traumatismos maxilofaciais causados por agressão ou violência física em mulheres adultas e os fatores associados: uma revisão de literatura / Prevalence of maxillofacial trauma caused by aggression or physical violence to adult women and the associated factors: a literature review

O traumatismo maxilofacial de mulheres causado porviolência tem sido mais abordado nos últimos anos. Oaumento dos casos tem sido acompanhado do aumentodas denúncias de violência contra a mulher, tornando oproblema mais visível à sociedade. Objetivo: o presentetrabalho teve o objetivo de fazer uma revisão de literaturaque aborda a prevalência de traumas maxilofaciaisdecorrentes de violência física contra mulheres e os fatoresrelacionados às lesões. Revisão de literatura: os estudosreportaram prevalências entre 24,4% e 81,0% detraumatismos maxilofaciais em mulheres causados porviolência. A maioria aponta o marido ou o companheirocomo principal agressor e o uso de força física comoprincipal tipo de agressão. Mulheres com idades entre 20e 39 anos, dependentes econômicas ou de baixa renda ecom nível de escolaridade inferior são mais susceptíveisa apresentar traumatismo maxilofacial mais prevalentenos tecidos moles. As consequências mais relatadasentre as mulheres com traumatismos maxilofaciais porviolência incluem problemas de autopercepção, de inter-relação social e de baixa autoestima. Consideraçõesfinais: conclui-se que a prevalência de traumatismosmaxilofaciais por violência em mulheres é alta, estandorelacionada à idade, à dependência econômica, ao graude escolaridade, à ocupação e a problemas psicoafetivosque podem também influenciar a dinâmica familiar. (AU)

Maxillofacial trauma caused by violence to women has been addressed more in recent years. The increase of trauma has been accompanied by an increase in the reported cases of violence to women, making the problem more visible to society. Objective: by means of a literature review, the present study aimed to review the prevalence of maxillofacial trauma caused by physical violence to women and the factors related to such injuries. Literature review: the studies reported that the prevalence of maxillofacial trauma in women due to violence was between 24.4% and 81.0%. Most studies indicate the husband or partner as the primary aggressor, and the use of physical force as the main type of aggression. Women aged between 20 and 39 years, who are economic dependent or have low income and low level of education are more likely to present maxillofacial trauma more prevalent in soft tissues. The consequences most reported among women with maxillofacial trauma caused by violence included issues regarding self-perception, social interrelation, and low self-esteem. Final considerations: it is concluded that the prevalence maxillofacial trauma caused by violence to women is high and it is related to age, economic dependence, level of education, occupation, and psycho-affective problems, which may also influence family dynamics. (AU)

The Effects of Intimate Partner Violence and Probable Traumatic Brain Injury on Central Nervous System Symptoms.

INTRODUCTION: Abused women often report a wide range of physical and psychological symptoms that present challenges to providers. Specifically, injuries to the head or strangulation, may initiate neurological changes that contribute to central nervous system (CNS) symptoms. These symptoms are often attributed to mental health diagnoses in this population. The purpose of this analysis is to examine the prevalence of and associations between reported probable traumatic brain injury (TBI) and CNS symptoms in a sample of women of African descent. METHODS: A convenience sample of 901 women of African descent from Baltimore, MD and the US Virgin Islands, aged 18-55, was used to examine relationships among self-reported intimate partner violence (IPV), TBI, and CNS symptoms. Data were collected via Audio Computer-Assisted Self-Interview. RESULTS: Abused women who experienced a probable TBI were more likely to report CNS symptoms than those who did not. When controlling for demographics, IPV, and mental health symptoms, probable TBI was associated with a two point increase in CNS symptom frequency score (95% confidence interval: 1.55-2.93, p < 0.001). CONCLUSIONS: Women who reported both probable TBI and IPV were more likely than their abused counterparts who reported no TBI to report CNS symptoms. This relationship held true even when controlling for symptoms of depression and post-traumatic stress disorder (PTSD). Clinicians working with women should be aware of TBI as a possible etiology for symptoms in abused women. Appropriate screening and treatment protocols should be designed and implemented across medical settings to improve outcomes for women who have experienced IPV and TBI.

Intimate Partner Violence Is Associated with Suicidality Among Low-Income Postpartum Women.

BACKGROUND: Although intimate partner violence (IPV) during perinatal period is more common than during other maternal health conditions, it receives less attention within research on maternal mortality rates. Given the risks for maternal mortality because of suicidality, the purpose of this investigation is to examine the risk of suicidal ideation (SI) among postpartum women exposed to IPV. MATERIALS AND METHODS: In this cross-sectional study, participants were recruited between May 2005 and March 2007 from primary care clinics in São Paulo, Brazil. A total of 701 postpartum women were included in the analysis. Postpartum SI was assessed using the clinical interview schedule-revised. IPV was assessed using a structured questionnaire previously validated in Brazilian populations. Crude and adjusted risk ratios with 95% confidence intervals (95% CI) were estimated using Poisson regression with robust variance to examine the association between IPV and the risk for postpartum SI. RESULTS: The prevalence of postpartum SI was 4%. Among those with postpartum SI, 70% reported IPV during the postpartum period. Compared with non-IPV counterparts, postpartum women who reported IPV had an increased risk for SI (relative risk [RR] 7.25, 95% CI: 3.23-16.27). In the fully adjusted model, the risk for SI remained significantly higher for women who experienced IPV than for those who did not (RR 3.02, 95% CI: 1.29-7.07). CONCLUSIONS: Postpartum women exposed to violence had a threefold greater risk of having suicidal thoughts.

Severe intimate partner physical violence as a risk factor for inadequate cervical cancer screening. / Violência física grave entre parceiros íntimos como fator de risco para inadequação no rastreio do câncer de colo de útero.

With the aim of assessing the occurrence of severe intimate partner physical violence as a risk factor for inadequate screening of uterine cervical cancer, a case-control study was performed with a multidimensional questionnaire in a sample of 640 users of the Family Health Strategy in the Municipality of Nova Iguaçu, Rio de Janeiro State, Brazil. Cases were defined as women who had not had a cervical cytology test in the previous three years. The results showed that severe physical violence against the woman (adjustedOR = 2.2; 95%CI: 1.1-4.4) and co-occurrence of the event in the couple (adjustedOR = 3.8; 95%CI: 1.4-9.8) were risk factors for inadequate screening. Alcohol abuse by the woman was an effect modifier for not having the test among victims of violence (adjustedOR = 10.2; 95%CI: 1.8-56.4) and in cases of co-occurrence of violence (adjustedOR = 8.5; 95%CI: 1.4-50.7). In addition to known causal factors for intimate partner violence, the results point to a risk association between women's exposure to abuse and inadequate screening. The findings call for an expanded view of women's absenteeism from screening, since this indicator can represent unmet demands not readily detected by health teams.

Com o objetivo de avaliar a ocorrência de violência física grave entre parceiros íntimos como fator de risco para inadequação no rastreio do câncer do colo do útero, foi desenvolvido um estudo do tipo caso-controle com aplicação de formulário multidimensional com 640 usuárias da Estratégia Saúde da Família do Município de Nova Iguaçu, Rio de Janeiro, Brasil. As mulheres que não realizaram o exame colpocitológico nos últimos três anos foram consideradas como casos. Os resultados demonstraram que as variáveis abusos contra a mulher (ORajustada = 2,2; IC95%: 1,1-4,4) e a coocorrência do evento no casal (ORajustada = 3,8; IC95%: 1,4-9,8) como fatores de risco à inadequação no rastreio da doença. O abuso de álcool pela mulher se mostrou como modificador de efeito para a não realização do exame pelas vítimas (ORajustada = 10,2; IC95%: 1,8-56,4) e nos casos de coocorrência de violência (ORajustada = 8,5; IC95%: 1,4-50,7). Além dos fatores já reconhecidos na causalidade das violências entre parceiros íntimos, os resultados apontam para relação de risco entre as experiências abusivas vivenciadas pelas mulheres e a inadequação do rastreamento. Desse modo, ampliar o olhar sobre o absenteísmo das mulheres aos exames deve ser considerado, já que esse indicador pode desvelar demandas não percebidas facilmente pelas equipes de saúde.

Con el objetivo de evaluar la ocurrencia de violencia física grave entre parejas sentimentales, como factor de riesgo para inadecuación en el rastreo del cáncer de cuello uterino, se desarrolló un estudio de tipo caso-control con la aplicación de un formulario multidimensional a 640 usuarias de la Estrategia Salud de la Familia en el municipio de Nova Iguaçu, Río de Janeiro, Brasil. Las mujeres que no realizaron el examen colpocitológico durante los últimos tres años fueron consideradas como casos. Los resultados demostraron que las variables: abusos contra la mujer (ORajustada = 2,2; IC95%: 1,1-4,4) y la coocurrencia del evento en la pareja (ORajustada = 3,8; IC95%: 1,4-9,8) son factores de riesgo para la inadecuación en el rastreo de la enfermedad. El consumo abusivo de alcohol por parte de la mujer se mostró como un modificador de efecto para que las víctimas no realizaran el examen (ORajustada = 10,2; IC95%: 1,8-56,4), así como en los casos de coocurrencia de violencia (ORajustada = 8,5; IC95%: 1,4-50,7). Además de los factores ya reconocidos en la causalidad de la violencia entre parejas sentimentales, los resultados apuntan a la relación de riesgo entre las experiencias abusivas, vividas por las mujeres, y la inadecuación del rastreo. De este modo, se debe considerar ampliar la perspectiva sobre el absentismo de las mujeres en los exámenes, ya que este indicador puede desvelar necesidades no percibidas fácilmente por parte de los equipos de salud.

An Exploratory Study on the Impact of Domestic Violence on the Families in Trinidad and Tobago, the West Indies.

The purpose of this study is to explore the impact of domestic violence on the economic condition of the families. This cross-sectional study utilized a non-probability sampling procedure (purposive sampling) that included 30 women who have sought services from the Coalition Against Domestic Violence Agency. Data were collected using a questionnaire, which was comprised of 21 questions. The questions sought information on socioeconomic conditions and impact on domestic violence on the financial position. The study revealed that more of domestic violence victims were at an early age. Recommendations for future research include identifying the major causes for family disorganization and break down in the families arise out of domestic violence and other associated factors where explored while emphasizing the importance of family-based programs that minimize the impact.