Judicial Actors' Understanding of the Mental Health Impacts of Intimate Partner Violence: A Scoping Review.

Intimate partner violence (IPV) is a global public health issue that has grave physical and mental health consequences for millions of women. The judicial system plays a critical role in responding to IPV principally through the criminal justice system, family law, and/or child welfare jurisdictions. However, victims/survivors who interact with the legal system report negative experiences. An under-researched area of scholarship is the degree to which judicial actors understand the mental health impacts of IPV on victims/survivors and how they apply that knowledge in practice. This scoping review aimed to identify and synthesize existing scholarship on judicial actors' understanding of the mental health impacts of IPV on women survivors. We searched 10 databases (Medline, Scopus, PubMed, PsycINFO, EMBASE, Westlaw, HeinOnline, the Cochrane Library, and the Joanna Briggs Library databases) for studies published between 2000 and 2023. A total of 27 studies were included in the review. We identified five main themes, including: awareness of survivors' experiences, gap in judicial actors' knowledge, understanding of perpetrator tactics and risk factors, disclosing mental health problems, training, and guidance. The review highlights significant gaps in judicial actors' understanding of this issue and recommends strategies to increase the awareness and understanding of IPV among judicial actors. The findings can be used to justify future research to better understand the training and development needs of judicial actors to improve their level of awareness of the dynamics and impact of IPV and to make policy and practice recommendations to build the capacity of the judicial workforce.

Child-to-Parent Violence and Abuse: A Scoping Review.

Child-to-parent violence and abuse (CPVA) is a pattern of behavior where a parent or carer is abused by a child they are caring for. The main body of work on CPVA is relatively recent and evolving at pace. This scoping review explores the characteristics of parents, carers, children, and young people in cases of CPVA, the characteristics of CPVA, and barriers to and facilitators of help-seeking in cases of CPVA. The scoping review did not exclude any studies on the basis of geographical location or date of the study. The databases Scopus, CINAHL, Web of Science, Medline, and PubMed were searched in August 2023, along with hand searches of key journals. A total of 145 reports were included in the review, selected for their relevance to the scoping review questions. The main findings were: (a) the field of CPVA is rapidly growing, doubling in the last decade but with a predominance of quantitative studies; (b) there is no agreed universal definition; (c) children and young people with disabilities; who identify as trans or nonbinary gender, or who are adopted or fostered, are almost completely absent from the existing research; (d) there is very limited research focusing on protective factors or on help-seeking.

Technology-Facilitated Sexual Violence and Abuse in Low and Middle-Income Countries: A Scoping Review.

Technology-facilitated sexual violence and abuse (TFSVA) is a pervasive phenomenon and a global problem. TFSVA refers to any form of sexual violence, exploitation, or harassment enacted through the misuse of digital technologies. This includes, but is not limited to, image-based sexual abuse, online sexual exploitation and harassment, sextortion, and the non-consensual sharing of sexual images. It has significant and long-lasting psychological, social, financial, and health impacts. TFSVA is on the rise, particularly in low and middle-income countries (LMICs), where there has been an explosion in digital technology overall. This scoping review aimed to identify studies on TFSVA in LMICs to examine its types, impacts, victim-survivor coping strategies, and help-seeking. To identify peer-reviewed literature, six databases were searched: Applied Social Sciences Index & Abstracts, ProQuest, PubMed, Scopus, Star Plus-University of Sheffield library search, and Web of Science. The review included empirical studies published in English between 1996 and 2022, focusing on TFSVA among adults (aged 18+) in LMICs. A total of 14 peer-reviewed studies were included, highlighting that scant empirical research is available on TFSVA in LMICs. This review found several types of TFSVA and their wide-ranging impacts; traditional patriarchal societal norms and values largely shape TFSVA for women in LMICs. It also found more social impacts linked to sociocultural factors. Survivors adopted various coping mechanisms and help-seeking behaviors primarily through informal family support. Studies highlighted the need for effective legislation; pro-victim-survivor policing; strong family support; increasing victim-survivors' knowledge about reporting; and more research.

"Survive, learn to live with it or not": A narrative analysis of women's repeat victimization using a lifecourse perspective.

Violence against women is a global public health concern, with high levels of prevalence and debilitating consequences for victims, including a higher risk of revictimization. Quantitative evidence shows a strong association between previous experiences of sexual victimization, particularly in childhood, and future victimization. However, there is limited rigorous qualitative scholarship that advances understanding about revictimization experienced from childhood into adulthood. In this study, we address this gap offering a novel contribution to qualitative insights on revictimization using a life-course perspective. We conducted a rigorous qualitative secondary analysis, adopting a feminist narrative approach, to explore how individuals make sense of their experiences of abuse. Findings showed five main themes about survivors' experiences of repeat victimization across the life-course including: abuse experiences in childhood and adolescence; mental health and 'risky' coping mechanisms; naming abuse in early adulthood; seeking support in adulthood; surviving and a life beyond abuse. Most participants experienced multiple incidents of sexual abuse in childhood, which led to helplessness, shame, blame, and normalization of their experiences, creating a vulnerability to repeat victimization. Childhood abuse had later mental health impacts. Many participants used risky coping mechanisms, such as substance use. Survivors tended to be seen through the lens of their mental health diagnosis and addiction rather than through the lens of how abuse caused complex trauma. To address the impacts of revictimization and complex trauma affecting women across the globe, healthcare policy and services need a narrative and trauma-informed approach, over the short-, medium- or longer-term, enabling survivors to make sense of the connected nature of their experiences and accumulated vulnerability resulting from the abuse by others, rather than factors associated with the individual (their mental ill health, for example, or substance use). This is important as women's individual understanding is critical to processing trauma and abuse, and to longer-term recovery.

PROTOCOL: Domestic abuse interventions for mothers in or exiting prison: An evidence and gap map.

This is the protocol for a evidence and gap map. The objectives are as follows: to identify existing research and gaps in evidence according to the types of interventions, settings, study design and outcomes; to use the EGM findings to inform subsequent systematic reviews and to identify gaps in evidence to inform future research, policy or practice.

Elder Mistreatment and Dementia: A Comparison of People with and without Dementia across the Prevalence of Abuse.

This paper examines the prevalence of different types of elder mistreatment, care needs, and risk factors amongst older adults living with and without dementia in any setting (community or institution). Three years (2014-2017) of anonymized reported incidents of elder mistreatment to a national UK helpline were examined in an exploratory study, using a matched sample design (N = 598) comparing adults with dementia (n = 299) to those without (n = 299) on mistreatment type, care needs, and risk factors for abuse. Financial exploitation was more common among older adults with dementia who required more daily care than those without. Risk factors for elder mistreatment among older adults without dementia were often chronic in nature (such as poor physical health) whereas risk factors for people with dementia were associated with a dementia diagnosis. Raising implications for health and social care, results show that older adults diagnosed with dementia had increased care needs and vulnerability to abuse.

Technology-Facilitated Abuse in Intimate Relationships: A Scoping Review.

Technology-facilitated abuse (TFA) is a significant, harmful phenomenon and emerging trend in intimate partner violence. TFA encompasses a range of behaviours and is facilitated in online spaces (on social media and networking platforms) and through the misuse of everyday technology (e.g. mobile phone misuse, surveillance apps, spyware, surveillance via video cameras and so on). The body of work on TFA in intimate relationships is emerging, and so this scoping review set out to establish what types of abuse, impacts and forms of resistance are reported in current studies. The scoping review examined studies between 2000 and 2020 that focused on TFA within intimate partnerships (adults aged 18+) within the setting of any of these countries: the UK and Ireland, USA, Canada, New Zealand and Australia. The databases MEDLINE, CINAHL and Scopus were searched in December 2020. A total of 22 studies were included in the review. The main findings were that TFA is diverse in its presentation and tactics, but can be typed according to the eight domains of the Duluth Power & Control Wheel. Impacts are not routinely reported across studies but broadly fall into the categories of social, mental health and financial impacts and omnipresence. Similarly, modes of resistance are infrequently reported in studies. In the few studies that described victim/survivor resistance, this was in the context of direct action, access to legal or professional support or in the identification of barriers to resistance.

Elder Abuse Vulnerability and Risk Factors: Is Financial Abuse Different From Other Subtypes?

Elder abuse (EA) affects one in six older adults, and financial EA, a common subtype, severely impacts victims and society. Understanding victim vulnerability and perpetrator risk factors is essential to EA prevention and management. The limited existing evidence about these factors in relation to EA types suggests that financial EA is different. In a cross-sectional quantitative analysis of secondary data (N = 1,238), we investigated EA vulnerability and risk factors, and victim-perpetrator family relationship, with respect to different EA types (financial only, financial co-occurring with other types, and nonfinancial abuse). Financial abuse-only cases had the lowest prevalence of vulnerability and risk factors. Most of these factors, and a familial relationship, were significantly more common in cases involving other EA types. Findings indicate that financial abuse, occurring in isolation, is distinct from other EA types. Risk assessment and future research should consider financial abuse separately to other EA forms.

PROTOCOL: Global elder abuse: A mega-map of systematic reviews on prevalence, consequences, risk and protective factors and interventions.

This is the protocol for a Campbell systematic review. The objectives are as follows: to produce a mega-map which identifies, maps and provides a visual interactive display, based on systematic reviews on all the main aspects of elder abuse in both the community and in institutions, such as residential and long-term care institutions.

A review of the clinical assistant workforce at a district general hospital during the COVID-19 pandemic.

INTRODUCTION: In April 2020, a new workforce of clinical assistants (CAs), comprising predominantly of medical students, began work at Northampton General Hospital. Clinical-years students had a role similar to final-year student assistants; pre-clinical students were offered a healthcare assistant role. This research aimed to evaluate both CAs' and clinicians' perceptions of this programme. METHODS: Separate questionnaires were developed for CAs and clinicians, assessing the scheme's successes and failures. Data analysis was carried out using MS Excel and SPSS. RESULTS AND DISCUSSION: Forty-nine CAs and 60 clinicians responded. CAs of all years were completing the higher-level role. They were perceived to improve continuity of care (74% CA agreement; 88% clinician agreement), reduce clinician workload (90% clinician agreement) and felt significantly more confident with practical and administrative tasks. Sixty-eight per cent of CAs and 72% of clinicians believed the role should be available to students before their final year.

Exploring the Domestic Abuse Narratives of Trans and Nonbinary People and the Role of Cisgenderism in Identity Abuse, Misgendering, and Pathologizing.

Drawing on data from two empirical studies, this article employs cisgenderism as a conceptual tool to explore trans people's experiences of domestic violence and abuse (DVA). Distinct modes of cisgenderism are analyzed. These are identity abuse, microaggressions, misgendering, and pathologizing practices. Qualitative data were collected via semistructured interviews (n = 24). Two inclusion criteria were used for this secondary analysis requiring participants to self-identify as trans or nonbinary and have experience of DVA. The findings illuminate the extent of cisgenderism as underpinning experiences of DVA. The article ends with a call for further theoretical and empirical research in this regard.

Frailty in orthopaedics: is age relevant?

Over the last decade, national guidelines and the Best Practice Tariff (BPT) have been created to incentivise quality care in patients aged over 60 with hip fractures. This has resulted in significantly decreased length of stay, mortality and post-operative complications in this patient cohort. However, there is increasing recognition of frail patients in all age groups sustaining all fragility fractures. Until recently, these patients experienced poorer outcomes and were excluded from the dedicated care pathways that hip fracture patients received. The BPT and other national guidelines are now expanding inclusion criteria into care packages between guidelines which were initially reserved for hip fracture patients. This expansion is placing increasing pressure on limited NHS resources. Current variations between society guidelines risks producing regional and departmental inconsistencies in care. There is therefore a need to provide consistent guideline targeted at the most vulnerable trauma patients of this expanded cohort. Although the current BPT applies to over 60s only, there is limited evidence to support age-related prognosis in trauma. In contrast, frailty is being increasingly recognised as a global indicator of patient outcomes irrespective of age, with use of Clinical Frailty Scale (CFS) being adopted in various medical fields. BOAST is already using CFS as an inclusion criterion for major trauma and there is increasing data to suggest that frail trauma patients benefit most from comprehensive geriatric care and expedient time-to-operation. We suggest that CFS should take precedence over age when ascertaining clinical priority and producing Best Practice Tariffs. Further research is required to investigate frailty-related outcomes in trauma and the impact of comprehensive care bundles on the outcomes of frail orthopaedic patients.

Growing spaces: an evaluation of the mental health recovery programme using mixed methods.

BACKGROUND: Therapeutic horticulture is a nature-based method that includes a range of green activities, such as gardening, to promote wellbeing. It is believed that therapeutic horticulture provides a person-centred approach that can reduce social isolation for people with mental health problems. AIMS: The aim of the project was to evaluate the impact of a mental health recovery programme that used therapeutic horticulture as an intervention to reduce social inclusion and improve engagement for people with mental health problems. METHODS: A mixed-methods approach was used and data from four semi-structured focus group interviews, 11 exit interviews and 20 'recovery star' datasets were collected from September 2015 to October 2017. Qualitative data from the interviews were thematically analysed, and quantitative data based on a recovery star outcomes tool were analysed using descriptive statistics to demonstrate trends and progression. The findings were then triangulated to provide a rich picture of the impact of the mental health recovery programme. RESULTS: The recovery star data indicated that participants were working towards self-reliance. Qualitative data from the exit interview and semi-structured focus groups found similar results. The triangulated findings highlight that the mental health recovery programme enabled participant integration into the community through providing a space to grow and build self-confidence while re-engaging with society. The results suggest that using therapeutic horticulture as an intervention within the mental health recovery programme can support people with mental health problems to re-engage socially. Nature-based activities could be used within the 'social prescribing' movement to encourage partnership working between the NHS and voluntary sector organisations which can complement existing mental health services. CONCLUSION: The use of therapeutic horticulture as an intervention within a mental health recovery programme can support people with mental health problems to re-engage with the community and is integral to the rehabilitation process. The mental health recovery programme should be promoted within the social prescribing movement as an evidence-based opportunity to support people in the community.

Transphobic 'Honour'-Based Abuse: A Conceptual Tool.

This article proposes that an understanding of transphobic 'honour'-based abuse can be employed as a conceptual tool to explore trans people's experiences of familial abuse. This conception has evolved by connecting a sociology of shame, Goffman's work on stigma and 'honour'-based ideology. The discussion draws upon findings of a qualitative study which explored trans people's experiences of domestic violence and abuse. Narrative interviews were undertaken with 15 trans people who had either experienced abuse or whose perceptions were informed experientially through their support of others. Transcripts were analysed using the Listening Guide. Findings indicate that trans people can experience abuse as a result of a family's perceptions of shame and stigma. This article offers a novel way of conceptualising trans people's experiences of family-based abuse, but it also holds potential for understanding other relational contexts, for example, those of intimate partnerships.

Breaking down barriers: exploring the potential for social care practice with trans survivors of domestic abuse.

There is increasing recognition that domestic abuse takes place outside the heteronormative paradigm of social life. This paper presents a discussion of the findings of doctoral research which explores trans people's experiences of domestic abuse, their social care needs and whether these are met by domestic abuse agencies. This paper foregrounds debate on the intersections of domestic abuse, trans communities and social care provision as this research, and previous studies, suggests that trans survivors do not seek out or benefit from social care intervention. Qualitative data, collected via narrative interviews, were collected during 2012 from participants mainly located in the United Kingdom (two participants were based in the United States). A total of 24 interviews were undertaken with trans people (n = 15) and social care practitioners (n = 9). Data were examined using a voice-centred relational technique. The findings reveal that barriers are multiple and complex but work could be undertaken to encourage help-seeking behaviours. Barriers include expectations of a transphobic response and 'Othering' practices; lack of entitlement felt by trans people; lack of knowledge/misunderstandings about trans social care needs; heteronormative bias of existing services; and practitioner attitudes fixed to notions about gender as binary. The paper ends by proposing a framework for practice with trans survivors which incorporates a person-centred, narrative approach.