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1.
J Forensic Sci ; 65(1): 193-195, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31433492

RESUMO

The interpretation of cranial base injuries has never been investigated from a purely anthropological perspective. Very little exists in forensic literature in order to interpret the significance of cranial base fractures. We analyzed 296 cases of deaths due to skull-brain injuries. The frequency of vault fractures was 75.7% and that of base fractures was 91.9%. We observed the distribution of cases of death according to manner of death and manner of injury and number of fossae involved. These observations were analytically compared to different variables (age, sex, manner of injury, and mode of injury). The study presented the proportion of base fractures associated with vault fractures, and the frequency of absence of base fracture in subjects with no vault fractures. Interesting associations of base fractures to age and manner of death are shown.


Assuntos
Lesões Encefálicas/mortalidade , Base do Crânio/lesões , Fraturas Cranianas/epidemiologia , Acidentes por Quedas/mortalidade , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Abuso Físico/estatística & dados numéricos , Distribuição por Sexo , Base do Crânio/patologia , Fraturas Cranianas/patologia , Ferimentos por Arma de Fogo/mortalidade , Adulto Jovem
2.
Br J Sports Med ; 54(3): 129-138, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31023860

RESUMO

OBJECTIVE: Para athletes reap significant health benefits from sport but are vulnerable to non-accidental harms. Little is known about the types and impacts of non-accidental harms Para athletes face. In this literature review, we summarise current knowledge and suggest priorities for future research related to non-accidental harms in Para athletes. DESIGN: Six electronic databases were searched between August and September 2017. 2245 articles were identified in the initial title/abstract review, and 202 records were selected for full-text review following preliminary screening. Two independent examiners evaluated each full text, and eight citations were selected based on inclusion/exclusion criteria. DATA SOURCES: MEDLINE, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Scopus and Academic Search Premier. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Inclusion criteria: (A) human participants; (B) written in English; (C) descriptive, cohort and case series, case-control, qualitative, mixed methods studies and all clinical trials; and (D) data pertain to harassment/abuse of youth, recreational, collegiate, national-level and/or elite-level athletes with a physical and/or intellectual impairment. RESULTS: Most studies focused on young, visually impaired athletes and approximately half of all studies described high rates of bullying and its social implications. One study confirmed remarkably high rates of psychological, physical and sexual harms in Para athletes, compared with able-bodied peers. CONCLUSIONS: Bullying in young, visually impaired athletes is described most commonly in the available literature. Due to the limited amount of data, the prevalence of non-accidental harms in Para athletes remains unclear and information on trends over time is similarly unavailable.


Assuntos
Bullying , Abuso Físico , Delitos Sexuais , Humanos
3.
Forensic Sci Int ; 307: 110118, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31869653

RESUMO

Brain and cervical injuries are often described after major facial impacts but rarely after low-intensity mandibular impacts. Force transmission to the brain and spinal cord from a mandibular impact such as a punch was evaluated by the creation and validation of a complete finite element model of the head and neck. Anteroposterior uppercut impacts on the jaw were associated with considerable extension and strong stresses at the junction of the brainstem and spinal cord. Hook punch impacts transmitted forces directly to the brainstem and the spinal cord without extension of the spinal cord. Deaths after this type of blow with no observed histological lesions may be related to excessive stressing of the brainstem, through which pass the sensory-motor pathways and the vagus nerve and which is the regulatory center of the major vegetative functions. Biological parameters are different in each individual, and by using digital modeling they can be modulated at will (jaw shape, dentition…) for a realistic approach to forensic applications.


Assuntos
Lesões Encefálicas/diagnóstico por imagem , Simulação por Computador , Traumatismos Mandibulares/diagnóstico por imagem , Traumatismos da Medula Espinal/diagnóstico por imagem , Adulto , Lesões Encefálicas/etiologia , Análise de Elementos Finitos , Medicina Legal/métodos , Humanos , Imagem Tridimensional , Masculino , Traumatismos Mandibulares/complicações , Abuso Físico , Traumatismos da Medula Espinal/etiologia , Tomografia Computadorizada por Raios X
4.
Ann Agric Environ Med ; 26(4): 572-578, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885230

RESUMO

INTRODUCTION: In 2017, the third cyclical study on the scale of domestic violence against schoolchildren and youth in one of the rural communes of the Western Pomerania (Poland) was carried out. The study took into account five forms of violence: mental, physical, neglect, economic and sexual. Previous two editions of the study covered urban-rural (2016) and urban gminas (2015). MATERIAL AND METHODS: The research concept was implemented by means of the representative research method, with the use of auditing questionnaire interview technique, based on a research tool developed on the basis of a number of previous qualitative research and quantitative tests to measure the social scale of domestic violence. RESULTS: Domestic violence against minors reaches 48.2% in the rural area under study, 51.8% in the urban-rural area and 65.5% in the urban area. In all types of areas the most frequent form of violence is psychological violence, it affects 42.4% of children in rural gminas, 51.3% in urban-rural and 60.5% in urban gminas. In reference to other, less frequent forms of violence, there is also a difference in scale due to the area type. CONCLUSIONS: The incidence of individual forms of domestic violence varies depending on the type of area: Psychological violence: rural areas - 42.4%, urban-rural - 51.3%, urban areas - 60.5%; Neglect: rural areas - 21.1%, urban-rural - 13.5%, urban areas - 22.3%; Physical violence: rural areas - 17.1%, urban-rural - 20.7%, urban areas - 29.4%; Economic violence: rural areas - 12.6%, urban-rural - 19.2%, urban areas - 29.3%; Sexual violence: rural areas - 3.2%, urban-rural - 3.6%, urban areas - 8.1%.


Assuntos
Violência Doméstica/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Criança , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Pré-Escolar , Violência Doméstica/psicologia , Feminino , Humanos , Masculino , Abuso Físico/psicologia , Abuso Físico/estatística & dados numéricos , Polônia , Inquéritos e Questionários
5.
N Engl J Med ; 381(18): 1741-1752, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31657887

RESUMO

BACKGROUND: Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. METHODS: A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender. RESULTS: Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients' families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00). CONCLUSIONS: Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.


Assuntos
Esgotamento Profissional/epidemiologia , Cirurgia Geral/educação , Internato e Residência , Abuso Físico/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Discriminação Social/estatística & dados numéricos , Esgotamento Profissional/psicologia , Feminino , Humanos , Masculino , Estado Civil , Corpo Clínico Hospitalar , Recursos Humanos em Hospital , Abuso Físico/psicologia , Relações Médico-Paciente , Relações Profissional-Família , Fatores Sexuais , Assédio Sexual/psicologia , Discriminação Social/psicologia , Ideação Suicida , Inquéritos e Questionários , Estados Unidos/epidemiologia
6.
Z Kinder Jugendpsychiatr Psychother ; 47(5): 453-465, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31414925

RESUMO

Authoritarianism becomes respectable in Germany: A risk factor for condoning physical violence toward children? Abstract. Objective: Authoritarianism denotes aggressive behavior toward subordinates, submission to authorities, and conventionalism. Authoritarianism is assumed to be a central factor in the emergence of right-wing extremist ideology. Horkheimer described a close relationship between authoritarianism and the use of physical violence as a disciplinary method. Against the background of the current increase in right-wing extremist ideologies in Germany, which manifests itself in both social and political realms, this study examines the association between authoritarian and right-wing extremist ideology and the affirmation of corporal punishment as a disciplinary method. Method: We performed a cross-sectional study on a representative sample of the German population (N = 2,524). Results: 44.5 % of the participants supported corporal punishment. When respondents reported authoritarian and right-wing extremist attitudes, we discovered an increased affirmation of physical violence as a disciplinary method. Regarding party preference, participants who stated that they preferred the right-wing Alternative for Germany Party (AfD) showed the highest rate of supporting corporal punishment. Conclusions: The results presented indicate that the condoning of corporal punishment is still very widespread in Germany, and that the children of parents with authoritarian and right-wing extremist attitudes comprise a risk group for physical violence. Increased social awareness of these risks is necessary in light of the current increase of right-wing ideologies.


Assuntos
Autoritarismo , Maus-Tratos Infantis/psicologia , Abuso Físico/psicologia , Criança , Estudos Transversais , Alemanha , Humanos , Política , Fatores de Risco
7.
BMC Psychol ; 7(1): 56, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455426

RESUMO

BACKGROUND: Parental physical punishment (e.g., spanking) of children can gradually escalate into child physical abuse (CPA). According to social-information processing (SIP) models of aggressive behaviors, distorted social cognitive mechanisms can increase the risk of maladaptive parenting behaviors by changing how parents detect, recognize, and act on information from their social environments. In this study, we aimed to identify differences between mothers with a low and high risk of CPA regarding how quickly they detect positive facial expressions. METHODS: Based on their use of spanking to discipline children, 52 mothers were assigned to a low- (n = 39) or high-CPA-risk group (n = 13). A single-target facial emotional search (face-in-the-crowd) task was used, which required participants to search through an array of faces to determine whether a target emotional face was present in a crowd of non-target neutral faces. Search efficiency index was computed by subtracting the search time for target-present trials from that for target-absent trials. RESULTS: The high-CPA-risk group searched significantly less efficiently for the happy, but not sad, faces, than did the low-CPA-risk group; meanwhile, self-reported emotional ratings (i.e., valence and arousal) of the faces did not differ between the groups. CONCLUSIONS: Consistent with the SIP models, our findings suggest that low- and high-CPA-risk mothers differ in how they rapidly detect positive facial expressions, but not in how they explicitly evaluate them. On a CPA-risk continuum, less efficient detection of positive facial expressions in the initial processes of the SIP system may begin to occur in the physical-discipline stage, and decrease the likelihood of positive interpersonal experiences, consequently leading to an increased risk of CPA.


Assuntos
Maus-Tratos Infantis , Expressão Facial , Mães/psicologia , Abuso Físico , Adulto , Criança , Emoções , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco
8.
Artigo em Inglês | MEDLINE | ID: mdl-31261833

RESUMO

Children exposed to negative neighborhood environments are at high risk of experiencing violence. This study aimed to explore the effects of parental perception of neighborhood collective efficacy on parental physical violence (PV) to their preschool children in a county of China. A total of 1337 parents from nine kindergartens were recruited by the stratified random cluster sampling method. Data about parental PV behavior toward children during the past three months, parental perception of neighborhood collective efficacy, together with their attitudes towards the use of corporal punishment to discipline children, and demographic characteristics were collected. Their relationships were investigated by applying multivariable logistic regression models. Overall, 67.5% of the parents reported at least one form of PV during the past three months. The rates of minor PV (MPV) and severe PV (SPV) were 67% and 22.8%, respectively. The results of multivariate logistic regression showed that only social cohesion was associated with lower odds of parental PV and MPV behavior after controlling for covariates. The results suggest that neighborhood collective efficacy is associated with parental PV behavior against their children to some extent, but the effects differ according to the severity level of PV. Neighborhood social cohesion may have a positive role in reducing parental PV behavior in the county surveyed at present study.


Assuntos
Atitude , Maus-Tratos Infantis , Pais/psicologia , Características de Residência , Pré-Escolar , China , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Modelos Logísticos , Masculino , Abuso Físico , Punição , Inquéritos e Questionários , Violência
9.
Artigo em Inglês | MEDLINE | ID: mdl-31159325

RESUMO

A history of childhood abuse has been linked to serious and long-lasting problems in adulthood. We developed two theoretical models concerning how early adverse experiences affect health in adulthood, and we tested the empirical fit of the two models in a population-based representative sample of Canadian adults (N = 25,113) using a structural equation modelling (SEM) technique, path analysis. The first model included direct pathways by which a history of three types of childhood abuse-exposure to intimate partner violence, physical abuse, and sexual abuse-affected adult physical and mental health, as well as indirect pathways by which perceived social support and everyday life stress acted as mediators of these associations. The second model included only indirect pathways and tested mediating effects. Global statistics indicated that both models were a good fit to the data, and local statistics supported the hypothesized associations between independent, dependent, and mediator variables.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Nível de Saúde , Saúde Mental/estatística & dados numéricos , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Canadá/epidemiologia , Maus-Tratos Infantis/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Abuso Físico/psicologia , Fatores Sexuais , Apoio Social , Fatores Socioeconômicos , Adulto Jovem
10.
J Forensic Leg Med ; 65: 137-142, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31154091

RESUMO

INTRODUCTION: Bereavement is usually difficult to come to terms with. However, sudden, violent or traumatic death can be particularly hard to accept for any family, group or nation as a whole. A retrospective study of all autopsies on unnatural and traumatic deaths of medico-legal importance was made at the Komfo Anokye Teaching Hospital from 2008 to 2016. METHODS: Information on cause of death and other relevant detail as well as demographics were extracted from the Autopsy Log Book of the department of pathology, Komfo Anokye Teaching Hospital where data on cause of death from autopsy findings and other relevant data were gathered and kept secured. The data was then analyzed using SPSS version 22. RESULTS: Findings from the study showed that Road Traffic Accidents (RTA) contributed to 58.51% of the total forensic death cases of a total of the 1470 registered unnatural deaths. Males accounted for 75.37% of deaths as compared to 24.63% for females. The mean age for the various cause of unnatural deaths was 34 years. The age ranges from a minimum of 0.02 year (1 week) to a maximum of 97 years with median age of 33. The modal age is 30 years with 75 cases. 1108 males and 362 females were involved, resulting in a gender ratio of 3:1. The age group 30-39 recorded the highest percentage of deaths due to Hanging, Gunshots, RTA and Falls with 22.45%, 34.69%, 21.75% and 25.44% respectively. Children aged ≤9 recorded the highest number of deaths due to chemical poisoning and drowning with 25.5 8% and 40.00% of cases respectively. People in the extremes of ages (≤9 and ≥ 70) recorded the least number of death cases by percentage. CONCLUSION: Road traffic accident is therefore the leading cause of unnatural traumatic deaths as it accounted for more than half of all unnatural traumatic death cases reported in the forensics department. Men, especially the youth are also more prone to violent unnatural deaths compared to women in general. It is shown that, men die more in the various categories than women. Males are likely to die on the average, 3 times more than the females by any of the manner of deaths.


Assuntos
Causas de Morte , Acidentes por Quedas/mortalidade , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Asfixia/mortalidade , Criança , Pré-Escolar , Afogamento/mortalidade , Feminino , Medicina Legal , Gana/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/mortalidade , Abuso Físico/estatística & dados numéricos , Envenenamento/mortalidade , Estudos Retrospectivos , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Ferimentos por Arma de Fogo/mortalidade , Adulto Jovem
11.
East Asian Arch Psychiatry ; 29(1): 15-19, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31237252

RESUMO

OBJECTIVES: This cross-sectional study aimed to assess the prevalence, factors, and consequences of physical violence by mentally ill patients against mental health professionals. METHODS: 124 of 145 mental health professionals at a Nigerian neuropsychiatric hospital satisfactorily completed a questionnaire on their experiences with physical assault. RESULTS: 77 (62.1%) staff had been assaulted during their whole career; 38 (30.6%) of them were assaulted in the past 12 months. The most common type of assault was pushing (32.9%). The most common antecedent event to assault was calming an aggressive patient (44.1%). In their whole career, 22.1% of assaulted staff sustained injuries that required medical attention; 42.4% of assaulted staff sometimes or frequently/always experienced posttraumatic stress disorder symptoms. Physical assault in the whole career was associated with older age (p = 0.04), longer years of practice (p = 0.01), and job dissatisfaction (p = 0.05). CONCLUSIONS: Physical violence encountered by mental health professionals at a Nigerian neuropsychiatric hospital is substantial. Policy review of staff safety, training, and support is recommended.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/estatística & dados numéricos , Hospitais Psiquiátricos , Pessoas Mentalmente Doentes/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Adulto , Fatores Etários , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Humanos , Satisfação no Emprego , Masculino , Pessoas Mentalmente Doentes/psicologia , Nigéria , Abuso Físico/psicologia , Prevalência , Inquéritos e Questionários , Tempo
12.
J Forensic Odontostomatol ; 37(1): 20-25, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31187739

RESUMO

The aim of the present study was to analyze the prevalence results of physical violence against children and adolescents in a 5-year period in Recife, Brazil. Inter-personal violence is one of the most recognizable forms of child aggression and has become as an imperative public health issue. All violence related forensic reports performed between 2009 and 2013 in the clinical services of the Institute of Legal Medicine Antônio Percivo Cunha were analyzed. Victims were classified according to sex, age, relationship with perpetrator, injuries and year of occurrence. Statistical analysis was performed using the SPSS (version 22.0). Continuous variables were described and when appropriate, frequencies were displayed and compared. The association between variables was evaluated using chi-square and Fisher's exact test. The margin of error for the statistical tests was 5.0%. A total of 9783 occurrences were evaluated, involving mainly male subjects (n=5447, 55.7%). Victims' mean age was 13.9 years, the most common perpetrators were victims' acquaintances (n=2538, 25.9%). Facial injuries were the most frequent affecting a little over a fifth of the total sample (n=3673, 20.1%). These findings support the important role dentists can play in identifying and reporting physical violence against children and adolescents.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Ferimentos e Lesões/epidemiologia
13.
Reprod Health ; 16(1): 77, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31182118

RESUMO

BACKGROUND: Recently WHO researchers described seven dimensions of mistreatment in maternity care that have adverse impacts on quality and safety. Applying the WHO framework for quality care, service users partnered with NGOs, clinicians, and researchers, to design and conduct the Giving Voice to Mothers (GVtM)-US study. METHODS: Our multi-stakeholder team distributed an online cross-sectional survey to capture lived experiences of maternity care in diverse populations. Patient-designed items included indicators of verbal and physical abuse, autonomy, discrimination, failure to meet professional standards of care, poor rapport with providers, and poor conditions in the health system. We quantified the prevalence of mistreatment by race, socio-demographics, mode of birth, place of birth, and context of care, and describe the intersectional relationships between these variables. RESULTS: Of eligible participants (n = 2700), 2138 completed all sections of the survey. One in six women (17.3%) reported experiencing one or more types of mistreatment such as: loss of autonomy; being shouted at, scolded, or threatened; and being ignored, refused, or receiving no response to requests for help. Context of care (e.g. mode of birth; transfer; difference of opinion) correlated with increased reports of mistreatment. Experiences of mistreatment differed significantly by place of birth: 5.1% of women who gave birth at home versus 28.1% of women who gave birth at the hospital. Factors associated with a lower likelihood of mistreatment included having a vaginal birth, a community birth, a midwife, and being white, multiparous, and older than 30 years. Rates of mistreatment for women of colour were consistently higher even when examining interactions between race and other maternal characteristics. For example, 27.2% of women of colour with low SES reported any mistreatment versus 18.7% of white women with low SES. Regardless of maternal race, having a partner who was Black also increased reported mistreatment. CONCLUSION: This is the first study to use indicators developed by service users to describe mistreatment in childbirth in the US. Our findings suggest that mistreatment is experienced more frequently by women of colour, when birth occurs in hospitals, and among those with social, economic or health challenges. Mistreatment is exacerbated by unexpected obstetric interventions, and by patient-provider disagreements.


Assuntos
Instalações de Saúde/normas , Pessoal de Saúde/normas , Serviços de Saúde Materna/normas , Mães/psicologia , Parto/psicologia , Abuso Físico/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde , Humanos , Gravidez , Estigma Social , Estados Unidos
14.
Matern Child Health J ; 23(8): 1108-1116, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31203524

RESUMO

Objectives Even during pregnancy women may suffer from violence. We estimated the prevalence of physical abuse during pregnancy, we analyzed the main risk factors and described the relationship between physical violence, psychological wellbeing and pregnancy outcome. Methods We used a national representative sample of births, in all public and private maternity units, in 2016 in France. Women were interviewed after delivery, on their living conditions and occurrence of physical violence at least once during pregnancy. The study of risk factors and pregnancy outcome was done with multivariable logistic regressions. Results Of 12,330 women included in the analysis 1.8% (95% CI 1.6-2.0) had been exposed to physical violence during pregnancy. Risk of violence was associated with the couple situation [women without a partner or in couple not cohabiting (OR 2.89, 95% CI 1.96-4.26)], household income (less than 3000 euros monthly), and state medical assistance coverage. Physical violence was more prevalent in case of a history of induced abortion or cannabis use during pregnancy. Psychological distress was more frequent with than without physical violence (e.g., 62% vs. 24% had a sadness period during pregnancy, p < 0.001). The risk of spontaneous preterm birth and transfer of the newborn to a neonatal intensive care unit were significantly higher among women experiencing physical violence during pregnancy compared to other women. Conclusions for Practice Main factors associated with increased risk of violence during pregnancy were socio-economics. The identification by caregivers of women exposed to violence during pregnancy needs to be improved to develop preventive and care strategies.


Assuntos
Nível de Saúde , Mães/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Adulto , Feminino , França/epidemiologia , Humanos , Renda/estatística & dados numéricos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Cuidado Pré-Natal/normas , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Fatores de Risco , Inquéritos e Questionários
15.
J Forensic Leg Med ; 66: 65-69, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31226501

RESUMO

In the last decade, the whole world has witnessed a chaotic process characterized by uprisings, revolutions, and wars in the Middle East. The Syrian civil war, with its local and global consequences, is the most destructive of these events. Social and economic aspects of the effects of the Syrian civil war were discussed in detail. However, the change in forensic postmortem case pattern of neighboring countries remains unclear. Here, we aim to discuss the effects of the Syrian civil war on forensic postmortem case patterns in Turkey as a neighboring country, with possible causes and suggestions. The postmortem case patterns of the 5-year period before the beginning of the Syrian war (2006-2011) and the next 5-year period after the start of the war (2012-2016) were investigated retrospectively. This aims to reveal the possible effects of the Syrian civil war on forensic postmortem case pattern of Turkey in relation to the assault deaths of statistics of Turkey. We found that explosion-related and firearm-related death cases significantly increased after the Syrian civil war. The dramatic increase in the explosion-related deaths can be attributed to terrorist attacks. Wounded civilians during the civil war were admitted to health units and hospitals in the south and southeast parts of Turkey, which consequently result in a crisis in the application of health services. There was no significant difference in Turkish death statistics, however forensic case pattern was affected.


Assuntos
Traumatismos por Explosões/mortalidade , Abuso Físico/tendências , Guerra , Ferimentos por Arma de Fogo/mortalidade , Humanos , Estudos Retrospectivos , Síria , Turquia/epidemiologia
16.
Forensic Sci Med Pathol ; 15(4): 580-590, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31073795

RESUMO

The correct assessment of signs of abuse on the skin is a challenge of utmost importance for both clinical and forensic applications. This review aims to investigate how differing cultural behaviors influence the perception of abuse, focusing on the need for a multidisciplinary approach and investigation. A literature search for articles that discussed folk practices from a forensic perspective was performed; articles with reference to abuse in the description of the main folk healing techniques and with reference to the differential diagnosis between physical abuse and skin injuries due to folk healing techniques were selected. A synoptic table of all skin injuries produced by folk healing techniques, divided by geographical area, was created. This table can be used as a tool for the thorough assessment of typical signs detectable on the skin, thus aiding in a differential diagnosis. The first approach to the patient represents a crucial step toward the identification of abuse; forensic practitioners ought to be aware of the existence of folk healing techniques which may mimic signs that can be interpreted as physical abuse in children and adults.


Assuntos
Medicina Tradicional , Pele/lesões , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/etiologia , Diagnóstico Diferencial , Medicina Legal , Humanos , Abuso Físico
17.
PLoS One ; 14(5): e0214962, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31042713

RESUMO

BACKGROUND: Intimate partner violence (IPV) against women is a major public health concern in low income countries. Violence against pregnant women has adverse effects on maternal and newborn outcomes. This study aimed to assess the prevalence and associated factors of intimate partner violence in Southeast Ethiopia pregnant women. METHODS: Institutional based cross-sectional study was conducted on pregnant women who were attending antenatal care (ANC) in Bale Zone health institution during study period. Face to face interviews were conducted using a pre-tested structured questionnaire. Data related to socio-demographic characteristic, pregnancy and reproductive history, intimate partner behavior and IPV encountered during recent pregnancy was gathered for this study. Descriptive analysis and logistic regression were used for the data analysis. Odds ratio with 95% CI was computed to determine the presence and strength of associated factors with IPV. RESULTS: A total of 612 pregnant women participated in the study. Of these, 361 (59.0%) pregnant women faced at least one type of IPV during the recent pregnancy. Physical violence (20.3%), sexual violence (36.3%), psychological/emotional violence (33.0), controlling behavior violence (30.4%) and economic violence (27.0) were the type of IPV encountered by participants. An intimate partners who were drank alcohol [AOR = 2.9; 95% CI: (1.5-5.4)], partners who were chewed Khat [AOR = 1.7; 95% CI: (1.1-2.6)], partners who were smoked cigarette [AOR = 2.6; 95% CI: (1.4-4.9)], partners who had aggressive behavior [AOR = 2.8; 95% CI: (1.7-4.6)], having partner age ≥30 year old [AOR = 1.8; 95% CI: (1.2-2.9)], unwanted pregnancy [AOR = 3.3; 95% CI: (1.9-5.5)] and history of adverse pregnancy outcome [AOR = 2.1; 95% CI: (1.2-3.6)] that were the factors that significantly associated with IPV of the pregnant women. CONCLUSION: The prevalence of IPV during pregnancy was high among the study participants. Intimate partners' use of substance, intimate partners' aggressive behavior, older intimate partners, unwanted pregnancy and history of adverse birth outcome were identified as associated factors for IPV. IPV needs to be considered during ANC service and integrated into the sexual and reproductive health education. Community-based interventions should be advocated as a way of health promotion. Counseling, awareness creation, service provision and program design on IPV is mandatory to minimize the victim.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Gestantes/psicologia , Delitos Sexuais/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Modelos Logísticos , Masculino , Idade Materna , Razão de Chances , Abuso Físico/psicologia , Gravidez , Resultado da Gravidez/epidemiologia , Resultado da Gravidez/psicologia , Gravidez não Desejada/psicologia , Cuidado Pré-Natal , Prevalência , Delitos Sexuais/psicologia , Parceiros Sexuais/psicologia , Fatores Socioeconômicos , Adulto Jovem
18.
Nord J Psychiatry ; 73(4-5): 248-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31081436

RESUMO

Purpose and aim: Out from the sparse literature on risk assessment for violence committed by women the Female Additional Manual (FAM) was developed to be a complement to the HCR-20v2. The aim of this study was to investigate and compare the psychometrics of the HCR-20v2 with and without the FAM on risk for inpatient physical violence for female forensic psychiatric patients. Methods: The participants were 100 female patients admitted to forensic psychiatric care in a high-security clinic, assessed by clinicians with the HCR-20v2 during their admission. Researchers performed the FAM, both retrospectively and prospectively. The follow-up period was 12 months before being discharged. Results: Four main results were found; first, many risk factors were present although the summary risk ratings were mainly low to moderate. Secondly, the reliability was in general good, where the HCR-20v2 mainly showed higher reliability without than with the FAM, indicating that FAM risk factors did equal or did not contribute to a higher reliability. Third, the internal validity was higher for the HCR-20v2 than for the FAM. Risk factors correlated stronger with the summary risk ratings for the HCR-20v2 than for the FAM. Fourth, the validity for inpatient physical violence was high for the total score of both the HCR-20v2 and the FAM, but contradictory to previous finding the validity for summary risk ratings was not significant. Conclusions: The results support the use of HCR-20v2 when assessing risk for inpatient violence for female forensic psychiatric patients, but with only some support for adding or changing risk factors according to the FAM.


Assuntos
Psiquiatria Legal/normas , Pacientes Internados/psicologia , Abuso Físico/psicologia , Escalas de Graduação Psiquiátrica/normas , Violência/psicologia , Adolescente , Adulto , Feminino , Psiquiatria Legal/métodos , Hospitalização/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente/tendências , Abuso Físico/prevenção & controle , Estudos Prospectivos , Psicoterapia/métodos , Psicoterapia/normas , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Violência/prevenção & controle , Adulto Jovem
19.
Int J Paediatr Dent ; 29(5): 624-634, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31071237

RESUMO

BACKGROUND: Child maltreatment is a complex social and public health problem. AIM: To evaluate the frequency of the recognition by Brazilian health professionals in primary care of child physical abuse (CPA) and associated factors. DESIGN: A representative cross-sectional study was conducted with dentists, nurses, family physicians, and pediatricians who participated in the network of the Family Health Strategy in the city of Belo Horizonte, Brazil. Data collection involved in the administration of a questionnaire validated for use in Brazil. Data were collected from 181 dentists, 235 nurses, 203 family physicians, and 96 pediatricians. RESULTS: Among the 715 health professionals, 499 (69.8%) had some type of postgraduate degree and 414 (57.9%) recognized suspected or proved cases of CPA. The recognition was associated with occupation, as pediatricians recognized 14.11-fold [OR = 14.11 (95% CI: 3.73 to 53.43)] more cases of CPA compared with dentists. The recognition was also associated with a longer period of time working in the city [OR = 2.79 (95% CI: 1.24 to 6.29)]. CONCLUSION: The recognition of cases was positively associated with the longer working time in the municipal network and with pediatricians. The dentist was the category that was least associated with the recognition of CPA.


Assuntos
Maus-Tratos Infantis , Abuso Físico , Atitude do Pessoal de Saúde , Brasil , Criança , Estudos Transversais , Humanos , Atenção Primária à Saúde , Inquéritos e Questionários
20.
J Forensic Leg Med ; 65: 81-85, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31121359

RESUMO

OBJECTIVE: The data of forensic cases who revisited to the emergency department (ED) more than once, remain uncertain. In this study, it was aimed that to determine characteristics of these cases and to investigate factors associated with forensic revisits. METHODS: All forensic cases who presented to emergency department of a secondary care hospital in Turkey were evaluated between July 2017 and June 2018, retrospectively. During a year study period, 7580 visits were performed by 5870 forensic cases in the ED. Characteristics of cases which were gender, age, injury patterns, number of revisits, outcomes, and total cost were noted. Factors associated with forensic revisits were identified by multivariate logistic regression analysis. RESULTS: During a year study period, 985 forensic cases had multiple ED visits (a total of 2692). Median revisit number was 2 (IQR 2-3). In logistic regression analysis, male gender (Odds ratio [OR], 1.76; 95% confidence interval [CI]: 1.47-2.10), physical assault (OR, 2.70; 95% CI: 1.40-5.20), and fall (OR, 0.21; 95% CI: 0.07-0.64) were associated with forensic revisits. Revisited group had lower hospitalization rate and hospital cost than those of non-revisited group (2.6% and 7.4%; 15.5 TL (interquartile range [IQR] 15.5-15.5) and 15.5 TL (IQR 15.5-107.8), respectively) (χ2; P < .001). CONCLUSION: One-sixth of all forensic cases revisited to the ED multiple times. Physical assault and male gender were the most important factors associated with forensic revisits in this study. Further, these revisits were often composed of simple reasons requiring less hospitalization and less cost.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Acidentes por Quedas/estatística & dados numéricos , Adulto , Feminino , Custos Hospitalares , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Análise Multivariada , Abuso Físico/estatística & dados numéricos , Estudos Retrospectivos , Fatores Sexuais , Turquia/epidemiologia , Adulto Jovem
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