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1.
Rev Saude Publica ; 54: 97, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33146302

RESUMO

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.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Abuso Físico/psicologia , Gravidez , Prevalência , Fatores de Risco , Delitos Sexuais/psicologia , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia
2.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32994176

RESUMO

A healthy Hispanic boy was born via cesarean delivery after an uncomplicated pregnancy. At 4 weeks old , his parents brought him to the emergency department for bruising on both soles of the feet. At 6 weeks old, his parents brought him to primary care for new bruises on his arms and back. After evaluation, primary care referred the patient to the emergency department. The parents denied any recent trauma, fever, cough, decreased urine, or change in appetite. Because of 2 episodes of unexplained bruising, the Department of Children and Families was granted emergency custody of the child. Hematology and ophthalmology did not identify any clear abnormalities. Skeletal surveys were normal. Dermatology was consulted. The examination was normal except for pink blanching patches on the upper back and linearly arranged pink blanching papules on the right lower leg. No crusting, erosions, hyperpigmentation, purpura, petechiae, or ecchymoses were seen. These lesions completely resolved the next day. He tested positive for dermatographism and developed similar lesions on his soles after pushing his feet down onto a soft surface. The intermittent urticarial skin changes were most consistent with physical urticaria. Such lesions could be mistaken for trauma; however, blood vessel damage typically results in progressive coloration changes for >1 day. At the emergency court hearing, given the concurring medical opinions of the dermatologist, pediatrician, and Child Protective Services, the judge returned full custody to the parents. This case reveals the value of dermatologic expertise in assessing skin changes, particularly those associated with physical abuse.


Assuntos
Pressão/efeitos adversos , Urticária/diagnóstico , Serviços de Proteção Infantil , Dermatologia , Diagnóstico Diferencial , Humanos , Lactente , Masculino , Abuso Físico , Encaminhamento e Consulta
3.
An. psicol ; 36(2): 188-199, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192055

RESUMO

El objetivo de este trabajo es evaluar empíricamente la eficacia de un programa de intervención con mujeres víctimas de violencia de género. El programa en conjunto se enmarca dentro de las Terapias Contextuales, específicamente se ha utilizado la Psicoterapia Analítica Funcional, combinada con la Terapia de Aceptación y Compromiso y la Activación Conductual. Se ha llevado a cabo en formato grupal, durante 11 sesiones de 2 horas cada una. Participaron un total de 21 mujeres (de una media de edad de 45 años), que habían sufrido violencia física y/o abuso emocional por parte de sus parejas, en diferente grado e intensidad, y en diferentes momentos en sus vidas. Se ha utilizado un diseño intragrupo con medidas pre-post. Se realizaron tres grupos de tratamiento en diferentes ciudades con 6 a 8 mujeres cada uno. Para medir la intervención se ha aplicado el cuestionario Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). Los resultados han mostrado una disminución estadísticamente significativa en la severidad del malestar, han disminuido los indicadores de riesgo de suicidio, y han mejorado las conductas problemáticas dentro y fuera de las sesiones, además de incrementarse la apertura hacia los demás. Se discute la utilidad de las terapias contextual es para mejorar la calidad de vida de mujeres maltratadas, y su utilidad de aplicación en grupos en las instituciones públicas


The goal of this study is to empirically evaluate the efficacy of an intervention program with women victims of gender violence. Specifically, Functional Analytical Psychotherapy has been used, combined with Acceptance and Commitment Therapy, and Behavioral Activation. It has been carried out in group format, during 11 sessions of 2 hours each. A total of 21 women participated (an average of 45 years-old), who had suffered physical violence and/or emotional abuse by their partners, with different degrees and intensity, and at different moments of their lives. An intra-group design with pre-post measures was used. Three treatment groups were carried out in different cities with 6 to 8 women each one. To measure the intervention, the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) questionnaire was applied. The results has shown a statistically significant decrease in the severity of discomfort, decreased suicide risk indicators, improved problem behavior inside and outside sessions, and increased openness to others. The usefulness of contextual therapies to improve the quality of life of battered women and their usefulness for application in groups in public institutions are discussed


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Violência de Gênero/psicologia , Resultado do Tratamento , Psicoterapia de Grupo/métodos , Psicometria/instrumentação , Inquéritos e Questionários , Abuso Físico/psicologia , Qualidade de Vida/psicologia , Apoio Social , Escalas de Graduação Psiquiátrica/normas , Análise de Variância , Maus-Tratos Conjugais/psicologia
6.
J Postgrad Med ; 66(3): 133-140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32675449

RESUMO

Background: Respectful maternity care is a rightful expectation of women. However, disrespectful maternity care is prevalent in various settings. Therefore, a systematic review and meta-analysis were conducted to identify various forms of ill-treatment, determinants, and pooled prevalence of disrespectful maternity care in India. Methods: A systematic review was performed in various databases. After quality assessment, seven studies were included. Pooled prevalence was estimated using the inverse variance method and the random-effects model using Review Manager Software. Results: Individual study prevalence ranged from 20.9% to 100%. The overall pooled prevalence of disrespectful maternity care was 71.31% (95% CI 39.84-102.78). Pooled prevalence in community-based studies was 77.32% (95% CI 56.71-97.93), which was higher as compared to studies conducted in health facilities, this being 65.38% (95% CI 15.76-115.01). The highest reported form of ill-treatment was non-consent (49.84%), verbal abuse (25.75%) followed by threats (23.25%), physical abuse (16.96%), and discrimination (14.79%). Besides, other factors identified included lack of dignity, delivery by unqualified personnel, lack of privacy, demand for informal payments, and lack of basic infrastructure, hygiene, and sanitation. The determinants identified for disrespect and abuse were sociocultural factors including age, socioeconomic status, caste, parity, women autonomy, empowerment, comorbidities, and environmental factors including infrastructural issues, overcrowding, ill-equipped health facilities, supply constraints, and healthcare access. Conclusion: The high prevalence of disrespectful maternity care indicates an urgent need to improve maternity care in India by making it more respectful, dignified, and women-centered. Interventions, policies, and programs should be implemented that will protect the fundamental rights of women.


Assuntos
Atitude do Pessoal de Saúde , Parto Obstétrico/psicologia , Serviços de Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materna/normas , Abuso Físico/estatística & dados numéricos , Relações Profissional-Paciente , Adulto , Parto Obstétrico/métodos , Feminino , Humanos , Índia , Parto , Gravidez , Qualidade da Assistência à Saúde , Respeito
7.
PLoS One ; 15(7): e0236448, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706805

RESUMO

INTRODUCTION: Despite interventions by low and middle-income countries toward the achievement of the global Sustainable Development Goal (SDG) on promoting mental health and well-being of their populace by the year 2030, suicidal behaviours continue to be major causes of premature mortality, especially among young people. This study examined the prevalence and predictors of suicidal behaviours among in-school adolescents in Mozambique. MATERIALS AND METHODS: This was a cross-sectional study of 1918 in-school adolescents using data from the 2015 Global School-based Health Survey (GSHS) of Mozambique. The outcome variables (suicidal ideation, suicidal plan, and suicidal attempt) were measured with single items in the survey. Both bivariate and multivariate analyses were performed using chi-square test of independence and binary logistic regression respectively. Results are presented as Adjusted Odds Ratios for the binary logistic regression analysis. Statistical significance was set at p<0.05. RESULTS: The prevalence of suicidal behaviours 12 months prior to the survey were 17.7%, 19.6% and 18.5% for suicidal ideation, suicidal plan, and suicidal attempt respectively. Adolescents who experienced anxiety had higher odds of suicidal ideation [AOR = 1.616, 95%CI = 1.148-2.275], suicidal plan [AOR = 1.507, 95%CI = 1.077-2.108], and suicidal attempt [AOR = 1.740, 95%CI = 1.228-2.467]. Adolescents who were physically attacked in school were also more likely to ideate [AOR = 1.463, 95%CI = 1.115-1.921], plan [AOR = 1.328, 95%CI = 1.020-1.728], and attempt [AOR = 1.701, 95%CI = 1.306-2.215] suicide. Having close friends was, however, an important protective factor against suicidal ideation [AOR = 0.694, 95%CI = 0.496-0.971], plan [AOR = 0.625, 95%CI = 0.455-0.860], and attempt [AOR = 0.529, 95%CI = 0.384-0.729]. Peer support also reduced the risk of suicidal ideation [AOR = 0.704, 95%CI = 0.538,0.920] and plan [AOR = 0.743, 95%CI = 0.572,0.966] among the in-school adolescents. CONCLUSION: Suicidal behaviours constitute major public health challenges among in-school adolescents in Mozambique. The behaviours are predominant among adolescents who are physically attacked and those who experience anxiety. Conversely, having close friends serves as a protective factor against suicidal behaviours. To ensure that Mozambique meets the SDG target of promoting the mental health of all by the year 2030, the Government of Mozambique and educational authorities should urgently design and implement innovative interventions and strengthen existing ones that seek to address physical attacks and anxiety among in-school adolescents. School administrations should also incorporate programmes that seek to congregate students and offer platforms for social interaction and cohesion.


Assuntos
Comportamento do Adolescente , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Ansiedade/psicologia , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Relações Interpessoais , Masculino , Moçambique/epidemiologia , Abuso Físico/psicologia , Prevalência , Fatores de Risco , Estudantes
8.
PLoS One ; 15(6): e0233907, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497059

RESUMO

INTRODUCTION: Intimate partner violence during pregnancy can contribute to maternal mortality and morbidity by limiting women's ability to receive maternal health services including antenatal care and skilled delivery care. In Ethiopia, evidence regarding intimate partner violence during pregnancy is limited, and no previous studies have been conducted in the Harari region. Therefore, this study aimed to investigate the prevalence and associated factors of intimate partner violence during pregnancy among women who had given birth in public hospitals in Harari regional state, eastern Ethiopia. METHODS: A hospital-based cross-sectional study was conducted from November 2018 to April 2019 among women who had given birth in public hospitals in Harari regional state, East Ethiopia. A systematic random sampling method was employed to select 648 participants. Data were collected using an interviewer-administered standardized questionnaire based on the World Health Organization Multi-Country Study on Women's Health and Domestic Violence against Women survey. Crude and adjusted odds ratios with respective confidence intervals were computed. Variables with a p-value of ≤0.05 were considered to have a significant association with intimate partner violence during pregnancy. RESULTS: The prevalence of intimate partner violence during the most recent pregnancy was found to be 39.81%. Furthermore, the prevalence of physical, emotional and sexual violence were found to be 25.93%, 25.62% and 3.7%, respectively. Longer duration of marriage (adjusted odds ratio = 1.68, 95% confidence interval = 1.01-2.79), most recent pregnancy being unplanned (adjusted odds ratio = 1.55, 95% confidence interval = 1.03-2.34), experiencing controlling behaviour by a partner, (adjusted odds ratio = 2.23, 95% confidence interval = 1.46-3.40) and having an attitude that justifies intimate partner violence (adjusted odds ratio = 1.60, 95% confidence interval = 1.09-2.36) were associated with experiencing intimate partner violence. CONCLUSION: The prevalence of intimate partner violence during pregnancy was found to be high. Pregnancy monitoring programs, which can detect and intervene with regard to partner's controlling behaviors and women's perception regarding justification of intimate partner violence, especially in those women with an unplanned pregnancy, could help to reduce intimate partner violence during pregnancy. Further, changing social norms that condone violence through advocacy and awareness creation might help in preventing partner violence.


Assuntos
Violência por Parceiro Íntimo , Maus-Tratos Conjugais , Adulto , Estudos Transversais , Etiópia , Feminino , Hospitais Públicos , Humanos , Masculino , Abuso Físico , Gravidez , Gravidez não Planejada , Delitos Sexuais , Parceiros Sexuais , Fatores Socioeconômicos , Adulto Jovem
9.
PLoS One ; 15(6): e0235203, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584889

RESUMO

BACKGROUND: Little is known about violence against HIV-positive adolescents and young adults (AYA) in sub-Saharan Africa. This analysis examines experiences of violence victimization, and the perpetrators of this violence, among AYA living with HIV, aged 15-24 years, in Zambia. METHODS: We analyzed baseline data from 272 AYA (60.1% female, 71.0% perinatally infected) enrolled in Project YES! (Youth Engaging for Success), a randomized controlled trial conducted in four HIV clinics in Ndola, Zambia. Violence measures were adapted from the ICAST-C and the WHO Multi-Country Study on Women's Health and Domestic Violence. Youth could report up to 12 perpetrator types for past-year experiences of violence. We estimated lifetime and past-year prevalence of physical violence, psychological abuse, and forced sex, disaggregated by sex and age group. Estimates were weighted using sex and age data from the 2013-14 Zambian Demographic and Health Survey to be representative of HIV-positive AYA in Zambia. RESULTS: Estimated lifetime prevalence of any violence victimization was 78.2%. Past-year prevalence was 72.0% among males and 74.5% among females. Almost half of AYA (46.1%) had ever experienced polyvictimization (2+ types of violence). Psychological abuse was most common (70.4% lifetime, 65.3% past-year), followed by physical violence (50.8% lifetime, 44.7% past-year) and forced sex (10.4% lifetime, 4.7% past-year). Among past-year victims, males experienced more violence than females from a friend/peer (74.3% vs. 45.1%, p<0.001); females experienced more violence than males from a romantic partner (33.3% vs. 5.0%, p<0.001), parent/caregiver (32.4% vs. 17.6%, p = 0.02), and stranger (19.7% vs. 5.2%, p<0.001). CONCLUSION: The widespread and overlapping prevalence of multiple types of violence highlights the critical need for prevention and response efforts that are tailored to youths' sex and the perpetrator type. Future research should explore violence victimization and HIV outcomes, and the measurement of psychological abuse and sexual violence, among HIV-positive AYA in the region.


Assuntos
Infecções por HIV , HIV-1 , Abuso Físico/psicologia , Delitos Sexuais/psicologia , Parceiros Sexuais , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Prevalência , Adulto Jovem , Zâmbia/epidemiologia
10.
PLoS One ; 15(5): e0229389, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469882

RESUMO

Links between crystalline methamphetamine (CM) use and criminal offending are often drawn in the media; however, there has been little scientific research into this relationship. The aim of this study was to ascertain the prevalence and correlates of lifetime CM use among a sample of young people in detention in Australia and to examine whether an association exists between lifetime CM use and recidivism in this population.The sample included 202 young people (164 males) in youth detention in the state of Victoria, Australia. Participants were administered questionnaires related to lifetime substance use and socio-environmental experiences. Lifetime mental health data and offending data were obtained for each participant from public mental health and policing databases. More than one third (38%) of the sample reported lifetime CM use. In multivariate logistic regression analyses, older age, male gender, polysubstance use, and high levels of community disorganisation were associated with CM use. The presence of a psychiatric diagnosis over the lifetime was not significantly associated with CM use. CM use was also not significantly associated with violent recidivism. Efforts to address CM use and related harm in detained youth should include community-based strategies to reduce CM use among this vulnerable population following their release from detention. However, the findings suggest that CM use on its own is unlikely to be an important consideration for professionals concerned with determining which young people should be selected for treatment designed to reduce the risk of violent recidivism.


Assuntos
Comportamento Criminoso/efeitos dos fármacos , Delinquência Juvenil/psicologia , Metanfetamina/toxicidade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Analgésicos Opioides/efeitos adversos , Austrália/epidemiologia , Cannabis/efeitos adversos , Comportamento Criminoso/fisiologia , Feminino , Medicina Legal , Humanos , Delinquência Juvenil/legislação & jurisprudência , Masculino , Saúde Mental , Abuso Físico/psicologia , Polícia/estatística & dados numéricos , Saúde Pública , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
11.
J Pediatr ; 221: 224-229, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32446486

RESUMO

OBJECTIVES: To describe patterns of overall, within-household, and community adverse childhood experiences (ACEs) among children in vulnerable neighborhoods and to identify which individual ACEs, over and above overall ACE level, predict need for behavioral health services. STUDY DESIGN: This was a cross-sectional study that used a sample of 257 children ages 3-16 years who were seeking primary care services with co-located mental healthcare services at 1 of 2 clinics in Chicago, Illinois. The outcome variable was need for behavioral health services (Pediatric Symptom Checklist score ≥28). The independent variables were ACEs, measured with an adapted, 28-item version of the Traumatic Events Screening Inventory. RESULTS: Six ACE items were individually predictive of a clinical-range Pediatric Symptom Checklist score after adjusting for sociodemographic covariates: emotional abuse or neglect (OR 2.93, 95% CI 1.32-6.52, P < .01), natural disaster (OR 3.89, 95% CI 1.18-12.76, P = .02), forced separation from a parent or caregiver (OR 2.95, 95% CI 1.50-5.83, P < .01), incarceration of a family member (OR 2.43, 95% CI 1.20-4.93, P = .01), physical attack (OR 2.84, 95% CI 1.32-6.11, P < .01), and community violence (OR 2.35, 95% CI 1.18-4.65, P = .01). After adjusting for overall ACE level, only 1 item remained statistically significant: forced separation from a parent or caregiver (OR 2.44, 95% CI 1.19-5.01, P = .02). CONCLUSIONS: ACEs that disrupt attachment relationships between children and their caregivers are a significant predictor of risk for child emotional or behavioral problems.


Assuntos
Experiências Adversas da Infância , Transtornos do Comportamento Infantil/epidemiologia , Adolescente , Chicago/epidemiologia , Criança , Maus-Tratos Infantis/psicologia , Pré-Escolar , Estudos Transversais , Exposição à Violência/psicologia , Separação da Família , Feminino , Humanos , Modelos Logísticos , Masculino , Desastres Naturais , Apego ao Objeto , Abuso Físico/psicologia
12.
J Stud Alcohol Drugs ; 81(2): 125-134, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32359041

RESUMO

OBJECTIVE: Most studies linking physical victimization and substance use have focused on concurrent or temporally proximal associations, making it unclear whether physical victimization has a sustained impact on substance use problems. We examined the long-term associations between adolescent physical victimization and symptoms of substance use disorders in adulthood, controlling for intermediating victimization during young adulthood and several control variables. METHOD: Data were obtained from the Monitoring the Future Study (N = 5,291). Women and men were recruited around age 18 and surveyed biennially through age 30, and again at 35. Past-year physical victimization (threatened physical assaults, injurious assaults) was measured regularly from age 18 to 30. Alcohol and cannabis use symptoms (e.g., withdrawal, tolerance) were assessed at age 35. Controls were measured in adolescence (e.g., prior substance use) and young adulthood (e.g., marriage). Interactions examined whether associations varied by sex. RESULTS: When we controlled for adolescent substance use, adolescents who were threatened with injury or who sustained physical injuries as a result of violence had more alcohol use symptoms at age 35 than nonvictims. However, when victimization during young adulthood was statistically accounted for, only victimization during young adulthood was associated with age-35 alcohol use symptoms. The effects of young adult victimization, but not adolescent victimization, were stronger for women. Victimization was mostly unrelated to age-35 cannabis use symptoms. CONCLUSIONS: Adolescents who are threatened with physical assaults or injured by physical assaults have significantly more alcohol use symptoms in their mid-30s than nonvictimized adolescents, but these associations are completely explained by subsequent victimization during young adulthood.


Assuntos
Comportamento do Adolescente/psicologia , Alcoolismo/psicologia , Vítimas de Crime/psicologia , Abuso de Maconha/psicologia , Abuso Físico/psicologia , Abuso Físico/tendências , Adolescente , Adulto , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Abuso de Maconha/diagnóstico , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
13.
BMC Public Health ; 20(1): 449, 2020 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32252723

RESUMO

BACKGROUND: International studies provide evidence of an association between child disabilities, including hearing impairment (HI), and child maltreatment. There are high prevalences of ear disease with associated HI, and child maltreatment among Australian Aboriginal children, but the link between HI and child maltreatment is unknown. This study investigates the association between HI and child maltreatment for Aboriginal children living in the Northern Territory (NT) of Australia. METHODS: This was a retrospective cohort study of 3895 Aboriginal school-aged children (born between 1999 and 2008) living in remote NT communities. The study used linked individual-level information from health, education and child protection services. The outcome variables were child maltreatment notifications and substantiations. The key explanatory variable, HI, was based on audiometric assessment. The Kaplan-Meier estimator method was used in univariate analysis; Cox proportional hazards regression was used in multivariable analysis. RESULTS: A majority of the study cohort lived in very remote (94.5%) and most disadvantaged (93.1%) regions. Among all children in the study cohort, 56.1% had a record of either HI or unilateral hearing loss (UHL), and for those with a history of contact with child protection services (n = 2757), 56.7% had a record of HI/UHL (n = 1564). In the 1999-2003 birth cohort, by age 12 years, 53.5% of children with a record of moderate or worse HI had at least one maltreatment notification, compared to 47.3% of children with normal hearing. In the 2004-2008 cohort, the corresponding results were 83.4 and 71.7% respectively. In multivariable analysis, using the full cohort, children with moderate or worse HI had higher risk of any child maltreatment notification (adjusted Hazard Ratios (adjHR): 1.16, 95% CI:1.04-1.30), notification for neglect (adjHR:1.17, 95% CI:1.04-1.31) and substantiation (adjHR:1.20, 95% CI:1.04-1.40), than children with normal hearing. In the 2004-2008 birth cohort, children with moderate or worse HI had higher risk of a substantiated episode of physical abuse (adjHR:1.47, 95% CI:1.07-2.03) than children with normal hearing. CONCLUSION: Our findings demonstrate the urgent need for HI and child maltreatment prevention strategies through raised community awareness and inter-agency collaboration. Effective information-sharing between service providers is a critical first step to a public health approach in child protection.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Serviços de Proteção Infantil/estatística & dados numéricos , Perda Auditiva/epidemiologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Criança , Maus-Tratos Infantis/etnologia , Pré-Escolar , Feminino , Perda Auditiva/etnologia , Humanos , Masculino , Northern Territory/epidemiologia , Abuso Físico/etnologia , Abuso Físico/estatística & dados numéricos , Prevalência , Estudos Retrospectivos , Fatores de Risco
14.
PLoS One ; 15(4): e0231737, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32320405

RESUMO

INTRODUCTION: We sought to estimate the prevalence, severity and identify predictors of violence among adolescent girls and young women (AGYW) in informal settlement areas of Nairobi, Kenya, selected for DREAMS (Determined Resilient Empowered AIDS-free, Mentored and Safe) investment. METHODS: Data were collected from 1687 AGYW aged 10-14 years (n = 606) and 15-22 years (n = 1081), randomly selected from a general population census in Korogocho and Viwandani in 2017, as part of an impact evaluation of the "DREAMS" Partnership. For 10-14 year-olds, we measured violence experienced either in the past 6 months or ever using a different set of questions from those used for 15-22 year-olds. Among 15-22 year-olds we measured prevalence of violence, experienced in the past 12 months, using World Health Organization (WHO) definitions for violence typologies. Predictors of violence were identified using multivariable logit models. RESULTS: Among 606 girls aged 10-14 years, about 54% and 7% ever experienced psychological and sexual violence, respectively. About 33%, 16% and 5% experienced psychological, physical and sexual violence in the past 6 months. The 10-14 year old girls who engaged in chores or activities for payment in the past 6 months, or whose family did not have enough food due to lack of money were at a greater risk for violence. Invitation to DREAMS and being a non-Christian were protective. Among 1081 AGYW aged 15-22 years, psychological violence was the most prevalent in the past year (33.1%), followed by physical violence (22.9%), and sexual violence (15.8%). About 7% experienced all three types of violence. Severe physical violence was more prevalent (13.8%) than moderate physical violence (9.2%). Among AGYW aged 15-22 years, being previously married/lived with partner, engaging in employment last month, food insecure were all risk factors for psychological violence. For physical violence, living in Viwandani and being a Muslim were protective; while being previously married or lived with a partner, or sleeping hungry at night during the past 4 weeks were risk factors. The odds of sexual violence were lower among AGYW aged 18-22 years and among Muslims. Engaging in sex and food insecurity increased chances for sexual violence. CONCLUSIONS: Prevalence of recent violence among AGYW is high in this population. This calls for increased effort geared towards addressing drivers of violence as an early entry point of HIV prevention effort in this vulnerable group.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Abuso Físico/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Adolescente , Criança , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Quênia/epidemiologia , Abuso Físico/prevenção & controle , Abuso Físico/psicologia , Prevalência , Parcerias Público-Privadas/organização & administração , Parcerias Público-Privadas/estatística & dados numéricos , Fatores de Risco , População Rural/estatística & dados numéricos , Delitos Sexuais/prevenção & controle , Delitos Sexuais/psicologia , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Adulto Jovem
15.
PLoS Med ; 17(3): e1003064, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32191701

RESUMO

BACKGROUND: Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intimate partner violence (IPV). We aimed to evaluate this relationship and to assess effect heterogeneity between population subgroups among women in 19 sub-Saharan African countries. METHODS AND FINDINGS: We used data from 19 Demographic and Health Surveys from 2011 to 2018 including 83,990 partnered women aged 15-49 years. Deviations in rainfall in the year before the survey date were measured relative to the 29 previous years using Climate Hazards Group InfraRed Precipitation with Station data, with recent drought classified as ordinal categorical variable (severe: ≤10th percentile; mild/moderate: >10th percentile to ≤30th percentile; none: >30th percentile). We considered 4 IPV-related outcomes: reporting a controlling partner (a risk factor for IPV) and experiencing emotional violence, physical violence, or sexual violence in the 12 months prior to survey. Logistic regression was used to estimate marginal risk differences (RDs). We evaluated the presence of effect heterogeneity by age group and employment status. Of the 83,990 women included in the analytic sample, 10.7% (9,019) experienced severe drought and 23.4% (19,639) experienced mild/moderate drought in the year prior to the survey, with substantial heterogeneity across countries. The mean age of respondents was 30.8 years (standard deviation 8.2). The majority of women lived in rural areas (66.3%) and were married (73.3%), while less than half (42.6%) were literate. Women living in severe drought had higher risk of reporting a controlling partner (marginal RD in percentage points = 3.0, 95% CI 1.3, 4.6; p < 0.001), experiencing physical violence (marginal RD = 0.8, 95% CI 0.1, 1.5; p = 0.019), and experiencing sexual violence (marginal RD = 1.2, 95% CI 0.4, 2.0; p = 0.001) compared with women not experiencing drought. Women living in mild/moderate drought had higher risk of reporting physical (marginal RD = 0.7, 95% CI 0.2, 1.1; p = 0.003) and sexual violence (marginal RD = 0.7, 95% CI 0.3, 1.2; p = 0.001) compared with those not living in drought. We did not find evidence for an association between drought and emotional violence. In analyses stratified by country, we found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemployed women. This study is limited by its lack of measured hypothesized mediating variables linking drought and IPV, prohibiting a formal mediation analysis. Additional limitations include the potential for bias due to residual confounding and potential non-differential misclassification of the outcome measures leading to an attenuation of observed associations. CONCLUSIONS: Our findings indicate that drought was associated with measures of IPV towards women, with larger positive associations among adolescent girls and unemployed women. There was heterogeneity in these associations across countries. Weather shocks may exacerbate vulnerabilities among women in sub-Saharan Africa. Future work should further evaluate potential mechanisms driving these relationships.


Assuntos
Grupo com Ancestrais do Continente Africano , Secas , Abuso Físico/etnologia , Delitos Sexuais/etnologia , Maus-Tratos Conjugais/etnologia , Saúde da Mulher/etnologia , Adolescente , Adulto , África ao Sul do Saara/epidemiologia , Grupo com Ancestrais do Continente Africano/psicologia , Fatores Etários , Emoções , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Abuso Físico/psicologia , Medição de Risco , Fatores de Risco , Fatores Sexuais , Delitos Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Fatores de Tempo , Desemprego , Adulto Jovem
16.
PLoS One ; 15(3): e0230085, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142550

RESUMO

BACKGROUND: Intimate partner violence (IPV) is prevalent in high- as well as low-income contexts. It results in a substantial public health burden and significant negative socioeconomic and health outcomes throughout the life-course. However, limited knowledge exists about IPV during early adolescence. This period is critical during the transition to adulthood for at least two reasons: it is when the majority of adolescents in low-income countries first encounter dating, sexuality and partnerships, often with older adolescents or adults, and it is also the period when lifelong patterns of violence and norms about acceptable IPV are formed. The current study is one of the first to measure IPV prevalence among young adolescents in a low-income setting, examine the potential etiology, and investigate relationships with gender ideology, poverty, mental health and childhood adversity. METHODS: We surveyed 2,089 adolescents aged 10-16 in Malawi using standardized instruments. We estimated the prevalence of IPV, and use multivariate logistic regression to test potential correlates. RESULTS: More than a quarter (27%) of ever-partnered adolescents in Malawi report being victimized. A substantial proportion of both male and female adolescents (15%) report committing violence against their partner. Girls were more likely than boys to report being a victim of sexual IPV (24% versus 8%), and boys more likely to perpetrate such (9% versus 1%). Almost 10% of the sample had both committed and been a victim of IPV. Cumulative childhood adversity (e.g., physical abuse, witnessing domestic violence) was a consistent and strong correlate of IPV victimization (adjusted odds ratio (aOR) 1.30) and of perpetration (aOR 1.35). Depression and PTSD were likewise associated with IPV victimization in the overall sample. Notably, gender ideology was not predictive of either victimization or perpetration, even among boys. CONCLUSIONS: IPV is common for both male and female young Malawian adolescents, and includes both victimization and perpetration. IPV compounds other adversities experienced by adolescents in this low-income setting, and it is rarely alleviated through help from the health system or other formal support. These findings underscore the need to intervene early when interventions can still break destructive pathways and help foster healthier relationships. This focus on early adolescence is particularly critical in low-income countries given the early onset and rapid pace of the transition to adulthood, with sexual activity, dating and partnership thus being common already in young adolescence. Promising interventions would be those that reduce violence against or around children, as well as those that reduce the impacts of such trauma on mental health during adolescence.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Criança , Depressão/epidemiologia , Depressão/patologia , Países em Desenvolvimento , Violência Doméstica/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Malaui , Masculino , Razão de Chances , Abuso Físico/estatística & dados numéricos , Pobreza , Prevalência , Parceiros Sexuais/psicologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-32164156

RESUMO

This study explored factors affecting parents' intentions to use physical violence (PV) to discipline their children in the future. The theory of planned behavior (TPB) guided selection of variables. A sample of 1337 preschool children's parents from nine kindergartens located in a county of Henan Province, China were selected by stratified random cluster sampling. Data on parents' attitudes, subjective norms, and perceived behavioral control over PV, intentions to engage in PV to discipline their preschool children in the future, self-reported PV behavior toward their children during the past three months, and demographic characteristics were collected via a paper-based questionnaire. Multivariable logistic regression analyses examined putative predictors of parents' intentions to use physically violent discipline. Nearly three-quarters of the sample said they definitely will not use violent discipline, while 23.4% either said they would use it, or did not rule it out. Logistic regression analysis showed that parents' lower level of perceived behavioral control over using violence (OR 4.17; 95% CI: 2.659, 6.551), attitudes that support PV (OR 2.23; 95% CI: 1.555, 3.203), and having been physically violent with their children during the past three months (OR 1.62; 95% CI: 1.032, 2.556) were significantly associated with parents' tendency either to include, or not exclude, the use of violent discipline. Parents' subjective norms regarding PV had no significant impact on their intentions (p > 0.05). The influence of TPB constructs varied according to parents' gender. Intervention programs that aim to reduce violent discipline should focus both on increasing parents' perceived behavioral control over PV and changing their attitudes toward physically violent practices, especially among mothers and parents who have already used PV to discipline their children.


Assuntos
Maus-Tratos Infantis , Relações Pais-Filho , Abuso Físico , Atitude , Criança , Pré-Escolar , China , Feminino , Humanos , Intenção , Masculino , Pais
18.
J Forensic Nurs ; 16(1): 6-15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32068675

RESUMO

BACKGROUND: Human sex trafficking is a major public health issue. The United States is the second largest market for sex-trafficked women, yet few healthcare interventions, designed for women specifically, have been identified. The purpose of this review was to present a systematic review of the literature on the characteristics and healthcare needs of women who have been trafficked for sex in the United States. METHODS: This literature review was conducted following the methodology outlined by Whittmore and Knalf and written using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Cumulative Index to Nursing & Allied Health, PsychInfo, PubMed, and Scopus databases were searched. A quality assessment tool was used to determine rigor of the studies included in this review. RESULTS: Nine publications met the inclusion criteria. Three studies specifically explored health. Four studies were composed solely of women born outside the United States, and two studies reported differences across many variables, including overall health, between women born outside the United States and women born within the United States. A lack of resources and an inadequate response by the health system resulted in care that was not optimal. CONCLUSION: There are differences between U.S.-born and non-U.S.-born victims. Evidence on the healthcare needs of U.S.-born women trafficked for sex in the United States is extremely limited. Research focusing on the health perceptions of women survivors of human sex trafficking may shed light on how they perceive health, care, and the health system and what they identify as important for key stakeholders to understand.


Assuntos
Vítimas de Crime , Necessidades e Demandas de Serviços de Saúde , Tráfico de Pessoas , Sobreviventes , Saúde da Mulher , Adultos Sobreviventes de Eventos Adversos na Infância , Atitude do Pessoal de Saúde , Continuidade da Assistência ao Paciente , Vítimas de Crime/psicologia , Cultura , Emigrantes e Imigrantes , Feminino , Humanos , Abuso Físico , Pobreza , Sobreviventes/psicologia , Estados Unidos , Populações Vulneráveis
19.
PLoS One ; 15(1): e0227884, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31990913

RESUMO

OBJECTIVES: Child maltreatment through physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence, causes substantial adverse health, educational and behavioural consequences through the lifespan. The generation of reliable data on the prevalence and characteristics of child maltreatment in nationwide populations is essential to plan and evaluate public health interventions to reduce maltreatment. Measurement of child maltreatment must overcome numerous methodological challenges. Little is known to date about the extent, nature and methodological quality of these national studies. This study aimed to systematically review the most comprehensive national studies of the prevalence of child maltreatment, and critically appraise their methodologies to help inform the design of future studies. METHODS: Guided by PRISMA and following a published protocol, we searched 22 databases from inception to 31 May 2019 to identify nationwide studies of the prevalence of either all five or at least four forms of child maltreatment. We conducted a formal quality assessment and critical analysis of study design. RESULTS: This review identified 30 national prevalence studies of all five or at least four forms of child maltreatment, in 22 countries. While sound approaches are available for different settings, methodologies varied widely in nature and robustness. Some instruments are more reliable and obtain more detailed and useful information about the characteristics of the maltreatment, including its nature, frequency, and the relationship between the child and the person who inflicted the maltreatment. Almost all studies had limitations, especially in the level of detail captured about maltreatment, and the adequacy of constructs of maltreatment types. CONCLUSIONS: Countries must invest in rigorous national studies of the prevalence of child maltreatment. Studies should use a sound instrument containing appropriate maltreatment constructs, and obtain nuanced information about its nature.


Assuntos
Maus-Tratos Infantis/psicologia , Abuso Físico/psicologia , Adolescente , Criança , Maus-Tratos Infantis/prevenção & controle , Estudos Transversais , Feminino , Humanos , Masculino , Abuso Físico/prevenção & controle , Prevalência , Fatores de Risco , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-31906306

RESUMO

Workplace physical violence against health care professionals perpetrated by patients and visitors has been a persistent problem worldwide. Prevalence estimates varied vastly across studies and there was a lack of quantitative syntheses of prevalence studies. This review aimed to quantify pooled one-year prevalence estimates at the global and regional levels. A systematic literature search was performed in the databases of PubMed, PsycINFO, Web of Science, and Embase between 1 January 2000 and 8 October 2018. Studies providing information about one-year prevalence of self-reported workplace physical violence against health care professionals perpetrated by patients or visitors were included. Heterogeneity between studies was evaluated using Cochran's chi-squared test (Cochran's Q) and I2 values. Subgroup analysis and meta-regression were used to explore heterogeneity. A total of 65 eligible studies reported one-year prevalence estimates for 61,800 health care professionals from 30 countries. The pooled one-year prevalence of workplace physical violence against health care professionals perpetrated by patients or visitors was 19.33% (95% confidence interval (CI): 16.49%-22.53%) and the overall heterogeneity was high across studies. We noted geographic and staff categories variations for prevalence estimates through subgroup analysis. The meta-regression showed that sample size, type of health care setting, and quality score were significant moderators for heterogeneity. One in five health care professionals experienced workplace physical violence perpetrated by patients or visitors worldwide annually. Practical intervention was needed to ensure safety of health care professionals.


Assuntos
Pessoal de Saúde , Pacientes , Visitas a Pacientes , Violência no Trabalho , Estudos Transversais , Pessoal de Saúde/estatística & dados numéricos , Humanos , Pacientes/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Exame Físico , Prevalência , Visitas a Pacientes/estatística & dados numéricos , Violência no Trabalho/estatística & dados numéricos
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