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PubMed1998

Domestic violence screening practices of obstetrician-gynecologists.

OBJECTIVE: To ascertain the current knowledge base and screening practices of obstetrician-gynecologists in the area of domestic violence. METHODS: We mailed a survey to 189 ACOG Fellows who are members of the Collaborative Ambulatory Research Network. Questionnaires were also mailed to a random sample of 1250 nonmember Fellows. RESULTS: Obstetrician-gynecologists are aware of the nature of domestic violence and are familiar with common symptomatology that may be associated with domestic violence. For pregnant patients, 39% of respondents routinely screen at the first prenatal visit; 27% of respondents routinely screen nonpregnant patients at the initial visit. Screening is most likely to occur when the obstetrician-gynecologist suspects a patient is being abused, both during pregnancy (68%) and when the patient is not pregnant (72%). Only 30% of obstetrician-gynecologists received training on domestic violence during medical school; 37% received such instruction during residency training. The majority (67%) have received continuing education on the subject. Years since training and personal experiences with intimate-partner violence were associated with increased screening practices. CONCLUSION: Routine screening of all women for domestic violence has been recommended by ACOG for more than a decade. The majority of obstetrician-gynecologists screen both pregnant and nonpregnant patients when they suspect abuse. However, with universal screening, more female victims of violence can be identified and can receive needed services.

Adult↗

PubMed1998

Alcohol dependence and domestic violence as sequelae of abuse and conduct disorder in childhood.

OBJECTIVES: To examine in the Navajo population: (1) the importance of childhood abuse as a risk factor for conduct disorder; (2) the importance of each form of abuse and conduct disorder as risk factors for alcohol dependence; and (3) the relative importance of each form of abuse, conduct disorder, and alcohol dependence as risk factors for being a perpetrator and/or victim of domestic violence. METHOD: The study is based on a case-control design. Cases (204 men and 148 women) between the ages of 21 and 65 were interviewed in alcohol treatment program and matched to community controls. There were two groups of controls: alcohol dependent (374 men, 60 women) and nonalcohol dependent (157 men, 143 women). When adjusted for stratification by age, community of residence, and sex, the combined control groups comprise a representative sample of the Navajo male and female population 21-65 years of age. RESULTS: The prevalence of physical and sexual abuse before age 15 is within limits observed in other populations. Each form of abuse is a risk factor for conduct disorder. Along with conduct disorder, physical abuse is a risk factor for alcohol dependence. Physical abuse and alcohol dependence are independent risk factors for being involved in domestic violence as both perpetrator and victim. There appears to have been no secular trend in the incidence of childhood abuse over the past several generations, but there is suggestive evidence that domestic violence has become more common. CONCLUSIONS: Physical abuse is a significant risk factor for alcohol dependence as well as for domestic violence independent of the effects of alcohol abuse. The effects of sexual abuse with regard to both domestic violence and alcohol dependence do not appear to be significant.

Adult↗

PubMed2000

Temporal patterns of domestic and wildlife rabies in central Namibia stock-ranching area, 1986-1996.

Eleven years (1986-1996) of wildlife- and domestic-rabies data from the agriculture stock-ranching area of central Namibia were studied using time-series analysis. Nine hundred and sixty three rabies cases were observed in domestic ruminants (5.4 cases/mo), black-backed jackals (Canis mesomelas, 1.3 cases/mo), domestic dogs (0.5 case/mo), and bat-eared foxes (Otocyon megalotis, 0.1 case/mo). The incidence of rabies for all species did not change significantly over the whole study period. However, seasonal variations with an increase in the number of cases between June and November of each year, as well as 34 yr cyclical fluctuations were identified in domestic ruminants and black-backed jackals. The black-backed jackal time-series variable was a significant predictor of the domestic-ruminant and dog time-series variables. The rainfall seasonality combined with the seasonal reproductive pattern of the black-backed jackal appeared to be plausible explanations for the seasonal variations of rabies. However, there was no overall significant correlation between the cyclical weather fluctuations and the 3-4 yr cyclical rabies variations.

Animals↗

PubMed1998

Emergency department-based study of risk factors for acute injury from domestic violence against women.

STUDY OBJECTIVES: To evaluate the associations between selected socioeconomic risk factors and acute injury from domestic violence against women. METHODS: We conducted a preliminary matched case-control study to measure the association of selected predictor variables with acute injury from domestic, violence against women. Patients identified as cases were Hispanic or white female emergency department patients, 16 to 65 years of age, with acute injury sustained from physical assault by an intimate male partner. Cases were selected for inclusion in the study if they reported or admitted acute physical assault by their male partners. Controls were selected from non-case female ED patients so as to represent the base population of the cases and enhance comparability. Two controls were matched to each case. The socioeconomic predictor variables examined were the education level, employment status, history of alcohol abuse, and history of drug abuse of the male partner and the education level and cohabitation status of the female partner. RESULTS: Forty-six cases were identified and included in the study. The age range was 16 to 51 years (mean, 33 years). There were 26 (57%) Hispanic and 20 (43%) white cases. The strongest predictor for acute injury from domestic violence in these patients was a history of alcohol abuse by the male partner, as reported by the female partner (odds ratio, 12.9). The remaining predictor variables were weakly associated or not associated with domestic violence. One half of the cases stated that their male partners were intoxicated with alcohol at the time of assault. CONCLUSION: Of the socioeconomic variables examined in this preliminary study, a history of alcohol abuse by the male partner, as reported by the female partner, was the strongest predictor for acute injury from domestic violence. A large-scale, multicenter, ED-based study is needed to clarify the relation between alcohol abuse, other socioeconomic factors, and acute physical assaults against women by their intimate male partners.

Academic Medical Centers↗

PubMed2005

[The role of governmental and non-governmental institutions in fighting domestic violence against women, with a special focus on prevention].

Domestic violence is the most important violation world wide of human rights of women and one of the most frequent causes for death! The WHO estimates that one of five women experience domestic violence throughout their lifetime. In Switzerland, as much as elsewhere. The batterers and the victims are to be found in all social strata, ages and origins. The costs cause enormous economic damage. Thanks to efficient cooperation of all the governmental and non-governmental institutions victims can be protected a lot better and batterers can be prosecuted. Coordinating the different measures to be taken by all these actors is the central duty of the cantonal intervention projects against domestic violence. Research - in the medical domain, too - is very important. New laws (e.g. domestic violence as officially prosecuted/ expulsion of the perpetrator) should have a preventive effect and express the very clear message: Domestic violence is not a private issue (any longer)!

Battered Women↗

PubMed1999

Domestic violence in Russia.

Reported incidence and frequency rates of domestic violence in Russia exceed Western figures by 4 or 5 times. Although a grassroots social services movement has emerged to provide services for victims and families, a number of historical and cultural influences unique to Russia present challenges with regard to the problem of domestic violence. These include a history of institutional oppression of women, arcane legal procedures, a shortage of housing and shelters, untrained medical professionals, and widespread misinformation and myths about domestic violence. This article documents incidence and prevalence of domestic violence, cultural and historical influences, legal issues, and specific challenges to ending domestic violence in Russia.

Culture↗

PubMed2004

Perceptual and acoustic evidence for species-level differences in meow vocalizations by domestic cats (Felis catus) and African wild cats (Felis silvestris lybica).

To test for possible anthropogenic selection effects on meows in domestic felids, vocalizations by domestic cats (Felis catus) were compared with cries by their closest wild relative, the African wild cat (Felis silvestris lybica). Comparisons included analysis of acoustic characteristics and perceptual studies with human (Homo sapiens) listeners. The perceptual studies obtained human listener ratings of call pleasantness. Both the acoustic and perceptual comparisons revealed clear species-level differences: The domestic cat meows were significantly shorter in mean duration than the wild cat meows, showed higher mean formant frequencies, and exhibited higher mean fundamental frequencies. Human listeners at all levels of experience and affinity for cats rated domestic cat meows as far more pleasant sounding than wild cat vocalizations. These results are consistent with a model of cat domestication that posits selective pressure on meows based on human perceptual biases.

Acoustics↗

PubMed2002

Focusing upon children and men in situations of domestic violence: an analysis of the gendered nature of British health visiting.

Despite considerable feminist critiques of British health visiting work which have pointed to its gendered nature, this issue has received very little attention within the professional literature. The emphasis has been upon the 'health' focus, often highlighting the needs of marginalized groups. The recent professional interest in women experiencing domestic violence draws upon a long-standing feminist concern which has established the extent and nature of domestic violence, and the difficulties facing women in seeking help about their situation. The present paper reports some findings from a study of British health visiting practice in relation to women experiencing domestic violence. Drawing upon interview data from 24 health visitors, this paper focuses specifically upon health visitors' accounts of their practice in relation to both children and men when they were aware women were experiencing domestic violence. Their concerns, which include child welfare and personal safety illustrate some of the complexities facing practitioners when faced with domestic violence situations. The analysis also highlights the gendered practices inherent within health visiting work.

Child↗

PubMed1998

Domestic violence training program for residents.

Domestic violence is occurring in epidemic proportions in the United States. Recent surveys have shown there is a need for educational programs for health care professionals. This report presents the results of a domestic violence workshop developed to increase knowledge and improve attitudes and skills in working with victims of domestic violence. The results of the workshop, measured by preintervention and postintervention attitude, knowledge, and skills surveys, are promising. There was a significant improvement in knowledge, self-assessed skills, and attitudes after the workshop. Although the full magnitude of the changes was not sustained over time, there was still significant improvement after 6 months in knowledge and attitude. Rates of detection and documentation did not change. Future educational programs will need to address maintaining routine screening for domestic violence in the primary care setting and to highlight more clearly the role of health care professionals in the detection and treatment of domestic violence.

Adult↗

PubMed2002

The Voices of survivors documentary: using patient narrative to educate physicians about domestic violence.

This article describes a method of developing physician education materials using analysis of domestic violence patient experiences and patients' descriptions of their experiences. The process began with interviews of 21 domestic violence survivors, focusing on what they wanted to teach physicians. Qualitative analysis of these interviews identified 4 main themes regarding what survivors wanted physicians to understand about life in an abusive relationship: that domestic violence is universal, that it is more than just physical assaults, that it is all about power and control, and that it affects the entire family. Because what survivors wanted from physicians differed depending on where they were in their abusive relationships, recommendations were developed for each of 5 common situations: when a patient may not yet recognize the abuse, when s/he may not be ready or able to disclose the abuse, when s/he chooses to remain in an abusive relationship, when s/he is seeking care for an acute assault, and when s/he has left the relationship but not yet healed. Interview excerpts representing each of the identified themes are used to create a 30-minute educational documentary. A written companion guide covers the traditional aspects of domestic violence education. In teaching about domestic violence or other health problems where it is difficult for physicians to understand their patients intuitively, an educator's most important role may be to direct learners to listen to the experience and wisdom of patients.

Adult↗

PubMed2001

Women's responses to screening for domestic violence in a health-care setting.

BACKGROUND: interest in the health impact of domestic violence is increasing and routine screening for violence in health settings has been recommended. However, there are limited data about how women feel about such screening. AIM: to investigate women's responses to being screened for domestic violence during a routine clinic visit. METHOD: a cross-sectional cohort study. Women (1500) from five Queensland hospitals were asked to complete a self-report questionnaire during the visit following the consultation at which they had been screened for domestic violence. Sealable envelopes and a 'posting box' were provided to ensure anonymity of returned envelopes. FINDINGS: of the 1313 respondents, 98% believed it was a 'good idea' to screen for domestic violence. Over 96% felt 'OK' during the process and 77% of the 30 women who felt uncomfortable still agreed that it was a good idea to screen. Women from rural and remote areas of Queensland had similar responses to those of their city counterparts. CONCLUSION: women in Queensland found screening for domestic violence acceptable and, where health providers are suitably educated, it should be included when taking a routine health history.

Attitude to Health↗

PubMed2003

Early identification of mild traumatic brain injury in female victims of domestic violence.

BACKGROUND: Domestic violence and traumatic brain injuries (TBIs) are major societal problems with public health implications. The inter-relationship between this specific form of violence and TBI has not been explored. However, a clinically relevant relationship is suggested by recent outcome data showing that TBI survivors who are victims of assault are more prone to a suboptimal outcome. METHODS: This observational study screened women who presented to 3 metropolitan emergency departments for health issues associated with domestic violence for a possible secondary mild TBI. RESULTS: Over a 7- to 9-month survey period, a total of 169 women with health issues directly attributable to domestic violence and who were referred to sexual assault-domestic violence health staff were identified. Thirty percent (n = 51) agreed to participate in this survey. A positive loss of consciousness on at least one occasion was reported in 30% of the respondents, and 67% of women reported residual problems that were potentially head-injury related. CONCLUSION: These data argue for greater vigilance in screening domestic violence victims for mild TBI because earlier identification and treatment of any postconcussive syndrome symptoms seems to diminish their adverse impact on outcome.

Adult↗

PubMed2006

Divergent mtDNA lineages of goats in an Early Neolithic site, far from the initial domestication areas.

Goats were among the first farm animals domesticated, approximately 10,500 years ago, contributing to the rise of the "Neolithic revolution." Previous genetic studies have revealed that contemporary domestic goats (Capra hircus) show far weaker intercontinental population structuring than other livestock species, suggesting that goats have been transported more extensively. However, the timing of these extensive movements in goats remains unknown. To address this question, we analyzed mtDNA sequences from 19 ancient goat bones (7,300-6,900 years old) from one of the earliest Neolithic sites in southwestern Europe. Phylogenetic analysis revealed that two highly divergent goat lineages coexisted in each of the two Early Neolithic layers of this site. This finding indicates that high mtDNA diversity was already present >7,000 years ago in European goats, far from their areas of initial domestication in the Near East. These results argue for substantial gene flow among goat populations dating back to the early neolithisation of Europe and for a dual domestication scenario in the Near East, with two independent but essentially contemporary origins (of both A and C domestic lineages) and several more remote and/or later origins.

Animals↗

PubMedDate not supplied

The out-of-hospital use of a domestic violence screen for assessing patient risk.

OBJECTIVES: To determine the following: 1) whether a Domestic Violence Scene Assessment Screen (DVSAS) is accurate at predicting domestic violence (DV) when compared with results on the validated Abuse Assessment Screen (AAS), and 2) whether EMTs can perform accurately on a DVSAS after they have finished a transport so as not to interfere with routine care. METHODS: All patients transported by ambulance from domestic environments (i.e., home) by an urban EMS system were included in the study. A ten-question screen was developed to assess whether a domestic environment had a high risk of having DV (DVSAS). A positive answer to any of the questions was considered to be a positive result on the screen. A trained observer with no clinical duties rode on the ambulance for randomized shifts during a two-month period. The observer completed the DVSAS while at the scene, then the patient, if able, completed the AAS. After finishing the transport, the EMT completed the DVSAS based on his or her memory of the scene. Results of the observer DVSAS were compared with the results of the EMT DVSAS and with the AAS. RESULTS: A total of 43 transports from domestic scenes were included in the study. The observer DVSAS alone was positive in five cases (12%), the EMT DVSAS alone was positive in five cases (12%), and both were positive in seven cases (17%). Agreement between the EMT and the observer yielded a kappa of 0.56 adjusted for chance. Of 15 (42%) patients able to complete the AAS, one (7%) was positive on the AAS alone, four (27%) were positive on the observer DVSAS alone, and three (29%) were positive on both. The observer DVSAS agreed with the AAS results in ten of 15 (66%) of cases. When compared with the AAS, the observer DVSAS had a sensitivity of 75%, specificity of 55%, positive predictive value of 38%, and negative predictive value of 86%. CONCLUSION: Emergency medical technicians can complete the DVSAS at the end of a transport with good agreement with results obtained by an independent observer at the scene. The DVSAS is able to reflect the results of the AAS with moderate to good agreement.

Ambulances↗

PubMed1999

Surveillance of the overall consumption of antibacterial drugs in humans, domestic animals and farmed fish in Norway in 1992 and 1996.

The annual overall consumption of antibacterial drugs in Norway, categorized into human use, use in domestic animals and in farmed fish, was estimated from wholesaler and feed-mill sales statistics. Comprehensive data on drug consumption in human medicine in Norway are published on a regular basis on behalf of the drug authorities. These data, including use of antibacterial drugs, are expressed as the number of defined daily doses (DDD)/1000 inhabitants/year. DDD cannot be employed to compare antibiotic consumption in human and veterinary medicine as it is possible to calculate such data for only a few veterinary drugs. The only parameter for which data are generally available, so far, is the amount used in kilograms of active substance, which is the unit of measurement chosen in this study. It was found that annual overall sales of antibacterial drugs in Norway, including antibacterial and ionophore feed additives, decreased from 77 tonnes in 1992 to 49 tonnes in 1996, a 37% reduction. The use in 1996 in human medicine, animals and farmed fish was 35 tonnes, 13 tonnes and 1 tonne, respectively. While the annual amounts used in human medicine remained unchanged from 1992 to 1996, therapeutic use in fish farming declined by 96%. In domestic animals, therapeutic use and use as feed additives declined by 17% and 5%, respectively. During the study period, the size of the human and domestic animal populations at risk remained almost constant, while the biomass (weight) of farmed fish at risk increased by > 100%. This implies that both the absolute and relative consumption of antibacterial drugs in Norway decreased substantially during the study period. The use of antibacterial drugs, both in humans and in domestic animals, has changed in favour of penicillins, this being in accordance with general recommendations. The reduction in the use of antibacterial drugs in farmed fish has been almost solely due to the introduction of oil-adjuvanted vaccines against furuncolosis. It is concluded that the decline in the amount of antibacterial drugs used in domestic animals, and the changes with regard to choice of drugs, could be mainly attributed to changes in prescribing behaviour following advice and recommendations. Moreover, the overall use of antibacterial drugs in Norway is very low compared with that in most other countries and has been significantly reduced during the 1990s.

Animal Diseases↗

PubMed2003

The criminalization of domestic violence: what social workers need to know.

Domestic violence is a crosscutting issue that affects clients seeking social work services. The criminalization of domestic violence refers to efforts to address domestic violence through the passage and enforcement of criminal and civil laws. This article reviews the social science, legal, and criminal justice literature regarding interventions used to stop domestic violence. The theoretical foundations and effectiveness of police interventions, the use of protective orders, prosecution and victim advocacy, court responses, batterers' intervention as a condition of probation, and coordinated community responses to domestic violence are examined. Implications for social work practice are given, along with basic information for assisting clients who are victims of violence in their own homes.

Battered Women↗

PubMed2000

A randomized controlled study of brief interventions to teach residents about domestic violence.

PURPOSE: To test an educational intervention regarding domestic violence. METHOD: Residents beginning their training in 1995 or 1996 were randomly assigned to attend, at their hospital orientation, either a 20-minute session emphasizing the importance of screening for domestic violence or a session on an unrelated topic. RESULTS: Seventy-one percent of the residents in the experimental group diagnosed domestic violence; 52% in the control did so (RR, 1.35; 95% CI, 0.96-1.90; p = .07) in the nine to 12 months following the intervention. Rates of diagnosis differed by specialty (p < .01): 100% family practice, 90% emergency medicine, 80% obstetrics-gynecology, 63% pediatrics, 47% internal medicine, 0% surgery. Change in knowledge was assessed in 1996; significant improvement was noted (p = .002). CONCLUSION: An intervention about domestic violence conducted at orientation for residents improved the rate of diagnosis of domestic violence. While the improvement was not statistically significant in this case, the intervention was brief and harmless. Other institutions should consider this kind of brief intervention.

Clinical Competence↗

PubMed1999

Violence in America: a public health crisis--domestic violence.

Domestic violence is a major public health problem. It is important that physicians are aware of the extent and pervasiveness of this disease. It is important to identify potential victims of domestic violence when they are encountered in the hospital or office environment. A few, short, carefully asked questions can serve an important surveillance and diagnostic function. Once domestic violence is identified, a well thought out, sensitive, safe plan of action should be discussed with the victim. In this way, not only will the current event be well managed, but also the potential for mitigating further domestic violence events will be initiated. Through this document, EAST hopes to add its voice to that of other physician groups to serve as a catalyst for broad education on the subject of domestic violence as well as activating victim advocacy among physicians and others who come into contact with this problem in their patients.

Adolescent↗