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Transmissible spongiform encephalopathies in non-domestic animals: origin, transmission and risk factors.

The transmissible spongiform encephalopathies (TSEs), scrapie and bovine spongiform encephalopathy (BSE), are serious diseases of domestic animals. Although not as significant in terms of numbers of animals affected or geographical distribution, TSEs also affect non-domestic animals. Transmissible mink encephalopathy (TME) was the first TSE to be identified in non-domestic animals. This disease of captive mink (Mustela vison) is very rare and is associated with exposure through feed contaminated by a TSE agent. The second TSE to be identified in non-domestic animals was chronic wasting disease (CWD) of deer and elk. This disease is not known to be associated with feedstuffs contaminated with the agent of CWD, but the natural route of exposure appears to be oral, possibly through direct interaction between animals or through environmental contamination. Over the last five years, the known distribution of CWD across North America has expanded, increasing concerns over the impact of this disease on populations of free-ranging cervids and the viability of game farming industries. Concurrent with the epidemic of BSE, a variety of non-domestic ruminants and felid species were also affected in the United Kingdom, presumably through exposure to the agent in contaminated feed. These examples illustrate that when non-domestic animals are held in captivity, they depend upon feeds supplied by their caretakers and may show degrees of susceptibility to infectious agents in feeds which vary from those of domestic species. Although humans have less influence over exposure of free-ranging species to infectious agents, monitoring these populations for diseases may be important for managing the health of these animals. It is important to institute or continue surveillance for an entire range of infectious diseases, including TSEs, in free-ranging and captive non-domestic species. Study of diseases in these species may provide important information about infectious agents of concern for domestic animals and humans.

Animals↗

Women veterans' experiences with domestic violence and with sexual harassment while in the military.

BACKGROUND: Both domestic violence and sexual harassment may adversely affect women's health but often go unrecognized. OBJECTIVE: To assess women veterans' experiences with domestic violence and with sexual harassment while in the military as well as the relationship of such experiences to health and health care utilization. METHODS: We surveyed all 191 women hospitalized from March 1992 to 1993 at the Minneapolis (Minn) Veterans Affairs Medical Center and 411 randomly selected female outpatients. Data were collected using an anonymous validated questionnaire. RESULTS: Results were stratified by age and analyzed using both bivariable and multivariable techniques. Twenty-four percent of respondents under age 50 years reported domestic violence in the past year and 90% reported sexual harassment while in the military. Among older respondents, 7% said they had experienced domestic violence in the past year and 37% reported a history of sexual harassment while in the military. Of those who reported domestic violence in the past year, 50% of respondents under age 50 years and 28% of older respondents said that at least one assault was life-threatening. Rates of reports of completed and attempted sexual assaults while in the military were 20 times higher than previous reports by other government employees. Respondents with a history of either domestic violence (odds ratio, 2.83; 95% confidence interval [CI], 1.38 to 5.78) or sexual harassment while in the military (odds ratio, 2.84; 95% CI, 1.22 to 6.53) were more than twice as likely to report a history of anxiety or depression, and a history of domestic violence was associated with more lifetime surgical procedures (odds ratio, 1.21; 95% CI, 1.10 to 1.33). CONCLUSIONS: Histories of domestic violence within the past year and of sexual harassment while in the military are common among women veterans. Both may be associated with adverse effects on mental and physical health.

Adult↗

Domestic violence: the Lebanese experience.

OBJECTIVES: To estimate the prevalence of domestic violence among women presenting to primary health care facilities in Lebanon; to identify presenting symptoms and responses to varied forms of violence; and to examine variables associated with domestic violence. STUDY DESIGN/METHODS: A cross-sectional survey of all women presenting to four primary health care centres in different geographic areas of Lebanon from September 2002 to October 2002. A questionnaire was administered in interview format. The following information was collected from participants: demographic characteristics, perceived health status, prior exposure and responses to domestic violence, and characteristics of the perpetrators. RESULTS: Of the 1418 participants, 494 (35%) reported experiencing domestic violence and 307 (22%) had family members who had been exposed to domestic violence. Among the women exposed to violence, verbal abuse or insult was most common (88%) followed by physical violence (66%); 57% reported their experiences to family, friends or authorities, whereas the remainder kept silent. Women who were exposed to domestic violence had higher frequencies of reported physical symptoms than those who were not exposed. Generally, the perpetrators were spouses who had demographic backgrounds comparable to their wives. Multiple regression analyses showed that women's education levels, work status, health status, and familial violence predicted domestic violence. CONCLUSIONS: Women readily talk about their abuse when asked. The rate of domestic violence is high among Lebanese women and is a significant health issue. Additional research is needed to better understand the extent of the problem and to develop more effective reporting methods.

Adolescent↗

Policy and procedures for domestic violence patients in Canadian emergency departments: a national survey.

OBJECTIVE: To obtain information concerning the following: (1) the proportion of Canadian emergency departments with domestic violence intervention policies and procedures, (2) how hospitals identify and provide service to patients who have been abused, and (3) measures that have been problematic/helpful in implementing domestic violence protocols in emergency departments. DESIGN: A cross-sectional survey of a stratified random sample of 230 Canadian hospitals with emergency departments. PARTICIPANTS: Head nurses/nurse managers of the sample emergency departments in July and August 1994. MEASURES: Informational and attitudinal questionnaire items concerning domestic violence policies and procedures in the emergency department, including services provided to patients, staff roles, perceived support and effectiveness of the policy/procedures, how problem areas were addressed. RESULTS: One hundred ninety-eight hospitals (198 of 230) returned questionnaires (86%). Of the 198, 39% (78) indicated there were policies and procedures concerning domestic violence for the emergency department. Large teaching hospitals were no more likely than smaller community hospitals to have policies or protocols in place. Screening all patients for domestic violence was reported by 26 hospitals (13% of all respondents, 33% of the group of hospitals with domestic violence policies). Referral services were provided by 61 hospitals (31% of all respondents; 78% of the subgroup with policies). On-site counseling was reported by 46 hospitals (23% of all respondents; 59% of the subgroup with policies). CONCLUSIONS: The actual implementation of domestic violence policies and procedures is far from universal and may well be as low as 10% or 20%. Hospital and ED resources are needed to identify and support staff members who will implement educational activities and monitor compliance with guidelines for cases of domestic violence.

Canada↗

Prevalence study of domestic violence victims in an emergency department.

STUDY OBJECTIVE: In 1992, a study of the prevalence and predictors of domestic violence victims among individuals who presented to a major public hospital emergency department was conducted to replicate a study conducted by the authors in the same setting 12 months previously. The second study aimed to investigate more accurately the presentation of current victims of domestic violence to the ED. METHODS: In a retrospective, cross-sectional study, a screening questionnaire was administered to participants to establish the prevalence of a history and current presentation of domestic violence problems among patients who presented to the ED of a major public hospital. The study group comprised a representative sample of 670 male and 553 female adults (older than 16 years) who presented to all sections of a public hospital ED during 53 randomly selected 8-hour nursing shifts over an 8-week period in 1992. RESULTS: The results of the second prevalence study confirmed those of the first study. Of the 1,223 respondents in the study, 15.5% disclosed a history of adult domestic violence (8.5% of men, 23.9% of women). Women were at greater risk than men for abuse as adults (raw relative risk [RR], 3.27; 95% confidence interval [CI], 2.23 to 4.79; RR adjusted for age, history of child abuse, and country of birth, 4.13; CI, 2.86 to 5.95). Women were at greater risk than men for being doubly abused (as a child and as an adult)(raw RR, 2.17; CI, 1.33 to 3.53). The second prevalence study confirmed what had been indicated in the first study: that 2.0% of women who presented to the ED (11.6% of all women with a history of adult domestic violence) were current victims of domestic violence and that these women presented mainly between the hours of 5 pm and 8 am, when no social work services were available for referral of victims. CONCLUSION: These Australian studies support the findings of prevalence studies of domestic violence victims in ED in the United States. The prevalence and risk factors indicate the need for training of physicians and nurses in the ED about domestic violence and for provision of appropriate backup referral services such as after-hours social work services.

Adolescent↗

Domestic violence compared to other health risks: a survey of physicians' beliefs and behaviors.

BACKGROUND: Physicians routinely confront patient risk behaviors once considered private, including tobacco use, alcohol abuse, and HIV/STD-risk behavior. We compared physicians' behaviors and beliefs on screening and intervention for domestic violence with each other risk. METHODS: Survey of nationwide, random sample of 610 primary care physicians from the American Medical Association Physician Masterfile. RESULTS: Fewer primary care physicians screened for domestic violence than for other risks (p <0.001); once domestic violence was identified, however, physicians intervened with equal or greater frequency than for other risks. Fewer believed that they knew how to screen or intervene for domestic violence compared with other risks, and significantly fewer believed that domestic violence interventions were successful compared with interventions for tobacco and HIV/STD risks (Bonferroni adjusted p<0.001). CONCLUSIONS: Lower domestic violence screening rates may reflect physicians' beliefs that they do not know how to screen or intervene, and that interventions are less successful for domestic violence than for other risks. We may improve screening rates by educating physicians that a simplified role, as for other risks, can be effective for domestic violence.

Attitude of Health Personnel↗

Screening for domestic violence among patients admitted to a French emergency service.

OBJECTIVE: The authors assessed the prevalence of domestic violence among patients examined in the emergency service of a general hospital. They compared the socio-demographic status and psychiatric comorbidity of victims of domestic violence and other patients. METHOD: An assessment was made on 126 consecutive patients received by the emergency service of Bichat-Claude Bernard hospital (Paris, France). Assessment of domestic violence was made through the use of a specific questionnaire. RESULTS: The prevalence rate of domestic violence was 18% among patients examined by the emergency service. Thirty-five percent of the cases were physical violence, 22% sexual violence, 17% psychological violence and 26% multiple forms of domestic violence. Domestic violence had been going on for less than 1 month in only one case. In 74% of the cases, violence lasted for more than 1 year. No differences were found in terms of socio-demographic characteristics (age, marital status, rate of unemployment, sex ratio) and psychiatric comorbidity between victims of domestic violence and others. CONCLUSION: Patients seen in an emergency service must be identified as a population at risk for domestic violence (18%). These situations can be identified only by a systematic assessment using a standardized questionnaire.

Adult↗

Domestic violence and the trauma surgeon: results of a study on knowledge and education.

BACKGROUND: Despite the frequency of domestic violence in trauma patients, little emphasis has been placed on this subject in the education of surgeons and emergency medicine physicians. The 1997 Advanced Trauma Life Support (ATLS) course included, for the first time, education about domestic violence. This study was done to test the hypothesis that baseline knowledge about domestic violence in trauma care providers is poor and is not improved by the 1997 ATLS course. STUDY DESIGN: A study on domestic violence was designed using attending general surgeons, general surgery and emergency medicine residents, and medical students as test subjects. An educational lecture and pre- and post-tests were developed using the Eastern Association for the Surgery of Trauma position paper on domestic violence and other peer-reviewed literature as information sources. Data collected included level of training, date ATLS course was taken, and pre- and post-test scores. Statistical analysis was performed with ANOVA, with significance attributed to p < 0.05. RESULTS: Ninety-two subjects attended the lecture and completed the pre- and post-tests. The overall mean pre-test score was 54 +/- 1. There was no difference in scores for the 1997 ATLS cohort (with domestic violence material) versus the group with earlier ATLS courses (52 +/- 2 versus 51 +/- 1). The group that had never taken ATLS scored significantly better on the pre-test than the other groups (58 +/- 2, p < 0.05). All groups had significantly increased scores on the post-test (mean 77 < 1, p < 0.001 versus pre-test). CONCLUSIONS: Baseline knowledge about domestic violence among surgeons and emergency medicine physicians was poor and was not improved by participation in the 1997 ATLS course. This study strongly supports the need for expanded domestic violence education for trauma care providers.

Adult↗

"Screening" for domestic violence.

Domestic violence has been recognized as a public health concern worldwide with serious social and health consequences, including adverse pregnancy outcome. Although health-care professionals are becoming better informed about domestic violence, and women accept being questioned in this regard, studies have shown that fewer than 10% of physicians ask women routinely about domestic violence, even during pregnancy. Further, based on traditional criteria for screening, reviews have not supported screening programs for domestic violence. This purist approach to screening is inconsistent with what we know about domestic violence and provides a rationale for health-care professionals who are personally uncomfortable with routinely asking women about domestic violence to avoid such an approach. Biomedical models are inadequate to measure the "success" of screening for complex psychosocial health issues. Recent studies suggest that merely asking about violence and providing validation and support reduces violent incidents. The term "screening" in this context may be a misnomer better replaced by "routine enquiry." Published systematic reviews and guidelines about domestic or relationship violence acknowledge the seriousness of the problem from a health perspective and the justification to include routine enquiry about domestic violence as part of health care, even when concluding that the evidence is lacking to justify screening programs as traditionally defined. Continued education and support for health professionals is essential in ensuring that women are not unknowingly left at greater risk due to a non-systematic approach.

Adult↗

Domestic violence is associated with environmental suppression of IQ in young children.

Research suggests that exposure to extreme stress in childhood, such as domestic violence, affects children's neurocognitive development, leading to lower intelligence. But studies have been unable to account for genetic influences that might confound the association between domestic violence and lower intelligence. This twin study tested whether domestic violence had environmentally mediated effects on young children's intelligence. Children's IQs were assessed for a population sample of 1116 monozygotic and dizygotic 5-year-old twin pairs in England. Mothers reported their experience of domestic violence in the previous 5 years. Ordinary least squares regression showed that domestic violence was uniquely associated with IQ suppression in a dose-response relationship. Children exposed to high levels of domestic violence had IQs that were, on average, 8 points lower than unexposed children. Structural equation models showed that adult domestic violence accounted for 4% of the variation, on average, in child IQ, independent of latent genetic influences. The findings are consistent with animal experiments and human correlational studies documenting the harmful effects of extreme stress on brain development Programs that successfully reduce domestic violence should also have beneficial effects on children's cognitive development.

Child Abuse↗

Seasonal alterations in circadian melatonin rhythms of the European wild boar and domestic gilt.

The aims of the present study were: 1) to determine if the European wild boar exhibits a circadian pattern of melatonin secretion under its natural light environment; 2) to compare this pattern with the pattern in domestic pigs reared under the light environment typical for domesticity; and 3) to determine if there are seasonal alterations in melatonin rhythms. Four to six young, pure-bred, European wild boars and four to six cross-bred (Yorkshire x Finnish Landrace) domestic gilts were sampled at 2-hr intervals for 48 hr at the spring/autumn equinoxes and summer/winter solstices. Samples were obtained via saphenous arterial catheters from the wild boars and via ear vein catheters from the domestic gilts. The ambient light intensity was recorded simultaneously with sampling both outdoors and indoors. Following ether extraction, the serum samples were assayed for melatonin using a commercial RIA (Bühlman). All the experimental animals exhibited a distinct circadian pattern in melatonin secretion, with high concentrations occurring during the scotophase. There was no difference in scotophase melatonin response between the wild boars and domestic gilts in any season in terms of mean melatonin concentration or peak value. The mean duration of increased melatonin secretion (more than two standard deviations over a mean photophase concentration) in 24 hr in the wild boars in spring, summer, autumn and winter, was 10, 6, 11 and 17 hr, respectively, and in the domestic gilts, 9, 8, 12 and 11 hr, respectively. These results demonstrate the existence of circadian rhythm in melatonin secretion in both the European wild boar and domestic pig. In both groups, the duration of secretion is subject to seasonal alterations. The results suggest no difference in photoperiodic-melatonin transduction between the European wild boar and domestic pig whether due to altered genotype or reduced light environment.

Animals↗

'I could have just done with a little more help': an analysis of women's help-seeking from health visitors in the context of domestic violence.

Domestic violence is a serious issue that adversely affects large numbers of women and children. Despite having an adverse impact upon health and welfare, women experiencing domestic violence face a number of difficulties seeking help about their situation from statutory health and welfare agencies. The present paper is based upon a study of British health visiting in relation to women experiencing domestic violence. Drawing upon interview data from 16 women who experienced domestic violence and were the mothers of small children, this paper explores their accounts of contact with the health visiting service. All of the 16 women who participated in this research described difficulties in seeking help about domestic violence. These included practical concerns such as fears for their own safety, lack of knowledge regarding appropriate sources of support and protection, and concerns about losing custody of their children. Given these concerns, some women concealed their experiences of domestic violence from their health visitors. For those who disclosed the domestic violence to their health visitors, they did not always receive appropriate support or protection. Of particular concern was the absence of information about accessing more specialist services. The research findings suggest that there is considerable scope for practice development in order to ensure that women experiencing domestic violence are able to receive safe and appropriate responses from health visitors.

Battered Women↗

Health visitors' understandings of domestic violence.

BACKGROUND: Feminist work has made visible the extent and nature of domestic violence and the problems women face in having their experiences recognized by health and welfare professionals. Research has demonstrated that many health care professionals, including nurses, midwives and health visitors have little working knowledge about this issue. This impacts on their ability to recognize and respond to domestic violence within their practice. AIM: This paper is based upon a study of British health visitors, which explored their practice in relation to domestic violence. Drawing upon empirical data from interviews with health visitors, it explores their understandings of the extent and nature of domestic violence in the context of their work. METHODS: Semi-structured interviews were undertaken with 24 health visitors selected by convenience and purposive sampling. Data collection took place during 1997-1998. The research draws on the theoretical perspectives of feminist poststructuralism. FINDINGS: The findings demonstrate considerable differences between health visitors in their understandings of the extent of domestic violence in their caseloads and their recognition of different types of abuse experienced by women. There were also differences between participants in their willingness to name situations other than physical violence as abusive, as well as the extent to which they recognized domestic violence within different social groups. CONCLUSIONS: A feminist perspective provides critical insight into the professional knowledge base in relation to domestic violence, demonstrating the need for health visitors to develop their understandings further in order to respond appropriately to women and children experiencing domestic violence. This is discussed in the context of ongoing struggles for professional identity within an ever-changing arena of health and welfare provision.

Attitude of Health Personnel↗

Analysis of mitochondrial DNA indicates that domestic sheep are derived from two different ancestral maternal sources: no evidence for contributions from urial and argali sheep.

To investigate the origins and phylogenetic relationships of domestic sheep, mitochondrial DNA (mtDNA) from 243 sheep of five European, one African, and four Asian breeds and several mouflon (Ovis musimon), urial (O. vignei bochariensis), and argali (O. ammon nigrimontana, O. a. collium) were assayed for restriction fragment length polymorphisms (RFLP). Twenty haplotypes were identified which occurred in three major phlogenetic groups: urial/argali, mouflon/domestic, and domestic sheep. From the branches that contain mouflon and domestic sheep, two major domestic sheep lineages are apparent. One lineage, termed European lineage, contains the majority of haplotypes detected among European domestic sheep. These mtDNAs resemble mouflon haplotypes. The other lineage, termed Asian lineage, consists of haplotypes found in central Asian and some European domestic sheep. The mean sequence difference between these two lineages (0.72%) is of similar magnitude as that between two argali subspecies. To accurately estimate sequence differences between the European and Asian mtDNA types, the mitochondrial control region of one animal from each lineage and of one mouflon and urial were completely sequenced. Sequence comparisons show that Asian and European domestic sheep lineages differ by 4.43%. The mouflon sequences diverges from the Asian type by 4.52%, but by only 1.36% from the European type. Our data supports the hypothesis that some modern domestic sheep and European mouflon derive from a common ancestor and provide evidence of an additional wild ancestor, other than the urial and argali groups, which has yet to be identified.

Africa↗

Screening for domestic violence: practice patterns, knowledge, and attitudes of physicians in Arizona.

OBJECTIVES: Victims of domestic violence presenting for health care are frequently referred to medical specialists, but little is known about domestic violence screening among specialists. The aim of this study was to evaluate attitudes and behaviors concerning domestic violence of all physicians in Arizona. METHODS: A cross-sectional survey of 2244 physicians from 13 medical specialties describes domestic violence screening practices, attitudes, and behaviors of practicing physicians in Arizona. RESULTS: Among 976 respondents, 56% reported prior education on domestic violence screening; 50.5% rarely or never screen their female patients for domestic violence; and 52% reported their competence for providing treatment for victims as poor to fair. Physicians from emergency medicine, psychiatry, obstetrics/gynecology, and family practice reported higher rates of domestic violence education, screening, awareness of services, and competence at treating victims. Physical medicine/rehabilitation, anesthesiology/pain control, surgical subspecialty, medicine subspecialty, general surgery, and orthopedic physicians scored lowest on these characteristics. CONCLUSIONS: Differences in attitudes and behaviors regarding domestic violence screening were noted among specialty groups. Customizing physician training based on these findings may be beneficial.

Arizona↗

Domestic violence: prevalence and association with gynaecological symptoms.

OBJECTIVE: To determine the prevalence of domestic violence in a population of women attending a gynaecology outpatient clinic in the United Kingdom and also to investigate whether women who reported domestic violence were more likely to complain of certain gynaecological symptoms. DESIGN: Questionnaire survey. SETTING: A gynaecology outpatient clinic in a North of England Hospital. SAMPLE: Nine hundred and twenty consecutive clinic attenders. METHODS: Anonymous confidential questionnaire given to women. MAIN OUTCOME MEASURES: Disclosure of a past history of domestic violence and gynaecological complaints. RESULTS: Nine hundred and twenty consecutive women were included and 825 questionnaires were returned (90% response rate). The prevalence of physical abuse was 21% (171/825). Thirty-four (4%) had experienced violence in the past year. Domestic violence is three times less common in women over 50 years old. Ex-husbands (32%) and ex-boyfriends (29%) were the main perpetrators. Forty-eight percent women who had experienced physical violence also had forced sexual activity. Of the 15 presenting symptoms reported by the women, lower abdominal pain, dysmenorrhoea, dyspareunia, smear abnormalities, cancer worries and bowel symptoms were significantly more common complaints in the group who reported domestic violence. The women with domestic violence also had significantly more consultations; however, the duration of their symptoms was not significantly different. CONCLUSION: The prevalence of domestic violence in a cohort of women who attended the gynaecology outpatient clinic in a North of England Hospital was 21%. Women who are subjected to domestic violence tend to have more consultations and are more likely to complain of certain symptoms.

Adult↗

Incidence and prevalence of domestic violence in a UK emergency department.

BACKGROUND: American and Australian studies indicate that domestic violence is common among patients attending for emergency care. It is not clear whether this applies to patients attending emergency departments in the UK. METHODS: A single centre cross sectional study. Adult patients attending the emergency department of Addenbrooke's Hospital, Cambridge were interviewed in randomly allocated time blocks, using validated questions from a US study. Potential participants were excluded if they (1) were unwilling (2) had an altered mental status (3) had a companion who refused to leave (4) were too ill (5) were unable to speak English (6) personal contacts of the interviewer. RESULTS: and CONCLUSIONS: 256 completed interviews were returned out of a possible 307 (84.8%). The incidence of domestic violence was 1.2% (95% CI 0.2% to 3.4%). The lifetime prevalence of domestic violence was 22.4% (95% CI 15.6% to 30.4%) among men and 22.1% (95% CI 15.1% to 30.5%) among women. The incidence and prevalence rates of domestic violence were considerably lower than in the US study, but similar to prevalence rates recorded in British community surveys. A significant association was found between reported domestic violence and reported deliberate self harm in women (odds ratio 75.4 95% CI 13.1% to 433.7). There was no significant association between higher use of medical care and domestic violence. INTERPRETATION: Domestic violence is common among patients attending for emergency care in the UK. There is a significant association between domestic violence and deliberate self harm in women, further work is required to see if this association is causal. Larger emergency department surveys are required to confirm these results.

Adult↗

Domestication and plasticity of brain organization in mallards (Anas platyrhynchos).

The sizes and histological differentiation of structures in the central nervous system of wild and domestic ducks were compared using allometric methods. Whole brain volume is 14.3% less in domestic ducks than in wild birds, and the size of certain brain structures is more variable in domestic ducks than in the wild birds. These findings are consistent with results of studies in other domestic birds and in domestic mammals. Although the brain subdivision volumes are not reduced to the same extent, the relative composition of the brain is maintained in domestic ducks. The overall reduction in rhombencephalic parts of the brain (16.3%) is greater than that in the prosencephalon (13.5%). Within sensory centers the nuclei of the trigeminal system undergo the most marked decrease (21.3%). Optic (13.3%) and limbic (11.1%) structures are less reduced, and the olfactory regions do not show any differences in volume compared to these regions in wild mallards. Reductions in the volumes of brain structures in domesticated animals have been thought to be processes of functional adaptation controlled by artificial selection. Our observations are discussed with regard to hypotheses about trends in domestication and evolutionary plasticity.

Animals↗