Project description:ObjectivesEmergency Department (ED) screening for intimate partner violence (IPV) is typically nursing-initiated, often with visitors present. Since the onset of the COVID-19 pandemic, we have seen both an increase in societal stress, a known exacerbator of IPV, and the implementation of visitor restriction policies. This combination presents the need for enhanced IPV screening and the opportunity to perform screening in a controlled, patient-only environment. Our goal was to evaluate the frequency of nurse-initiated screening for IPV prior to and during the early months of the COVID-19 pandemic as well as the frequency of positive screens for IPV.MethodsWe conducted a retrospective cross-sectional study evaluating all adults (age >18 years) presenting to a tertiary care center ED. Patients were identified as presenting prior to the COVID-19 pandemic (June 1, 2019 to August 31, 2019) and after the COVID-19 visitor restriction policies (June 1, 2020 to August 31, 2020). Descriptive statistics were performed using chi-square and t-tests compared the demographic variables. Chi-square was used for a bivariate analysis of our primary outcomes (IPV screening performed and screening positive for IPV). Further analysis was done using a binary logistic regression model adjusting for the demographic characteristics.ResultsBoth the odds of nursing-initiated IPV screening and the odds of verbally screening positive for IPV significantly increased (OR 1.509, 95% CI 1.432-1.600) and (OR 1.375, 95% CI 1.126-1.681) respectively following the implementation of COVID-19 visitor restriction policies.ConclusionsThese findings suggest that nurse-initiated IPV screening should continue to be performed with the patient privately, even after COVID-19 related ED visitor restrictions are removed. These findings also support the hypothesis that the stress related to COVID-19 is contributing to a rise in IPV.
Project description:Stay-at-home policies have been implemented worldwide to reduce the spread of the SARS-CoV-2 virus. However, there is a growing concern that such policies could increase violence against women. We find evidence in support of this critical concern. We focus on Peru, a country that imposed a strict nationwide lockdown starting in mid-March and where nearly 60% of women already experienced violence before COVID-19. Using administrative data on phone calls to the helpline for domestic violence (Línea 100), we find that the incidence rate of the calls increased by 48 percent between April and July 2020, with effects increasing over time. The rise in calls is found across all states and it is not driven by baseline characteristics, including previous prevalence of violence against women. These findings create the need to identify policies to mitigate the negative impact of stay-at-home orders on women's safety.
Project description:IntroductionKey measures in preventing spread of the virus that causes coronavirus disease 2019 (COVID-19) are social distancing and stay-at-home mandates. These measures along with other stressors have the potential to increase incidences of intimate partner violence (IPV), sexual assault, and child maltreatment.MethodsWe performed a retrospective review of county police dispatches, emergency department (ED) visits, Sexual Assault Nurse Examiner (SANE) consults, Domestic Violence Healthcare Project (DVHP) team consults, and Child Protection Team consults at a large, tertiary, Level I trauma center. We queried International Classification of Diseases Revision 10 codes most specific to IPV, sexual assault, and child maltreatment from March-October 2020 compared to 2019. Similarly, the number of consults performed by SANE, DVHP, and our Child Protection Team were collected. We compared all ED visits and consultations to total ED visits for the reviewed time period. Finally, the total number of calls and referrals to a child advocacy center and resource call line for victims were recorded during this timeframe.ResultsPolice dispatches for IPV-related assaults increased by 266 reports from 2019 to 2020 (P = 0.015). Emergency department visits related to IPV increased from 0.11% of visits in 2019 to 0.15% in 2020 (P = 0.032), and DVHP consults increased from 0.31% in 2019 to 0.48% in 2020 of ED visits in the first three months (P < 0.001). Child maltreatment visits increased from 0.47% of visits in 2019 to 0.81% of visits in 2020 (P = 0.028), and a higher percentage of patients required Child Protection team consults from 1% in 2019 to 1.6% in 2020 (P = 0.004). Sexual assault-related visits and SANE consults both showed a small increase that was not statistically significant. Fewer calls and referrals were made to our child advocacy center and resource call line, decreasing by 99 referrals and 252 calls, respectively.ConclusionDespite decreased ED volumes throughout the pandemic, we observed an increase in police dispatches, ED visits, and utilization of hospital consult services related to IPV and child maltreatment following the initiation of stay-at-home orders. However, use of community resources, such as the local child advocacy center, declined.
Project description:BackgroundIntimate partner violence (IPV) is a significant problem with several negative health outcomes. Disasters are linked to increased IPV, but little is known about reporting of and strategies to address IPV during the COVID-19 pandemic. This review maps the IPV reporting during the pandemic and interventions to prevent and respond to IPV in 11 Western and Southern European countries.MethodsGovernment websites, news articles and pre-prints were searched using the terms 'domestic violence' or 'violence' in combination with 'Covid' or 'Corona'. Embase, PubMed, Scopus and Google Scholar were searched using the terms 'domestic violence' and 'partner violence' and 'interventions'.ResultsSix countries showed an increase in domestic violence reports (Austria, Belgium, France, Ireland, Spain and UK), two countries a drop (Italy and Portugal), two countries showed no change (The Netherlands and Switzerland) and one country did not provide comparative data (Germany). Common measures to address IPV were starting a campaign (nine countries), creating online support (seven), more funding for alternative accommodation (seven) and support (eight) and use of a code word (four).ConclusionsIPV reports or helpline calls in Western and Southern European countries in the first weeks of COVID-19 measures increased in six countries, remained the same in two countries and showed a decrease in two countries. While this review cannot ascertain the impact of the measures taken by the countries during the pandemic and beyond, this mapping provides a foundation for future research, and an opportunity to trace the efficacy of these strategies.
Project description:At least half a million women are victims of intimate partner violence in the United States annually, resulting in substantial harm. However, the etiology of violence to intimate partners is not well understood. Witnessing such violence in childhood has been proposed as a principal cause of adulthood perpetration, yet it remains unknown whether the association between witnessing intimate partner violence and adulthood perpetration is causal.We conducted a propensity-score analysis of intimate partner violence perpetration to determine whether childhood witnessing is associated with perpetration in adulthood, independent of a wide range of potential confounding variables, and therefore might be a causal factor. We used data from 14,564 U.S. men ages 20 and older from the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Nearly 4% of men reported violent behavior toward an intimate partner in the past year. In unadjusted models, we found a strong association between childhood witnessing of intimate partner violence and adulthood perpetration (for witnessing any intimate partner violence, risk ratio [RR] = 2.6 [95% confidence interval = 2.1-3.2]; for witnessing frequent or serious violence, 3.0 [2.3-3.9]). In propensity-score models, the association was substantially attenuated (for witnessing any intimate partner violence, adjusted RR = 1.6 [1.2-2.0]; for witnessing frequent or serious violence, 1.6 [1.2-2.3]).Men who witness intimate partner violence in childhood are more likely to commit such acts in adulthood, compared with men who are otherwise similar with respect to a large range of potential confounders. Etiological models of intimate partner violence perpetration should consider a constellation of childhood factors.
Project description:BackgroundThe purpose of this study is to assess the prevalence and associated factors of physical and sexual intimate partner violence (IPV) among married women of reproductive age in a rural population in northeast Bangladesh. In addition, we examined women's sharing and disclosure of violence experience with others.MethodsThis cross-sectional study uses data from a household survey of 3966 women conducted in 2014 in the Sylhet District of Bangladesh. Interviews were completed in respondent's homes by trained local female interviewers.ResultsTwenty-nine percent (28.8%, 95% CI 27.4-30.3%) of the women reported ever experiencing physical or sexual IPV by their spouse; 13.2% (95% CI 12.1-14.3%) reported physical or sexual IPV in the past year. Of the 13.2%, 10.1% (95% CI 9.2-11.1%) reported experiencing physical IPV and 4.6% (95% CI 4.0-5.3%) reported sexual IPV. In a combined model, the adjusted odds of having experienced physical or sexual IPV in the past year were higher for women who were raised in households with history of IPV (AOR = 4.35, 95% CI 3.26-5.80); women with no formal education (AOR = 1.76, 95% CI 1.30-2.37); women whose husbands had no formal education (AOR = 1.63, 95% CI 1.22-2.17); Muslim (AOR = 1.63, 95% CI 1.03-2.57); women younger than age 30 (AOR = 1.53, 95% CI 1.11-2.12); and women who were members of an NGO or microcredit financial organization (AOR = 1.38, 95% CI 1.04-1.82). Wealth, parity, number of household members, and pregnancy status (pregnant, postpartum, neither pregnant nor postpartum) were not associated with physical or sexual IPV after adjusting for other factors. Data on disclosure was available for women who reported experiencing physical violence in the last year; only 31.8% of victims told someone about the violence they had experienced and 1% reported to police, clerics, health workers, or a counselor altogether.ConclusionsIn rural northeast Bangladesh, a high proportion of women of reproductive age experience physical or sexual IPV. Women do not often speak of these experiences, especially to anyone outside of family. Interventions aimed at preventing future IPV and addressing current IPV should focus on women who witnessed IPV in childhood, as well as younger women and less educated couples.Trial registrationThis study was registered as a Clinical Trial (Identifier: NCT01702402). https://clinicaltrials.gov/ct2/show/NCT01702402.
Project description:BackgroundIntimate Partner Violence (IPV) is the most common form of interpersonal violence and a major public health problem. The COVID-19 pandemic might have contributed to an increase in IPV experiences. To evaluate changes in IPV prevalence during the pandemic, it is important to consider studies' methodological characteristics such as the assessment tools used, samples addressed, or administration modes (e.g., face-to-face, telephone or online interviews), since they may influence disclosure and were likely affected by pandemic-imposed mobility restrictions.MethodsSystematic review and meta-analysis of empirical studies addressing IPV against women, men, or both, during the COVID-19 period. We searched six electronic databases until December 2021, including articles in English, German, Spanish, French or Portuguese languages. We extracted and synthesised characteristics of studies related to sampling (clinical, community, convenience), type assessment tool (standardised questionnaire, specifically created questions), method of administration (online, telephone, face-to-face), and estimates of different forms of IPV (physical, sexual, psychological). IPV estimates were pooled stratified by study characteristics using random-effects models.ResultsOf 3581 publications, we included 103 studies. Fifty-five studies used a standardized instrument (or some adaptations) to assess IPV, with the World Health Organisation Questionnaire and the Revised Conflicts Tactics Scales being the most frequent. For 34 studies, the authors created specific questions to assess IPV. Sixty-one studies were conducted online, 16 contacted participants face-to-face and 11 by telephone. The pooled prevalence estimate for any type of violence against women (VAW) was 21% (95% Confidence Interval, 95%CI = 18%-23%). The pooled estimate observed for studies assessing VAW using the telephone was 19% (95%CI = 10%-28%). For online studies it was 16% (95%CI = 13%-19%), and for face-to-face studies, it was 38% (95%CI = 28%-49%). According to the type of sample, a pooled estimate of 17% (95%CI = 9%-25%) was observed for studies on VAW using a clinical sample. This value was 21% (95%CI = 18%-24%) and 22% (95%CI = 16%-28%) for studies assessing VAW using a convenience sample and a general population or community sample, respectively. According to the type of instrument, studies on VAW using a standardized tool revealed a pooled estimate of 21% (95%CI = 18%-25%), and an estimate of 17% (95%CI = 13%-21%) was found for studies using specifically created questions.ConclusionsDuring the pandemic, IPV prevalence studies showed great methodological variation. Most studies were conducted online, reflecting adaptation to pandemic measures implemented worldwide. Prevalence estimates were higher in face-to-face studies and in studies using a standardized tool. However, estimates of the different forms of IPV during the pandemic do not suggest a marked change in prevalence compared to pre-pandemic global prevalence estimates, suggesting that one in five women experienced IPV during this period.
Project description:Lifelong brain health consequences of traumatic brain injury (TBI) include the risk of neurodegenerative disease. Up to one-third of women experience intimate partner violence (IPV) in their lifetime, often with TBI, yet remarkably little is known about the range of autopsy neuropathologies encountered in IPV. We report a prospectively accrued case series from a single institution, the New York City Office of Chief Medical Examiner, evaluated in partnership with the Brain Injury Research Center of Mount Sinai, using a multimodal protocol comprising clinical history review, ex vivo imaging in a small subset, and comprehensive neuropathological assessment by established consensus protocols. Fourteen brains were obtained over 2 years from women with documented IPV (aged 3rd-8th decade; median, 4th) and complex histories including prior TBI in 6, nonfatal strangulation in 4, cerebrovascular, neurological, and/or psychiatric conditions in 13, and epilepsy in 7. At autopsy, all had TBI stigmata (old and/or recent). In addition, white matter regions vulnerable to diffuse axonal injury showed perivascular and parenchymal iron deposition and microgliosis in some subjects. Six cases had evidence of cerebrovascular disease (lacunes and/or chronic infarcts). Regarding neurodegenerative disease pathologies, Alzheimer disease neuropathologic change was present in a single case (8th decade), with no chronic traumatic encephalopathy neuropathologic change (CTE-NC) identified in any. Findings from this initial series then prompted similar exploration in an expanded case series of 70 archival IPV cases (aged 2nd-9th decade; median, 4th) accrued from multiple international institutions. In this secondary case series, we again found evidence of vascular and white matter pathologies. However, only limited neurodegenerative proteinopathies were encountered in the oldest subjects, none meeting consensus criteria for CTE-NC. These observations from this descriptive exploratory study reinforce a need to consider broad co-morbid and neuropathological substrates contributing to brain health outcomes in the context of IPV, some of which may be potentially modifiable.
Project description:ObjectiveThis study aimed to assess the prevalence of perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021.MethodA facility-based cross-sectional study was conducted among 657 postpartum mothers from 1 to 30 March 2021 in southern Ethiopia. All postpartum mothers who visited the selected hospitals or health centers for newborn immunization and met the inclusion criteria were included in this study. Data were cleaned, coded, entered into Epidata manager version 4.2 and then exported into SPSS version 26 for analysis. Binary and multivariate logistic regression analysis was used.ResultsThe prevalence of perinatal intimate partner violence was 62.4%. In this study, income loss due to COVID-19 (adjusted odds ratio: 12.00, 95% confidence interval: 5.60, 25.71, p < 0.001) was the strongest factor associated with perinatal intimate partner violence. Young age women (adjusted odds ratio: 5.82, 95% confidence interval: 2.72, 12.46, p < 0.001), partner alcohol use (adjusted odds ratio: 2.21, 95% confidence interval: 1.37, 3.56, p = 0.001), partner substance use (adjusted odds ratio: 2.07, 95% confidence interval: 1.12, 3.83, p = 0.021), and partner relationships (cohabited) (adjusted odds ratio: 1.88, 95% confidence interval: 1.06, 3.34, p = 0.032) were also strongly associated with perinatal intimate partner violence.ConclusionThe prevalence of perinatal intimate partner violence was relatively high. The health of the women should be maintained through empowerment of women and provision of health education in order to minimize prevalence of perinatal intimate partner violence associated with low income, young age, substance use, and cohabited marital status. Future qualitative studies are required to identify the underlying multifactorial reasons for intimate partner violence.