Coping with multiple adversities: Men who sought medico-legal care because of physical violence from a partner or ex-partner.

Objectives: To describe male victims of physical violence by an intimate partner who consulted a medico-legal unit, and information available on their perpetrators; to characterize the violent events and their contexts. Little research exists on male victims of physical intimate partner violence seeking medical care. Method: Based on Heise’s ecological framework, mixed methods were used to analyze quantitative and qualitative data collected during 122 medico-legal consultations attended by 115 men who sustained physical violence by an intimate partner from 2006–2012. Results: Quantitative and quantitative data collected from male victims concurred in showing that many of such victims, as well as their partners, faced at the time of the assault multiple adversities and challenges at individual and relationship levels. Among male victims, 26% had no paid job. Among perpetrators, 34% were third-country nationals subject to restricted residence permits. Health issues, worries about money or work combined with complex and conflictive family situations were often in the background of violent events. In a few cases, however, male victims reported no other problems than their partner’s assault. Conclusions: Our findings point out gender-specific aspects of female-to-male physical partner violence. The most common feature is that violence was experienced as one among several adversities. Even though wounds sustained by male victims were not necessarily severe, their emotional suffering was frequent. When underage children were involved, their situation was particularly noteworthy. Interventions with male victims of intimate partner violence should include protection of minors as a priority and as an incentive for fathers to seek help

Self-Reported Violence Experienced by Swiss Prehospital Emergency Care Providers.

Workplace violence is a serious and increasing problem in health care. Nevertheless, only few studies were carried out concerning this topic and then mainly in English-speaking countries. The objectives were to describe the acts of violence experienced by prehospital emergency care providers (PECPs) in the western part of Switzerland between January and December 2016 and to assess the consequences for subsequent PECPs behaviors. An observational cross-sectional study, carried out using an online survey, has been sent to all 416 PECPs in the Canton of Vaud, in the western, French-speaking, part of Switzerland. The survey contained items of demographic data and items to assess the type and consequence of violence sustained. This was classified as five types: verbal assault, intimidation, physical assault, sexual harassment, and sexual assault. 273 (65.6%) PECPs participated in the survey. During 2016, workplace violence was reported by 229 survey participants (83.9%). Most declared to be the victim of such violence between one and three times during the year. In all cases of violence described, the patient and/or a relative initiated aggressive behavior in 96% of cases. Verbal assaults were the most common (99.2% of all acts), followed by intimidation (72.8%), physical assault (69.6%), and sexual harassment (16.3%). Concerning physical assault, PECPs were predominantly victims of spitting and/or jostling (50%). After a violent event, in 50% of cases, the PECPs modified their behavior owing to the experience of workplace violence; 82% now wear protective vests, and 16% carry weapons for self-defense, such as pepper sprays. Seventy-five percent changed their intervention strategies, acting more carefully and using verbal de-escalation techniques or physical restraints for violent patients. Workplace violence is frequent and has significant consequences for PECPs. In order to increase their own security, they increased their protection. These results illustrate their feelings of insecurity, which may have deleterious effects on work satisfaction and motivation. Trial Registration. Our article does not report the results of a health care intervention on human participants

La prévention et le sexting : un état des lieux

Le développement social et relationnel des adolescent-e-s et des jeunes adultes s’effectue aujourd’hui avec celui d’Internet et des nouvelles technologies. Dans ce contexte, les interactions et la transmission d’informations numériques sont facilitées et peu restreintes, ce qui peut mener à un certain nombre d’enjeux en termes d’usage des technologies et de gestion de l’image numérique. Le sexting fait partie de ces problématiques. Cette pratique pouvant, de manière générale, se définir comme l’échange électronique de matériel personnel à caractère sexuel ou intime, peut parfois mener à des situations dramatiques lorsque, par exemple, le contenu d’un message est transféré sans consentement à d’autres personnes. Après avoir mené une première recherche exploratoire qualitative sur la pratique du sexting chez les jeunes, la thématique de la prévention relative au sexting s’est avérée particulièrement intéressante à approfondir. En effet, très peu de jeunes ont rapporté se rappeler de messages ou campagnes de prévention autour du sexting spécifiquement. Au vu de ces résultats, nous avons considéré qu’il était essentiel d’établir un état des lieux de l’offre préventive sur la thématique du sexting, plus particulièrement dans le canton de Vaud, afin de vérifier les dires de certains jeunes sur le manque d’intervention et de discussion sur le sexting et ses possibles dérives. A travers cet état des lieux et ce rapport, nous proposons donc un catalogue permettant de répertorier et d’offrir une vue d’ensemble des différents acteurs-trices et ressources à disposition dans le cadre de la prévention relative à la pratique du sexting auprès des jeunes

Current prevalence of self-reported interpersonal violence among adult patients seen at a university hospital emergency department in Switzerland.

To evaluate the current prevalence of self-reported interpersonal violence amongst patients consulting at the emergency department (ED) of a university hospital and to describe the characteristics of the violence sustained. Ours was a cross-sectional study using a modified version of the Partner Violence Screen questionnaire, which was distributed to every patient over 16 years old consulting at the ED between the 1st and 30th September 2016. Excluded were those incapable of decision-making, unable to understand owing to language difficulties, or in police detention. Questions pertained to violence endured during the year prior to their attendance at the ED and, where relevant, the date, place, and type of violence (physical or psychological), the perpetrator and the means used (firearms or other weapons). Demographic details were taken from the hospital records. Of 628 patients included (participation rate 86%), 19% were victims of violence, for 27% of whom it was the motive for ED attendance. The median age of these victims of violence was 28 years (interquartile range 22–43), 39% were female, 71% single and 38% foreign nationals. Typical characteristics of self-reported violence were: (1) violence sustained within the previous 24 h (26%); (2) perpetrators unknown (35%); (3) occurrence at a café, bar, restaurant or nightclub (32%); (4) use of knives (19%); (5) prior consumption of alcohol by the victims themselves (28%). Females were more susceptible to domestic violence than males (45 vs 7%), the latter mostly reporting public violence (64 vs 43% in women). The prevalence of self-reported interpersonal violence has reached one patient in five in our ED. Our results underline the importance of screening for this, as well as providing the means to offer specific follow-up. &nbsp

Enfants exposés à la violence dans le couple parental : étude rétrospective des données récoltées auprès de 430 mères et pères de 654 enfants âgés de 0 à 17 ans, lorsque ces parents avaient consulté l’Unité de médecine des violences du CHUV suite à un événement violent dans le couple survenu entre 2011 et 2014

[Préface (extraits)] L'étude menée par l'équipe de l'Unité de médecine des violences (UMV) entrouvre la porte de la chambre des enfants, afin d’amener un éclairage supplémentaire sur la nature et les circonstances de l’exposition des enfants à la violence dans le couple parental. Elle montre comment les enfants sont directement concernés dans la violence qui a lieu dans leur foyer. Souvent atteints psychiquement et physiquement, il n'est pas rare qu'ils aillent jusqu’à s'interposer au milieu de ces rapports de violence en se mettant eux-mêmes en danger lorsqu’ils prennent la défense de la victime, le plus souvent d'ailleurs leur mère. Dans d'autres cas, ils et elles intériorisent les modèles genrés d'auteur ou de victime auprès desquels ils grandissent et puisent leur identité. Les prérequis favorables à une transmission intergénérationnelle de la violence dans le couple sont renforcés par cette immersion quotidienne

Developing assessments for child exposure to intimate partner violence in Switzerland – A study of medico-legal reports in clinical settings

Purpose: Evidence to inform assessment of needs of children exposed to intimate partner violence (IPV) in health settings is limited. A Swiss hospital-based medico-legal consultation for adult victims of violence also detects children’s exposure to IPV and refers cases to the Pediatrics Child Abuse and Neglect Team. Based on a conceptual ecological framework, this study examined the nature and circumstances of children’s exposure to IPV described in accounts collected by nurses in consultations with adult IPV victims. Methods: From 2011-2014, 438 parents (88% female) of 668 children aged 0 to 18 sought medico-legal care from the Violence Medical Unit in Lausanne Switzerland, following assaults by intimate partners (85% male). As part of the consultation, nurses completed a semi-structured questionnaire with victimized parents, recording their answers in the patient file. Victims’ statements about the abuse, their personal, family and social contexts, and their children’s exposure to IPV were analyzed. Descriptive statistics and qualitative thematic content analyses were conducted to identify, from the victimized parents’ accounts, elements useful to understand the nature and circumstances of children’s exposure and involvement during violent events. Results: Parent statements on specific violent events described children being present in 75% of the cases. Children were said to be exposed to, and responded to, severe physical violence, serious threats and insults, in the context of repeated assaults and coercive control. Families, especially mothers, were often coping with additional socio-economic vulnerabilities. Conclusions: Implications for further developing assessments of children living with IPV, especially in health settings were identified

Epidemiology and injury patterns of patients consulting following assault by nightclub security agents in a university hospital emergency service and an associated specialised forensic consultation

Introduction: The Violence Medical Unit (VMU), a specialised forensic medical consultation, was created at the Lausanne university Hospital in 2006. All patients consulting at the ED for interpersonal violencerelated injury are referred to the VMU, which provides forensic documentation of the injury and referral to the relevant community based victim-support organisations within 48 hours of the ED visit. This frees the ED medical staff from forensic injury documentation and legal/social referral, tasks for which they lack both time and training. Among community violence, assaults by nightclub security agents against patrons have increased from 6% to 10% between 2007 and 2009. We set out to characterise the demographics, assault mechanisms, subsequent injuries, prior alcohol intake and ED & VMU costs incurred by this group of patients. Methods: We retrospectively included all patients consulting at the VMU due to assault by nightclub security agents from January 2007 to December 2009. Data was obtained from ED & VMU medical, nursing and administrative records. Results: Our sample included 70 patients, of which 64 were referred by the CHUV ED. The victims were typically young (median age 29) males (93%). 77% of assaults occurred on the weekend between 12 PM and 4 AM, and 73% of the victims were under the influence of alcohol. 83% of the patients were punched, kicked and/or head-butted; 9% had been struck with a blunt instrument. 80% of the injuries were in the head and neck area and 19% of the victims sustained fractures. 21% of the victims were prescribed medical leave. Total ED & VMU costs averaged 1048 SFr. Conclusion: Medical staff treating this population of assault victims must be aware of the assault mechanisms and injury patterns, in particular the high probability of fractures, in order to provide adequate diagnosis and care. Associated inebriation mandates liberal use of radiology, as delayed or missed diagnosis may have medical, medicolegal and legal implications. Emergency medical services play an important role in detecting and reporting of such incidents. Centralised management of the forensic documentation facilitates referral to victim support organisations and epidemiological data collection. Magnitudes and trends of the different types of violence can be determined, and this information can be then impact public safety management policies

Des infirmières en médecine légale suisse

Au Centre Hospitalier Universitaire Vaudois, l'Institut Universitaire de Médecine Légale de Lausanne a ouvert, en 2006, l'Unité de mödecine des Violences qui offre une consultation médico-légale spécialisée pour adultes victimes de violence. L'ouverture de cette unité a vu l'entrée de la profession infirmière dans le champ de la médecine légale clinique

Pas de limite d’âge aux violences dans le couple : une étude sur la violence dans les couples âgés

La violence dans le couple âgé est une problématique encore peu connue qui risque d’augmenter avec le vieillissement de la population. A Lausanne, une étude rétrospective sur les dossiers traités de 2006 à 2016 dans le cadre d’une consultation médico-légale dresse un tableau précis de la situation – les résultats sont édifiants

Médecine légale et prise en charge des victimes de violence: Les infirmières en première ligne

Au Centre Hospitalier Universitaire Vaudois, l'Institut Universitaire de Médecine Légale de Lausanne a ouvert en 2006 l'Unité de Médecine des Violences qui offre une consultation médico-légale spécialisée dans la prise en charge des adultes victimes de violence. L'ouverture de cette unité a vu l'entrée de la profession infirmière dans le champ de la médecine légale clinique. Les infirmières assurent en effet de manière autonome les consultations sous la supervision d'un médecin légiste