The prevalence of exposure to domestic violence and the factors associated with co-occurrence of psychological and physical violence exposure: a sample from primary care patients

<p>Abstract</p> <p>Background</p> <p>Since many health problems are associated with abuse and neglect at all ages, domestic violence victims may be considered as a group of primary care patients in need of special attention.</p> <p>Methods</p> <p>The aim of this multi-centre study was to assess the prevalence of domestic violence in primary care patients, and to identify those factors which influence the co-occurrence of psychological and physical violence exposure and their consequences (physical, sexual and reproductive and psychological) as obtained from medical records.</p> <p>A study was carried out in 28 family practices in Slovenia in 2009. Twenty-eight family physicians approached every fifth family practice attendee, regardless of gender, to be interviewed about their exposure to domestic violence and asked to specify the perpetrator and the frequency. Out of 840 patients asked, 829 individuals, 61.0% women (n = 506) and 39.0% men (n = 323) were assessed (98.7% response rate). They represented a randomised sample of general practice attendees, aged 18 years and above, who had visited their physician for health problems and who were given a physical examination. Visits for administrative purposes were excluded.</p> <p>Multivariate binary logistic regression analysis was used to determine the factors associated with exposure to both psychological and physical violence.</p> <p>Results</p> <p>Of 829 patients, 15.3% reported some type of domestic violence experienced during the previous five years; 5.9% reported physical and 9.4% psychological violence; of these 19.2% of men and 80.8% of women had been exposed to psychological violence, while 22.4% of men and 77.6% of women had been exposed to physical violence. The domestic violence victims were mostly women (p < 0.001) aged up to 35 years (p = 0.001). Exposure to psychological violence was more prevalent than exposure to physical violence. Of the women, 20.0% were exposed to either type of violence, compared to 8.0% of male participants, who reported they were rarely exposed to physical violence, while women reported often or constant exposure to physical violence. Their partners were mostly the perpetrators of domestic violence towards women, while amongst men the perpetrators were mostly other family members.</p> <p>In univariate analysis female gender was shown to be a risk factor for domestic violence exposure. Regression modelling, explaining 40% of the variance, extracted two factors associated with psychological and physical violence exposure: the abuse of alcohol in the patient (OR 4.7; 95% CI 1.54-14.45) and their unemployment (OR 13.3; 95% CI 1.53-116.45).</p> <p>Conclusions</p> <p>As far as the study design permits, the identified factors associated with both psychological and physical violence exposure could serve as determinants to raise family physicians' awareness when exploring the prevalence of domestic violence. The results of previous research, showing at least 15% prevalence of exposure to domestic violence among primary care patients in Slovenia, and the female gender as a risk factor, were confirmed.</p

New Developments in Brief Interventions to Treat Problem Drinking in Nonspecialty Health Care Settings

The delivery of brief interventions (BIs) in health care settings to reduce problematic alcohol consumption is a key preventive strategy for public health. However, evidence of effectiveness beyond primary care is inconsistent. Patient populations and intervention components are heterogeneous. Also, evidence for successful implementation strategies is limited. In this article, recent literature is reviewed covering BI effectiveness for patient populations and subgroups, and design and implementation of BIs. Support is evident for short-term effectiveness in hospital settings, but long-term effects may be confounded by changes in control groups. Limited evidence suggests effectiveness with young patients not admitted as a consequence of alcohol, dependent patients, and binge drinkers. Influential BI components include high-quality change plans and provider characteristics. Health professionals endorse BI and feel confident in delivering it, but training and support initiatives continue to show no significant effects on uptake, prompting calls for systematic approaches to implementing BI in health care

River runoff reconstructions from novel spectral luminescence scanning of massive coral skeletons

Inshore massive corals often display bright luminescent lines that have been linked to river flood plumes into coastal catchments and hence have the potential to provide a long-term record of hinterland precipitation. Coral luminescence is thought to result from the incorporation of soil-derived humic acids transported to the reef during major flood events. Corals far from terrestrial sources generally only exhibit dull relatively broad luminescence bands, which are attributed to seasonal changes in coral density. We therefore tested the hypothesis that spectral ratios rather than conventional luminescence intensity provide a quantitative proxy record of river runoff without the confounding effects of seasonal density changes. For this purpose, we have developed a new, rapid spectral luminescence scanning (SLS) technique that splits emission intensities into red, green and blue domains (RGB) for entire cores with an unprecedented linear resolution of 71. 4 μm. Since humic acids have longer emission wavelength than the coral aragonite, normalisation of spectral emissions should yield a sensitive optical humic acid/aragonite ratio for humic acid runoff, i. e., G/B ratio. Indeed, G/B ratios rather than intensities are well correlated with Ba/Ca, a geochemical coral proxy for sediment runoff, and with rainfall data, as exemplified for coral records from Madagascar. Coral cores also display recent declining trends in luminescence intensity, which are also reported in corals elsewhere. Such trends appear to be associated with a modern decline in skeletal densities. By contrast, G/B spectral ratios not only mark the impact of individual cyclones but also imply that humic acid runoff increased in Madagascar over the past few decades while coral skeletal densities decreased. Consequently, the SLS technique deconvolves the long-term interplay between humic acid incorporation and coral density that have confounded earlier attempts to use luminescence intensities as a proxy for river runoff