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Dams-O'Connor K, Seifert AC, Crary JF, Delman BN, Del Bigio MR, Kovacs GG, Lee EB, Nolan AL, Pruyser A, Selmanovic E, Stewart W, Woodoff-Leith E, Folkerth RD. The neuropathology of intimate partner violence. Acta Neuropathol 2023; 146:803-815. [PMID: 37897548 PMCID: PMC10627910 DOI: 10.1007/s00401-023-02646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/14/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023]
Abstract
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.
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Affiliation(s)
- Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan C Seifert
- Department of Diagnostic, Molecular and Interventional Radiology, Biomedical Engineering and Imaging Institute, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - John F Crary
- Department of Pathology, Molecular, and Cell Based Medicine, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Neuropathology Brain Bank & Research CoRE, Mount Sinai Hospital, New York, NY, USA
| | - Bradley N Delman
- Department of Diagnostic, Molecular and Interventional Radiology, Biomedical Engineering and Imaging Institute, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Marc R Del Bigio
- Department of Pathology, Rady Faculty of Health Sciences, University of Manitoba, Room 401 Brodie Centre, 727 McDermot Avenue, Winnipeg, MB, Canada
- Diagnostic Services - Pathology, Shared Health Manitoba, Winnipeg, MB, Canada
| | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease (CRND) and Department of Laboratory Medicine and Pathobiology, Krembil Discovery Tower, University of Toronto, 60 Leonard Ave, Toronto, ON, Canada
- Laboratory Medicine Program and Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Edward B Lee
- Translational Neuropathology Research Laboratory, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Nolan
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Ariel Pruyser
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Enna Selmanovic
- Department of Rehabilitation and Human Performance, Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William Stewart
- Department of Neuropathology, Elizabeth University Hospital, Glasgow, G514TF, Queen, UK
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, G128QQ, UK
| | - Emma Woodoff-Leith
- Department of Pathology, Molecular, and Cell Based Medicine, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Neuropathology Brain Bank & Research CoRE, Mount Sinai Hospital, New York, NY, USA
| | - Rebecca D Folkerth
- Office of Chief Medical Examiner, 520 First Avenue, New York, NY, 10116, USA.
- Department of Forensic Medicine, New York University Grossman School of Medicine, New York, NY, USA.
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Li H, Pu Y, Li Z, Jin Z, Jiang Y. Socioeconomic inequality in teenage pregnancy in Papua New Guinea: a decomposition analysis. BMC Public Health 2023; 23:2184. [PMID: 37936107 PMCID: PMC10631214 DOI: 10.1186/s12889-023-17067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Teenage pregnancy is a global public health issue, and it poses a serious threat to the health and socioeconomic status of mothers and their newborn children. Although Papua New Guinea has recorded one of the highest teenage pregnancy rates among Asia-Pacific countries, few studies have conducted research on the related inequality in the country. Therefore, this study aimed to assess socioeconomic inequality in teenage pregnancy and its contributing factors in Papua New Guinea. METHODS Data for this cross-sectional study were obtained from the 2016-2018 Papua New Guinea Demographic and Health Survey. The analytical sample consisted of 2,864 girls aged 15-19 years. We employed Erreygers normalized concentration index (ECI) and concentration curves to measure and depict socioeconomic inequality in teenage pregnancy. Decomposition analysis was likewise performed to identify the contributions of determinants to the observed inequality. RESULTS Weighted ECI for teenage pregnancy was - 0.0582 (P < 0.001), thereby indicating that teenage pregnancy in Papua New Guinea is disproportionately concentrated among poor girls. Decomposition analysis suggested that education level (65.2%), wealth index (55.2%), early sexual debut (25.1%), region (8.5%), and sex of household head (4.1%) are the main determinants explaining the pro-poor socioeconomic inequality in teenage pregnancy. CONCLUSIONS A pro-poor socioeconomic inequality of teenage pregnancy was present in Papua New Guinea. This inequality may be alleviated by such interventions as ensuring that teenage girls receive education; implementing poverty alleviation projects, eliminating child, early, and forced marriages; strengthening promotion for household head to support teenagers in accessing sexual and reproductive health education; improving geographical accessibility to health facilities on contraceptive services, and taking necessary precautions and responses to sexual misconduct.
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Affiliation(s)
- Hao Li
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yiran Pu
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Zhen Li
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Ziyang Jin
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yi Jiang
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
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Urquhart G, Maclennan SJ, Guntupalli AM. Is there an association between intimate partner violence and the prevalence of cervical cancer screening in Jordan? PLoS One 2023; 18:e0290678. [PMID: 37651440 PMCID: PMC10470966 DOI: 10.1371/journal.pone.0290678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/13/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Major health inequalities exist surrounding the utilisation of cervical cancer screening services globally. Jordan, a low- and middle-income country, has poor screening rates (15.8%), with barriers to accessing services, including lack of education. Emerging studies demonstrate that intimate partner violence (IPV) impacts reproductive health decisions. As a large proportion of Jordanian women have reported experiencing IPV, this study examines the association between IPV and cervical cancer screening in Jordan, the first of its kind using national-level data. METHODS Using Jordan's Demographic Health Survey 2017-18, cervical cancer screening awareness and self-reported screening were estimated in participants who answered questions on IPV (n = 6679). After applying sample weights, Heckman's two-stage probit model determined the association of awareness and utilisation of cervical cancer screening with experience of IPV, adjusting for the socio-economic factors. RESULTS Of the women with privacy to answer the IPV module, 180 (3.4%) were found to be victims of sexual violence, 691 of physical violence (12.6%) and 935 (16.2%) of emotional violence. Women subjected to sexual violence were less likely to admit to having awareness of a Pap smear test; however, this did not impact screening rates. Victims of emotional violence were more likely to be screened than non-victims. No association between physical violence and cervical cancer screening was found. CONCLUSIONS A significant association between cervical screening awareness and IPV demonstrates that cancer screening policies must consider IPV among women to improve screening awareness. The paper further sheds light on the paradoxical association between emotional violence and screening. It is acknowledged this situation may be far worse than reported, as women without autonomy were unlikely to answer IPV questions that may endanger them-targeted surveys on cervical cancer screening warrant further investigation.
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Affiliation(s)
- Grace Urquhart
- Queen Elizabeth Health NHS Foundation Trust, Gateshead, Newcastle, United Kingdom
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Ogbuabor DC, Ogbuabor AO, Igwe MC. Determinants of cigarette smoking and smoking frequency among women of reproductive age in Nigeria: evidence from a nationwide cross-sectional survey. Subst Abuse Treat Prev Policy 2023; 18:20. [PMID: 37020223 PMCID: PMC10077715 DOI: 10.1186/s13011-023-00530-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/23/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Smoking is a leading cause of avoidable deaths and attributable disability-adjusted life years globally. Yet, the determinants of smoking practices among women are understudied. This study assessed the determinants of smoking and smoking frequency among women of reproductive age in Nigeria. METHODS AND MATERIALS Data from the 2018 Nigeria Demographic and Health Survey (NDHS) were used in this study (n = 41,821). The data were adjusted for sampling weight, stratification, and cluster sampling design. The outcome variables were smoking status and smoking frequency (daily smoking and occasional smoking). The predictor variables included women's socio-demographic and household characteristics. Pearson's chi-squared test was used to evaluate the association between outcome and predictor variables. All variables significant in bivariate analyses were further analysed using complex sample logistics regression. Statistical significance was set at a p-value < 0.05. RESULTS The prevalence of smoking among women of reproductive age is 0.3%. The prevalence of smoking frequency is 0.1% (daily) and 0.2% (occasionally). Overall, women aged 25-34 (AOR = 2.13, 95%CI: 1.06-4.29, ρ = 0.034), residing in the South-south region (AOR = 9.45, 95%CI: 2.04-43.72, ρ <0.001), being formerly married (AOR = 3.75, 95%CI: 1.52-9.21, ρ = 0.004), in female-headed households (AOR = 2.56, 95%CI: 1.29-5.08, ρ = 0.007) and owning mobile phones (AOR = 2.10, 95%CI: 1.13-3.90, ρ = 0.020) were more likely to smoke. Whereas female-headed households (AOR = 4.34, 95%CI: 1.37-13.77, ρ = 0.013) and being formerly married (AOR = 6.37, 95%CI: 1.67-24.24, ρ = 0.007) predisposed to daily smoking, age 15-24 (AOR = 0.11, 95%CI: 0.02-0.64, ρ = 0.014) was protective of daily smoking among women. Owning mobile phones (AOR = 2.43, 95%CI: 1.17-5.06, ρ = 0.018) increased the odds of occasional smoking among women. CONCLUSIONS The prevalence rates of smoking and smoking frequency are low among women of reproductive age in Nigeria. Women-centred approaches to tobacco prevention and cessation must become evidence-informed by incorporating these determinants into interventions targeting women of reproductive age in Nigeria.
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Affiliation(s)
- Daniel Chukwuemeka Ogbuabor
- Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria.
- Department of Health Systems and Policy, Sustainable Impact Resource Agency, Enugu, Nigeria.
| | - Alphonsus Ogbonna Ogbuabor
- Department of Medical Laboratory Sciences, College of Medicine, Enugu State University of Science and Technology, Enugu, Nigeria
| | - Matthew Chibunna Igwe
- Department of Medical Laboratory Sciences, College of Medicine, Enugu State University of Science and Technology, Enugu, Nigeria
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Mehfooz M, Amir-Ud-Din R, Zafar S. Does Childhood Experience of Interparental Abuse Shape Women's Attitude Toward Intimate Partner Violence in Their Adult Life? Evidence From 31 Developing Countries. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5490-5518. [PMID: 36112826 DOI: 10.1177/08862605221123293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A significant amount of literature exists on the lasting effects of interparental abuse on children's psychological health as adults. However, evidence on how children's childhood experience of interparental violence shapes their attitude toward partner violence in adult intimate relationships is limited. Given the existing evidence that women's acceptance of partner violence as a social norm increases the risk of partner violence, we analyzed the effect of girls' witnessing interparental abuse (where a father is a perpetrator) on their attitude toward partner violence in their intimate relationships as adults. We used data from the Demographic and Health Surveys for 31 low and middle-income countries in Asia and Africa. Aggregating information about women's attitudes toward partner violence into a binary "intimate partner violence acceptance" variable, we found that a woman who witnessed her father beat her mother was 1.62 times more likely to justify partner violence than a woman who did not experience such interparental abuse (adjusted odds ratio [AOR] = 1.62, 95% CI [1.57, 1.66], p < .001). Additionally, using individual components of acceptance as response variables, we found that a woman who witnessed interparental abuse was significantly more likely to justify partner violence if she went out without telling her husband (OR = 1.49, 95% CI [1.45, 1.54], p < .001), neglected children (OR = 1.53, 95% CI [1.49, 1.58], p < .001), argued with the husband (OR = 1.49, 95% CI [1.45, 1.53], p < .001), refused sex with the husband (OR = 1.35, 95% CI [1.31, 1.39], p < .001), or burned food (OR = 1.36, 95% CI [1.31, 1.41], p < .001). This study highlights the need to put in place children-specific social policies to limit the intergenerational transmission of the adverse effects of intimate partner violence.
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Affiliation(s)
| | | | - Sameen Zafar
- Lahore University of Management Sciences (LUMS), Lahore, Pakistan
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Cadri A, Aboagye RG, Boadu Frimpong J, Yeboah PA, Seidu AA, Ahinkorah BO. Partner alcohol consumption and intimate partner violence among women in Papua New Guinea: a cross-sectional analysis of Demographic and Health Survey. BMJ Open 2023; 13:e066486. [PMID: 36918235 PMCID: PMC10016301 DOI: 10.1136/bmjopen-2022-066486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE We examined the association between partner alcohol consumption and the experience of intimate partner violence among women in Papua New Guinea. DESIGN We performed a cross-sectional analyses of data extracted from the 2016-2018 Papua New Guinea Demographic and Health Survey. We included 3319 women in sexual unions. Multilevel binary logistic regression analysis was used to examine the association between partner alcohol consumption and intimate partner violence, controlling for the covariates. Results from the regression analysis were presented using the crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95% confidence intervals (CIs). SETTING Papua New Guinea. PARTICIPANTS Women aged 15-49 years in sexual unions. OUTCOME MEASURES Physical, emotional, and sexual violence. RESULTS The prevalence of physical, emotional and sexual violence among women in sexual unions in Papua New Guinea were 45.9% (42.4 to 47.7), 45.1% (43.4 to 46.8) and 24.3% (22.9 to 25.8), respectively. The level of partner alcohol consumption was 57.3%. Women whose partners consumed alcohol were more likely to experience physical violence (aOR=2.86, 95% CI=2.43 to 3.37), emotional violence (aOR=2.89, 95% CI=2.44 to 3.43) and sexual violence (aOR=2.56, 95% CI=2.08 to 3.16) compared with those whose partners did not consume alcohol. CONCLUSION This study found a relatively high prevalence of intimate partner violence among women in Papua New Guinea. Most importantly, this study found partner alcohol consumption to be significantly and positively associated with intimate partner violence. The study, therefore, recommends that interventions seeking to reduce intimate partner violence among women in Papua New Guinea should intensify behaviour change and education on reducing or eliminating partner alcohol consumption.
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Affiliation(s)
- Abdul Cadri
- Department of Social and Behavioural Science, University of Ghana, Legon, Ghana
- Department of Family Medicine, McGill University Montreal, Montreal, Quebec, Canada
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Paa Akonor Yeboah
- Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
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