Violence against women as a public health issue

Overlooked Realities: Reimagining "Home" and "House" Among Women Domestic Workers in India

Domestic workers (DWs) are integral to the daily lives of a significant portion of India's urban population, with an estimated 3.9 million individuals employed in domestic roles in urban areas, mostly women. This article explores the perceptions of home, house, and safe spaces among migrant women DWs in Delhi. Through in-depth interviews, it delves into their lived experiences as both breadwinners and survivors of domestic violence, revealing that (a) house and home are differently conceptualized by these workers; (b) their homes are perceived as warzones, reinforcing patriarchy through incidents of domestic violence and gendered subordination; and (c) women DWs navigate the complexities of conflicting identities as breadwinners and survivors within unequal gendered relationships.

Intangible Identity Theft and Intimate Partner Violence

While tougher domestic violence laws and protective orders are frequently credited with attenuating intimate partner violence (IPV), one unexplored explanation for this observed reduction is that intimate partner abusers are shifting their abusive behavior to intangible identity theft to thwart legal mechanisms traditionally used to deter IPV. Unlike the monetary motive associated with document identity theft, intangible identity theft is committed by someone with a preexisting grievance against the victim because the theft's primary purpose is to tarnish the victim's reputation. Results from a multilevel analysis show that a woman has a lower probability of being a victim of an intimate rather than nonintimate partner crime in cities with a higher intangible identity theft rate. Such a finding suggests that intangible identity theft may be a form of intimate partner abuse with few adverse consequences for offenders because identity thieves are rarely arrested and prosecuted. Nevertheless, the current study is only preliminary. Further research is needed before our findings and conclusions can be universally accepted.

Family and domestic violence policy discourses and narratives: implications for Emergency Departments and communities in rural Australia

BACKGROUND

Australian data has indicated that the frequency and severity of family and domestic violence (FDV) tends to increase with remoteness. Rural communities rely on Emergency Departments (ED) within public hospitals for general health and safety needs. Public health departments within Australia are strongly influenced by Government policies which can define 'health problems' and limit institutional responses to patients presenting with FDV. The current study therefore aimed to critically examine FDV Australian Government policies to explore how policy meanings could potentially impact on ED staff and individuals within rural communities.

METHODS

Foucauldian Discourse Analysis and Policy Narrative Analysis were used to examine 9 policy documents which represented national, state/territory and clinical practice levels. Publication dates ranged from 2006 to 2020.

RESULTS

A total of 8 discourses were identified, with each one providing a unique construction of the target problem and determining the potential agency of health professionals and subjects of FDV. Discourses combined to produce an overall narrative within each policy document. Narrative constructions of the target problem were compared which produced three narrative themes: 1) Deficit Subject Narratives; 2) Object Oriented Narratives; and 3) Societal Narratives.

CONCLUSION

The results reflected a transition in the meaning of FDV within Australian society and over the past decade, with policies trending away from Deficit Subject Narratives and towards Object Oriented or Societal Narratives. Institutional systems, sociohistorical context and broader societal movements may have shaped this transition by stagnating policy meanings or introducing new insights that expanded the possibilities of understanding and action. Narratives produced assumptions which significantly altered the relevance and agency of individuals and groups when applied to a rural ED setting. As FDV was moved out of the clinical space and into the public domain, the agency of health professionals was reduced, while the values and strengths of FDV subjects and rural communities were potentially recognised. Later policies provided contextual specificity and meaning fluidity that could benefit diverse groups within rural areas; however, the expectation for ED staff to learn from their communities and challenge institutionalised approaches to FDV requires careful consideration in relation to rural hospital systems and resources.

What isn't public health?

By recognizing the structural causes of health and illness, public health has often been associated with values of compassion and solidarity, and a relational understanding of human agency. Rather than supporting the consistent integration and application of these insights, however, public health is now sometimes invoked more as a rhetorical move, used to construct issues as simple questions of neoliberal scientistic rationalism. Public health practitioners must reckon, therefore, with how the field can be discursively deployed in the public square, for multiple divergent political ends. If public health is always positioned as a value-neutral and detached scientific approach to addressing complex subjects, from drug use to pandemics, it not only fails to connect with the arguments of its critics, but further divorces what was once called the public health 'movement' from the strong and progressive political and theoretical positions it was founded upon and should advocate for today.

Legislative and judicial responses to workplace sexual harassment in mainland China: Progress and drawbacks

Background

China has recently upgraded its anti-sexual harassment laws and regulations. The first-ever Chinese Civil Code, which took effect in 2021, has explicitly defined sexual harassment and imposed affirmative duties on employers to prevent and correct work-related sexual harassment. This study aims to map the status quo of China's anti-sexual harassment legal system and explore its progress and limits in dealing with workplace sexual harassment.

Methods

We reviewed China's anti-sexual harassment laws at the national, provincial, and municipal levels and observed how they were enforced in courts. All judicial cases of workplace sexual harassment published by Chinese courts between January 2021 and June 2022 were examined. From a comparative law perspective, we then identified the progress and drawbacks of China's legislative and judicial responses to workplace sexual harassment.

Results

China's current anti-sexual harassment legal system, while have made commendable progress, has its drawbacks: the definition of sexual harassment remains to be clarified and expanded to make it clear that sexual harassment is a form of gender discrimination and can include hostile environment harassment that is not directed against a specific person; the employer's obligations to prevent and correct sexual harassment need further delineation; employers lack guidelines for establishing a fair and effective grievance procedure; the difficulty of proving sexual harassment in litigation remains unsolved; the employer liability doctrine for sexual harassment lacks clarity; workers not in a traditional employment relationship receive inadequate legal protection from work-related sexual harassment.

Conclusions

The issues mentioned above merit consideration in China's future law revisions and judicial practice. In China and other societies where gender inequality remains high, it is recommended to regulate sexual harassment as a form of discrimination and to set clear compliance standards for employers in preventing and correcting sexual harassment.

Crimes Against Women in India: A District-Level Analysis (1991-2011)

Crimes against women (CAW) in India have been rising despite faster economic growth, higher education attainment, and increasing numbers of women in the economic sphere. This article explores the reasons for the incidence of reported CAW in India. We study five CAW (rape, kidnapping, cruelty, dowry deaths, and molestation), across 35 states and union territories, 594 districts, over three decades (1991-2011). We use panel fixed-effects regression models to explain crime. Our results confirm the importance of female literacy rates, female paid workforce participation, and female-male ratio in understanding crime. We find that these commonly-used socioeconomic variables have nonlinear effects on CAW. Our findings improve upon earlier results that have not explored either spatial distribution or nonlinearity in India. These findings could have significant implications for the policies aiming to reduce CAW.

Lifetime Prevalence of Victimization and Perpetration as Related to Men's Health: Clinical Insights

Violence is a known risk factor for health problems. In this epidemiological study across 5,385 male patients, we investigate the prevalence of perpetrated violence, exposure to violence, their overlap and the relationship between violence, mental, and psychosomatic health, as well as adverse health behaviors, such as self-harming behavior and the consumption of drugs. Participants completed an anonymous questionnaire addressing violence experience (i.e., both expose and perpetration), age of victimization/perpetration, frequency, and perceived severity of violence exposure. We considered physical, psychological as well as sexual violence. Information on health status and adverse health behaviors complemented the data. Results showed that 48.4% of the sample reported having experienced violence (perpetration, victimization, or both). The victim-perpetrator overlap formed the largest group, in which the incidence of having experienced multiple types of violence was significantly higher compared to victims and perpetrators. The age-crime curve flattened more slowly with increasing age in this group. Although the perceived severity of exposure to violence is lower in the overlap group, its health status and adverse health behaviors were worse. Interventions should focus on this group since they constitute a burden for the healthcare system.

Physical Harm Reduction in Domestic Violence: Does Marijuana Make Assaults Safer?

Studies on the effect of marijuana on domestic violence often suffer from endogeneity issues. To examine the effect of marijuana decriminalization and medical marijuana legalization on serious domestic assaults, we conducted a difference-in-differences analysis on a panel dataset on NIBRS-reported assaults in 24 states over the 12 years between 2005 and 2016. Assaults disaggregated according to situation and extent of injury were employed as dependent variables. We found that while the total number of assaults did not change, decriminalization reduced domestic assaults involving serious injuries by 18%. From a harm reduction perspective, these results suggest that while the extensive margin of violence did not change, the intensive margin measured by the seriousness of assaults were substantially affected by decriminalization. This result may be partially explained by reductions in offender alcohol intoxication and weapon-involved assault.

The Impact of National-Level Gender Inequality on the Sexual Abuse of Girls

Feminist scholars from various social science disciplines posit that gender inequality (GI) is harmful to women's well-being. Feminist criminologists argue that GI is criminogenic, especially of sexual violence. I apply this framework to a specific form of sexual violence: child sexual abuse (CSA). Using multilevel generalized linear modeling to analyze the responses of 10,106 women from 27 countries in the International Dating Violence Study, I test for significant associations between national-level GI and self-reported retrospective reports of CSA. While controlling for other risk factors, I find that GI is significantly associated with increased odds of having experienced CSA among women.

Intimate Partner Violence: Innovations in Theory to Inform Clinical Practice, Policy, and Research

Intimate partner violence (IPV) and intergenerational transmission of IPV in families are destructive social issues in need of considerable attention. Knowledge of the multi-level, complex causes, and consequences of IPV in the United States has increased significantly over the last two decades. Given these gains in learning, the authors’ aim here is to highlight recent critical and emerging theoretical perspectives on IPV. Frameworks included for application are intersectionality theory, historical trauma and decolonization, human rights, constructivist self-development theory, the posttraumatic growth paradigm, and adverse childhood experiences. This discussion will help to illuminate the dynamics of IPV that are actionable by practitioners using frameworks that promote cultural sensitivity, inclusion, and strengths-based practice with diverse populations. The authors discuss the scope of IPV while focusing on critical vulnerable people and exploring issues of relative privilege and oppression. Next, the authors review the historical body of theory informing understandings of IPV, and emerging theoretical frameworks on IPV. We offer conclusions throughout as they relate to the application of highlighted theories to IPV.

Enough of This Nonsense! Rape Is Rape: A Malaysian Perspective

There is an average of five rape cases reported in Malaysia on a daily basis. The problem lies not in the hands of an individual or a few misogynistic men but in society as a whole. It lies in the mind-set of the people and every one of us taking part in rape culture by endorsing rape myths. Rape myth acceptance within the Malaysian society encourages sexual assaults or sexual violence. Some of the popular rape myths are the victim’s choice of clothing, emotional reactions of victims, presence of physical injuries, rape happens between strangers, women lie about rape, and men cannot be raped. These most common rape myths are discussed and then debunked. Subsequently, the aftermath of rape is explained. Proactive actions against rape are also presented as many of the existing school-based programs against rape are lopsided as women are taught on how to avoid rape instead of men being taught to respect women and prevent rape. This article aims to serve as an eye-opener for Malaysian counselors, psychologists, educators, and society as a whole to build up their knowledge, skills, and experience when working or dealing with rape victims.

Theoretical framework and protocol for the evaluation of Strong Through Every Mile (STEM), a structured running program for survivors of intimate partner violence

BACKGROUND

Intimate partner violence can have a devastating impact on victims' psychological and physical health and ability to maintain and preserve interpersonal relationships. The aim of the current study is to empirically test the effectiveness of Strong Through Every Mile (STEM), a 10-week structured running (exercise) program designed to increase psychological, social, and physical well-being among survivors of intimate partner violence. To the authors' knowledge, STEM is the only community-based structured running program designed to improve the quality of life of survivors of intimate partner violence. This paper will describe the STEM program and present the theoretical basis of the program and the program evaluation design.

METHODS

The current study will utilize an interdisciplinary lens to evaluate a community-based intervention aimed at decreasing the negative effects of intimate partner violence on women's lives. The study will use a mixed method approach (qualitative and quantitative), including a pre- and post-test evaluation of the STEM running program. Primary data will be collected using paper and pencil surveys which assess women's psychological, social, and physical well-being prior to participation in the program and following the completion of the program. Qualitative data from focus groups will also be collected and allow for a more rich understanding of the changes that women experience over the course of the program and specific mechanisms underlying these changes.

DISCUSSION

The current study will employ an interdisciplinary lens to examine the extent to which a structured exercise program, specifically running, impacts the psychological, social and physical well-being of women survivors of intimate partner violence. Findings of this study can influence the development and implementation of similar programs for survivors of intimate partner violence and other types of trauma by identifying mechanisms central in achieving positive outcomes for participants.

Assessing Intimate Partner Abuse: Associated Factors and Health Consequences among Jordanian Women

In this cross-sectional study, we assessed levels and types of psychological and physical intimate partner abuse (IPA), and the association of IPA with socio-demographic factors and health consequences. The Abusive Behavior Inventory was completed by 471 Jordanian women. IPA was higher among older women who were: of older age, of younger age at marriage, married to unemployed spouses, living in urban residence, and of lower educational level. IPA was associated with most of the health problems except dental injuries and burns. We recommend educational programs that raise women's awareness to their rights to education, free choices in marital age, and policies that mitigate IPA in Jordan and similar patriarchal societies.

The Monetary Cost of Sexual Assault to Privately Insured US Women in 2013

OBJECTIVES

To determine whether privately insured female rape victims were billed for charges associated with a specific rape in the United States.

METHODS

We examined 2013 de-identified patient data from Truven Analytics Health MarketScan database for an assault that occurred by using International Classification of Diseases, Ninth Revision, code E960.1.

RESULTS

Analysis of insurance providers' payment patterns for 1355 incident events to female victims aged between 16 and 61 years revealed that victims remit, on average, 14% or $948 of the rape cost, whereas insurance providers pay 86% or $5789 of the total cost.

CONCLUSIONS

Hospital billing procedures for privately insured victims of rape across the United States are not separate from billing procedures for privately insured nonrape patients. This standardized procedure leads hospitals to bill victims directly for services not paid under the victims' insurance policy. Public Health Implications. The Violence Against Women Act (passed in 1994, reauthorized in 2000, 2005, and 2013) must be amended to mandate that all costs incurred because of rape are not passed on to the victim.

Sexual Violence Among College Students: An Examination of Individual and Institutional Level Factors Associated With Perpetration

BACKGROUND

Sexual violence incidents involving college students have received media attention and increased awareness of this public health problem in the United States; prevention efforts are needed that target potential perpetrators. We examined characteristics of self-reported perpetrators of sexual violence on campuses.

METHODS

This study used a secondary data analysis of the 2015 College Student Health Survey, an annual survey, which was completed by students attending 17 colleges/universities in Minnesota. The analytic sample included 6,548 18-to 24-year-old college students who answered at least one of two questions assessing perpetration in the past 12 months (i.e., sex/sexual touch without consent). Chi-square tests were used to detect associations between perpetration and individual (e.g., age, race, substance use, victimization) and institutional (e.g., school type, location) level characteristics. Multiple logistic regression analyses identified predictive models for being a perpetrator of sexual violence.

RESULTS

Fifty-two students reported perpetration of sexual violence in the past year, including 29 rapes. Overall, self-reported perpetrators of sexual violence are more likely to be men, to have been a victim in his or her lifetime, to have smoked marijuana in the past 12 months (but not the past month), and to be younger (18 or 19 years old). Institutional level characteristics, including school type and location, did not yield significant associations with perpetration.

DISCUSSION

Sexual violence prevention and response efforts toward college students need to be inclusive, especially targeting individual level factors, and considerate of the victimization-perpetration comorbidity experienced by many students.

The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo

BACKGROUND

Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls' hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced girls.

METHODS

Secondary analysis, using multivariable regression of cross-sectional data from girls ages 10-14 in South Kivu, Democratic Republic of the Congo. Key variables of interest were attitudes toward intimate partner violence (IPV), Children's Hope Scale (CHS) score, and exposure to physical, emotional, and sexual violence within the last 12 months. Additional covariates included age, educational status, and territory.

RESULTS

The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for physical violence (β = -0.09, p = 0.040) and unwanted sexual touching (β = -0.20, p = 0.003) among girls age 10-14, when adjusting for other covariates. The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for forced sex (β = -0.22, p = 0.016) among girls age 13-14, when adjusting for covariates. Findings for emotional violence, any form of sexual violence, and coerced sex trended toward lower CHS scores for girls who reported higher acceptance of IPV, but did not reach significance.

CONCLUSIONS

Findings support the utility of gender norms-transformative programming in increasing resilience of girls who have experienced sexual violence in humanitarian contexts.

Trampled Autonomy: Women, Athleticism, and Health

Philosophical analysis has paid scant attention to the gender inequalities women athletes face compared to the myriad ways in which social science shows that athleticism values masculinity and devalues femininity. Athletic endeavors diverging from gendered norms are sexualized, feminized, devalued, and delegitimized. A philosophical analysis reveals deep and serious double binds constraining women's autonomy to engage and succeed in sport and thus to participate in a major social institution granting status and recognition. More importantly, these constraints to autonomy undermine women's choices to promote and preserve health.

Campus Sexual Violence Resources and Emotional Health of College Women Who Have Experienced Sexual Assault

Institutional characteristics may help mitigate trauma associated with sexual assault. This study examines associations between resources on college campuses for sexual violence prevention and the emotional well-being of female students who have experienced sexual assault. There were 495 female college students who have experienced sexual assault who provided survey data in 2010-2011. Sexual violence resource data from 28 college campuses were combined with student survey data in multilevel analysis. Dependent variables include diagnosis with anxiety, depression, panic attacks, and PTSD, and models adjust for covariates and clustering of students within colleges. Participants attending colleges with more sexual violence resources had lower rates of mental health conditions than those attending colleges with fewer resources. Colleges are encouraged to expand their array of sexual violence resources to create a supportive environment for victims of sexual assault and to connect affected students with appropriate services.

Rape as an Economic Crime: The Impact of Sexual Violence on Survivors' Employment and Economic Well-Being

This article examines how isolated instances of sexual violence affect adult female survivors' employment and economic well-being. This study draws on data from 27 in-depth, qualitative interviews with sexual assault survivors and rape crisis service providers. The findings suggest that sexual assault and the related trauma response can disrupt survivors' employment in several ways, including time off, diminished performance, job loss, and inability to work. By disrupting income or reducing earning power, all of these employment consequences have implications for survivors' economic well-being in the months or years following the assault. In addition, I argue that for many survivors, these employment consequences compound one another and ultimately shift survivors' long-term economic trajectories. By highlighting survivors' lived experiences of the financial aftermath of sexual assault, these findings help to illuminate the processes by which sexual violence decreases survivors' income over the life course. Understanding the financial effects of sexual violence can help researchers better understand and predict the recovery process, while helping practitioners to design more effective interventions for survivors.

The Role of Sexual Violence in Creating and Maintaining Economic Insecurity Among Asset-Poor Women of Color

This article argues that economic instability and sexual violence reinforce each other in two ways. First, the devastating psychological consequences of sexual assault can diminish work performance and disrupt income, creating economic instability, particularly for the asset-poor. Latina and African American women face particular risk due to barriers to appropriate post-assault resources and low rates of asset ownership. Second, income- and asset poverty increase women’s risk for sexual violence and complicate recovery. Women with financial and social resources can leverage these assets to both avoid and recover from sexual assault, whereas women without such resources lack these options. Policy solutions are proposed.

Women’s Land Ownership and Relationship Power

Violence against women is a widespread societal problem substantiated and perpetuated through inequities that operate within numerous levels of the society. Challenging and ending gender-based violence therefore requires addressing social structures that perpetuate gendered hierarchies and maintain women’s susceptibility to experiencing violence worldwide. The present study examines novel approaches taken by women in two different countries in the Global South, one in Nicaragua and another in Tanzania, to examine macro-level processes involved in land ownership in regions where owning land is a marker of dominance. Using data from 492 women, results from structural equation models and qualitative thematic analyses demonstrate significant links among women’s ownership of land, relationship power, and receipt of physical and psychological violence in both the countries. Collectively, the findings suggest that when women own land, they gain power within their relationships and are less likely to experience violence. Implications for theoretical conceptualizations of eradicating violence against women and practical interventions are discussed.

Progress in preventing injuries: a content analysis of national policies in Europe

The aim of this paper is to provide a content analysis of national policies to address violence and injury prevention in the World Health Organization (WHO) European Region so as to inform where future improvements can be made. Multiple search methods were used to identify national policies for violence and injury prevention. Application of a framework based on a WHO guide was used for policy analysis. A multiple correspondence analysis (MCA) was additionally conducted. One hundred and twenty-three national policies were identified; of these, 80 were available in English language and analysed further. Most national policies had been developed after 2003. The majority of policies fulfilled most of the WHO criteria for effective policy-making. Policy areas requiring improvement include quantifying objectives, targeting the socio-economic gap in injury burden and increased focus on primary prevention. Results from the MCA confirmed the ones obtained with the descriptive statistics. Encouraging progress is being made in formulating national policy for violence and injury prevention within the WHO European Region. There are specific areas that warrant increasing attention in future policy development.

Investigating partner abuse among HIV-positive men who have sex with men

High rates of partner abuse (PA) of all types-physical, sexual, and psychological-have been identified in studies of HIV-positive individuals. We examined both the prevalence and correlates of same-sex PA in HIV-positive men who have sex with men (MSM). Participants recruited from public outpatient HIV clinics (N = 168) completed CASI surveys about PA and current physical and mental health. Electronic medical record data were obtained for HIV biomarkers. Results indicate high rates of past year PA (physical, 19%; sexual, 17%; psychological, 51%; any, 54%), with rates comparable to, or higher than, those reported in recent studies of HIV-positive women and older studies of HIV-positive MSM. Overall, participants endorsing past year PA reported poorer mental but not physical health. Participants who endorsed past year physical PA, specifically, reported the largest number of mental health problems. HIV care providers should routinely assess PA, especially physical PA, in all MSM patients.

Applying the Good Lives Model to Male Perpetrators of Domestic Violence

Domestic violence is a pervasive social problem that has devastating emotional, physical, psychological, and financial costs for individuals, families, and communities. Despite the widespread use of current intervention programmes, recent reviews have demonstrated that these have only a small impact on the reduction of recidivism. In this article, we briefly summarise the features identified in the literature that distinguish domestically violent men from those who do not engage in such behaviours. We then explore the most common interventions used to treat domestic violence offenders and discuss the limitations of these interventions, before outlining the assumptions of the Good Lives Model (GLM), a strength-based approach to the treatment of offenders. We discuss the advantages of using the GLM compared to existing approaches and finally, we consider future directions for the use of the GLM in domestic violence interventions.

Violence against women from different relationship contexts and health care utilization in Spain

BACKGROUND

Studies reported an excess of health services utilization among women with violence by an intimate partner (IPV). However, little is known about health utilization by women victims of other forms of interpersonal violence than IPV. This study aimed to determine the effect of violence from different relationship contexts on health care utilization.

METHODS

A cross-sectional study following a multistage cluster sampling scheme was conducted. Women aged 18 to 70 years were randomly selected according to their scheduled health care visit. The number of women invited to participate was 16,419 and 73% accepted. After exclusion, the final sample consisted of 10,815 women. The outcome variables were health care utilization (primary care, specialty services, emergency rooms, and hospital admissions) and the predictor variable was interpersonal violence from different relationship contexts. Multivariable adjusted logistic regression models were conducted to assess the independent effect of each violence relationship context on health care utilization.

MAIN FINDINGS

Compared with never abused women, use of health services was significantly higher for abused women, although the rates varied depending on the violence relationship context. The greatest probability of service use was among women whose abuse was perpetrated by both a partner and others. Comparing the magnitude of effect of each violence category by perpetrators other than a partner, this effect was stronger for violence in a social context in the case of emergency rooms only.

CONCLUSION

Regardless of the perpetrator, lifetime violence increased health services utilization. Violence affects women's behavior in terms of how they use health services.

Intimate Partner Violence and Adverse Health Consequences

Nearly 1 in 4 women and 1 in 13 men experience intimate partner violence (IPV) at some time in their life. Victims of IPV suffer significant negative health consequences because of the physical, sexual, and emotional abuse they have experienced. Elevated risks have been observed for a wide range of adverse health outcomes. Research has substantially improved our understanding of the physiology that underlies the association between violence victimization and an array of adverse health outcomes. Given the high prevalence of IPV and the associated medical consequences and costs of IPV, it is critical to address this public health problem. IPV prevention and intervention can substantially decrease the public health burden of IPV and greatly improve the health of patients being seen in the medical system. Primary care and family physicians are in an ideal position to diagnose victims of IPV and provide the victims and their families the appropriate care that is needed. However, to accomplish this goal, there remains an urgent need to integrate information on IPV into medical and health care curricula, and to train future physicians and other health care providers about the pervasiveness of IPV and the far-reaching implications for patient health.

Sexual violence: psychiatric healing with eye movement reprocessing and desensitization

Sexual violence, which affects one in three women worldwide, can result in significant psychiatric morbidity and suicide. Eye movement desensitization and reprocessing (EMDR) offers health care providers the option of a brief psychiatric intervention that can result in psychiatric healing in as few as four sessions. Because health care providers often hear stories of sexual violence from their patients, they are in an ideal position to make recommendations for treatment. The purpose of this article is to introduce health care providers to the technique of EMDR, review safety and appropriateness, and discuss clinical and research implications.

Sexually harassing behavior against adolescent girls in rural Bangladesh: implications for achieving millennium development goals

This study examines the extent and type of sexually harassing behavior or intimidations unmarried adolescent girls experienced on their way to school, college or social visits and type of perpetrators in victims' view in rural Bangladesh using data of the 2004 National Nutrition Programme baseline survey. The survey collected self-reported data on sexual harassments of 5,106 girls aged 13-19 years selected randomly. Results reveal that gendered harassments were experienced by 35% of the girls, unwanted sexual attentions by 34%, and sexual intimidations by 14%, yielding prevalence of sexual harassments of any type 43%. Higher girls' education and household economic status heightened their risks of being harassed. Perpetrators were male young spoilt bullies (64%), neighborhood youths (30%), students (22%) and hoodlums (6%). High prevalence of sexual harassments mirrors vulnerability of adolescent girls in the community and deserves to be tackled to achieve millennium development goals (MDGs) in gender equality in health and social development.

The essence of healing from sexual violence: a qualitative metasynthesis

A qualitative metasynthesis was conducted to identify the essence of healing from sexual violence, as described by adults who experienced it as children or as adults. Based on the findings of 51 reports, four domains of healing were identified: (a) managing memories, (b) relating to important others, (c) seeking safety, and (c) reevaluating self. The ways of healing within each domain reflected opposing responses. The dialectical process identified for each of the four domains include, respectively: (a) calling forth memories, (b) regulating relationships with others, (c) constructing an "as-safe-as-possible" lifeworld, and (d) restoring a sense of self. These complex processes resulted in a new reality for the participants that was based on a greater sense of agency and provided a more satisfying life course.

Poverty, near-poverty, and hardship around the time of pregnancy

To describe income levels and the prevalence of major hardships among women during or just before pregnancy. We separately analyzed 2002-2006 population-based postpartum survey data from California's Maternal and Infant Health Assessment (n = 18,332) and 19 states participating in CDC's Pregnancy Risk Assessment Monitoring System (n = 143,452) to examine income and several hardships (divorce/separation, domestic violence, homelessness, financial difficulties, spouse/partner's or respondent's involuntary job loss or incarceration, and, in California only, food insecurity and no social support) during/just before pregnancy. In both samples, over 30% of women were poor (income </=100% of federal poverty level [FPL]) and 20% near-poor (101-200% FPL); and around 60% of low-income (poor or near-poor) women experienced at least one hardship. While hardship prevalence decreased significantly as income increased, many non-low-income women also experienced hardships; e.g., in California, 43% of all women and 13% with incomes >400% FPL experienced one or more hardships. These findings paint a disturbing picture of experiences around the time of pregnancy in the United States for many women giving birth and their children, particularly because 60% had previous births. The high prevalence of low income and of serious hardships during pregnancy is of concern, given previous research documenting the adverse health consequences of these experiences and recognition of pregnancy as a critical period for health throughout the life course. Low income and major hardships around the time of pregnancy should be addressed as mainstream U.S. maternal-infant health and social policy issues.

Unexplained and underpowered: the relationship between psychosomatic disorders and interpersonal abuse -- a critical review

Although it is commonly accepted that interpersonal violence (IntPV) leads to adverse health consequences, the available data are far from decisive. To test the hypothesized link, the authors devised an evidence-based strategy to determine the data quality in studies purporting to link IntPV and some medically unexplained disorders in women (irritable bowel syndrome, chronic pelvic pain, fibromyalgia/chronic fatigue, and other chronic pain syndromes). English language studies with control groups of unaffected women were assessed for the quality of their methodologies. The number of studies, together with the consistency of their findings in each domain, was collated to determine the overall weight of evidence regarding the link for each condition. The quantity and quality of research in each clinical area proved to be sparse. In general, most research was limited to small, convenience samples, with insufficient attention to the design of control groups and to sample size. The evidence currently available regarding irritable bowel syndrome, fibromyalgia/chronic fatigue, chronic pelvic pain, and other chronic pain syndromes does not allow for any firm conclusion regarding their link to IntPV. More research - paying particular regard to the methodological concerns identified here - is required in order to generate any definitive conclusions.