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Callaghan LT, Moran G, Brisola D, Blackburn K, Camarena B, Dumbre O, Cain C, Perez-Stable C, Lee T, Seger C, Naik-Mathuria B. Female Victims of Firearm Intimate Partner Violence: Characterization and Lethality Predictors. J Womens Health (Larchmt) 2024. [PMID: 39229718 DOI: 10.1089/jwh.2024.0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
Objective: To characterize the sociological risk factors for firearm intimate partner violence (IPV) among women in Texas, with a focus on lethal predictors to aid in screening and intervention guidelines. Methods: A retrospective medical and forensic chart review was conducted and supplemented by news sources, public police reports, and court records on firearm cases in Houston, TX, from 2018 to 2020. IPV was defined as a cis-gendered female victim of firearm violence from a current or ex-intimate partner. Non-IPV was defined as cis-gendered female victims of firearm violence from strangers, friends/acquaintances, gang, client, or similar relationships. Numeric variables were compared using the Wilcoxon rank-sum test and reported as median [Q1, Q3]. Categorical variables were compared using Fisher's exact test and reported as count (%). Results: A total of 102 cases of IPV were identified. Nonspousal IPV was more prevalent than spousal (65.7% versus 34.3%). Lethal injuries, older age, home location, and head injuries were more prevalent in the IPV cohort. Older age, spousal perpetrator, home shooting location, and history of prior domestic abuse were associated with lethal IPV. There were 31 cases of murder-suicide. During the COVID-19 pandemic, IPV cases increased by 91.3%, with lethal cases increasing by 57.6%. Conclusion: Risk factors for overall IPV and lethal IPV are not the same; therefore, it is imperative that all women, irrespective of race, age, or relationship status, be screened for IPV and prior domestic violence to allow intervention and prevention of lethal IPV. Patients should also be screened for personal or partner access to firearms as firearm IPV is a highly lethal form of violence.
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Affiliation(s)
| | - Gracen Moran
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Deborah Brisola
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Kyle Blackburn
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Belia Camarena
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | - Cary Cain
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | - Tiffany Lee
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Catherine Seger
- Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Bindi Naik-Mathuria
- Department of Pediatric Surgery, University of Texas Medical Branch, Galveston, Texas, USA
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Pebole MM, Iverson KM, Bolduc CM, Joyce JM, Sablone CA, Fortier CB. Examining the Utility of Veterans Health Administration (VHA) Traumatic Brain Injury Screening among Women Veterans: Recommendations for Expansion to Include Interpersonal Violence. Brain Sci 2024; 14:814. [PMID: 39199505 PMCID: PMC11352346 DOI: 10.3390/brainsci14080814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024] Open
Abstract
Women veterans (WVs) are more likely than men veterans to experience traumatic brain injury (TBI) from causes unrelated to deployment. Yet, current Veterans Health Administration (VHA) TBI screening focuses on deployment. This study examines the utility of the VHA TBI screening tool for WVs. Using the Boston Assessment for TBI-Lifetime (BAT-L) as the gold standard, sensitivity and specificity of the VHA screen were identified for deployment and non-deployment injuries. Injuries missed by the screen were thematically described. Sensitivity and specificity were compared by context (research, clinical). Ninety WVs were included; fifty-three (60.9%) met TBI criteria per the BAT-L. For TBIs occurring during deployment, sensitivity was higher in research (89.1%) compared to clinics (61.7%); specificity was lower in research (60.7%) compared to clinics (93.0%). The BAT-L identified 27 non-deployment TBIs not captured by the VHA screen, most frequently from physical assault or sports. The VHA screen does not include non-deployment events; thus, non-deployment sensitivity and specificity could not be calculated. For lifetime TBIs (deployment + non-deployment etiologies), sensitivity was higher in research (73.5%) compared to clinics (48.9%). Specificity was lower in research (60.0%) compared to clinics (100.0%). Findings can inform improvements to TBI screening among WVs, including expansion for interpersonal violence.
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Affiliation(s)
- Michelle M. Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Jamaica Plain, Boston, MA 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Katherine M. Iverson
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
| | - Caitlin M. Bolduc
- The Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Jamaica Plain, Boston, MA 02130, USA
| | - Julie M. Joyce
- The Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Jamaica Plain, Boston, MA 02130, USA
| | - Caroline A. Sablone
- The Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Jamaica Plain, Boston, MA 02130, USA
| | - Catherine B. Fortier
- The Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Jamaica Plain, Boston, MA 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
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Silima M, Christofides N, Franchino-Olsen H, Woollett N, Meinck F. "I've accepted it because at the end of the day there is nothing, I can do about it": A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002588. [PMID: 38709813 PMCID: PMC11073682 DOI: 10.1371/journal.pgph.0002588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/08/2024] [Indexed: 05/08/2024]
Abstract
In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often co-occurring and create complex adversities for women. Recognising these intersections and the broader socio-cultural dynamics at play is crucial to understanding the layered experiences of these women and developing effective interventions. This research explores the experiences of the women living with at least two of the epidemics (HIV, IPV and or MH) and how they cope. A qualitative study design was used and 20 women (22-60 years) were recruited from Mpumalanga, South Africa. To be eligible for the study the women had to have experienced at least two of the epidemics. Data were collected through home-based interviews, arts-based activities, and analysed thematically using MAXQDA (2022) software. MH challenges were prevalent among all the participants and were linked to both IPV and HIV, resulting in symptoms such as anxiety, depression, and suicidal thoughts. In relation to the HIV-MH link, MH challenges in this combination included feelings of denial, sadness and anxiety related to participant's HIV diagnosis. A bidirectional relationship also existed in the IPV-MH group where pre-existing MH challenges among women increased their vulnerability of having violent partners, whilst IPV also increased MH challenges. In the IPV-MH-HIV group early childhood violence exposure was linked with MH challenges and later victimization and vulnerability to HIV. Participants primarily used religion, acceptance, occasional alcohol, and family support as coping strategies. Particularly in IPV situations, alcohol use/misuse was the most prevalent coping strategies. The study highlights the syndemic relationship between HIV, IPV and MH challenges among South African women living in a peri-urban community, with a central emphasis on MH challenges. Interventions should holistically address these challenges, with particular focus on MH challenges, cultural sensitivity, and promotion of healthy coping strategies.
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Affiliation(s)
- Mpho Silima
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Hannabeth Franchino-Olsen
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Nataly Woollett
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Visual Arts, University of Johannesburg, Johannesburg, South Africa
| | - Franziska Meinck
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
- School of Health Sciences, North-West University, Vanderbijlpark, South Africa
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Weaver DF. Thirty Risk Factors for Alzheimer's Disease Unified by a Common Neuroimmune-Neuroinflammation Mechanism. Brain Sci 2023; 14:41. [PMID: 38248256 PMCID: PMC10813027 DOI: 10.3390/brainsci14010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024] Open
Abstract
One of the major obstacles confronting the formulation of a mechanistic understanding for Alzheimer's disease (AD) is its immense complexity-a complexity that traverses the full structural and phenomenological spectrum, including molecular, macromolecular, cellular, neurological and behavioural processes. This complexity is reflected by the equally complex diversity of risk factors associated with AD. However, more than merely mirroring disease complexity, risk factors also provide fundamental insights into the aetiology and pathogenesis of AD as a neurodegenerative disorder since they are central to disease initiation and subsequent propagation. Based on a systematic literature assessment, this review identified 30 risk factors for AD and then extended the analysis to further identify neuroinflammation as a unifying mechanism present in all 30 risk factors. Although other mechanisms (e.g., vasculopathy, proteopathy) were present in multiple risk factors, dysfunction of the neuroimmune-neuroinflammation axis was uniquely central to all 30 identified risk factors. Though the nature of the neuroinflammatory involvement varied, the activation of microglia and the release of pro-inflammatory cytokines were a common pathway shared by all risk factors. This observation provides further evidence for the importance of immunopathic mechanisms in the aetiopathogenesis of AD.
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Affiliation(s)
- Donald F Weaver
- Krembil Research Institute, University Health Network, Departments of Medicine, Chemistry, Pharmaceutical Sciences, University of Toronto, Toronto, ON M5T 0S8, Canada
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Sedgewick AE, Wang CL, Levine EA, Greenfield SF, Sugarman DE. Recovering Safety: A Pilot Study of a Women's Empowerment Group for Survivors of Intimate Partner Violence with Substance Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2023; 42:62-75. [PMID: 38370979 PMCID: PMC10871666 DOI: 10.1080/07347324.2023.2272799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This pilot study examined the feasibility and satisfaction of the Recovering Safety group, an outpatient empowerment, psychoeducational skills group for women with substance use disorders (SUDs) who have experienced intimate partner violence (IPV). Patient satisfaction, empowerment, and safety were assessed at three time points. Participants (N=8) reported high satisfaction with the group and rated the IPV-informed content, women-only participants, and female therapist as important factors; empowerment increased from pre- to post group. These results support initial feasibility; further study of such treatments is needed to examine efficacy of this group intervention.
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Affiliation(s)
- Amanda E. Sedgewick
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Callie L. Wang
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
| | - Emily A. Levine
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
| | - Shelly F. Greenfield
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Dawn E. Sugarman
- Division of Alcohol, Drugs, and Addiction and the Division of Women’s Mental Health McLean Hospital, Belmont, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Dams-O'Connor K. Cardiovascular disease after traumatic brain injury: the heart of the matter. Lancet Neurol 2023; 22:878-879. [PMID: 37739565 DOI: 10.1016/s1474-4422(23)00312-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Kristen Dams-O'Connor
- Brain Injury Research Center, Department of Rehabilitation and Human Performance, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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West NS, Kussaga F, Rittenhouse A, Duroseau B, Knight D, Mbwambo J, Likindikoki S, Saleem HT. From trauma to transmission: exploring the intersection of adversity, substance use, and HIV risk in women's life histories. Int J Equity Health 2023; 22:174. [PMID: 37658358 PMCID: PMC10474777 DOI: 10.1186/s12939-023-01994-4] [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: 05/27/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND At increased risk for poor health outcomes, physical and/or sexual violence, and onward transmission of HIV, women who use drugs and are living with HIV (WWUDHIV) are vulnerable and in need of services. Understanding the role of trauma across their life history may offer insights into HIV and drug use prevention and opportunities for intervention. We explored trauma and drug use among WWUDHIV in Dar es Salaam, Tanzania. METHODS We conducted in-depth interviews with 30 WWUDHIV from January-March 2019. Interviewers used semi-structured interview guides and asked questions about the life history as related to drug use. Interviews were audio recorded, transcribed, translated, coded, and life histories charted. We utilized content analysis. RESULTS Participants described death of family members as traumatic catalysts for drug use. Sexual partners early in their life history were often the point of introduction to drugs and source of HIV acquisition. Death of partners was present across many life histories and was a traumatic event negatively influencing life trajectories, including start of sex work for survival or to support drug use. Sex work in-turn often led to traumatic events including sexual and/or physical violence. HIV diagnosis for many participants followed the start of drug use, frequently occurred during pregnancy or severe illness and was described by most participants as a trauma. Despite this, particularly during pregnancy, HIV diagnosis was a turning point for some participant's desire to engage in drug use treatment. Traumatic events were often cumulative and regularly described as catalysts for poor mental health that could lead to new or increased drug use for coping. CONCLUSIONS These findings suggest trauma is common in the life history of WWUDHIV and has negative impacts on drug use and HIV vulnerability. Our life history charting highlights the cumulative and cyclical nature of trauma and drug use in this population. This study allows for better understanding of trauma, drug use, and HIV prevention, which offers opportunities for intervention among a group with limited access to services: during adolescence for orphaned youth, following the death of a child or partner, and when vulnerable women engage with the health system (HIV diagnosis, pregnancy, illness).
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Affiliation(s)
- Nora S West
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Frank Kussaga
- Internal/Preventive Medicine, Griffin Hospital, Derby, CT, USA
| | - Alex Rittenhouse
- Department of Environmental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Deja Knight
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jessie Mbwambo
- Department of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Samuel Likindikoki
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Haneefa T Saleem
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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