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In a national survey of 7409 surgical residents, 32% reported discrimination based on their self-identified gender, 32% verbal or physical abuse, 10% sexual harassment, and 38% burnout symptoms. Mistreatment was more frequently reported by female residents, and burnout symptoms were more common among residents who reported mistreatment.

Workplace physical violence against health care professionals perpetrated by patients and visitors has been a persistent problem worldwide. Prevalence estimates varied vastly across studies and there was a lack of quantitative syntheses of prevalence studies. This review aimed to quantify pooled one-year prevalence estimates at the global and regional levels. A systematic literature search was performed in the databases of PubMed, PsycINFO, Web of Science, and Embase between 1 January 2000 and 8 October 2018. Studies providing information about one-year prevalence of self-reported workplace physical violence against health care professionals perpetrated by patients or visitors were included. Heterogeneity between studies was evaluated using Cochran’s chi-squared test (Cochran’s Q) and I2 values. Subgroup analysis and meta-regression were used to explore heterogeneity. A total of 65 eligible studies reported one-year prevalence estimates for 61,800 health care professionals from 30 countries. The pooled one-year prevalence of workplace physical violence against health care professionals perpetrated by patients or visitors was 19.33% (95% confidence interval (CI): 16.49–22.53%) and the overall heterogeneity was high across studies. We noted geographic and staff categories variations for prevalence estimates through subgroup analysis. The meta-regression showed that sample size, type of health care setting, and quality score were significant moderators for heterogeneity. One in five health care professionals experienced workplace physical violence perpetrated by patients or visitors worldwide annually. Practical intervention was needed to ensure safety of health care professionals.

Intimate partner violence is a thoughtful public health concern and human rights violation towards pregnant women for it has a significant negative health effect on the life of both the mother and her fetus. However, there is a scanty of information about the extent of intimate partner violence during pregnancy in Ethiopia, particularly in the study area. Therefore, the current study was conducted to determine the prevalence of intimate partner violence among pregnant women attending antenatal care and identify associated factors that cause it. An institution based cross-sectional study was conducted on 409 pregnant women who were attending antenatal care service in Debre Markos town from March 17, 2018 -April 28, 2018. Systematic random sampling technique was used to select study participants. A pre-tested structured questionnaire was used to collect the data. Bivariable and Multivariable logistic regression models were done. Adjusted odds ratio with 95% confidence interval was used to identify factors associated with intimate partner violence during pregnancy. The prevalence of intimate partner violence during current pregnancy was found to be 41.1% (95% confidence interval (CI): 36.0-46.0). Of this, the prevalence of psychological, physical, and sexual violence was 29.1%, 21%, 19.8% respectively. Lower educational status of partners (AOR = 3.26, 95%CI: 1.45-7.36), rural residency (AOR = 4.04, 95%CI: 1.17-13.93), frequent alcohol abuse by partner (AOR = 4.79, 95% CI: 2.08-11.04), early initiation of antenatal care (AOR = 0.44, 95% CI: 0.24-0.81), the age of women between 17-26 years (Adjusted odds ratio (AOR) = 0.21, 95%CI: 0.09-0.49),choice of partner by the women only (AOR = 3.26,95% CI:1.24-8.57) were statistically significant factors associated with intimate partner violence towards pregnant women. In this study, the prevalence of intimate partner violence during pregnancy is found to be high. As a result, interventions that would address the above mentioned factors need to be implemented.

Background This study described exposure to abuse (emotional, sexual, and physical) against Latinas in the seasonal farmworker community, and visualized associations of exposure at three time points (past-month, past-12 months, and lifetime) with social network structures. Methods Data were collected from 260 Latina seasonal farmworkers in South Florida between 2015 and 2016; the data included 20 friendship networks, each with 13 participants. Chi-square and ANOVA tests describe participants’ characteristics. To evaluate the total number of friendship connections (e.g., ties) an individual (e.g., node), had to the other nodes in a network, R was used to calculate degree centrality. Visone and Cytoscape software were then used to create social network visualizations for each of the sociocentric networks. Results Non-U.S. born respondents reported experiencing some form of abuse more often than U.S. born respondents (e.g., 69.7% vs. 13.8% for lifetime emotional abuse). Across all forms of abuse and time points, the prevalence of abuse perpetuated by husbands was the largest, except for lifetime sexual abuse, which was led by close family members (26.8% vs. 21.1%). Network visualizations show that participants who reported lifetime emotional abuse tended to cluster together in their social networks. Cases for the three forms of abuse were present in all networks. Conclusions By understanding how women from an undeserved population who have experienced these forms of abuse are linked through their friendship network structures, interventionalists can better identify the role of intimate partner violence in HIV/STD risk reduction interventions, targeted reproductive health approaches, and empower women to report abuse. Network visualizations can be used in process evaluations by informing how to restructure network configurations.

We sought to estimate the prevalence, severity and identify predictors of violence among adolescent girls and young women (AGYW) in informal settlement areas of Nairobi, Kenya, selected for DREAMS (Determined Resilient Empowered AIDS-free, Mentored and Safe) investment. Data were collected from 1687 AGYW aged 10-14 years (n = 606) and 15-22 years (n = 1081), randomly selected from a general population census in Korogocho and Viwandani in 2017, as part of an impact evaluation of the \"DREAMS\" Partnership. For 10-14 year-olds, we measured violence experienced either in the past 6 months or ever using a different set of questions from those used for 15-22 year-olds. Among 15-22 year-olds we measured prevalence of violence, experienced in the past 12 months, using World Health Organization (WHO) definitions for violence typologies. Predictors of violence were identified using multivariable logit models. Among 606 girls aged 10-14 years, about 54% and 7% ever experienced psychological and sexual violence, respectively. About 33%, 16% and 5% experienced psychological, physical and sexual violence in the past 6 months. The 10-14 year old girls who engaged in chores or activities for payment in the past 6 months, or whose family did not have enough food due to lack of money were at a greater risk for violence. Invitation to DREAMS and being a non-Christian were protective. Among 1081 AGYW aged 15-22 years, psychological violence was the most prevalent in the past year (33.1%), followed by physical violence (22.9%), and sexual violence (15.8%). About 7% experienced all three types of violence. Severe physical violence was more prevalent (13.8%) than moderate physical violence (9.2%). Among AGYW aged 15-22 years, being previously married/lived with partner, engaging in employment last month, food insecure were all risk factors for psychological violence. For physical violence, living in Viwandani and being a Muslim were protective; while being previously married or lived with a partner, or sleeping hungry at night during the past 4 weeks were risk factors. The odds of sexual violence were lower among AGYW aged 18-22 years and among Muslims. Engaging in sex and food insecurity increased chances for sexual violence. Prevalence of recent violence among AGYW is high in this population. This calls for increased effort geared towards addressing drivers of violence as an early entry point of HIV prevention effort in this vulnerable group.

Background Recently WHO researchers described seven dimensions of mistreatment in maternity care that have adverse impacts on quality and safety. Applying the WHO framework for quality care, service users partnered with NGOs, clinicians, and researchers, to design and conduct the Giving Voice to Mothers (GVtM)–US study. Methods Our multi-stakeholder team distributed an online cross-sectional survey to capture lived experiences of maternity care in diverse populations. Patient-designed items included indicators of verbal and physical abuse, autonomy, discrimination, failure to meet professional standards of care, poor rapport with providers, and poor conditions in the health system. We quantified the prevalence of mistreatment by race, socio-demographics, mode of birth, place of birth, and context of care, and describe the intersectional relationships between these variables. Results Of eligible participants ( n  = 2700), 2138 completed all sections of the survey. One in six women (17.3%) reported experiencing one or more types of mistreatment such as: loss of autonomy; being shouted at, scolded, or threatened; and being ignored, refused, or receiving no response to requests for help. Context of care (e.g. mode of birth; transfer; difference of opinion) correlated with increased reports of mistreatment. Experiences of mistreatment differed significantly by place of birth: 5.1% of women who gave birth at home versus 28.1% of women who gave birth at the hospital. Factors associated with a lower likelihood of mistreatment included having a vaginal birth, a community birth, a midwife, and being white, multiparous, and older than 30 years. Rates of mistreatment for women of colour were consistently higher even when examining interactions between race and other maternal characteristics. For example, 27.2% of women of colour with low SES reported any mistreatment versus 18.7% of white women with low SES. Regardless of maternal race, having a partner who was Black also increased reported mistreatment. Conclusion This is the first study to use indicators developed by service users to describe mistreatment in childbirth in the US. Our findings suggest that mistreatment is experienced more frequently by women of colour, when birth occurs in hospitals, and among those with social, economic or health challenges. Mistreatment is exacerbated by unexpected obstetric interventions, and by patient-provider disagreements.

In China, medical staff of children's hospitals are commonly exposed to violence. However, few studies on medical violence are conducted in the settings of children's hospitals. The aim of this study is to assess the incidence, magnitude, consequences, and potential risk factors of workplace violence (WPV) against medical staff of children's hospitals. A retrospective cross-sectional design was used. A self-administered questionnaire was utilized to collect data on 12 children's hospitals. The questionnaires were distributed to a stratified proportional random sample of 2,400 medical staff; 1,932 valid questionnaires were collected. A chi-square test and multiple logistic regression analysis were conducted. A total of 68.6% of respondents had experienced at least one WPV incident involving non-physical and/or physical violence in the past year. The perpetrators were mainly family members of patients (94.9%). Most of the WPV occurred during the day shift (70.7%) and in wards (41.8%). Males were 1.979 times (95% CI, 1.378 to 2.841) more likely than females to experience physical violence. Emergency departments were more exposed to physical violence than other departments. Oncology was 2.733 times (95% CI, 1.126 to 6.633) more exposed to non-physical violence than the emergency department. As a result of WPV, victims felt aggrieved and angry, work enthusiasm declined, and work efficiency was reduced. However, only 5.6% of the victims received psychological counseling. Medical staff are at high risk of violence in China's children's hospitals. Hospital administrators and related departments should pay attention to the consequences of these incidents. There is a need for preventive measures to protect medical staff and provide a safer workplace environment. Our results can provide reference information for intervention strategies and safety measures.

ObjectiveTo examine associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) athletes.MethodsThe study population consisted of all athletes (n=402) selected for a Swedish Athletics team between 2011 and 2017. Data on suicidal ideation, suicidal events (estimated through the 1 year non-sports injury prevalence), lifetime abuse experiences, sociodemographics, sense of coherence and coping strategies were collected using a cross-sectional survey. The data were analysed using binary logistic regression with suicidal ideation and non-sports injury as outcomes.Results192 athletes (47.8%) returned data. The prevalence of suicidal ideation was 15.6% (men 17.4%; women 14.2%) and the non-sports injury prevalence was 8.0% (men 11.6%; women 5.7%). Among women, suicidal ideation was associated with having been sexually abused (OR 5.94, 95% CI 1.42 to 24.90; p=0.015) and lower sense of coherence (OR 0.90, 95% CI 0.85 to 0.96; p=0.001) (Nagelkerke R2=0.33). Among men, suicidal ideation was only associated with use of behavioural disengagement for coping (OR 1.51, 95% CI 1.18 to 1.95; p=0.001) (R2 =0.25). Among women, non-sports injury prevalence was associated with having been sexually abused (OR 8.61, 95% CI 1.34 to 55.1; p=0.023) and participating in an endurance event (OR 7.37, 95% CI 1.11 to 48.9; p=0.039 (R2 =0.23), while among men, having immigrant parents (OR 5.67, 95% CI 1.31 to 24.5; p=0.020) (R2 =0.11) was associated with injury outside sports.ConclusionsAbout one out of six international athletics athletes reported having experienced suicidal ideation. World Athletics and National Olympic Committees need to include suicide prevention in their athlete protection programmes.

Background International reports indicating that around 10–50% of health care staff are exposed to violence every year; in certain settings, this rate might reach over 85%. Evidence has shown that people who experience psychological violence are seven times as likely to be victims of physical violence. Although there have been numerous studies on WPV in general hospitals, there is no consensus regarding the current status of psychological violence directed at health care workers in township hospitals in China. The purpose of this study was to estimate the prevalence and the risk factors of psychological violence in Chinese township hospitals. Methods A retrospective cross-sectional survey of township hospitals general practitioners and general nurses was conducted in Heilongjiang Province, China.Descriptive analyses and binary logistic regression analysis were used to estimated the prevalence and the risk factors of psychological violence. Results Regardless of whether the assessment period was the past 12 months, past 36 months, or during their entire career,GPs and nurses reported that verbal abuse was the most common type of psychological violence (28.05, 30.28, 38.69 and 40.45%, 43.86, 54.02%).The main perpetrator was patients’ relatives. Most participants responded to violence with “pretend nothing happened”, 55.63% of GPs and 62.64% of nurses reported that the perpetrator received no punishment. Around 47.62% of respondents reported that their workplace had no procedures for reporting violence. When workplaces did have a reporting system, 57.73% knew how to use them. Only 36.98% had training in managing aggression and violence. General nurses, individuals 35 years or younger, those with higher professional titles and who work in shifts are at greater risk of psychological violence. Conclusions Our results indicate a high prevalence of psychological violence in Chinese township hospitals, which can no longer be ignored. Effective measures should be taken to prevent and respond to workplace violence(WPV), especially psychological violence. Trial registration (Project Identification Code: HMUIRB20160014), Registered May 10, 2016.

Background. A history of childhood abuse may affect people’s health and criminal justice system involvement. Understanding the prevalence of childhood abuse among individuals in prison is important to inform effective and appropriate correctional services. Objectives. To review and summarize data on the prevalence of childhood abuse among people experiencing imprisonment in Canada. Search Methods. We searched for studies in bibliographic indexes, reference lists, and gray literature, and we consulted experts. Selection Criteria. We included studies published since 1987 that reported data on prevalence of a history of abuse before the age of 18 years among people in Canadian prisons, including any abuse, physical abuse, sexual abuse, emotional abuse, and neglect. Data Collection and Analysis. Two authors independently reviewed titles and abstracts for eligibility and reviewed full texts for eligibility. Analyses included summary estimates and meta-regression with random effects. Main Results. The search identified 1429 records. We included 34 unique studies in our review and 29 nonoverlapping studies in our meta-analysis. The summary prevalence for any type of childhood abuse was 65.7% (95% confidence interval [CI] = 52.6, 77.7; range = 56.2% to 75.0%) among women; only one study reported the prevalence among men (35.5%). The summary prevalence of sexual abuse was 50.4% (95% CI = 33.5, 67.2; range = 9.9% to 77.3%) among women and 21.9% (95% CI = 15.7, 28.8; range = 8.3% to 55.6%) among men. The prevalence of neglect was 51.5% (95% CI = 43.1, 59.7; range = 45.5% to 65.1%) among women and 42.0% (95% CI = 12.7, 74.6; range = 6.8% to 99.0%) among men. The prevalence of physical abuse was 47.7% (95% CI = 41.3, 54.0; range = 16.3% to 83.0%), and the prevalence of emotional abuse was 51.5% (95% CI = 34.8, 67.9; range = 8.7% to 96.0%); we did not find differences according to gender. Prevalence estimates for all types of abuse showed high and unexplained variability across studies. Conclusions. Half of people in prisons in Canada experienced abuse in childhood. Public Health Implications. Prisons should incorporate trauma-informed approaches. Research is required to understand the association between a history of childhood abuse and criminal justice system involvement and to prevent childhood abuse and mitigate its adverse effects. Systematic Review Registration. PROSPERO CRD42017056192.