A Research report submitted to the Faculty of Health Sciences at the University of the Witwatersrand in partial fulfillment of Master of Medicine in Emergency Medicine Johannesburg, 2016 / Objective Intimate partner violence (IPV) is a significant social and health concern in South Africa, with far reaching consequences. One in three South African women will experience IPV, and many of the survivors of IPV will have contact with Emergency Care Practitioners (ECPs), either for treatment related to the direct sequelae of the abuse or for other health issues. ECPs already play a role in identifying and managing IPV but current knowledge, attitudes and practices were not known. The aim of the study therefore was to describe current levels of knowledge, attitudes and practices regarding IPV amongst ECPs, including doctors, nurses and paramedics in South Africa and to describe differences according to the respondent's reported prior training and profession. Methods A prospective, cross sectional study was performed using an online survey administered anonymously to ECPs in South Africa. Information regarding demographic data, qualification, prior IPV training, knowledge, attitudes and practices towards IPV were obtained. Results One hundred and fifty three respondents completed the survey. Of those 56% were doctors, 33% paramedics and 9.8% nurses. In total 65% reporting having received no training on IPV. There was a significant association between respondents reporting having received any IPV training and improved self-reported knowledge (p=0.0001), and actual knowledge (p=0.011). Of the respondents in clinical practice 75% had diagnosed IPV in the last six months, although the frequency of diagnoses being made is lower than would be suggested by the South African prevalence rates. Those respondents who reported any prior training on IPV were more likely to have diagnosed IPV in the last 6 months (p= 0.0076) Most of the ECPs who diagnosed IPV counselled the patients on options and/or referred to police and/or social workers. Conclusion Although ECPs are diagnosing and managing IPV, training in this important health concern is inadequate. Any reported training on IPV for ECPs improves self-reported knowledge, actual knowledge and practices regarding IPV. / MT2017

Thesis advisor: Natana DeLong-Bas / This thesis analyzes intimate partner violence (IPV, also referred to as domestic violence) in Muslim communities in the U.S. from a legal, psychological, and theological perspective. IPV is a global issue—it is in no way confined to one ethnicity or religion. However, every community has its own set of challenges to face when dealing with IPV. This thesis assesses the risk factors that may be present in Muslim communities in the U.S.— risk factors include behaviors and beliefs that may harm victims of IPV as they seek help, support, and safety. It is equally important to assess sources of strength found within the community that help victims fight oppression, re-gain self-esteem, live in safety, and face their experiences of IPV with a resilient spirit. This thesis is a resource for all advocates who work with Muslim IPV victims and will enable them to use an Islamic framework to help bring healing and restoration to survivors of IPV. / Thesis (BA) — Boston College, 2016. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Arts and Sciences Honors Program. / Discipline: Theology.

Thesis advisor: Lisa Goodman / As domestic violence (DV) shelters have proliferated across the country over the last three decades, there has been a corresponding increase in the number of rules to which shelter residents must adhere. This qualitative content analysis study represents the first research to explore IPV survivors' experiences living with emergency DV shelter rules. Eight clusters emerged from interviews with 11 survivors: 1) Entering the shelter in a vulnerable state; 2) Perceiving staff-resident relationships as empowering or disempowering; 3) Making sense of the rules in the context of these relationships; 4) Experiencing staff enforcement as collaborative or hierarchical; 5) Experiencing the rules' impact on daily life; 6) Coping with rules; 7) Coping in the shelter generally; and 8) Making recommendations. Results suggest that less boundaried staff-resident relationships, less restrictive rules, and flexible, consistent, and collaborative enforcement lead to more positive experiences for residents. Recommendations are made for shelter practice and future research. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

Influente político, autor de diversos livros e industrial de sucesso, o general José Vieira Couto de Magalhães (1837-1898) foi um dos raros homens de seu tempo que deixou registradas preciosas informações cotidianas quanto aos medicamentos e cuidados com seu próprio corpo na busca por reestabelecer a saúde. Suas anotações pessoais corresponderam a dois momentos distintos de sua vida. Primeiro ao início da década de 1880, quando vivia sempre muito incomodado pela frequente dificuldade de digestão. Nessa fase, Couto demonstrou estar mais interessado em se medicar a partir da leitura de compêndios de medicina. Posteriormente, entre os anos 1887-1890, o general escreveu um caderno de anotações onde redigiu breves referências sobre o diagnóstico de sífilis dado a ele por dois médicos que estiveram em sua casa, quando tinha 52 anos e era presidente da Província de São Paulo. Doença incurável e fortemente atrelada à moral, a sífilis era então associada à prostituição e considerada uma das causas da degeneração da prole. Bastante debilitado quando estava no estágio terciário da sífilis, o general se consultou com os melhores médicos do Brasil e também da França, onde esteve por duas vezes a tratamento. Na tentativa de compreender qual teria sido o sentido desse diagnóstico para um homem de alta projeção social, eu me deparo nesse trabalho com algumas questões caras para a época. Uma delas diz respeito à vida nem sempre fácil e muito menos prestigiada dos médicos os mesmos que por muito tempo foram analisados a partir de um enfoque predominantemente foucaultiano como sendo detentores de um poder disciplinar sobre a sociedade. Para trabalhar com a história de vida e as anotações do general Couto de Magalhães e, acima de tudo, com os silêncios contidos em seus escritos, procuro cruzar informações dos diários com alguns periódicos, teses e livros de medicina da época. / As an influential politician and a successful industrialist, and having written a number of books, General José Vieira Couto de Magalhães (1837-1998) was one of the few men of his time leaving a register with precious information about everyday life concerning medicine and body care aiming to the restoring of health. His personal notes correspond to two different moments of his life. Firstly, to the beginning of the 1880s, when he was affected by digestion problems. In this phase, Couto demonstrated more interest in self-medication based on the reading of medical compendiums. Afterwards, between 1887 and 1890, the General kept a notebook in which he wrote brief reference notes on the syphilis diagnosis he was given at home by two doctors. At this time he was 52 and used to be the president of the Province of São Paulo. Incurable and closely related to moral issues, syphilis was then associated with prostitution, being considered one of the causes of degeneration in offspring. At the third stage of the disease, the General was quite impaired and thus had appointments with the best physicians in Brazil as well as in France, where he travelled to twice during the treatment. In an attempt to understand the implications of such diagnosis for a man in a high social position, this study faces crucial issues for that time period. One of them concerns the usually difficult and much less prestigious life of medical doctors who were for a long time analyzed from a predominantly foucaultian perspective as having a disciplinary power over society. In order to work with Magalhãess life story and notes and above all with the silences inside his writings I try to compare the information in his journals with other from periodicals , theses and medical books from that historical period.

Thesis advisor: Lisa A. Goodman / For survivors of intimate partner violence, the very act of seeking help from a domestic violence (DV) shelter can incur enormous costs. One such cost involves what this study calls “parenting surveillance:” that is, DV advocates can observe, monitor, evaluate, and sometimes control survivors’ parenting—activities given added weight through their mandated reporter role. Although parenting surveillance has long been a feature of state intervention into family life, particularly for low-income women of color, it is largely unexplored in the DV shelter system. This is a striking gap for several reasons: First, most DV programs are committed to supporting survivors’ autonomy and empowerment, seemingly at odds with surveillance. Second, shelter surveillance may echo abusive dynamics from which survivors are attempting to escape. Third, survivors consistently cite fears of losing control of their parenting as a barrier to help-seeking. It is critical to understand the extent to which parenting surveillance prevents programs from achieving their own goals, potentially harming survivors, and obstructing their ability to seek help. Using a community-based participatory research approach, this qualitative-descriptive study aimed to explore survivor-mothers’ experiences of parenting surveillance among 12 residents of four shelters. Qualitative content analysis of the data that drew upon constant comparison techniques yielded six clusters: survivor-mothers (1) want and find support in their programs; (2) experience and witness parenting surveillance; (3) describe negative psychological responses to surveillance; (4) report varying effects on parenting and help-seeking related to surveillance; (5) cope with and resist surveillance; and (6) offer recommendations for improvements to DV shelters. Results suggest that although surveillance is a structural phenomenon, survivors perceived and experienced it differentially, based on their own identities and prior experiences, and the nature of their relationships with advocates. For advocates, ameliorating the damaging effects of surveillance involves both pragmatic and relational shifts grounded in empathy for survivor-mothers’ subjective experience of parenting in the context of their histories, identities, strengths, and vulnerabilities. / Thesis (PhD) — Boston College, 2019. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Background: The perpetration of intimate partner violence by women remains a controversial issue with historical focus on males as perpetrators and females as victims. The Domestic Violence, Crime and Victims Act (2004) in the United Kingdom emphasised the importance of arresting domestic violence perpetrators regardless of gender and this has resulted in significant arrests of female perpetrators of IPV. This has been paralleled by a growing interest in understanding these offenders. Central to this, is gaining an understanding of the aetiology of this population of offenders and their motivations for perpetrating IPV. Investigating this empirically may inform understanding of females’ pathways into perpetrating IPV and may also inform treatment pathways and risk management of these offenders. Design/Methodology: Aims are addressed separately in two journal articles. In journal article 1, systematic searches of bibliographic databases, in addition to hand searches of various articles was conducted to identify any association between personality psychopathology and the perpetration of IPV in females. Journal article 2 describes an empirical investigation of motivation in 8 female IPV perpetrators through semi-structured interviews. The data was transcribed and analysed using interpretative phenomenological analysis. Results: The results of the systematic review revealed an association with personality psychopathology and female perpetration of IPV, in particular cluster B traits. In relation to motivations the results revealed the value of considering offence supportive cognitions which underpin females’ motives for IPV, in addition to the context of women’s lives and the dynamic of the relationship. Conclusions: The relevance of personality psychopathology identified in journal article 1 is discussed in relation to assessment and intervention, in addition to limitations of the synthesis and clinical and empirical utility. The offence supportive cognitions identified in journal article 2 are discussed in relation to other offending behaviour groups, in addition to their clinical implications in the development of assessment and management of this population and of the development of effective interventions.

Forskning kring våld i nära relationer handlar ofta om fysiskt våld. Fysiskt våld uppfattas som mer allvarligt än psykiskt våld. Psykiskt våld har visats vara mer vanligt och skadorna går inte att upptäcka med blotta ögat. Studiens syfte var att undersöka uppfattningar om psykiskt våld i nära relationer. Etthundrasextionio högskolestudenter, varav 88 kvinnor läste en av två fiktiva vinjetter om psykiskt våld i en nära relation där förövaren var antingen man eller kvinna. Därefter svarade de på en enkät relaterat till vinjetten med frågor från mätinstrumentet Opinions on Domestic Violence Scale (ODVS). Tvåvägs variansanalyser för oberoende mätningar visade att kvinnorna uppfattade situationerna mer allvarligt än männen. När en kvinna blev utsatt för våld uppfattades det mer allvarligt. Resultaten var i linje med tidigare forskning om fysiskt våld. Det är av värde att fortsätta undersöka psykiskt våld i nära relationer för att våldet ska upphöra.

Many family mediators encounter intimate partner violence (IPV) during the course of child-custody and divorce mediation. By interviewing family mediators in Oregon I have established concrete strategies that mediators use when working with parties who may have a history of IPV. These strategies may be structural, such as building design and intake procedures, or they may be verbal interventions employed during the course of mediation. Mediators employed a wide variety of strategies based on their experience, situations, and intuition. Some strategies, like the use of shuttle mediation, were used by all the mediators I contacted. Other strategies, such as naming problematic behavior, were limited to only a few of the mediators. All the participating family mediators were aware of the possibility of IPV and consciously took measures to limit its influence on the mediation process when it existed.

Na contemporaneidade, a violência é apontada e reconhecida como um problema social, relacional e de saúde, e se faz presente nas diversas formas de relações de intimidade entre os adolescentes, compreendidas por crush, \"pegar\", \"ficar\" ou namorar. A violência é um tema prioritário de atenção, uma vez que representa um problema social grave e impacta negativamente a saúde dos adolescentes. O presente trabalho visa analisar o sentido da violência nas relações de intimidade sob a ótica dos adolescentes, ancorada na perspectiva epistemológica e metodológica do Paradigma da Complexidade, de modo a contemplar todos os aspectos e dimensões que envolvem o fenômeno da violência na relação de intimidade, sejam sociais, históricos, culturais, gênero, econômicos, poder e psicológicos. Este estudo foi delineado em uma abordagem qualitativa do tipo pesquisa social estratégica, e teve como participantes 39 adolescentes, de ambos os sexos, frequentadores do ensino médio de duas escolas estaduais de um município do interior do estado de São Paulo. Os dados foram coletados através de entrevistas semiestruturadas, grupos focais e diários de campo, e analisados à luz do referido Paradigma. Os resultados indicaram (i) a aceitação da ocorrência de violência nos relacionamentos íntimos entre os adolescentes; (ii) a existência de questões relacionadas ao gênero e passividade frente à violência perpetrada por mulheres; (iii) a persistência de tabus na sociedade e a reprodução de questões estigmatizantes nos relatos dos participantes; (iv) a prevalência de violência psicológica e emocional entre os adolescentes, além da violência figurada bidirecional. Em suma, o Paradigma da Complexidade contribuiu de forma imprescindível para o desenvolvimento de um olhar integral sobre a temática, proporcionando maior clareza sobre os elementos que compõem o fenômeno, e principalmente, sobre a interdependência e interconectividade entre eles, de modo articulado e contextualizado. / In contemporary times, violence is identified and recognized as a social, relational and health problem, and it is present in the various forms of intimacy relations between adolescents, known as crush, \"getting\", \"staying\" or dating. Violence is a priority issue in care because it represents a severe social problem and negatively affects the adolescents\" health. The aim in this study is to analyze the meaning of intimate partner violence from the adolescents\" perspective, through the epistemological and methodological principles of the Paradigm of Complexity, so as to address all - such as social, historical, cultural, gender, economic, power and psychological - aspects and dimensions of the phenomenon of intimate partner violence. This study adopted a qualitative, social strategic research design, and its participants were 39 male and female adolescents who attended high school in two state schools located in an interior city in the state of São Paulo. Data were collected through semistructured interviews, focus groups and field diaries, and further analyzed in the light of the aforementioned Paradigm. The results indicated (i) acceptance of the occurrence of intimate partner violence between adolescents; (ii) existence of gender issues and passivity towards violence perpetrated by women; (iii) persistence of taboos in society and reproduction of stigmatizing issues in the participants\' reports; (iv) prevalence of psychological and emotional violence among the adolescents, in addition to the two-way figured violence. In summary, the Paradigm of Complexity offered essential contributions to develop a comprehensive view on the theme by shedding light on the elements that compose the phenomenon, and especially on the interdependence and interconnectivity between them, in an articulated and contextualized manner.

Background: Intimate partner violence is a structural problem in our society because of the inequality between men and women. Nurses are often the first person to meet the abused woman in health care and therefore have an important role in identifying the violence and in trying to influence the women's future choices in life. Aim: To illustrate nurses' experiences of meeting women exposed to partner violence. Method: A literature-based study based on analysis of 10 qualitative scientific articles. Results: Nurses meeting women subjected to partner violence experienced a lot of emotions both at work and in private. They experienced that the lack of time in care was crucial to how they were able to respond to the women. According to the nurses, lack of training and knowledge were the main reasons to why they refrained from posing questions on experiences of violence. Fear, frustration, suffering and the feeling of not being able to perform good care affected the well-being of the nurses. Conclusion: Knowledge about the topic and time for the healthcare encounter are crucial for nurses to create trustworthy relationships and provide a good care for women subjected to partner violence. Importantly, the findings in this study show that time and knowledge are the major barriers in the care of these women. / En av fyra kvinnor i Sverige blir utsatta för partnervåld. Partnervåld förklaras vanligen med att vi lever i ett ojämställt samhälle där män som grupp strukturellt har mer makt än kvinnor. Forskning visar att orsaken till våldet framförallt handlar om mannens behov av att kontrollera kvinnan. Våld mot kvinnor går långt tillbaka i tiden och var länge ett accepterat beteende för män i samhället. Våldet är i dagens samhälle ett tabubelagt problem vilket gör att många våldsutsatta kvinnor lever i tystnad med skam och rädsla för att anmäla. Det är känt att våldsutsatta kvinnor ofta söker vård för andra symtom än de våldet orsakat. Det är därför av stor vikt att sjuksköterskan har kunskap och tid för att kunna identifiera de eventuella underliggande orsakerna till vårdbesöket samt det våld som kvinnan utsatts för. Mötet mellan den våldsutsatta kvinnan och sjuksköterskan utspelar sig olika beroende på hur sjuksköterskan väljer att bemöta henne. Personcentrerad vård lyfts ofta fram som nyckeln till bättre förutsättningar för sjuksköterskan att möta den våldsutsatta kvinnan där hon befinner sig psykiskt. En utmaning är samtidigt den emotionella påfrestning som dessa möten utgör för sjuksköterskan. Ledningen inom sjukvården har här ett stort ansvar att stötta sjuksköterskor för att kunna möta kvinnor som är utsatta för partnervåld. Studien är en kvalitativ evidensbaserad litteraturstudie. I studien har artiklar från olika länder systematiskt och osystematiskt sökts fram och använts i resultatet. Artiklarna som valdes att inkluderas har sjuksköterskor som är erfarna av att möta våldsutsatta kvinnor. De artiklar som valdes att exkluderas var där de våldsutsatta kvinnorna hade barn eller då den våldsutsatta inte var en kvinna i partnerrelation till mannen som utövade våldet. Samtliga artiklar är granskade med Fribergs (2012) femstegsanalysmetod. Samtliga artiklar granskades även med kvalitetsbedömningsmall samt att alla artiklar har ett etiskt förhållningssätt.  Resultatet är uppbyggt på tre teman och nio subteman som visade att sjuksköterskor har brist på utbildning, brist på tid, är rädda och upplever frustration under mötet med den våldsutsatta kvinnan. Dessa faktorer kunde leda till att sjuksköterskan valde att inte fråga eller se våldet. Många sjuksköterskor var också rädda för att mötet kunde drabba det personliga välmåendet. Resultatets olika teman som framkom var påverkan på sjuksköterskans personliga liv, sjuksköterskans upplevda känslor och att våga fråga om våld. Sjuksköterskor behöver mer stöd i arbetet med våldsutsatta kvinnor. Både en ökad praktisk samt teoretisk utbildning är nödvändigt för att kunna minska våld mot kvinnor.