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Injuries and violence: a global public health challenge
Muazzam Nasrullah
Italian Journal of Public Health , 2010, DOI: 10.2427/5719
Abstract: Injuries and violence are a significant cause of mortality and physical disability. Injuries killed five million people worldwide each year [1]. The level of this dilemma, however, differs significantly by age, sex, region and economic development [2]. Globally, road traffic injury mortalities, self-inflicted injury mortality and interpersonal violence, war, drowning, and exposure to fire are the leading cause of deaths among people aged 15-44 years [3]. This special issue aims to assess the magnitude of this problem, identify risk factors and explore prevention strategies to alleviate the burden of injuries and violence. There is a dire need to increase the knowledge of the extent of problem, and associated risk factors that needs to be targeted for prevention. Erosa et al., examined reports of verbal and physical abuse from family caregivers of adults with severe physical, neurological and developmental disabilities, and found that caregivers who reported some form of abuse reported significantly greater distress and burden than caregivers who did not report any abuse. Grice et al., found that reported histories of work-related physical assault and work-related threat were associated with elevated risks of current work-related physical assault. Ahmad, systematically reviewed and summarized current scientific knowledge on the use of interactive computer-assisted screening to detect intimate partner violence (IPV).
Environmental lead exposure: a public health problem of global dimensions
Tong,Shilu; Schirnding,Yasmin E. von; Prapamontol,Tippawan;
Bulletin of the World Health Organization , 2000, DOI: 10.1590/S0042-96862000000900003
Abstract: lead is the most abundant of the heavy metals in the earth?s crust. it has been used since prehistoric times, and has become widely distributed and mobilized in the environment. exposure to and uptake of this non-essential element have consequently increased. both occupational and environmental exposures to lead remain a serious problem in many developing and industrializing countries, as well as in some developed countries. in most developed countries, however, introduction of lead into the human environment has decreased in recent years, largely due to public health campaigns and a decline in its commercial usage, particularly in petrol. acute lead poisoning has become rare in such countries, but chronic exposure to low levels of the metal is still a public health issue, especially among some minorities and socioeconomically disadvantaged groups. in developing countries, awareness of the public health impact of exposure to lead is growing but relatively few of these countries have introduced policies and regulations for significantly combating the problem. this article reviews the nature and importance of environmental exposure to lead in developing and developed countries, outlining past actions, and indicating requirements for future policy responses and interventions.
A new definition of drowning: towards documentation and prevention of a global public health problem
Bulletin of the World Health Organization , 2005, DOI: 10.1590/S0042-96862005001100015
Abstract: drowning is a major global public health problem. effective prevention of drowning requires programmes and policies that address known risk factors throughout the world. surveillance, however, has been hampered by the lack of a uniform and internationally accepted definition that permits all relevant cases to be counted. to develop a new definition, an international consensus procedure was conducted. experts in clinical medicine, injury epidemiology, prevention and rescue from all over the world participated in a series of "electronic" discussions and face-to-face workshops. the suitability of previous definitions and the major requirements of a new definition were intensely debated. the consensus was that the new definition should include both cases of fatal and nonfatal drowning. after considerable dialogue and debate, the following definition was adopted: "drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid." drowning outcomes should be classified as: death, morbidity, and no morbidity. there was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used. thus a simple, comprehensive, and internationally accepted definition of drowning has been developed. its use should support future activities in drowning surveillance worldwide, and lead to more reliable and comprehensive epidemiological information on this global, and frequently preventable, public health problem.
Trends of violence among 7th, 8th and 9th grade students in the state of Lara, Venezuela: The Global School Health Survey 2004 and 2008
Ricardo Granero, Esteban S Poni, Bertha C Escobar-Poni, Judith Escobar
Archives of Public Health , 2011, DOI: 10.1186/0778-7367-69-7
Abstract: The Global School-based Student Health Survey (GSHS), State of Lara, Venezuela (GSHS-Lara) is a school-based surveillance system. It comprises a repeated, cross-sectional, self-administered survey drawn from a representative sample of 7th to 9th grade students, performed in the school years 2003-2004 (GSHS-Lara 2004) and 2007-2008 (GSHS-Lara 2008). It explores, among other things, a general violence indicator such as school absenteeism due to feeling unsafe at school or on the way to or from school for any reason; and more specific indicators of violence such as robbery, bullying, physical fights and use of weapons, as well as exposure to lectures on how to prevent violence. Results are given in terms of prevalence percentage.Absenteeism doubled between the two study periods (10.8% to 20.8%). The number of students that were a victim of robbery remained high and without change both outside (14.2% and 14.8%) and inside school (21.7% and 22.0%). The number of victims of bullying was high and increasing (33.4% and 43.6%). Bullying associated with being physically attacked decreased (18.5% to 14.3%). Physical attacks without active participation and not associated with bullying were frequent (21.5%). Physical fighting with active participation prevalence remained high and without change (27.5% and 28.2%). Carrying a weapon almost doubled (4.3% to 7.1%). Less than 65% reported classes for violence prevention.The GSHS-Lara shows that violence is an important public health problem that needs to be addressed by the community and its authorities.Youth violence, an aggressive and hostile behavior amongst youth, is one of the most visible forms of violence in society and a major public health problem worldwide [1]. The World Report on Violence and Health-2000 indicated that fatal forms of violence (i.e. any form of violence and injuries that result in homicide) takes the lives of 545 people aged 10 to 29 years as a result of interpersonal violence each day [2]. Those who survi
Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: a major public health problem and global comparison
Bener A, Gerber LM, Sheikh J
International Journal of Women's Health , 2012, DOI: http://dx.doi.org/10.2147/IJWH.S29380
Abstract: evalence of psychiatric disorders and associated risk factors in women during their postpartum period: a major public health problem and global comparison Original Research (3251) Total Article Views Authors: Bener A, Gerber LM, Sheikh J Published Date May 2012 Volume 2012:4 Pages 191 - 200 DOI: http://dx.doi.org/10.2147/IJWH.S29380 Received: 21 December 2011 Accepted: 18 January 2012 Published: 10 May 2012 Abdulbari Bener1–3, Linda M Gerber3, Javaid Sheikh4 1Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Qatar; 2Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, United Kingdom; 3Department of Public Health, 4Department of Psychiatry, Weill Cornell Medical College, Qatar Background: Postnatal depression has received considerable research and clinical attention; however, anxiety and stress in postpartum women have been relatively neglected. Objective: The aim of this study was to determine the prevalence of depression, anxiety, and stress during the postpartum period of women using the Depression Anxiety Stress Scales, and to examine the associated correlates of these conditions. Design: This was a cross-sectional study conducted from January 2010 to May 2011. Setting: Primary health care centers of the State of Qatar Supreme Council of Health. Subjects: A representative sample of 2091 women who attended primary health care centers was surveyed. From this sample, 1659 women (79.3%) consented to participate in the study. Methods: The study was based on a face-to-face interview using a designed questionnaire covering sociodemographic characteristics, family history, medical history, the obstetric variables of patients, and stressful life events. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales. Results: In the study sample, the prevalence of depression, anxiety, and stress was 18.6%, 13.1%, and 8.7%, respectively. Young mothers and those with higher education (above secondary level) were more depressed (35.7% and 67.5%, respectively), anxious (34.9% and 68.3%, respectively), and under stress (29.7% and 62.1%, respectively) in their postpartum period. Postpartum working women were more stressed (60.7%) and anxious (51.8%), while housewives were more depressed (51.6%). Nearly half of the depressed mothers reported experiencing more than one stressful life event in their postpartum period, such as low income (41.9%; P = 0.05) or unplanned pregnancy (60.4%; P < 0.001). Unplanned pregnancy (OR = 1.9; P < 0.001) was the major significant correlate for postpartum depression, while a lack of family support (OR = 1.9; P < 0.001) was the major significant correlate for postpartum anxiety. For stress, being an older mother aged from 40 to 45 years of age (OR = 2.0; P = 0.04) and having dissatisfaction in married life (OR = 1.9; P = 0.006) were the significant correlates. Conclusion: The
Towards a Global Interdisciplinary Evidence-Informed Practice: Intimate Partner Violence in the Ethiopian Context  [PDF]
Sepali Guruge,Amy Bender,Fekadu Aga,Ilene Hyman,Melesse Tamiru,Damen Hailemariam,Andargachew Kassa,Khosro Refaie-Shirpak
ISRN Nursing , 2012, DOI: 10.5402/2012/307271
Abstract: Background. Intimate partner violence is a global health issue and is associated with a range of health problems for women. Nurses, as the largest health workforce globally, are well positioned to provide care for abused women. Objectives. This nursing-led interdisciplinary project was conducted to understand the current state of knowledge about intimate partner violence in Ethiopia and make recommendations for country-specific activities to improve response to intimate partner violence through practice changes, education, and research. Methods. The project involved two phases: review of relevant literature and an interdisciplinary stakeholder forum and a meeting with nurse educators. Findings. The literature review identified the pervasiveness and complexity of intimate partner violence and its sociocultural determinants in the Ethiopian context. Two significant themes emerged from the forum and the meeting: the value of bringing multiple disciplines together to address the complex issue of intimate partner violence and the need for health care professionals to better understand their roles and responsibilities in actively addressing intimate partner violence. Conclusions. Further research on the topic is needed, including studies of prevention and resilience and “best practices” for education and intervention. Interdisciplinary and international research networks can support local efforts to address and prevent intimate partner violence. 1. Introduction Intimate partner violence (IPV) is defined as the threat of, and/or actual, physical, sexual, psychological, or verbal abuse by a current or former spouse or nonmarital partner [1]. At a global level, IPV occurs in epidemic proportions; the rates of IPV are comparable to those for cancer, cardiovascular diseases, and HIV/AIDS [2]. IPV has been linked to a range of physical and mental health problems [3–7] that may persist long after the violence has ended. Although IPV is considered to be a global public health problem, few health sciences studies have focused on it in low-income countries. This gap is a major impediment to improving the response of local health sectors to the needs of women who are experiencing IPV in these countries and to improving health equity for women everywhere [8]. In particular, the response of nurses as frontline care providers could be improved. This paper presents the findings from a nurse-led, international, interdisciplinary project aimed at understanding the current situation of IPV in Ethiopia and developing recommendations for country-specific activities to address
Violence permeating daily life: a qualitative study investigating perspectives on violence among women in Karachi, Pakistan  [cached]
Ali TS,Krantz G,Mogren I
International Journal of Women's Health , 2012,
Abstract: Tazeen S Ali,1,2,* Gunilla Krantz,3 Ingrid Mogren4,*1School of Nursing, Aga Khan University, Karachi, Pakistan; 2Department of Public Health Sciences, Division of Global Health, Karolinska Institute, Stockholm, 3Department of Public Health and Community Medicine/Social Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, 4Department of Clinical Sciences, Obstetrics and Gynecology, Ume University, Ume , Sweden *These authors contributed equally to this workBackground: This study explored how married women perceive situations which create family conflicts and lead to different forms of violence in urban Pakistan. In addition, it examines perceptions of consequences of violence, their adverse health effects, and how women resist violence within marital life.Methods: Five focus group discussions were conducted with 28 women in Karachi. Purposive sampling, aiming for variety in age, employment status, education, and socioeconomic status, was employed. The focus group discussions were conducted in Urdu and translated into English. Manifest and latent content analysis were applied.Results: One major theme emerged during the analysis, ie, family violence through the eyes of females. This theme was subdivided into three main categories. The first category, ie, situations provoking violence and their manifestations, elaborates on circumstances that provoke violence and situations that sustain violence. The second category, ie, actions and reactions to exposure to violence, describes consequences of ongoing violence within the family, including those that result in suicidal thoughts and actions. The final category, ie, resisting violence, describes how violence is avoided through women’s awareness and actions.Conclusion: The current study highlights how female victims of abuse are trapped in a society where violence from a partner and family members is viewed as acceptable, where divorce is unavailable to the majority, and where societal support of women is limited. There is an urgent need to raise the subject of violence against women and tackle this human rights problem at all levels of society by targeting the individual, family, community, and societal levels concurrently.Keywords: violence against women, domestic violence, women’s perceptions, gender inequality, empowerment, qualitative study, Pakistan
Stigma, prejudice and discrimination in global public health
Parker, Richard;
Cadernos de Saúde Pública , 2012, DOI: 10.1590/S0102-311X2012000100017
Abstract: this article reviews the development of international research on the relationship between discrimination and health. it provides an overview of theoretical and empirical work on stigma and prejudice and their impact on discrimination and health. it argues that the literature on these issues has drawn primarily from social psychology and has focused on the impact of attitudes associated with stigma and prejudice on discriminatory practices and consequently health outcomes. it also identifies a growing trend in recent research towards a reconceptualization of stigma, prejudice and discrimination from the perspective of social inequality and structural violence, highlighting relations of power and exclusion that reinforce vulnerability within a complex social and political process. it concludes by briefly examining the ways in which this reconceptualization of discriminatory practices has generated a growing interest in the linkages between health and human rights and renewed interest in health and social justice; two major trends in the field of global public health.
Pain as a global public health priority
Daniel S Goldberg, Summer J McGee
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-770
Abstract: Despite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe.The prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem.By any measure, pain is an enormous global health problem. Globally, it has been estimated that 1 in 5 adults suffer from pain and that another 1 in 10 adults are diagnosed with chronic pain each year [1]. While pain affects all populations, regardless of age, sex, income, race/ethnicity, or geography, it is not distributed equally across the globe. Those who experience pain can experience acute, chronic, or intermittent pain, or a combination of the three. The four largest causes of pain are cancer, osteo- and rheumatoid arthritis, operations and injuries, and spinal problems, making the etiology of pain a complex, transdisciplinary affair. Pain has multiple, serious sequelae including but not limited to depression, inability to work, disrupted social relationships and suicidal thoughts. Of those living with chronic pain, the median time of exposure is 7 years [1].In this article, we argue that the paradigmatic view of pain as a symptom of disease, rather
Violence permeating daily life: a qualitative study investigating perspectives on violence among women in Karachi, Pakistan
Ali TS, Krantz G, Mogren I
International Journal of Women's Health , 2012, DOI: http://dx.doi.org/10.2147/IJWH.S33325
Abstract: lence permeating daily life: a qualitative study investigating perspectives on violence among women in Karachi, Pakistan Original Research (1321) Total Article Views Authors: Ali TS, Krantz G, Mogren I Published Date November 2012 Volume 2012:4 Pages 577 - 585 DOI: http://dx.doi.org/10.2147/IJWH.S33325 Received: 26 April 2012 Accepted: 31 August 2012 Published: 02 November 2012 Tazeen S Ali,1,2,* Gunilla Krantz,3 Ingrid Mogren4,* 1School of Nursing, Aga Khan University, Karachi, Pakistan; 2Department of Public Health Sciences, Division of Global Health, Karolinska Institute, Stockholm, 3Department of Public Health and Community Medicine/Social Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, 4Department of Clinical Sciences, Obstetrics and Gynecology, Ume University, Ume , Sweden *These authors contributed equally to this work Background: This study explored how married women perceive situations which create family conflicts and lead to different forms of violence in urban Pakistan. In addition, it examines perceptions of consequences of violence, their adverse health effects, and how women resist violence within marital life. Methods: Five focus group discussions were conducted with 28 women in Karachi. Purposive sampling, aiming for variety in age, employment status, education, and socioeconomic status, was employed. The focus group discussions were conducted in Urdu and translated into English. Manifest and latent content analysis were applied. Results: One major theme emerged during the analysis, ie, family violence through the eyes of females. This theme was subdivided into three main categories. The first category, ie, situations provoking violence and their manifestations, elaborates on circumstances that provoke violence and situations that sustain violence. The second category, ie, actions and reactions to exposure to violence, describes consequences of ongoing violence within the family, including those that result in suicidal thoughts and actions. The final category, ie, resisting violence, describes how violence is avoided through women’s awareness and actions. Conclusion: The current study highlights how female victims of abuse are trapped in a society where violence from a partner and family members is viewed as acceptable, where divorce is unavailable to the majority, and where societal support of women is limited. There is an urgent need to raise the subject of violence against women and tackle this human rights problem at all levels of society by targeting the individual, family, community, and societal levels concurrently.
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