Clinically assessed consequences of workplace physical violence

OBJECTIVES: To assess consequences of physical violence at work and identify their predictors. METHODS: Among the patients in a medicolegal consultation from 2007 to 2010, the subsample of workplace violence victims (n = 185) was identified and contacted again in average 30 months after the assault. Eighty-six victims (47 %) participated. Ordinal logistic regression analyses assessed the effect of 9 potential risk factors on physical, psychological and work consequences summarized in a severity score (0-9). RESULTS: Severity score distribution was as follows: 4+: 14 %; 1-3: 42 %; and 0: 44 %. Initial psychological distress resulting from the violence was a strong predictor (p < 0.001) of the severity score both on work and long-term psychological consequences. Gender and age did not reach significant levels in multivariable analyses even though female victims had overall more severe consequences. Unexpectedly, only among workers whose jobs implied high awareness of the risk of violence, first-time violence was associated with long-term psychological and physical consequences (p = 0.004). Among the factors assessed at follow-up, perceived lack of employers' support or absence of employer was associated with higher values on the severity score. The seven other assessed factors (initial physical injuries; previous experience of violence; preexisting health problems; working alone; internal violence; lack of support from colleagues; and lack of support from family or friends) were not significantly associated with the severity score. CONCLUSIONS: Being a victim of workplace violence can result in long-term consequences on health and employment, their severity increases with the seriousness of initial psychological distress. Support from the employer can help prevent negative outcomes.

Alcohol may not cause partner violence but it seems to make it worse: a cross national comparison of the relationship between alcohol and severity of partner violence.

This study assesses whether severity of physical partner aggression is associated with alcohol consumption at the time of the incident, and whether the relationship between drinking and aggression severity is the same for men and women and across different countries. National or large regional general population surveys were conducted in 13 countries as part of the GENACIS collaboration. Respondents described the most physically aggressive act done to them by a partner in the past 2 years, rated the severity of aggression on a scale of 1 to 10, and reported whether either partner had been drinking when the incident occurred. Severity ratings were significantly higher for incidents in which one or both partners had been drinking compared to incidents in which neither partner had been drinking. The relationship did not differ significantly for men and women or by country. We conclude that alcohol consumption may serve to potentiate violence when it occurs, and this pattern holds across a diverse set of cultures. Further research is needed that focuses explicitly on the nature of alcohol's contribution to intimate partner aggression. Prevention needs to address the possibility of enhanced dangers of intimate partner violence when the partners have been drinking and eliminate any systemic factors that permit alcohol to be used as an excuse. Clinical services for perpetrators and victims of partner violence need to address the role of drinking practices, including the dynamics and process of aggressive incidents that occur when one or both partners have been drinking.

Prevalence of victims of violence admitted to an emergency department.

OBJECTIVE: To collect data on the consultation frequency and demographic profile of victims of violence attending an emergency department (ED) in Switzerland. METHODS: We undertook screening of all admitted adult patients (>16 years) in the ED of the CHUV, Lausanne, Switzerland, over a 1 month period, using a modified version of the Partner Violence Screen questionnaire. Exclusionary criteria were: life threatening injury (National Advisory Committee on Aeronautics score > or =4), or inability to understand or speak French, to give oral informed consent, or to be questioned without a family member or accompanying person being present. Data were collected on history of physical and/or psychological violence during the previous 12 months, the type of violence experienced by the patient, and if violence was the reason for the current consultation. Sociodemographic data were obtained from the registration documents. RESULTS: The final sample consisted of 1602 patients (participation rate of 77.2%), with a refusal rate of 1.1%. Violence during the past 12 months was reported by 11.4% of patients. Of the total sample, 25% stated that violence was the reason for the current consultation; of these, 95% of patients were confirmed as victims of violence by the ED physicians. Patients reporting violence were more likely to be young and separated from their partner. Men were more likely to be victims of public violence and women more commonly victims of domestic violence. CONCLUSIONS: Based on this monthly prevalence rate, we estimate that over 3000 adults affected by violence consult our ED per annum. This underlines the importance of the problem and the need to address it. Health services organisations should establish measures to improve quality of care for victims. Guidelines and educational programmes for nurses and physicians should be developed in order to enhance providers' skills and basic knowledge of all types of violence, how to recognise and interact appropriately with victims, and where to refer these patients for follow up care in their local networks.

Aspects of leaf anatomy of kudzu (Pueraria lobata, Leguminosae-Faboideae) related to water and energy balance

Kudzu is a cover crop that has escaped cultivation in some subtropical and warm temperate regions. Kudzu has previously demonstrated broad intraspecific physiological plasticity while colonizing new environments. The objective of this paper was to investigate characteristics of kudzu leaflet anatomy that might contribute to its successful growth in climatically distinct environments, and to escape cultivation as well. Fresh and fixed leaflet strips of field-grown plants were analyzed. The lower epidermis of kudzu showed a higher frequency of stomata (147 ± 19 stomata mm-2) than the upper epidermis (26 ± 17 stomata mm-2). The average number of trichomes per square milimeter was 8 for both the upper and the lower epidermis. The average trichome length was 410 ± 200 mum for the upper epidermis and 460 ± 190 mum for the lower epidermis. Cuticle thickness was not considerably different between lower and upper epidermis. The leaflet blade consisted basically of two layers (upper and lower) of unicellular epidermis, two layers of palisade parenchyma and one layer of spongy parenchyma. One layer of paraveinal mesophyll was found between palisade and spongy parenchyma. In conclusion, leaflets of kudzu present anatomical characteristics that might contribute to the broad physiological plasticity shown by kudzu.

Accidentologic aspects of helicopter rescue missions involving winching of a physician

Introduction: Medical helicopter services provide several advantages,like the ability to perform air searches for lost victims, a rapid method ofshuttling rescue personnel and equipment to the victim, and the deliveryof early on-site advance medical care. When landing is not possible, therescuers can also be directly winched to the victim. As outdoor activitiesare increasing, few data are available about the type of accidentsleading to a rescue operation involving the use of the winch. We soughtto study the epidemiology and accidentology of such rescues.Methods: We retrospectively reviewed the medical reports of a singlehelicopter-based emergency medical service. Data from 1 January 2003to 31 December 2008 were analyzed. Cases with emergency callindicating that the victim was deceased were excluded. Data includedthe age and gender of the patients, the type of patients activitypreceeding the injury, the mecanism of injury, and the type of lesions(main diagnosis).Results: 9879 rescue missions were conducted between 1 January2003 and 31 December 2008. The 921 (9.3%) missions involvingwinching of the emergency physician were analysed. The male:femaleratio of the patients was 2:1. There were 56 (6%) patients aged 15 orunder. Most of the patients, while injured, were practising winter sportsor mountain-related activities in the summer (table 1). Falls accountedfor the great majority of the trauma events (700 patients or 76%),followed by illnesses (81 patients or 9 %). Of the 921 missions in whichthe physician was winched in the field, 28 (3%) were avalanche rescuesand 13 (1%) were glacier crevasse rescues. Trauma to the upper andlower extremities accounted for 429 (47%) of all injuries, followed by175 (19%) head injuries and 108 (12%) spinal lesions. Hypothermia,frostbite and altitude illnesses were diagnosed in 11 (1%) cases.In 128(14%) cases two different diagnoses were made, and in 69 (7%) threeor more diagnoses.Conclusions: In our helicopter emergency base, between 2003 and2008, 921 rescue missions (9.3%) involved winching of the emergencydoctor. Patients rescued using the winch usually practice outdoorsports, and are predominantly male. The mechanism of the injury isusually a fall, and extremities and head injuries account for more than50% of the main diagnosis made on the field.

Psychosocial analysis of ETA's violence legitimation discourse

This study analyses the fundamental components shaping the violence legitimation discourse of ETA (Euskadi Ta Askasuna). With this aim, a category system has been built, which organizes the psychosocial processes identified in previous studies related to violence legitimation. Based on the proposed category system, a content analysis was conducted on 21 statements of ETA, released between 1998 and 2011. An intraobserver and inter-observer reliability analysis reveals high level stability and replicability of the categorization. The results show, firstly, that outgroup components have a predominant presence over ingroup components. Secondly, in the components hierarchy, we observe that elements referring to identity come in first place, followed in similar frequencies by those related to violence representation and the definition of the situation.

Psychosocial analysis of ETA"s violence legitimation discourse

Este artículo analiza los componentes fundamentales que configuran el discurso legitimador de la violencia de ETA (Euskadi Ta Askatasuna). Con este objetivo, se construye un sistema de categorías, el cual organiza los procesos psicosociales identificados en investigaciones previas relacionadas con la legitimación de la violencia. A partir del sistema de categorías propuesto, se realiza un análisis de contenido en 21 comunicados de ETA publicados entre 1998 y 2011. El análisis de fiabilidad intraobservador e interobservador muestra una alta estabilidad y replicabilidad de la categorización. Los resultados muestran, en primer lugar, que los componentes exogrupales son predominantes respecto a los endogrupales. Segundo, en la jerarquización, se observa la preminencia de los elementos referidos a la identidad, seguido por frecuencias similares los relacionados con la representación de la violencia y la definición de la situación.