Don't Be a Hero when You're Assaulted!

Several times I heard the TV host advise people this way: "Don’t be a hero when you are assaulted. What you should do is call 911 afterwards." Personally, I have been advised by several friends to keep 20 dollars in my pocket whenever I

Sexual Assault and Its Psychopathological Repercussions in the Life of Female Students in Northeastern Benin (2023)

Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023 among all students at the University of Parakou. The sampling technique was stratified non-proportional at two levels. The dependent variable was self-reported sexual assault. The psychopathological repercussions linked to sexual assault and explored in these students were: post-traumatic stress disorder assessed with the Post Traumatic Stress Disorder Checklist-5 (PCL-5) scale;and current depression screened with the Patient Health Questionnaire-9 (PHQ-9) scale. Results: A total of 376 female students from the University of Parakou meeting the inclusion criteria were surveyed. The average age of the subjects surveyed was 20.56 ± 2.46 years, with extremes of 16 and 32 years. A predominance of subjects under 25 was observed. The prevalence of sexual assault among female students at the University of Parakou was 10.63%. The types of aggression suffered were mostly rape (18 people;45%) and sexual touching (16 people;40%), and the aggressors were mainly friends/boyfriends (13;32.5%), family members (12;30.0%) and people from the house/neighborhood (9;22.5%). Psychological repercussions included depression in 72.5% (29) of cases, with mild depression in 30% (12), moderate depression in 37.5% (15) and severe depression in 5% (2). Anxiety disorders were present in 27.50% (11) of victims. The risk factors associated with sexual assault in these students were gravidity (p = 0.014;OR = 15.32), unhappy life events (p = 0.01;OR = 17.24), and age of first sexual intercourse (p = 0.016;OR = 4.608). Conclusion: One in ten female students in Parakou has been sexually assaulted. Once again, preventive action through effective sex education is a means of fighting the problem that should be prioritized for every girl and boy from an early age. Psychological support by specialists should be offered to any victim discovered without delay. Communication on the subject should be multiplied in all family and academic educational environments, from the lowest to the highest levels.

Testing a mobile app for child abuse treatment: A mixed methods study

Objective:This study provides a preliminary evaluation of the usability and acceptability of a mobile application(sexual assault care algorithm,SACA).Methods:An explanatory sequential mixed methods research was used.A quantitative survey was followed up by a qualitative study.A convenience sample of participants(n=4)was recruited.The research was conducted on a one-on-one basis.In the quantitative phase,a random assignment technique was used to divide four participants into two groups of two participants each.Post-Study System Usability Questionnaire(PSSUQ)and Acceptability e-Scale were used to collect quantitative data.In the qualitative phase,interview,observation,and documentation were used to collect qualitative data.Data were analyzed both quantitative and qualitatively.The qualitative data were linked with the initial quantitative data to determine how the follow-up qualitative data helped explain the initial quantitative results.Results:The quantitative results suggested that SACA has high usability(5.05±1.83)and acceptability(3.81±1.22).The qualitative results further indicate that the participants thought SACA was easy to use and useful,and most of them would recommend it to others.Areas of improvement include adding features that would calculate and validate the elapsed time since the sexual assault,adding explanations to some buttons,and providing training.Conclusions:Our findings highlight the value of using a mixed methods research design to conduct a usability and acceptability test.Nurses are more likely to adopt a new technology for their evidencebased practice when the technology is easy to use and useful and requires less time to find the right piece of guideline evidence.Individualized training needs to be designed based on users'characteristics.

Sexual Assault: Epidemiological Profile and Clinical Aspects at the Brazzaville University Hospital Center

Objective: to identify the socio-demographic profile of the alleged victims of sexual assault, to define the characteristics of the aggressors, to describe the types of clinical lesions, and to analyze the link between these different parameters.?During the study period, 5620 clients were admitted to gynecological emergencies, including 150 for sexual assault (2.6%). The alleged victims of aggression were 14 years old on average [range: 2?-?49 years]. Among these clients, there were 147 (98%) women and 3 (2%) men [sex ratio: 0.02]. They had a primary education level of 38%, secondary to 42.7%, and single in 87.2% of cases. Clients came from home (69.3%) or police station (24.7%). The perpetrator was male, with an average age of 25.5 years [range: 16 to 35 years]. Regarding the relationship with the victim, the neighborhood accounted for 83%. The perpetrator was alone in 76.7% of cases, two (14%) or more (16.7%), up to 18.?The aggressor’s home was the place of aggression (39.3%). The threats were made using knives (49.3%) and firearms (8.5%). The perpetrator used either his sex (79.9%), his fingers (34.2%) or an object (2.7%). The route of entry was vaginal (94.6%), anal (21.7%) and oral (10%). The abuser used the condom in 74.7% of cases.?Customers had viewed within 24 hours (40.7%). The general state and hemodynamics at admission was normal for all clients. Physical injuries were injuries (23%) and scrapes (34.5%). External genitalia included perineal tears (28%), vaginal tears (8.6%), hymenal tears (7.3%), and old deflowering (72.7%). The hymen was intact in 20%.?The bi-varied analysis found a correlation with a statistically significant difference in the age range of the alleged victims with the number of aggressors, the time of aggression, the path and type of penetration, and the weapon used for the threat.

Orofacial Human Bite: A Six Year Review of Cases from Komfo Anokye Teaching Hospital

Background: The orofacial region of the human body is usually not protected during a fight, making it prone to several injuries including human bite. Patients with human bite injury are often either intoxicated or are known to their assailant, and this makes the process of obtaining a reliable history especially about the aetiology difficult. In 2002, a study estimated the rate of infection secondary to human bite to be about 10%. Aim/Objective: The aim of the current study was to have a general overview of orofacial human bites seen at our unit including the aetiology, presentations, anatomic location, treatment and the treatment outcome. Results: Total number of cases was 127 over the six year period. Age range for females was 15 - 61 years with an average of 29.9. Age range for males was from 17 to 60 years and an average of 30.2 years. There were 31 males and 96 females, giving a male to female ratio of approximately 1:3. All of the reported cases resulted from a fight. Most of the offenders are known to the patients. Majority of the cases, except those infected at the time of presentation, were treated on the same day of presentation under local anaesthesia. Relationship of victim to the offender: Spouse/sexual partners were 21, rivals formed 70, known persons to the victim were 26 and strangers were 10. Sex distribution of offenders and victims: Females who bit females were 86 followed by females who bit males (24), males who bit females (10) and males who bit males (7). Conclusion: Most of the offenders are known to the patients. Majority of the cases, except those infected at the time of presentation, were treated on the same day of presentation under local anaesthesia after they had received antibiotics and anti-tetanus prophy-laxis. Early repair is now the recommended mode of treatment for human bites of the orofacial region, accompanied with good oral hygiene instructions and broad spectrum antibiotics and metro-nidazole.

WORLD NEWS IN BRIEF(October 1-15, 1993)

Russian President Boris Yeltsin declared a state of emergency in Moscow on October 3 shortly after demonstrators captured the city hall. On the night of October 4, the arch rivals of Yeltsin were prisoners after hundreds died in an all-out tank assault on the parliament building. On October 11, Yeltsin arrived in Tokyo on his first foreign trip since the Moscow bloodshed.

An epidemic of violence on medical personnel:are we prepared

The incidence of violence against doctors has been increasing, both in China and worldwide. Very often we hear doctors being molested, thrashed and abused by lay public for a trivial medical malpractice or even no fault of theirs. The once glittering halo of medical workers is being shredded thanks to the stressed health system and a lack of evaluation for risk of violence of the patients. Modem China sees a wide disparity between industry standards in rural and urban areas. People seeking health care service are often scared, can＇t get timely service and turn their anger towards those around them. To change a whole system in this giant nation is too hard a rock. Therefore, our focus is on the prompt awareness and preparation of a possible patient violence. The simplest approaches seem to be the most effective. Medical staffs should re-leam empathy on patients and be better trained on recognizing and reducing conflicts

Evidence Collection for the Unconscious and Unconsented Patient

Forensic nurses are faced with making an ethical decision when an unconscious patient presents with signs of sexual assault. If the patient is unable to consent, the nurses need to decide whether or not to perform a forensic exam. Hospitals have policies in place regarding consent for emergency care, but not all of them consider the collection of forensic evidence. The window of opportunity for forensic collection may disappear before contacts are made or proper consent is established. Ethical, legal, and policy considerations that complicate this scenario are discussed.

Sexual assaults in therapeutic relationships: prevalence, risk factors and consequences

A law has been passed in Germany (paragraph 174c StGB), which prohibits therapists from having sexual contact with their patients. This provides the background for a follow-up survey to the previous study completed by Becker- Fischer and Fischer in 1995. The results of this survey are discussed here on the basis of the current status of research concerning preva- lence and risk factors of sexual assaults in therapeutic relationships. The focus of the re- search lies in determining the specific condi- tions of sexual assaults in psychotherapy and psychiatry, risk variables of the therapists and patients, the effects it has on the patients as well as the legal consequences it results in. To en- sure the comparability of the data, an online version of the Questionnaire about Sexual Con- tacts in Psychotherapy and Psychiatry (SKPP;Becker-Fischer, Fischer & Jerouschek) was cre- ated and a survey of N = 77 affected patients was conducted. The majority of the participants in the study reported a serious decline in their overall well being following the incident. How- ever only very few undertook legal steps - only in three cases did it come to a legal procedure. The assumption that sexual contacts in psy- chotherapy result in extremely damaging con- sequences to patients, was affirmed. Despite the changed legal situation, therapists in Ger- many are still not held legally responsible more often than they were 10 years ago. Based on these results a more intensive education of the patients concerning their legal rights is recom- mended.

Intimate Partner Violence in Papua New Guinea

The aim of the study was to determine the prevalence, associated risk factors, consequences and preventive measures oflPV （intimate partner violence） within the selected population in Goroka, Papua New Guinea. Questions derived from the prevalidated scales were used to measure the IPV. Questionnaires were distributed to both men and women aged from 18 to 60. The participants were staff and students of University of Goroka, staff of the Goroka Secondary school and North Goroka Primary school, Teachers in-charges of the elementary schools in the Eastern Highlands Province and the villagers from Asaroufa and Kotuni villages. Of the 95 respondents, 78.95% were victims of IPV. Among the victims 37.33% were males and 62.67% females. The physical, sexual and psychological abuses were experienced by both men and women. The significant risk factors found to be associated with violence were young age, low education, low socioeconomic status, marital conflicts, history of abuse during childhood, and male patriarchal values. The interpersonal relationship tends to be an important factor for prevailing violence free environment within the intimate partners. Intimate partner violence is prevalent in PNG. The strongest independent predictors were the excessive drinking of alcohol and marital conflict. Preventive measures such as compulsory and free technical education for all children less than 14 years old and life skills training and violence awareness campaign for both men and women must be provided to reduce the intimate partner violence.

Verbal Abuse, Physical Assault, and Harassment in Pediatric Medical Settings: A Nationwide Survey in Japan

Background: Verbal abuse, physical assault, and harassment of pediatric healthcare workers by patients and their families have become increasingly serious. These incidents lead to various problems, including the deterioration of staff members’ mental health and employee turnover. Methods: This study was conducted as the first Japanese nationwide survey to assess the abuse perpetrated by patients and families and experienced by medical staff in pediatric medical settings in 2018, countermeasures employed, and staff member evaluations of the countermeasures. Results: Responses from 526 facilities were received, clinics accounted for 79.8% of these facilities;88.1% of the respondents were females. Further, 10.5% of the facility staff reported having experienced verbal abuse, violence, or harassment from patients or family members. Of 1103 cases of victimizations, there were 719, 136, and 248 cases of verbal abuse, violence, and harassment, respectively. Manuals and guidelines had been created and training and drill performances were conducted as countermeasures in 10.7% and 9.0% of facilities, respectively;7.3% of staff members felt that the countermeasures were effective, corresponding to 45.6% of the affected staff. Conclusion: The findings suggest the necessity of thoroughly familiarizing staff with existing facility countermeasures as well as introducing new countermeasures such as victimization simulations.

Correlates of Anogenital Injuries in Adolescent Females

Objective: We sought to investigate correlates of anogenital injuries (AGIs) in adolescents. Methods: Our retrospective study included sexually assaulted female patients aged 12 to 17 reporting attempted or completed vaginal or anal penetration between 2002 and 2011. Forensic nurses performed anogenital examinations using colposcopy, digital macrovisualization, and toluidine blue dye application. We reviewed case files for AGIs and demographic and sexual assault characteristics. Results: Of the 1961 sexual assault examinations that met our inclusion criteria, 59.6% displayed AGIs. Our logistic regression model using 1752 examinations found the following variables associated with less injury: intercourse within 5 days prior to assault (OR 0.72, 95% CI = 0.55 to 0.95);post-coital interval of 49-72 (OR 0.50, 95% CI = 0.36 to 0.71), 73-96 (OR 0.41, 95% CI = 0.25 to 0.68), and 97-120 hours (OR 0.26, 95% CI = 0.13 to 0.51). Only lack of prior sexual experience was associated with increased injury (OR 2.01, 95% CI = 1.58 to 2.55). Conclusions: In our adolescent patient population, examination findings of AGIs correlate with variables related to time from assault and prior sexual experience.

far和by far与比较级连用

新编高中一年级英语课本上(P.156)有两个这样的句子:This is better by far.(这好得多。)He is by far the tallest among us.(他在我们这些人中间个子比谁都高得多。)两句中都有“by far”,一个在形容词比较级之后,一个在形容词最高级之前,

Relationship between Level of Knowledge on Anger Control and Occurrence of Real Assaultive Behaviour in Patients (20 - 45 Years) Admitted at a National Referral Psychiatric Hospital in Zimbabwe

Background: Aggressive tendencies from psychiatric inpatients are increasingly becoming problematic at a national referral psychiatric hospital in Zimbabwe. No research has been done in this context to determine the dynamics around this disturbing phenomenon. Objectives: To determine the level of knowledge on anger control, to determine the occurrence of real assaultive behaviour and to examine the relationship between level of knowledge on anger control and occurrence of real assaultive behaviour in patients aged 20 - 45 years admitted at a national referral psychiatric hospital in Zimbabwe. Method: A descriptive correlational design was used. Seventy-six respondents aged between 20 and 45 years were selected using simple random sampling. A structured interview was used to collect data. The occurrence of real assaultive behaviour was adapted from the Staff Observation and Aggression Scale completed by observing patients during the assaultive behaviour occurrence. Patient observation was done by the psychiatric trained nurses who were specifically trained for this study to fill the part of the data collection instrument that needed observation. Data were analysed using descriptive statistics, Pearson Correlation Coefficient test and simple regression analysis. Results: Results showed a Pearson coefficient test of (r = -3.47, p Conclusions: Results call for collaboration of mental health practitioners to empower patients with anger control skills.

An impacted oesophageal foreign body in a physically abused child

Physicians under-report cases of child abuse or child maltreatment. We present a case of an impacted oesophageal foreign body in a physically abused child. S.H. is a 7-year-old male child who accidentally ingested metal clip while being assaulted by his paternal uncle whom he resides with. He presented with dysphagia, odynophagia and drooling of saliva and urgent x-ray soft tissue neck revealing the presence of the metallic foreign body in the prevertebral region. He had emergency oesophagoscopy with the removal of foreign body, did well and was discharged home 4th day postoperatively after parental counselling. It remains the responsibility of paediatric healthcare providers to consider child maltreatment as a differential diagnosis of any unexplained injury or medical problems, including oesophageal foreign body impaction.

Epidemiological Clinical Aspects and Medical Management of Sexual Assault in the Region of Ségou in Mali

Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.

Sexual Assault in the Department of Obstetrics and Gynaecology of the Bamako’s 5th Municipality Medical Center

Background: The authors report cases of sexual assault reported to the obstetrics and gynecology department of the Bamako’s 5th municipality medical center during a prospective study of eight months from 1st January to 31st August 31st, 2012. Results: Twenty-one cases of assault were reported out of a total of 13,482 consultations, representing a frequency of 0%, 15%. Most victims were represented by students and accounted 43% of the study population. In 76% of cases the victims knew their assailant. The type of sexual contact was genito-genital vaginal penetration in 67% of cases and the condom was used in only one case. The average time before consultation was 3 days. The preventive ARV treatment was administered in 24% of cases and emergency contraception in 43% of cases. Conclusion: Sexual assault is common in Bamako. The reality is probably underestimated because many cases are not reported. The victims are mostly children and adolescents. The risk of transmission of STIs and HIV is very high during the sexual assault. Education and awareness of the population are essential for early consultation. Training of health workers to care for victims of sexual assault is needed.

Epidemiology of children and adolescent eye injuries in British Columbia

To quantify and characterize children and adolescent eye injuries treated in trauma department.METHODSA retrospective analysis was conducted of children and adolescent patients （0-19 years of age） with eye injuries using the British Columbia Trauma Registry （BCTR） data. BCTR data was obtained from January 1, 2000 to December 31, 2008. The BCTR provides the most detailed information on severe injuries throughout the province of BC. There are 12 trauma-receiving facilities in BC from which BCTR collects data.RESULTSA total of 162 patients with eye injuries were registered in BCTR during the data collection period. The highest number of injuries occurred in the 15-19 age group, followed by 10-14 and 5-9 age groups. Seventy-one point six percent of all patients were male. The mean age for all patients was 12.9 （SD = 5.8） years. Vehicular crash was by far the most common mechanism of injury among all patients （42.0%） followed by blunt injury （14.2%） and cuts （12.3%）. The child and adolescent eye injury data set we used for our study indicated that there were in total, 50 patients that were tested for alcohol and drug use. The majority of them were 15-19 years of age （ n = 38）. Among the tested eye injury patients in the 15-19 age group, 47% （18/38） tested positive for alcohol. There were approximately 30 cases of physical fighting （assault） and fighting-related injury among adolescents. Some injuries were caused by use of fire arms and knife during the assaults. Out of all patients, 62 （38%） were seen by an Ophthalmologist on admission, whereas 100 （62%） patients were not seen by an eye specialist on admission. The most common injury diagnosis among the patients not consulted by ophthalmologist was conjunctiva injury （53%）, whereas almost 9 out of 10 patients with ophtha-lmological consultation had laceration of cornea injury diagnoses. Using Glasgow Coma Scale （GCS）-basedclassification of brain injury severity, 3.7% of all patients were classified with severe brain injury （GCS ≤ 8）, while more than 64% had diagnosed with a mild brain injury （GCS ≥ 13）.CONCLUSIONThis study suggests that most child and adolescent eye injuries in BC occur at street/highway locations followed by incidents at home. Vehicular crash was by far the most common mechanism of injury among all patients （42%）. Sixty-four point two percent of child and adolescent eyeinjury patients also had mild brain injuries. Further, the child and adolescent eye injury data set we used for our study indicated that there were in total, 50 patients tested for alcohol and drug use. There is an urgent need for a child and adolescent eye injury prevention plan in our province.