Background: In the Philippines, 25% of ever-married women reported experiencing some form of violence from their partners but only 10% of them actually sought medical or legal help (NDHS, 2013). The objective of this study was to describe the type and severity of intimate partner violence experienced, and its association with formal help-seeking,among women aged 15-49 years in the Philippines. Methodology: The cross-sectional data used for this study came from the National Demographic and Health Survey of women aged 15-49 years old conducted in 2013. To estimate the association of interest, confounders were identified using the change-in-estimate criterion and were controlled by multiple logistic regression modelling. Results: Among women aged 15-49 years who experienced intimate partner violence, those who experienced all types of abuse had the highest proportion of formal help-seeking (7.3%), while women who experienced only sexual abuse had the lowest (0 out of 67). Controlling for the effect of other variables, women who experienced severe physical abuse were more likely to seek medical or legal assistance compared to those who experienced moderate physical abuse (OR=4.77; 95% Confidence Interval: 1.96 – 11.62). Conclusion Formal help-seeking rates were low among victims of intimate partner violence in the Philippines. The severity of the abuse experienced is likely an important factor in seeking medical and legal help. These systems should thus be capable of handling severe cases of abuse in order to address the needs of women who seek help. Efforts should be made to increase formal help-seeking among all victims of domestic violence.
Intimate Partner Violence ; Domestic Violence ; Physical Abuse

BACKGROUND: Dating violence refers to violence occurring between people in an intimate relationship. Forms of dating violence are often categorized into physical, psychological, and sexual violence, and most existing literature has followed this frame. However, few studies have focused on the phenomenon of living under the perpetrator's coercive control in victims of dating violence, although those experiences are known to be signs of severe forms of violence later on. PURPOSE: The purpose of this study was to explore the experiences of being coercively controlled in female victims who had experienced dating violence. METHODS: For this study, in-depth interviews were conducted with a total of 14 female victims, and all interviews were audio-recorded and transcribed. The data were analyzed using the phenomenological analysis method suggested by Colaizzi. RESULTS: Three themes were derived in chronological order: idealizing the relationship (period of potential control), facing severer tyranny (period of coercive control), and escaping from the unending trap (period of post-control). The results showed that the victims experienced perpetrators' control with specific patterns. The perpetrators' controlling behaviors were invisible, literally benevolent, at the beginning; however, severe forms of violence seemed to appear as their relationship deepened and the perpetrators failed to control the victims. CONCLUSION: Findings from this study presented vivid experiences of female victims who needed help and care. Hopefully, the results can benefit in terms of developing evidence-based prevention strategies for victims as well as assessing the risks of severe forms of dating violence, such as physical attack or murder.
Crime Victims ; Female ; Homicide ; Humans ; Intimate Partner Violence ; Methods ; Physical Abuse ; Qualitative Research ; Sex Offenses ; United Nations ; Violence

INTRODUCTION: Child abuse, sexual and domestic violence are among the most destructive experiences afflicting women and children that result to physical, behavioral, psychological and economic consequences. Physicians in the front line need to be sensitive and vigilant in identifying both overt and subtle signs of these violations. As such, identification of victims is vital to prevent further abuse and injury, as well as to manage the patient holistically.
OBJECTIVE: To assess the skill of Family Medicine (FM) residents in detecting cases of violence against women and children (VAWC).
METHODS: Eight case scenarios were presented to 48 resident trainees from government and private hospitals in Metro Manila. They were tasked to identify cases pertaining to VAWC, and distinguish the case type.
RESULTS: Red flags that were easily detected by more than 80% of trainees were cases of physical abuse towards men, and neglect. Circumstances with moderate challenge were sexual harassment, rape, and abandonment, in that order. On the other hand, respondents had inadequacy in detecting cases of sexual abuse and physical abuse towards children; while the most difficult to recognize was emotional abuse.
CONCLUSION: Acquisition of this new skill set may prove beneficial in providing the ideal environment for proper management and support provision for the VAWC subjects. Lack of knowledge and training in this rising societal and health threat may cause underdiagnosis of common VAWC presentations. Consequently, this leads to failure of identification, assessment, documentation, and management of such patients.

Human ; Male ; Female ; Child ; Sexual Harassment ; Rape ; Physical Abuse ; Domestic Violence ; Child Abuse ; Sex Offenses ; Surveys And Questionnaires

This paper reviews relevant literatures at home and abroad. The cases of child sexual abuse are systematically discussed from the aspects of epidemiology and forensic examination, in order to develop and improve the inspection and appraisal thinking and ability of domestic forensic workers in such cases. The paper also briefly introduces the current situation and existing problems of dealing with child sexual abuse cases for case-handling units at base level in China, in order to provide help to the formulation, improvement and development of relevant standards and norms for child protection in China.
Child ; Child Abuse, Sexual/diagnosis* ; Child Protective Services ; China ; Forensic Medicine/methods* ; Humans ; Physical Examination/methods*

Children who have been raped some years back may have hymenal scars. However, medical professionals are not accustomed in assessing these scars because of the lack of experience in performing physical examinations of the external genitalia of children who suffered from rape some years back. Moreover, the importance of physical examination of the victim's external genitalia is sometimes overlooked. Two cases of rape victims with hymenal scars who visited Daegu Child Sexual Abuse Response Center several years after their first sexual abuse along with a literature review are presented here.
Child Abuse, Sexual ; Child* ; Cicatrix* ; Daegu ; Female ; Genitalia ; Humans ; Hymen* ; Physical Examination ; Rape* ; Sex Offenses

This study used a grounded theory approach to primarily understand the processes Caviteña participants go through in order to arrive at a decision about how to optimize intimate relationships in the presence of abuse and also on how to generate a conceptual framework out of the interconnections of the concepts identified. Eleven participants were interviewed. Five core categories emerged namely: intimate partner violence (IPV), gender differences, processes, consequences and interventions. IPV from the perspective of Caviteñas can be constructed as an inner experience that affects many dimensions of a woman as a person. It causes pain that goes beyond what is physical and deeply penetrates an affected person's inner emotional core. It is a product of interplay among a multitude of factors and is a culprit of many physical and psychological health problems. It affects not just the woman and the perpetrator but also the children, the rest of the family's members, and the community as well. The conceptual framework challenges nurses to address the phenomenon through a holistic, integrated, multidisciplinary approach by taking into account the many layers of the victim's persona - physically, psychologically, emotionally and even economically.
Intimate Partner Violence ; Grounded Theory

OBJECTIVES

This study aims to describe patterns of IPV-associated ophthalmic injuries among women: Specifically, it seeks to identify factors associated with ophthalmic injuries in women secondary to IPV, determine practices and/or protocols in identifying IPV-associated ophthalmic injuries, and to examine practices in referral to ancillary services for IPV survivors with such injuries.

METHODS

A systematic literature search was conducted for observational studies published from 2009 to 2022 using PubMed, Google Scholar, HERDIN, and the Cochrane Library. Studies were screened and appraised using the Newcastle-Ottawa Quality Assessment Scale (NOS) for risk of bias. Relevant data on injury types, screening protocols, and referral practices were extracted and synthesized. Analysis of risk of bias (ROB) for each study utilizing the NOS scale indicated that four studies exhibited a good ROB.

RESULTS

A total of 567 female patients with IPV-related facial injuries were included in the selected studies. Of these, 98 cases (17.28%) involved ophthalmic injuries, including orbital fractures, subconjunctival hemorrhages, and contusions. Factors associated with these injuries included delayed healthcare-seeking behavior, bilateral and recurrent trauma, and psychological distress. Current practices in IPV identification were found to be inconsistent, with a lack of standardized screening protocols, especially in ophthalmology settings. Referral to ancillary services was often suboptimal due to poor interdepartmental coordination and absence of formal pathways.

CONCLUSION

There is a significant gap in the recognition and management of IPV-associated ophthalmic injuries among women. Establishing standardized screening protocols and improving referral systems can enhance care outcomes and provide holistic support for survivors, particularly in low-resource settings.

Human ; Female ; Intimate Partner Violence

The recent cases of anthrax due to bioterrorism in the United States have reminded us that our society is also vulnerable to biological attacks. Illnesses due to bioterrorism are not naturally occurring diseases, and therefore may show presentations not familiar to many doctors. The last case of smallpox was reported in 1960, and doctors aged less than 60 years have no experience of smallpox. Anthrax is a rare zoonosis, and no case of inhalation anthrax has been reported in Korea. American doctors might be on high alert to bioterrorism after September 11, 2001. However, it took more than 2 weeks from the symptom onset of the index case to the recognition that anthrax outbreak had occurred due to bioterrorism. This delay shows how difficult it is to recognize bioterrorism. This article describes clinical recognition and management of patients exposed to biological warfare agents, especially agents causing anthrax, smallpox, plague, and botulism.
Anthrax ; Biological Warfare Agents* ; Biological Warfare* ; Bioterrorism ; Botulism* ; Humans ; Inhalation ; Korea ; Plague* ; Smallpox ; United States

The management of nuclear, biological and chemical (NBC) terrorism events is critical to reducing morbidity and mortality in the next decade; however, initial patient care considerations and protective actions for staff are unfamiliar to most front-line clinicians. High explosive events (bomb and blast) remain the most common type of terrorism and are easy to detect. Conversely, some types of terrorist attacks are more likely to be unsuspected or covert. This paper explains the current threat of terrorism and describes clues for detection that an event has occurred. Specific criteria that should lead to a high suspicion for terrorism are illustrated. The manuscript outlines initial actions and clinical priorities for management and treatment of patients exposed to nuclear/radiological, biological, chemical and combined agents (for example an explosion involving a chemical agent). Examples of terrorist events include: a nuclear explosion, an aerosolised release of anthrax (biological), dissemination of sarin in a subway (chemical), and the detonation of a radiologic dispersion device or "dirty bomb" (combined explosive and radiological). Basic principles of decontamination include potential risks to healthcare providers from secondary exposure and contamination. Unique issues may hinder clinical actions. These include coordination with law enforcement for a crime scene, public health entities for surveillance and monitoring, hazardous materials teams for decontamination, and the media for risk communications. Finally, the importance of personal preparedness is discussed.
Biological Warfare Agents ; Chemical Warfare Agents ; Civil Defense ; Nuclear Weapons ; Terrorism

Drunk driving is a serious social problem. We estimated the blood alcohol concentration of a defendant on the request of local prosecutor's office in Korea. Based on the defendant's history, and a previously constructed pharmacokinetic model for alcohol, we estimated the possible alcohol concentration over time during his driving using a Bayesian method implemented in NONMEM®. To ensure generalizability and to take the parameter uncertainty of the alcohol pharmacokinetic models into account, a non-parametric bootstrap with 1,000 replicates was applied to the Bayesian estimations. The current analysis enabled the prediction of the defendant's possible blood alcohol concentrations over time with a 95% prediction interval. The results showed a high probability that the alcohol concentration was ≥ 0.05% during driving. The current estimation of the alcohol concentration during driving by the Bayesian method could be used as scientific evidence during court trials.
Bayes Theorem ; Blood Alcohol Content ; Driving Under the Influence ; Forensic Sciences* ; Korea ; Pharmacology, Clinical* ; Social Problems ; Uncertainty