1,721,099 research outputs found
Vulnerability and risk among victims and suspects in sexual assault and rape
Full text linkTo increase our knowledge about sexual violence against women, the three studies in this thesis aimed at analyzing and comparing subgroups of both victims and assailants, as evidence-based research on these topics is limited. This thesis examines how sexual assaults committed against women with certain vulnerability factors differ from assaults against women who do not have such vulnerability characteristics. Further, the quality of police investigations of these crimes is studied with regard to differences between the corresponding cases of victims with and without vulnerability. Finally, three categories of rape suspects are examined to detect differences in assault characteristics and police investigations depending on the category of the suspect involved.
The basis for Paper I was a relatively large collection of data from the Sexual Assault Center (SAC) at St. Olavs University Hospital in Trondheim, Norway, from the period 2003–2010. These SAC data (Paper I) were then merged with corresponding data from police files at the Sør-Trøndelag Police District (STPD), and Papers II and III were based on data from the merged data sources, but then with different perspectives. All three papers in the thesis have a retrospective and descriptive design, although Papers II and III could be seen as having qualities of a historical prospective cohort design.
There are four main themes: (a) the association between victim vulnerability and assault characteristics, (b) the association between victim vulnerability and police investigation, (c) the association between suspect category and assault characteristics, and d) the association between suspect category and police investigation.
Vulnerable groups of victims constituted the majority of women contacting the Trondheim SAC and the STPD after being sexually assaulted. There were obvious patterns of difference in characteristics of sexual assaults committed against women with vulnerability compared to those without vulnerability.
Victims without any of the vulnerability factors were more often young students and assaulted during or after social settings where alcohol, and relatively large amounts of it, was served. In the cases of vulnerable victims, and presumably by the nature of these victims’ inherent vulnerability, alcohol seemed to a lesser degree “to be needed” in order to attract, mislead, and abuse them.
We found a trend showing less thorough police investigation of rape cases if the victims had vulnerability than in cases where victims did not have vulnerability. The police less often interrogated witnesses other than the victim and suspect, and they also less often secured biological material from the crime scene in cases involving victims with vulnerability than in cases involving non-vulnerable victims. Patterns of rape were different depending on the categories of suspects involved. Cases involving suspects who had a criminal record as a former suspect of a sexual/violent crime (recidivist suspects), were investigated more thoroughly by the police and were more often prosecuted than cases where suspects did not have a record of such crimes. More knowledge is needed in the future to improve preventive and protective means toward groups of women who are at increased risk of being sexually assaulted. Future research should explore the presence of eventual rape myth endorsement among law enforcement personnel, and whether such preconceived attitudes bias police investigations in rape cases depending on the characteristics of victims and suspects
Obesity, diabetes and hypovitaminosis D among women in a rural district of Nepal: Prevalence and risk factors. A population-based study
No full textThe prevalence of obesity, diabetes, and hypovitaminosis D has increased worldwide over the last decades, and these conditions have reached epidemic proportions. Low- and middleincome countries have experienced the most pronounced rise. South Asians tend to be more susceptible to obesity and diabetes than other ethnicities. Few studies have addressed the prevalence of these conditions among women in rural Nepal. The overall aim of this doctoral thesis was to investigate the prevalence of overweight/obesity, central obesity, diabetes and hypovitaminosis D, and associated risk factors among women in a rural district of Nepal. The thesis is based on two population-based cross-sectional surveys. Survey I was conducted in 2012-2013 among women in a rural district of Nepal (paper 1 and 2), and the outcomes were prevalence of sexually transmitted infections, and prevalence of overweight/obesity and diabetes and associated risk factors. The inclusion criteria were that they were or had been married and >15 years. Pregnancy was an exclusion criterion. Survey II was conducted in 2019-2020, and women who participated in survey I were invited (paper 3). The main outcome was prevalence of diabetes and risk factors and relation with vitamin A and D. In collaboration with female community health volunteers, all eligible participants received verbal information about the project and were invited to participate. In both surveys, information was collected through questionnaire, anthropometric and blood pressure measurements, and blood tests.
In paper 1, 1391 women aged 17 to 86 years (43.1 ± 14.4 years) were included. The women belonged to three ethnic groups, and the majority were uneducated. The prevalence of overweight/obesity, and central obesity was examined using cut-offs for Asians for body mass index (BMI) and waist circumference (WC). Altogether, 30.4% of the women were overweight and 12% obese; 34.2% had central obesity, whereas 25.7% exhibited both overweight/obesity and central obesity. Underweight was observed in 9.8%. Altogether 13.7% had hypertension. Intake of instant noodles ≥2 times weekly was associated with increased risk for central obesity and overweight/obesity, however, borderline significant for the latter. Current smoking and having >3 children were associated with a reduced risk for central obesity, although not significant. Hypertension was associated with both overweight/obesity and central obesity.
The aim of paper 2 was to assess the prevalence of diabetes and associated risk factors using HbA1c with a cut-off ≥6.5% (≥48 mmol/mol) as a diagnostic tool. HbA1c was analyzed in 757 women, age 17-86 years who were included in the study. We observed a high prevalence of diabetes and prediabetes, 13.5% and 38.5%, respectively. When using a cut-off of 7.0% to increase the specificity, the prevalence of diabetes was 5.8%. Aging, and intake of instant noodles and milk ≥2 times weekly were associated with increased risk for diabetes. Women with diabetes displayed a higher WC than those with normoglycemia, although not significant. The awareness on diabetes was low.
The aim of paper 3 was to study the prevalence of hypovitaminosis D (< 50 nmol/L) and risk factors. Altogether 733 women, 21-80 years of age, were included in the analyses, based on completion of vitamin D measurements. Vitamin D deficiency (< 30 nmol/L) and vitamin D insufficiency (30-50 nmol/L) were observed in 6.3% and 42.4%, respectively. Women reporting intake of milk or eggs ≥2 times a week displayed higher vitamin D levels than those with intake < 2 times weekly. Current smokers displayed lower levels of 25(OH)D than never smokers, although borderline significant. Women with vitamin D levels < 50 nmol/L exhibited higher levels of cholesterol, low-density lipoprotein-cholesterol, triglycerides, and HbA1c. Moreover, a regression analysis showed a significant association between hypovitaminosis D, dyslipidemia, and HbA1c elevation.
In conclusion, we show that obesity, diabetes, and hypovitaminosis D were highly prevalent among women in all age groups in a rural district of Nepal. Consumption of instant noodles was associated with increased risk both for overweight/obesity, central obesity, and diabetes.
Low vitamin D levels seemed to imply increased risk for diabetes and dyslipidemia. Eggs and milk appeared to be the best dietary sources of vitamin D. Our findings show that there is a need for increased awareness at all levels. Our study provides knowledge that could be used to develop preventive and promotive health programs addressing overweight/obesity, diabetes and hypovitaminosis D at community level, thereby slowing down the diabetes epidemics. Moreover, an intervention study with vitamin D supplements to those with vitamin D levels below 50 nmol/L is warranted to explore the effect of metabolic components
Prevalence of abuse reported by pregnant women - impact on postpartum depression and breastfeeding: A prospective population-based analysis in the Norwegian Mother and Child Cohort Study
Full text linkBackground: Abuse of women is a violation of human rights, and has adverse impact on
physical, mental and reproductive health. Yet, there is limited population based knowledge
about the effect on postpartum health and breastfeeding. There is also need for increased
understanding about the impact of abuse from different perpetrators. Large scale, population
based, prospective studies are requested to assess the public health impact of abuse.
Aims: To investigate the prevalence of adult sexual, physical and emotional abuse, and its
relation to socio demographics and other characteristics. To examine the association between
abuse and postpartum depression and early breastfeeding cessation and whether a potential
association differed between known and unknown perpetrators in a population based sample.
Methods: Our studies included pregnant women participating in the Norwegian Mother and
Child Cohort study. The information was based on self reported questionnaires and was
linked to the Medical Birth Registry of Norway. Paper I had a cross-sectional design and
included 65,393 women. Papers II and III were prospective, and included 53,065 and 53,934,
respectively.
Results: Overall, 32% reported any lifetime abuse, whereas 20% had experienced adult abuse
and 19% childhood abuse. Recent abuse was reported by 5% of the women. Emotional abuse
was the most common type of abuse both for adults and children, and 30% of the abused
reported two or more types of abuse. For all types of abuse, known perpetrator was more
commonly reported. Logistic regression analyses found that all types of adult abuse, as
singular or combined exposures, were significantly associated with postpartum depression.
The highest risk was seen among those exposed to recent adult abuse, compared with no adult
abuse. Past and recent abuse was associated with cessation of breastfeeding before four
months, and highest risk of cessation was seen in women exposed to three types of abuse.
This is one of the first studies to document the association between emotional abuse, as
singular or combined exposure, and early breastfeeding cessation. The increased risk of early
breastfeeding cessation was independent of prior depression, postpartum depression and other
confounders.
Conclusion: Norwegian women reported high prevalence rates of abuse. Different types of
abuse, as singular and combined exposures, whether recent or past, were associated with postpartum depression and early cessation of breastfeeding; which underscore the huge
burden of abuse on women’s health. The strong association between emotional abuse and
breastfeeding cessation highlights that emotional abuse alone, or in combination with other
types of abuse, should be assessed for. Abuse is not inevitable, accordingly, higher attention
and effort from health care providers, in order to initiate interventions to end abuse is crucial
Childhood abuse : pregnancy and childbirth
Full text linkBackground: Childhood abuse affects adult physical and psychological health. There is limited research on the effect of childhood abuse on pregnancy and childbirth. Studies usually focus on a single type of abuse, commonly sexual and/or physical abuse, few have considered emotional abuse. The results of studies on childhood abuse and mode of delivery are inconsistent. This might be due to methodological differences. No studies so far have focused on the relationship between childhood abuse and fear of childbirth, even though clinical practice and research suggest a correlation.
Objectives: The first aim of our study was to estimate the prevalence of any childhood abuse,
and for the sub-categories sexual, physical and emotional abuse, among unselected pregnant women in Norway. Secondly we assessed the association between childhood abuse and common complaints in pregnancy. Thirdly we investigated the relationship between a history of childhood abuse and mode of delivery. Finally we explored the relationship between a history of childhood abuse and fear of childbirth.
Subjects and methods: Study I, II and IV use data from questionnaires from the Norwegian Mother and Child Cohort (MoBa) Study linked to data from the Norwegian Medical Birth Registry. Study III used the Norwegian data from the European Bidens study, including only data from questionnaires. Study I was a cross-sectional study which included 55,776 pregnant women. Study II was a cohort study of 26,923 primiparous women. Study III was a crosssectional study including 2,365 pregnant women. Study IV is a longitudinal study which followed 4,876 women, collecting data during their first pregnancy, at birth, 6 months after birth and again during the second pregnancy.
Results: In our studies 18–24% of the women reported any childhood abuse, 5–11% emotional abuse, 11–16%, physical abuse, and 7–12% sexual abuse in childhood. Women reporting abuse in childhood were significantly more likely to report 7 or more common complaints in pregnancy. Primiparous women reporting a history of childhood abuse had an increased risk to give birth by caesarean section during labour. A history of childhood abuse was a significant risk factor for experiencing severe fear of childbirth among primiparous women in the cross-sectional Bidens study and among multiparous women in longitudinal MoBa study
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Vulnerability and risk among victims and suspects in sexual assault and rape
No full textTo increase our knowledge about sexual violence against women, the three studies in this thesis aimed at analyzing and comparing subgroups of both victims and assailants, as evidence-based research on these topics is limited. This thesis examines how sexual assaults committed against women with certain vulnerability factors differ from assaults against women who do not have such vulnerability characteristics. Further, the quality of police investigations of these crimes is studied with regard to differences between the corresponding cases of victims with and without vulnerability. Finally, three categories of rape suspects are examined to detect differences in assault characteristics and police investigations depending on the category of the suspect involved.
The basis for Paper I was a relatively large collection of data from the Sexual Assault Center (SAC) at St. Olavs University Hospital in Trondheim, Norway, from the period 2003–2010. These SAC data (Paper I) were then merged with corresponding data from police files at the Sør-Trøndelag Police District (STPD), and Papers II and III were based on data from the merged data sources, but then with different perspectives. All three papers in the thesis have a retrospective and descriptive design, although Papers II and III could be seen as having qualities of a historical prospective cohort design.
There are four main themes: (a) the association between victim vulnerability and assault characteristics, (b) the association between victim vulnerability and police investigation, (c) the association between suspect category and assault characteristics, and d) the association between suspect category and police investigation.
Vulnerable groups of victims constituted the majority of women contacting the Trondheim SAC and the STPD after being sexually assaulted. There were obvious patterns of difference in characteristics of sexual assaults committed against women with vulnerability compared to those without vulnerability.
Victims without any of the vulnerability factors were more often young students and assaulted during or after social settings where alcohol, and relatively large amounts of it, was served. In the cases of vulnerable victims, and presumably by the nature of these victims’ inherent vulnerability, alcohol seemed to a lesser degree “to be needed” in order to attract, mislead, and abuse them.
We found a trend showing less thorough police investigation of rape cases if the victims had vulnerability than in cases where victims did not have vulnerability. The police less often interrogated witnesses other than the victim and suspect, and they also less often secured biological material from the crime scene in cases involving victims with vulnerability than in cases involving non-vulnerable victims. Patterns of rape were different depending on the categories of suspects involved. Cases involving suspects who had a criminal record as a former suspect of a sexual/violent crime (recidivist suspects), were investigated more thoroughly by the police and were more often prosecuted than cases where suspects did not have a record of such crimes. More knowledge is needed in the future to improve preventive and protective means toward groups of women who are at increased risk of being sexually assaulted. Future research should explore the presence of eventual rape myth endorsement among law enforcement personnel, and whether such preconceived attitudes bias police investigations in rape cases depending on the characteristics of victims and suspects
Prevalence of abuse reported by pregnant women - impact on postpartum depression and breastfeeding: A prospective population-based analysis in the Norwegian Mother and Child Cohort Study
No full textBackground: Abuse of women is a violation of human rights, and has adverse impact on
physical, mental and reproductive health. Yet, there is limited population based knowledge
about the effect on postpartum health and breastfeeding. There is also need for increased
understanding about the impact of abuse from different perpetrators. Large scale, population
based, prospective studies are requested to assess the public health impact of abuse.
Aims: To investigate the prevalence of adult sexual, physical and emotional abuse, and its
relation to socio demographics and other characteristics. To examine the association between
abuse and postpartum depression and early breastfeeding cessation and whether a potential
association differed between known and unknown perpetrators in a population based sample.
Methods: Our studies included pregnant women participating in the Norwegian Mother and
Child Cohort study. The information was based on self reported questionnaires and was
linked to the Medical Birth Registry of Norway. Paper I had a cross-sectional design and
included 65,393 women. Papers II and III were prospective, and included 53,065 and 53,934,
respectively.
Results: Overall, 32% reported any lifetime abuse, whereas 20% had experienced adult abuse
and 19% childhood abuse. Recent abuse was reported by 5% of the women. Emotional abuse
was the most common type of abuse both for adults and children, and 30% of the abused
reported two or more types of abuse. For all types of abuse, known perpetrator was more
commonly reported. Logistic regression analyses found that all types of adult abuse, as
singular or combined exposures, were significantly associated with postpartum depression.
The highest risk was seen among those exposed to recent adult abuse, compared with no adult
abuse. Past and recent abuse was associated with cessation of breastfeeding before four
months, and highest risk of cessation was seen in women exposed to three types of abuse.
This is one of the first studies to document the association between emotional abuse, as
singular or combined exposure, and early breastfeeding cessation. The increased risk of early
breastfeeding cessation was independent of prior depression, postpartum depression and other
confounders.
Conclusion: Norwegian women reported high prevalence rates of abuse. Different types of
abuse, as singular and combined exposures, whether recent or past, were associated with postpartum depression and early cessation of breastfeeding; which underscore the huge
burden of abuse on women’s health. The strong association between emotional abuse and
breastfeeding cessation highlights that emotional abuse alone, or in combination with other
types of abuse, should be assessed for. Abuse is not inevitable, accordingly, higher attention
and effort from health care providers, in order to initiate interventions to end abuse is crucial
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