Thea Brown is Professor of Social Work and Director of the Family Violence and Family Court Research Program at Monash University. She has served on Family Court committees and on the Commonwealth Family Law Pathways Advisory Group. Dr Renata Alexander is Senior Lecturer in Law at Monash University and a member of the Victorian Bar. She was Deputy Registrar in the Family Court and is the author of Domestic Violence in Australia, 3rd edition.
..THEA BROWN RENATA ALEXANDER
Understanding the issues facing human service and legal professionals
Child maltreatment constitutes a social problem that affects all societies of the world.
A recent study by the World Health Organisation points out that millions of children
suffer some form of maltreatment and require medical and social attention. It should
be noted that around 53,000 children are murdered every year; the prevalence of
sexual abuse is 73 million (7%) and 150 million (14%) in boys and girls, respectively,
under 18 years of age; and between 25% and 50% of the children inform that they have
been physically abused....
I’ve been thinking about putting this book together for
several years. During two de cades of writing about nursing, I’ve read
many inspirational books, articles, and essays that offer up the literary
equivalent of comfort food for RNs. The authors invariably mean
to be helpful to the nursing profession by lifting the spirits of its practitioners
at a time when so many are feeling tired, stressed out, dispirited,
A frank discussion alone with the patient before the examination provides op-
portunity to discuss any sexual symptoms or concerns without another
person present. Common reasons for fearing or avoiding pelvic examinations
include embarrassment, lack of information, cultural or language barriers,
pain with previous examinations, or post-traumatic stress related to sexual
abuse. Each of these circumstances requires additional sensitivity and efforts
to minimize emotional or physical discomfort. Often, given an opportunity,
patients can articulate ways to decrease personal discomfort.
I am writing this Foreword in my role as the founding editor of
the new Springer Series on Family Violence and editor of Volume
I in the series entitled Battered Women and Their Families: Interven-
tion Strategies and Treatment Programs, 2nd edition (1998).
Public health is emerging as one of the most important drivers
in midwifery, and yet there are few textbooks that address the
midwife’s role in public health.
This book summarises the important developments in public
health over recent years and will relate the recommendations to
midwifery practice in a clear and easily understood manner. It
highlights issues around health inequalities pertinent to maternity
services and promotes individualised, non-judgmental approaches
The absorption of midwifery into medical practice is a recent process, a
development linked in many western countries with the diminishing role of
midwives, the increased involvement of the man-midwife, the general
practitioner and the obstetrician in the birthing process and, in the twentieth
century, the increased hospitalization of childbirth.
The care of a woman and her baby in the immediate hours, days and
weeks following birth can make an enormous difference to their longterm
health and well-being. The content and timing of postnatal care
led by midwives was formalised in the United Kingdom following a
statutory legislation that was first introduced in England in 1902. Then
there were concerns that too many women were dying following birth.
This is an exciting and timely book. It describes how nurses are pioneering
complementary therapies within the medical system to give comfort and healing to
their patients. It is 40 years since I graduated from general nursing training at Prince
Henry’s Hospital Melbourne with deep disappointment about the medical model of
1960. Perhaps my greatest concern was that nurses had insufficient opportunity and
resources to give true caring to their patients.
No one is immune from the risk of abuse. The National Center on Elder Abuse estimates
that 818,000 elderly Americans were victims of domestic abuse in 1994.
There are far
fewer data on lesbian, gay, transgender, and bisexual (LGTB) victimization. However, the
available literature suggests similarly high rates for LGTB adolescent and adult
with higher rates in male same-sex relationships than female.
Women who are abused have poorer mental and
physical health, more injuries, and a greater need for
medical resources than non-abused women.
Multi-Country Study on Women’s Health and Domestic
Violence found that abused women in Brazil, Japan, and
Peru are almost twice as likely as non-abused women to
report their current health status as poor or very poor.
The impact of gender-based abuse on physical health
can be immediate and long-term. Women who are abused
rarely seek medical care for acute trauma, however.
Including urinary issues in the gynecologic evaluation is helpful. Urinary
tract infections (UTIs) are one of the most common reasons to seek medical
care and are sometimes triggered by sexual activity. Urinary incontinence is
an increasingly recognized health problem (see Chapter 10).
Finally, because domestic violence is common (2), screening for current or
previous physical, emotional, or sexual abuse is an important part of the pa-
tient’s history and in some states is mandatory.
Early researchers in the field played down individual
personality disturbances as causal agents of
family violence in favour of social and cultural
factors (27). More recently, though, research on
family violence has shown that abusers who are
physically aggressive are more likely to have
personality disorders and alcohol-related problems
than the general population (28).
Most of the early work on abuse of the elderly was
limited to domestic settings and carried out in
developed countries. In seeking explanations for
elder abuse, researchers drew from the literature in
the fields of psychology, sociology, gerontology
and the study of family violence. To accommodate
the complexity of elder abuse and the many factors
associated with it, researchers have turned to the
ecological model, which was first applied to the
study of child abuse and neglect (24) and has been
applied more recently to elder abuse (25, 26).
The abuse of older people by family members dates
back to ancient times. Until the advent of initiatives
to address child abuse and domestic violence in the
last quarter of the 20th century, it remained a
private matter, hidden from public view. Initially
seen as a social welfare issue and subsequently a
problem of ageing, abuse of the elderly, like other
forms of family violence, has developed into a
public health and criminal justice concern.
According to the focus group study in South
Africa mentioned earlier, much of the abuse – and
particularly domestic violence – occurred as a result
of social disorder, exacerbated by crime, alcohol
and drugs. Similar conclusions came from an
exercise conducted by seven male community
leaders of the Tamaho squatter camp in Katlehong,
South Africa (15).
Courts are now required to notify all domestic violence offenders of
the two federal domestic violence-related gun prohibitions. Courts
must inform all domestic violence offenders that they may be subject
to federal firearm prohibition(s). The notification should also inform
the abuser of applicable state, tribal, or territorial laws that may limit
purchase or possession of firearms and ammunition. It is important
that offenders are aware of these prohibitions.
To plan and conduct their attack, the 9/11 plotters spent somewhere between $400,000
and $500,000, the vast majority of which was provided by al Qaeda. Although the origin
of the funds remains unknown, extensive investigation has revealed quite a bit about the
financial transactions that supported the 9/11 plot. The hijackers and their financial
facilitators used the anonymity provided by the huge international and domestic financial
system to move and store their money through a series of unremarkable transactions.
In 1999, in collaboration with an expert advisory committee, the FVPF published
Preventing Domestic Violence: Clinical Guidelines on Routine Screening. This document
endorsed a set of national guidelines on screening for abuse and offered recommendations
on whom to screen, how often and in what settings. As inquiry for domestic violence
becomes more widespread, the need to expand these guidelines to include guidance
regarding assessment and response has become apparent.
ON To develop these Guidelines, the FVPF partnered with advisors from the National Health
Care Standards Campaign on Domestic Violence: a coalition of health care providers,
public health and policy leaders, and domestic violence advocates from 15 states working to
promote improved health care responses to victims of abuse. The FVPF also invited the
Advisory Committee from the 1999 Preventing Domestice Violence: Clinical Guidelines on
Routine Screening to be reviewers. Advisory Committee members worked assiduously to
develop and revise the Guidelines.