Frequent Perpetrators Research Articles

Sexual harassment, abuse and intimate relationships between coaches and athletes: a systematic review

ABSTRACT While sexual harassment and abuse (SHA) can be perpetrated by various individuals in sport, coaches have been studied as one of the most frequent perpetrators due to their physical and emotional proximity to athletes. This systematic review attempted to evaluate the past 20 years of research (2003–2023) examining SHA and inappropriate intimate relationships between coaches and athletes. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline, 20 studies that met the eligibility criteria were identified using four databases (PubMed, PsycNET, ScienceDirect and SportDiscus). Findings reveal common thematic measures among the studies reviewed, including characteristics of SHA (n = 9), coach-athlete sexual relationships (CASR; n = 7) and grooming (n = 4). Based on the narrative synthesis of each thematic measure, SHA in sport is experienced and/or perceived as various forms of sexual misconduct, ranging from harassment (e.g. sexual jokes, unwanted comments, fondling) to abusive behaviors (e.g. kissing, showing coach's private body parts, sexual intercourse). Although some studies show the acceptance of CASR especially when athletes are above the age of legal consent, the strong majority of studies suggest that CASR in general is harmful and unacceptable given the unequal power dynamics between the two parties. Additionally, grooming was often involved as a conscious strategy to cross athletes’ personal boundaries for eventual sexual misconduct through building trust and manifesting seemingly innocuous behaviors. Overall, these findings shed light on the current state of research on SHA occurring between coaches and athletes and have implications for sport governing bodies and organizations to be better aware of the issue, which in turn can result in creating a safer environment for youth athletes.

Using Social Media to Recruit Seldom-Heard Groups: Reaching Women and Girls with Experience of Violence in Iran

Social media recruitment and online surveys are valuable tools in social science research, but their effectiveness in reaching seldom-heard victims of gender violence in low-middle income (LMI) countries is under-explored. This empirical study aims to: (1) describe violence and abuse experiences and (2) assess the benefits and limitations of using social media to document violence against women and girls (VAWGs) in a LMI country to render visible the experiences of potentially isolated victims. A total of 453 Iranian women (aged 14–59, mean = 28.8, SD = 8.04) responded to an Instagram invitation for a study on women’s health and violence exposure from February 2020 to January 2022. The questionnaire covered general gendered abuse, domestic violence (DV), and forced unemployment. The analysis was performed using Stata 17. Nearly all participants reported abuse, including sexual (85.0%), psychological (83.4%), and technology-facilitated (57.4%) abuse, with 77.4% experiencing multiple forms. The street (62%) and home (52.8%) were common abuse locations. The perpetrators included known individuals (75.9%) and strangers (80.8%), with 56.7% reporting abuse by both. DV was reported by 72.6%, mainly involving psychological (73.1%), physical (53.4%), and/or sexual (17.2%) violence, with fathers (47.8%), husbands (42.7%), and brothers (40.2%) as frequent perpetrators. A quarter reported forced unemployment. Those experiencing DV and/or forced unemployment showed higher depression levels, suicidal ideation, and lower marital satisfaction. The study suggests using social media recruitment for VAWG research but cautions against overgeneralising from these data.

Australian nursing students' experiences of workplace violence during clinical placement: A cross-sectional study.

To identify the nature, degree and contributing factors of workplace violence (WPV) incidents experienced by Australian nursing students during clinical placement. Descriptive cross-sectional study. Data were collected from 13 September to 25 November 2022. Eligible participants included all nursing students enrolled in nursing degrees at any Australian university who had completed at least one clinical placement. An adapted version of the WPV in the Health Sector Country Case Study survey was used. A total of 381 nursing students across eight states of Australia completed the survey. More than half of the students had experienced an episode of WPV; patients were the most frequent perpetrators. Personal factors of patients, staff and students, organizational factors and cultural norms within the workplace supported acts of WPV. Student nurses (SNs) most often experience violence from patients during direct care. Patient encounters are the core component of clinical placement. Education providers have a responsibility to effectively prepare students to be able to identify escalating situations and manage potentially violent situations. Registered nurses who supervise students during clinical placement require support to balance their clinical role with student supervision. Experiencing WPV can negatively impact relationships between students, healthcare professionals and care recipients. This results in personal distress, decreased job satisfaction and potentially the decision to leave the nursing profession. What already is known: SNs are exposed to WPV during clinical placement. More than half the SNs in this study experienced violence inclusive of physical, verbal, racial and sexual harassment. Patients were the predominant perpetrators. Implications for practice/policy: Interventions at individual and systemic levels are required to mitigate WPV. This study is reported using the STROBE guidelines.

Comparative analysis of codes white given by the emergency departments of two different third level hospitals in Ankara

Aims: In our study, we aimed to compare the codes white given by the emergency services of two tertiary hospitals in Ankara, to reveal the significant differences between them and to discuss the reasons that may lead to these differences. Methods: In our study, we compared the codes white data given from the Emergency Medicine Department of Bilkent Ankara City Hospital (ABCH) and Ankara Training and Research Hospital (ATRH) between 01.01.2021 and 31.12.2022. We classified the data according to the gender, occupation, working hours of the violence, the person who caused the violence, and the type of violence. For research analysis, we grouped the data using Windows-based Microsoft 365 Excel, and for statistical analysis, we used IBM SPSS version 26. Results: The gender that was exposed to violence more in ABCH was women, the most frequent perpetrators were the relatives of the patients, and the type of violence experienced was verbal violence. In ATRH, male health workers were the most frequently exposed to violence, while the most frequent perpetrator was the patient himself, and more cases of physical violence were reported. Conclusion: There are significant differences between the incidents of violence in the emergency departments of the two hospitals, which have different socio-cultural environments due to their location.

Non-Accidental Injuries in Pediatric Primary Care: A Systematic Literature Review of Objective Assessment Tools and Trends in Gulf Cooperation Council Region.

Nonaccidental injuries (NAI) in pediatric primary care in the Gulf Cooperation Council (GCC) region refer to intentional injuries inflicted on children, usually by a caregiver or a family member. The region has seen an increase in nonaccidental injuries in recent years, and healthcare providers have a crucial role in identifying and managing the cases. The aim of research on nonaccidental injuries in pediatric primary care in the GCC region is to identify objective assessment tools and evaluate trends in the region. PubMed, Google Scholar, and EMBASE databases were searched using search string keywords. The search was conducted on 7thFebruary 2023. The keywords included in the search included the search terms: nonaccidentalinjuries, pediatric, and GCC. All the studies were published between 1990 and 2023.The articles that passed the eligibility criteria were read fully to examine whether they would be relevant to the current systematic literature review. An initial search identified 3059 studies (Google Scholar = 6, EMBASE =12, PubMed = 4732). After the deletion of similar articles, only 3613 articles were left for further screening. The abstracts and titles of the left articles were scanned and screened to decide whether they were included in this systematic review. After deletion, 16 papers were inspected and read fully based on predefined eligibility criteria. Eventually, 11 papers were recognized and identified that passed the eligibility criteria of this systematic review. The studies reviewed in this analysis highlight the significant problem of child abuse in the GCC region, particularly neglect as the most common form of abuse. The studies also suggest that parents are the most frequent perpetrators of abuse. The need for policies and interventions to prevent child abuse and support victims is paramount.

CHARACTERISTICS OF ADOLESCENT, FAMILY, AND PARENTING STYLES ON SEXUAL VIOLENCE IN ADOLESCENTS

Violence is a case that teenagers often experience, and violence cases in Indonesia are increasing every year. This study aims to analyze how adolescent and family characteristics and parenting styles influence sexual violence in adolescents. The research design used a cross-sectional study, followed by 45 young women who had experienced sexual violence in several provinces in Indonesia. The data collection technique used voluntary sampling using google-form, distributed through social media. This study uses the Parental Acceptance Rejection (PARQ) and Child Sexual Abuse (CSA). The results showed that adolescents who experienced violence were in the age range of 13 to 18 years. Teenage fathers primarily work as labourers, and mothers do not work/IRT. Parental marital status in general, living in their own home and residing in rural areas. The style of acceptance, aggression, neglect, and rejection of parents is low. However, sexual violence against adolescents is severe, with the most frequent perpetrators of violence perpetrated by their peers. The results showed that parents whose status was married had a rejection style of parenting, and teenagers who did not have their bedroom felt more cared for. Adolescents who live with nuclear families and receive an accepting parenting style from their parents are less likely to experience sexual violence.
 Keywords: family characteristics, parenting style, sexual violence, teenagers

Experience of Workplace Violence from the Patients among Mental Health Nurses in Indonesia: A Mixed Method Study

Background: Workplace violence by patients and visitors (PVV) against nurses is regarded a devastating occupational issue around the world. The most frequent perpetrators of violence against nurses were patients, followed by their families and other healthcare professionals. Aim:This study aimed to use a mixed method to analyze violence by patients and visitors against nurses in mental health hospital in Indonesia. Methods: The 250 mental health nurses at two general public hospitals in Bandung were recruited with stratified convenience sampling by years of working experience. Result: All nurses experienced workplace violence from both patients and their families. At least nurses experienced more than 3 types of violence with the most frequent type of violence were verbal and physical violence. The six themes were emerged including variation of violence in nurse, traumatic impact of violence, impacts of violence on profession, violence not only come form patients but also family, reason of violence, and spiritual coping. Conclussion: It is necessary to prioritize more efficient and approachable methods for nurses to deal with patients’ aggresive behavior, and to establish constant training program.

One-year prevalence of domestic violence against women during the COVID-19 pandemic in an urban community in Southern Nigeria

Background:Violence against women is a major public health challenge particularly in the developing countries. During the COVID-19 pandemic, varied rising incidence of domestic violence against women were reported. This study determined the one-year prevalence of domestic violence against women during the COVID-19 pandemic in an urban community in Southern Nigeria.Methods: This descriptive cross-sectional study was conducted during the COVID-19 pandemic. Multistage sampling technique was utilized in recruiting 616 female respondents from an urban community in Benin City, Nigeria. Structured intervieweradministered questionnaire was the tool for data collection. The questionnaire was adapted from the 2018 Nigeria Demographic Health Survey and the 2006 World Health Organization multi-country survey tool. Data analysis was done using IBM-SPSS version 25.Results: More than a third of the women 221 (35.9%) had been victims of domestic violence in the last one year of the COVID-19 pandemic. The types of domestic violence experienced by the women included: psychological 120 (54.3%), physical 68 (30.8%), sexual 38 (17.2%) and economic 36 (16.3%). Husbands 52 (76.5%) and boyfriends 39 (57.4%) of the victims were the most frequent perpetrators of physical violence.Conclusion: The study revealed a high one-year prevalence of violence against women in the community during the COVID-19 pandemic. Psychological and physical violence were most prevalent and were perpetrated mainly by intimate partners of the women. The social media can be utilized routinely to educate the masses about violence against women. Also, men should be engaged in the prevention of domestic violence programmes through education workshops.
 Keywords: Prevalence; Perpetrators; Violence against women; Domestic violence; COVID-19 pandemic; Southern Nigeria

Socijalne komunikacije i praksa kriminalnih aktivnosti krađom beba u Republici Srbiji

We live in a world full of controversial contradictions, with a large number of different threats, dangers, risks and consequences, among which are the problems of stealing babies from maternity hospitals in the Republic of Serbia. In a large number of countries where babies are targeted, there is the former Yugoslavia, and thus the Republic of Serbia. In the description of this research problem, there is a significant problem of state institutions that do not have evidence and results on the prevention and detection of violators of criminal and criminal acts of theft of babies. On the contrary, state and private social and medical institutions have successfully communicated, cooperated and carried out criminal activities of stealing babies. So, in these and similar conditions, families and their babies have been the targets of organized crime in committing crimes of illicit theft or kidnapping of babies, by their parents. Frequent perpetrators of crimes and participants in crime are individual doctors, midwives, nurses and criminals, who buy or payfor the delivery of a baby, by acquiring large amounts of money, for each baby sold. The analysis showed that state institutions, including some members, the Ministry of Health (maternity hospitals), the Ministry of the Interior (Police) and the Ministry of Justice (prosecutor's offices and courts), which did not show, participated, communicated and acted in the mentioned acts. responsibility and results in finding and seizing stolen babies, except for a small number of individual cases. Their stated results, they needed to protect their colleagues who participated in the theft of babies. Accordingly, an association of families was organized and formed, whose stolen and sold babies just disclosed the participants who stole their babies, as shown by our research results. Key words: baby theft, crime, crime, doctors, midwives, medical staff

Bullying, undermining and harassment in vascular surgery training: a stubborn problem that damages the specialty

Background: Bullying, undermining and harassment (BUH) behaviours are present amongst healthcare workers and have detrimental effects on the victim’s well-being and adversely affect patient outcomes. Although it is known that these problems are prevalent within surgery, there are few data on the extent of the issue amongst UK vascular trainees specifically. Methods: The Rouleaux Club (RC), representing UK vascular trainees, has conducted two surveys which were distributed amongst 137 members of the RC between May and July 2017 and 831 between March and April 2021. Data were collected on demographics and personal experiences of BUH behaviours as well as those witnessed by trainees. Comparisons were made between the responses of each survey. Results: The 2017 survey yielded 71 responses and the 2021 survey resulted in 86 responses, with estimated response rates of 51.8% and 10.3%, respectively. In 2017, 33 (47.1%) respondents reported personally experiencing BUH compared with 57 (72.2%) in 2021 (p=0.002). In 2017, seven (20%) reported witnessing BUH compared with 45 (57.7%) four years later. The most frequent perpetrators were vascular consultants (31 (81.6%) in 2017 and 55 (96.5%) in 2021, p= 0.020). BUH behaviours related to gender or sexual orientation increased from affecting two respondents (5%) in 2017 to 18 respondents (28.1%) in 2021 (p=0.004). Conclusions: BUH behaviours are an ongoing problem within UK vascular training. Despite recent attempts to tackle these issues, there is no evidence of improvement and a signal for possible worsening of the problem. There is a need for further research to understand this issue in more detail in order to plan long-lasting interventions that will minimise detriment to individual trainees, protect the reputation of the specialty and maintain the safety of patients and optimal delivery of care.

Effects of workplace violence on the quality of care by nurses: A study of the Volta Region of Ghana

This study examined the incidence of workplace violence (WPV) against nurses and its effect on quality of care. A cross-sectional survey was conducted among 584 nurses working in public hospitals in the Volta Region. Almost twelve percent of the respondents experienced physical violence during the period under study. Although patients’ relatives were the most frequent perpetrators, it is disturbing to note that almost a fifth (17.1%) of all physical violence cases recorded in this study were perpetrated by supervisors and other staff members. There was a significant association between physical violence and the rank of the nurse (X2 = 14.196, df = 4, N = 584, p =.01). In relation to quality of care, we found that WPV was statistically significantly associated with a decline in all the facets of quality of care. It, for instance, impacted negatively on nurses’ relationship with patients (X2 = 26.862, df = 1, N = 41, p =.000). We suggest enhanced public awareness campaign and increased support for victims of workplace violence.

Perpetrators of Gender-Based and Sexual Harassment in the Field of Orthopaedic Surgery.

Background:The prevalence of gender-based and sexual harassment in the field of orthopaedic surgery in Canada is high. Previous research in other jurisdictions has identified the most common perpetrators of harassment to be senior surgeons or directors. We aimed to identify the most frequent perpetrators of gender-based and sexual harassment in orthopaedic surgery in Canada.Methods:We conducted a Canada-wide survey of all orthopaedic surgeons registered with the Canadian Orthopaedic Association and the Canadian Orthopaedic Residents’ Association. The development of our 116-item questionnaire was informed by a review of the literature and other published gender-based and sexual harassment surveys. Descriptive analyses, including frequency counts with associated 95% confidence intervals (CIs), are reported for all data.Results:Of the 465 survey respondents, the median age was 43 years (interquartile range, 35 to 59) and respondents were most commonly male (72%), White (81%), married (77%), and staff orthopaedic surgeons (68%). Peers were identified as the most common perpetrators of gender-based harassment (55%, 95% CI, 50 to 59), and patients were identified as the most common perpetrators of sexual harassment (48%, 95% CI, 43 to 52). Women were more likely to report direct supervisors or patients as the perpetrators of gender-based and sexual harassment, and men reported peers as the most common perpetrators.Conclusion:Orthopaedic surgery peers and patients are the most commonly reported perpetrators of gender-based and sexual harassment in Canada. The results of this study may be helpful to institutions in designing and focusing educational programs and/or policies and procedures to help reduce harassment incidents in the training and work environment.

Observations and reports of incidents of how birthing persons are treated during childbirth in two public facilities in Argentina.

This study sought to estimate the frequency and types of mistreatment during childbirth and explore health professionals' opinions on barriers/facilitators to providing respectful childbirth care. This prospective mixed-methods investigation consisted of direct observations of childbirth (n=250), at-home surveys with birthing individuals (n=45), and qualitative in-depth health staff interviews (n=6), conducted between January and July 2019, in two public facilities in Argentina. Frequencies of clinical practices and mistreatment and 5% confidence intervals were calculated. A logistic regression analysis was also conducted to examine associations between mistreatment and covariates of interest, with P<0.05 considered statistically significant. Overall, 61/250 (24.4%, confidence interval 19.6%-30.6%) observations recorded instances of mistreatment; 20/45surveyed participants (44.4%) reported at least one episode of mistreatment. The most frequent perpetrators were physicians (35.6%), birth companions (24.4%), midwives (22.2%), and nurses (13.3%). Participants with lower educational attainment and those racialized as non-white had higher odds of being mistreated. Health providers reported that respectful childbirth is currently widely implemented due to authorities' and communities' awareness on respectful birth´s rights. Almost a quarter of birthing people were observed to suffer mistreatment - primarily verbal abuse - and 44.4% of surveyed individuals reported mistreatment. Future research is needed to determine how to ensure the provision of respectful childbirth care for all. A quarter of participants experienced mistreatment; mostly those with lower educational attainment and/or racialized as non-white. Further research on implementation of respectful childbirth is warranted.

Violence among Female Health Care Workers

Introduction: Healthcare workers (HCWs) are at risk for workplace violence(WPV). It is a serious problem in both developed and developing countries andhas a great negative impact on the well-being of HCWs and on the quality of thehealth system. Aim of Work: To determine the prevalence, pattern, associatedfactors and impacts of WPV among female HCWs at Al-Zahraa UniversityHospital and to detect the causes and seek out suggestions to prevent suchincident. Materials and Methods: A cross-sectional study was conducted over4 months from September to December 2019 at Al-Zahraa University Hospitalusing a standardized questionnaire. The sample size was 312 physicians andnurses. Results: The prevalence of violence was 66.3% among the studiedHCWs with statistically significant higher prevalence among nurses (72.5%)than physicians (61.9%). Verbal violence was the most recurrent type (62.3%)followed by the physical type (19.8%). Patient relatives and friends were themost frequent perpetrators (63.3%). Emergency room was the most commonplace for violence (42.5%). Violent incidents result in physical, psychologicalimpacts and job dissatisfaction. There was significant association of violencewith the marital status and the work shift (p value 0.05). Low socioeconomic status of patients, shortage of medicalequipment and medicine and inadequate security were the most frequentlysuggested causes of violence. Conclusion and Recommendations: WPVis highly prevalent among the studied HCWs particularly the verbal one andresulted in physical, psychological and work related effects; that highlightsthe need to develop management strategy to overcome WPV against HCWs.Provision of medical equipment, medicine, security measures, legislationand to restrict public access to examination rooms were the most frequentlysuggested preventive measures.

The influence of experienced violence and the clinical learning environment on vocational identity in nursing students

Purpose: The purpose of this study is to determine the influence of the learning environment on nursing students' clinical practice education and the violence experienced during clinical practice on vocational identity. Methods: The design of the study was a descriptive survey, and data were collected from November 15 to November 27, 2019. The data of the study were obtained from 515 nursing students attending three universities using self-administered questionnaires. Data were analyzed using the SPSS 25.0 program. Results: For the experience of violence, verbal violence (98.3%) was the type most commonly experienced, and patients (97.7%) were the most frequent perpetrators. The clinical learning environment was perceived differently according to gender, personality, interpersonal relationship, satisfaction with nursing, clinical practice satisfaction, violence prevention education, the need for violence prevention education, sexual violence experiences, and violent perpetrators. The most influential factor on vocational identity was satisfaction with the nursing major (β=0.24, p&lt;.001), followed by extroverted personality (β=0.18, p&lt;.001), clinical learning environment (β=0.15, p=.001), satisfaction with clinical practice (β =0.15, p=.002), and the experience of violence by patients (β=-0.10, p=.016), which together explained 24.1% of the variance in the model. Conclusion: It is necessary to make efforts to ensure that students do not experience violence during clinical practice, to maintain a close cooperative relationship between university and clinical institutions to improve the learning environment for clinical practice, and to make the clinical field an educational learning environment.

Experiences of stigma among individuals in recovery from opioid use disorder in a rural setting: A qualitative analysis

IntroductionStigma is a barrier to accessing treatment and support services for individuals with substance use disorder. Stigma is negatively associated with completion of treatment for substance use disorder and management of recovery. ObjectiveTo learn from individuals in recovery from opioid use disorder in a largely rural area about how their personal experiences of stigma affected their ability to enter into treatment and stay in recovery. MethodsWe conducted ten focus group sessions with established cohorts of individuals in recovery who met regularly as part of recovery programs in central Maine, including two cohorts of postpartum women. Focus groups included 58 participants (33 women and 25 men, age > 18). We conducted a content analysis of focus group transcripts. ResultsStudy participants identified hospitals, government agencies, and pharmacies as the primary locations where they had stigmatizing experiences. Participants identified pharmacists and pharmacy technicians as the most frequent perpetrators of stigma. Participants identified fear and secrecy as pathways through which stigma negatively affected their recovery. ConclusionAnti-stigma training programs and related efforts conducted in rural areas may benefit from including pharmacists and pharmacy technicians in training activities, and from considering hospital, government agency, and pharmacy settings as venues for anti-stigma interventions.

Self-reported violence by nursing students in the context of undergraduate studies.

to identify the characteristics of violence in the context of the teaching and learning of the undergraduate Nursing course, from the perspective of students. quantitative, cross-sectional study, developed with 208 undergraduate students in Nursing. The data was obtained through the application of a survey questionnaire and processed by descriptive and bivariate statistics. of the participants, 69.2% (n = 144) have experienced some kind of violence. Violent acts of a psychological nature were the most frequent, but there were also reports of physical, sexual violence and deprivation or abandonment. Violence was practiced in a theoretical and practical learning environment. Teachers and classmates were the most frequent perpetrators. Most students had no reaction, told friends, family, and colleagues, or pretended that nothing happened in the face of the violent acts. violence is present at various moments in the undergraduate Nursing course and can negatively impact the quality of training in the area.

An Exploratory Study of Bullying Directed Toward Clinical Nursing Faculty: Prevalence and Impact.

Clinical education is an integral component of nursing education and relies heavily on clinical nursing faculty (CNF). However, there are not enough nurses seeking CNF positions to meet the current demand of the nursing workforce. The purpose of this study was to examine the prevalence and impact of workplace bullying directed toward CNF. For this exploratory cross-sectional study, a web-based survey was distributed to CNF working in New England states. A total of 76 participant responses were analyzed. Eighteen percent of the participants met the criteria for being either occasionally or frequently bullied. Nursing staff in the clinical agencies and colleagues and administrators in the nursing program where CNF teach were identified as the most frequent perpetrators. Understanding the prevalence and impact of bullying of CNF helps inform the development of strategies to support and retain these essential members of the nursing education workforce.

Bullying and undermining behaviours in surgery: A qualitative study of surgical trainee experiences in the United Kingdom (UK) & Republic of Ireland (ROI)

BackgroundBullying and undermining (B/U) behaviours are documented in the international surgical workplace. This study is the largest assessment of prevalence of B/U behaviours within UK & ROI surgical training to date. Materials and methodsUK & ROI surgical trainees were electronically surveyed in July 2017. The survey was open for one month and sent to all registered trainees at Core and Specialty level by the Joint Committee on Surgical Training (JCST) along with email and social media dissemination by the Association of Surgeons in Training (ASiT) and the British Orthopaedic Trainees Association (BOTA). A consensus session on the topic was conducted at the ASiT Conference in Edinburgh in March 2018. Standards for reporting of Qualitative Research were followed. Results1412 responses were received (26.6% response rate). All training regions, grades and specialties were represented. 60% of trainees (n = 837) reported witnessing or experiencing B/U behaviours in the surgical workplace. The most common reports related to sexism; 42% (n = 568) reported witnessing or experiencing sexist language/attitudes in the workplace. This was reported more by female respondents (66% compared to 27% male). 21% (n = 291) and 13% (n = 180) reported witnessing or personally experiencing racist and homophobic language or attitudes respectively. Consultants were identified as the most frequent perpetrators. The surgical wards or theatres were the most frequently reported areas that trainees either witnessed or experienced B/U behaviours. Of those trainees who had reported a personal experience of B/U behaviours (n = 344), 20% described their experiences of reporting as negative or very negative. 48.1% of respondents felt that surgery as a whole had a moderate, high or very high degree of a concern about B/U behaviours. ConclusionB/U behaviours are prevalent in the surgical domain. Urgent action is required to eradicate this unacceptable behaviour. A cross-specialty, intercollegiate response is required to tackle this issue and improve the working culture in surgery for all.

A multi-center study of horizontal violence in United States military nursing

Horizontal violence refers to repeated behaviors over time that intimidate or demean another. These behaviors may negatively impact the nursing workplace. The purpose of this study was to describe horizontal violence occurrence in the United States military nursing workplace and to determine the effectiveness of an educational intervention. Using a one group before-after design, survey data on horizontal violence behaviors, personal effects, perpetrators, job satisfaction and intention to leave were collected before and after a 30-min educational intervention. Reported horizontal violence behaviors and personal effects from horizontal violence averaged once to twice in a three month period. Staff nurses (peers) were the most frequent perpetrators. Job satisfaction and intent to leave significantly correlated with horizontal violence. There were no significant differences in overall horizontal violence before and after the intervention. Within the United States military nursing workplace horizontal violence does occur, although less frequently than in the United States civilian nursing population. Education on horizontal violence may not be sufficient as a sole intervention.