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Background Identification in UK general practice of women affected by domestic violence and abuse (DVA) is increasing, but men and children/young people (CYP) are rarely identified and referred for specialist support. To address this gap, we collaborated with IRISi (UK social enterprise) to strengthen elements of the IRIS+ intervention which included the identification of men, direct engagement with CYP, and improved guidance on responding to information received from other agencies. IRIS+ was an adaptation of the national IRIS (Identification and Referral to Improve Safety) model focused on the needs of female victim-survivorsof DVA. Without diminishing the responses to women, IRIS+ also responded to the needs of men experiencing or perpetrating DVA, and CYP living with DVA and/or experiencing it in their own relationships. Our study tested the feasibility of the adapted IRIS+ intervention in England and Wales between 2019-21. Methods We used mixed method analysis to triangulate data from various sources (pre/post intervention questionnaires with primary care clinicians; data extracted from medical records and DVA agencies; semi-structured interviews with clinicians, service providers and referred adults and children) to assess the feasibility and acceptability of the IRIS+ intervention. Results The rate of referral for women doubled (21.6/year/practice) from the rate (9.29/year/practice) in the original IRIS trial. The intervention also enabled identification and direct referral of CYP (15% of total referrals) and men (mostly survivors, 11% of total referrals). Despite an increase in self-reported clinician preparedness to respond to all patient groups, the intervention generated a low number of male perpetrator referrals (2% of all referrals). GPs were the principal patient referrers. Over two-thirds of referred women and CYP and almost half of all referred men were directly supported by the service. Many CYP also received IRIS+ support indirectly, via the referred parents. Men and CYP supported by IRIS+ reported improved physical and mental health, wellbeing, and confidence. Conclusions Although the study showed acceptability and feasibility, there remains uncertainty about the effectiveness, cost-effectiveness, and scalability of IRIS+. Building on the success of this feasibility study, the next step should be trialling the effectiveness of IRIS+ implementation to inform service implementation decisions.

One in five children in the UK are affected by domestic violence and abuse. However, primary care clinicians (GPs and nurses) struggle to effectively identify and support children and young people living in homes where it is present. The IRIS+ (Enhanced Identification and Referral to Improve Safety) training and advocacy support intervention aimed to improve how clinicians respond to children and young people affected by domestic violence and abuse. IRIS+ training was delivered as part of a feasibility study to four general practices in an urban area in England (UK). Our mixed method design included interviews and questionnaires about the IRIS+ intervention with general practice patients, including children and young people as well as with clinicians and advocacy service providers. We collected the number of identifications and referrals by clinicians of children experiencing domestic violence and abuse through a retrospective search of medical and agency records 10 months after the intervention. Forty‐nine children exposed to domestic violence and abuse were recorded in medical records. Thirty‐five children were referred to a specialist domestic violence and abuse support service over a period of 10 months. Of these, 22 received direct or indirect support. The qualitative findings indicated that children benefitted from being referred by clinicians to the service. However, several barriers at the patient and professional level prevented children and young people from being identified and supported. Some of these barriers can be addressed through modifications to professional training and guidance, but others require systematic and structural changes to the way health and social care services work with children affected by domestic violence and abuse.

The COVID-19 pandemic, and associated social restrictions, have amplified women’s experiences of domestic abuse (DA). In usual times, female DA survivors reach out to those around them (friends, family members, neighbors, and colleagues) for support. Accessing of both professional and informal support by survivors has increased during the pandemic. Informal supporters are often deeply invested and immersed in situations of DA because of the closeness of relationships. The accounts of informal supporters are rarely sought, yet these are people who may have a considerable awareness of what is happening. The aim of this study was to explore how the pandemic had impacted people’s assessment of abusive situations and their ability to provide informal support. This paper reports a secondary analysis of qualitative data collected in 2020 in England. The data were gathered in 18 in-depth interviews with people who knew a female friend, relative, neighbor, or colleague who had experienced DA. The age range of participants was 25–69 years, three were men and fifteen were women. A reflexive thematic analysis was carried out. Findings indicated: (i) the pandemic had changed people’s ability to read situations and assess risk (ii) perpetrators were exploiting the pandemic to further abuse (iii) within the context of the pandemic there was additional challenge to offering support (iv) informal supporters found creative ways to remain in-touch and to continue offering support. Further research with informal supporters is needed to ascertain how best to support and equip people, without imposing an impossible burden.

Background The COVID-19 pandemic created new challenges to delivering safe and effective health care while minimizing virus exposure among staff and patients without COVID-19. Health systems worldwide have moved quickly to implement telemedicine in diverse settings to reduce infection, but little is understood about how best to connect patients who are acutely ill with nearby clinical team members, even in the next room. Objective To inform these efforts, this paper aims to provide an early example of inpatient telemedicine implementation and its perceived acceptability and effectiveness. Methods Using purposive sampling, this study conducted 15 semistructured interviews with nurses (5/15, 33%), attending physicians (5/15, 33%), and resident physicians (5/15, 33%) on a single COVID-19 unit within Stanford Health Care to evaluate implementation outcomes and perceived effectiveness of inpatient telemedicine. Semistructured interview protocols and qualitative analysis were framed around the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, and key themes were identified using a rapid analytic process and consensus approach. Results All clinical team members reported wide reach of inpatient telemedicine, with some use for almost all patients with COVID-19. Inpatient telemedicine was perceived to be effective in reducing COVID-19 exposure and use of personal protective equipment (PPE) without significantly compromising quality of care. Physician workflows remained relatively stable, as most standard clinical activities were conducted via telemedicine following the initial intake examination, though resident physicians reported reduced educational opportunities given limited opportunities to conduct physical exams. Nurse workflows required significant adaptations to cover nonnursing duties, such as food delivery and facilitating technology connections for patients and physicians alike. Perceived patient impact included consistent care quality, with some considerations around privacy. Reported challenges included patient–clinical team communication and personal connection with the patient, perceptions of patient isolation, ongoing technical challenges, and certain aspects of the physical exam. Conclusions Clinical team members reported inpatient telemedicine encounters to be acceptable and effective in reducing COVID-19 exposure and PPE use. Nurses adapted their workflows more than physicians in order to implement the new technology and bore a higher burden of in-person care and technical support. Recommendations for improved inpatient telemedicine use include information technology support and training, increased technical functionality, and remote access for the clinical team.

BACKGROUND The COVID-19 pandemic created new challenges to delivering safe and effective health care while minimizing virus exposure among staff and patients without COVID-19. Health systems worldwide have moved quickly to implement telemedicine in diverse settings to reduce infection, but little is understood about how best to connect patients who are acutely ill with nearby clinical team members, even in the next room. OBJECTIVE To inform these efforts, this paper aims to provide an early example of inpatient telemedicine implementation and its perceived acceptability and effectiveness. METHODS Using purposive sampling, this study conducted 15 semistructured interviews with nurses (5/15, 33%), attending physicians (5/15, 33%), and resident physicians (5/15, 33%) on a single COVID-19 unit within Stanford Health Care to evaluate implementation outcomes and perceived effectiveness of inpatient telemedicine. Semistructured interview protocols and qualitative analysis were framed around the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, and key themes were identified using a rapid analytic process and consensus approach. RESULTS All clinical team members reported wide reach of inpatient telemedicine, with some use for almost all patients with COVID-19. Inpatient telemedicine was perceived to be effective in reducing COVID-19 exposure and use of personal protective equipment (PPE) without significantly compromising quality of care. Physician workflows remained relatively stable, as most standard clinical activities were conducted via telemedicine following the initial intake examination, though resident physicians reported reduced educational opportunities given limited opportunities to conduct physical exams. Nurse workflows required significant adaptations to cover nonnursing duties, such as food delivery and facilitating technology connections for patients and physicians alike. Perceived patient impact included consistent care quality, with some considerations around privacy. Reported challenges included patient–clinical team communication and personal connection with the patient, perceptions of patient isolation, ongoing technical challenges, and certain aspects of the physical exam. CONCLUSIONS Clinical team members reported inpatient telemedicine encounters to be acceptable and effective in reducing COVID-19 exposure and PPE use. Nurses adapted their workflows more than physicians in order to implement the new technology and bore a higher burden of in-person care and technical support. Recommendations for improved inpatient telemedicine use include information technology support and training, increased technical functionality, and remote access for the clinical team.

Objective: To evaluate routinely collected service data from a ‘Birth Trauma’ psychology clinic integrated into maternity services, in order to review effectiveness for women with symptoms of Post-Traumatic Stress Disorder (PTSD) following childbirth. Background: Prevalence of PTSD after child-birth has been estimated to be around 3% for women meeting full diagnostic criteria and up to 9% for sub-threshold symptoms. This can occur even in response to deliveries considered to be medically straightforward. NICE guidelines (2018) recommend psychological therapy as a first line treatment for symptoms of PTSD. Methods: The sample included 114 women referred post-natally for psychological assessment and intervention following a traumatic birth experience. Measures were routinely administered as part of initial assessment (T1) and at completion of intervention (T2). Data from these measures were collated and analyzed using a series of paired sample t tests. Following assessment 101 women were taken on for psychological intervention and of these, 74 completed both T1 and T2 measures. Results: There were highly significant reductions across all measures of PTSD, anxiety and negative mood symptoms. The treatment effect sizes were very large. Mean total score on a measure of PTSD symptomatology was no longer clinically significant following interventions. Conclusion: This evaluation suggests an integrated Birth Trauma psychology clinic using a small number of contact sessions is a highly efficient and effective model of care for women experiencing symptoms of PTSD following childbirth.

Following lockdowns in countries around the world, reports emerged of a ‘surge’ or ‘spikes’ in the number of domestic violence and abuse cases. It is critical to contextualise this: more men are not starting to be abusive or violent; rather, the patterns of abuse are becoming more frequent. Spiking and surging make us think in terms of more one-off incidents but it is more likely that the pattern of abuse that is already there is increasing in terms of frequency and type because both parties remain together at all times. Amid such a crisis, it is imperative that we continue to see the dynamics of domestic violence and abuse as both a pattern of abusive behaviours and a product of gendered social and cultural norms, rather than a reaction to a specific factor or event, such as COVID-19.

Background Domestic violence and abuse is a violation of human rights which damages the health and wellbeing of victims, their families and their friends. There has been less research on the experiences and support needs of male victims than those of women. Historically research on men’s experiences has not focused on what constitutes effective, needs-led service provision. The aim of this paper was to conduct an integrated mixed methods synthesis of systematic review evidence on the topic of help-seeking by male victims of domestic violence and abuse. Methods An integrated mixed methods synthesis approach was taken to enhance our understanding of the complex phenomenon of help seeking by, and service provision to male victims. This process also identifies gaps in the evidence. Using previously identified systematic review data; mixed methods data from four primary-level service evaluation studies, along with expert and patient consultation were used to develop research propositions. Primary-level qualitative interview and survey data from 12 studies of men experiences were mapped onto the propositions to support them. Results Fourteen propositions were composed. Seven propositions were supported or at least partly supported by the qualitative data. These supported propositions were used to make recommendations for policy and practice particularly concerning service preferences of male victims. The remaining seven propositions were not specifically supported by the qualitative data. These unsupported propositions were used to develop research recommendations concerning the need to further understand the potential blurred boundaries of victim–perpetrator, hybrid perpetrator-victim experiences, men who are/have been victims of childhood sexual abuse and determining the level of risk for men. They also highlight the need to produce better guidance for the response of the police & the criminal justice system. Finally, they highlight the need to produce the most appropriate service for men in terms of access, linkage, substance/alcohol abuse, mental health, sexuality, and race. Conclusion Integrated mixed-methods synthesis of systematic review evidence is a relatively novel approach. This approach can lead to recommendations for policy and practice as well as highlighting gaps in the research agenda as shown in this example.

Many women who experience domestic violence (DV) seek support from friends, relatives, colleagues and neighbours. There are substantial knock-on effects for informal supporters, and they may seek help themselves. Tailored services for this group are rare, but domestic violence helplines can provide listening and signposting support. The aim of this exploratory study was to understand which informal supporters contact domestic violence helplines, and what form these calls take.Three focus groups, following a topic guide, were conducted with staff and volunteers for domestic violence helplines during autumn 2015. Discussions were digitally recorded, transcribed verbatim, and imported into NVivo10 software. Transcripts were coded line-by-line, and a thematic analysis carried out. All participants were female, aged between 22 and 54 years, with between two months’ and eight years’ experience of taking helpline calls.Findings indicate that people with broad ranging connections to a survivor call a helpline. Calls can be triggered by disclosures, abuse escalation, witnessing incidents, feeling overwhelmed, and media highlighting of DV. Informal supporters respond to survivors, and experience impacts, in differing ways, often associated with their gender and their relationship with the survivor. Frequently, they feel a sense of responsibility and a desire to rescue the survivor, often calling a helpline to reduce feelings of helplessness and to seek a ‘magic’ solution. Many people are concerned about the legitimacy of their involvement and seek reassurance about the validity of their own help-seeking. Helpline workers feel that informal supporters would benefit from opportunities to reduce isolation, have their predicament acknowledged, and learn from peers.DV helplines have an important role in helping informal supporters of survivors. The help requested is predominantly to equip and empower the informal supporter, so that they feel more adept at coping themselves and, are thus, better able to offer support to the survivor.

Background The COVID-19 pandemic intensified women's experiences of domestic abuse. Demand for specialist support increased substantially, and UK campaigns encouraged friends, family members, neighbours, and colleagues of domestic abuse survivors to provide support informally. Research with informal supporter participants is rare, and yet, they are likely to have a good knowledge of the situation and to have substantial influence on outcomes. The aim of this research was to investigate how the pandemic impacted on informal supporters' appraisals of abusive situations and on their ability to provide assistance. Methods A qualitative study with informal supporters of female domestic abuse survivors was underway at the start of the COVID-19 pandemic. Participants were recruited in the Southwest of England using advertisements in community venues and, once social distancing and lockdown measures were introduced, recruitment was extended across England using social media advertisements. We added additional questions about the impact of the pandemic and the related social restrictions to the topic guide. 18 in-depth semi-structured interviews were conducted with three male and 15 female informal supporters (aged 25–69 years), over the telephone and using Skype. All participants gave recorded, oral informed consent. A secondary analysis of data relating specifically to the pandemic was undertaken using reflexive thematic analysis. The original study, and subsequent amendments, were granted ethics approval by the Research Ethics Committee in the School for Policy Studies at the University of Bristol. Findings The subset of participant interviews reported in this paper were held between March 30, 2020, and Sept 15, 2020. The themes generated in the analysis indicated four main findings. First, it seemed that the pandemic changed people's ability to “read” situations and to accurately assess the level of risk. Informal supporters felt greater uncertainty about whether the abuse had continued, altered, or escalated. Second, perpetrators' tactics evolved to further abuse by exploiting the pandemic. In particular, they increased surveillance and capitalised on reduced in-person contact. Third, the pandemic created a context where the capacity of informal supporters was increasingly stretched, and where safely offering support became more challenging. Finally, informal supporters demonstrated resourcefulness and creativity, for example, by forming support bubbles with survivors and finding novel ways to monitor the situation, in order to continue offering help. Interpretation In the face of uncertainty, and an incredibly challenging life-context, informal supporters of domestic abuse survivors demonstrated resilience, creativity, and innovation as they continued to offer support. The pandemic has simultaneously highlighted the importance of informal support, and the challenges in providing it. More direct research with informal supporters is crucial to determine how best to support and equip this population. Funding AXA Research Fund.

This article discusses the book, The Handmaid’s Tale, by Margaret Atwood. Recently made into a televised series in the US and also aired in the UK, the book, which was written in 1985, presents a dystopic/futuristic vision of an American future Puritan society called Gilead where women have no rights and function in terms of the wider needs of the society. This book has received particular attention recently because of some of the parallels that can be drawn between the evangelical utterings of the current US Republican administration, and the fictional world which Atwood created over 30 years ago. The book also, however, raises a whole raft of questions which lie at the foundations of feminism: the relationships which exist between women, the role of reproduction and power, sexuality, repression, endemic violence against women and resistance. This article will look at the key themes in the book alongside recent discussions about the lessons which can be learnt from the text and the warnings we need to heed.

This paper presents a narrative review of empirical evidence looking at connections between poverty and DVA. The findings presented includes social survey and qualitative evidence from the UK, and elsewhere where relevant, and is drawn from more than 80 research studies. The material was collated and supplemented by further secondary analysis of data collected as part of the 2012 UK Poverty and Social Exclusion Survey. Our review suggests that women experiencing poverty in the UK are more vulnerable to DVA, and this conclusion is consistent with wider international evidence. However, while associations clearly exist between poverty and DVA vulnerability, potential causal mechanisms are poorly understood and this reflects the limitations of existing data in this area. This paper highlights the need for further research exploring financial abuse within DVA relationships and post-separation financial abuse and poverty. Caution is needed in interpreting this relationship and drawing inferences for policy and practice. DVA is endemic throughout society in rich and poor countries, and interventions targeted at specific populations (including poverty) on their own are likely to be inadequate in the absence of a wider understanding of the social drivers of violence against women associated with patriarchal norms and practices in particular contexts.

Domestic violence (DV) is experienced by 1 in 4 women in the United Kingdom during their lifetime, and most survivors will seek informal support from the people around them, even if they choose not to access help from professionals. Support from these relatives, friends, neighbors, and colleagues can provide a buffer against effects on the survivor’s physical health, mental health, and quality of life, and has been shown to be protective against future abuse. There has been an absence of research studying members of survivors’ networks and, in particular, investigating how the impact of DV might diffuse to affect them. A systematic literature review of reported research (either in peer-reviewed journals or in gray literature) was undertaken to explore the impacts of DV on survivor networks. Of the articles found, 24 had data relating to the topic area, though no study addressed the question directly. Framework analysis and meta-ethnography generated the following themes: physical health impacts, negative impacts on psychological well-being, direct impacts from the perpetrator, and beneficial impacts on psychological well-being. The studies in this review indicated that informal supporters may be experiencing substantial impact, including vicarious trauma and the risk of physical harm. Currently, there is little support available which is directly aimed at informal supporters of DV survivors, thus these findings have practical and policy implications, in order to acknowledge and meet their needs.

Domestic violence and abuse (DVA) can include physical, psychological, sexual, emotional or financial abuses, and is a globally widespread problem across all age groups, cultures and socioeconomic groups. Alongside the impacts of DVA experienced by survivors, there is a growing recognition that other people, who form the support network of survivors, may also be affected by the situation. Domestic violence organisations such as helplines are important third sector services supporting survivors. However, there has been little research into the impact on those providing the support. This qualitative study of domestic violence helpline workers explored their needs and well-being. We used qualitative methodology, conducting interviews with staff recruited from a selection of different helplines who all undertook direct client-focused work. The interviews used a semi-structured format and followed a topic guide covering the training received before commencing work, self-care strategies, the impact of work on their daily life and support offered by their employer. Ten helpline staff were interviewed, all female. Following analysis of the qualitative data, a number of themes emerged. Participants disclosed numerous ways in which their work challenged their well-being, including burnout, impact on personal relationships, and lack of training and support at work. Participants used some self-care strategies in order to "switch off" from work, but they also wanted clinical supervision to support them with the difficulties they experienced at work. This study suggests that helpline staff should receive more education about trauma triggers, and ongoing support to reduce the impact on their home and social life, thus improving mental well-being and job satisfaction. This work begins the debate on the well-being needs of frontline helpline workers, and whether better meeting these needs can facilitate the provision of better support.

PURPOSE: Military populations may experience more severe forms of domestic violence than the general population. Although mental disorders are associated with domestic violence perpetration among the general population, it is not clear whether this is the case for military populations. This review aimed to establish the prevalence and odds of domestic violence perpetration among male and female military personnel with mental disorders.METHODS: Systematic review: searches of eleven electronic databases were supplemented by hand searches, reference screening, citation tracking and expert recommendations.RESULTS: Ten studies were included; nine reporting on partner violence and one on violence against an adult family member. Median prevalence estimates were calculated for partner violence perpetration among male military personnel with post-traumatic stress disorder (PTSD); estimates on other disorders were not possible due to lack of data. 27.5 % of men with PTSD reported past year physical violence perpetration against a partner and 91.0 % reported past year psychological violence perpetration against a partner. Due to limited data, no median estimates could be calculated for female military personnel. Data from individual papers indicate increased odds of past year partner violence perpetration among male and female military personnel with depression; inconsistent findings were reported for risk of partner violence perpetration among male and female military personnel with PTSD.CONCLUSIONS: There is some evidence that mental disorders among military personnel are associated with past year domestic violence perpetration, though current data cannot confirm direction of causality. Research is needed to inform the development of interventions targeted to reduce domestic violence perpetration among military personnel.

AimTo evaluate a training intervention for general practice-based doctors and nurses in terms of the identification, documentation, and referral of male patients experiencing or perpetrating domestic violence and abuse (DVA) in four general practices in the south west of England.BackgroundResearch suggests that male victims and perpetrators of DVA present to primary care clinicians to seek support for their experiences. We know that the response of primary care clinicians to women patients experiencing DVA improves from training and the establishment of referral pathways to specialist DVA services.MethodThe intervention consisted of a 2-h practice-based training. Outcome measures included: a pre-post, self-reported survey of staff practice; disclosures of DVA as documented in medical records pre-post (six months) intervention; semi-structured interviews with clinicians; and practice-level contact data collected by DVA specialist agencies.ResultsResults show a significant increase in clinicians’ self-reported preparedness to meet the needs of male patients experiencing or perpetrating DVA. There was a small increase in male patients identified within the medical records (6 pre- to 17 post-intervention) but only five of those patients made contact with a specialist DVA agency identified within the referral pathway. The training increased clinicians’ confidence in responding to male patients affected by DVA. The increase in recorded identification of DVA male patients experiencing or perpetrating DVA was small and contact of those patients with a specialist DVA support service was negligible. We need to better understand male help seeking in relation to DVA, further develop interventions to increase identification of male patients experiencing or perpetrating DVA behaviours, and facilitate access to support services.

Programmes of research which combine related studies are commonplace, including in the field of Intimate Partner Violence (IPV). Whereas the systematic synthesis of published qualitative data is now well established, the synthesis of qualitative data that make up a programme of work is rare. A Programme of Research on Violence in Diverse.Domestic Environments (PROVIDE) is a UK NIHR funded programme. The five studies associated with PROVIDE are sited in general practice, sexual health clinics, mental health services and 3rd sector IPV agencies. Synthesising the data from across-the studies offered an opportunity to highlight variations in help-seeking strategies according to gender and sexual orientation and identify variations in help-seeking across different contexts. The approach to the synthesis was meta-ethnography. The synthesis identified 23 2nd order constructs in relation to helpseeking. Findings show gender and sexuality influences how help-seeking in different contexts is viewed. Disclosure of IPV to mental health services was rare. Women favour help-seeking from primary care which is familiar and where they are known, whilst gay men favour help-seeking from GUM clinics where there is a taken for granted acknowledgement of sexual identity. These differences suggest an intersectional approach to providing support services for IPV is needed. (C) 2016 Published by Elsevier Ltd.

ObjectivesTo understand help-seeking by male victims of domestic violence and abuse (DVA) and their experiences of support services by systematically identifying qualitative and mixed-method studies and thematically synthesising their findings.DesignSystematic review and qualitative evidence synthesis. Searches were conducted in 12 databases and the grey literature with no language or date restrictions. Quality appraisal of the studies was carried out using the Critical Appraisal Skills Programme tool. Reviewers extracted first and second order constructs related to help-seeking, identified themes and combined them by interpretative thematic synthesis.SettingDVA experienced by male victims and defined as any incident or pattern of incidents of controlling coercive or threatening behaviour, violence or abuse among people aged 18 or over who are or have been intimate partners or family members, regardless of gender or sexuality.ParticipantsMale victims of DVA.InterventionsAny intervention which provides practical and/or psychological support to male victims of DVA including but not limited to DVA-specific services, primary healthcare and sexual health clinics.Primary and secondary outcome measuresQualitative data describing help-seeking experiences and interactions with support services of male victims of domestic violenceResultsWe included twelve studies which were published between 2006 and 2017. We grouped nine themes described over two phases (a)barriers to help-seeking: fear of disclosure, challenge to masculinity, commitment to relationship, diminished confidence/despondency and invisibility/perception of services; and (b)experiences of interventions and support: initial contact, confidentiality, appropriate professional approaches and inappropriate professional approaches.ConclusionThe recent publication of the primary studies suggests a new interest in the needs of male DVA victims. We have confirmed previously identified barriers to help-seeking by male victims of DVA and provide new insight into barriers and facilitators to service provision.PROSPERO registration numberCRD42016039999.

Objective To measure the experience and perpetration of negative behaviour, including domestic violence and abuse (DVA), and investigate its associations with health conditions and behaviours in men attending general practice. Design Cross-sectional questionnaire-based study conducted between September 2010 and June 2011. Setting 16 general practices in the south west of England. Participants Male patients aged 18 or older, attending alone, who could read and write English. A total of 1403 of eligible patients (58%) participated in the survey and 1368 (56%) completed the questions relevant to this paper. 97% of respondents reported they were heterosexual. Main outcome measures Lifetime occurrence of negative behaviour consistent with DVA, perceived health impact of negative behaviours, associations with anxiety and depression symptoms, and cannabis use in the past 12 months and binge drinking. Results 22.7% (95% CI 20.2% to 24.9%) of men reported ever experiencing negative behaviour (feeling frightened, physically hurt, forced sex, ask permission) from a partner. All negative behaviours were associated with a twofold to threefold increased odds of anxiety and depression symptoms in men experiencing or perpetrating negative behaviours or both. 34.9% (95% CI 28.7% to 41.7%) of men who reported experiencing negative behaviour from a partner, and 30.8% (95% CI 23.7% to 37.8%) of men who perpetrated negative behaviours said they had been in a domestically violent or abusive relationship. No associations with problematic drinking were found; there was a weak association with cannabis use. Conclusions DVA is experienced or perpetrated by a large minority of men presenting to general practice, and these men were more likely to have current symptoms of depression and anxiety. Presentation of anxiety or depression to clinicians may be an indicator of male experience or perpetration of DVA victimisation.

This paper reports findings from a longitudinal study of homeless women. Thirty-eight women were recruited with a retention rate of 58% over three rounds of interviews. Interviews explored specific events in women's lives, their current living arrangements and how their experiences and needs, including for social care, changed over time. Data were analysed thematically using a priori codes. Women reported a range of complex issues, consistent with experiences of deep social exclusion and received support from both statutory and voluntary agencies. Although women appreciated the support they received, many reported that services were fragmented and rarely personalised to their needs.

PDF version of an article written for the Creative Industries Innovation Website creativeinnovation.net.au, part of a series of articles showcasing the experience and knowledge of companies in the creative industries in Australia. This article features CODA, an innovative Perth based architectural firm who in 2011 had quadrupled its turnover in just three years after restructuring its business model and processes.