Patterns of cumulative abuse among female survivors of intimate partner violence: links to women's health and socioeconomic status.

Drawing on the Women's Health Effects Study, a community sample of women (N = 309) who recently left an abusive partner, this study examines patterns of cumulative abuse experiences over the life course, their socioeconomic correlates, and associations with a range of health outcomes. Latent class analysis identified four groups of women with differing cumulative abuse profiles: Intimate Partner Violence (IPV) Dominant, Child Abuse and IPV, All Forms, and All Forms Extreme. We find a relationship pattern between cumulative abuse and socioeconomic circumstances, and significantly worse health outcomes among women with the All Forms Extreme profile. Implications for research and practice are discussed.

When 'breast' is no longer 'best': Post-partum constructions of infant-feeding in the hospital.

In this paper, we focus on the initial experiences of breastfeeding among mothers to examine the ways that infant-feeding is socially constructed in the hospital. Data comes from 51 in-depth interviews with 17 first-time mothers in Ontario, Canada. Analysis reveals 52 magnified moments that we categorize as Successful, Ultimately Successful and Unsuccessful. For mothers who describe Successful and Ultimately Successful moments, breastfeeding is understood as physiologically natural, and as something they must learn to do. Unsuccessful moments reveal that when health care providers interpret breastfeeding as not working, the breastfeeding discourse frequently shifts to one that incorporates formula as the means to achieve optimal infant health. In other words, in the hospital 'breast is best' holds true when breast 'works', otherwise mothers are often directed to give their babies formula. While formula appears to be compulsory in these moments, it is not typically understood as a "good or best" infant-feeding practice. For mothers in this situation, the shift from breast to formula is experienced as failures or evidence of inadequacy in their mothering. Paradoxically, our results suggest that formula may not, in and of itself, pose a threat to mothers' overall continued practice of breastfeeding. It appears that Successful and Ultimately Successful moments coincide with the current dominant 'breast is best' understanding. Unsuccessful moments, conversely, are insightful because they reveal when and how hospital practices disrupt mothers' understanding of their bodies and their role in providing the 'best' form of infant food. The implications for policy and practice are discussed.

Identifying factors that predict women's inability to maintain separation from an abusive partner.

In this study, the extent to which nine indicators of intrusion (i.e., unwanted interference in everyday life) predicted the odds of women maintaining separation from an abusive partner was examined using data from a community sample of 286 Canadian women. Higher levels of depression and PTSD symptoms significantly and independently increased women's risk of being unable to maintain separation from a former or new abusive partner over a 12-month period (Odds Ratios 4.6 and 2.7, respectively). These finding underscore the importance of supporting women to identify and manage mental health problems as a means of enhancing their safety.

Patterns of depressive symptoms and antidepressant use among women survivors of intimate partner violence.

PURPOSE: One of the primary mental health responses of women experiencing intimate partner violence (IPV) is depression, yet little is known about the mental health and antidepressant use of women in the period after leaving an abusive partner. We investigate patterns of antidepressant use and depressive symptoms by various social indicators (parenting status, socioeconomic status, severity of abuse and disclosure of abuse). Second, we examine whether variation in antidepressant use is explained by higher rates of depression diagnoses and/or depressive symptoms, taking these social indicators into consideration. METHODS: We examine data from the Women's Health Effects Study, a community sample of 309 Canadian women who have recently left an abusive partner. RESULTS: Bivariate results reveal that over 80% of women with elevated depressive symptoms are without diagnosis and antidepressant medication. Multivariate analyses show that antidepressant use is predicted by an indicator of economic disadvantage, with women who receive social assistance or disability benefits being more likely to report elevated antidepressant use, controlling for both depressive symptoms and depression diagnoses. CONCLUSIONS: Documenting and explaining depressive symptoms and antidepressant use among IPV survivors provides insight into one of many possible treatment options available to women with depression, and sheds light on potential health disparities among this subgroup of the population.

Leaving ≠ moving: housing patterns of women who have left an abusive partner.

Access to safe and affordable housing is a key concern for women leaving abusive partners. Yet little is known about women's housing patterns around leaving. In this community sample, approximately equal numbers of women did not move, moved once, and moved two or more times during the transition period around leaving. Overall, moving patterns were associated with housing type and suitability, economic circumstances, and severity of violence. This study calls into question the tendency to equate leaving with moving, draws attention to the different housing patterns after leaving, and highlights the need to tailor housing supports to diverse women.

Modelling the effects of intimate partner violence and access to resources on women's health in the early years after leaving an abusive partner.

Although the negative health effects of intimate partner violence (IPV) are well documented, little is known about the mechanisms or determinants of health outcomes for women who had left their abusive partners. Using data collected from a community sample of 309 Canadian women who left an abusive partner, we examined whether women's personal, social and economic resources mediate the relationships between the severity of past IPV and current health using structural equation modelling. A good fit was found between the model and data for hypothesized models of mental and physical health. In the mental health model, both the direct and total indirect effects of IPV were significant. In the physical health model, the direct effect of IPV on physical health was about four times as large as the total indirect effects. In both models, more severe past IPV was associated with lower health and women's personal, social, and economic resources, when combined, mediated the relationship between IPV and health. These findings demonstrate that the health outcomes of IPV for women who have left an abusive partner must be understood in context of women's resources.

Natural killer cells in peripheral blood and lung tissue are associated with chronic rejection after lung transplantation.

BACKGROUND: Natural killer (NK) cells have the capacity to recognize and respond to alloantigen, yet their role in lung transplant rejection is not well defined. The aim of this study was to correlate NK cell numbers and immunophenotype in peripheral blood and tissue with graft function after lung transplantation. METHODS: NK cell subsets were immunophenotyped in peripheral blood (n = 41). Lung tissue was stained for NK cells via CD16 and morphologic assessment (n = 30). RESULTS: Peripheral blood NK cells were activated in patients with chronic rejection, but the overall number of cells was lower in these patients when compared with stable patients. Furthermore, there was significantly more CD16(+) NK cells in the lung compartment of patients with bronchiolitis obliterans syndrome compared with stable patients (p = 0.001). CONCLUSIONS: In patients with chronic rejection, peripheral blood NK cells are activated but their numbers decrease, while the number of NK cells in the lungs increases. This suggests NK cells systemically activate and migrate to the lung during the progression of chronic rejection after lung transplantation.

Family structure, gender, and health in the context of the life course.

We estimate the effects of single parenthood on parental health and determine whether such effects are similar for all single parents or whether there are variations by gender among young, middle-aged, and older adults. The results of our analyses of the Canadian National Population Health Survey (NPHS) reveal that single parenthood is associated with elevated psychological distress and alcohol consumption among women, especially among those who are in younger age groups. Although we find no such differences among men, there is some indication of elevated distress among younger fathers. We discuss the implications of these findings for thinking about single parenthood at various life stages.