Psychosocial risk and protective factors associated with perpetration of gender-based violence in a community sample of men in rural KwaZulu-Natal, South Africa.

BACKGROUND: Rates of gender-based violence (GBV) in South Africa (SA) are among the highest in the world. In societies where social ideals of masculinity encourage male dominance and control over women, gender power imbalances contribute to male perpetration and women's vulnerability. The drivers that cause men to perpetrate GBV and those that lead to HIV overlap and interact in multiple and complex ways. Multiple risk and protective factors for GBV perpetration by males operate interdependently at a number of levels; at the individual level, these include chronic anxiety and depression, which have been shown to lead to risky sexual behaviours. OBJECTIVES: (i) To examine psychosocial risk factors (symptoms of anxiety and depression) as well as protective factors (social support and self-esteem) as self-reported by a cohort of males in rural KwaZulu-Natal (KZN) Province, SA; and (ii) to determine whether there are differences in anxiety, depression, social support and self-esteem between perpetrators and non-perpetrators. METHODS: A cross-sectional study using quasi-probability cluster sampling of 13 of 28 wards in Harry Gwala District, KZN. Participants were then randomly chosen from each ward proportionate to size. RESULTS: The participants were relatively young (median age 22 years); over half were schoolgoers, and 91.3% had never married. Over 43% of the sample reported clinical levels of anxiety and depressive symptoms on the Brief Symptom Inventory. Rates of GBV perpetration were 60.9%, 23.6% and 10.0% for psychological abuse, non-sexual physical violence and sexual violence, respectively. GBV perpetration was associated with higher depression, higher anxiety, lower self-esteem and lower social support. CONCLUSIONS: Interventions to address GBV need to take modifiable individual-level factors into account.

Resistance to passive shoulder external rotation in persons with hemiplegia: evaluation of an assessment system.

OBJECTIVES: To determine the LIDO Active System's reliability and validity in measuring resistance to passive external rotation (RPER) of the shoulder in subjects who have sustained a cerebrovascular accident (CVA). STUDY DESIGN: Twenty hemiplegic subjects, between the ages of 38 and 78 yrs, participated in the study; 14 agreed to be tested on two occasions, for the reliability phase of the study. OUTCOME MEASURES: RPER, measured by the LIDO Active system; tone in the internal rotator musculature, measured by the Ashworth Scale; and shoulder external rotation range of motion, measured by a standard goniometer. RESULTS: Test-retest reliability of RPER measured on the LIDO system was demonstrated with intraclass correlation coefficients of .95 and .67 on the affected and nonaffected limb, respectively. Differences in RPER between the affected and nonaffected limb were significant (p<.01) and RPER on the affected limb correlated significantly with Ashworth measures of muscle tone (Spearman's rho = .62). CONCLUSION: The LIDO Active System provided reliable and valid measures of RPER of the shoulder in hemiplegic subjects. The LIDO system may be a useful device for objective measurement of the effectiveness of medical and rehabilitation interventions designed to bring muscle tone into the normal range and decrease contracture in the shoulder musculature.