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Prevalence of domestic violence during pregnancy and related risk factors: a cross-sectional study in southern Sweden
Hafrún Finnbogadóttir1,
Anna-Karin Dykes1,2 &
Christine Wann-Hansson1,3
Domestic violence during pregnancy is a serious public health issue which threatens maternal and foetal health outcomes. The aim of the study was to explore prevalence of domestic violence among pregnant women in southern Sweden (Scania) and to explore associations with background factors, as symptoms of depression and sense of coherence.
This study has a cross-sectional design and is the first part of a longitudinal, cohort study. Inclusion criteria were women ≥ 18 years, registered at antenatal care when pregnant and who understand and write Swedish or English. Questionnaires were collected prospectively at seventeen antenatal care receptions situated in the two cities and six smaller municipalities in Scania. Statistical analyses were done using descriptive statistics, chi-square tests, bivariate logistic regression and multiple regression with Odds ratios (OR) and 95% confidence intervals (95% CI).
Study sample included 1939 women. History of violence was reported by 39.5% (n =761) women. Significant differences were obtained between the groups with or without history of violence regarding being single/living apart, unemployment, financial distress, smoking/snuffing, unintended pregnancy as well as history of miscarriage/legalised abortion (p < 0.001). Experience of domestic violence during pregnancy regardless of type or level of abuse was 1.0% (n = 18); history of physical abuse by actual intimate partner was 2.2% (n = 42). History of violence was the strongest risk factor associated with domestic violence during pregnancy, where all women (n = 18) exposed reported history of violence (p < 0.001). Several symptoms of depression (adjusted for low socio-economic status, miscarriage/abortion, single/living apart, lack of sleep, unemployment, age and parity) were associated with a 7.0 fold risk of domestic violence during pregnancy (OR 7.0; 95% CI: 1.9-26.3).
The reported prevalence of domestic violence during pregnancy in southwest Sweden is low. However, a considerable proportion of women reported history of living in a violent relationship. Both history of violence and the presence of several depressive symptoms detected in early pregnancy may indicate that the woman also is exposed to domestic violence during pregnancy. Increased attention to this vulnerable group of women is needed to improve maternal and child health.
Domestic violence (DV) during pregnancy is a serious public health issue which threatens maternal and foetal health outcomes [1–7]. DV is defined according to World Health Organisation (WHO) as psychological/emotional, physical, or sexual violence, or threats of physical or sexual violence that are inflicted on a woman by a family member: an intimate male partner, marital/cohabiting partner, parents, siblings, or a person very well known within the family or a significant other (i.e. former partner) when such violence often takes place in the home [8].The prevalence of DV against pregnant women varies widely in the literature, ranging from 1.2 to 66% [2]. This variation is probably attributable to differences across studies in sampled populations, as well as differences in methodologies, definitions, and cultural aspects that make it difficult to compare the results [2, 9]. The prevalence regarding intimate partner violence (IPV) during pregnancy has been demonstrated in the first global report of internationally comparable data on populations from 19 countries, ranged between 2.0% and 13.5% [10]. A recently published meta-analysis of 92 independent studies concerning prevalence and risk factors associated with DV among pregnant women showed an average prevalence of emotional abuse of 28.4%, and prevalence rates of physical abuse and sexual abuse were 13.8% and 8.0%, respectively [11]. Further, the overall prevalence of DV during pregnancy in less developed countries is higher (27.7%) than that in developed countries (13.3%) [11]. Most of the violence against women occurs at home; thus women are more at risk of violence from an intimate partner than from any other type of perpetrator [12].
A meta-analysis of 55 independent studies found that the strongest predictor of DV among pregnant women was experience of abuse before pregnancy [11]. Pregnant women whose partners previously abused them had four times greater odds of being abused during pregnancy than those women who had no history of violence. Other risk factors identified for DV among pregnant women were single marital status, lower education, low socioeconomic status, alcohol abuse (above all by the perpetrator), and unintended or unwanted pregnancy [11]. IPV is a strong risk factor for unintended pregnancy and abortion across variety of settings worldwide [13], and women undergoing repeated induced abortion are more likely to have a history of physical abuse by a male partner or a history of sexual abuse [13–15]. High levels of symptoms of mental disorders such as depression, anxiety and post-traumatic stress disorder during the perinatal period are also significantly associated with experience of DV both during lifetime and pregnancy [16].
DV during pregnancy also confers a risk for the unborn child. Thus, a systematic review of thirty studies showed that abused pregnant women are 1.5 times more likely to deliver a low birth-weight baby and almost 1.5 times more likely to have preterm births [7]. Moreover, ablation placenta, uterus rupture, [17, 18] foetal trauma [18, 19] or foetal death [19–21] have also been reported. The most extreme consequence of violence during pregnancy is femicide (homicide of females) and most likely by a current or former intimate partner [22].
In previous Swedish prevalence studies of physical or sexual abuse during pregnancy the prevalence varied between 1.3% and 11% [23–25]. However, these studies were conducted almost two decades ago, and due to continuous societal changes it is important to obtain more current prevalence rates. Further, the Swedish National Council for Crime Prevention has reported increasing numbers of abused women during the last two decades, with an increase of 1% during 2012 and primarily increases in single mothers and women in the workforce. The increasing figures can partly be explained by changes in legislation in the beginning of the 1980s such that abused women could no longer withdraw already submitted written reports of abuse [26]. Also, several studies from different regions in the country are required in order to be able to understand the entire population in the increasingly multicultural society of Sweden, as well as to allocate resources to those regions that might have higher prevalence rates of DV. Finally, results from a survey concerning DV during pregnancy would highlight the problem and hopefully increase awareness and action for identification and prevention. The aim of the study was to explore the prevalence of DV among pregnant women in southwest Sweden in the region of Scania and to identify possible differences between groups with or without a history of violence. A further aim was to explore associations between DV and potential risk factors such as; i) socio-demographic background variables ii) maternal characteristics iii) high risk health behaviour iv) self-reported health-status and sleep as well as symptoms of depression, and v) sense of coherence.
This study has a cross-sectional design and is the first part of a longitudinal cohort study. According to the WHO's ethical and safety recommendations for research into DV against women it is important that the survey on violence is framed in a different way, and also that the woman is fully informed about the nature of the questions [27]. Our study is framed as "Pregnant women and new mothers' health and life experience" were 'life experience' covers experienced violence. Pregnant women who fulfilled the inclusion criteria for the study were consecutively recruited during their first visit at Antenatal Care (ANC) for study participation. Inclusion criteria were women ≥ 18 years, registered at ANC when pregnant and who understood and could write Swedish or English. A power analysis indicated that at least 2000 participants were needed to detect with 98% certainty at least 2.5% prevalence of DV.
ANC's services in Sweden
In Sweden the ANC services are included in the overall health insurance system, free of charge (inclusive private care facilities) and available all over the country. Since the autumn 2011, private care facilities have increased in number, and women have the right to choose the type of care and midwife by herself. Midwives have the main responsibility for the normal pregnancy, and the father-to-be is also welcome to attend ANC visits. According to Swedish health care reports, almost 100% of pregnant women utilise their right to ANC services [28].
Settings and participants
The geographical area of Scania in southwest Sweden is characterised by multicultural diversity. Initially 26 ANCs in the area, a multicultural city with > 300 000 inhabitants, a university city with > 110 000 thousand inhabitants and surrounding municipalities were asked to participate in this study, among which nine ANCs declined. Four public ANC's in the municipality's area and five privately driven ANC's in the multicultural city declined to participate in the study due to high work load, or a new organization. The population includes all registered pregnant women at 17 ANCs situated in the multicultural city (n = 7), the University City (n = 4) and smaller municipalities (n = 6). One ANC providing specialised care for complicated pregnancies such as women with diabetes and one unique activity group for women with history of drug abuse in need of extra support were also included. Two of the ANCs in the multicultural city, one ANC in the University City and one ANC in the municipalities are private care facilities. Most of the women in the sample would presumably give birth at the regional university hospital, which has two separate delivery departments, with an approximately birth rate of 8000–9000 deliveries per year.
Data were collected prospectively between March 2012 and September 2013. Approximately 80 midwives performed the recruitment. Prior to the study all recruiting midwives were personally informed about the study design by the first author (HF). At every participating ANC maximally 24 to 29 questionnaires were distributed to each midwife. The pregnant women were invited to participate during their first visit to ANC, during the 6-8th week of pregnancy or at the visit when registered at the ANC during gestational weeks 11–13. If the midwife missed the opportunity to recruit the woman at these time periods, she was given the opportunity to recruit that woman at the latest during gestational week 25. If the woman had been delayed in registration at the ANC, the midwife was still encouraged to recruit her. The pregnant women received individually verbal and written information about the study by their midwife and were invited to answer the questionnaire in a private place at the ANC facility (possibilities for privacy varied between the facilities). After giving written informed consent, they received the questionnaire. The participant placed the completed questionnaire in a sealed envelope together with the signed consent form, which was similarly placed in a smaller sealed envelope and handed them over to the recruiting midwife. The woman was promised confidentiality and it was completely up to her if she disclosed to her midwife that she was living in a violent relationship. All answered questionnaires were kept in a safe place until they were collected every third week by the first author (HF) who gave each questionnaire (participant) a unique code. Both participants and recruiting midwives had the possibility to e-mail or call the first author whenever they wished. To facilitate the recruitment when the women were accompanied by their partner, simultaneously the partner was invited to take part in another study completely independent from the present study, Fathers to-be and new fathers'/partners', health and lifestyle. In the waiting room there were two different posters with information about the studies.
All data were based on a self-administrated questionnaire with 122 questions that took approximately 15–30 minutes to answer, depending on the individual.
NorVold Abuse Questionnaire (NorAQ)
The main instrument was the NorAQ, constructed and validated in Nordic countries [29]. This instrument measures emotional, physical and sexual abuse as a child (<18 years) and as an adult (≥18 years), and also includes a question about the age when first subjected to abuse. Further, a yes/no question about experience of abuse during the past 12 months is included, followed by the question "by whom", with eight alternatives and the possibility of a write-in alternative. All answer alternatives ('boxes to tick in') are followed by the alternative "by male" or "by female". The abuse variables in NorAQ have previously shown good reliability, validity and specificity [29]. All questions about abuse from the NorAQ questionnaire were administered in their original format in order to maintain the instrument's reliability, validity and specificity. Further, the questionnaire also included one question concerning health and one concerning sleep from the original NorAQ. The health question "How do you feel your health has been, generally speaking, for the last 12 months?" had the following four alternatives: i) very good, ii) rather good, iii) rather poor, iiii) very poor; sleep question "During the last 12 months, have you suffered from insomnia to such an extent that you have had problems coping with your daily life?" had the following four alternatives: i) No, ii) yes but rarely, iii) yes sometimes, iiii) yes often. In addition, the questionnaire contained questions validated and applied in the Nordic abuse study [30] relating to health and socio-demographic background.
Additionally questions to the questionnaire
One modified question was used from the Abuse Assessment Screen (AAS), "Have you been exposed to abuse during current pregnancy?" in order to investigate emotional, physical, and sexual abuse (yes/no, if yes by whom). One question concerned private economy: "If you received an unexpected bill of 20.000 SEK, (approximately USD 3000 or 1875 GBP or 2243 EUR) how easy would it be for you to pay within a week?" [31] Choices were: i) no problem, ii) pretty hard, iii) very hard.
Sense of coherence scale (SOC-13)
Views on life, stress management and the use of one's own resources to maintain and improve health were measured by a short form of the SOC-13 [32]. The SOC-scale instrument is reliable, valid and cross-culturally applicable with acceptable face validity [33]. Strong SOC (high score) is a significant predictor of good health [34].
Edinburgh Postnatal Depression Scale (EPDS)
Symptoms of depression were assessed using the EPDS, an instrument covering common symptoms of depression and that is designed to screen for risk of depression during the postnatal period [35], but can also be used during pregnancy (EDS) [36]. The instrument EPDS has a satisfactory sensitivity (85%) and specificity (77%) [35], and has been validated in a Swedish community sample against criteria for major depression, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) [37]. Also, the EDS has been validated for the detection of depressive symptoms during pregnancy with an optimal cut-off at ≥ 13 and indicates qualification for a diagnosis of probable depression (DSM-IV) [36]. The instrument has a sensitivity of 77% according to DSM-IV criteria and a specificity of 94%. The current study used the EDS full scale with 10 items on a four point scale from 0–3 (high scores = more symptoms of depression).
Finally, one question from the AUDIT was used for the detection of harmful alcohol consumption [38]. The question, which is the first item in the AUDIT, concerns the frequency of drinking alcohol. The answer alternatives were: 'never' or the amount of beverage consumption.
Classification of the variables
Age was classified as 18–25, 26–34 and ≥ 35 years. Country of origin was classified as born in Sweden, in another Nordic country or in other countries. Language was dichotomised as Swedish language or foreign language spoken at home. Educational status was classified as compulsory school or less, high school or less, or university. Cohabiting status was classified as single, living apart, or common law spouse/married. Employment status was dichotomised as employed (including parental leave and studying) or unemployed (including long illness). Financial distress was dichotomised as "no" (no problem) or "yes" (serious financial distress).
Maternal characteristics concerning body mass index (BMI) were calculated from maternal weight and height before the pregnancy and classified according to WHO's definition [39] as underweight (<18.5), normal weight (18.50- 24.99), overweight (≥25- 29.99), and obese (≥30). Smoking was dichotomised as "yes" (if the woman was a daily smoker or smoking at some point during pregnancy) and "no" (never smoked or ceased before pregnancy). Snuffing was dichotomised as "yes" (if the woman was a daily user of snuff or snuffing at some point during pregnancy) and "no" (never snuffed or ceased before pregnancy). Use of alcohol was dichotomised as "yes" or "no". Unintended pregnancy was dichotomised as "yes" or "no". Abortion/miscarriage was classified as "no", "miscarriage", "abortion" or both "miscarriage/abortion".
The study uses Swahnberg et al.'s [29] definitions for severity of abuse, classified as mild, moderate or severe and also type of abuse. Mild emotional abuse is the experience of being systematically and persistently repressed, degraded or humiliated. Moderate emotional abuse is the experience of being systematically and by threat or force restricted with regard to contacts with others or subjected to total control concerning what one may and may not do. Severe emotional abuse is the experience of living in fear due to systematic and persistent threats by someone close.
Mild physical abuse is being hit, smacked in the face or held in involuntary restraint. Moderate physical abuse is being hit with the fist(s) or with a hard object, being kicked, violently pushed, or beaten, or similar experiences. Severe physical abuse is being exposed to life threatening experiences, such as attempted strangulation, being confronted by a weapon or knife, or any other similar act.
Mild sexual abuse (with no genital act) is being touched on parts of the body other than the genitals in a sexual way against one's will or being forced to touch other parts of another person's body in a sexual way. Further, mild sexual abuse (emotional or sexual humiliation) is the experience of being forced to watch a pornographic film, to participate in a pornographic film or similar, being forced to show one's body naked or to look at someone else's naked body. Moderate sexual abuse (genital contact) is the experience of being touched on the genitals against one's will, being forced to satisfy him/herself sexually, or forced to touch another person's genitals. Severe sexual abuse (penetration) is forced penetration of the penis into the vagina, mouth or rectum, or forced penetration or attempted penetration by an object or other part of the body into the vagina, mouth or rectum [29].
History of violence is defined as lifetime experience of emotional, physical or sexual abuse, occurring during childhood (<18 years), adulthood (≥18 years) or both, regardless of the level of abuse or the perpetrator's identity, in accordance with the operationalization of the questions in the NorAQ [29].
As recommended by the Declaration of Helsinki [40], the likelihood of benefits from the current research was considered. Research on violence against women during pregnancy raises important ethical and methodological challenges in addition to those raised by any other type of research on human subjects [27]. Therefore, the current study was conducted in accordance with the WHO's ethical and safety recommendations for research on DV against women [27]. Approval was provided from the Regional Ethical Review Board in Southern Sweden (Dnr: 640/2008).
Descriptive statistics were used to show prevalence and severity of lifetime experience of any type and level of abuse (Table 1). Chi-square analysis was used to investigate differences in socio-demographic and maternal characteristics between women with and without reported 'history of violence' (Tables 2 and 3). OR and 95% CI were calculated for the crude associations between possible risk factors and 'DV during pregnancy', with 'DV during pregnancy' as a dependent variable for bivariate logistic regression. Age was dichotomised as 18–34 or ≥ 35 years, educational status as high school or less versus university, language as foreign language spoken at home or Swedish (solely), cohabiting status as single/living apart or cohabiting with spouse/married, and smoking and/or snuffing as "yes" versus "no". BMI was dichotomised as under-/normal weight or overweight/obese, miscarriage or abortion history as miscarriages/abortions versus solely abortion, miscarriages or not at all, self-reported health as poor health versus rather good health, "lack of sleep versus adequate sleep". For the purpose of bivariate logistic regression, a variable for depression was computed on the basis of EDS scores, i.e. symptoms of depression during pregnancy, whereby an optimal cut-off of ≥ 13 was chosen as representing presence of symptoms of depression [36]. The EDS score was computed only for those responding to all ten questions (missing = 62). In order to analyse the association between SOC score and exposure to 'DV during pregnancy', the SOC-scale was dichotomised, utilizing the first quartile of the distribution as a cut-off value (SOC ≤ 64 and SOC >64) [41]. The SOC score was only computed for those responding to all thirteen items (missing = 101). Multiple logistic regression was performed in order to evaluate the influence of variables that were significant in the bivariate logistic regression with 'DV during pregnancy' as a dependent variable; the multiple logistic regression analyses were thus step-wise adjusted (Forward selection) for EDS ≥ 13, SOC Low score, miscarriage/abortion, single/living apart, lack of sleep, unemployment and also age and parity. Statistical significance was accepted at p < 0.05. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 21.0 for Windows.
Table 1 Type and severity of abuse: lifetime and during pregnancy (N = 1939)
Table 2 Distribution of socio-demographic background factors at recruitment to the study (N = 1939)
Table 3 Overview of maternal characteristics and high risk health behavior at recruitment (N = 1939)
In total 1940 women accepted participation in the study. One woman was excluded because of age ≤ 18 years (Figure 1), leaving 1939 women primarily recruited during gestational week 13 (mean 12.84, SD 5.11, min 4- max 35). The distribution of the participants was: multicultural city, 51.9% (n = 1006), University City 22.3% (n = 433) and surrounding municipalities 25.8% (n = 500). Almost 80% had Sweden as a country of origin and the remaining participants were born in 93 foreign countries. Reported 'DV during pregnancy', regardless of type or level of abuse, was 1.0% (n = 18) in the entire cohort. Greater proportion of women born outside the Nordic countries compared to the native of Sweden reported DV during pregnancy (RR, 2.4). In the total cohort 39.5% (n =761) of the women reported experience of 'history of violence' with eleven answers missing (Table 1). Among the eleven cases with missing answers, there was a greater percentage of women who were foreign-born, who spoke foreign languages at home, and who were low educated.
Flowchart over recruitment to the study. The study population includes all registered pregnant women during the recruitment time n = 8194 at the 17 attending ANCs. Of those, 687 women did not fulfill the inclusions criteria for age or sufficient reading and writing skills in Swedish or English leaving 7507 women as eligible participants. External drop-out constitutes of women not invited to take part in the study or those who refused participation leaving 1940 participants. One of those did not fulfill the inclusion criteria for age (≥18 years) and was therefore excluded.
DV during pregnancy and abuse committed by intimate partner (solely)
DV by actual intimate partner in terms of lifetime emotional abuse was 0.8% (n =16) and seven of these reported 'DV during pregnancy'. Reported DV by actual intimate partner in terms of lifetime physical abuse was 2.2% (n = 42) and seven of these reported 'DV during pregnancy'. Reported DV by actual intimate partner in terms of lifetime sexual abuse was 0.2% (n =4) and two of these reported 'DV during pregnancy'.
DV and the perpetrator
Of those 19.5% (n = 374) women who reported lifetime emotional abuse (Table 1), 66.3% (n = 248) were exposed to DV and the perpetrator was male in all cases and in six cases also female (figures not offered in Table 1). Among the 29.3% (n = 561) women who reported lifetime physical abuse (Table 1), 74.2% (n = 416) were exposed to DV and the perpetrators were male in all cases but one, and in 28 cases females were also involved (figures not offered in Table 1). Among those 15.7% (n = 302) women who reported lifetime sexual abuse (Table 1), 37.1% (n = 112) were exposed to DV and the perpetrators were male in all cases, and in one case also female (figures not offered in Table 1).
Experience of a history of violence
Table 1 provides prevalence and severity of lifetime experience of emotional 19.5% (n = 374), physical 29.3% (n = 561) and sexual 15.7% (n = 302) abuse as well as experienced abuse during pregnancy 1.5% (n = 29) solely. Emotional abuse during current pregnancy was experienced by 1% (n = 20), physical abuse by 0.4% (n = 7) and sexual abuse by 0.1% (n =2). Of those women who reported 'history of violence', 16.5% (n = 61) had experienced emotional abuse, 6.7% (n = 36) physical abuse and 0.7% (n = 2) sexual abuse during the past year (Table 1).
Differences between groups with or without a history of violence
Table 2 shows the distribution of the socio-demographic factors for the total cohort (n =1939) of women with or without experience of a "history of violence". Statistical differences were found between the groups with regards to cohabitation, employment- and financial distress (p = 0.001). Further, Table 3 shows the results regarding maternal characteristics and high risk health behaviour for women with or without experience of a 'history of violence'. There were statistical difference between the groups regarding smoking and snuffing, unintended pregnancies and experience of legalised abortion or having had both a miscarriage and legalised abortion (p < 0.001).
Association between possible risk factors and exposure to DV during pregnancy
The strongest risk factor for DV during pregnancy was 'history of violence', whereby all women (n = 18) exposed to 'DV during pregnancy' also had reported 'history of violence' (p < 0.001). Unemployed women were 5.1 times more likely to report being exposed to 'DV during pregnancy' (p < 0.002). Women who were single or living apart were 6.9 times more likely to be exposed to 'DV during pregnancy' (p < 0.001). Further, women having a history of miscarriages and abortions were 7.6 times more likely to be exposed to 'DV during pregnancy' (p < 0.001). Those who reported lack of sleep during the past year were 4.7 times more likely to be exposed to 'DV during pregnancy' (p = 0.001). Women having EDS score ≥ 13 indicating presence of several symptoms of depression were 13.4 times more likely to be exposed to 'DV during pregnancy' (p < 0.001). Finally, women having low score on SOC indicating inability to use their own resources to maintain and improve their health in stressful situations were 9.1 more likely to be exposed to 'DV during pregnancy' (p < 0.001) (Table 4).
Table 4 Association between possible risk factors and exposure to DV during pregnancy (N = 1939)
When the analyses were controlled for low SOC score, miscarriage/abortion, single/living apart, lack of sleep, unemployment (significant in the bivariate analysis), age and parity, only EDS ≥ 13 remained significant (p < 0.004) and had 7.0 fold risk associated with 'DV during pregnancy'. Marginal associations were also found between 'DV during pregnancy' and miscarriage/abortion (p = 0.053), low SOC-score (p = 0.075) and age ≥ 35 years (p = 0.097) (Table 5).
Table 5 Association between possible risk factors and exposure to DV during pregnancy (n = 18) presented by OR with 95% CI
This study showed that the prevalence of 'DV during pregnancy' was 1%. However, more women reported a history of emotional, physical and sexual abuse performed by their actual intimate partner and also experiences of abuse during the past year. Women born outside Nordic countries were proportionally over-represented among those who experienced 'DV during pregnancy'. To our knowledge 'DV during pregnancy' has not previously been explored among pregnant woman in the same catchment area. Participation recruitment was mostly performed during the first and early second trimesters of pregnancy, and therefore, the results reflect responses to questions about abuse that were posed only once and at this particular time. It has been shown that repeated questioning increases the likelihood of disclosing experiences of physical violence [24, 42]. Further, the true prevalence of abuse may be difficult to determine because of fears concerning abuse escalation, if the abuse were to become known by the perpetrator [21]. However, the occurrence of current abuse may also be underestimated due to selection or non-respondent bias. A British longitudinal study indicated that the time of pregnancy was not a sensitive period for DV compared to the postpartum period, where prevalence of physical violence during pregnancy was 1% compared to almost 3% three years later [43]. Therefore, hypothetically, early pregnancy may be protective for women who live in violent relationships. However, the literature is not consistent concerning decreased violence when the woman becomes pregnant [10, 16, 44, 45]. Devries et al. [10] found that in countries reporting high levels of severe IPV, women did not necessarily report high levels of IPV during pregnancy, indicating that cultural factors may be important determinants of IPV during pregnancy. Previous studies have also indicated that IPV could start during pregnancy [45] or be initiated during the first pregnancy [44].
History of physical abuse performed by the actual intimate partner was reported by 2.2% (n = 42) of the subjects. These figures are similar to a previous Swedish study conducted in Uppsala where 2.8% (n = 29) admitted physical abuse by a close acquaintance the year before pregnancy, during pregnancy or 20 weeks postpartum [24]. Nevertheless, it is difficult to compare these results due to the use of different methods and definitions and the lack of separation of history of violence before or after pregnancy from violence during pregnancy. However, in a global perspective the prevalence rates of DV during pregnancy appear to be realistic, since in more developed countries rates seem to be lower than in developing countries [10, 11]. However, current results indicate that there is a need for increased attention to this vulnerable group of women who are exposed to violence during their pregnancy and to offer them first line help according to the WHO [46]. It could be of significance for the women exposed to violence to know in what matters society can help them and in what way they can get support from their midwives.
In the present study 'history of violence' or lifetime experience of emotional, physical or sexual abuse was reported by 39.5% (n = 761) of the women and was absolutely the strongest indicator of exposure to 'DV during pregnancy'. This is in accordance with results from a newly conducted meta-analytic review [11]. The response rates reported for 'history of violence' are slightly higher than those reported by non-pregnant women visiting gynaecological clinics in Sweden (37.5%) [30], as also measured by the NorAQ instrument. However, the rate reported by Stensson et al. [24] for lifetime emotional, physical or sexual abuse in pregnant women was considerably lower (19.4%), albeit another instrument was used. Also, the Stensson et al. [24] data collection was performed during 1997–1998, and several years have elapsed since this time. The prevalence rates of reported violence against women from the Swedish National Council for Crime Prevention have steadily been increasing during the past years, which partly can be explained by changes in the legislation in the beginning of the 1980s, whereby already submitted written reports about abuse cannot be subsequently withdrawn [26]. Also, media and authorities have called attention to the topic, and hopefully tolerance levels and attitudes towards DV are changing to the benefit of DV survivors.
In the present study the findings showed that the presence of several symptoms of depression was 7.0 fold more likely to be associated with 'DV during pregnancy'. Those findings are in accordance with a recently conducted meta-analytic review [11]. Both national and international studies show that several symptoms of perinatal depression are indeed significantly associated with the experience of 'DV during pregnancy' [16, 36, 47]. However, the direction of causality with regard to these findings has yet to be determined. The extent to which depression is a consequence of DV or a contributing factor for exposure to DV is entirely unknown. Nevertheless, the most important concern is the pregnant woman's health, and midwives and other health care professionals need to be aware of these results and to take action accordingly. Screening for depression during pregnancy together with anamnesis on history of violence may be the best way to address DV during pregnancy. The conversation between the pregnant woman and the health care giver must be performed in a safe, confidential atmosphere in an empathic and non-judgmental manner. Both relational ethics, i.e. sensitivity to a specific situation through the initiation of a dialogue between and among individuals [48], and a person-centred care, i.e. an attitude of being with people in a respectful and non-hierarchal way, [49] could be helpful approaches. However, it is not enough to address the violence, but it is also crucial to have guidelines and a plan of action for all health care personnel [50] in an attempt to improve health outcomes for mother and child. However, a recent Cochrane review has presented insufficient data regarding the usefulness of interventions for DV in relation to pregnancy outcomes [51]. Therefore it seems extremely important to focus on testing interventions with the aim of improving the care of those vulnerable women.
Strength and weaknesses in the study
The strength of the current study is its sample size (n = 1939) and the use of prospectively collected data in a well-defined group of pregnant women. Moreover, the study is only slightly under-powered for detection of prevalence with 98% certainty of DV during pregnancy. However, the results of this study might potentially be biased due to selection or non-respondent bias. Slightly more than 20% of the investigated cohort were women borne outside Sweden. In 2012 approximately 24% of all delivered women in Sweden were foreign borne [52]. These figures suggests that foreign born women are somewhat underrepresented in the material investigated possibly due to language or cultural barriers. Since, proportionally more women born outside Nordic countries reported 'DV during pregnancy' suggests the prevalence to be underestimated. Moreover, according to our inclusion criteria participants not understanding Swedish or English were excluded. This might be a weakness with regard to generalisation of the results to the population in the investigated geographical area. In 11 cases the participants did not answer the questions related to violence. Analysis of those 11 women may indicate cultural barriers as there were proportionately more women who did not answer the specific questions about abuse who were foreign born, spoke another language than Swedish at home and had a low level of education. However, it's also possible, that the questions were felt to be so intrusive that the participant was not prepared to answer them. Only four of the ANC's receptions have recruited consecutively as instructed and the rest of the receptions have performed convenient recruitment. Therefore, the reported prevalence of current abuse may be underestimated. The data collection period coincided with a strained working situation at the ANCs due to changes in the organization and implementation of a new electronically based medical record system which further increased the work load. An additional possible explanation for under-estimation is that some of the midwives could be an obstacle by themselves. Because of their lack of knowledge about the topic and their fear concerning what to do about disclosure of violence [50], they may have avoided the recruitment of women. Another weakness in the study is uncertainty with regard to exactly how many potentially eligible women were not invited to participate or how many who declined participation in the study. Therefore, unfortunately the prevalence of 'DV during pregnancy' may be underestimated. Also, it was not possible to translate the questionnaire to other languages than English, and therefore women who did not have sufficient reading and writing skills in Swedish or English were excluded. However, at least 20% of the included women were foreign-born and originated from 93 different countries.
The results showed a low prevalence of 'DV during pregnancy' in the included group of women from this area of Sweden. However, prevalence rates concerning reported history of emotional, physical and sexual abuse performed by actual intimate partner and history of exposure to violence during the past year indicate that a significant higher prevalence of women are living in a violent relationship. Also, the fact that four of ten women have some 'history of violence' which is the strongest factor associated with 'DV during pregnancy' must be carefully considered by midwives, obstetricians and other health care givers. Additionally, the knowledge that high levels of depressive symptoms are associated with DV during pregnancy should lead to actions to address mental disorders during early pregnancy. Both 'history of violence' and depressive symptoms detected in early pregnancy can indicate that the woman also is exposed to 'DV during pregnancy'. There is a need to increase attention to this vulnerable group of women who are living in dysfunctional and violent relationships.
AAS:
Abuse assessment screen
ANC:
AUDIT:
Alcohol use disorders identification test
BMI:
CI:
DSM:
DV:
EDS:
Edinburgh depression scale
EPDS:
Edinburgh postnatal depression scale
IPV:
NorAQ:
NorVold abuse questionnaire
Odds ratios
SOC-13:
Sense of coherence scale-short form
World Health Organisation.
World Health Organization; Violence against women. Intimate partner and sexual violence against women. Facta sheet No 239. [http://www.who.int/mediacentre/factsheets/fs239/en/]
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Chambliss LR: Intimate partner violence and its implication for pregnancy. Clin Obstet Gynecol. 2008, 51 (2): 385-397. 10.1097/GRF.0b013e31816f29ce.
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Shoffner DH: We don't like to think about it: intimate partner violence during pregnancy and postpartum. J Perinat Neonatal Nurs. 2008, 22 (1): 39-48. 10.1097/01.JPN.0000311874.30828.4e.
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Janssen PA, Holt VL, Sugg NK, Emanuel I, Critchlow CM, Henderson AD: Intimate partner violence and adverse pregnancy outcomes: a population-based study. Am J Obstet Gynecol. 2003, 188 (5): 1341-1347. 10.1067/mob.2003.274.
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Cheng D, Horon IL: Intimate-partner homicide among pregnant and postpartum women. Obstet Gynecol. 2010, 115 (6): 1181-1186. 10.1097/AOG.0b013e3181de0194.
Hedin LW, Grimstad H, Moller A, Schei B, Janson PO: Prevalence of physical and sexual abuse before and during pregnancy among Swedish couples. Acta Obstet Gynecol Scand. 1999, 78 (4): 310-315. 10.1080/j.1600-0412.1999.780407.x.
Stenson K, Heimer G, Lundh C, Nordstrom ML, Saarinen H, Wenker A: The prevalence of violence investigated in a pregnant population in Sweden. J Psychosom Obstet Gynaecol. 2001, 22 (4): 189-197. 10.3109/01674820109049973.
Lundgren E, Heimer G, Westerstrand J, Kalliokoski AM: Captured Queen Men's violence against women in "equal" Sweden - a prevalence study. 1 st edition. Edited by: Mikaelsson J, French G. 2002, Umeå: Åström tryckeri AB, 57-66-3-144.
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Socialstyrelsen (The National Board of Health and Welfare): Folkhälsorapport 2012 (Swedish Health Care Report). 2012, Stockholm: Socialstyrelsen
Swahnberg IM, Wijma B: The NorVold Abuse Questionnaire (NorAQ): validation of new measures of emotional, physical, and sexual abuse, and abuse in the health care system among women. Eur J Public Health. 2003, 13 (4): 361-366. 10.1093/eurpub/13.4.361.
Wijma B, Schei B, Swahnberg K, Hilden M, Offerdal K, Pikarinen U, Sidenius K, Steingrimsdottir T, Stoum H, Halmesmaki E, Nordic cross-sectional study: Emotional, physical, and sexual abuse in patients visiting gynaecology clinics: a Nordic cross-sectional study. Lancet. 2003, 361 (9375): 2107-2113. 10.1016/S0140-6736(03)13719-1.
Statistiska centralbyrån: ULF – Undersökningarna av Levnadsförhållanden (ULF-Survey on Swedish Living Conditions). 2007
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Antonovsky A: The structure and properties of the sense of coherence scale. Soc Sci Med. 1993, 36 (6): 725-733. 10.1016/0277-9536(93)90033-Z.
Eriksson M, Lindstrom B: Antonovsky's sense of coherence scale and its relation with quality of life: a systematic review. J Epidemiol Community Health. 2007, 61 (11): 938-944. 10.1136/jech.2006.056028.
Cox JL, Holden JM, Sagovsky R: Detection of Postnatal Depression. Development of the 10-item Edinburgh Postnatal depression Scale. Br J Psychiatry. 1987, 150: 782-786. 10.1192/bjp.150.6.782.
Rubertsson C, Borjesson K, Berglund A, Josefsson A, Sydsjo G: The Swedish validation of Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Nord J Psychiatry. 2011, 65 (6): 414-418. 10.3109/08039488.2011.590606.
Wickberg B, Hwang CP: The Edinburgh Postnatal Depression Scale: validation on a Swedish community sample. Acta Psychiatr Scand. 1996, 94 (3): 181-184. 10.1111/j.1600-0447.1996.tb09845.x.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II. Addiction. 1993, 88 (6): 791-804. 10.1111/j.1360-0443.1993.tb02093.x.
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Ekelin M, Crang Svalenius E, Larsson AK, Nyberg P, Marsal K, Dykes AK: Parental expectations, experiences and reactions, sense of coherence and grade of anxiety related to routine ultrasound examination with normal findings during pregnancy. Prenat Diagn. 2009, 29 (10): 952-959. 10.1002/pd.2324.
Gazmararian JA, Lazorick S, Spitz AM, Ballard TJ, Saltzman LE, Marks JS: Prevalence of violence against pregnant women. JAMA. 1996, 275 (24): 1915-1920. 10.1001/jama.1996.03530480057041.
Bowen E, Heron J, Waylen A, Wolke D, ALSPAC Study Team: Domestic violence risk during and after pregnancy: findings from a British longitudinal study. BJOG. 2005, 112 (8): 1083-1089. 10.1111/j.1471-0528.2005.00653.x.
Finnbogadottir H, Dejin-Karlsson E, Dykes AK: A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term. BMC Pregnancy Childbirth. 2011, 11: 14-10.1186/1471-2393-11-14.
Garcia-Moreno C, Jansen H, Ellsberg M, Heise L, Watts C: WHO Multi-Country Study on women's Health and Domestic Violence Against Women. 2005, Geneva: World Health Organization
World Health Organization (WHO): Responding to Intimate Partner Violence and Sexual Violence Against Women. WHO Clinical and Policy Guidelines. 2013, 1-68.
Rubertsson C, Wickberg B, Gustavsson P, Radestad I: Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health. 2005, 8 (2): 97-104. 10.1007/s00737-005-0078-8.
Bergum V, Dossetor J: Relational Ethics; The Full Meaning of Respect: 1st ed. 2005, Hagerstown: University Publishing Group
Miller WR: Motiverande Samtal: att Hjälpa Människor Till Förändring (In Swedish: Motivational Interviewing): 3rd ed. 2013, Natur & kultur: Stockholm
Finnbogadottir H, Dykes AK: Midwives' awareness and experiences regarding domestic violence among pregnant women in southern Sweden. Midwifery. 2012, 28 (2): 181-189. 10.1016/j.midw.2010.11.010.
Jahanfar S, Janssen PA, Howard LM, Dowswell T: Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database Syst Rev. 2013, 2: CD009414
Socialstyrelsen (The National Board of Health and Welfare): Statistikdatabas för Graviditeter, Förlossningar och Nyfödda. 2012, [http://www.socialstyrelsen.se/statistik/statistikdatabas/graviditeter-forlossningarochnyfodda]
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6874/14/63/prepub
The authors would like to thanks all the midwives who carried out the recruitment and gave us possibility to carry this study out. General Maternity Hospital Foundation has contributed with funding for this research. The Swedish Society for Health Sciences (Vårdalinstitutet) has contributed with admission for scanning to this research. We also acknowledge that both Department of Health Sciences, Medical Faculty, Lund University and Malmoe University, Faculty of Health and Society has supported this research.
NorAQ was developed by NorVold, a research network established in 1997 to explore the prevalence of violence against women and its effects on women's health. The NorVold research network was supported by grants from the Nordic Council of Ministers. Principal investigators: Barbro Wijma, Berit Schei. Coordinator: Katarina Swahnberg. Local investigators: Denmark: Katrine Sidenius, Malene Hilden, Finland: Erja Halmesmäki, Ulla Pikkarinen, Iceland: Tora Steingrimsdottir, Norway: Berit Schei, Hildegunn Stoum-Hinsverk, Kristin Offerdal, Sweden: Barbro Wijma, Katarina Swahnberg.
Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
Hafrún Finnbogadóttir
, Anna-Karin Dykes
& Christine Wann-Hansson
Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
Anna-Karin Dykes
The Swedish Institute of Health Sciences (Vårdalinstitutet), Lund University, Lund, Sweden
Christine Wann-Hansson
Search for Hafrún Finnbogadóttir in:
Search for Anna-Karin Dykes in:
Search for Christine Wann-Hansson in:
Correspondence to Anna-Karin Dykes.
HF and AKD conceived the study. Collection of data were performed by the first author HF. All authors HF, AKD, CWH participated in the study design and coordinated and helped to draft the manuscript. All authors read and approved the final manuscript.
Hafrún Finnbogadóttir, Anna-Karin Dykes and Christine Wann-Hansson contributed equally to this work.
Finnbogadóttir, H., Dykes, A. & Wann-Hansson, C. Prevalence of domestic violence during pregnancy and related risk factors: a cross-sectional study in southern Sweden. BMC Women's Health 14, 63 (2014) doi:10.1186/1472-6874-14-63
DOI: https://doi.org/10.1186/1472-6874-14-63
Women's public health issues public health issues


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While crypto startups and ICO issuers worry about social media platforms cutting their ads, they could be missing an even more intimidating threat – regulators.
Crypto entrepreneurs reeled late last month after Facebook announced it would be banning "misleading or deceptive" ads about financial products and services, including bitcoin and ICOs. These stakeholders saw a crucial advertising avenue dry up, but according to some, the drought isn't over yet.
"The regulators will look at advertisements put out by the company. That's always something they're going to look at," said Johanna R. Collins-Wood, an associate at Pepper Hamilton and member of the law firm's blockchain group.
Others agreed and voiced concern about the industry where you never have to look too far to find suspect advertisements.
Indeed, crypto advertising is a immensely popular Wild West of sorts, where all token sales, legitimate or otherwise, are all vying for attention. And all the issuers and entrepreneurs in the space are still grappling with just what kinds of claims they can make in their marketing.
If the industry doesn't police itself, regulators are sure to come knocking.
Just recently even, on February 22, France's stock market regulator, the L'Autorite Des Marches Financiers (AMF), released a statement about looking to curb advertising on cryptocurrency-tied derivatives.
And others may soon follow. According to Collins-Wood, some of the regulators that have already taken a more keen notice of the crypto industry as of late will certainly use advertising to build their cases.
Above and beyond financial regulators looking at advertisements to build fraud cases, though, formal guidelines for ads and marketing are less clear at this point.
Many of the regulators that oversee false advertising claims have yet to announce any specific policies on the nascent industry.
"There are a lot of shades of false advertising and misleading advertising. Some are more blatant than others," said Carl Johnston, a corporate securities lawyer at FisherBroyles LLP.
Case in point, last year, a crypto ad made the rounds on Facebook with a stolen logo from the New Zealand Herald newspaper and an image of the former New Zealand prime minister John Key with a fake quote claiming he invested in bitcoin.
And in Australia, the continent's securities watchdog received more than 1,200 crypto scam complaints, with one complaint detailing how an exchange advertised that it was an existing Australian company to gain consumer's trust.
Though, maybe the most mainstream example is that of Japanese exchange Coincheck, which ran a TV ad campaign touting, only to be hacked to the tune of $533 million shortly after.
Several industry observers have since accused Coincheck of downplaying its securityprotections and criticized for skimping on security spending in favor of lavish ads. Indeed, the CEO of SBI Holdings reportedly called the company "scum of scum" for the spending.
As these instances pique regulators interest to the industry as a whole, some believe advertising regulation is not far away, and looking to the regulations facing traditional companies is probably a good place to start for determining how those rules will be laid down.
"We certainly do have laws against false and misleading advertising," Johnston said.
Although Johnston didn't have any insight into whether the Federal Trade Commision, the government agency charged with overseeing these complaints in the U.S. was active in this area yet.
The FTC did not respond to requests for comment.
And advertising standards groups have yet to chime in on the subject also. New Zealand's Advertising Standards Authority told CoinDesk it had not received any crypto-related ad complaints, and the UK's ad standards body said they had received less than 10 cryptocurrency-related ad complaints so far.
Although, the spokesperson did point to the Financial Conduct Authority (FCA) as the regulator in charge of financial ads, but when asked, the FCA said it has no position on crypto ads.
It seems like many are taking a wait-and-see approach.
With more than a million people on the social network following cryptocurrency communities, the company also said it would reject crypto ads that violated its rules by promoting unsupported guarantees.
No other social network has taken a similar position yet. A Twitter spokesperson said it had no comment on cryptocurrency advertising. And Google pointed to its existing policies on misleading ads, which it said would apply to cryptocurrency.
But even if social media platforms moved to tighten up their procedures, it might have minimal impact on the ecosystem.
According to Midori Kanemitsu, CFO of bitFlyer, which ran both a social media and television ad campaign, the Facebook ban had minimal effects.
"Our understanding is that our TV commercials have contributed to a large increase in users," Kanemitsu said.
As such, bitFlyer remains cautious about the claims it makes in its advertising.
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Home / Publications / Last chance saloon for life insurers?
Last-chance-saloon-for-life-insurers
19 September 2019 | Brief Counsel
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The life insurance industry is under threat of further regulation unless it deals with the issues raised by the Reserve Bank of New Zealand (RBNZ)/Financial Markets Authority (FMA) conduct and culture review.
In February 2019, 16 life insurers were asked to conduct a gap analysis of their business, including a systematic review their policyholders and policy portfolios, and provide work plans setting out how they would respond to the review's findings and recommendations.
They submitted their responses at the end of June, but some of them failed to meet the RBNZ and the FMA's expectations. In a media release this week, the regulators stated that the sector had a "weak appetite for change" and that:
significant work is still needed to improve governance and to better manage conduct risk
there is a wide variance in the quality and depth of the policyholder and products reviews, with some uncompleted and others failing to provide data on the number of policyholders affected or the estimated cost of remediation activities, and
some have yet to commit to removing or altering indirect sales incentives or put in place appropriate systems and controls to manage conflicts of interest.
Individual letters have been sent out to each of the 16 insurers recording the regulators' findings in relation to their progress. Those insurers that have not undertaken comprehensive systematic reviews, have until December this year to complete further reviews to identify any issues and to develop mature response and remediation plans.
Other life insurance companies operating in New Zealand were asked to develop similar plans in March and have until the end of October to deliver.
Should the RBNZ and the FMA still not be satisfied with the results achieved through this process, they will go to the Government seeking that "additional obligations" be imposed upon the life insurance sector.
If the Government agrees that stronger regulation is necessary, it will be in an easy position to respond as Commerce and Consumer Affairs Minister Kris Faafoi has indicated that the legislation arising from the reviews into the banking and insurance industries will soon be available for presentation to Parliament. The FMA has also indicated that it intends to seek legislative power allowing it to proactively examine how insurers handle complaints and manage risk, and what governance systems are in place.
Related topics: Financial services regulation; Insurance
Penny Sheerin; Tim Williams; John Knight; Bradley Kidd; Kara Daly
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Standard Cylinder Heads for Single Port and Twin Port engines. Our brand new 1600cc Twin Port items being the most popular, ideal if you are upgrading a 1300cc to 1600cc or 1641cc.
Cylinder Head Stud kits, including Studs, Washers and Nuts. Standard length 8mm items, and also 10mm for high performance applications.
These Air Deflector Baffle plates clip onto the Cylinder Head studs, above your pushrod tubes. An essential part of cooling system.
Used as standard on Type-3 and late twin port engines, but can be fitted to any Twin Port .. Cool Tins increase the air flow around the heads to improve cooling.
Correct the compression ratio of your engine with these shims.


The Apple iPhone 4S has now been revealed to the world, with gross sales set to start mid-October 2011 in most main markets. Trying over your page to see whether it still displays reality is a type of easy website improvements you can in a jiffy. Boards may be as fundamental as displaying your current improvements and tasks, or as detailed as displaying the relationships between initiatives, events, improvements, and key metrics.
The 'home first used to provide revenue' does not apply as a result of the improvements had been first used to produce revenue before 21 August 1996. However, if the dwelling shouldn't be your most important residence or you use the improvements to supply income for any period, the a part of any gain that is attributable to the improvements for that interval is taxable.
Tympanic Thermometers, generally often called ear thermometers are also based mostly on infrared know-how. All requests for alterations or improvements have to be submitted by a Dean or Director stage. Circulation improvements at Northeast Calhoun/Bde Maka Ska and Southeast Harriet and basic trail and access improvements round each Lake Calhoun/Bde Maka Ska and Lake Harriet.
Repairs, upkeep and maintenance typically don't qualify as a capital improvements. There are actually many unique improvements in the colours and supplies in addition to their value. If you are planning improvements to an space of your house that's in want of repair you could possibly embrace the repair as an improvement.
Capital infrastructure improvements are one of many five components of the Corner Store Pilot Program , which goals to re-set up the neighbourhood shopping centre as a hub of group activity via improvements to Metropolis infrastructure, the buildings, and the companies inside.


This is a replica of a reading candle holder. It sits by the chair and you can adjust the height to the best height for reading a book.
Well there you go! Just like a Project I had on here and don't even know if it's still there.
Their called "Ratcheting Candle Stands" from the early 1900's.
Yes they can be used for Reading and also a multitude of other Purposes as they were pretty well the only source of Light they had in those days.
Thanks for showing me your picture. That is the only other one I have seen a picture of that someone had built. My daughter stole mine.
This is a nice reproduction and will make a great conversation piece.
You're certainly Welcome. Download this one and DON'T tell your Daughter you have it! ....LOL..


text:
package ui

import (
	"unsafe"
)

// #include "ui.h"
// extern void doButtonOnClicked(uiButton *, void *);
// static inline void realuiButtonOnClicked(uiButton *b)
// {
// 	uiButtonOnClicked(b, doButtonOnClicked, NULL);
// }
import "C"

// no need to lock this; only the GUI thread can access it
var buttons = make(map[*C.uiButton]*Button)

// Button is a Control that represents a button that the user can
// click to perform an action. A Button has a text label that should
// describe what the button does.
type Button struct {
	c	*C.uiControl
	b	*C.uiButton

	onClicked		func(*Button)
}

// NewButton creates a new Button with the given text as its label.
func NewButton(text string) *Button {
	b := new(Button)

	ctext := C.CString(text)
	b.b = C.uiNewButton(ctext)
	b.c = (*C.uiControl)(unsafe.Pointer(b.b))
	freestr(ctext)

	C.realuiButtonOnClicked(b.b)
	buttons[b.b] = b

	return b
}

// Destroy destroys the Button.
func (b *Button) Destroy() {
	delete(buttons, b.b)
	C.uiControlDestroy(b.c)
}

// LibuiControl returns the libui uiControl pointer that backs
// the Button. This is only used by package ui itself and should
// not be called by programs.
func (b *Button) LibuiControl() uintptr {
	return uintptr(unsafe.Pointer(b.c))
}

// Handle returns the OS-level handle associated with this Button.
// On Windows this is an HWND of a standard Windows API BUTTON
// class (as provided by Common Controls version 6).
// On GTK+ this is a pointer to a GtkButton.
// On OS X this is a pointer to a NSButton.
func (b *Button) Handle() uintptr {
	return uintptr(C.uiControlHandle(b.c))
}

// Show shows the Button.
func (b *Button) Show() {
	C.uiControlShow(b.c)
}

// Hide hides the Button.
func (b *Button) Hide() {
	C.uiControlHide(b.c)
}

// Enable enables the Button.
func (b *Button) Enable() {
	C.uiControlEnable(b.c)
}

// Disable disables the Button.
func (b *Button) Disable() {
	C.uiControlDisable(b.c)
}

// Text returns the Button's text.
func (b *Button) Text() string {
	ctext := C.uiButtonText(b.b)
	text := C.GoString(ctext)
	C.uiFreeText(ctext)
	return text
}

// SetText sets the Button's text to text.
func (b *Button) SetText(text string) {
	ctext := C.CString(text)
	C.uiButtonSetText(b.b, ctext)
	freestr(ctext)
}

// OnClicked registers f to be run when the user clicks the Button.
// Only one function can be registered at a time.
func (b *Button) OnClicked(f func(*Button)) {
	b.onClicked = f
}

//export doButtonOnClicked
func doButtonOnClicked(bb *C.uiButton, data unsafe.Pointer) {
	b := buttons[bb]
	if b.onClicked != nil {
		b.onClicked(b)
	}
}

redpajama_set_name: RedPajamaGithub


Well we had a nice weekend my husband surprised us and arrived home last night. We had dinner at home watched movies as a family.
Today we went to get items at Target got some coffee while we were there. Our dear friends Carol and Marcus came over for a visit it was great to see them.
We then took car to get cleaned had lunch with kids at the mall and found our Halloween costumes. We got little one down for a nap and I got laundry and dishes done.
We had a nice dinner at home kids went swimming and we watched Sleeping Beauty before getting the kids set for bed.
Our son leaves for his field trip tomorrow morning we got him all packed up. Our daughter has picture day at her pre school.
I will be going to Pure Empower in the morning after dropping her off. Then I will get rest of my errands done. Maybe be able to have lunch with my friend Chelsea.
I have a busy week ahead and my Birthday is this coming Friday. Hoping to see my friends this week and have a great Birthday.
I will get packed for our weekend trip and also get our house all cleaned up. I'd like to make an appointment to get a facial and wax at Organic Glow Skin studio. I would also like to plan a girls day soon at Miramonte Spa it's been a very long time.
I need to make dentist appointments for me and the kids. I am so proud of how hard my son is working and how well he is doing in his new school. I am such a proud parent my little one is learning so much too she is so strong so intelligent and loving and yes sassy but what a blessing she is to us. I am so grateful to have our wonderful kids.
They definitely drive me crazy but being a mom is the best job ever it's a 24/7 stressful highly emotional job but most rewarding job I will ever have. Some days I don't get a shower in or shave my legs or get all my errands done. My house doesn't always look perfect. But my house always feels like a home and my kids always know their loved and safe .
I want to lead by example and try to show my kids how to be genuine, loving, kind faithful and always have positivity and hope and to work hard. I make mistakes everyday but I've worked on being less critical of myself.
I feel out of shape and old and wrinkly but I know I am way harder on myself than what others see. I am working on getting physically emotionally and mentally stronger everyday.


text:
Q: "from flaskext.mysql import MySQL" causes server to show 502 bad gateway new to python. Following a couple tutorials to serve an application (ddworkflow.com) using Python 3.6.7, Flask, Gunicorn, NGINX, and MySQL on Ubuntu 18.04
The tutorials are:
https://philchen.com/2019/02/11/how-to-make-a-python-web-app-in-virtualenv-using-flask-gunicorn-nginx-on-ubuntu-18-04
and
https://code.tutsplus.com/tutorials/creating-a-web-app-from-scratch-using-python-flask-and-mysql--cms-22972
I got through the first tutorial and am able to successfully serve the basic web pages from the second tutorial.
Installing everything in a virtual environment and just installed flask-mysql using pip install flask-mysql.
My pip freeze shows:
Click==7.0
Flask==1.0.2
Flask-MySQL==1.4.0
itsdangerous==1.1.0
Jinja2==2.10
MarkupSafe==1.1.0
PyMySQL==0.9.3
Werkzeug==0.14.1

After installing Flask-MySQL I tested the installation by trying the following different variations of the "from" command (at the python prompt):

*

*from flask.ext.mysql import MySQL

*from flaskext.mysql import MySQL

*from flask_mysql import MySQL

*from flaskext.mysql import MySQL
1, 2, and 3 all produce ModuleNotFoundError... The only one that does not throw an error is from flaskext.mysql import MySQL
However, when I add from flaskext.mysql import MySQL to my flask app file (app01.py) I immediately get a 502 bad gateway error. My app01.py file is
from flask import Flask, render_template, json, request
#from flaskext.mysql import MySQL #<--comment out or get 502 error
hello = Flask(__name__)

@hello.route("/")
def greeting():
    return render_template('index.html')

@hello.route('/showSignUp')
def showSignUp():
    return render_template('signup.html')

@hello.route('/signUp',methods=['POST'])
def signUp():
    # read the posted values from the UI
    _name = request.form['inputName']
    _email = request.form['inputEmail']
    _password = request.form['inputPassword']

    # validate the received values
    if _name and _email and _password:
        return json.dumps({'html':'All fields good !!'})
    else:
        return json.dumps({'html':'Enter the required fields'})

if __name__ == "__main__":
    hello.run(host='0.0.0.0')

Any help getting the 502 error to go away so that I connect to the database is much appreciated. Thank you.

A: This could be a virtualenv error, check out this link: https://www.pythonanywhere.com/forums/topic/2877/
Very similar question from earlier: ImportError: No module named flask.ext.mysql

redpajama_set_name: RedPajamaStackExchange


text:
Walkergate: How Partisan Is John Doe?
The right wing's complaints of "partisan witch hunt" is pure bullshit
By Chris capper Li...
As noted earlier, Scott Walker and his right wing apologists are scared witless about an upcoming decision by the Wisconsin Supreme Court about the ongoing John Doe investigations into Walker's illegal collaboration with dark money groups like Wisconsin Club for Growth.
In an effort to stem the bad press that will come with the court's rulings, win or lose, the right wing has gone on the offensive to start the damage control and trying to control the spin. Among these propagandists is David French, who wrote some horrible dreck for the National Review. Besides the over the top melodrama and flights of imagination, French included another utterly false talking point from Team Walker - that the investigation and subsequent criminal convictions are the result of a partisan witch hunt:
It all began innocently enough. In 2009, officials from the office of the Milwaukee County executive contacted the office of the Milwaukee district attorney, headed by John Chisholm, to investigate the disappearance of $11,242.24 from the Milwaukee chapter of the Order of the Purple Heart. The matter was routine, with witnesses willing and able to testify against the principal suspect, a man named Kevin Kavanaugh.
What followed, however, was anything but routine. Chisholm failed to act promptly on the report, and when he did act, he refused to conduct a conventional criminal investigation but instead petitioned, in May 2010, to open a "John Doe" investigation, a proceeding under Wisconsin law that permits Wisconsin officials to conduct extensive investigations while keeping the target's identity secret (hence the designation "John Doe").
At the same time that the public protests were raging, so were private — but important — protests in the Chisholm home and workplace. As a former prosecutor told journalist Stuart Taylor, Chisholm's wife was a teachers'-union shop steward who was distraught over Act 10's union reforms. He said Chisholm "felt it was his personal duty" to stop them.
Meanwhile, according to this whistleblower, the district attorney's offices were festooned with the "blue fist" poster of the labor-union movement, indicating that Chisholm's employees were very much invested in the political fight.
Unfortunately, French is just repeating misinformation that has been utterly debunked.
The John Doe did not begin with Walker asking District Attorney John Chisholm to look into the theft of money from a veterans fund. The investigation started when Walker started to stonewall the investigation by refusing to release requested emails and documents.
As far as the myth that the investigation and prosecutions were due to unionism, eye witnesses thoroughly discredited those allegations. On top of that, the supposed "whistleblower" whom French refers to was a disgruntled former employee who was suffering from PTSD and alcoholism and who had made death threats against Chisholm and his family.
It later turned out that these accusations were nothing but a campaign gimmick to promote Walker's name and set up the story line they are now using.
As for the mewling that John Doe is partisan, that couldn't be any further from the truth. The fact is that three of the five district attorneys working on the John Doe are Democrats while the other two are Republicans. The special prosecutor that the DAs hired to handle the case is a Republican who openly states he voted for Walker in the recall.
Furthermore, all of the judges that authorized the John Doe investigations are Republican, including James Daley, the Republican candidate who lost his bid for the state supreme court earlier this month. In addition, all of the members of the Government Accountability Board, which oversaw the investigations, are Republicans.
The only way that this could be a partisan witch hunt is if Walker turned out to be a partisan witch, which at this point, wouldn't surprise me in the least.
David French, John Doe, National Review, partisanship, Scott Walker, Walkergate
Walkergate Prosecutors To Walker: Put Up Or Shut Up
Top John Doe prosecutors dare Scott Walker to go big, go bold or go home
George Will Carries Scott Walker's Water
George Will laments that prosecutors investigate white, conservative criminals.


text:
El franc congolès (en francès franc congolais o, simplement, franc) és la unitat monetària de la República Democràtica del Congo. El codi ISO 4217 és CDF i l'abreviació és FC. Se subdivideix en 100 cèntims (centimes).

Història
Durant el domini colonial belga, es va introduir l'anomenat franc del Congo Belga, que equivalia al franc belga. El 1960, amb la independència del país, va passar a ser conegut simplement com a franc congolès. El franc va ser moneda del Congo fins al 1967, en què fou substituïda pel zaire a raó de 1.000 francs per zaire.

Havent patit una forta devaluació que va substituir 3.000.000 zaires vells per un de nou, el franc congolès es va establir de nou el 1997, en substitució del nou zaire a raó de 100.000 nous zaires per franc.

Bitllets
Emès pel Banc Central del Congo (Banque Centrale du Congo), en circulen bitllets d'1, 5, 10, 20 i 50 cèntims i d'1, 5, 10, 20, 50, 100, 200 i 500 francs. No se n'emeten monedes.

Taxes de canvi
 1 EUR = 528,27 CDF (15 de gener del 2006)
 1 USD = 438,07 CDF (15 de gener del 2006)

Vegeu també
 Franc

Enllaços externs

  Banc Central del Congo

Monedes africanes
República Democràtica del Congo

redpajama_set_name: RedPajamaWikipedia


text:
Erratum To: Discovery and validation of breast cancer subtypes
Amy V Kapp1,
Stefanie S Jeffrey2,
Anita Langerød3,
Anne-Lise Børresen-Dale3,4,
Wonshik Han5,
Dong-Young Noh5,
Ida RK Bukholm6,7,
Monica Nicolau2,
Patrick O Brown8 &
Robert Tibshirani1,9
BMC Genomics volume 8, Article number: 101 (2007) Cite this article
The Original Article was published on 11 September 2006
Following the publication of our recent article (Kapp et al., BMC Genomics 2006, 7:231), we (the authors) regrettably found several errors in the published Table 5. This correction article not only describes what makes the published Table 5 incorrect, it also presents the correct Table 5.
I regret to say that several errors exist in Table 5 of our recently published paper [1]. Here we present the correct version of Table 5 and explain what is incorrect about the published Table 5. (See Table 1 of this manuscript.)
Table 1 The (original) incorrect Table 5 as published in Kapp et al. (2006).
A typographical error exists in Table 5 (upper panel). The 6 that is presented in the upper right-hand corner of the published Table 5 (upper panel) should be a zero. The correct version of Table 5 (upper panel) is shown in Table 2 of the present manuscript.
Table 2 The correct Table 5 (upper panel).
The paragraphs in the paper associated with Table 5 (upper panel) are correct as published.
Table 5 (lower panel) has a more significant error. The correct version of Table 5 (lower panel) is shown in Table 3 of the present manuscript.
Table 3 The correct Table 5 (lower panel).
What was presented in the paper was a comparison of the Sørlie et al. (2003) classifications of the Sørlie dataset (without a cutoff), not a subset of the Norway/Stanford arrays.
Moreover, the Comparison of ESR1/ERBB2 subtypes and Sørlie et al. (2003) subtypes section is incorrect. The text in this section is associated with Table 5 (lower panel) and describes the results for the Sørlie dataset, not the results for a subset of the Norway/Stanford dataset as intended (and as stated in the table's legend). Based upon the correct Table 5 (lower panel) which presents the results for the Norway/Stanford arrays of samples from Ullevål University Hospital, the subtypes described by [2] are fairly similar to the ESR1/ERBB2 subtypes we defined. All of the luminal A and luminal B samples were classified to Group 1 (the ESR1+/ERBB2- subtype). All but one of the Ullevål samples in the Norway/Stanford dataset that were classified to the ERBB2-overexpressing Sørlie et al. (2003) subtype were classified by us to Group 2 (the ERBB2+ subtype). Finally, except for one sample, all of the basal samples were classified to Group 3 (the ESR1-/ERBB2- subtype). All of the samples that were not classified to any of the Sørlie et al. (2003) subtypes were classified to our ESR1+/ERBB2- subtype rather than being uniformly distributed among all three of our subtypes.
It may be surprising to see one of the basal samples in our ERBB2+subtype and not with the rest of the basal samples in our ESR1-/ERBB2- subtype. In all other papers, the basal subtype has been the most cohesive. Our ESR1/ERBB2 centroids consist of approximately four times as many genes as the Sørlie et al. (2003) centroids do (1908 genes and 496 genes, respectively). Not all of the genes in the ESR1/ERBB2 centroids belong to the ESR1 gene cluster or to the ERBB2 gene cluster. It is the influence of the genes which do not belong to these clusters that causes one of the basal samples to not be classified with the others.
Table 4 of the present document contains the 45 arrays used to make the correct Table 5 (lower panel). Anita Langerød classified each array to one of the Sørlie et al. (2003) subtypes if the array's correlation with one of the subtypes centroids was at least 0.2. These classifications will appear in an upcoming publication.
Table 4 The arrays used to make the correct Table 5 (lower panel)
Kapp AV, Jeffrey SS, Langerød A, Børresen-Dale AL, Han W, Noh DY, Bukholm IR, Nicolau M, Brown PO, Tibshirani R: Discovery and validation of breast cancer subtypes. BMC Genomics. 2006, 7: 231-10.1186/1471-2164-7-231.
PubMed Central PubMed Article Google Scholar
Sørlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, Deng S, Johnsen H, Pesich R, Geisler S, Demeter J, Perou CM, Lønning PE, Brown PO, Børresen-Dale AL, Botstein D: Repeated observation of breast tumor subtypes in independent gene expression data sets. Proceedings of the National Academy of Sciences of the United States of America. 2003, 100 (14): 8418-8423. 10.1073/pnas.0932692100.
Department of Statistics, Stanford University, Stanford, CA, USA
Amy V Kapp & Robert Tibshirani
Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
Stefanie S Jeffrey & Monica Nicolau
Department of Genetics, Institute for Cancer Research, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
Anita Langerød & Anne-Lise Børresen-Dale
Medical Faculty, University of Oslo, Oslo, Norway
Anne-Lise Børresen-Dale
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
Wonshik Han & Dong-Young Noh
Department of Surgery, Akershus University Hospital, Nordbyhagen, Norway
Ida RK Bukholm
University of Oslo, Oslo, Norway
Department of Biochemistry, Stanford University School of Medicine, Stanford, CA, USA
Patrick O Brown
Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
Robert Tibshirani
Amy V Kapp
Stefanie S Jeffrey
Anita Langerød
Wonshik Han
Dong-Young Noh
Monica Nicolau
Correspondence to Amy V Kapp.
The online version of the original article can be found at 10.1186/1471-2164-7-231
Kapp, A.V., Jeffrey, S.S., Langerød, A. et al. Erratum To: Discovery and validation of breast cancer subtypes. BMC Genomics 8, 101 (2007). https://doi.org/10.1186/1471-2164-8-101
Accepted: 13 April 2007
DOI: https://doi.org/10.1186/1471-2164-8-101


text:
Q: Spring Data Neo4J @Query I have two NodeEntities: Speaker and Talks.
Speaker has Set
Now I'm creating SpeakerRepository extends GraphRepository and everything is working.
But I'm not succeeding to create Query for fetching all Speakers which has talks with titles, which contains specific words.
For example I want to get all speakers which talks about spring.
The method would be: Set findAllSpeakerWithTalksLike(String partOfTalkTitle)
Can you please explain what should be the content of @Query annotation above this method

A: Try this one, assuming your Talk has a title property and the Speaker has a talks related-to collection.
  Set<Speaker> findAllSpeakerWithTalksTitleContaining(String partOfTalkTitle)

the cypher query would be, it won't be very fast on large datasets b/c there is no index supporting it.
MATCH (t:Talk)<-[:TALK]-(s:Speaker) WHERE t.title = ".*partOfTalkTitle.*"
RETURN s

You could annotate @Indexed(type=FULLTEXT) String title;  then it would use a legacy lucene fulltext index for the search.