Article 1
Barriers and facilitators to screening for intimate partner violence at a Level I trauma center. Melhado C, Decker H, Schwab M, et al. Surgery. 2024 Nov;176(5):1525-1531.
Intimate partner violence (IPV) is a significant public health issue affecting up to 40% of female trauma patients and 16% of male trauma patients. Despite recommendations from professional societies such as EAST, IPV screening is not uniformly performed in trauma centers. This qualitative study examined trauma clinicians’ perspectives on intimate partner violence (IPV) screening at a Level I safety-net hospital. Semi-structured interviews identified several key facilitators for screening: standardized education and EMR-integrated workflows that normalized screening and reduced clinician discomfort, interdisciplinary teamwork with immediate social work support, and timing of screening after stabilization in a private, safe setting, such as during a tertiary exam by a provider with developed rapport with the patient. These elements helped reduce discomfort and made screening more routine.
Barriers included lack of time on busy services, language barriers and cultural differences that hindered rapport, and skepticism about the appropriateness of universal screening, with some clinicians screening only when IPV was suspected, despite evidence supporting universal screening. Overall, participants acknowledged hospitalization after trauma as a critical opportunity to identify unsafe relationships but highlighted the need for standardized protocols, sustained education, and robust psychosocial support to achieve consistent universal screening.
Article 2
Intimate Partner Violence Among Surgeons: We are Not Immune. Stein S, Bliggenstorfer J, Ofshteyn A, et al. Ann Surgery. 2021 Mar 1;273(3):387-392.
This study presents the results of an online survey sponsored by the Association of Women Surgeons that evaluated the experience of surgical trainees and practicing and retired surgeons regarding intimate partner violence (IPV). Individuals from four large professional societies were contacted via email and 882 practicing and retired surgeons and trainees responded. The majority were white (76%) and identified as women (70%). IPV was evaluated using validated surveys, based on WHO definitions of emotional, physical, sexual abuse and controlling behaviors.
A surprising 61% of overall respondents, including 74.1% of women surgeons surveyed reported experiencing behavior consistent with IPV in either their current or prior relationship. Emotional abuse, defined as belittling, insults, humiliation, threats of harm, acts of intimidation (e.g. destruction of personal property) was reported by 57.3% of respondents. Controlling behavior was the second most common form of IPV (35.6%), characterized as isolation from friends and family, monitoring movements and restricting access to financial resources, employment, education or medical care. Of all surveyed surgeons, 13.1% reported physical abuse and 9.6% reported sexual abuse. Prior IPV was associated with current IPV (53.7%) and factors associated with IPV in multivariable regression were similar to previously published studies (childhood abuse, exposure to violence, mental illness, alcohol use). Approximately 1/3 of respondents experiencing IPV did not seek assistance, and the majority (80%) described their relationship as happy. Of those who sought help, over 50% turned to friends and family for support.
The findings of this article emphasize that the problem of IPV is present among surgeons at similar rates of the general population. Rates of emotional abuse and controlling behaviors were slightly higher in surgeons surveyed than the general population, while rates of physical and sexual abuse were slightly lower. Higher educational attainment, socioeconomic status and an understanding of the problem of domestic violence does not leave surgeons immune from IPV and in fact, surgeons were less likely to seek formal legal or social work assistance when experiencing IPV. While there are limitations with the survey sampling acknowledged by the authors, this study reminds us of the importance of caring for our trainees and colleagues in our high intensity professions. The American College of Surgeons has developed an Intimate Partner Violence Toolkit available on their website for recognizing and navigating intimate partner violence.
Article 3
Examining the impacts of firearm purchaser licensing laws on firearm deaths among youth aged 15 to 24, by age group – USA, 1990-2019. Kennedy KS, Wagner ED, Meyerson NS, et al. Injury Prevention. 2025 Aug 20:ip-2025-045700.
Firearm-related injury is the leading cause of death among children and adolescents in the United States, though gun policy remains a divisive issue across the country. This study evaluates the effects of state firearm purchaser licensing (FPL) laws on firearm homicide and suicide among U.S. youth aged 15-24 over an almost 30-year period. Using national mortality data and an augmented synthetic control model, the authors evaluated two adoptions (Connecticut in 1995, Maryland in 2013) and two repeals (Missouri’s full repeal in 2007, Michigan’s partial repeal in 2012). Controls were comprised of the remaining states that did not make changes to their FPL status during the study period (never treated vs always treated). The primary outcomes were homicide and suicide rates, stratified by firearm involvement and age subgroups: 15-17, 18-20, 21-24. The use of an augmented synthetic control model creates a robust statistical counterfactual to account for unmeasured confounding.
Adoption of comprehensive FPL laws in Connecticut was associated with significant reductions in youth firearm homicide (-38.3% overall) and suicide (-32.1% overall), with minimal change in non-firearm mortality. Age-stratified analyses showed approximately two-fold decreases in firearm versus non-firearm suicide rates among adolescents and young adults, suggesting a policy-driven impact on youth mortality. In contrast, Maryland’s FPL adoption yielded no clear change in firearm homicide and only a decrease in firearm suicide among those aged 18–20 (-20.4%), with inconsistent patterns for non-firearm outcomes. Repeal in Missouri was followed by marked increases in firearm homicide and suicide (+63.2% and +39.7% respectively), while non-firearm mortality did not rise, again suggesting correlation with firearm access. Michigan’s partial repeal (removing licensing for dealer sales but not private sales) was correlated with mixed effects on homicide and suicide overall and across age groups, thus making it difficult to draw conclusions on the effects of changes to FPL legislation in this state.
Fundamentally, these findings strengthen the evidence that FPL legislation is associated with a decrease in youth firearm deaths. While this may be directly by deterring impulsive purchases or indirectly by reducing downstream access to guns, restricting access to firearms had a measurable correlation with reductions in mortality. That adoption of FPL laws was protective and repeal was harmful suggests that even a brief delay or added difficulty in obtaining a firearm may be a matter of life and death for youth in crisis. The greater effect of FPL laws on firearm deaths compared to non-firearm deaths across states strengthen the correlation between state policy and death from gun violence. Further, the more consistent negative effects of full FPL repeal in Missouri compared to partial repeal in Michigan indicates that more comprehensive legislation is likelier to yield meaningful reductions in youth firearm mortality. Overall, this study offers actionable evidence that FPL laws are effective at reducing youth firearm deaths, though further research focusing on specific FPL features, enforcement, and interactions with other firearm policies could affect even more promising change.
