Violence-related Events Research Articles

Violence-related morbidity among people released from prison in Australia: A data linkage study.

People released from prison have an increased risk of morbidity, including from nonfatal violence. We examined the incidence and predictors of violence-related morbidity after release from prison and investigated whether there are differences according to sex and Indigenous status. Baseline data were collected from 1325 people within 6 weeks of release from prisons in Queensland, Australia, between 1 August 2008 and 31 July 2010. Data were linked to state-wide health (ambulance, emergency department and hospital) and prison records, and national death records until 31 July 2012. Predictors were identified using a multivariable Andersen-Gill model. Differences according to sex and Indigenous status were investigated using effect modification. A total of 225 (18.2%) people experienced 410 violence-related events that were recorded in health records. The incidence was 12.8 per 100 person-years [95% confidence interval (CI) 11.7, 14.1]. Risk factors for violence-related morbidity included diagnosed mental illness [hazard ratio (HR)=2.0, 95% CI 1.1, 3.8], substance use disorder (HR=1.6, 95% CI 1.1, 2.3) or dual diagnosis (HR=3.2, 95% CI 2.2, 4.8); high-risk alcohol use (HR=2.1, 95% CI 1.5, 2.8); being Indigenous (HR=1.7, 95% CI 1.2, 2.5); and two or more prison releases (HR=1.7, 95% CI 1.2, 2.6). Indigenous status modified the risk of violence-related morbidity, with Indigenous men having twice the risk of non-Indigenous men (HR=1.9, 95% CI 1.3, 2.8). Approximately one in five people released from prisons in Queensland experienced violence-related morbidity. Coordinated and continuous mental health and substance use treatment from prison to the community may reduce the risk of violence-related morbidity in this population.

Patient reported outcomes 6 to 12 months after interpersonal violence: A multicenter cohort study.

Violence continues to be a significant public health burden, but little is known about the long-term outcomes of these patients. Our goal was to determine the impact of violence-related trauma on long-term functional and psychosocial outcomes. We identified trauma patients with moderate to severe injuries (Injury Severity Score, ≥9) treated at one of three level 1 trauma centers. These patients were asked to complete a survey over the phone between 6 and 12 months after injury evaluating both functional and psychosocial outcomes (12-item Short Form Survey, Trauma Quality of Life, posttraumatic stress disorder [PTSD] screen, chronic pain, return to work). Patients were classified as having suffered a violent injury if the mechanism of injury was a stab, gunshot, or assault. Self-inflicted wounds were excluded. Adjusted logistic regression models were built to determine the association between a violent mechanism of injury and long-term outcomes. A total of 1,050 moderate to severely injured patients were successfully followed, of whom 176 (16.8%) were victims of violence. For the victims of violence, mean age was 34.4 years (SD, 12.5 years), 85% were male, and 57.5% were Black; 30.7% reported newly needing help with at least one activity of daily living after the violence-related event. Fifty-nine (49.2%) of 120 patients who were working before their injury had not yet returned to work; 47.1% screened positive for PTSD, and 52.3% reported chronic pain. On multivariate analysis, a violent mechanism was significantly associated with PTSD (odds ratio, 2.57; 95% confidence interval, 1.59-4.17; p < 0.001) but not associated with chronic pain, return to work, or functional outcomes. The physical and mental health burden after violence-related trauma is not insignificant. Further work is needed to identify intervention strategies and social support systems that may be beneficial to reduce this burden. Prognostic and epidemiological, level III.

Posttraumatic Distress and Treatment Barriers Among Former Gang Members: Implications for Improving Access to Traumatic Stress Resources in Marginalized Populations.

Limited research has examined the links among violent victimization, mental health, and service utilization among gang-involved individuals. This mixed-methods preliminary study examined narratives of psychiatric distress, current psychiatric morbidity, and mental health treatment experiences among a sample of former gang members (N = 32; M age = 44.4 years, 87.5% male; 56.3% Hispanic or Latino, 31.3% African American). Participants completed online questionnaires to assess trauma exposure and current psychiatric symptoms as well as a semistructured interview to examine histories of psychiatric distress and mental health treatment. Participants reported exposure to an average of 10.2 discrete traumatic events (range: 3-21). On average, participants reported exposure to five to six community violence-related events, ranging from never or one time up to monthly and weekly exposure. Participants generally described histories of depression, anxiety, posttraumatic stress disorder (PTSD), and substance abuse, although a thematic analysis revealed PTSD symptoms predominated the psychiatric distress described, including symptoms related to intrusions, avoidance, negative alterations in cognitions and mood, and alterations in arousal. Grounded theory analysis revealed barriers to traditional models of mental health treatment included self-isolation, gang rules, and social stigma, especially in the context of interpersonal disconnect with providers. Given conditions of limited resources to access treatment, participants engaged in peer support services, which may have reduced their psychiatric distress to currently low levels. Implications for understanding these notable findings of recovery and resilience for some individuals and building trauma-informed communities that improve access to traumatic stress resources for marginalized populations are discussed.

FRENCH PRINT MEDIA: DEMONISATION OF RUSSIA’S IMAGE IN THE LIGHT OF DOMESTIC VIOLENCE ISSUES

This article looks at the image of Russia constructed by French quality papers (Le Monde, Le Figaro, Le Parisien). In today’s world, the role of the media as a regulator of public opinion is becoming increasingly important. The linguistic techniques used by journalists allow the media to influence the reader’s perceptions, opinions, and views. The issue of neutrality of a country’s image inspires academic interest, since such perceptions affect bilateral and international relations. France and Russia are among the key global actors, and their dialogue is thus crucial. However, the two countries often disagree on human rights. Domestic violence and its decriminalisation in Russia are today widely covered in French media. Russia’s image in France has been studied by a number of Russian and foreign scholars. Their works are primarily focused on political events and conflicts, while the image in the context of social issues requires additional research. Unlike previously conducted studies, the scientific value of this work is that it does not only describe the image itself but specifically analyses linguistic tools employed for image construction. The purpose of this study is to determine the dynamics of Russia’s image in the light of domestic violence related events. The functional, narrative, and discourse analysis of the publications have revealed the general tone of the image and identified the main methods of manipulating readers’ consciousness. In the face of recent events, the French papers demonise Russia’s image pointing to the inconsistency of the authorities, decriminalisation of domestic violence, conservative values and violation of human rights. The negative image is mostly created by means of linguistic tools that can be divided into three categories: derogatory language, consciousness manipulation methods and implicit connotations. This classification and the results of the research could serve as a basis for linguistic examinations of media texts and be used for a wide range of journalism and linguistics related courses.

Individual, business-related, and work environment factors associated with driving tired among taxi drivers in two metropolitan U.S. cities

Introduction: Violence-related events and roadway incidents are the leading causes of injury among taxi drivers. Fatigue is under-recognized and prevalent in this workforce and is associated with both injury outcomes. We describe the association of individual, business-related, and work environment factors with driving tired among taxi drivers in two very different cities. Method: We developed a comprehensive survey for licensed taxi drivers. We trained surveyors to administer the 30-min survey using systematic sampling among taxi drivers waiting for fares in two large U.S. cities: the Southwest (City 1) and the West (City 2). A driving tired scale of the Occupational Driver Behavior Questionnaire was the outcome. Multivariate logistic models described driving tired behavior in city-specific models using adjusted Odds Ratios (ORadj). Results: City 1 and City 2 had 496 and 500 participants, respectively. Each driving tired behavior was significantly more prevalent in City 2 than City 1 (p < .05). There were more variables and a greater diversity of variables in the models describing drowsy driving in City 1 than City 2. In City 1, variables describing negative safety climate (ORadj = 1.15), socio-demographic groups (identifying as Asian, educational attainment), passenger-related violence (ORadj = 1.79), and company tenure (ORadj =1.15) were associated with driving tired. In City 2, high perceived safety training usefulness (ORadj = 0.48) was associated with driving tired. A risk factor for driving tired that was common to both cities was job demands (ORadj = 1.21 in City 1; 1.43 in City 2). Conclusions: These findings represent two diverse taxi populations driving in two geographically distinct regions that differ in safety regulation. It is important that safety measures that include fatigue awareness training are reaching all drivers. Fatigue management training should be integrated into driver safety programs regardless of location. Practical applications: Fatigue management strategies that recognize individual factors, business-related characteristics, and work environment are an important component of road safety and are particularly relevant for occupational drivers.

Nonpowder firearms cause significant pediatric injuries.

We hypothesize that nonpowder firearms cause significant injuries in children, often requiring intervention. We have noted a difference in demographics of children presenting with injuries from nonpowder firearms compared with patients injured by powder firearms. We reviewed our institution's experience with patients with nonpowder firearm injuries to evaluate these aspects. A retrospective chart review was completed for all patients with a firearm injury from 2003 through February 2013 to a pediatric urban Level I trauma center. Patients were excluded if they were 18 years of age or older or readmitted. Demographics, injury circumstances, interventions, and outcomes were reviewed for 303 patients. The χ test and analysis of variance were completed with a statistical significance of p < 0.05. There were 57 nonpowder firearm injuries and 246 injuries from other firearms. Injuries occurred from BB, pellet, and paintball guns. Treatment included computed tomography scan in 39 patients, three bedside procedures, one angiography, and operative intervention in 25 patients. The most common injury locations were the eye (n = 37), head (n = 7), and neck (n = 6). Children injured by nonpowder firearms were less likely to be female (p = 0.04), more likely to be white (p < 0.01), and less likely to be injured in a violence-related event (p < 0.01). Nonpowder firearms can cause severe pediatric injuries requiring operative intervention and significant radiographic exposure from computed tomography scans. Prevention and education are important in decreasing this risk in the pediatric population and should be targeted to a different population than powder firearm prevention. Epidemiologic study, level V.

Brief interventions for hazardous and harmful alcohol consumption in accident and emergency departments.

The prevalence of alcohol abuse among patients treated in accident and emergency departments (A&E) is considered as substantial. This paper is a narrative review of studies investigating the effectiveness of brief interventions (BI) for hazardous and harmful alcohol consumption in A&E. A&E departments in hospitals (and other health care infrastructures) are commonly the place where serious consequences of alcohol drinking are seen and need to be tackled, supporting the suggested theoretical usefulness of delivering BI in this environment. Available research shows that BI may be considered a valuable technique for dealing with alcohol-related problems. However, it is suggested that the usefulness of BI may depend significantly on the target population to be dealt with. BI have proved to be beneficial for male individuals and those patients who do not abuse other psychoactive substances. In contrast, evidence indicates that BI in A&E settings are not effective at all when dealing with men admitted as a consequence of a violence-related event. In addition, some studies were unable to confirm the effectiveness of BI in female population, in emergency setting. Studies investigating the association between drinking patterns and the effectiveness of BI also present inconsistent results. Most studies assessing the effectiveness of BI in A&E settings only adopted a short perspective (looking at the impact up to a maximum of 12 months after the BI was delivered). When assessing the effects of BI, both the amount of alcohol consumed and expected reductions in alcohol consequences, such as injuries, can be taken into account. Evidence on the implementation of brief intervention in emergency departments remains inconclusive as to whether there are clear benefits. A variety of outcome measures and assessing procedures were used in the different studies, which have investigated this topic.

Escenario de agitación socio - política en la Venezuela contemporánea: d e los factores de conflictividad a la apertura de ventanas de oportunida d

So far during 2014, Venezuelan political events have been influenced by a climate of constant confrontation. These violence-related events have left a troubling death toll within months. This intricate context invites to provide approaches from the scope of the political science in order to unravel causes, effects and prospects of the present situation. This article discusses a number of factors of socio-political conflict that have influenced relations between antagonistic actors. Also, it analyzes some juncture components that may facilitate the understanding of the contemporary climate of hostility. During the process, key elements related to the context of political and institutional crisis that took place between 2002 and 2003 are addressed, considering that several of these elements persist in today's Venezuela. Afterwards, the article highlights the importance of restoring the communication conduits between opposing political actors. Finally, some key features of the National Conference for Peace are addressed, and some considerations about its course of action are provided.

Posttraumatic stress disorder in a nationally representative mexican community sample.

This study describes the public health burden of trauma exposure and posttraumatic stress disorder (PTSD) in relation to the full range of traumatic events to identify the conditional risk of PTSD from each traumatic event experienced in the Mexican population and other risk factors. The representative sample comprised a subsample (N = 2,362) of the urban participants of the Mexican National Comorbidity Survey (2001-2002). We used the World Health Organization's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and the presence of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, ) in each respondents' self-reported worst traumatic event, as well as a randomly selected lifetime trauma. The results showed that traumatic events were extremely common in Mexico (68.8%). The estimate of lifetime PTSD in the whole population was 1.5%; among only those with a traumatic event it was 2.1%. The 12-month prevalence of PTSD in the whole population was 0.6%; among only those with a traumatic event it was 0.8%. Violence-related events were responsible for a large share of PTSD. Sexual violence, in particular, was one of the greatest risks for developing PTSD. These findings support the idea that trauma in Mexico should be considered a public health concern.

The consequences of orofacial trauma resulting from violence: a study in Porto

Orofacial injuries resulting from violence are a fairly common event. In Portugal, however, the impact of these injuries remains to be elucidated. This study aims to analyze the injuries and permanent consequences of orofacial trauma (in a three-dimensional perspective: organic, functional and situational), resulting from violence. To do so, a retrospective analysis of all violence-related forensic reports performed in the North Branch of the National Institute of Legal Medicine, during 2007, was carried out (n = 513). It was found that most victims were men with a mean age of 35.4 (SD = 15.1). Most aggressions were due to punches and/or kicks. The most frequent orofacial injuries were lip injuries (57.7%), followed by extra-oral soft tissue injuries (35.9%), gingival and oral mucosa injuries (29.2%), and teeth and/or periodontal injuries (17.5%). The most frequent long-term consequences concerned the teeth and periodontal area (14.0%), followed by the lip area (7.4%), and gingival and oral mucosa tissues (3.9%). In terms of the effect on functions and life situations, it was found that chewing and embarrassment in social life events were the most prevalent (43.6% and 83.6%, respectively). These results showed that orofacial trauma from violence-related events can damage a person's quality of life, especially those concerning the teeth area, as a result of their implications in normal function and in life situations.

Violence-related mortality and morbidity of humanitarian workers

(1) To determine the rate of violence-related deaths, medical evacuations, and hospitalizations occurring to national and expatriate staff of participating humanitarian organizations; (2) to describe the distribution of all-cause and cause-specific mortality and morbidity of humanitarian workers with regard to possible risk factors. Surveillance study of field-based humanitarian workers; data were regularly collected from headquarters of participating organizations via e-mail and telephone between September 2002 and December 2005. Eighteen humanitarian organizations reported on any death, medical evacuation, or hospitalization of any national or expatriate staff for any cause, in any field location during the study period. None. Risk of violence-related events was calculated as the number of deaths, medical evacuations, and hospitalizations during the study period divided by the total number of field staff for organizations that had staff in those countries where events occurred to the staff of any participating organization. Distribution descriptions are presented as simple proportions. Risk of violence-related deaths, medical evacuations, and hospitalizations was six per 10,000 aid worker person-years. Fifty percent of intentional violence cases were lethal. Intentional violence accounted for 55 percent of all deaths reported, followed by coincidental illness (27 percent) and accidents (15 percent). Aid worker deaths in this group were more frequently caused by intentional violence than either accidents or coincidental illness. The rate of six intentional violence events per 10,000 person-years can be used as a baseline by which to track changes in risk over time.

Validity of Self-Reported Drinking Before Injury Compared With a Physiological Measure: Cross-National Analysis of Emergency-Department Data From 16 Countries*

Self-reports of alcohol consumption among patients visiting an emergency department (ED) have been used extensively in the investigation of the relationship between drinking and injury. Little is known, however, about the associations between validity of self-reports with patient and injury characteristics and whether these relationships vary across regions or countries. Both of these issues are explored in this article. In the construct of a multilevel logistical model, validity of self-reports was estimated as the probability of a positive self-report given a positive blood alcohol concentration (BAC). The setting included 44 EDs across 28 studies in 16 countries. Participants included 10,741 injury patients from the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study of Alcohol and Injuries. Data were analyzed on self-reported drinking within 6 hours before injury compared with BAC results obtained from breath-analyzer readings in all but two studies, which used urine screens. Covariates included demographic, drinking, and injury characteristics and aggregate-level contextual variables. At the individual level, a higher BAC measurement was associated with a higher probability of reporting drinking, as was heavy drinking and sustaining injuries in traffic accidents or violence-related events. At the study level, neither aggregate BAC nor other sociocultural variables affected the validity of self-reported drinking. This study provides further evidence of the validity of self-reported drinking measures in crossnational ED studies based on the objective criterion of BAC estimates.

The Context of Violence for Children of Color: Violence in the Community and in the Media

Exposure to community violence may be associated with psychological distress, greater risk taking and aggression, and learning problems in children of color, while exposure to media violence may be related to increased aggression, psychological trauma, and other psychological and behavioral sequelae. Unfortunately, relationships between children's exposure to community and media violence have not been fully examined. Based on existing findings, this article presents a conceptual model of the potential effects of exposure to community and media violence on child functioning which suggests that the impact may be cumulative and should be examined in future studies of development in children of color. Low-income children of color in America are exposed to many types of violence. They may experience violence in the home and they experience or observe violence in schools, playgrounds, parks, and the communities in which they play and grow (Veenema, 2001). In addition, children are growing up in a media-saturated environment. Portrayals of violence in the media-through television, video games, and the Internet-touch virtually every child (Gentile & Walsh, 2002; Osofsky, 1999; Singer et al., 1999). While community and media violence affect all racial and ethnic groups, ethnic minority youth, particularly African Americans and Hispanic Americans, may be disproportionately affected by exposure to both community violence and exposure to media violence (Attar, Guerra, & Tolan, 1994; Bureau of Justice Statistics, 1991; Cooley-Quille, Boyd, Frantz, & Walsh, 2001). Violence refers to immediate or chronic situations that result in injury to the psychological, social, or physical well-being of individuals or groups (American Psychological Association, 1993). Violence, however, is not evenly distributed across all neighborhoods and demographic groups. Evidence suggests that it occurs at a higher rate in low-income/no income neighborhoods, especially among the young, and in public places (Bell & Jenkins, 1993). Research shows that children's exposure to community violence is related to a wide array of behavioral and psychological difficulties (Ceballo, Dahl, Aretakis, & Ramirez, 2001). Similarly, children's exposure to media violence is related to increased aggression, the prevalence of symptoms of psychological trauma, and other psychological and behavioral sequelae (American Academy of Pediatrics, 1995; Gentile & Walsh, 2002; McCann, Sakheim, & Abrahamson, 1988; Rosenthal, 2000; Sanders-Phillips, 1997; Strasburger & Donnerstein, 1999). As this selective review of the literature suggests, the level of children's exposure to community violence or media violence may vary; however, the psychological and behavioral risks that are associated with children's exposure to these types of violence are remarkably similar. This article reviews existing findings on exposure to community violence and exposure to media violence and on the associated adverse psychosocial and behavioral outcomes in children and adolescents. The lack of scientific inquiry linking the potential cumulative effects of the co-occurrence of exposure to community and exposure to media violence to adverse psychosocial and behavioral outcomes in children, particularly children of color, is noted. Based on the literature review, a conceptual model of the relationship between exposure to community violence and psychosocial adjustment and risk behaviors in children of color, moderated by exposure to media violence, is presented. LOW-INCOME CHILDREN'S EXPOSURE TO COMMUNITY & MEDIA VIOLENCE: EFFECTS AND RESPONSES Exposure to Community Violence While the nation publicly mourns shootings at schools such as Columbine High School in Littleton, Colorado, life-threatening community violence is a daily obstacle for many low-income, inner-city children (Ceballo et al., 2001). Groves (1997) defines community violence as the chronic and pervasive presence of violence and violence-related events within an individual's proximal environment. …

Out-of-Hospital Violence Injury Surveillance: Quality of Data Collection

Study objective: The recognized need to improve data collection for violence prevention may be met, in part, by using out-of-hospital data for injury surveillance. The purpose of the Prehospital Violence Injury Surveillance project was to examine the extent to which paramedics can adequately collect information about injuries, particularly intentional injuries, at emergency scenes. Methods: Paramedics in a large Midwestern metropolitan area were trained to assess violence-related events and collect relevant data using a modified ambulance run report form. Data collected from 8 violence-related training scenarios and from 13 ride-along observations were analyzed to estimate paramedic interrater reliability using the κ statistic. Data from 7,363 run report forms, filed during a 3-month study period, were abstracted and analyzed for completeness and quality. Results: Paramedics demonstrated fair to good, and sometimes excellent, interrater agreement when documenting the training scenarios. Paramedics revealed barriers to collecting violence-related out-of-hospital data. The paramedics and the observer disagreed in documenting 77% of the ride-along observations. Overall, 73% of abstracted run report forms showed documentation errors, with more than 99% of these reports containing errors of omission and 29% showing internal documentation inconsistencies. Despite the emphasis on violence-related data, documentation of domestic abuse screening was missing from more than 99% of run reports from female patients. Conclusion: Significant barriers to quality out-of-hospital data collection were identified during study implementation and in abstracted run reports. These barriers included the following: lack of organizational support; characteristics of the violence-related data elements; design of the ambulance run report form; and paramedic knowledge, attitudes, and behaviors regarding data collection. [Boergerhoff LA, Gerberich SG, Anderson A, Kochevar L, Waller L: Out-of-hospital violence injury surveillance: Quality of data collection. Ann Emerg Med December 1999;34:745-750.]

Refugee children from the Middle East.

To map the frequency (prevalence) of torture victims among parents in asylum seeking Middle Eastern refugee families, to map the occurrence (prevalence) of experiences of war and other forms of organised violence among the children in these families, to map the occurrence (prevalence) of emotional symptoms and behavioural problems among the children, and to identify risk indicators and modifying factors for anxiety symptoms among the children. Interview with parents using a structured interview questionnaire developed for this study. Validated through a blinded semi-structured interview conducted with approximately 1/3 of the families. AUSPICES: The study has been carried out by the Rehabilitation and Research Centre for Torture Victims (RCT) in cooperation with the Danish Red Cross. Structured interviews with parents regarding 311 children aged 3-15 from 149 families, all registered as asylum seekers from the Middle East between February 1, 1992 and April 30, 1993. The response was 90.4%. PRINCIPAL VARIABLES: Background (past-past)--social and demographic data; trauma complex (past)--war-related life circumstances (conditions) and experiences of war and other forms of organized violence such as loss, separation, direct exposure to violence and witnessing acts of violence (specific events and changes of life conditions); present life context (past-present)--family circumstances upon arrival in Denmark; effect (present)--the child's current psychological state. 28% of the parents (44% of the fathers and 13% of the mothers) had been tortured, to the effect that 51% of the children were part of a family including a survivor of torture. The most frequent specific types of violence-related events or circumstances were 'lived in a refugee camp outside the home country' (92%), 'lived under conditions of war' (89%) and 'been on the run with parents' (89%). Twenty percent of the children had lost one parent, and another 60% had been separated from one parent for more than a month. The highest prevalence of emotional symptoms were found within the anxiety dimension, as 67% of the children were assessed as being clinically anxious. The most important risk indicators for anxiety were 'lived in a refugee camp outside the home country', 'part of a torture surviving family', 'lack of opportunities for play with other children', 'beaten/kicked by an official', and 'loss of father'. Current parental behaviour was also an important risk indicator for anxiety, if the mother or father hit or punished the child more than was the case prior to arrival in Denmark. The most important anxiety-modifying factor was arrival in Denmark in the company of both parents. Asylum seeking refugee children from the Middle East have had many experiences of war and other forms of organised violence. The children frequently reacted with anxiety and with other symptoms of emotional instability. Prevalent anxiety symptoms correlated both with previous living conditions and present family situation. Living under prolonged conditions influenced by war and other forms of organised violence (prevalence) were found to a higher degree to be risk indicators for anxiety than were specific events or changes of life conditions (incidence).