VIOLENCE

暴力
  • 文章类型: Case Reports
    这份病例报告描述了一名来自瑞士的47岁男性超级足球迷的治疗轨迹,他被诊断并接受了注意力缺陷/多动障碍的治疗,同时伴随酒精滥用和失眠。在这一集护理之前,患者表现出冲动和注意力不集中的症状以及持续的有害饮酒模式,经常参与与足球有关的暴力。涉及心理治疗和精神药理学的多模式方法在症状管理方面取得了显着改善。迄今为止,患者的心理社会功能得到了改善,报告显著减少饮酒和停止所有攻击性行为。因此,这个案例提供了对注意力缺陷/多动障碍与足球相关暴力之间关系的见解,强调量身定制的心理健康干预措施以提高整体生活质量的潜力。
    This case report describes the therapeutic trajectory of a 47-year-old male ultra football fan from Switzerland, who was diagnosed and treated for attention-deficit/hyperactivity disorder, together with comorbid alcohol misuse and insomnia. Prior to this episode of care, the patient exhibited symptoms of impulsivity and inattention and persistent patterns of harmful alcohol consumption, recurrently participating in football-related violence. A multimodal approach involving psychotherapy and psychopharmacology yielded notable improvements in symptom management. To date, the patient has shown improved psychosocial functioning, reporting a significant reduction in alcohol use and the cessation of all aggressive acts. Consequently, this case provides insights into the relationship between attention-deficit/hyperactivity disorder and football-related violence, underlining the potential for tailored mental health interventions to enhance overall quality of life.
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  • 文章类型: Editorial
    这篇社论批评了现有的关于全球健康非殖民化的文献,以目前对加沙健康的攻击为例。它认为,未能解决持续不断的暴力和公然针对卫生设施的问题,人员和无辜平民最清楚地表明了这种做法的局限性,这种做法在言辞上很强,在对支持和延续定居者殖民主义的整个系统提出直率挑战方面很弱。我们建议对全球卫生机构在当前新自由主义体系中的地位以及知识生产体系进行更彻底的重新思考,这些体系继续支持对定居者殖民主义受害者健康的现有殖民方法。
    This editorial critiques the existing literature on decolonizing global health, using the current assault on health in Gaza as a case in point. It argues that the failure to address the ongoing violence and blatant targeting of health facilities, personnel and innocent civilians demonstrates most clearly the limitations of an approach that is strong on rhetoric and weak on mounting a forthright challenge to the entire system supporting and perpetuating settler colonialism. We propose a more radical rethinking of the position of global health institutions within the current neoliberal system and of the systems of knowledge production that continue to underpin the existing colonial approach to the health of victims of settler colonialism.
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  • 文章类型: Journal Article
    背景:暴力刀击(\'刺伤\')被认为是发病率和死亡率的来源。这项研究的两个目的是描述安大略省人口中刺伤的流行病学,加拿大,并评估邻里边缘化的两种措施之间的关联-物质剥夺和住房不稳定,还有刺伤的危险.
    方法:我们在2004-18年间使用关联的管理数据进行了一项基于人群的病例对照研究。案件遭受刺伤,导致急诊就诊,住院或死亡。每个病例匹配四个年龄和性别匹配的对照。多变量逻辑回归用于评估邻里物质剥夺以及住房不稳定与受伤风险之间的关联。平均年度伤害发生率是使用确定的病例数除以当年安大略省的总人口来估算的。
    结果:我们确定了26657名刺伤患者,其中724人(2.7%)死亡。年平均发病率为13.4/10万(95%CI:12.7至15.9)。受害者是不成比例的年轻(中位年龄25岁;IQR:20-37岁)男性(84.1%),来自大型城市中心(77.5%),收入最低的五分之一(39.3%)。在多变量模型中,邻里物质剥夺(OR1.45,95%CI:1.43~1.47)和住房不稳定(OR1.4,95%CI:1.22~1.26)与受伤风险相关.
    结论:刺伤伤害是一个严重的公共卫生问题,影响所有年龄和人口统计学的个体,但不成比例地影响城市环境中的年轻男性。边缘化社区的居住与刺伤的风险之间的联系较弱。未来的研究应旨在更好地了解这种关联的性质,并考虑公共卫生干预措施的机会,以减轻暴力刀伤的负担。
    BACKGROUND: Violent knife assaults (\'stabbings\') are underappreciated as a source of morbidity and mortality. The two objectives of this study were to describe the epidemiology of stabbing injuries in the population of Ontario, Canada and to assess the associations between two measures of neighbourhood marginalisation-material deprivation and housing instability, and the risk of stabbing injury.
    METHODS: We conducted a population-based case-control study over 2004-18 using linked administrative data. Cases suffered a stabbing injury resulting in an emergency department visit, hospitalisation or death. Four age and sex-matched controls were matched to each case. Multivariate logistic regression was used to assess the associations between neighbourhood material deprivation as well as housing instability and the risk of injury. Mean annualised injury incidences were estimated using the number of cases identified divided by the total population of Ontario for that year.
    RESULTS: We identified 26 657 individuals with a stabbing injury, of which 724 (2.7%) were fatal. The mean annualised incidence was 13.4 per 100 000 (95% CI: 12.7 to 15.9). Victims were disproportionately young (median age 25 years; IQR: 20-37 years) males (84.1%), from large urban centres (77.5%), and in the lowest income quintile (39.3%). In multivariate models, neighbourhood material deprivation (OR 1.45, 95% CI: 1.43 to 1.47) and housing instability (OR 1.4, 95% CI: 1.22 to 1.26) were associated with risk of injury.
    CONCLUSIONS: Stabbing injuries are a substantial public health problem that affects individuals of all ages and demographics but disproportionately affects younger men in urban settings. There is a weak association between residence in marginalised neighbourhoods and the risk of stabbing injury. Future studies should aim to better understand the nature of this association and consider opportunities for public health interventions to reduce the burden of violent knife injuries.
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  • 文章类型: Case Reports
    很少有关于暴力发作的详细描述。我们从索引病例和对暴力后发作的系统回顾中提供了证据,这些证据证明了某些暴力后发作行为的脑病特征。我们讨论了这些案件如何适应罪责的法律框架。数据支持以下观点:某些暴力行为的发作更准确地归类为神经性谵妄或脑病,而不是病后精神病。当前的医学术语可能会对在谵妄发作期间表现出发作后暴力的患者提出不必要的(并且可能是无意的)障碍,在此期间患者不知道他或她的暴力行为。
    Detailed descriptions of violent postictal episodes are rare. We provide evidence from an index case and from a systematic review of violent postictal episodes that demonstrates the encephalopathic features of some violent postictal behaviors. We discuss how these cases may fit in the legal framework of culpability. The data support the view that some episodes of violent postictal behavior are more accurately classified as a neurological delirium or encephalopathy rather than as a postictal psychosis. Current medical terminology may present unwarranted (and presumably unintended) barriers to exculpation for patients who exhibit post-ictal violence during an episode of delirium during which the patient was unaware of his or her violent conduct.
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  • 文章类型: Journal Article
    背景:在联邦AWB到期后,很少有州制定攻击性武器禁令(AWB)。州AWB以及邻近州立法的有效性,在降低攻击武器(AWs)的局部流行率或降低整体射击杀伤力方面尚不清楚。
    方法:我们查询了枪支暴力档案(2014-2021),以确定美国枪支伤害和死亡人数。比较了有和没有AWB的州之间的射击死亡率,根据国家枪支法律数据库的报告。有关回收枪支的数据是从ATF枪支追踪数据库获得的,用于估计武器流行率。回收的枪支根据口径(7.62毫米,5.56mm,0.223卡)。我们进行了空间加权线性回归模型,对州和年份具有固定影响,以评估地理上聚集的州立法与枪支结果之间的关联。
    结果:从2014年到2021年,美国枪击受害者的死亡率为8.06%,在有和没有AWB的州之间没有差异。在没有AWB的州,AWs占枪支总数的比例为5.0%,在有AWB的州为6.0%(平均差[95%CI]=-0.8%[-1.6%至-0.2%],P=0.03)。AWB州的大多数回收枪支都来自非AWB州。在调整后的模型上,州级AWB和枪支案件死亡之间没有关联;然而,与AWB状态相邻与病死率较低相关(P<0.001).与美国其他地区相比,边界共享的AWB集群州的AW患病率和死亡率较低。
    结论:孤立状态的AWB与射击病死率或AWs的患病率无关,但是多个相邻状态之间的AWB可能与两个结果相关联。
    BACKGROUND: Few states established assault weapon bans (AWBs) after the federal AWB expired. The effectiveness of state AWBs as well as neighboring state legislation, in reducing the local prevalence of assault weapons (AWs) or in reducing overall shooting lethality is unknown.
    METHODS: We queried the Gun Violence Archive (2014-2021) to identify US firearm injuries and fatalities. Shooting case fatality rates were compared among states with and without AWBs, as reported in the State Firearm Laws Database. Data on recovered firearms was obtained from the ATF Firearms Trace Database and used to estimate weapon prevalence. Recovered firearms were classified as AWs based on caliber (7.62 mm, 5.56 mm, 0.223 cal). We performed spatially weighted linear regression models, with fixed effects for state and year to assess the association between geographically clustered state legislation and firearm outcomes.
    RESULTS: From 2014 to 2021, the US shooting victim case fatality rate was 8.06% and did not differ among states with and without AWBs. The proportion of AWs to total firearms was 5.0% in states without an AWB and 6.0% in states with an AWB (mean difference [95% CI] = -0.8% [-1.6% to -0.2%], P = 0.03). Most recovered firearms in AWB states originated from non-AWB states. On adjusted models, there was no association between state-level AWB and firearm case fatality; however, adjacency to states with an AWB was associated with lower case fatality (P < 0.001). Clustered AWB states with shared borders had lower AW prevalence and fatality rates than the rest of the US.
    CONCLUSIONS: Isolated state AWBs are not inversely associated with shooting case fatality rates nor the prevalence of AWs, but AWBs among multiple neighboring states may be associated with both outcomes.
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  • 文章类型: Journal Article
    目的:探讨其发生情况,人口统计,以及医生杀人的情况。
    方法:作者询问了国家暴力死亡报告系统(NVDRS),疾病控制和预防中心的监测系统追踪2003年至2018年间的暴力死亡,该系统整合了执法和验尸官/体检医师报告的数据。作者确定了以医生为职业的凶杀死者的案例,外科医生,或者精神病医生.收集的数据包括死者的人口统计学和死亡情况。
    结果:数据由7-41个州提供,参与州随时间增加。据报道有56起凶杀案,大多数是男性(73.2%)和白人(76.8%)。据报道,大多数(67.9%)确定的袭击者知道死者:23.2%是由伴侣/前伴侣犯下的;10.7%是由患者/患者\'家庭成员。死亡主要是枪伤(44.6%),刺伤(16.1%),和钝器外伤(16.1%)。在受害者家中发生的凶杀案(58.9%)多于工作(16.1%)。
    结论:医生杀人相对罕见,发生率低于普通人群。与患者相比,医生被伴侣或前伴侣杀死的频率更高。大多数凶杀案发生在远离工作场所的地方。需要更广泛的努力来促进整个美国暴力社会的干预措施,以减少家庭/伴侣暴力和枪支暴力。
    OBJECTIVE: To explore the occurrence, demographics, and circumstances of homicides of physicians.
    METHODS: Authors interrogated the National Violent Death Reporting System (NVDRS), the Centers for Disease Control and Prevention\'s surveillance system tracking violent deaths between 2003 and 2018 which integrates data from law enforcement and coroner/medical examiner reports. Authors identified cases of homicide decedents whose profession was physician, surgeon, or psychiatrist. Data collected included decedents\' demographics as well as circumstances of death.
    RESULTS: Data were provided by 7-41 states as participating states increased over time. Fifty-six homicides were reported, most were male (73.2%) and white (76.8%). Most (67.9%) identified assailants reportedly knew decedents: 23.2% were perpetrated by partners/ex-partners; 10.7% by patients/patients\' family members. Deaths were mainly due to gunshot wounds (44.6%), stabbing (16.1%), and blunt force trauma (16.1%). More (58.9%) homicides occurred at victims\' homes than work (16.1%).
    CONCLUSIONS: Physician homicides are relatively rare and occur at lower rates than in the general population. Physicians were more frequently killed by partners or ex-partners than by patients. Most homicides occurred away from the workplace. Broader efforts are needed to promote interventions throughout America\'s violent society to reduce domestic/partner violence and gun violence.
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  • 文章类型: Journal Article
    本文介绍了“因枪伤而残疾的年轻人:来自《记忆叙事》的探索性研究”的部分研究结果,旨在通过调查来解决暴力和犯罪在青少年领域的影响,除了死亡率和监禁率的上升,这些年轻人转变为残疾人,具体来说,坐在轮椅上的人为了实现这一目标,我们使用记忆叙事作为一种方法,研究排斥的类别,暴力和以创伤为标志的身体。我们会反思Guilherme的案子,一个可怜的,由于枪伤,残疾和轮椅使用者被边缘化的年轻人。他的案件的选择与暴力可以采取的不同形式有关,影响生活并留下痕迹,此外,我们相信,他的生活故事可以有助于使心理学在暴力背景下看待年轻人。
    The present text presents partial results of the research \"Young people with disability due to gunshot wounds: an exploratory study from the Memorialistic Narratives\", which aimed to problematize the effects of violence and criminality in the juvenile sphere by investigating, beyond the increase in mortality and incarceration rates, the transformation of these young people into people with disabilities, specifically, people in wheelchairs. To achieve this goal, we used as a method the Memorialistic Narratives and worked on the categories of exclusion, violence and a body marked by trauma. We will reflect on the case of Guilherme, a poor, marginalized young man with a disability and a wheelchair user due to a gunshot wound. The choice for his case relates to the different forms that violence can assume, influencing lives and leaving marks, besides, we believe that his life story can contribute to qualifying psychology\'s look at young people in contexts of violence.
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  • 文章类型: Journal Article
    背景:大多数美国K-12学校都采取了诸如武装教师和安装金属探测器之类的安全策略和政策,解决故意的学校枪支暴力。然而,对其有效性的研究很少。此外,社会人口因素可能会影响其实施。对照研究对于调查其对枪支暴力和相关纪律结果的影响是必要的。
    目的:本文概述了一项病例对照研究的协议,该研究检查了美国K-12学校的枪支暴力预防政策。该研究旨在调查特定安全策略和政策的总数和类型与K-12公立学校故意枪击事件的发生之间是否存在关联,学生的纪律成果,如果城市化,经济,种族因素改变了这些联系。
    方法:我们将为本研究创建一个具有全国代表性的数据集,并通过国家学校射击数据库确定案例学校(自2015年以来在校园里发生故意枪击事件的学校)的全面普查。匹配的控制学校将从美国教育部的所有公立学校的国家数据库中随机选择。我们将分析27个学校安全策略,分为七个关键的暴露组。
    结果:由美国国立儿童健康与发展研究所(R01HD108027-01)支持,并已获得机构审查委员会的批准,我们的研究目前处于数据收集阶段.我们的分析计划将确定学校安全策略和政策的数量和类型与约650K-12公立学校的全国样本中故意枪击,停学和驱逐的发生之间的关联。其他分析将研究特定协变量的效果修改。
    结论:作为第一个国家,对照研究,其结果将提供有关学校安全策略和政策在防止K-12公立学校故意枪击事件中的有效性的新颖和必要的数据。
    BACKGROUND: Most U.S. K-12 schools have adopted safety tactics and policies like arming teachers and installing metal detectors, to address intentional school gun violence. However, there is minimal research on their effectiveness. Furthermore, sociodemographic factors may influence their implementation. Controlled studies are necessary to investigate their impact on gun violence and related disciplinary outcomes.
    OBJECTIVE: The paper outlines the protocol for a case-control study examining gun violence prevention policies in U.S. K-12 schools. The study aims to investigate if there is an association between the total number and type of specific safety tactics and policies and the occurrence of intentional shootings in K-12 public schools, student disciplinary outcomes, and if urbanicity, economic, and racial factors modify these associations.
    METHODS: We will create a nationally representative dataset for this study and ascertain a full census of case schools (schools that experienced intentional gunfire on the campus during school hours since 2015) through national school shooting databases. Matched control schools will be randomly selected from U.S. Department of Education\'s national database of all public schools. We will analyze 27 school safety strategies organized into seven key exposure groupings.
    RESULTS: Supported by the National Institutes for Child Health and Development (R01HD108027-01) and having received Institutional Review Board approval, our study is currently in the data collection phase. Our analytical plan will determine the association between the number and type of school safety tactics and policies with the occurrence of intentional shootings and suspensions and expulsions in a national sample of approximately 650 K-12 public schools. Additional analyses will investigate the effect modification of specific covariates.
    CONCLUSIONS: As the first national, controlled study, its results will provide novel and needed data on the effectiveness of school safety tactics and policies in preventing intentional shootings at K-12 public schools.
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  • 文章类型: Journal Article
    背景:尽管经常有人说有特殊需要的儿童有被虐待和被忽视的风险,对有特定学习障碍(SLDs)的儿童的虐待进行的研究是有限的.
    方法:本病例对照研究旨在比较被诊断为SLDs的儿童(病例组)和具有典型发育的儿童(对照组)的忽视和虐待暴露。该研究包括6至12岁的儿童,他们被转诊到蒂尔基耶一家医院的儿童和青少年精神病学门诊和儿科门诊。数据收集过程包括196名参与者,在2020年持续了7个月。
    结果:根据对学龄儿童情感障碍和精神分裂症时间表-现在和终身土耳其版本(K-SADS-PL-T)和虐待评估问卷收集的数据进行分析,我们确定,与对照组儿童相比,SLDs儿童在身体和情感上受到的虐待更多.此外,他们目睹父母之间的暴力比对照组更多。身体虐待,情感虐待和目睹家庭暴力被认为是SLD的重要预测因素.
    结论:SLDs的存在是儿童遭受虐待的一个重要危险因素,即使没有ADHD作为合并症。
    BACKGROUND: Although it is often stated that children with special needs are at risk of being abused and neglected, research conducted on the abuse of children with specific learning disorders (SLDs) is limited.
    METHODS: This case-control study aims to compare exposure to neglect and abuse among children diagnosed with SLDs (case group) and children with typical development (control group). The study included children aged 6 to 12 years who were referred to the Child and Adolescent Psychiatry Outpatient Clinic and Pediatric Clinic of a hospital in Türkiye. The data collection process included 196 participants and lasted for 7 months in 2020.
    RESULTS: Based on the analysis of the data collected with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Turkish Version (K-SADS-PL-T) and the Abuse Assessment Questionnaire, we determined that children with SLDs were physically and emotionally abused more than the children of the control group. In addition, they witnessed violence between their parents more than the control group. Physical abuse, emotional abuse and witnessing family violence were identified as significant predictors for SLD.
    CONCLUSIONS: The presence of SLDs is a significant risk factor for children to be exposed to abuse even in the absence of ADHD as a comorbidity.
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  • 文章类型: Journal Article
    背景:为青年提供健康和社会服务的设施通常需要评估和管理暴力行为。这些供应商经常经历资源短缺,损害进行全面暴力风险评估的可行性。12-18岁青年暴力风险评估清单(V-RISK-Y)是一项12项暴力风险筛查工具,旨在快速识别在需要对暴力风险进行权宜评估的情况下具有暴力行为高风险的青年。V-RISK-Y仪器在青年急性精神病院试用,产生预测效度的阳性结果。本研究的目的是评估V-RISK-Y在儿童和青少年精神科和急性儿童保护服务机构中的评估者间可靠性。
    方法:采用案例插图研究设计来评估V-RISK-Y的评估者间可靠性。挪威和瑞典青年设施(N=163)的工作人员在三个小插曲中获得了V-RISK-Y,采用组内相关系数(ICC)评估评分者间的信度.
    结果:结果表明,在不同设施和职业的员工中,总分和低-中-高风险水平评估者之间具有良好的可靠性。对于单个项目,评估者间的可靠性从差到优不等。
    结论:这项研究是建立V-RISK-Y的心理测量特性的重要一步。调查结果支持该工具所基于的结构化专业判断传统,在整体风险评估上达成高度一致。这项研究有一个案例插图设计,下一步是评估V-RISK-Y在自然主义环境中的可靠性和有效性。
    BACKGROUND: Facilities providing health- and social services for youth are commonly faced with the need for assessment and management of violent behavior. These providers often experience shortage of resources, compromising the feasibility of conducting comprehensive violence risk assessments. The Violence Risk Assessment Checklist for Youth aged 12-18 (V-RISK-Y) is a 12-item violence risk screening instrument developed to rapidly identify youth at high risk for violent behavior in situations requiring expedient evaluation of violence risk. The V-RISK-Y instrument was piloted in acute psychiatric units for youth, yielding positive results of predictive validity. The aim of the present study was to assess the interrater reliability of V-RISK-Y in child and adolescent psychiatric units and acute child protective services institutions.
    METHODS: A case vignette study design was utilized to assess interrater reliability of V-RISK-Y. Staff at youth facilities (N = 163) in Norway and Sweden scored V-RISK-Y for three vignettes, and interrater reliability was assessed with the intraclass correlation coefficient (ICC).
    RESULTS: Results indicate good interrater reliability for the sum score and Low-Moderate-High risk level appraisal across staff from the different facilities and professions. For single items, interrater reliability ranged from poor to excellent.
    CONCLUSIONS: This study is an important step in establishing the psychometric properties of V-RISK-Y. Findings support the structured professional judgment tradition the instrument is based on, with high agreement on the overall risk assessment. This study had a case vignette design, and the next step is to assess the reliability and validity of V-RISK-Y in naturalistic settings.
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