Adverse childhood experiences, education, and involvement in terrorist violence: Examining mediation and moderation.

Most perpetrators of terrorist violence have had some level of post-secondary school education, with many enrolled in education at the time of their attacks. Exploring this premise in the context of prevention, this article draws from data gathered on a purposive sample (N = 206) of radicalized individuals from Europe and North America, half of whom became involved in terrorist violence at the end of their radicalization trajectories. Through a lens of educational participation, we propose novel, non-linear frameworks for understanding radicalization outcomes. To do so, two factors are explored that uniquely intersect when an individual enters a school setting: Adverse childhood experiences (ACE) and the human capital provided by education. As hypothesized, exposure to ACE was found to be associated with radicalization trajectories culminating in terrorist violence at the bivariate level (OR = 2.08). Consistent with the developmental-assets framework, it was further hypothesized that this relationship would be mediated by enrollment in education; however, results did not support this hypothesis. Instead, consistent with resiliency-based models, it was found that the relationship between ACE and involvement in terrorist violence was significant for those who abandoned education during radicalization (OR = 2.07). As well as contributing to theoretical models of radicalization to terrorist violence, identifying the furtherance of education as a moderator of risk may signal an important preventative strategy for violent extremism. Keeping enrolled students engaged in their programs, even if only nominally, may also forego the need for educators to engage in potentially controversial practices such as alerting the authorities to students who display signs of radicalization.

Violent extremism in the U.S.: Causes and consequences for youth, families, schools, and communities.

Violent extremism in the United States has surged over the past 25 years, with attacks on and threats to major governmental and other institutions, infrastructure (e.g., electric grid), and specific segments of the population, including immigrant and BIPOC (Black, Indigenous, and other People of Color) communities. Violent extremism can take multiple and diverse forms, such as bombings in public spaces or specific sites (e.g., house of worship, governmental office), mass and more targeted types of shootings, bombings, fire setting, and vehicle-based ramming attacks. This article provides an overview of key issues surrounding terrorism and violent extremism, especially as they can impact youth, schools, and families. Characteristics of violent extremism, radicalization processes, subsequent types of harm, and prevention approaches are discussed. Issues impacting students and schools and the work of school psychologists are also considered. The article closes with broader recommendations for moving forward.

Understanding and preventing violent extremism in school settings.

Violent extremism (VE; i.e., terrorism) is an issue of increasing relevance in school settings. Worldwide, terrorist actors have increasingly targeted youth in schools both for victimization via attacks as well for radicalization and recruitment to their ranks. Although violent extremism as an ideologically motivated act can be distinguished from mass shootings in school settings in that most school-based mass shootings are not ideologically motivated, there is obvious overlap. The threat of violent extremism, however, also represents a distinct issue that warrants increased attention from school professionals. We present an overview of several related issues before exploring strategies to mitigate the threat of targeted violence in school settings, including opportunities for school personnel to assist in identifying, assessing, and managing threats of violent extremism. In the final section, we focus specifically on ways that school psychologists can increase awareness and help bring about individual and systemic changes to prevent violent extremism in schools.

Comprehensive examination of etiological factors and clinical manifestations of maxillofacial traumas in forensic cases: A five-year retrospective study.

BACKGROUND: Maxillofacial injuries, due to their diverse etiological causes, are often considered a component of multi-trauma and constitute a significant portion of trauma. This study aims to elucidate the incidence of maxillofacial traumas, particularly among military personnel, various clinical courses, and characteristics, thereby contributing to the literature. METHODS: Forensic reports, primarily related to military personnel and organized between 2011 and 2016 at the Forensic Medicine Department of Gülhane Medical Faculty, Health Sciences University, were retrospectively examined. The study involved a detailed analysis of cases with maxillofacial injuries resulting from trauma, focusing on aspects such as age, gender, the origin of the trauma, degree of injury, the presence of bone and dental fractures, and the occurrence of psychiatric disorders as a result of the trauma. RESULTS: This study demonstrated that maxillofacial traumas predominantly occurred in young male individuals, particularly among military personnel. The most common etiological factor identified was interpersonal violence. The majority of injuries were soft tissue damages, with the nasal bone being the most frequently fractured area. Injuries to the head and upper extremities were also detected in some of the cases, showing that multiple injuries are common in such cases. Post-traumatic psychological disorders developed in some cases, with anxiety disorders being the most commonly observed. CONCLUSION: It has been determined that maxillofacial injuries can affect multiple body regions, necessitating a multidisciplinary approach. This study underscores the importance of developing comprehensive strategies and policies for understanding and managing maxillofacial traumas, providing a fundamental reference for future studies in this field.

Urban children at risk of violence: A qualitative study of experiences of parents, teachers, and service providers of collaborative support.

Children who are at risk of involvement in violence need assistance from multisector agencies such as social services, law enforcement, health, and education. The aim of this study was to understand the perceptions and experiences of parents, teachers, and service providers (i.e., counselors, psychologists, paralegals, and social workers) on collaborative support for children at risk of violence in Banda Aceh, Indonesia. Twenty-four structured interviews were conducted with ten parents whose children were victims of sexual or physical abuse or were involved in substance abuse and theft and have received support from the Integrated Service Center for the Empowerment of Women and Children in Banda Aceh, Indonesia; ten service providers; and four teachers who either worked with the concerned children or knew them. Using a thematic analysis approach, the data was systematically coded and analyzed to identify important themes. Most parents who sought help or support from governmental agencies were referred by other service providers or recommended by relatives or friends. Parents hesitated to discuss their children's problems with the teachers, worrying about stigma, particularly for sexual abuse victims. The school's lack of collaboration with external agencies was consistent with the teacher's claim that they seldom work with other agencies outside of school, resulting in a siloed system of care. It can be concluded that the biggest barrier to communication and coordination among parents, teachers, and service providers is the parents' and service providers' lack of willingness and confidence to work with teachers. Clear policies are needed to establish a cross-institutional linkage structure that promotes shared responsibilities.

Police violence reduces trust in the police among Black residents.

Recent high-profile incidents involving the shooting or killing of unarmed Black men have intensified the debate about how police violence affects trust in the criminal justice system, particularly among communities of color. In this article, we propose a quasi-experimental design that leverages the timing of the shooting of Jacob Blake by the Kenosha Police Department relative to when a large survey was fielded in the city of Chicago. We demonstrate that individuals interviewed 4 weeks before and 4 weeks after the shooting are comparable across a large set of observed characteristics, thus approximating an experimental setting. We find that Blake's shooting caused substantial reductions in Black respondents' trust in the police, concentrated among younger residents and criminalized residents. These results suggest that police violence against racial minorities may lead to lower civic engagement and cooperation with law enforcement in those communities, exacerbating issues of public safety and community well-being. The pronounced distrust among younger Black residents suggests a generational rift that could risk further entrenching systemic biases and inequalities within the criminal justice system. Additionally, the higher levels of distrust among criminalized respondents could have implications for research detailing this population's decreased willingness to engage with public institutions more broadly.

Disrupting Social Violence Is Everybody's Business.

Our overarching theme for Creative Nursing Volume 30 is The Impact of Social Forces on Nursing and Health. The theme of this current journal issue was originally called Social Violence. In planning this issue, our Editorial Board had to confront head-on the many ways in which overt violence or the threat of violence pervades our lives, as nurses and as individuals. We broadened the title to Consequences and Disruptive Solutions for Social Violence, choosing to focus on what we can do to recognize the interlocking processes that enable, promote, reward, and sustain violent behavior, and to mitigate those effects when and where we can. The sobering content in this issue is the business of each of us. The realities of domestic violence and gun violence, the impact of othering and marginalization, the effects of substance use on family members and of students' experiences of trauma on the school nurses who care for them, and the lethal legacy of unthinking adherence to policies and procedures that is still relevant today-Awareness of this part of our lives and of our practice is where we must start.

Interpersonal Violence Against Indigenous Sámi and Non-Sámi Populations in Arctic Sweden and the Mediating Effect of Historical Losses and Discrimination.

The prevalence of interpersonal violence has been reported at higher levels among Indigenous than non-Indigenous populations worldwide, but has not been thoroughly investigated among the Sámi population in Sweden. The aims of this study were to investigate: (1) the prevalence of emotional, physical, and sexual violence and violence by intimate partners, family members, acquaintances, and strangers among participants identifying as Sámi or Swedish, (2) whether reporting experiences of historical losses and discrimination mediated the anticipated association between identifying as Sámi and reporting experiences of violence, and (3) whether background characteristics were associated with reporting experiences of violence. Cross-sectional questionnaire data collected in 2021 for the "Health and Living conditions in Sápmi" study were used. All adults in an arctic region in Sweden were invited to participate (response rate: 41%). Respondents self-identifying as Sámi (n = 375; 24.7%) or Swedish (n = 1,144; 75.3%) were included in this study. Sámi respondents of both sexes more often reported violence by an acquaintance or stranger. Likewise, more Sámi than Swedish women reported family violence (16.4% vs. 9.2%), but there was no difference concerning intimate partner violence (13.3% vs. 15.4%). Mediation analyses revealed strong positive indirect effects of historical losses and discrimination on the different types of violence. Being female was the strongest predictor of reporting intimate partner violence, and younger age was associated with violence by all perpetrators except family members. In conclusion, interpersonal violence was more often reported by Sámi respondents, but the association was explained in full by experiences of historical losses and discrimination. The results underline the importance of a life-course and even intergenerational and historical perspectives when investigating interpersonal violence.

Promoting the well-being of sexual and gender minority individuals: Reflecting on the past and future directions.

There is a long history of institutional and interpersonal stigma, violence, and oppression of sexual and gender minority (SGM) individuals in the United States and around the world. Structural and sociocultural factors have served to promote and justify criminalization, discrimination, and violence targeting SGM groups. This commentary provides a brief chronological summary of laws and policies that served to pathologize, oppress, and justify violence and discrimination; the evolution of academic study and understanding; activism aimed at changing laws, questioning pathologizing assumptions and practices, and protecting human rights; current challenges; and recommendations for policy, research, and practice. This commentary pays particular attention to the roles the Global Alliance for Behavioral Health and Social Justice and its journal, American Journal of Orthopsychiatry, have played to advocate for full recognition of the human rights of SGM individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluation of stabbing assault injuries in a tertiary emergency department: a retrospective observational study.

BACKGROUND: Approximately 458,000 victims were deceased from intentional violence in 2021. A stabbing assault causes 25% of homicides. The study aims to evaluate injury patterns, trauma scores, radiological findings, types of treatment, and outcomes of stab assault patients admitted to a tertiary emergency department (ED). METHODS: This is a retrospective observational study of stabbing injury patients in the ED of Hacettepe University, Turkey. The sites and patterns of injury, radiological findings, treatment methods, consultations, and complications are acquired from the patient's files. Trauma scores and frequency of outcomes, such as the need for surgery, hospitalization, or mortality, were calculated for all patients. RESULTS: Among the 648 patients, 564 (87%) were male. The median age was 28 (interquartile range [IQR]:13). The commonly injured body parts were the extremities (75%), thorax (21.9%), and abdomen (16.9%). The median RTS was 7,84 (IQR:0), and the median ISS was 2 (IQR:3). The fluid was detected in 13 of 88 patients by FAST, solid organ injuries in 21 patients, and gastric and intestinal injuries in 11 patients by abdominal CT. One hundred sixty-one patients underwent moderate and major surgery. Complications developed in 13 patients. 74,4% of the patients (n = 482) were treated in ED and 21.8% (n = 141) of patients were hospitalized in wards, 2.3% (n = 15) in intensive care unit and 1.5% (n = 10) patients died. GCS, RTS, and probability of survival (Ps) were significantly lower, and ISS was significantly higher in deceased patients and patients who needed erythrocyte replacement. CONCLUSION: The majority of stab wounds were detected in extremities, but severe and lethal stabbing injuries were on the thorax and abdomen. In thoracoabdominal stabbing injuries, x-rays and FAST can be ineffective in detecting critical and fatal injuries. Therefore, thoracic and abdominal CT should be planned early to detect possible causes of death and make a timely and accurate diagnosis. Lower GCS, RTS, and Ps or higher ISS scores were related to the need for erythrocyte replacement.

[Wars and the search for a safer world. The role of healthcare.] / Le guerre e la ricerca di un mondo più sicuro. Il ruolo della sanità.

Wars destroy human rights, promoting violence as a means to resolve conflicts and cause profound direct and indirect health consequences for people. As important as it is that healthcare does not enter into the merits of the responsibilities for wars, it is equally important that healthcare places itself, in principle, in opposition to war. Despite the enormous impacts of wars and armed conflicts, global public health is poorly prepared to mitigate the threats of wars and armed conflicts. The tragedies, challenges and public health consequences of war are often overlooked and do not receive adequate attention from the international community. Healthcare should globally recognize wars and armed conflicts as a public health emergency and provide the required level of attention. Public health professionals should be aware of the impacts of wars, represent a single voice and coordinate in concerted efforts globally to stand in solidarity, without any discrimination, with conflict-affected communities by understanding their critical needs. Together we can be the voice that says "stop", striving to build a safer world for all.

[Psychotraumatic consequences of coercive control]. / Conséquences psychotraumatiques du contrôle coercitif.

Coercive control is a process of violence in which one person acts in such a way as to subject the other to persistent controlling behavior. In the majority of cases, these are men, and the targets are their spouses and children. The psychotraumatic consequences are innumerable, and need to be understood before they can be identified and treated. The repercussions of coercive control are numerous, whether somatic, psychological, familial, social, professional or academic. This article describes the psychotraumatic consequences for both the victim and the children.

Indirect victims of violence: a look at health impacts. / Vítimas indiretas da violência: um olhar sobre os impactos na saúde.

We sought to investigate the perceptions of indirect victims or family members of homicide victims, about the repercussions of these deaths on their health. A qualitative, exploratory, descriptive study was carried out, based on eight semi-structured individual interviews with two groups: family members of police officers victimized by lethal violence, and family members of people killed as a result of police intervention, designated here as homicide. Both groups reported the perception that their health deteriorated after the homicide, and mentioned problems such as depression, panic disorder, insomnia, heart conditions and eating disorders. They also highlighted the acquisition of habits that are harmful to health, such as the consumption of alcoholic beverages, tobacco and self-medication, and the worsening of pre-existing health issues. It was observed that the homicide committed and suffered by police agents affects various aspects of the lives of indirect victims that are inseparable from health issues in a broader sense. These people are also victims of this violence, although their suffering is often made invisible. Studying this topic helps to give space to the suffering and mourning of these people and to subsidize the best performance of the institutions and services involved.

Buscou-se investigar as percepções das vítimas indiretas, ou familiares de vítimas de homicídio, sobre as repercussões dessa morte em sua saúde. Fez-se um estudo qualitativo, exploratório, descritivo, a partir de oito entrevistas individuais semiestruturadas com dois grupos: familiares de agentes policiais vitimados por violência letal, e familiares de pessoas mortas em decorrência de intervenção policial, aqui designada como homicídio. Ambos os grupos relataram a percepção de que sua saúde piorou após o homicídio, e mencionaram problemas de depressão, síndrome do pânico, insônia, problemas cardíacos e distúrbios alimentares. Destacaram ainda a aquisição de hábitos danosos à saúde, como consumo de bebidas alcoólicas, tabaco e automedicação, e o agravamento de problemas de saúde pré-existentes. Observou-se que o homicídio praticado e sofrido por agentes policiais afeta vários aspectos da vida das vítimas indiretas que são indissociáveis das questões de saúde em sentido ampliado. Essas pessoas também são vítimas dessa violência, embora muitas vezes tenham seu sofrimento invisibilizado. Estudar o tema contribui para dar espaço ao sofrimento e ao luto, e para subsidiar a melhor atuação das instituições e serviços envolvidos.

Systematic review protocol to determine the most effective pharmacological and non-pharmacological interventions for the management of acute methamphetamine toxicity.

INTRODUCTION: This study describes the protocol for a systematic review. The systematic review will address experiences of managing methamphetamine intoxication, specifically violence and agitation related to intoxication, in the emergency department (ED). METHODS AND ANALYSIS: This study uses the Grading of Recommendations Assessment, Development and Evaluation system to guide the methods in this section. The primary objective of the review is to identify experimental studies assessing the effectiveness of both pharmacological and non-pharmacological strategies to manage acute methamphetamine intoxication in patients presenting violently in the ED. Our secondary objectives will be to assess the impact of specific strategies on the time it takes to achieve de-escalation and/or sedation, the length of stay in the ED, frequency of admission, mortality and provider satisfaction with the intervention. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Conjoint Health Research Ethics Board REB21-1387. Results will be published in a peer-reviewed journal and presented at healthcare conferences in Canada. TRIAL REGISTRATION NUMBER: The protocol is registered through the International Prospective Register of Systematic Reviews (identification number: CRD42020157938) and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extensions for systematic review protocols.

Institutional Violence Perpetrated against Transgender Individuals in Health Services: A Systematic Review of Qualitative Studies.

This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and MEDLINE databases using the descriptors "transgender people", "violence", and "health services". The eligibility criteria included original qualitative articles addressing the research question, with fully available text, reporting violence specifically by health workers, involving trans individuals aged 18 and above, and published in Portuguese, English, or Spanish. In addition, studies were included that reported experiences of violence suffered by the trans population, through their narratives, in health services. A total of 3477 studies were found, of which 25 were included for analysis. The results highlighted situations such as refusal of service; resistance to the use of social names and pronouns; barriers to accessing health services; discrimination and stigma; insensitivity of health workers; lack of specialized care and professional preparedness; and a system focused on binarism. The analysis of the studies listed in this review highlights the multiple facets of institutional violence faced by the transgender population in health services. It is evident that the forms of violence often interlink and reinforce each other, creating a hostile environment for the transgender population in health services. Thus, there is an urgent need to create strategies that ensure access to dignified and respectful care for all individuals, regardless of their gender identity.

Life-course influences of poverty on violence and homicide: 30-year Brazilian birth cohort study.

BACKGROUND: Homicide is the leading cause of death among young people in Latin America, one of the world's most violent regions. Poverty is widely considered a key cause of violence, but theories suggest different effects of poverty, depending on when it is experienced in the life-course. Longitudinal studies of violence are scarce in Latin America, and very few prospective data are available worldwide to test different life-course influences on homicide. METHODS: In a prospective birth cohort study following 5914 children born in southern Brazil, we examined the role of poverty at birth, in early childhood, and in early adulthood on violence and homicide perpetration, in criminal records up to age 30 years. A novel Structured Life Course Modelling Approach was used to test competing life-course hypotheses about 'sensitive periods', 'accumulation of risk', and 'downward mobility' regarding the influence of poverty on violence and homicide. RESULTS: Cumulative poverty and poverty in early adulthood were the most important influences on violence and homicide perpetration. This supports the hypothesis that early adulthood is a sensitive period for the influence of poverty on lethal and non-lethal violence. Results were replicable using different definitions of poverty and an alternative outcome of self-reported fights. CONCLUSION: Cumulative poverty from childhood to adulthood was an important driver of violence and homicide in this population. However, poverty experienced in early adulthood was especially influential, suggesting the importance of proximal mechanisms for violence in this context, such as unemployment, organized crime, drug trafficking, and ineffective policing and justice systems.

Obstetric racism, a debate under construction in Brazil: perceptions of black women on obstetric violence. / Racismo obstétrico, um debate em construção no Brasil: percepções de mulheres negras sobre a violência obstétrica.

This article aims to know the perception of women on obstetric violence from a racial perspective. This was a qualitative study carried out in a public maternity hospital with 25 women in the city of Salvador, Bahia, Brazil. Data were collected through semi-structured interviews and participant observation from November 2021 to February 2022. Content analysis was used to organize the data obtained through the interviews. The results were analyzed through the theoretical contributions of intersectionality, focusing on the interaction between obstetric violence and obstetric racism. The narratives discuss issues of obstetric violence, institutional racism, and how these experiences are permeated by issues of race, gender, and class. Questions related to the feelings of these women regarding the experience of violence at the time of childbirth care were also highlighted. Obstetric racism denies reproductive rights and hinders access to respectful and equitable care for black women.

O objetivo deste artigo é conhecer a percepção de mulheres sobre a violência obstétrica em uma perspectiva racial. Trata-se de uma pesquisa qualitativa realizada em uma maternidade pública, com 25 mulheres, no município de Salvador, Bahia, Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas e observação participante, no período de novembro de 2021 a fevereiro de 2022. Utilizou-se, para organização dos dados obtidos através das entrevistas, a análise de conteúdo. Os resultados foram analisados através das contribuições teóricas da interseccionalidade, tendo como foco a interação entre violência obstétrica e racismo obstétrico. As narrativas discorrem sobre questões da violência obstétrica, racismo institucional, e como essas vivências são permeadas pelas questões de raça, gênero e classe. Foram apontadas também questões relacionadas aos sentimentos dessas mulheres frente a vivência da violência no momento da assistência ao parto. O racismo obstétrico nega os direitos reprodutivos e dificulta o acesso a uma assistência respeitosa e equânime as mulheres negras.

Researchers' perspectives of self-agency within a context of violence and harm in maternity care.

PROBLEM: There is an increasing awareness of the prevalence of obstetric violence within maternity care and that some women and birthing people are at greater risk of experiencing violence and harm. BACKGROUND: Supporting self-agency for women and birthing people in maternity care may be a way of addressing the disparities in vulnerability to violence and harm. AIM: To explore researchers' perspectives of self-agency for women from different backgrounds, what inhibits and prevents self-agency, and how self-agency can be enabled. METHODS: A qualitative research design was undertaken underpinned by a reproductive justice framework. Group interviews were held with researchers working with perinatal women/birthing people with histories and experiences of violence and abuse. Reflexive thematic analysis using Bronfenbrenner's ecological systems theory was undertaken. FINDINGS: 12 participants took part in two group interviews. Two themes were developed: 'defining self-agency' and 'ecological influences on self-agency'. DISCUSSION: The findings identify how self-agency should not be perceived as an intrinsic attribute, but rather is underpinned by exogenous and endogenous influences. Whether and how self-agency is enacted is determined by interacting factors that operate on a micro, meso and macro level perspective. Self-agency is undermined by factors including immigration policies and sociocultural perspectives that can lead to under-resourced and judgemental care, other intersectional factors can also lead to some individuals being more vulnerable to violence and harm. CONCLUSION: Implications from this work include strategies that emphasise woman-centred care, staff training and meaningful organisational change to optimise positive health and wellbeing.