The Canadian war on drugs: Structural violence and unequal treatment of Black Canadians

This paper examines the impact of Canada's war on drugs on segments of the Black community, specifically with respect to the impact of structural violence, over-policing, and high incarceration rates. It offers evidence of the systemic nature of these dynamics by examining the early context of the war, growing stigma against Blacks, globalizing influences, and the punitive focus of funding and policy. The paper also explores how Black men have been identified as the main enemy and how drug control efforts have served to diminish the health, well-being, and self-image of Black men via discriminatory and inequitable treatment before the law. The current high rates of imprisonment of Black men are an indicator of systematic deprivation of significant social capital, which will perpetuate socioeconomic harm and cycles of violence. This commentary calls for an immediate dissolution of policies regulating the war on drugs as the first step in remedying the injustices experienced by Black Canadians. Due to the lack of Canadian data in this important area, the paper also emphasizes the critical need for more research to shed more light on the Canadian-specific complexities.     

School Shootings,High School Size,and Neurobiological Considerations

SUMMARY

In the last decade 17 multiple-injury student school shootings have occurred in the United States, 13 at high schools and 4 at middle schools. Research suggests that high schools function best academically as well as socially at enrollments around 600 (150 students per grade), the natural group size of humans. Eleven of 13 high school shootings occurred in schools with enrollments over 600 students, and many with over 1,000 students. Violent and antisocial behavior is associated with deficits in social information processing, which is necessarily exacerbated by complex social environments. School shootings may be in part a response to the unprecedented social complexity of large schools. Median public high school enrollment now stands at 1,200 in suburbs and 1,600 in cities despite the fact that smaller schools are superior to large schools on nearly all academic and social measures of success including graduation rate, student satisfaction, conduct infractions, athletic participation, absenteeism, and dropout rate. Educational institutions should adapt to the neurobiological limitations of children instead of forcing children to adapt to the unnatural requirements of such institutions.     

Domestic Violence in Later Life: An Overview for Health Care Providers

ABSTRACT

Domestic violence is a significant problem that adversely affects the health and safety of millions of women throughout their life-span. Most cases of what is considered elder abuse occurs at home rather than in institutions, and the evidence suggests that only 1 in 5 cases are recognized. Frequently the perpetrator is a spouse, adult child, or other family member. Given the demographics of aging women and their longer life expectancies, clinicians are increasingly likely to see patients whose injuries or poor health status are caused or affected by abusive relationships. Improving the ability of physicians to identify domestic violence is an important skill needed for establishing comprehensive intervention and prevention efforts. In addition to conducting universal screening of all female patients, using clinical and behavioral indicators is a critical component of the intervention.     

Prediction of intimate partner violence by type of substance use disorder

The present study investigated whether (combinations of) specific substance use disorders predicted any and severe perpetration and victimization in males and females entering substance abuse treatment. All patients (N = 1799) were screened for IPV perpetration and victimization; almost one third of the sample committed or experienced any IPV in the past year. For males, an alcohol use disorder in combination with a cannabis and/or cocaine use disorder significantly predicted any IPV (perpetration and/or victimization) as well as severe IPV perpetration. For females, alcohol and cocaine abuse/dependence predicted both any IPV (perpetration and/or victimization) and severe IPV perpetration. Results from the present study emphasize the importance of routinely assessing IPV in patients in substance abuse treatment and demonstrate that clinicians should be particularly alert for IPV in patients with specific substance use disorder combinations.     

Domestic violence against elderly with disability

Abuse against elders with disabilities is a growing problem as the world population ages. Though they require mandatory reporting, these cases are most frequently not detected or not reported by health professionals for a variety of reasons, including the difficulty of making an accurate diagnosis. By performing a retrospective analysis of alleged domestic violence cases against elders with moderate or severe disability, presented to medical forensic examination at the North Branch of the National Institute of Legal Medicine and Forensic Sciences of Portugal, in Porto, between 2005 and 2013 (n = 70), we aimed to improve our knowledge of some demographic and forensic characteristics of these cases as well as improve their detection and prevention. The most frequently reported type of abuse was physical (86%), allegedly perpetrated by male abusers (63%) living with their victims (90%), who were most commonly their children (47%) or partners (49%; when victims are married). The victims were most frequently female (63%) who had motor disabilities (49%) and presented a history of previous episodes of abuse in 74% of cases; however, only 28% were previously reported. The physical consequences were most frequently minor injuries (95%) with permanent consequences (scars) in only 6.8% of the cases. The injuries were multiple in the majority of the cases (64%), and the preferred locations were the head and neck (75%). Elderly females with motor disabilities appear to have a greatest risk of domestic violence, which translates, most frequently, into multiple injuries that are mainly in the head and neck.     

Challenges for Teaching Injury Prevention in a Juvenile Detention Center

This case study explored the injury related experiences and perceptions of youth in detention and the delivery of first aid education in youth detention contexts. It aimed to develop an understanding of how a mainstream injury prevention intervention could be modified for youth detention populations. Teacher and student reactions to the program were examined and injury checklists, focus groups, and staff interviews were conducted. Analysis revealed serious injuries related to criminal behaviors, violence, dangerous driving, and substance use. Recommendations for youth detention interventions include lesson flexibility, discussions, role-plays, visual materials, peer support strategies, student-teacher relationships, and positive reinforcement.     

Structured Risk Assessment Instruments: A Systematic Review of Implementation Determinants

Research-based structured risk assessment instruments (SRAIs) can improve violence risk assessment and clinical judgements in mental health and correctional services. Practical challenges of implementing SRAIs have led to calls for more research to understand the determinants influencing this process. Studies describing determinants for SRAI implementation in psychiatric, correctional, or community in-patient settings were systematically reviewed. Findings were analysed according to the Consolidated Framework for Implementation Research. A total of 11 studies were included. Four types of main implementation determinants were found: characteristics of the SRAI; users of the SRAI; inner setting; and process. Findings underscore the importance of applying a multifactorial approach to the implementation of SRAIs to address many different barriers and facilitators. More stringent research is needed to obtain more solid evidence of factors that impede or enable SRAI implementation, especially regarding patient perspectives and outer setting determinants. Constructing shared concepts of determinants across research fields could further aid information transferences.