Fatal thromboembolic complications following assault in a subject with an abdominal aortic aneurysm

A 62-year-old male with no significant medical history developed thromboembolic complications in the lower limbs shortly after an assault which involved punching and kicking to the trunk. Laparotomy revealed intra-abdominal injuries and an abdominal aortic aneurysm. Death from multi-organ failure and sepsis occurred 9 days post-injury. The discussion concentrates on blunt force trauma to the abdominal aorta, specifically on causation, mechanisms of injury and complications.     

Risk factors for rape, physical assault, and posttraumatic stress disorder in women: examination of differential multivariate relationships

The National Women's Study, a 2-year, three-wave longitudinal investigation, employed a national probability sample of 3,006 adult women to: (a) identify separate risk factors for rape and physical assault, and (b) identify separate risk factors associated with post-rape posttraumatic stress disorder (PTSD) and post-physical assault PTSD. This investigation differed from previous studies in that it prospectively examined risk factors at the multivariate, as opposed to univariate level. Overall, past victimization, young age, and a diagnosis of active PTSD increased women's risk of being raped. By contrast, past victimization, minority ethnic status, active depression, and drug use were associated with increased risk of being physically assaulted. Risk factors for PTSD following rape included a history of depression, alcohol abuse, or experienced injury during the rape. However, risk factors for PTSD following physical assault included only a history of depression and lower education.     

Vulnerability and revictimization: Victim characteristics in a Dutch assault center

Sexual and family violence are highly prevalent problems with numerous negative health consequences. Assault centres, such as the Centre for Sexual and Family Violence (CSFV) in the Netherlands, have been set up to provide optimal care to victims. We wanted to gain insight into characteristics of the population that presented to the Centre in order to customize care to their needs. File analysis was conducted of victims who attended the CSFV between 2013 and 2016. Data were analyzed in SPSS. A total of 121 victims entered the Centre, 93% of them being female. Forty-two per cent were adult victims of sexual violence, 28% minor victims of sexual violence and 30% adult victims of family violence. One-third of sexual and two-third of family violence victims had experienced prior abuse. Current use of psychosocial services and psychiatric medication was high, and a cognitive disability was present in 18% of the sexual violence victims. Half the victims reported, but when the perpetrator was a recent contact, e.g., someone met at a party, reporting rates went down. Sexual and family violence victims share characteristics that indicate vulnerability, suggesting that care for both groups might best be combined in one single assault centre. In this way, victims can make use of the same services and knowledge of gender-based violence. One of the major aims of assault centres is to provide psychosocial follow-up care and facilities for reporting. The victims' needs in these matters deserve further research.     

How Does Alcohol Contribute to Sexual Assault? Explanations from Laboratory and Survey Data

This article summarizes the proceedings of a symposium of the 2001 RSA Meeting in Montreal, Canada. The chair was Antonia Abbey and the organizers were Tina Zawacki and Philip O. Buck. There were four presentations and a discussant. The first presentation was made by Maria Testa whose interviews with sexual assault victims suggest that there may be differences in the characteristics of sexual assaults in which both the victim and perpetrator were using substances as compared to when only the perpetrator was using substances. The second presentation was made by Tina Zawacki whose research found that perpetrators of sexual assaults that involved alcohol were in most ways similar to perpetrators of sexual assaults that did not involve alcohol, although they differed on impulsivity and several alcohol measures. The third presentation was made by Kathleen Parks who described how alcohol consumption affected women's responses to a male confederate's behavior in a simulated bar setting. The fourth presentation was made by Jeanette Norris who found that alcohol and expectancies affected men's self-reported likelihood of acting like a hypothetical sexually aggressive man. Susan E. Martin discussed the implications of these studies and made suggestions for future research.     

Linkage of ambulance service and accident and emergency department data: a study of assault patients in the west midlands region of the UK

OBJECTIVE: The objectives of this study are to determine whether it is possible to link ambulance service and Emergency Department (ED) data for assault patients, to look at the potential advantages of this linkage and to investigate the quality of coding in the two data sets. DATA AND METHODS: Data from West Midlands Ambulance Service and seven EDs in the urban West Midlands were linked using probabilistic linkage. The linked data were analysed to investigate demography, priority category, diagnosis, conscious level, disposal and assault coding. PRINCIPAL FINDINGS: 84.2% of the ambulance records were linked to an ED record. Only 40.7% of the linked records were coded as assault in the ED data and only 46.7% of ED assault cases brought by ambulance could be linked. 77.6% of all assault injuries were to the head, face and neck. Only 1.0% of patients presented with coma. 12.0% of all assault patients and 53.5% of the highest priority cases were admitted. CONCLUSIONS: Data linkage is possible and can increase the amount of information available. Data quality problems were identified in both datasets, which has implications for the monitoring and prevention of assaults. The use of a common identifier would aid the following of patient pathways.     

Why SANEs matter: models of care for sexual violence victims in the emergency department

This study examines models of SANE service in the ED and quality of care. Nurse managers of all 82 EDs in Virginia were surveyed (RR 76%). Five models emerged: 1) No SANE services (27.4%); 2) Victims transferred off-site for services (14.5%); 3) Partial coverage of services by ED SANEs (16.1%); 4) SANEs called in from off-site (6.5%); and 5) full-coverage of services by ED SANEs (35.5%). Models 4 and 5 consistently provided a higher quality of care.     

Preventing EMS workplace violence: A mixed-methods analysis of insights from assaulted medics

ObjectiveTo describe measures that assaulted EMS personnel believe will help prevent violence against EMS personnel.MethodsThis mixed- methods study includes a thematic analysis and directed content analysis of one survey question that asked the victims of workplace violence how the incident might have been prevented.ResultsOf 1778 survey respondents, 633 reported being assaulted in the previous 12 months; 203 of them believed the incident could have been prevented and 193 of them (95%) answered this question. Six themes were identified using Haddon’s Matrix as a framework. The themes included: Human factors, including specialized training related to specific populations and de-escalation techniques as well as improved situational awareness; Equipment factors, such as restraint equipment and resources; and, Operational and environment factors, including advanced warning systems. Persons who could have prevented the violence were identified as police, self, other professionals, partners and dispatchers. Restraints and training were suggested as violence-prevention tools and methodsConclusionsThis is the first international study from the perspective of victimized EMS personnel, to report on ways that violence could be prevented. Ambulance agencies should consider these suggestions and work with researchers to evaluate risks at the agency level and to develop, implement and test interventions to reduce the risks of violence against EMS personnel. These teams should work together to both form an evidence-base for prevention and to publish findings so that EMS medical directors, administrators and professionals around the world can learn from each experience.     

精神分裂症伤害案的对比研究

目的　探讨精神分裂症患者和精神正常者伤害案的差异。方法　用自制犯罪行为特征调查表对精神分裂症患者和精神正常者各 80例的伤害行为进行对比研究。结果　在伤害致死、伤害对象、作案场所和作案后有无自杀和自首行为等方面 ,两组有显著差异。研究组大多数受幻觉 ,忘想支配下作案 ( 88 6 % ) ,致死率高 ( 4 3 8% ) ,作案对象多为亲属 ( 37 5% ) ,多在家中或在晚上作案 ,少有自首行为。结论　精神分裂症患者伤害案的犯罪特征明显异于正常人 ,此差异与患者病理心理特征有关     

The Nexus between Alcohol and Violent Crime

The present study examines the nexus between alcohol and violent crime by specifying alcohol as a moderating variable that may interact with other major causes of violent crime. Four major causes of violent crime at the individual level are identified: deviant motives or attitudes, aggression and hostility, impulsivity, and problem-solving ability. Analyses are conducted at two levels of aggravated assault: prevalence of assault and frequency of assault. At the level of prevalence of assault, data indicate that the usual drinking pattern does not constitute an independent cause, but has significant interactions with two of the major causes: deviant attitudes and aggression and hostility. However, in the analysis of the frequency of assault, the findings indicate a pattern that both usual drinking pattern and drinking before offending have independent explanatory power for aggravated assault, but no interactions were found. These findings suggest that alcohol may have different roles in explaining different levels of violent offending.