Review article: Emergency department data sharing to reduce alcohol-related violence: a systematic review of the feasibility and effectiveness of community-level interventions.

The present paper aims to review current evidence for the effectiveness and/or feasibility of using inter-agency data sharing of ED recorded assault information to direct interventions reducing alcohol-related or nightlife assaults, injury or violence. Potential data-sharing partners involve police, local council, liquor licensing regulators and venue management. A systematic review of the peer-reviewed literature was conducted. The initial search discovered 19,506 articles. After removal of duplicates and articles not meeting review criteria, n = 8 articles were included in quantitative and narrative synthesis. Seven of eight studies were conducted in UK EDs, with the remaining study presenting Australian data. All studies included in the review deemed data sharing a worthwhile pursuit. All studies attempting to measure intervention effectiveness reported substantial reductions of assaults and ED attendances post-intervention, with one reporting no change. Negative logistic feasibility concerns were minimal, with general consensus among authors being that data-sharing protocols and partnerships could be easily implemented into modern ED triage systems, with minimal cost, staff workload burden, impact to patient safety, service and anonymity, or risk of harm displacement to other licensed venues, or increase to length of patient stay. However, one study reported a potential harm displacement effect to streets surrounding intervention venues. In future, data-sharing systems should triangulate ED, police and ambulance data sources, and assess intervention effectiveness using randomised controlled trials that account for variations in venue capacity, fluctuations in ED attendance and population levels, seasonal variations in assault and injury, and control for concurrent interventions.

Restrictions in pub closing times and lockouts in Newcastle, Australia five years on.

In 2008 pub closing times were restricted from 5 am to 3:30 am in the central business district (CBD) of Newcastle, Australia. A previous study showed a one-third reduction in assaults in the 18 months following the restriction. We assessed whether the assault rate remained lower over the following 3.5 years and whether the introduction of a 'lockout' in nearby Hamilton was associated with a reduction in assaults there.

Prosecutors' perspectives on clarifying terms for genitalia in child sexual abuse interviews

In investigative interviews with alleged victims of child sexual abuse, professionals must establish the nature of the alleged abuse by determining what body parts were involved in the offending. This can be difficult, however, because children often use colloquial (non-anatomical) terms to describe genitalia, and there has been little direction for interviewers about clarifying these terms sufficiently to establish the charge. The aim of this study was to address the need for guidance from prosecutors about the level of clarity in terms required from a legal perspective, and how this clarity can be achieved. A focus group of nine prosecutors (representing all but one Australian State and Territory) were asked to consider what degree of clarity in terminology for genitalia was adequate and how such clarity could be achieved. Thematic analysis revealed that a reduction in specific questioning around genitalia would improve the usefulness of investigative interviews with children from a legal perspective. Recommendations for improving interviews about abuse with child witnesses are discussed. © 2014 The Australian Psychological Society.

Young people's perceptions of the risks of methamphetamine use in Adelaide nightclubs: a quantitative study

Understanding young people’s perceptions of the risks associated with the use of methamphetamines is an important but under-researched area. Precisely how these young people use the space of Adelaide nightclubs, perceive such drug risks, employ risk management strategies and how these factors interact to influence their experience of methamphetamines in the nightclub is largely unknown. This article presents self-report data drawn from a sample of 457 young people who completed the Perception of Risk survey questionnaire while waiting to enter one of five key Adelaide nightclubs in 2010. Participants were examined in terms of gender, age, drug use history, motivations for nightclub attendance and frequency of nightclub attendance. Approximately one-fifth of the sample reported using methamphetamines (21.0 percent).Participants demonstrated a pattern of attendance at Adelaide nightclubs that reflects a broader understanding of the important role of the nightclub in their social lives, which for some also involves the use of methamphetamines. Specifically, participants’ motivations for ‘nightclubbing’ concern the consumption of leisure and are guided by social group membership, in which methamphetamine use is not prioritised, as evident in the development of knowledge and risk management strategies to ensure safe consumption in the club. Perceptions of risk reflect concern surrounding unregulated methamphetamine use, as well as gendered concerns linked to safety and the prevalence of alcohol misuse, violence, drink spiking, physical injury and sexual assault. These findings were consistent across the sample, suggesting a shift in youth nightclub culture that has numerous implications for understanding and reducing the use of methamphetamines and regulation of the night-time economy generally, which are discussed herein.

The relationship between exposure to violence and anger in Thai adolescents

Youth violence is a serious public health problem in Thailand, and yet is poorly understood and is thought to vary considerably between metropolitan and rural areas. This article reports the findings of a cross-sectional study involving 1,170 technical college students who completed self-report questionnaires assessing the frequency of violent acts, antisocial behavior, and angry emotion. There were no differences in self-reported violent activities between metropolitan and rural participants, but those attending colleges in the metropolitan areas reported more acts involving weapons. Scores on the measure of anger expression predicted physical and verbal assault, specifically punching and name calling, suggesting that the implementation of interventions which help students to improve control over anger may be a useful violence prevention approach.

Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors

Background : Violence risk assessment in schizophrenia relies heavily on criminal history factors.

Aims : To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia.

Method : A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification.

Results : Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder.

Conclusions : Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance.

Blood alcohol and injury in Bhutan: targeted surveillance in a national referral hospital emergency department

Bhutan is a low-middle-income country with poor roads, rapidly increasing motor vehicle use and heavy alcohol consumption. We estimated the proportion of emergency department patients presenting with injury who had positive blood alcohol. We sought to breathalyse and interview all adult patients (≥18 years) presenting with injury at the Jigme Dorji Wangchuck National Referral Hospital in the capital city Thimphu, from April to October 2015. Breath tests and interviews were conducted with 339 (91%) of 374 eligible adult patients. A third (34%) were alcohol-positive and 22% had blood alcohol concentrations >0.08 g/dL. The highest alcohol-positive fractions were for assault (71%), falls (31%) and traffic crashes (30%). Over a third (36%) of patients had a delay of >2 h between injury and breath test. The results underestimate blood alcohol concentrations at the time of injury so the true prevalence of pre-injury alcohol impairment is greater than our estimates suggest. Countermeasures are urgently needed, particularly roadside random breath testing and alcohol controls.

Professionals' perceptions regarding the suitability of investigative interview protocols with Aboriginal children

Objective: Despite the heterogeneity of Australian Aboriginal peoples, certain styles of relating are shared and are markedly different to the communication styles of non-Aboriginal peoples. These differences may affect the suitability of current investigative interview protocols to Australian Aboriginal children. This study aimed to qualitatively evaluate the applicability of an investigative interview protocol to Australian Aboriginal children and examine how it could be modified to better suit the communication styles in many Aboriginal communities. Method: A diverse group of 28 participants who had expertise in Aboriginal language and culture, as well as an understanding of the child investigative interview process, each partook in an in-depth semi-structured interview where they were prompted to reflect on Aboriginal language and culture with reference to a current interview protocol (in the context of sexual assault investigation). Results: Thematic analysis revealed overall support for the narrative-based structure of the interview protocol when eliciting information from Aboriginal children. A number of concerns were also identified, and these largely related to the syntax and vocabulary within the protocol, as well as the methods of questioning and building rapport with the child. Conclusions: Directions for future research and potential modifications to investigative interview protocols to better suit Aboriginal children are discussed.