Self-Harm in Secondary Schools: What are the Perceptions and Experiences of Staff ?

The purpose of this study is to explore the perceptions and experiences of secondary school staff with regard to adolescent self-harm. The research was conducted in a Local Authority where there were particular concerns about rising numbers of young people presenting with self-harm. While the majority of young people who self-harm are supported in the community and never access clinical services, surprisingly little research has considered the role of schools and their staff. The research that has been done suggests that school staff can feel underqualified and overwhelmed in their attempts to support young people who self-harm. Further, there is a growing evidence base that when young people experience negative attitudes towards self-harm it is distressing and reduces the chance of them seeking further help. To address this, qualitative exploratory research was conducted with thirteen members of staff working in secondary schools. Since the research was concerned not just with experiences, but also with perceptions of adolescent self-harm, the participants were from two groups: those with direct experience of supporting young people who have self-harmed and those without any direct experience. Data collection involved individual semi-structured interviews which were analysed using thematic analysis. The research indicated that secondary school staff are keen to help and understand young people who self-harm, but that they do not always feel skilled or confident enough to do so, often feeling that some kind of specialist is required and/or fearing that they might make a situation worse. Findings highlighted the emotional impact of this work and illustrated the importance of supporting staff, who expressed a desire for further training and other forms of professional support such as supervision.

Copying to be Different: Violent Dissident Irish Republican Learning

While the impact of the Troubles retains centrality within much of Northern Irish political life, the spectre of almost daily violence is becoming a more distant memory. Peace has come to the region. In spite of this, however, there are those who wish to maintain the utility of violence to achieve their stated aims. Most dominant amongst these are the violent dissident republican groups. No longer is their existence solely defined by their desire to bring about a united Ireland. In order to have any opportunity of longevity, they must first legitimise their continued existence, and in turn distance themselves from their former Provisional comrades. This paper assesses how groups, such as the Continuity IRA, Óglaigh na hÉireann and the IRA/New IRA utilise the lessons learned from their Provisional history to differentiate themselves from the politicised dominance of Sinn Féin. This evaluation is carried out through the analysis of interviews with leadership and rank and file members of both political and paramilitary dissident groupings, which is complimented by the analysis of the Violent Dissident Republican (VDR) events database. These sources are supplemented with the assessment of organisational statements, from 2007 to the present day. The article focuses on violent, and non-violent, learning.

Role of assessment components and recent adverse outcomes in risk estimation and prediction: use of the Short Term Assessment of Risk and Treatability (START) in an adult secure inpatient mental health service

The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its’component parts contribute to the assignment of risk estimates and how those estimates fare in prediction of non-violent adverse outcomes compared with the structured components. START assessment and outcomes data from a secure mental health service (N=84) was collected. Binomial and multinomial regression analyses determined the contribution of selected elements of the START structured domain and recent adverse risk events to risk estimates and outcomes prediction for violence, self-harm/suicidality, victimisation, and self-neglect. START vulnerabilities and lifetime history of violence, predicted the violence risk estimate; self-harm and victimisation estimates were predicted only by corresponding recent adverse events. Recent adverse events uniquely predicted all corresponding outcomes, with the exception of self-neglect which was predicted by the strength scale. Only for victimisation did the risk estimate outperform prediction based on the START components and recent adverse events. In the absence of recent corresponding risk behaviour, restrictions imposed on the basis of START-informed risk estimates could be unwarranted and may be unethical.

Performance of protective factors assessment in risk prediction for adults: systematic review and meta-analysis

Protective factors are neglected in risk assessment in adult psychiatric and criminal justice populations. This review investigated the predictive efficacy of selected tools that assess protective factors. Five databases were searched using comprehensive terms for records up to June 2014, resulting in 17 studies (n = 2,198). Results were combined in a multilevel meta-analysis using the R (R Core Team, R: A Language and Environment for Statistical Computing, Vienna, Austria: R Foundation for Statistical Computing, 2015) metafor package (Viechtbauer, Journal of Statistical Software, 2010, 36, 1). Prediction of outcomes was poor relative to a reference category of violent offending, with the exception of prediction of discharge from secure units. There were no significant differences between the predictive efficacy of risk scales, protective scales, and summary judgments. Protective factor assessment may be clinically useful, but more development is required. Claims that use of these tools is therapeutically beneficial require testing.

Incidence of violent behavior among patients in Psychiatric Intensive Care Units

Background and Objectives: Both psychiatric acute units and psychiatric intensive care units (PICUs) focus on acute treatment of behavioral disturbances such as violence and aggressive threats and acts. The aim of the present study is to describe the frequency of violent behavior; such as verbal or physical threats and physical attacks, among patients admitted to psychiatric intensive care unit (PICU). In addition the relationship between the episodes of threats and/or attacks in relation to time of the day, days of the week, and their seasonal variations was explored. Methods: All violent behavior was continuously assessed at the psychiatric emergency department. Data were collected during the period from May 2010 to May 2012. Results: Patients with only one hospitalization were less violent than those who have had two hospitalizations. There was a statistically significant difference in violence among patients without formal secondary education and those who have not formal education. Violent behavior showed two peaks during the day; the first occurring at 1 pm and the second at 8 pm. In regard to seasonality, summer had a higher incidence of violence. The most peaceful seasons of the year were spring and autumn. Conclusions: Violent behavior shows variation in daytime, days of the week and season in acute psychiatric intensive care. Daytime variation shows two peaks of violence at 1 pm and 8 pm, Sundays and Wednesdays being the quietest days regarding violence both in winter and summer. Patient's level of education and hospitalization status partially explain the variation.

Violent Dissent and Rebellion in Africa

This article analyzes how the selection process for the executive affects the risk of rebellion and insurgencies in sub-Saharan Africa between 1971 and 1995. Four executive recruitment processes are distinguished, which are characteristic for the African context: (1) a process without elections, (2) single candidate elections, (3) single party, multiple candidate elections, and (4) multiparty executive elections. The results suggest that single candidate elections and multiparty elections substantially reduce the risk of insurgencies compared to systems without any kind of executive elections. They further show that during times of political instability the risk of large-scale violent dissent increases substantially. The article supports findings of the civil war literature that higher levels of income are associated with a lower risk of intrastate violence, while oil-exporting countries are at a higher risk of rebellion. In short, this article further strengthens the need to use more specific measures of elements of political regimes, which also take into account regional particularities, in order to paint a more informative picture of how political structures influence the risk of internal violence.

Influence of information about trip time variability, personal benefits, and environmental harm from cars versus public transportation on the choice of transportation mode

The influence of information about trip time variability, personal benefits, or environmental harm from cars or public transportation on commuting mode choice (car or subway) is examined in an experimental study. In addition to these experimentally manipulated variables, the influence of prior attitudes towards the subway was verified. The sample is made up of habitual users of the car to travel to work (N = 220, age M = 37.4, SD = 8.1, 63.2% women). The results show that providing information about the advantages of public transportation, as well as prior attitudes towards the subway, decrease the preference, choice, and perceived control of car use. Of the experimentally manipulated variables, information about the variability of trip time had the greatest influence. These results highlight the importance of taking into account these variables to implement institutional campaigns to reduce car use as transportation mode.

Le mariage forcé de femmes immigrantes au Québec

Cette thèse a pour objet de comprendre la question du mariage forcé vécu par des femmes immigrantes vivant au Québec et, les réponses politiques, législatives et sociales qu’on y apporte. De façon plus spécifique, il s’agit de mettre à jour la diversité des situations et des significations que recouvre la notion de mariage forcé pour tenter d’en dégager des éléments de définition et de compréhension. La thèse vise également à identifier les conséquences spécifiques qui découlent d’un mariage forcé pour les femmes immigrantes vivant au Québec, et enfin, d’analyser les réponses politiques, législatives et sociales visant le mariage forcé au Canada et au Québec afin de prévenir, dépister et d’en protéger ses victimes en contexte interculturel. S’appuyant sur un corpus de dix entrevues avec des femmes immigrantes vivant, ayant vécu ou menacées d’un mariage forcé et de dix-huit informateurs clés intervenant auprès d’elles et provenant de différents milieux de pratique (police, justice, santé services sociaux et communautaires), une analyse intersectionnelle a permis de révéler toute la complexité des mariages forcés due notamment aux interrelations entre des systèmes d’oppression et des vulnérabilités multiples. La recension des écrits et nos résultats indiquent que certains éléments caractérisent les mariages forcés. Premièrement, la préservation de l’honneur patriarcal qui problématise et contrôle le comportement des femmes en ce qui à trait notamment à leur vie sexuelle, mais aussi sociale. Deuxièmement, le fait que le mariage forcé soit un moyen de poursuivre des intérêts plus souvent collectifs qu’individuels. Dimension collective qui devra nécessairement être prise en considération lors des solutions à apporter à cette problématique. Troisièmement, le rôle des femmes (mères, belles-mères et autres femmes de la communauté culturelle d’appartenance) dans l’arrangement des mariages, mais également dans la surveillance et le contrôle de tous les faits et gestes des autres femmes. i Quatrièmement, le potentiel d’agresseurs multiples, y compris la communauté elle-même, dans les actes de violence commis avant, pendant et, le cas échéant, après le mariage. Une autre dimension qui devra elle aussi être prise en compte lors de l’inter- vention. Cinquièmement, le potentiel d’exploitation sexuelle (viol conjugal, grossesses forcées), physique (mauvais traitements, blessures), psychologique (pressions, manipulations) ou encore économique (travail forcé, privation d’autonomie financière). L’ensemble de ces résultats a permis de cerner certains besoins liés à l’intervention, en terme de prévention, de dépistage et de protection des victimes de mariage forcé.

Young people with learning disabilities who sexually harm others: the role of criminal justice within a multi-agency response

This paper outlines the key findings from a recent study of statutory service responses to young people with learning disabilities who show sexually inappropriate or abusive behaviours, with a particular focus on the involvement of criminal justice agencies. The study found that although inappropriate sexual behaviours were commonplace in special schools, and that serious acts of abuse including rape had sometimes occurred, education, welfare and criminal justice agencies struggled to work together effectively. In particular, staff often had difficulty in determining the point at which a sexually inappropriate behaviour warranted intervention. This problem was frequently compounded by a lack of appropriate therapeutic services. In many cases this meant that no intervention was made until the young person committed a sexual offence and the victim reported this to the police. As a consequence, young people with learning disabilities are being registered as sex offenders. The paper concludes by addressing some of the policy and practice implications of the study’s findings, particularly those which relate to criminal justice.

Absolute Inequality and Violent Property Crime

Rational choice models argue that income inequality leads to a higher expected utility of crime and thus generates incentives to engage in illegal activities. Yet, the results of empirical studies do not provide strong support for this theory; in fact, Neumayer provides apparently strong evidence that income inequality is not a significant determinant of violent property crime rates when a representative sample is used and country specific fixed effects are controlled for. An important limitation of this and other empirical studies on the subject is that they only consider proportional income differences, even though in rational choice models absolute difference in legal and illegal incomes determine the expected utility of crime. Using the same methodology and data as Neumayer, but using absolute inequality measures rather than proportional ones, this paper finds that absolute income inequality is a statistically significant determinant of robbery and violent theft rates. This result is robust to changes in sample size and to different absolute inequality measures, which not only implies that inequality is an important correlate of violent property crime rates but also suggests that absolute measures are preferable when the impact of inequality on property crime is studied.

Systematic review and meta-analysis of interventions relevant for young offenders with mood disorders, anxiety disorders, or self-harm

Background: Mood and anxiety disorders, and problems with self harm are significant and serious issues that are common in young people in the Criminal Justice System. Aims: To examine whether interventions relevant to young offenders with mood or anxiety disorders, or problems with self harm are effective. Method: Systematic review and meta-analysis of data from randomised controlled trials relevant to young offenders experiencing these problems. Results: An exhaustive search of the worldwide literature (published and unpublished)yielded 10 studies suitable for inclusion in this review. Meta-analysis of data from three studies (with a total population of 171 individuals) revealed that group-based Cognitive Behaviour Therapy (CBT) may help to reduce symptoms of depression in young offenders. Conclusions: These preliminary findings suggest that group-based CBT may be useful for young offenders with such mental health problems, but larger high quality RCTs are now needed to bolster the evidence-base.

Risk of repeated self-harm and associated factors in children, adolescents and young adults

Background: Repeated self-harm represents the single strongest risk factor for suicide. To date no study with full national coverage has examined the pattern of hospital repeated presentations due to self-harm among young people. Methods: Data on consecutive self-harm presentations were obtained from the National Self-Harm Registry Ireland. Socio-demographic and behavioural characteristics of individuals aged 10–29 years who presented with self-harm to emergency departments in Ireland (2007–2014) were analysed. Risk of long-term repetition was assessed using survival analysis and time differences between the order of presentations using generalised estimating equation analysis. Results: The total sample comprised 28,700 individuals involving 42,642 presentations. Intentional drug overdose was the most prevalent method (57.9%). Repetition of self-harm occurred in 19.2% of individuals during the first year following a first presentation, of whom the majority (62.7%) engaged in one repeated act. Overall, the risk of repeated self-harm was similar between males and females. However, in the 20–24-year-old age group males were at higher risk than females. Those who used self-cutting were at higher risk for repetition than those who used intentional drug overdose, particularly among females. Age was associated with repetition only among females, in particular adolescents (15–19 years old) were at higher risk than young emerging adults (20–24 years old). Repeated self-harm risk increased significantly with the number of previous self-harm episodes. Time differences between first self-harm presentations were detected. Time between second and third presentation increased compared to time between first and second presentation among low frequency repeaters (patients with 3 presentations only within 1 year following a first presentation). The same time period decreased among high frequency repeaters (patients with at least 4 to more than 30 presentations). Conclusion: Young people with the highest risk for repeated self-harm were 15–19-year-old females and 20–24-year-old males. Self-cutting was the method associated with the highest risk of self-harm repetition. Time between first self-harm presentations represents an indicator of subsequent repetition. To prevent risk of repeated self-harm in young people, all individuals presenting at emergency departments due to self-harm should be provided with a risk assessment including psychosocial characteristics, history of self-harm and time between first presentations.

[health Protection For Rural Workers: The Need To Standardize Techniques For Quantifying Dermal Exposure To Pesticides].

Quantification of dermal exposure to pesticides in rural workers, used in risk assessment, can be performed with different techniques such as patches or whole body evaluation. However, the wide variety of methods can jeopardize the process by producing disparate results, depending on the principles in sample collection. A critical review was thus performed on the main techniques for quantifying dermal exposure, calling attention to this issue and the need to establish a single methodology for quantification of dermal exposure in rural workers. Such harmonization of different techniques should help achieve safer and healthier working conditions. Techniques that can provide reliable exposure data are an essential first step towards avoiding harm to workers' health.

Health-related And Socio-demographic Factors Associated With Frailty In The Elderly: A Systematic Literature Review.

Frailty is a syndrome that leads to practical harm in the lives of elders, since it is related to increased risk of dependency, falls, hospitalization, institutionalization, and death. The objective of this systematic review was to identify the socio-demographic, psycho-behavioral, health-related, nutritional, and lifestyle factors associated with frailty in the elderly. A total of 4,183 studies published from 2001 to 2013 were detected in the databases, and 182 complete articles were selected. After a comprehensive reading and application of selection criteria, 35 eligible articles remained for analysis. The main factors associated with frailty were: age, female gender, black race/color, schooling, income, cardiovascular diseases, number of comorbidities/diseases, functional incapacity, poor self-rated health, depressive symptoms, cognitive function, body mass index, smoking, and alcohol use. Knowledge of the complexity of determinants of frailty can assist the formulation of measures for prevention and early intervention, thereby contributing to better quality of life for the elderly.