Working with a child Exposed to Community and Domestic violence in Northern Ireland: An Illustrated Case Example.

The focus of this paper is on the author’s multi-modal therapeutic practice with a 7-year-old boy referred to the Family Trauma Centre, following paramilitary assaults on his father. The work also addresses the boy’s experience of domestic violence. The work is contextualised in terms of the ‘Peace Process’ in Northern Ireland, including the establishment of the Family Trauma Centre as a response to the needs of victims of the Troubles. A rationale for working with children using a multi-modal approach is presented.

Effect of tailored practice and patient care plans on secondary prevention of heart disease in general practice: cluster randomised controlled trial

Objective: To test the effectiveness of a complex intervention designed, within a theoretical framework, to improve outcomes for patients with coronary heart disease. Design: Cluster randomised controlled multicentre trial. Setting: General practices in Northern Ireland and the Republic of Ireland, regions with different healthcare systems. Participants: 903 patients with established coronary heart disease registered with one of 48 practices. Intervention: Tailored care plans for practices (practice based training in prescribing and behaviour change, administrative support, quarterly newsletter), and tailored care plans for patients (motivational interviewing, goal identification, and target setting for lifestyle change) with reviews every four months at the practices. Control practices provided usual care. Main outcome measures: The proportion of patients at 18 month follow-up above target levels for blood pressure and total cholesterol concentration, and those admitted to hospital, and changes in physical and mental health status (SF-12). Results: At baseline the numbers (proportions) of patients above the recommended limits were: systolic blood pressure greater than 140 mm Hg (305/899; 33.9%, 95% confidence interval 30.8% to 33.9%), diastolic blood pressure greater than 90 mm Hg (111/901; 12.3%, 10.2% to 14.5%), and total cholesterol concentration greater than 5 mmol/l (188/860; 20.8%, 19.1% to 24.6%). At the 18 month follow-up there were no significant differences between intervention and control groups in the numbers (proportions) of patients above the recommended limits: systolic blood pressure, intervention 98/360 (27.2%) v control, 133/405 (32.8%), odds ratio 1.51 (95% confidence interval 0.99 to 2.30; P=0.06); diastolic blood pressure, intervention 32/360 (8.9%) v control, 40/405 (9.9%), 1.40 (0.75 to 2.64; P=0.29); and total cholesterol concentration, intervention 52/342 (15.2%) v control, 64/391 (16.4%), 1.13 (0.63 to 2.03; P=0.65). The number of patients admitted to hospital over the 18 month study period significantly decreased in the intervention group compared with the control group: 107/415 (25.8%) v 148/435 (34.0%), 1.56 (1.53 to 2.60; P=0.03). Conclusions: Admissions to hospital were significantly reduced after an intensive 18 month intervention to improve outcomes for patients with coronary heart disease, but no other clinical benefits were shown, possibly because of a ceiling effect related to improved management of the disease. Trial registration: Current Controlled Trials ISRCTN24081411.

Behavior analytic perspective on victimology

The field of victimology has become an area of serious scientific enquiry only recently and now attracts a wide range of theories from within multiple disciplines. In this paper the contribution that the science of behavior analysis can make to the conceptualization of the field is explored by investigating what makes people vulnerable to becoming victims or indeed perpetrators of violence and by examining why some people who have experienced violent incidents become victims while others grow to be survivors. A behavior analytic perspective sheds new light on these issues

Between Colonial Violence and Socialist Worldview: The Conversions of Ernst Daumig

In 1900, Ernst Däumig (1866–1922) wrote to Karl Kautsky of his ‘bitter experiences’ of violence in the French Foreign Legion and then in the Prussian military that had led to his recent ‘conversion’ to the socialist worldview. This article takes up Däumig's letters, articles and travelogues, and a drama, to explore how he recast his experiences of colonial and military violence twice, first as a writer for a German soldiers’ journal and then as an aspiring socialist journalist. As well as a burden that pushed him to critique his past, Däumig's military and colonial experiences are shown to have been his starting capital in the world of journalism and politics. The article gives particular attention to the process of conversion, through which Däumig forged a new life narrative out of the moral tales offered by the adopted worldview and the events of his own past. In addition to providing a case study of worldview conversion, this article demonstrates how biographical research can challenge assumptions about the impact of colonial violence on German metropolitan culture. At the same time, this biographical analysis sheds light on the early career of one of the key figures in the German Revolution of 1918 to 1921. As co-chairman of the Independent Social Democratic Party (USPD), Däumig led the USPD into union with the Communist Party in 1920.