Imagining Kyrgyzstan's nationhood and statehood: reactions to the 2010 Osh violence

This article explores the tensions inherent in how Kyrgyzstan's nationhood and statehood have been imagined and practised via an analysis of local reactions to the findings of the Kyrgyzstan Inquiry Commission's (KIC) investigation into the 2010 Osh violence and in particular the threat narrative that developed in opposition to the investigation. In the wake of the clashes that erupted in Osh in June 2010, a recurrent theme was calls from the international community for an independent investigation. Within Kyrgyzstan, however, some politicians argued that investigations violated the republic's sovereignty. Despite local reluctance, a number of investigations did subsequently take place. Yet the reports of the respective investigations did little to quell controversy, with the KIC report being strongly criticized and declared a threat to national security. The strength of feeling demonstrated by this reaction was indicative of long-standing and unresolved tensions in Kyrgyzstan between international and local imaginings of nationhood and statehood. The article concludes by arguing that nationhood and statehood need to be reimagined to focus on re-establishing state–society relations by both local and international actors in order for Kyrgyzstan to begin repairing the already fragile sociopolitical relationships that were grievously damaged by the violence and the subsequent investigations.

Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

There is a lack of appropriate services to manage youth with comorbid mental health problems and violence risks. To address this gap, we implemented a forensic satellite clinic in a youth mental health service. This paper characterises offending histories among 45 young patients referred to the clinic, and compares them with matched clinical controls (n = 45). Levels of prior risk taking and aggression were prominent among referred patients. Forensic cases and controls did not differ on demographic and clinical variables, with the exception of psychiatric inpatient admissions, which were higher among referred patients. Group differences were observed for prior offending variables (e.g., physical aggression), which were significantly higher among referred patients than controls. Findings suggest that referrals were made to the clinic based on challenging and aggressive behaviour rather than specific clinical characteristics. The role of specialist assessment, treatment and management of violence risks in youth mental health services are discussed.

Intimate partner violence in prisoners: toward effective assessment and intervention

This paper reviews the significant challenges that are involved in the development of services for perpetrators of intimate partner violence who are in prison. It is suggested that difficulties in accurately identifying intimate partner violence, reliably assessing risk of re-offense, and in identifying offending behavior programs that meet the specific needs of prisoners have limited the development of services in this area. As a result it is argued that unique and complex victim related issues that arise during incarceration and post-release are not adequately recognized in current correctional assessment and case management systems. Four avenues for future research and service development in this area are identified, with a view to developing the role that correctional services have to play in preventing intimate partner violence.

"Sometimes cathartic. Sometimes quite raw": Benefit and harm in an intimate partner violence trial

 Research on intimate partner violence (IPV) has increased over the past two decades, however empirical research on potential harm to participants is limited. The aim of this study was to assess whether 272 women involved in a general practice based IPV intervention trial (weave) reported more benefit or harm, whether this differed by intervention or comparison group, and what types of benefit and harm were reported. Feedback was obtained via adapted Consequences of Screening Tool, visual analogue scale and open-ended question in baseline, 6-month, 12-month and 24-month surveys (all participants), and semi-structured interviews (subset of 28 participants). Participants in both the intervention and comparison groups tended to respond positively on all quantitative items, although on a number of items, the intervention group responded even more positively. At 6 and 12 months, 51.1% and 54.7% of all participants, respectively, reported their quality of life as becoming better and over 40% of women at each time-point, indicated they felt more positive about themselves as a result of some aspect of their involvement in weave. 42% of all participants reported their home lives becoming less difficult. In qualitative analyses, positive themes identified were altruism, value, evaluation of relationship, validation, self-awareness, empowerment, positive reinforcement, catharsis, motivation to seek help, and response to the research process. Negative themes identified were short-term emotional reactions, long-term emotional reactions, recall, retraumatization and minimization. Many participants indicated short-term negative emotions had been balanced by longer-term positive benefits. Further research is needed regarding characteristics and experiences of the small minority of participants who did not report positive benefit. © 2014 Elsevier Ltd. All rights reserved.

Selecting outcomes for intimate partner violence intervention trials: overview and recommendations

 Intimate partner violence (IPV) is endemic in societies around the world and detrimental to women's wellbeing. Abused women are frequent users of health services. Despite the recent World Health Organization guidelines on IPV and sexual violence, we need more evidence on effective responses to women in health care settings. Developing robust evidence with potential to inform policy and clinical practice requires greater clarity and consistency across studies in the selection and use of outcomes to evaluate interventions. Drawing on systematic reviews and individual trials aimed at reducing abuse and improving women's health, we discuss critical issues in respect of outcomes. We discuss primary, secondary, intermediate and proxy outcomes and measures used to evaluate interventions for women who experience IPV. We offer recommendations about which outcomes to assess and approaches to doing so within the context of trials in health care settings. © 2014 Elsevier Ltd. All rights reserved.

Student perspectives on the reasons for physical violence in a Thai vocational college: an exploratory study

Physical violence in Bangkok schools has been the subject of considerable public concern in recent years and yet relatively little is known about the nature of violence perpetrated by vocational college students. This study sought to understand the reasons for such violence through a series of semi-structured interviews with 32 male students. The analysis identified revenge from previous fights as a key motivation for violence. Students described a range of different responses to threats of violence, including renting safe accommodation and concealing weapons. These findings are discussed in relation to how an understanding of cross-cultural risk factors for violence is important for the development of effective prevention strategies.

Offending competency and coercive control in intimate partner violence

This paper considers some of the ways in which intervention approaches for perpetrators of intimate partner violence (IPV) might be enhanced through the explicit consideration of the offense process. It is suggested that those who are experts in perpetrating this type of violence routinely use coercive controlling violence in intimate relationships. This group, for whom violence is instrumental, are not only likely to be at highest risk of offending, but also the most difficult to treat. They are more likely to have long developmental histories of violence, hold entrenched attitudes, and utilize knowledge about the effects of intimidation to avoid detection. It is suggested that specific consideration of what is known about the causes and correlates of IPV in those who follow this approach-explicit pathway can improve the outcomes of current perpetrator behavior change programs.

Problem gambling and intimate partner violence : a systematic review and meta-analysis

This study provides a systematic review of the empirical evidence related to the association between problem gambling and intimate partner violence (IPV). We identified 14 available studies in the systematic search (8 for victimisation only, 4 for perpetration only and 2 for both victimisation and perpetration). Although there were some equivocal findings, we found that most of the available research suggests that there is a significant relationship between problem gambling and being a victim of IPV. There was more consistent evidence that there is a significant relationship between problem gambling and perpetration of IPV. Meta-analyses revealed that over one third of problem gamblers report being victims of physical IPV (38.1%) or perpetrators of physical IPV (36.5%) and that the prevalence of problem gambling in IPV perpetrators is 11.3%. Although the exact nature of the relationships between problem gambling and IPV is yet to be determined, the findings suggest that less than full employment and clinical anger problems are implicated in the relationship between problem gambling and IPV victimization and that younger age, less than full employment, clinical anger problems, impulsivity, and alcohol and substance use are implicated in the relationship between problem gambling and IPV perpetration. The findings highlight the need for treatment services to undertake routine screening and assessment of problem gambling, IPV, alcohol and substance use problems, and mental health issues and provide interventions designed to manage this cluster of comorbid conditions. Further research is also required to investigate the relationship between problem gambling and violence that extends into the family beyond intimate partners.

Last drinks: a study of rural emergency department data collection to identify and target community alcohol-related violence

The present study summarises the methodology and findings of a pilot project designed to measure the sources and locations of alcohol-related harm by implementing anonymised 'last drinks' questions in the ED of a rural community.

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.

Pharmacological management of aggression and violence.

The pharmacological management of violence and aggression is a common and substantial clinical dilemma in the emergency psychiatric situation. A literature search was conducted through PubMed and using the Cochrane Library. This was followed by a manual search of selected literature. Randomised controlled trials were sought that specifically addressed the acute situation, rather than the ongoing management of chronic conditions. There was a paucity of well-controlled data and insufficient evidence to support the use of many agents in emergency situations. Many studies had considerable limitations making comparison difficult. Efficacy data for a range of treatment options exists, including the use of classical and atypical anti-psychotic agents, benzodiazepines and combination therapies. Clinical risk, tolerability and environmental factors need to form part of a careful and considered judgement in the choice of treatment. Safety, tolerability and the potential for a positive experience are major considerations, thus paving the way for long term compliance.