Child maltreatment is a major public health concern worldwide and may worsen during crises, particularly in low- and middle-income countries. Despite recurrent severe flooding in Brazil, evidence on disaster-related changes in police-recorded child maltreatment is limited. To evaluate the impact of the historic 2024 floods in Porto Alegre, Brazil, on official police-recorded child maltreatment crimes. All police-recorded child maltreatment cases involving individuals aged 0-17 years in Porto Alegre from January 2022 to December 2025 (7107 records). An ecological interrupted time-series analysis using quasi-Poisson regression was conducted to estimate immediate and gradual changes in reporting after the floods (May 1-June 30, 2024). Outcomes consisted of weekly counts of official police-recorded child maltreatment crimes. Subgroup analyses were performed by sex, age group, race/ethnicity, maltreatment type, and neighborhood flood severity. Police-recorded child maltreatment showed a significant upward secular trend over the study period (IRR per year = 1.0109; p < 0.001). At flood onset, weekly records dropped by 62.9% relative to the counterfactual expectation (IRR = 0.371; p < 0.001), followed by a significant recovery during the flood period (slope IRR = 1.180; p < 0.001). After floodwaters receded, no significant trend change was observed (p = 0.649). The immediate decline was larger among males, younger children, and physical abuse records. By neighborhood flood impact, severely affected areas showed a 39.6% reduction during the flood (RR = 0.604), moderately affected areas a 32.6% reduction (RR = 0.674), and less affected areas a non-significant 18.2% decline (RR = 0.817); all strata returned to near-baseline levels post-flood. The 2024 floods caused substantial, heterogeneous interruptions in police-recorded child maltreatment in Porto Alegre, with abrupt declines at onset, partial recovery during the flood, and post-flood stabilization. Strengthening administrative monitoring and protection structures is essential to maintaining child safety during climate-related emergencies. These findings reflect changes in formal police reporting rather than the true incidence of child maltreatment.
People in mental distress are best supported by mental health services, yet initial contact often occurs with the police. In many jurisdictions, police may detain and transport individuals at risk to healthcare providers (e.g., emergency departments). This article reviews the literature on models of transfer of care from police to healthcare to identify the types of models reported, the outcomes associated with their implementation and possible factors influencing outcomes. A rapid review was conducted. Embase, Medline, Web of Science, and Google Scholar databases as well as grey literature and hand searches were explored to identify primary research studies published in English during January 2010-January 2025. Eligible articles were empirical evaluations or descriptions of models of transferring of care, regardless of methodology. Twenty-four studies were included, most utilising data from crisis response professionals and administrative records. Identified models tend to fall into one of four categories: co-response models, liaison models, designated places of safety models, and screening tools. A range of outcomes that the transfer of care models might influence has been reported including time under police care, rates of police calls and detention/sanctions, quality of care during call and/or transportation, emergency department utilisation/attendance duration, hospital diversion, and treatment admission. Effective communication and inter-service collaboration were identified as key factors in the effectiveness of the models. The identified models of transfer of care show promising outcomes, however, the absence of robust methodological evaluation indicates that the evidence base is not yet sufficiently developed to demonstrate their broader value.
Research on police violence (PV) narrowly defines it as physical force, disregarding its other forms, like psychological violence and neglect, and its co-occurrence with non-police victimization (NPV). This omission is important because of overlapping risk factors and potential compounding harm. Using the National Crime Victimization Survey and Police-Public Contact Survey, this study employs a more expansive definition that includes psychological and neglectful PV and assesses the overlap of these harms with NPV. Psychological PV was the most experienced form, and it was most prevalent among individuals who are male, younger, Black, city residents, and low-income. Any PV exposure, especially physical, was associated with a heightened NPV risk. While Black respondents had a higher likelihood of psychological PV than White individuals, its association with NPV was strongest for White respondents. Findings underscore the need to include PV in polyvictimization research and for alternatives to formal institutions that may perpetuate harm.
Suicide is a leading cause of death globally and represents a common, resource-intensive duty for police patrol officers (PPOs). Responding to suicidal crises is often traumatic, and PPOs rarely receive comprehensive training, leaving them inadequately prepared. Police authorities frequently assume operational responsibility in such situations, encompassing emotional, legal, tactical and safety considerations. This study aimed to explore and describe the competencies required of PPOs when encountering individuals in suicidal crisis. An exploratory, descriptive design was employed using a modified Delphi technique. Descriptions provided by PPOs of encounters with individuals in suicidal crisis were used to inform the development of items for a two-round questionnaire distributed to an expert panel. Experts were defined as individuals employed by the Swedish Police Authority or a university college, with additional training and/or teaching experience related to managing suicidal crises. Of the 50 experts invited, 43 completed both rounds, yielding a response rate of 86%. Consensus was achieved on 50 items, categorised into knowledge (n = 14), skills (n = 22) and attitudes (n = 14). The findings highlight the wide-ranging competencies required of PPOs, including policing-specific skills related to safety, interpersonal communication and psychiatric knowledge such as understanding mental disorders. Attitudinal competencies, such as demonstrating compassion and adopting a problem-solving approach, were also emphasised.
Effective police responses to intimate partner violence (IPV) require empirically supported risk assessment to guide intervention and resource allocation. IPV practice guidelines commonly emphasize partner stalking as a key risk factor for IPV recurrence, particularly for severe or lethal outcomes, yet evidence supporting this position is limited. The current study therefore examined 1,126 IPV cases reported to New Zealand Police (NZP) to explore whether partner stalking predicted (a) any IPV recurrence or (b) physical IPV recurrence in a 12-month follow-up. For each recurrence type, we examined whether partner stalking was predictive on its own, and then when controlling for other risk assessment information commonly used by NZP. Partner stalking initially predicted any IPV recurrence, irrespective of severity or type; but lost statistical significance when other commonly assessed risk factors were included. It did not predict physical IPV recurrence at all. Although not directly testing severe or lethal IPV outcomes emphasized in practice guidelines, this study provides a useful examination of the possible links between partner stalking and subsequent IPV more generally. Findings suggest that partner stalking may not warrant a special status in predicting IPV recurrence, because it often co-occurs with other risk factors that collectively provide stronger predictive utility. Overall, this study represents a valuable step toward grounding partner stalking and IPV risk assessment, prediction, and triage practices in empirical evidence.
Indigenous gay and bisexual men (GBM) in Guatemala face high rates of violence and HIV. This study seeks to understand the relationship between exposure to different forms of violence and PrEP use to inform PrEP programming in Guatemala. From June 2023- May 2024, two partner organizations administered a cross-sectional questionnaire to 395 Indigenous Guatemalan GBM. We examined the relationship between violence (physical, sexual, and police violence due to sexual orientation; forced migration and knowing someone missing, injured, or killed in the internal armed conflict; and intimate partner violence [IPV] victimization and perpetration) and PrEP use using logistic regression in R. In multivariable analysis, we found that participants who experienced police violence had 75% greater odds of PrEP use than those who did not experience police violence (aOR:1.73, 95% CI: 1.09, 2.75, p = 0.02). Participants who experienced forced migration during the internal conflict had twice the odds of being current PrEP users, (aOR: 2.02, 95% CI: 1.11, 3.70, p = 0.02). Participants who perpetrated IPV had 80% lower odds of using PrEP (aOR: 0.17, 95% CI: 0.03, 0.65, p = 0.02). Indigenous GBM experience a high burden of violence which may affect their use of PrEP. Future longitudinal research should explore how violence victimization affects perceived HIV risk and resilience, which may explain why Indigenous GBM who experienced violence may be more likely to use PrEP. Los hombres indígenas gais y bisexuales en Guatemala enfrentan altas tasas de violencia y VIH; este estudio investiga la relación entre la exposición a la violencia y el uso de la PrEP. Entre junio de 2023 y mayo de 2024, dos organizaciones de base comunitaria administraron un cuestionario transversal a 395 hombres indígenas gais y bisexuales en Guatemala. Examinamos la relación entre la violencia (violencia física, sexual y policial por motivos de orientación sexual; migración forzada y el hecho de conocer a alguien desaparecido, herido o asesinado durante el conflicto armado interno; y la victimización y perpetración de violencia por parte de la pareja íntima) y el uso de la PrEP, utilizando regresión logística en R. En el análisis multivariable, hallamos que los participantes que sufrieron violencia policial presentaban mayores probabilidades de utilizar la PrEP (aOR: 1.73; IC 95%: 1.09–2.75; p = 0.02). Los participantes que experimentaron migración forzada durante el conflicto interno mostraron mayores probabilidades de ser usuarios actuales de la PrEP (aOR: 2.02; IC 95%: 1.11–3.70; p = 0.02). Por el contrario, los participantes que perpetraron violencia de pareja íntima presentaron menores probabilidades de utilizar la PrEP (aOR: 0.17; IC 95%: 0.03–0.65; p = 0.02).
Public debate about policing highlights competing views about whether community initiatives build trust or reinforce surveillance. We argue that perceptions depend on prior state orientations, which can polarize opinions across groups. Using a preregistered survey experiment in Chicago, we examined responses to the police department's "Sentiment Dashboard," a project designed to enhance legitimacy by collecting community feedback. Results show that the dashboard increased trust in police among non-Black respondents but reduced trust among Black respondents, especially when framed as monitoring. Among non-Black respondents, dashboard exposure also reduced support for the Black Lives Matter movement and racial equity policies unrelated to policing, such as diverse hiring and climate justice. Mechanism testing with qualitative evidence suggests that treated non-Black participants were more likely to regard police reforms as substitutes for racial equity policies, rendering further measures unnecessary. These findings reveal how state legitimacy initiatives may instead widen racial divides and weaken coalitions for structural reform.
Policing is a social determinant of health that disproportionately affects racially, socially, and economically marginalized communities. Gentrification is hypothesized to alter policing, yet findings have not been synthesized across studies. We conducted a scoping review of studies examining gentrification's effects on direct policing (e.g., person-police encounters) and indirect policing (e.g., vicarious exposure through media or word-of-mouth) and related outcomes. Searches across multiple electronic databases identified 2680 records; after screening titles and abstracts, 42 full texts were reviewed and 26 were included (14 qualitative, 9 quantitative, 3 multi-method). Studies varied widely in how gentrification was defined; few were from public health or medicine. No study examined indirect policing in the context of gentrification. We identified three pathways through which gentrification increases direct policing: resident-led calls for service (via 911/311), police-led expansions of order-maintenance policing in gentrifying areas, and investment-led policing to protect new commercial development. Adverse effects were concentrated among longer-term Black, Latine, unstably housed, and gender minority residents. Health-related studies reported significant negative psychosocial impacts linked to these dynamics. Overall, gentrification appears to increase population-level exposure to direct policing via residents, police, and investors, with potential contributions to poorer mental health among longer-term residents. The review also highlights critical gaps, including sparse health-specific research and the absence of research on indirect policing.
This study provides the first national-level longitudinal analysis directly linking mobility data to police-recorded crime across local authorities in England and Wales, while controlling for stable structural differences between places. Its purpose is to examine how changes in human mobility are associated with changes in crime, taking advantage of the disruption in mobility caused by the COVID-19 pandemic. Negative binomial regression models were applied across 328 local authorities from March 2020 to October 2022, with area fixed effects, to assess how mobility across different activity spaces relates to police-recorded crime while accounting for unobserved, time-invariant local characteristics. The exploratory and modelling analyses showed that the mobility-crime relationship varied considerably by offence type and across local authorities. Increased residential mobility was consistently associated with lower levels of property, violent, and public order crimes, while mobility around retail, grocery, transit, and workplace areas was generally associated with higher crime once stable local differences were controlled. Sensitivity analyses suggested the results are robust to plausible levels of unobserved confounding. The impact of mobility on crime during and after the pandemic in England and Wales was not uniform but was shaped by local conditions and time-invariant characteristics. The findings underline the need for place-specific approaches in crime prevention and suggest that mobility-related interventions should be tailored to the structural and social context of each area. The online version contains supplementary material available at 10.1186/s40163-026-00291-z.
So-called Super-Recognizers (SRs)-individuals with exceptional face recognition ability-are increasingly being deployed by international police agencies. Currently, however, empirical evidence supporting their utility for law enforcement stems from a single study based on a small forensic stimulus set and a predominantly civilian sample. Here, on the basis of data collected from within the entire cohort of ∼18,000 Berlin Police officers employed in 2021, we report the performance of officers identified as SRs, using previously published lab-based criteria under operationally relevant, highly challenging 1:n facial identity matching conditions via the Berlin Test for Super-Recognizer Identification (beSure®)-the only existing tool that uses authentic forensic material. As a group, lab-identified SRs exhibited increased proficiency across a range of forensically relevant tasks. However, lab-based SR selection methods showed limited sensitivity at the individual level. These findings support the utility of lab-based SR identification while emphasizing the value of bespoke, professionally relevant assessment for deployment within law enforcement.
Protests are a persistent feature of contemporary urban life, often producing mass injuries through police repression. Yet the role of medical care in these contexts-especially when provided by informal collectives-remains understudied. Drawing on 21 in-depth interviews with members of volunteer medical brigades during Chile's 2019-2020 Estallido Social, this paper examines how care was improvised, coordinated and transformed under conditions of sustained police violence, where more than 3500 people were wounded and 36 died. The analysis explores how brigade members interpreted harm, navigated the collapse of medical neutrality, which was first denied by the state and then renounced by brigade members, and embedded rudimentary clinical practice within the protest itself. The paper proposes the concept of protest medicine. Unlike security-based approaches that presuppose the legitimacy of state action, protest medicine is a grassroots, politically entangled form of medical care shaped by the spatial, ethical and affective logics of protest. In doing medicine outside and against the state, protest medicine foregrounds a form of healthcare rooted in proximity, solidarity and resistance rather than neutrality, regulation and order, opening space to rethink the social and political functions of medicine when the state is a source of harm.
Opioid-related fatal overdoses have increased over the past decade in the United States, including in Rhode Island (RI). Naloxone (Narcan) is a medication that can quickly reverse opioid-involved overdoses. Understanding why people do not carry naloxone is critical to inform prevention and outreach efforts to increase naloxone coverage among those most at risk for experiencing or witnessing an overdose. This convergent parallel mixed methods study used pooled data from the RI Harm Reduction Surveillance System survey from 2021 to 2024 to describe reasons why people who use non-prescribed substances in RI reported not carrying naloxone. We first conducted descriptive and bivariate analyses of respondents' demographics and key variables of interest. Then we used thematic coding to develop and assign themes for respondents' open-ended responses on their decision to not carry naloxone with a team of 3 coders. Of the 670 respondents, 40% reported not currently carrying naloxone, with most of those not carrying naloxone reporting using non-opioid substances. Among individuals who did not carry naloxone, 54% witnessed and 20% personally experienced an overdose in the last 12 months. Many described not feeling personally at risk for an opioid overdose or lacked awareness of how to use naloxone. Stigma and not wanting the responsibility or trauma of administering naloxone was described throughout responses. Others indicated having naloxone confiscated or questioned by police, keeping it at another location, or having recently used or lost it. This study illuminated reasons for not carrying naloxone, primarily related to stigma, discomfort with administration, or a lack of awareness/risk perception for an opioid-related overdose. More prevention and education work are needed to increase carrying and confidence in administration of naloxone among people who use drugs and people likely to witness an overdose in RI.
BackgroundPublic safety communicators (PSCs, 911 call-takers, dispatchers, and others) play a critical role in Canada's emergency response system, yet they remain largely understudied compared with other public safety professionals (PSP). Although PSCs do not intervene directly at emergency scenes, they are routinely exposed to potentially psychologically traumatic events and high operational stress during calls, placing them at elevated risk for post-traumatic stress injuries (PTSIs). This study aimed to (1) estimate the prevalence of various PTSIs and suicidal behaviors among Canadian PSCs, (2) compare the prevalence with those reported for other Canadian PSP, and (3) identify associated sociodemographic factors.MethodsThe final analytic sample included 508 PSCs. Participants completed validated screening measures assessing symptoms of post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, panic disorder, and alcohol use disorder, along with questions regarding suicidal behaviors.ResultsNearly half of PSCs (48.6%) screened positive for at least 1 PTSI, exceeding the prevalence observed among other Canadian PSP. Symptoms of PTSD, depression, anxiety, and panic disorder were significantly higher, while alcohol abuse disorder symptoms were comparable to levels observed among other PSP. Suicide attempts were also significantly more frequent in our sample. Being female emerged as the strongest predictor of screening positive for a PTSI, whereas higher educational attainment was associated with reduced odds of both PTSI symptoms and suicidal ideation.ConclusionsThese findings highlight PSCs as a high-risk and overlooked subgroup within public safety. Trauma-informed training, targeted organizational adjustments, and profession-specific support resources are essential to mitigate the significant psychological burden on this workforce and foster long-term occupational well-being. Mental health among Canadian public safety communicators: a nationwide comparative studyPlain Language SummaryWhy was the study done? Public safety communicators (PSCs), including 911 call-takers and dispatchers, handle emergency calls daily and are exposed to stressful and potentially traumatic situations, but little is known about their mental health.What did the researchers do? The study surveyed 508 Canadian PSCs about symptoms of stress, depression, anxiety, panic reactions, alcohol use, and suicidal thoughts. The researchers also compared their results with existing research on other public safety workers, including firefighters, police officers, and other PSCs, and examined whether sociodemographic factors predicted mental health outcomes.What did the researchers find? Almost half of PSCs screened positive for at least one mental health condition. Rates of stress, depression, anxiety, and panic were higher than in other public safety workers. Suicidal thoughts were also more common. Female sex increased risk, while higher education reduced risk.What do the findings mean? PSCs are at higher risk for mental health difficulties than often recognized. Interventions such as trauma-informed training, workplace support, and profession-specific mental health resources are needed to help protect this workforce. The results also encourage research focused specifically on PSCs, rather than treating them only as a subgroup in broader public safety studies. Les communicateurs de la sécurité publique (CSP: opérateurs 911, répartiteurs, etc.) jouent un rôle essentiel dans le système d’intervention d’urgence du Canada, mais ils demeurent en grande partie sous-étudiés par rapport aux autres professionnels de la sécurité publique (PSP). Bien que les CSP n’interviennent pas directement sur les lieux d’urgence, ils sont régulièrement exposés à des événements potentiellement traumatisants sur le plan psychologique et à un stress opérationnel élevé pendant les appels, ce qui les expose à un risque élevé de blessures de stress post-traumatique (BSPT). Cette étude visait à 1) estimer la prévalence de divers BSPT et comportements suicidaires chez les CSP canadiens, 2) comparer la prévalence avec celles rapportées pour d’autres PSP canadiens et 3) déterminer les facteurs sociodémographiques associés. L’échantillon analytique final comprenait 508 CSP. Les participants ont répondu à des questionnaires de dépistage validés évaluant évaluant les symptômes du trouble de stress post-traumatique, du trouble dépressif majeur, du trouble anxieux généralisé, du trouble panique et du trouble d’usage de l’alcool, ainsi qu'à des questions concernant les comportements suicidaires. Près de la moitié des CSP (48.6%) ont obtenu un résultat positif pour au moins une BSPT, dépassant la prévalence observée chez les autres PSP canadiens. Les symptômes du TSPT, de la dépression, de l’anxiété et du trouble panique étaient significativement plus élevés, tandis que les symptômes du trouble d’usage de l’alcool étaient comparables aux niveaux observés chez d’autres PSP. Les tentatives de suicide étaient également beaucoup plus fréquentes dans notre échantillon. Le sexe féminin est apparu comme le facteur prédictif le plus important d’un résultat positif au dépistage de BSPT, tandis qu’un niveau de scolarité plus élevé a été associé à une diminution de la probabilité des symptômes de BSPT et des idées suicidaires. Ces résultats mettent en évidence que les CSP constituent un sous-groupe à risque élevé et négligé au sein de la sécurité publique. La formation sensible aux traumatismes, des ajustements organisationnels ciblés et des ressources de soutien propres à la profession sont essentiels pour atténuer le fardeau psychologique important imposé à ce personnel et favoriser le bien-être professionnel à long terme.
Research into the profiles of serial killers has largely relied on generalisations derived from studies conducted in the United States and parts of Europe, limiting the applicability of such findings to culturally diverse contexts. The present study addresses this gap by examining the profiles of serial killers in India, the most populous country in the world. Adopting an exploratory descriptive research design, the study analyses 132 serial killers reported between 1997 and 2025 using a database constructed from both primary and secondary sources. Employing quantitative methods, the study examines key variables including spatial analysis, socio-economic characteristics, prior criminal history, and victim counts. The findings of the study largely aligned with existing literature while also identifying certain patterns that are unique to the Indian context. Characteristics of Indian Serial Killers from 1997 to 2025Most research on serial killers is based in the United States and Europe. As a result, there is less knowledge about the applicability of findings from these studies to non-Western countries. This study fills this gap by analysing the characteristics of 132 serial killers in India from 1997 to 2025. By using interviews, police records, prison files, and media reports, the study explains the social and economic backgrounds of serial killers, their prior criminal records, and the number of victims they have had. Many of the findings were similar to Western research, but the study also identified some features that are unique to Indian serial killers.
Empirical analyses have grown increasingly important in discrimination litigation with the greater availability of detailed data on individuals and decisions. A popular analytic strategy is to estimate disparities after adjusting for observed covariates, typically with a regression model, in hopes of ferreting out discriminatory intent. This approach, however, is ill-suited to auditing algorithms that are now commonly used to aid decisions, which typically do not include race or other legally protected factors as inputs. Motivated by legal understandings of disparate impact, we introduce an approach that aims to measure "unjustified" disparities in both human and machine decisions. Our method, which we call risk-adjusted regression, proceeds in three steps. In the first step, we combine all available information in a machine learning model to estimate the value, or inversely, the risk, of taking a certain action, such as approving a loan application or hiring a job candidate. Second, we measure disparities in decisions after adjusting for these risk estimates alone. Finally, in the third step, we assess the sensitivity of results to potential mismeasurement of risk. We demonstrate this approach on a detailed dataset of 2.2 million police stops of pedestrians in New York City, and show that traditional statistical tests of discrimination can substantially understate the magnitude of (risk-adjusted) racial disparities.
After an industrial accident, workers at the site of the accident, as well as workers from nearby companies and responders (such as firefighters and police officers), and the surrounding population could be exposed to hazardous chemicals. In these situations, human biomonitoring measures are required by the population to assess the impact of the accident. However, HBM studies are usually conducted to assess the chronic exposure of chemicals for the general population, and no frame exists to apply these measures to such accidental context. Following a major industrial fire that occurred in Normandy in 2019, Santé publique France established a framework for HBM measurements following an industrial accident, in order to assess the relevance of such measurements and give operational guidelines to carry out these measures, from the sampling to the interpretation of the measures, in support to policy makers and health professionals. A bibliographic search on HBM protocols in case of accidents and HBM studies already implemented worldwide following an accident was conducted as well as numerous consultations covering scientific aspects, ethical and deontological considerations, and practical aspects of implementing an HBM protocol in the event of an accident. The HBM framework designed includes an initial HBM phase within 48 h following the end of emissions from the accident. Given the short deadlines for this first phase, it is advisable to target the most exposed and impacted individuals, that is, all persons (workers, occupants, emergency services, etc.) who were present on site during the industrial accident, as well as all individuals who visit a healthcare facility from the day of the accident until 48 h after the end of accidental emissions and for circumstances related to the accident. Sampling kits have to be quickly deployed in the event of an industrial accident requiring the implementation of HBM. Following this initial phase, medium- and long-term biological monitoring may be considered based on available information about the emitted chemicals and observed environmental contamination. The assessment of exposure to chemical substances through HBM after an accident requires the development of a standardized framework, particularly for chemicals with short half-lives. Exposure to chemical substances, after an accident, affects the general population residing near the accident site, as well as workers and emergency services.
Child physical abuse (CPA) is a serious public health concern with lifelong adverse consequences. Socioeconomic position (SEP) is a well-established determinant of adverse exposures. However, evidence of its role as a risk factor for CPA and its interaction with other risk factors remains limited. This study aimed to identify the effect of SEP on CPA and how SEP might condition other risk factors, comparing police-reported and forensically examined children with the background population in Denmark. We extracted register-based data on 356 children who underwent forensic examinations in Copenhagen between 2020 and 2023. A register-based control group was established, including all children in Denmark aged 4-14 years as of January 1, 2022 (N = 697,550). Logistic regression models were applied to model the odds of CPA as a function of SEP with child- and family characteristics. We observed that children living in families with low SEP had higher odds of being exposed to CPA (OR: 6.16; CI: 4.51-8.41), especially younger children aged 4-7 years (OR: 3.66; CI: 2.91-4.56), children with immigrant parents (OR: 8.83; CI: 6.12-12.73), and children living in single-parents families (OR: 2.90; CI: 2.29-3.67). No changes in odds were observed with the child's sex or maternal age at the child's birth. In conclusion, the odds of exposure to CPA were increased with low SEP, younger age (4-7 years), parental origin outside Denmark, and growing up in single-parent families. In contrast, the child's sex and the mother's age at the child's birth were not significantly associated with abuse.
Road injuries are a leading cause of mortality and morbidity worldwide. Years of international efforts have aimed to strengthen policy engagement, including the 2020 UN General Assembly's proclamation of the Second Decade of Action for Road Safety (2021-30), targeting a 50% reduction in road traffic deaths and serious injuries by 2030. The aim of this study is to provide estimates to monitor progress and identify intervention gaps. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2023, we estimated incidence, mortality, and morbidity of road injuries for 204 countries and territories from 1990 to 2023. Four road injury types and 47 nature-of-injury categories were examined. Morbidity and mortality data from clinical records, vital registration, and police reports were harmonised using meta-analytic techniques to ensure consistency and correct for systematic bias. Incidence was modelled with the meta-regression tool Disease Modelling-Meta-Regression version 2.1 and cause-specific mortality with the Cause of Death Ensemble model, both incorporating location-specific covariates to support interpolation. Years of life lived with disability (YLDs) were estimated from the prevalence and severity of the nature of road injury, and years of life lost (YLLs) from the number of cause-specific deaths multiplied by the standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were the sum of YLLs and YLDs. All metrics were calculated with 95% uncertainty intervals (UIs). In 2023, there were 50·9 million (95% UI 46·1-56·1) road injury incident cases, 1·34 million (1·04-1·58) deaths, and 75·3 million (59·8-89·2) DALYs globally. Road injuries were the leading global cause of death among males aged 10-39 years. Between 1990 and 2023, age-standardised incidence decreased by 38·3% (95% UI 36·9-39·7) and mortality decreased by 32·3% (6·1-49·0), but progress varied widely by World Bank income group. Mortality in low-income countries (43·8 [95% UI 31·7-56·0] deaths per 100 000 population) was approximately six times higher than in high-income countries (7·5 [7·1-7·9] deaths per 100 000), despite the high-income countries showing the highest age-standardised incidence rates (858·1 [95% UI 781·9-947·1] cases per 100 000). In the past decade, many countries achieved notable reductions in road injuries, but others, including Ghana and the USA, saw increases. More severe injuries tended to occur in low-income and middle-income countries. Although global incidence, mortality, and DALY rates from road injuries have declined, progress remains uneven, with pronounced disparities across income groups reflecting systemic inadequacies in infrastructure, vehicle standards, enforcement, and post-crash care. Strengthening emergency response, improving road design, enforcing safety measures, and adapting policies to the evolving demographics remain essential. Gates Foundation.
Field triage guidelines exist to inform first responder personnel on criteria to expedite the transfer of motor vehicle collision (MVC) patients to trauma centers; however, these guidelines are minimally informed by the vehicle characteristics and collision characteristics. Given this, we studied associations of the vehicle characteristics and collision characteristics with patient injury and outcomes. We conducted a retrospective study using Michigan State Police crash reports linked with Michigan Trauma Quality Improvement Program collaborative quality initiative data. Univariable analysis was used to identify characteristics predictive of the primary outcome of severe injury, defined as an Injury Severity Score >15 (ISS>15), and multivariable logistic regression analysis was performed across primary and secondary outcomes of ISS>15, mortality, and the need for surgery, intensive care, or transfer to another hospital. There were 13 154 linked cases between the two data sources. This contained 52.3% males with a mean age of 41.7 years (SD 20.7 years). In multivariable logistic regression, the collision characteristics associated with the highest increased odds of ISS>15 were single-vehicle crashes (OR 1.35, p<0.01) and head-on crashes (OR 1.54, p<0.01). Head-on crashes (OR 1.60, p<0.01) and single-vehicle crashes (OR 1.46, p=0.03) were associated with a significantly increased risk of mortality. Head-on crashes (OR 1.49, p<0.01) and single-vehicle crashes (OR 1.37, p<0.01) were associated with the highest odds of operative intervention or intensive care. Several vehicle and collision characteristics are associated with increased odds of severe traumatic injury and death after MVC. The addition of these characteristics to field triage assessments could improve triage decision-making to predict injury severity and the risk of mortality. III, prognostic, epidemiological.
The aim of the study is to explore professional identity to inform role development, recruitment and retention strategies for the highly specialised nursing population of Custodial Health Nurses (CHNs) who deliver health care to people detained in correctional centres, youth justice centres and police cells. A survey including a demographic instrument and a context-specific version of Stamps Index of Work Satisfaction (IWS), which has two parts, was used in this quantitative workforce study. Of the 982 CHN employed in public custodial health organisations eligible to undertake the survey, 127 (12.9%) completed the demographic questionnaire and 119 (12.1%) completed the survey in its entirety. Demographic characteristics are reported using frequency and percentage for categorical variables and mean and standard deviation for continuous variables. IWS analysis uses frequency and proportional matrices, and calculation of a final mean score establishing what pre-determined components impacted workplace satisfaction. The Total IWS Score for the CHNs was 12.44 (range 0.9-37.1), representing a low level of workplace satisfaction overall. The least influential components were pay, organisational policy and task. However, the data also indicate that the CHNs experience moderately high levels of workplace satisfaction with (in preference order) professional status, autonomy and interaction, as the most significant positively influencing factors. This study has found that overall CHNs experience their work in the same way as many other nursing specialties and embrace their professional nursing identity to thrive in this highly context-specific specialisation. This research is the first quantitative measure of the experience of Australian CHNs' workplace satisfaction. Findings can be used to shape a more positive professional identity for CHNs and improve prospects for their future recruitment and retention. The results of this study may inform the development of organisational policy, planning and role development of many areas of nursing; not only custodial health but primary health contexts of practice more generally.