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Discussions of robotics and the law are often limited to 'what technology harms humans', rather than considering what it means when 'humans harm technology'. This article looks to advancements of Brain-Computer Interface (BCI) technology to argue how this can be an extension of individuals and therefore causes complicated legal questions that are yet to be resolved. This article identifies the law and explains BCI technology within the context of Australian criminal, property, negligence, personal injury and civil procedure laws. These areas of law need to be read with a clearer understanding of the way that technology is advancing. Currently these areas are not sufficiently prepared to respond to questions of BCI technology and where the human body begins and ends. [ABSTRACT FROM AUTHOR]

BACKGROUND: Half of all reported violent incidents in health care settings occur in the emergency department (ED) placing all staff members at risk. However, research typically does not include all ED work groups or validated measures beyond nurses and physicians. OBJECTIVE: The aims of this study were to (a) validate an established instrument measuring perceptions of causes of violence and attitudes toward managing violence within an inclusive workforce sample; and (b) explore variation in perceptions, attitudes, and incidence of violence and safety to inform a violence prevention program. METHODS: This is an investigator-initiated single-site cross-sectional survey design assessing the psychometric properties of the Management of Aggression and Violence Attitude Scale (MAVAS) within a convenience sample (n = 134). Construct validity was assessed using exploratory factor analysis and reliability was evaluated by the Cronbach's α estimation. Descriptive, correlational, and inferential estimates explored differences in perceptions, attitudes, and incidence of violence and safety. RESULTS: Exploratory factor analysis indicated validity of the MAVAS with a seven-factor model. Its internal consistency was satisfactory overall (Cronbach's α= 0.87) and across all subscales (Cronbach's α values = 0.52–0.80). Significant variation in incidence of physical assault, perceptions of safety, and causes of violence was found between work groups. CONCLUSIONS: The MAVAS is a valid and reliable tool to measure ED staff members' perceptions of causes of violence and attitudes toward managing violence. In addition, it can inform training according to differences in work group learner needs. [ABSTRACT FROM AUTHOR]

Background: Violence against nurses is a growing problem. Minimizing violence against nurses will contribute to a safer clinical environment. Local Problem: An increase in violence against nurses was identified at a regional medical center in the Midwest. Methods: A clinical nurse leader (CNL)–led behavior management consult team was developed to support the clinical team with aggressive, disruptive, or violent patients. The team consulted, assigned interventions to address potential source(s) of agitation, provided clinical support and guidance, and developed clinical tools to manage future patients with similar behavior patterns. Results: Between April 2019 and January 2023, a total of 108 behavior management consults were completed. Staff appreciated the additional support from the team. Conclusions: Implementation of a CNL-led behavior management consult team was found to be beneficial; other health care systems should consider implementing a similar consult team. [ABSTRACT FROM AUTHOR]

Sexual assault (SA) is a serious challenge faced by the U.S. military. Participants in this study included men and women who volunteered in response to a call for survivors of SA. Participants included active duty and reserve U.S. Air Force (USAF) members, spouses of service members, or civilian employees for the USAF (beneficiaries). The primary research question was, "if you could design the perfect response system to support survivors, what would be included in this system?" The research team conducted in-depth interviews with nine survivors. Next, 82 survivors completed a survey agreeing or disagreeing with strategies identified by interview participants to improve services for survivors and offered additional suggestions. Analysis revealed survivor recommendations to improve SA services. [ABSTRACT FROM AUTHOR]

Workplace violence remains a significant threat to the United States health care workforce. With increasingly aggressive patients, emergency nurses reported that the increased prevalence of workplace violence impacted their professional and personal lives. This study employed a qualitative, descriptive phenomenological approach with purposive sampling. Participants were asked to describe their lived experience with workplace violence while working as emergency nurses and how this affected them personally and professionally. Eleven experienced emergency registered nurses from 3 mid-Atlantic hospitals participated in the study. After reviewing, clustering, and validating significant statements, 4 major themes were identified: walking wounded to wounded healer, unexpected shock, betrayal, and resilient but changed. Our findings were consistent with other studies exploring the effects of workplace violence in emergency departments. We validated that trauma has long-lasting effects. Organizations should ensure that programs and processes are in place to support the nurse or health care worker when workplace violence events occur. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a serious public health issue. This study aims to characterize IPV-related injuries in trauma patients presenting to emergency departments (ED) who required hospitalization. Trauma registries of two Level 1 trauma centers were searched for assault-related ED visits by adults reporting "abuse" over 3 and 5 years to identify IPV victims. Imaging and electronic medical records were reviewed for demographics, injury type, hospital stay, and previous or subsequent presentations for presumed IPV. Twenty-nine of 18,465 (0.2%) individuals seen on the trauma service had reported IPV. Majority were women (90%, mean age 37) and Caucasian (69%), over 50% had psychiatric or substance use comorbidities, and 45% reported prior IPV. Blunt trauma (22/29) was more common than penetrating trauma. Soft tissue injuries dominated when including both radiologic and non-radiologic findings. Excluding two patients who were not imaged, most frequent injuries identified on imaging were to the head/face (14/27), followed by the chest (9/27; mainly rib fractures), upper extremity and abdomen (7/27 each). All spinal fractures involved the upper lumbar spine. Synchronous injuries to multiple body regions were common, particularly craniofacial and upper extremity. Twenty-eight of 29 patients scored a grade 3-4 on the IPV severity grading scale. Eight (28%) patients required intensive care unit -level care. One patient passed. Four (14%) patients had prior IPV-related ED presentations. While craniofacial and soft tissue injuries dominate, IPV can also result in serious thoracoabdominal, extremity and spinal injuries, even death. Multisystem injuries are common with synchronous craniofacial and upper extremity injuries being the most common combination. [ABSTRACT FROM AUTHOR]

Purpose To investigate the types and frequency of workplace violence experienced by radiologic technologists and to identify which technologists using specific imaging modalities are at increased risk. Methods A mixed-methods approach was employed using a research electronic data capture (REDCap; Vanderbilt University) survey designed to establish information on radiologic technologists' self-reported experiences with workplace violence. The survey was distributed to a random sample of 10 000 radiologic technologists working with various imaging disciplines. Participants (N = 193) were asked questions regarding personal and employment demographics, experiences with violence, and reporting and education practices. Results Radiologic technologists were shown to have experienced most workplace violence from patients or visitors. Among those surveyed, 50% or more reported being hit, bitten, called names, harassed, threatened, or having hair pulled by a patient. Verbal intimidation by patients, visitors, and others also was reported, with more than 50% experienced from visitors and more than 40% from patients, coworkers, radiologists, other physicians, or other health care providers. Statistical tests to evaluate a relationship between types of workplace violence and imaging modalities showed an association between name-calling by visitors and modality (P < .001). Results indicated that technologists performing computed tomography imaging, adult diagnostic imaging in the emergency department, and magnetic resonance imaging experienced the most frequent occurrences of name-calling by visitors. Discussion Workplace violence, which can affect a person mentally, physically, and emotionally, might occur in any work environment. In the health care setting, radiologic technologists might experience workplace violence originating from coworkers, other health care professionals, patients, visitors, or a combination of these sources. Therefore, a health care organization's acknowledgment of workplace violence and their resolve to prevent or reduce its occurrence is important. Providing sufficient human resources and adequate workplace violence education courses might be the first steps in eliminating workplace violence in the health care environment. Conclusion Workplace violence creates an undesirable working environment, leading to negative implications for the health care worker and the patient. Education that details possible types of workplace violence and best practices for handling each type is key to protecting employees. This study provides a foundation for future quality improvement studies aimed at protecting the mental and physical health of imaging professionals. [ABSTRACT FROM AUTHOR]

BACKGROUND: The impact of coronavirus disease-2019 (COVID-19) on geriatric trauma presenting to the emergency department is unknown. OBJECTIVE: To examine geriatric trauma emergency department admission trends during the COVID-19 pandemic. METHODS: This retrospective, observational, comparison study was conducted in an academic emergency department in Turkey. Trauma patients 65 years and older who presented to the emergency department within 1 year of March 12, 2020, were included. Patients admitted in the same date range in the previous year were included as the control group. The characteristics of the patients, injured area, and injury mechanisms were compared. RESULTS: Geriatric trauma admissions decreased (relative risk = 0.71, odds ratio [OR] = 0.69 [95% confidence interval, CI: 0.62, 0.77], p <.001). According to the type of injury, there was no significant difference in admissions to the emergency department (p =.318). During the pandemic, there was an increase in falls and a decrease in stab wounds and gunshot wounds (p =.001). Multiple trauma (OR = 5.56 [95% CI: 3.75, 8.23], p <.001), fall (OR = 2.41 [95% CI: 1.6, 3.73], p <.001), and-assault related injuries (OR = 4.43 [95% CI: 2.06, 9.56], p <.001) were determined as factors that increased the admissions to the emergency department compared with the prepandemic. CONCLUSION: Although geriatric trauma emergency department admissions decreased during the pandemic, those due to falls and assaults increased. Although curfews and social isolation resulted in a decrease in penetrating injuries, assault-related trauma has increased. [ABSTRACT FROM AUTHOR]

Background: This study describes the profile, mechanism and pattern of injuries, and highlights important gaps in clinicians' consultations with patients who experienced interpersonal violence (IPV) in the predominantly black South African township of Mdantsane, Eastern Cape. Methods: This retrospective cross-sectional study was conducted at the Cecilia Makiwane Regional Hospital, Mdantsane. Medical records of patients who received emergency care for trauma between 01 December 2017 and 31 March 2018 were reviewed. The records of patients identified with IPV were selected for further analysis. Data were disaggregated by demographics, mechanism of injuries and circumstances of the incidents using simple descriptive statistics. Results: A total of 1064 patients reported IPV as the mechanism of injury for emergency department (ED) visits, accounting for 42.4% of all trauma-related injuries. The majority of patients with IPV were men (72.0%), unemployed (78.0%) and single (89.0%). Blunt force injury was the most common pattern of injury (53.3%); about half (50.5%) of the incidents took place in the patients' homes. The majority of the patients (68%) knew their assailants, and a quarter of them were an intimate partner of the assailant (27.6%). The flow of patient with IPV to the ED was skewed towards the weekend (weekend effect). Also, there was an upward trend in the flow of patients with IPV to the ED from 19:00 onwards, reaching a peak at 20:00. Conclusion: Interpersonal violence is the most prevalent mechanism of injury reported in this region. It is crucial to engage stakeholders in the design of interventions in order to reduce IPV-related injuries in the region. [ABSTRACT FROM AUTHOR]

Restraint, often linked with limiting an individual's freedom of movement, has become a focal point of extensive discussion and evaluation within the realm of mental healthcare. Striking a delicate balance between ensuring individual safety and minimizing reliance on restraint methods poses a significant challenge. In mental health inpatient settings, the prevalent forms of restraint encompass physical, chemical, environmental, and psychological methods. Paradoxically, the consequences of employing restraint can be severe, ranging from injuries and cognitive decline to sedation and, in extreme cases, fatalities. This paper seeks to offer a nuanced exploration of the landscape surrounding psychiatric patient restraints, considering both global perspectives and specific insights from the Indian context. The guidelines outlined in India's Mental Healthcare Act of 2017, which governs the use of restraint on individuals suffering with mental illnesses, are also examined in detail. • Aggressive, self-harming, and violent behavior is common in psychiatric wards, posing risks to patients and staff • Empirical research on the subject is limited, and the ethical implications of restraint are significant • Aggressiveness and violence are frequent in mental health settings, often connected to emotional dysregulation • Factors such as overcrowding, staff shortages, and financial constraints contribute to the violence • Proper procedures, training, and monitoring are crucial to minimize risks and legal issues associated [ABSTRACT FROM AUTHOR]

Community assault is an interpersonal violence frequently seen in the emergency centres around South Africa. Its aim is to inflict serious injuries to a suspected perpetrator. Data has not been published in Mamelodi Regional Hospital setting whereas the cases have been observed in the emergency centre (EC). The study objectives were to determine the incidence and factors associated with being a victim of community assault in the EC in a regional hospital in Pretoria and clinical outcomes. We retrospectively reviewed the medical records of adult patients who were treated for assault in the EC of Mamelodi Regional Hospital between 5 March 2017 and 5 March 2018. EC electronic registries and medical file were used to identify all patients who presented with body injuries due to assault. Only 807 of 1070 medical records had complete data on the exposure variables of study interest. Of the 807 participants who presented with body injury due to assault, 77 (9.544% (95% CI 7.52 to 11.57)) were due to community assault. The majority of the victims were young adults, of male gender and not married. More than half of the participants were unemployed. Young adult age doubled the odds of being a victim of community assault odds ratio (OR) 2.19 (95% CI 1.02 to 4.70). The odds of being a victim of community assault for males were 11 times the odds of females OR 11.30 (95% CI 2.74 to 46.49). Of the 77 victims of community assault, 45 (58%) were admitted, 25 (32%) were discharged after receiving treatment, 6 (8%) refused treatment and 1 (1%) died. We describe the incidence of, and factors associated with, community assault in the EC of Mamelodi Regional Hospital in Pretoria. Our findings suggest that a modest incidence rate of being a victim of community assault. Young adult males are mostly the target victims of community and non-community assault. Further research is needed to understanding factors precipitating community assault and to test potential community and non-community assault prevention interventions, targeting young adult males. • Our study describes the prevalence and factors associated with being a victim of community assault. • Community assault in African settings contributes significantly to morbidity and mortality. • Study findings may inform the allocation of resources, development of targeted interventions to mitigate community assault. [ABSTRACT FROM AUTHOR]

Most studies of violence from the health care system lack reliable information about the counterpart, which is important for distinguishing between different types of violence. Since 2014, the emergency department at Odense University Hospital in Denmark has routinely registered information about the counterpart. The purpose of this study was to evaluate the completeness of registering information about the counterpart during routine registration of victims of interpersonal violence in the emergency department. We included 11,200 victims treated at the emergency department 2014–2021. Using the patient registration data, we estimated the proportion of missing information on the counterpart, stratified by age group and gender of the victim as well as type of incident and severity of injury. Information about the counterpart was registered in 91.5 % of all cases. In 43.1 % (CI: 42.2–44.0) of the cases, the counterpart was unknown to the victim, in 24.3 % (CI: 23.5–25.1) the counterpart was an acquaintance, in 10.5 % (CI: 10.0–11.1) the counterpart was a partner, and in 4.2 % (CI: 3.8–4.5) the counterpart was another family member. The proportion of cases with no information about the counterpart varied with gender, age group, time of violence, place of violence, weapon use, and severity of injury. Half of the victims injured with firearms (46.2 %, CI: 30.1–62.8) and one-fourth of the victims injured with knives (25.9 %, CI: 21.9–30.2) did not reveal information about the counterpart. The majority of the victims revealed information about the counterpart, making it possible to analyse different types of violence separately. • Overall, 91.5 % of the victims revealed information about the counterpart. • In 43.1 % of cases, the counterpart was unknown to the victim, in 24.3 % an acquaintance, and in 10.5 % a partner. • The willingness to reveal information about the counterpart varied with age, gender, time, place, and severity. • Half of the victims injured with firearms and 1/4 injured with knives did not reveal information about the counterpart. [ABSTRACT FROM AUTHOR]

The main objective of this study was to evaluate whether the 2016 Brexit referendum has contributed to an increase in maxillofacial injuries specifically targeted against ethnic minority groups in the district of North London. The secondary objectives were to identify the most common types of injuries following the assaults and the number of patients admitted to hospital. A total of 1,391 people was assaulted between 1 January 2014 and 31 December 2018. They were classified into the following categories: White (62.4%), Asian (13.6%), Black/African-Caribbean (11.9%), Other (Arab) (9%) and Mixed Ethnic Group (3.2%). A shift in the proportion of ethnicities affected, rather than an increase in the overall number of injuries, was observed during the five-year period. A significant increase in assaults against individuals of Asian ethnicity (p<0.01) and against Croatians (p<0.01) was recorded between 2014 and 2018. Peaks in assaults against white non-British individuals and Romanians were also identified in 2017 (p=0.04 and p<0.01, respectively). Furthermore, the White British (p=0.02), Asian (p<0.01) ethnic groups and the Spanish, Romanian, Italian, Russian, Lithuanian, Albanian and Croatian (p<0.01) nationalities experienced a significantly disproportionate number of attacks compared to their population share in North London during this five-year period. The most common injuries were contusion, and fractures of the nasal bones and mandible at 24.2%, 17.1%, and 16.5%, respectively. A total of 415 patients (29.8%) required hospital admission for treatment and 47.6% received conservative treatment. The authors have concluded that the Brexit vote may have played an important role in increasing violence and hate crime against specific ethnic minorities. [ABSTRACT FROM AUTHOR]

• This is a rare case of traumatic enucleation of the right globe sustained after an assault. • Traumatic enucleation requires significant retro-ocular force to cause globe separation from the surrounding supportive structures within the orbit. • Optic nerve avulsion from traumatic enucleation can cause contralateral visual deficits such as temporal hemianopia in the uninjured eye. • Current open and closed globe injury classification systems are not applicable to traumatic enucleation indicating the need for new system development to guide treatment options. Ocular trauma is a common occurrence in trauma settings but often occurs with little to no effect on the vision of the patient. Traumatic enucleation is a rare but devastating injury. A 40-year-old male presented to our trauma center after an assault resulting in right globe enucleation. CT confirmed absence of the globe with disruption of the ipsilateral orbital contents and distal optic nerve disruption. The patient was started on intravenous antibiotics and the right orbit was packed. He was taken to the operating room for exploration of the right orbit and placement of an implant. His remaining hospital course was unremarkable. Documented mechanisms of injury for traumatic enucleation are diverse, but often involve significant retro-ocular force to completely dislodge the globe from the orbit. Optic nerve avulsion may cause associated optic nerve chiasm damage leading to temporal hemianopia in the uninjured contralateral eye. Treatment involves stabilization and preparation for future implant placement. Traumatic enucleation is extremely rare. Development of a grading system applicable to traumatic enucleation may be helpful in guiding management in this complex patient population. [ABSTRACT FROM AUTHOR]

• Assault with iron made belan is the first case in its kind to be reported as per my best knowledge. • Penetration of iron made belan inside the vagina is the rare mode of assault. • Timely intervention, and definitive surgical interventions to control bleeding are the key steps in managing such patient. • The secondary survey is very important to assess the extent of injury with such a rare weapon. Assault with iron made belan causing penetration of it into vagina and perforation of posterior fornix is extremely rare. The commonly used weapon in assault are knife, wood, iron stick, wire, bomb or gun and most commonly affected body parts are cheeck, throat, back, abdomen, chest wall and extremities. We report a case of iron made belan penetrated into vagina with posterior fornix perforation and mesenteric tear in a 30 years old lady with history of pregnancy of 14 weeks. She was haemodynamically unstable at the time of presentation. She was treated with advanced trauma life support Protocol (ATLS), taken to operation room where iron made belan was removed with repair of posterior fornix and mesentery was done. Assault to genital organ in female is not uncommon. In present case the offender used the metallic iron made belan for assault which is the house hold material in India. In such situation high degree of suspicion and diagnostic modality are helpful to save the golden hour of patient and save the life of patients. General principles of trauma management is really very helpful to save the life threatening conditions. Urgent exploratory laparotomy with control of bleeding and repair of damaged structures are the cornerstone steps to manage such cases. Assault with iron made belan and its penetration inside vagina is extremely rare mode of injury. Timely intervention, concept of ATLS and definitive surgical interventions are the key steps in managing such patient. [ABSTRACT FROM AUTHOR]

Objective: To evaluate racial disparities among White and Black pediatric firearm injury patients on a national level. Background: Pediatric firearm-related morbidity and mortality are rising in the United States. There is a paucity of data examining racial disparities in those patients. Methods: The Pediatric Trauma Quality Improvement Program (2017) was queried for pediatric (age -17 years) patients admitted with firearm injuries. Patients were stratified by race: White and Black. Injury characteristics were assessed. Outcomes were mortality, hospital length of stay, and discharge disposition. Hierarchical regression models were performed to determine predictors of mortality and longer hospital stays. Results: A total of 3717 pediatric firearm injury patients were identified: Blacks (67.0%) and Whites (33.0%). The majority of patients were male (84.2%). The most common injury intent in both groups was assault (77.3% in Blacks vs in 45.4% Whites; P<0.001), followed by unintentional (21.1% vs 35.4%; P<0.001), and suicide (1.0% vs 14.0%; P<0.001). The highest fatality rate was in suicide injuries (62.6%). On univariate analysis, White children had higher mortality (17.5% vs 9.8%; P<0.001), longer hospital stay [3 (1-7) vs 2 (1-5) days; P = 0.021], and more psychiatric hospital admissions (1.3% vs 0.1%; P<0.001). On multivariate analysis, suicide intent was found to be an independent predictor of mortality (aOR 2.67; 95% CI 1.35-5.29) and longer hospital stay (bþ4.13; P<0.001), while White race was not. Conclusion: Assault is the leading intent of injury in both Black and White children, but White children suffer more from suicide injuries that are associated with worse outcomes. Level of Evidence: Level III Prognostic. [ABSTRACT FROM AUTHOR]

We explore the presence of gender sentencing disparities using large samples of assault, burglary and drugs offences from the Crown Court Sentencing Survey. We find significantly harsher sentences imposed on male offenders even after controlling for most case characteristics, including mitigating factors such as "caring responsibilities". Specifically the odds ratios of receiving a custodial sentence for offences of assault, burglary and drugs committed by a man as opposed to a woman are 2.84, 1.89 and 2.72. To put it in context, with the exception of "intent to commit serious harm", the gender effect was stronger than any other "harm and culpability 'factor applicable to assault offences. These disparities do not seem to stem primarily from differential interpretations of offender dangerousness. It is possible that they might be due to lower rates of reoffending amongst female offenders, or more probably to the higher punitive effect of custodial sentences on women. What seems clear is that sentencing is not gender neutral. If gender-specific sentencing guidelines are to be developed in the future it would be important that the noted disparities are taken in consideration. [ABSTRACT FROM AUTHOR]

Testicular loss following assault is a very rare occurrence and uncommon in the low income countries. Testicular amputation is usually associated with blast injuries, sexual violence and self-mutilation in psychiatric cases. Management involves a multidisciplinary approach and is focused on resuscitation, aggressive debridement, testosterone supplementation, and reconstructive surgery. We present a 31 year old male referred to the emergency department of a Regional Referral Hospital in western Uganda with a history of trauma to his scrotum. The patient had been well till 16 h prior to presentation when he was attacked by unknown assailants who broke into his house in the night. The patient was reportedly beaten before his scrotum was pulled and amputated with eventual profuse bleeding. Evacuation of approximately 150 cc hematoma was done plus debridement of necrotic testes and achieving hemostasis. To the best of our knowledge, this was the first reported case of bilateral traumatic testicular amputation as a result of assault. Revascularization with micro-vascular techniques can be done if the patient presents early, but due to late presentation, the patient was only managed with aggressive debridement, reconstruction and testosterone supplementation. • Testicular amputation is rarely a result of assault. • This injury can result in hemodynamic instability, requiring immediate attention. • Management requires resuscitation, aggressive debridement, testosterone supplementation, and reconstructive surgery. [ABSTRACT FROM AUTHOR]

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