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Cali is one of the cities in Colombia and Latin America with the highest rate of homicides, with around one third of homicides being attributed to street gang-related violence. In 2016, the Mayor's office from Santiago the Cali - Colombia, the Police Department and the Cisalva institute from Universidad del Valle worked together to develop an holistic intervention, "TIP -Youth without frontiers", to reduce street gang-related violence in Cali's communes. The intervention comprised six components focusing on developing personal/emotional skills, improving access to health and other public services, reducing substance use, connecting youth with employment and educational opportunities, promoting participation in sports and recreational activities, and improving the restitution of citizen rights to street gang members. This study aimed to describe the characteristics and implementation of this transformative street gang program and to describe changes in street gang-related homicides that could be associated with the implementation of this program. The program started contacting street gangs in January 2016, recruiting the first street gang members in August 2016. As of December 2018, 2.107 youth (from 84 Police identified street gangs) have participated in the program. A reduction in street gang-related homicides was observed in Cali's communes from 2015 to 2018. In intervened communes these homicides decreased on average by 80%, suggesting that the program could have contributed to the reduction of street gang-related violent behavior in these areas. Resumen Cali es una de las ciudades de Colombia y de Latinoamérica con la tasa de homicidios más alta, con alrededor de un tercio de los homicidios atribuidos a la violencia entre pandillas. En 2016, la Alcaldía de Santiago de Cali - Colombia, la Policía Nacional y el Instituto Cisalva de la Universidad del Valle trabajaron juntos para desarrollar una intervención holística, "TIP - Jóvenes sin fronteras", con el fin de reducir la violencia relacionada con las pandillas en las comunas de Cali. La intervención abarcó seis componentes centrados en desarrollar habilidades personales/emocionales, mejorar el acceso a los servicios de salud y otros servicios públicos, reducir el consumo de sustancias, conectar a los jóvenes con oportunidades laborales y educativas, fomentar la participación en actividades deportivas y recreativas, y restituir los derechos cívicos a integrantes de las pandillas. El objetivo de este estudio era describir las características y la implementación de este programa de transformación de pandillas, y describir los cambios en la tasa de homicidios relacionados con pandillas que podrían estar asociados con la implementación de este programa. El programa comenzó contactando a las pandillas en enero del 2016, reclutando a los primeros miembros de estas en agosto del 2016. A diciembre del 2018, 2.107 jóvenes (de 84 pandillas identificadas por la policía) han participado en el programa. Se observó una reducción de los homicidios relacionados con pandillas en las comunas de Cali entre 2015 y 2018. En las comunas intervenidas, estos homicidios disminuyeron en promedio un 80%, lo que sugiere que el programa podría haber contribuido a la reducción del comportamiento violento relacionado con las pandillas en estas áreas. Resumo Cali é uma das cidades da Colômbia e da América Latina com a maior taxa de homicídios, com cerca de um terço dos homicídios atribuídos à violência de gangues. Em 2016, a Prefeitura de Santiago de Cali - Colômbia, a Polícia Nacional e o Instituto Cisalva da Universidad del Valle trabalharam juntos para desenvolver uma intervenção holística, "TIP - Jovens sem fronteiras", a fim de reduzir a violência das gangues nas comunas de Cali. A intervenção abrangeu seis componentes focados no desenvolvimento de habilidades pessoais/emocionais, melhoria do acesso aos serviços de saúde e outros serviços públicos, redução do uso de substâncias, conexão dos jovens com oportunidades de emprego e educação, incentivo à participação em atividades esportivas e recreativas, e a restauração dos direitos cívicos para os membros das gangues. O objetivo deste estudo foi descrever as características e a implementação do programa de transformação de gangues e descrever as mudanças na taxa de homicídios por gangues que poderiam estar associadas à implementação deste programa. O programa começou contatando as gangues em janeiro de 2016 e foram recrutados os primeiros membros das gangues em agosto de 2016. Em dezembro de 2018, participaram do programa 2.107 jovens (de 84 gangues identificadas pela polícia). Uma redução dos homicídios relacionados a gangues nas comunas de Cali foi observada entre 2015 e 2018. Nas comunas intervencionadas, esses homicídios diminuíram em média 80%, sugerindo que o programa possa ter contribuído para a redução do comportamento violento relacionado a gangues nessas áreas.

supp_file_one_c_j_psych_robin_williams for Suicide Mortality in Canada after the Death of Robin Williams, in the Context of High-Fidelity to Suicide Reporting Guidelines in the Canadian Media by Rob Whitley, David S. Fink, Julian Santaella-Tenorio and Katherine M. Keyes in The Canadian Journal of Psychiatry

Opioid morbidity and mortality and suicide are two current and central public health problems in the U.S. Both have continuously increased in the last two decades, and disproportionately affected some groups more than others, leading to the suggestion that these epidemics are connected. However, there is little evidence on the potential role that the opioid epidemic had on the rise of suicides. The overarching goal of this dissertation was to advance our understanding of the effects of the opioid epidemic on the rise in suicide rates in the U.S. First, a systematic review of the literature was conducted to critically evaluate the evidence on the effects of different opioid exposures on suicidal outcomes (e.g., suicidal ideation, attempts and suicides). There was ample evidence of individual-level associations between opioid use and related abuse/ dependence on suicidal outcomes. In contrast, the gap in the literature on group-level effects was clear, with only two studies examining these effects and showing that opioid availability was associated with suicide behavior in different populations. Several limitations were also identified in the reviewed studies that could partially explain the observed associations, indicating the need for further research. Second, the individual-level effects of prescription opioids nonmedical use and related abuse/ dependence on persistence and onset of suicidal ideation and attempts were examined. Longitudinal data from a national representative sample of the adult U.S. population was used to examine these associations. Results showed that heavy/ frequent use of prescription opioids and related abuse/ dependence had an effect on persistence and onset of suicidal ideation and persistence of attempts. However, none of these exposures were associated with onset of suicide attempt. Overall, these findings suggest that by increasing the number of those using prescription opioids and with opioid abuse/ dependence, and in turn the number of those with suicidal ideation/ behavior, the prescription opioid epidemic could have led to increases in suicide rates in the population. Finally, the group-level (i.e., state level) effects of three state level exposures, i.e., increasing trends in the per capita volume of prescription opioids, in the nonmedical use of these drugs, and in unintentional fatal opioid overdoses, on the increase in suicide rates were examined. For this, pooled cross sectional time series data from the 50 states (1999-2016) were used in linear regression models with state and year fixed effects. Although the volume of prescription opioids and the rate of fatal opioid overdoses increased over the study period, the prevalence of nonmedical use of prescription opioids decreased in most states. Results showed that the rate of unintentional fatal prescription opioid overdoses was associated with an increase in the rate of suicides. The range of effects sizes compatible with the data also suggested that the increase in the per capita volume of prescription opioids was linked to increases in suicide rates. Overall, this dissertation increased our understanding of the possible role that the opioid epidemic played on the increase in suicide rates in the U.S. As public efforts continue to fight the opioid epidemic, these findings can help inform future research that will guide the development of suicide prevention strategies and approaches to reduce the burden that the opioid epidemic poses on communities.

Background and Objectives: To describe the association between social and problem gambling and first criminal arrest by age 23 in a cohort of urban, mainly African-American youth. Methods: Data for this study were derived from several annual interviews being completed on a community sample of 617 participants during late adolescence until age 23. Information on gambling status, engagement in deviant behaviors, illegal drug use, and arrest history were collected through yearly interviews. Analysis was carried out using Nelson–Aalen cumulative hazard models and simple and adjusted Cox proportional hazards models. Results: More problem gamblers had been arrested before age 23 than social gamblers and non-gamblers, ie, 65% of problem gamblers were arrested before age 23, compared to 38% of social gamblers and 24% non-gamblers. Social gambling was only significantly associated with the hazard of first arrest by age 23 in the unadjusted model (HR: 1.6, p

Background: Little is known about the relationship between stressful life events and alcohol craving in the general population, and whether a history of childhood maltreatment sensitizes individuals to crave alcohol after adult stressors. Methods: Participants were 22,147 past-year drinkers from Wave 2 (2004 to 2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. A structured, face-to-face interview assessed past-year stressful life events, alcohol craving, and history of childhood maltreatment. Logistic regression was used to generate adjusted odds ratios (aOR) to evaluate the relationship between stressful life events and craving, adjusting for demographic characteristics and parental history of alcoholism. Interaction between stressful life events and childhood maltreatment was also assessed. Results: Compared to participants with no stressful life events, those with ≥3 events had increased odds of moderate alcohol craving (aOR = 3.15 [95% CI = 2.30 to 4.33]) and severe craving (aOR = 8.47 [95% CI = 4.78 to 15.01]). Stressful life events and childhood maltreatment interacted in predicting severe craving (p = 0.017); those with ≥3 events were at higher risk of craving if they had been exposed to childhood maltreatment. Conclusions: A direct relationship between stressful life events and risk of alcohol craving was observed. Further, history of childhood maltreatment increased the salience of stressful life events in adulthood. Future studies should examine the role of psychiatric comorbidity in more complex models of stress sensitization and alcohol craving.