Slide 1Guest speaker- Peer advocates on Monday- Topic- Sexual ViolenceExam 1Today’s lectureUnintentional InjuriesUnintentional Injuries in the United States 2009Motor Vehicle AccidentsHome InjuriesLeisure InjuriesWork InjuriesClinical implicationsIntentional Injuries / ViolenceQ. What factors contribute to violence?Types of violenceRape CultureSlide 16Factoid- Violence in schoolsRich-Grey Pathway1 to Recurrence of Urban street ViolenceSlide 19Psychology of ViolenceSlide 21Slide 22Slide 23Role of mental health in perpetrating violenceCharacteristics of violent behaviorClinical ImplicationsPreventionReferencesIN 123: FOUNDATIONS OF HEALTHM/W/F 1-1.50PmQuinn AuditoriumShabnam LateefFall 2013Personal SafetyGuest speaker- Peer advocates on Monday- Topic- Sexual ViolenceExam 1Will be conducting a review on Wednesday.Please read the topics once before Wednesday.Exam on Friday 10/4. Exam format: Multiple choice questions, True and False.Exam topics: Till Psychological health [Wednesday 9/25].Violence is not included in Exam 1. It is part of Exam 2.Today’s lectureUnintentional injuries: - Motor vehicle - Home - Leisure - WorkIntentional injuries - School violence - Terrorism - Family violence: Battering - Violence against childrenUnintentional InjuriesUnintentional Injuries in the United States 2009CAUSE OF INJURY DEATHS DISABLING INJURIESMotor Vehicle 35,900 3,300,000Home 65,200 21,100,000Leisure 25,100 9,400,000Work 3,582 5,100,000All classes 128,200 38,900,000* National Safety Council 2011, Injury facts 2011Motor Vehicle AccidentsCauses?Bikers/PedestriansHome InjuriesCauses? Most common?Treatment of suffocation?Leisure InjuriesActivitiesWeather: - Heat- conditions? - Cold - Storm/Wind - Lightning - FloodingWork InjuriesTypes?Most common body part affectedClinical implicationsDeathDisability [Physical therapy/Occupational therapy]- Disease burden: Paraplegia, AmputationsQuality of life/ Lifestyle changeIntentional Injuries / ViolenceQ. What factors contribute to violence?Types of violenceFamily and Intimate violence [Battering, Sexual, Stalking/Cyberstalking, Children, Elderly neglect/abuse]Assault [Robbery, Mugging- Inflict injury or death]HomicideGang-related violenceHate crimesSchool violence [Newtown, CT], BullyingWorkplace violence [D.C- Navy yard]Terrorism [Boston]War: Genocide, Torture, RiotsRape CultureSlutwalk Toronto April 3rd, 2011: Been able to separate individual choice from the issue of whether they will be raped.Constable Michael Sanguinetti – York University- Campus rape- “ I’ve been told I’m not supposed to say this- however, women should avoid dressing like sluts in order not to be victimized”.Co-founders Sonya Barnett and Heather Jarvis set out to reclaim the word slut.NYC, India, BrazilComparable to ‘Reclaim the night’ 1970’s movement protesting violence against women.Opponents: Labels, Marginalize people not comfortable with the connotations of the word, Promotes promiscuity.Q. Do you think the ‘Slutwalk’ is an effective form of activism for women’s rights?Why? Why not?Factoid- Violence in schoolsAccording to the CDC- 2011 report: 16.6% of high school students carried a gun at least once to school.7.3% of high school students have been threatened or injures with a weaponRich-Grey Pathway1 to Recurrence of Urban street ViolenceMay 2005, Vol 95, No. 5 | American J ournal of Public Health Rich and Grey | Peer Reviewed | Public Health Matters | 821½PUBLIC HEALTH MATTERS½Code of the street/“being a sucker”(pressure to retaliate)Symptoms oftraumatic stressLack of faithin policeINJURY Disrupted senseof safetyOptions for safety after injury:“move away”“avoid public transportation”“stay in the house”“police as the last resort”WeaponMarijuana use(including self-medication)Positive drug testsArrest/incarcerationEmployment problemsIllicit economyREINJURYRetaliationFIGURE 1—Model illustrating pathways to recurrence.I’ll go outside and just smoke it.When I come in the house,the first thing I do is knock out.Whenever I don’t do that,I get nightmares.Baron’s case provides an example of the re-lationship between symptoms of trauma anddrug use, a pattern that emerged from ourinductive analysis and was discernible in asmall number of the participants. All of theparticipants were asked about their use ofmarijuana; however, not all were asked aboutchanges in use after their injury, since this in-sight emerged well into the course of thestudy. Nonetheless, this finding suggests hy-potheses about the relationship betweensubstance use, PTSD, and recurrent trauma.Self-medication of symptoms of traumaticstress may drive substance use in some vic-tims of violent injury.Pathways to RecurrenceThe narrative analysis just presented dem-onstrates that young men feel unsafe aftertheir injuries and suggests possible pathwaysto recurrent injury. As shown in the model il-lustrated in Figure 1, the experience of injurydisrupts their sense of safety in 3 ways: it ac-tivates the need to acknowledge the code ofthe street and to avoid being a “sucker”; it in-tensifies lack of faith in the police; and it pre-cipitates symptoms of traumatic stress.This disrupted sense of safety creates a needto find a way to deal with a new sense of dan-ger. Young men have few options for avoidingdanger. Our participants suggested alternativessuch as moving away (most often “downsouth”), staying in the house, and avoiding pub-lic transportation. These options are impracticalin the long run. Given that they lack faith in thepolice, they will rely on this option only as alast resort. Faced with these realities, they mayfeel they have few options other than obtaininga weapon to stay safe. Studies have shown thatcarrying a weapon raises the risk of reinjury,perhaps because it emboldens the victim toconfront potential victimizers.27,29,30Our model includes the complicationsbrought on by traumatic stress. Some symp-toms, such as blunted emotions and hypervig-ilance, can make day-to-day situations seemmore threatening than they are31,32and canlead young victimized men to self-medicatewith marijuana or alcohol.Use of marijuana has consequences thatmay contribute to recurrent violence. For ex-ample, low-income men competing for low-wage jobs often face drug testing, and a posi-tive drug test disqualifies them