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PubMed1991

Occupational risk of hepatitis B for police and customs personnel.

A cross-sectional study was undertaken in 1987 to establish whether New Zealand police and customs officers are at excess risk of hepatitis B virus infection as a consequence of occupational exposure to human blood and penetrating injury. The study population comprised all full-time police (n = 5,193) and customs officers (n = 1,026) excluding only a small number on special duty who had already been immunized. The control group comprised the civilians employed by both organizations (n = 964). The prevalence of hepatitis B markers in the control group, when standardized for age, sex, and ethnic distribution, was 13.4%, which agrees well with New Zealand blood donor figures. The prevalence ratios for police officers and customs officers compared with the civilians (adjusted for age, sex, and ethnic distributions) were 0.82 (95% confidence interval (CI) 0.63-1.06) and 0.49 (95% CI 0.34-0.70), respectively. Multivariate analysis was used to further explore the differences in marker prevalence among the three groups, but failed to demonstrate any significant association between occupational variables and marker prevalence. There was an association between time spent living in high-risk areas of the country and marker prevalence. The authors conclude that the question as to whether police personnel should be immunized begs the wider issue of whether or not the whole New Zealand population should be so protected.

Adult↗
PubMed1996

Comparison of accident and emergency with police road injury data.

This paper examines the consistency of police and hospital reporting of outcomes of road traffic crashes using a database of linked police crash reports and accident and emergency department data. The database used consisted of linked records of road traffic crashes in Western Australia for the period of October 1, 1987 to December 31, 1988 from police reported casualty crashes, the discharge records from all hospital admissions in Western Australia, the Registrar-General's death records, and records for each ambulance trip as a result of a road crash in the metropolitan area of Perth. The results suggest that police records of hospital admissions from the group of accident and emergency attendances underestimated the total by approximately 15%.

Accidents, Traffic↗
PubMed2002

Dropouts in a long-term follow-up study involving voluntary counseling and HIV testing: experience from a cohort of police officers in Dar Es Salaam, Tanzania.

BACKGROUND: Results of most population-based studies primarily are derived from people who responded positively and thereby continued to participate in such studies. It is, however, equally important to know the characteristics of study subjects who drop out to learn the reasons that kept them from continuing to participate in the study, especially because they had initially agreed to participate in such a study. In studies with long-term follow-up, reasons for nonresponse may provide invaluable information that may be gathered through continued contact with study subjects who have withdrawn from the study. OBJECTIVES: To determine characteristics of study participants who withdrew from an ongoing study of police officers, which involved counseling and HIV testing, and to determine reasons for their discontinued participation. METHODS: Demographic characteristics of a cohort of police officers who had been participating in a study to determine their suitability for HIV vaccine trials were analyzed. Characteristics of those who did not return for the second survey of appointments for HIV testing were compared with those who continued their participation. A randomly selected sample of 132 police officers who did not participate in the second survey of HIV testing were asked why they did not return. Answers were obtained from 84 people who had discontinued their participation. RESULTS: Of eligible police officers, 2087 (72.1%) responded to the call for follow-up appointments, whereas 807 (27.9%) did not return. Those who did not return to participate in the second survey had significantly higher rates of HIV seropositivity (17.2%) than those who did return (13.5%) (p <.05). The rate of return in unmarried participants was worse (p <.05) than the rate among married participants. Rates of sexual contacts with partners other than their spouses and levels of alcohol consumption did not differ between the two groups. Reasons for dropping out of the study included fear of knowing results of HIV testing in 54.6%, lack of time to continue in 34.5%, and fears about job security in 3.6%. CONCLUSION: Fears of finding out that one might be seropositive need to be answered at recruitment, and practical arrangements must be made to facilitate further follow-up. A bias for lower incidence might be introduced in vaccine trials if participants thought to be at highest risk for HIV infection discontinue participation.

Adult↗
PubMed2004

Reality check: using newspapers, police reports, and court records to assess defensive gun use.

OBJECTIVE: To identify legitimate defensive gun uses (DGUs), and provide a reality check on previous estimates of the rate of DGUs by using a novel approach based on newspaper reports and police and court records. Previous estimates have relied on self report, differ by a factor of 10 or more, and are viewed as highly controversial. DESIGN AND SETTING: The reported uses of firearms in a newspaper covering roughly the Phoenix metropolitan area over almost a 3.5 month period were examined, supplemented where necessary by police and court records. RESULTS: Two DGUs involving killing assailants and one involving firing at an assailant were found. The three DGUs stemmed from cases of "mutual combat" or exposed bystanders to gunfire. CONCLUSIONS: These findings cast doubt on rates of DGUs reported in an influential study by Kleck and Gertz, which predict that the police should have known about 98 DGU killings or woundings and 236 DGU firings at adversaries during the time the newspaper was surveyed. The findings reported here were closer to predictions based on the National Crime Victimization Survey, which suggest that the police should have known about eight DGU killings or woundings and 19 DGU firings at adversaries.

Arizona↗
PubMed2002

Identification and characteristics of victims of violence identified by emergency physicians, triage nurses, and the police.

OBJECTIVES: The objectives of the study were threefold-to evaluate the identification and characteristics of victims of assault who attend an accident and emergency (A&E) department; to compare the total number of assaults recorded in the A&E department with the number recorded by the police; and to assess a system for collecting the location and method of assault. SETTING: The A&E department of Chorley and South Ribble Hospital Trust, Lancashire, England. METHODS: A three month prospective study was performed. Victims of violence recorded on computer by doctors at discharge were compared with those identified at initial nurse triage. A comparison of police data with the A&E data relating to Chorley residents was performed. Additional information on the method and location of assault was also collected. RESULTS: During the period 305 (2.6%) of the patients attending A&E were identified as having been assaulted. Of the 305 individuals, 236 (77%) were identified by a doctor while 173 (57%) such patients were identified by a triage nurse. A&E identified twice the number of assaults involving Chorley residents as the police. Both men and women were most likely to have been injured on the street (44% and 37% respectively), although a greater proportion of women were injured at home (24%) than men (10%). The majority of injuries were sustained by blows from fists, feet, and heads (73%). CONCLUSIONS: A&E doctors identify significantly more patients as the victims of violence than do nurses at triage. Using A&E data identifies assaulted individuals not identified by the police. Computer systems can be used in A&E to provide a more complete picture of the occurrence of violence in the community.

Adolescent↗
PubMed1993

Improving mortality data in South Africa: review of next of kin statements to determine cause of death in police certification.

STUDY OBJECTIVE: The study aimed to improve mortality data by finding ways of reducing the large number of deaths certified as being from "ill-defined" causes (ICD 780-798) in South Africa. This problem is attributable to the absence of cause of death information in many cases where the police issue the death certificate. DESIGN AND SETTING: A total of 600 consecutive death certification records at the Salt River State Mortuary, Cape Town were reviewed. MEASUREMENTS AND MAIN RESULTS: Altogether 347 (58%) deaths were from unnatural causes, 111 (18%) were certified by a doctor, 83 (14%) were certified as being the result of natural causes after a necropsy, and 59 (10%) were certified by the police as being from natural causes. Analysis of sworn statements obtained from the next of kin of all those certified dead by the police rather than a doctor provided a clear cause of death in 72.9%, and a history of recent contact with health services (less than one week previously) in 47.5%. All infants certified dead by the police had a history consistent with diarrhoeal disease. CONCLUSIONS: The method of death certification may be an indicator of access to health care and reviewing sworn statements to determine the cause of death should improve the quality of mortality data in the developing world.

Adolescent↗
PubMed2000

Comparing outcomes of major models of police responses to mental health emergencies.

OBJECTIVE: The study compared three models of police responses to incidents involving people thought to have mental illnesses to determine how often specialized professionals responded and how often they were able to resolve cases without arrest. METHODS: Three study sites representing distinct approaches to police handling of incidents involving persons with mental illness were examined-Birmingham, Alabama; and Knoxville and Memphis, Tennessee. At each site, records were examined for approximately 100 police dispatch calls for "emotionally disturbed persons" to examine the extent to which the specially trained professionals responded. To determine differences in case dispositions, records were also examined for 100 incidents at each site that involved a specialized response. RESULTS: Large differences were found across sites in the proportion of calls that resulted in a specialized response-28 percent for Birmingham, 40 percent for Knoxville, and 95 percent for Memphis. One reason for the differences was the availability in Memphis of a crisis drop-off center for persons with mental illness that had a no-refusal policy for police cases. All three programs had relatively low arrest rates when a specialized response was made, 13 percent for Birmingham, 5 percent for Knoxville, and 2 percent for Memphis. Birmingham's program was most likely to resolve an incident on the scene, whereas Knoxville's program predominantly referred individuals to mental health specialists. CONCLUSIONS: Our data strongly suggest that collaborations between the criminal justice system, the mental health system, and the advocacy community plus essential services reduce the inappropriate use of U.S. jails to house persons with acute symptoms of mental illness.

Adult↗
PubMed2004

Police officers' attitudes toward and decisions about persons with mental illness.

OBJECTIVE: A significant portion of police work involves contact with persons who have mental illness. This study examined how knowledge that a person has a mental illness influences police officers' perceptions, attitudes, and responses. METHODS: A total of 382 police officers who were taking a variety of in-service training courses were randomly assigned one of eight hypothetical vignettes describing a person in need of assistance, a victim, a witness, or a suspect who either was labeled as having schizophrenia or for whom no information about mental was provided. These officers completed measures that evaluated their perceptions and attitudes about the person described in the vignette. RESULTS: A 4 x 2 multivariate analysis of variance (vignette role by label) examining main and interaction effects on all subscales of the Attribution Questionnaire (AQ) indicated significant main effects for schizophrenia label, vignette role, and the interaction between the two. Subsequent univariate analyses of variance indicated significant main effects for role on all seven subscales of the AQ and for label on all but the anger and credibility subscales. Significant role-by-label interaction effects were found for the responsibility, pity, and credibility subscales. CONCLUSION: Police officers viewed persons with schizophrenia as being less responsible for their situation, more worthy of help, and more dangerous than persons for whom no mental illness information was provided.

Adult↗
PubMed2005

Assessment of police calls for suicidal behavior in a concentrated urban setting.

As a result of deinstitutionalization over the past half-century, police have become frontline mental health care workers. This study assessed five-year patterns of police calls for suicidal behavior in Toronto, Canada. Police responded to an average of 1,422 calls for suicidal behavior per year, 15 percent of which involved completed suicides (24 percent of male callers and 8 percent of female callers). Calls for suicidal behavior increased by 4 percent among males and 17 percent among females over the study period. The rate of completed suicides decreased by 22 percent among males and 31 percent among females. Compared with women, men were more likely to die from physical (as opposed to chemical) methods (22 percent and 43 percent, respectively). The study results highlight the importance of understanding changes in patterns and types of suicidal behavior to police training and preparedness.

Adult↗
PubMed2005

The role of Afro-Canadian status in police or ambulance referral to emergency psychiatric services.

OBJECTIVE: This study tested the hypothesis that among patients admitted to a hospital with psychosis, Afro-Canadian patients would be more likely than Euro-Canadian or Asian-Canadian patients to be brought to emergency services by police or ambulance. METHODS: Data on psychotic patients admitted to the psychiatry ward in 1999 were extracted from records of a general hospital in Montreal. Logistic regression models examined the relationship between being Afro-Canadian and being brought to the emergency service by police or ambulance, while controlling for age, gender, marital status, and number of psychotic symptoms. RESULTS: Of the 351 patients with psychosis, 59 percent were Euro-Canadian, 11 percent were Afro-Canadian, and 18 percent were Asian Canadian. Most Afro-Canadian patients in the study were immigrants from the Caribbean and Africa. Being Afro-Canadian was independently and positively associated with police or ambulance referral to emergency services. CONCLUSIONS: Afro-Canadians admitted to the hospital with psychosis are overrepresented in police and ambulance referrals to emergency psychiatric services.

Adult↗
PubMed2005

High-resolution brain SPECT imaging and eye movement desensitization and reprocessing in police officers with PTSD.

Eye movement desensitization and reprocessing (EMDR) has been shown to be an effective treatment for posttraumatic stress disorder (PTSD). In this study, the authors evaluated the effectiveness and physiological effects of EMDR in police officers involved with on-duty shootings and who had PTSD. Six police officers involved with on-duty shootings and subsequent delayed-onset PTSD were evaluated with standard measures, the Posttraumatic Stress Diagnostic Scale, and high-resolution brain single photon emission computed tomography (SPECT) imaging before and after treatment. All police officers showed clinical improvement and marked reductions in the Posttraumatic Stress Diagnostic Scale Score (PDS). In addition, there were decreases in the left and right occipital lobe, left parietal lobe, and right precentral frontal lobe as well as significant increased perfusion in the left inferior frontal gyrus. In our study EMDR was an effective treatment for PTSD in this police officer group, showing both clinical and brain imaging changes.

Adult↗
PubMed1992

A mobile crisis program: collaboration between emergency psychiatric services and police.

An emergency psychiatry-mobile crisis program was established in 1987 in Charleston, South Carolina, linking professionals from the mental health center, the university, and the local police department. The program has two goals: to provide emergency psychiatric services to persons in the community and to train psychiatric residents in crisis intervention. Mental health staff act as consultants to the police in some situations, and in others the police provide security. The authors describe the development of the collaboration with police and important features of the program. Three cases illustrate how such collaboration can be of mutual benefit and can save lives.

Adult↗
PubMed2000

The identification and treatment of opiate users in police custody.

All detainees admitted to seven London police stations were observed over a six-month period (n=2,947). Four per cent were identified as opiate users, although the actual percentage is likely to be much higher. Compared to the general population of detainees there were significantly more women among known opiate users and this group also contained a higher percentage of white detainees and people born in the British Isles. People born in continental European countries were also over-represented. A little more than half of known users did not reveal their use on arrival at the police station. At least 60% of known opiate users remained well throughout their detention, 30% were intoxicated through drugs at the time of their arrest, but only 13% displayed signs or symptoms of withdrawal during their detention. Overall, 65% of the known opiate users were seen by a police surgeon and of these 52% were given medication. All of those withdrawing were given drug treatment, but most of those who were intoxicated by opiates, or who remained well throughout their detention, received no medication. Of those given medication 86% received an opiate, dihydrocodeine being the commonest preparation, usually in association with a benzodiazepine. Despite the adoption of differing management paradigms among police surgeons, the actual medical treatment of opiate-using detainees was pragmatic and determined by individual need.

Adult↗
PubMed1994

Hospital and police procedure when a patient absconds from a mental hospital.

Despite several studies of absconding from mental hospitals, what the hospitals and the police do following a patient absconding from a mental hospital has been largely ignored. This article fills that gap. It looks at the procedure followed by three conventional mental hospitals in south-east England and the procedure followed by the three Police Forces in those hospitals' catchment areas. It is based on twelve months of fieldwork, during which period the policy files of all the hospitals were studied and, among other things, interviews were carried out with a cross-section of both the hospitals' staff and police officers. The crucial factors determining the type of action taken by the hospitals or the police were found to be whether the matter was one of grave concern and whether the absconder was a compulsory patient. Certain aspects of the procedure were found to be unsatisfactory and suggestions for improving them are made.

Commitment of Persons with Psychiatric Disorders↗
PubMed1994

Drug misusers in police custody: a prospective survey.

Approximately 11% of individuals seen by forensic medical examiners in police custody in London are drug misusers. This prospective survey using an anonymized structured questionnaire attempted to define some of the characteristics of this selected group of drug misusers. The study was undertaken in Metropolitan Police Service stations (London, UK) within the area covered by Group IV Forensic Medical Examiners. One hundred and fifty consecutive drug misusers in police custody were assessed. Of these individuals 77% used heroin; 30% used both heroin and cocaine regularly; 72% were injecting drugs; 32% were being prescribed drugs (e.g. methadone) by general practitioners or drug agencies. Those individuals prescribed drugs spent a similar amount per day on illicit drugs as those who were not (100.30 pounds versus 106 pounds). Four per cent of individuals were HIV-positive; 25.7% were hepatitis-B positive. Only 9.7% were aware that prophylaxis for hepatitis-B was possible. Seventy-four per cent had served previous prison sentences and of those 82% had used class A controlled drugs whilst serving the sentence. It is concluded that drug misusers seen in police custody tend to be recidivists. It seems that some clear means of identifying and ensuring referral and attendance at an appropriate agency may be the only way to break the cycle of drug misuse, prison and further drug misuse in this highly (self) selected group of patients.

Adolescent↗
PubMed2004

Between normality and deviance: the breakdown of batterers' identity following police intervention.

With the transformation of intimate violence from private trouble to social problem, police intervention in domestic violence cases became more prevalent. Research has focused mainly on battered women's perception of police intervention, their evaluations, and their level of satisfaction with the intervention. However, there is little research examining the perpetrators' subjective perceptions of such interventions. The purpose of this study is to describe and analyze battering men's perceptions of police intervention. The study is based on semistructured, in-depth interviews with 20 batterers who had repeated encounters with police. Findings show a continuum of self-management, ranging from attempts to preserve a normative identity in the first encounter to struggling against criminalization in the second encounter and adopting a victim identity in the third encounter. The findings are discussed in the context of gender identity and power relations.

Adult↗
PubMed2006

Evaluation of a police and social services domestic violence program: empirical evidence needed to inform public health policies.

The Family Violence Response Team (FVRT) responded to police calls for domestic violence and provided services to victims. Police records were followed for (a) 327 FVRT clients with an index police visit in 1998 and (b) 498 nonconcurrent controls with an index visit in 1997. Except for marriage, no demographic characteristics were associated with batterer recidivism, as measured by police calls. The between-group odds ratio (OR) suggested that FVRT clients experienced a 1.7 (95% Confidence Interval [CI]: 1.2 to 2.5) times greater recidivism rate than controls. Although increased reporting cannot be ruled out, results raise concerns about the effects of domestic violence interventions.

Adult↗
PubMed2004

Post-traumatic stress disorder in UK police officers.

Prevalence rates for post-traumatic stress disorder (PTSD) in police officers may be six or more times the prevalence rates for the community. Once established, is PTSD in police officers more severe than PTSD in civilians? This small study looks at the symptom frequencies in established cases of PTSD in 31 police officers and 72 civilians and compares the two. No significant differences were found, although there was a tendency for higher use of alcohol and to try not to think about the trauma. Police officers had more experiences of reliving the trauma or acting as if the trauma were recurring but, again, not to a significant degree.

Adult↗