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A growing body of research has found there to be disproportionate physical restraint and chemical sedation use for historically marginalized populations in the emergency department (ED). This association has been examined with regard to patient race, ethnicity, sex, and age. Preliminary research has highlighted the ways in which unhoused status may also relate to the use of physical restraint and chemical sedation in the ED. Given the adverse health outcomes associated with these methods in the ED, further research is needed to explore the relationship between patient housing status and physical restraint/chemical sedation use in more depth. We conducted a cross-sectional study of all ED visits among patients aged 18 years of age and older presenting to eight hospitals within a regional healthcare network in New England between January 1, 2013, and December 31, 2021. Descriptive statistics and mixed effects logistic regression models nesting by patient were used to characterize the relationship between housing status and likelihood of restraint and/or sedation use. Restraint orders were found in 3,160 (5.7%) visits by unhoused patients, compared to 44,155 (1.5%) for housed patients. Unhoused status was significantly associated with restraint/sedation use (adjusted odds ratio =  1.45, 95% CI 1.36-1.54). Our study identified a significant association between housing status and ED restraint and sedation use after adjusting for demographic factors and chief complaints. This finding has important implications pertaining to the care of unhoused patients in the ED and for examination of structural factors like housing status and their impact on psychiatric emergency care.

Background Hospitalized older adults, especially those with Alzheimer’s Disease and Related Dementias (PwD), are at high risk for delirium and distressing behaviors. Using physical restraints leads to functional decline and increased mortality. Our project aims to reduce restraint use by implementing a 4Ms approach for enhanced delirium management. Methods Our interdisciplinary team used the Plan‐Do‐Study‐Act methodology over a 7‐month period (including 8 weeks of training) to introduce the 4Ms (Mentation, Mobility, Medication, what Matters) model in our 25‐bed Acute Care for Elders (ACE) unit. Nurses were trained in the Confusion Assessment Method (CAM) for delirium assessment, CAM‐S for delirium severity, and Six‐item Cognitive Impairment Test (6CIT) for cognitive impairment. Staff conducted the 6CIT per admission and CAM/CAM‐S per shift for patients aged ≥65, with electronic score documentation. Physical therapy assessed mobility within 24 hours of admission and during medical rounds. Medication reviews, led by the medical team and a geriatric pharmacist, occurred for new admissions. What Matters considerations were addressed through comprehensive geriatric assessments. Chart review collected data. An electronic record quantified physical restraint orders for six months pre‐ and post‐intervention, by patient days and distinct patients per month. Results In the 19 weeks following data collection initiation, ACE unit patients (n = 362) averaged 81 years old, 60% female, 83% white, 14% Black, 18% were PwD, and 24% had significant cognitive impairment (6CIT score). Twenty‐two percent experienced incident delirium during a mean 6‐day stay. Documentation improved: CAM (68% to 86%), CAM‐S (0% to 79%), 6CIT (0% to 89%). A 4Ms checklist achieved a 96% completion rate with 37.5% receiving a geriatric assessment, 25% were discharged with an ADL disability, and 12.5% had medication deprescribed. Restraint use decreased from 7.7 patient days per month to 2.2, distinct patients with restraints decreased from 2.7 to 1.7. Conclusions In a high‐risk older adult population, a low‐resource quality improvement intervention effectively implemented the 4Ms model of care, showing a positive trend in reducing restraint use.

It is estimated that the proceeds of crime, corruption and tax evasion represent between $1 trillion and $1.6 trillion per year, with half coming from developing countries. Proceeds are typically transferred abroad and hidden in foreign jurisdictions, thus requiring international cooperation. Various international conventions and agreements require international cooperation on this issue, in particular the United Nations Convention against Corruption; however, only $5 billion in stolen assets have been repatriated over the last 15 years. This enormous gap reveals that significant barriers continue to impede asset recovery despite the commitments taken by governments, civil society and the private sector. Drawing on the experience of practitioners with hands-on experience, the Stolen Asset Recovery (StAR) Initiative launched this study to identify the barriers to stolen asset recovery internationally, provide brief analysis of the impact of these barriers, and propose recommendations for overcoming these obstacles. This volume is intended to guide policy makers in their efforts to ensure necessary resources and the development of a plan, policy or strategy aimed at eradicating the barriers to asset recovery. In addition, this study proposes actions to be taken by the G20, international organizations, financial institutions, developmental agencies and civil society.

PurposeDomestic violence (DV) is a problem of global significance and remains a gendered issue that disproportionately affects women and children. Prevalence studies on women’s experiences of DV suggest that around 50% of victims identify as mothers. The effects of DV on mothers and children are well documented, raising implications for their protection. Civil protection orders are a legal tool used to reduce and prevent experiences of DV. Research on protection order effectiveness is mixed with research suggesting that the ongoing relationship between a respondent and aggrieved parent around child contact presents ongoing opportunities for re-victimization. This study contributes to the scant literature on the implications of protection orders on parental responsibilities.MethodThe study draws on surveys with duty lawyers and focus groups with police officers. A thematic analysis was used to examine perceptions and experiences of ‘no contact’ protection orders and respondent parent non-compliance where mutual children are involved.ResultsFindings suggest that ambiguous ‘no contact’ conditions and a lack of clarity around their implications for child contact play a key role in respondent parent non-compliance, ranging from uninformed non-compliance to the strategic use of children as a form of coercive control in non-compliance.ConclusionFindings raise implications for specialist legal advice and support for parents affected by DV to sit alongside protection order court proceedings. Findings highlight the need for greater system accountability to ensure court-issued protection orders take a family-centred approach that align with parental responsibilities and ensure child and adult victims’ safety and wellbeing.

The use of physical restraint exposes patients and staff to negative effects, including death. Therefore, teaching nursing staff to develop the improve knowledge, skills, and attitudes regarding physical restraint has become necessary. A quasi-experimental pre-post design was used to evaluate the effect of educational intervention on nurses' knowledge, attitude, intention, practice and incidence rate of physical restraint in 12 wards of a hospital using a self-reported questionnaire and a restraint order form in Malaysia. The educational intervention, which included a one-day session on minimising physical restraint use in hospital, was presented to 245 nurses. The results showed a significant increase in the mean knowledge, attitude sand practice score and a significant decrease in the mean intention score of nurses to use physical restraint after intervention. There was a statistically significant decrease in the incidence rate of physical restraint use in the wards of the hospital except geriatric-rehabilitation wards after intervention. •The knowledge, attitudes and intentions of nurses towards physical restraint use are essential factors that may contribute to this practice.•The best approach to improve knowledge and attitudes towards the use of physical restraint is through educational interventions.•Educational intervention could improve nurses' knowledge, attitude, and practice and reduce their intention to use physical restraint.•Reduction in physical restraint use indicates the effectiveness of the educational intervention.

Purpose Intimate partner abuse and violence has a high incidence rate in the United States. However, it remains underreported to formal agencies, including the police. With a focus on women who had contacted the police at least once, this study explored the complexity of intimate partner abuse and violence experienced between women who contacted the police each time they needed them and those who did not. The study also compared women who used force against abusers and women who did not in terms of their victimization and police utilization. Methods This research is part of a longitudinal study of 172 women’s experiences within the U.S. civil protection order system. In-person, structured quantitative interviews were conducted at a safe and convenient location for the participants and focused on participants’ experiences of intimate partner abuse and violence as well as their experiences within the civil and criminal legal systems. Results Most participants contacted the police at least once for violence against them. However, over half of participants also had at least one time when they said they needed police intervention but did not contact the police. Women who contacted the police each time they needed them reported less frequent sexual assault and more injuries than women who had not. Also, women who used force against their abusers indicated more frequent physical victimization, sexual victimization, and higher rates of injuries, compared to women who had not. Furthermore, women who used force reported significantly less perceived fairness when they interacted with the police. No group differences were found for age, race, income, and length of relationships. Conclusion This paper contributes to the literature about police utilization among women experiencing intimate partner abuse and violence. The findings suggest that women’s experiences of victimization and use of force play a role in their decision-making about calling the police, which in turn indicates that the legal system to some extent does not meet these women’s needs. It highlights the importance of empowerment during women’s help-seeking process and the complexity of survivor decision-making.

Civil protection orders are individualized orders that survivors of intimate partner abuse and violence can pursue in addition to or independently of criminal charges. The efficacy of protection orders is defined in various ways in existing literature. One way to understand the effectiveness of these orders is to determine the extent to which they are violated, the willingness of survivors to report violations, and the legal system’s (i.e., police, criminal court, and civil court) responses to survivors’ reports. Research exists on the extent to which protection orders are violated, the extent to which violations are reported, and factors affecting enforcement of the orders. However, research has yet to examine the perceptions and behaviors of survivors who do not report order violations. Drawing on in-depth qualitative interviews with women who sought civil protection orders against abusive male partners, this research uses a legal consciousness framework to examine survivors’ perceptions of order violations, their decision-making processes regarding whether to report violations, and barriers to reporting the violations. The interviews reveal that not all survivors perceive contact as an order violation and, for those who do, not all survivors report the violations. Specifically, obstacles to reporting were related to survivors’ perceptions of the violations and accessibility to and usefulness of the legal system. Policy implications for both the civil and criminal justice systems to create more victim-centered and trauma-informed responses to survivors who experience protection order violations are discussed.

Risk-based firearm laws are a firearm injury prevention strategy. However, evidence for their efficacy in reducing firearm injury is mixed. There is agreement that the magnitude of their effect depends on implementation and efficacy would improve with better implementation. Local context and processes are key to evaluating outcomes of these laws. To contribute to the evidence base we conducted a case study of Firearm Restraining Order (FRO) implementation in Lake County, Illinois. The details of Illinois FRO policy are, similar those of other locations with notable exceptions that in Illinois roommates are allowed to petition and medical care providers are not. The study examined data from court documents related to 42 FRO petitions filed between January 2021 and June 2024. Lake County is similar to other locations studied in terms of respondent demographics including age, race and gender. It differs in the distribution of types of incidents precipitating FROs. Lake County has a greater share of emergency FROs petitioned due to threats related to harm to others, while other locations studied typically have a higher burden of self-harm threat incidents triggering FRO initiation. The share of initiating incidents related to mass shooting threats is similar to that of other locations studied. In Lake County, IL most petitioners are law enforcement officers with few petitions made by others enabled by the law. This too is similar to that of other jurisdictions. Our study finds that in Lake County the EFRO petition process generally proceeds within established policy timelines and the majority of FRO cases resulted the issuance of plenary FROs. Two implementation areas identified for further investigation include the low level of intimate partner notification when an emergency FRO is petitioned and the volume of emergency FRO dismissals due to lack of petitioner appearance at plenary FRO hearings.

A good example of such balancing is the \"serious questions\" test used in the Second Circuit and some other circuits.18 That approach rightly centers irreparable injury as the single most important consideration for the preliminary injunction.19 The normative analysis presented in this Article coheres with equitable doctrines. In the absence of statutory modification, the federal courts' power to grant equitable remedies is tied to traditional equity practice.20 As the Supreme Court recently said, \"When Congress empowers courts to grant equitable relief, there is a strong presumption that courts will exercise that authority in a manner consistent with traditional principles of equity. In these cases, there may be references to the preliminary injunction in the procedural history, the court may deny the preliminary injunction for lack of standing, the preliminary injunction may be moot because of other procedural actions (e.g., dismissal of the complaint), the plaintiff may seek to stay a preliminary injunction, or the court may refer to a preliminary injunction in the course of evaluating a motion for a temporary restraining order. (Outside of the Fifth and Sixth Circuits, state and local government defendants strongly predominated.) The dramatic differences in Table 4 lie behind the intense forum shopping by plaintiffs who chose district courts in the Fifth Circuit

Victims of stalking use multiple help-seeking behaviors including reporting their experiences to the police, obtaining a restraining order, blocking communication, and relying on informal social networks like friends, family, or therapists. The goal of this study is to, first, identify distinct subgroups of stalking victims based on their help-seeking behaviors. Next, we identify the direct effect of sex, victim-offender relationship, and offense severity on class membership. Finally, we include negative emotions as a mediating effect. Using the 2016 National Crime Victimization Survey’s Supplemental Victimization Survey data, latent class analysis was utilized to identify class membership among 1,459 stalking victims. The results indicate three groups: passive help-seekers, informal help-seekers, and active help-seekers. We found that females are more likely to be assigned to the active or informal group and these two groups appear to experience more severe stalking behaviors compared to the passive group. Specifically, victims were less likely to ask for help actively and ask family, friends, and non-professional people for help for whom stalking took place by other/unable to identify individuals. Victims whose stalkers had a criminal record, whose stalkers threatened themselves or others, as well as who suffered stalking lasting for months and the most often were more likely to ask for help actively and ask family, friends, and non-professional people for help. The significance of victims’ perceptions of severity of both groups is only partially mediated by negative emotions.