Few studies examine the comparative effectiveness of different formal interventions for domestic violence. Using arrest and civil protection order data, we compare three intervention scenarios (arrest, civil protection order, and both). Results suggest that intervention type has no substantive influence on the odds of reoffending. However, subsequent domestic violence is significantly associated with offender age, sex, and prior offense history as well as victim age and sex. We discuss our findings and their policy implications, noting that responding agencies should be sensitive to the characteristics that increase the odds of reoffending among those they come into contact with.

Procedural sedation and analgesia (PSA) is a key element for patient‐centered care in emergency medicine. In this manuscript, we review the available evidence for PSA in the emergency department, including guidelines for evaluation, monitoring, pharmacology, adverse events, and special populations such as pediatric and elderly patients.

The multidisciplinary, interprofessional practice of fatality review is quickly becoming more methodologically sophisticated. However, the discussion of ethical issues related to fatality review has been limited to the topics of confidentiality and the ethical guidelines of participant professions. We propose that the work of fatality review teams is similar to the research practice of evaluation. Using the Guiding Principles of Evaluation recommended by the American Evaluation Association (AEA), this paper begins an exploration of potential ethical conundrums faced by domestic violence fatality review teams and identifies suggestions for ensuring that the teams have the necessary tools for ethical practice.

IntroductionForeign body airway obstruction (FBAO) is a major public health issue worldwide. In 2017, there were more than 5000 fatal choking cases in the USA alone, and it was the fourth leading cause of preventable injury-related death in the home and community. In Japan, FBAO is the leading cause of accidental death and with almost 9000 fatalities annually. However, research on FBAO is limited, particularly on the impact of a foreign body (FB) removal manoeuvres by bystanders. The primary objective of this study is to determine the impact of bystander FB removal manoeuvres on 1 month neurological outcome. Our secondary objectives include (1) evaluating the efficacy of a variety of FB removal manoeuvres; (2) identifying risk factors for unsuccessful removal and (3) evaluating the impact of time intervals from incidents of FBAO to FB removal on neurological outcome.Methods and analysisWe will conduct a nationwide multi-centre prospective cohort study of patients with FBAO who present to approximately 100 emergency departments in both urban and rural areas in Japan. Research personnel at each participating site will collect variables including patient demographics, type of FB and prehospital variables, such as bystander FB removal manoeuvres, medical interventions by prehospital personnel, advanced airway management and diagnostic findings. Our primary outcome is 1 month favourable neurological outcome defined as cerebral performance category 1 or 2. Our secondary outcomes include success of FB removal manoeuvres and complications from the manoeuvres. We hypothesise that bystander FB removal manoeuvres improve patient survival with a favourable neurological outcome.Ethics and disseminationThis study received research ethics approval from Nippon Medical School Hospital (B-2019-019). Research ethics approval will be obtained from all participating sites before entering patients into the registry. The study was registered at the University Hospital Medical Information Network (UMIN) Clinical Trials Registry.Trial registration numberUMIN 000039907.

Background: Health professionals need to be both person- and community oriented to improve population health. For educators to create socially accountable physicians, they must move learners from understanding social accountability as an expectation to embracing and incorporating it as an aspect of professional identity that informs medical practice.Aim: The aim of this article was to assess the degree to which medical students, preceptors and community mentors understand the concept of social accountability.Setting: The setting is the KwaZulu-Natal Province in Durban, South Africa.Methods: Using an observational design, we surveyed 332 participants, including the first- and sixth-year medical students, physician preceptors and community mentors.Results: Whilst most respondents understood social accountability as requiring an action or set of actions, it was defined by some as simply the awareness one must have about the needs of their patients, community or society at large. Some respondents defined social accountability as multi-dimensional, but these definitions were the exception, not the rule. Finally, most respondents did not identify to whom the accountable party should answer.Conclusion: Whilst the development of professional identity is seen as a process of ‘becoming’, the ability to define and understand what it means to be socially accountable is not a linear process. Assessment of this progress may start with comprehending how social accountability is understood by students when they begin their education and when they are graduating, as well as in knowing how their educators, both clinical and community, define it.