Do digital technologies reduce racially biased reporting? Evidence from NYPD administrative data.

Recent work has emphasized the disproportionate bias faced by minorities when interacting with law enforcement. However, research on the topic has been hampered by biased sampling in administrative data, namely that records of police interactions with citizens only reflect information on the civilians that police elect to investigate, and not civilians that police observe but do not investigate. In this work, we address a related bias in administrative police data which has received less empirical attention, namely reporting biases around investigations that have taken place. Further, we investigate whether digital monitoring tools help mitigate this reporting bias. To do so, we examine changes in reports of interactions between law enforcement and citizens in the wake of the New York City Police Department's replacement of analog memo books with mobile smartphones. Results from a staggered difference in differences estimation indicate a significant increase in reports of citizen stops once the new smartphones are deployed. Importantly, we observe that the rise is driven by increased reports of "unproductive" stops, stops involving non-White citizens, and stops occurring in areas characterized by a greater concentration of crime and non-White residents. These results reinforce the recent observation that prior work has likely underestimated the extent of racial bias in policing. Further, they highlight that the implementation of digital monitoring tools can mitigate the issue to some extent.

Characteristics of background check findings in nursing students.

BACKGROUND: Background checks are used in nursing education to assess public risk. To date, no study has described the most common and most serious findings in nursing students. PURPOSE: Our study describes the most common and most serious characteristics of BGC findings in nursing students attending large universities. METHOD: Our retrospective study describes characteristics of aggregated, de-identified background check data from a convenience sample of 16 US nursing programs set in large universities 2014-2019. FINDINGS: Sampled programs collected 45,613 background checks, with 1548 findings (3.4 %). Severity of findings included criminal (62.5 %), non-criminal (4.6 %), felony (0.8 %), and other (11.6 %). Severity data were missing from 20.4 % of records. Finding types included substance use (23.7 %), disorderly conduct (8.7 %), property crimes (2.4 %) and crimes against persons (1 %). Type data was missing from 64.3 % of records. DISCUSSION: Future research should examine whether background check type or severity indicates a nursing student poses a public risk.

Maximal fines and corruption: An experimental study on illegal waste disposal.

Corruption is known to be one of the real life situations which may jeopardize the effectiveness of fines in deterring crime. We present a model of 'crime with corruption' by which both the dilution of crime deterrence due to corruption, as well as the possibility of crime encouraging fines, are formally highlighted. More importantly, by running an experiment on a subject pool of students for the case of illegal waste disposal, we provide experimental evidence on the validity of our theoretical predictions. We find that increasing fine rate may become crime encouraging, or at least ineffective, beyond a context-specific fine threshold. From a policy perspective, we suggest that the optimal design of a crime-deterring sanctioning system must simultaneously account for both corruption practices and anti-corruption policies.

On the advantages of using AI-generated images of filler faces for creating fair lineups.

Recent advances in artificial intelligence (AI) enable the generation of realistic facial images that can be used in police lineups. The use of AI image generation offers pragmatic advantages in that it allows practitioners to generate filler images directly from the description of the culprit using text-to-image generation, avoids the violation of identity rights of natural persons who are not suspects and eliminates the constraints of being bound to a database with a limited set of photographs. However, the risk exists that using AI-generated filler images provokes more biased selection of the suspect if eyewitnesses are able to distinguish AI-generated filler images from the photograph of the suspect's face. Using a model-based analysis, we compared biased suspect selection directly between lineups with AI-generated filler images and lineups with database-derived filler photographs. The results show that the lineups with AI-generated filler images were perfectly fair and, in fact, led to less biased suspect selection than the lineups with database-derived filler photographs used in previous experiments. These results are encouraging with regard to the potential of AI image generation for constructing fair lineups which should inspire more systematic research on the feasibility of adopting AI technology in forensic settings.

Risk factors for dropout from psychological substance use disorder treatment programs in criminal justice settings.

BACKGROUND: Substance use disorders are highly prevalent in people within the criminal justice system. Psychological programs are the most common type of treatment available and have been shown to decrease recidivism, but dropping out of treatment is common. Risk factors associated with treatment dropout remain unclear in this setting, and whether the risk factors differ by treatment form (group-based vs. individual). METHODS: Outcome (treatment dropout) was defined as not finishing the program due to client's own wish, misbehavior, no-shows, or because program leader found client to be unsuitable. Predictors of treatment dropout included a comprehensive set of individual-level clinical, socioeconomic, and crime-related pre-treatment characteristics. Multivariable regression models were used to estimate the associations between predictors and dropout. FINDINGS: The study cohort included 5239 criminal justice clients who participated in a psychological treatment program (group-based or individual). Multivariable logistic regression models showed that female sex (OR=1.64, 95% CI 1.20-2.25), age (0.99, [0.97-1.00]), sentence length (0.98, [0.97-0.98]), higher education (0.54, [0.28-1.00]), number of violent offenses (1.03, [1.01-1.05]), and anxiety disorders (1.32, [1.01-1.72]) were associated with dropout from the individual treatment program. For the group-based program, age (OR=0.98, 95% CI 0.96-1.00), sentence length (OR=0.96, 95% CI 0.94-0.98), stimulant use disorder (OR=1.48, 95%, 1.00-2.19), and self-harm (OR 1.52, 95% CI 1.00-2.34) were associated with dropout. CONCLUSIONS: We identified certain sociodemographic, crime-related, and clinical characteristics that were particularly important in predicting dropout from psychological treatment. Further, we find that there are similarities and differences in predictors of dropout from group-based and individual treatment forms.

Application of artificial intelligence to eyewitness identification.

Artificial intelligence is already all around us, and its usage will only increase. Knowing its capabilities is critical. A facial recognition system (FRS) is a tool for law enforcement during suspect searches and when presenting photos to eyewitnesses for identification. However, there are no comparisons between eyewitness and FRS accuracy using video, so it is unknown whether FRS face matches are more accurate than eyewitness memory when identifying a perpetrator. Ours is the first application of artificial intelligence to an eyewitness experience, using a comparative psychology approach. As a first step to test system accuracy relative to eyewitness accuracy, participants and an open-source FRS (FaceNet) attempted perpetrator identification/match from lineup photos (target-present, target-absent) after exposure to real crime videos with varied clarity and perpetrator race. FRS used video probe images of each perpetrator to achieve similarity ratings for each corresponding lineup member. Using receiver operating characteristic analysis to measure discriminability, FRS performance was superior to eyewitness performance, regardless of video clarity or perpetrator race. Video clarity impacted participant performance, with the unclear videos yielding lower performance than the clear videos. Using confidence-accuracy characteristic analysis to measure reliability (i.e., the likelihood the identified suspect is the actual perpetrator), when the FRS identified faces with the highest similarity values, they were accurate. The results suggest FaceNet, or similarly performing systems, may supplement eyewitness memory for suspect searches and subsequent lineup construction and knowing the system's strengths and weaknesses is critical.

Effectiveness of substance use disorder treatment as an alternative to imprisonment.

INTRODUCTION: Drug courts are criminal justice programs to divert people with substance use disorders from incarceration into treatment. Drug courts have become increasingly popular in the US and other countries. However, their effectiveness in reducing important public health outcomes such as recidivism and substance-related health harms remains ambiguous and contested. We used nationwide register data from Sweden to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism. METHODS: In this prospective cohort study, two quasi-experimental designs were used: difference-in-differences and the within-individual design. In the latter, we compared the risk of outcomes during time on contract treatment to, 1) parole after imprisonment and, 2) probation. RESULTS: The cohort included 11,893 individuals (13% women) who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points (95% CI: -.088, -.055) in substance misuse, 5 percentage points (-.064, -.034) in adverse mental health events, 9 percentage points (-.113, -.076) in adverse somatic health events, and 3 fewer charges (-3.16, -2.85) for crime in difference-in-differences analyses. Within-individual associations suggested that the same individual had longer times-to-event for all outcomes during contract treatment than on parole or on probation. CONCLUSIONS: Contract treatment is an effective intervention from both public health and criminal justice perspective. Our findings suggest that it is a superior alternative to incarceration in its target group. Further, we find that an implementation approach that is less punitive and more inclusive than what is typical in the US can be successful.

Do inconclusive forensic decisions disadvantage the innocent?

OBJECTIVE: Two experiments examined the potential for inconclusive forensic decisions to disadvantage the innocent. HYPOTHESES: Both experiments tested the hypothesis that inconclusive decisions produce more incriminating legal judgments than do clearly exculpatory forensic decisions. Experiment 2 also examined whether this hypothesized effect conformed to a confirmation bias, a communication error, or perceptual accuracy. METHOD: In Experiment 1 (N = 492), a forensic expert testified that physical evidence recovered from a crime scene either matched or did not match a suspect's evidence or produced an inconclusive result. In Experiment 2 (N = 1,002), a forensic expert testified that physical evidence recovered from a crime scene either matched or did not match a suspect's evidence, produced an inconclusive result, or was unsuitable for analysis. A fifth condition omitted the forensic evidence and expert testimony. RESULTS: The inconclusive decision produced less incriminating legal judgments than did the match forensic decision (|d|average = 0.96), more incriminating legal judgments than did the no-match forensic decision (|d|average = 0.62), and equivalent legal judgments to the unsuitable decision (|d|average = 0.12) and to legal judgments made in the absence of forensic evidence (|d|average = 0.07). These results suggest that participants interpreted the inconclusive decision to be forensically neutral, which is consistent with a communication error. CONCLUSION: The findings provide preliminary support for the idea that inconclusive decisions can put the innocent at risk of wrongful conviction by depriving them of a clearly exculpatory forensic decision. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Advancing the Shift-of-Strategy approach: Shifting suspects' strategies in extended interviews.

OBJECTIVE: Interviewers often face the challenge of obtaining information from suspects who are willing to speak but are motivated to conceal incriminating information. The Shift-of-Strategy (SoS) approach is an interviewing technique designed to obtain new information from such suspects. This study provides a robust empirical test of the SoS approach using more complex crime events and longer interviews than previously tested as well as testing a new variation of the approach (SoS-Reinforcement) that included a strategic summary of the suspect's statement. We compared this new variation with a standard version of the approach (SoS-Standard) and an interviewing approach that involved no confrontation of discrepancies in the suspects' statements (Direct). HYPOTHESES: We predicted that the two SoS versions would outperform the Direct condition in terms of participants' disclosure of previously unknown information. We also predicted that SoS-Reinforcement would outperform SoS-Standard. Finally, we expected that participants in the SoS conditions would not assess the interview or the interviewer more poorly than participants in Direct. METHOD: A total of 300 participants completed an online mock crime procedure, and they were subsequently interviewed with one of the three interviewing techniques. Following the interview, participants provided assessments of their experiences being interviewed. RESULTS: Participants in both SoS-Standard (d = 0.49, 95% confidence interval [CI: 0.21, 0.78]) and SoS-Reinforcement (d = 0.59, 95% CI [0.30, 0.87]) disclosed more previously unknown information than participants in the Direct condition, but SoS-Reinforcement did not outperform SoS-Standard (d = 0.08, 95% CI [-0.20, 0.36]). Participants in SoS-Reinforcement assessed their experience more negatively than those in Direct. No such differences were observed in the remaining two-way comparisons. CONCLUSIONS: The study provides support for the effectiveness of eliciting new information through the SoS approach and illuminates possible experiential downsides with being subjected to the SoS-Reinforcement approach. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Analysing Crime Scene Data, Medical Records and Forensic Information to Determine the Causes of Suicides.

OBJECTIVE:  To analyse crime scene data, medical records, and forensic information to unveil insights into the causes and traits of suicides. STUDY DESIGN:  Descriptive study. Place and Duration of the Study: Department of Family Medicine, Kayseri City Hospital, Kayseri, Turkiye, between January 2020 to December 2021. METHODOLOGY:  A suicide investigation team (doctor, social worker, psychologist) was created to study cases and conduct on-site psychological autopsies. Triggered by emergency calls, the team interviewed suicide victims' relatives using semi-structured questionnaires, gathering data on personal details, time, method, and potential motives. Medical records revealed psychiatric history and medication use, while national judicial systems were reviewed for legal records. RESULTS:  A total of 158 fatal suicides were studied. Males accounted for 73.4%, females 26.6%. The leading cause was psychiatric illness (43%), chiefly depression (39%). Suicide peaked in the fall, especially in September, mainly at 23:00-23:59. Home was the common site (58.9%), and hanging was the primary method (44.3%). Prior hospitalisation for suicide attempts was 7.5%. Criminal records were held by 16.4% (26 individuals). CONCLUSION:  The results support the idea that suicides have seasonal patterns and that there are temporal windows of increased risk for suicide. KEY WORDS:  Suicide reasons, Suicide time, Psychological autopsy, Seasonal and temporal patterns.

Examining the effectiveness of the Gateway conditional caution on health and well-being of young adults committing low-level offences: a randomised controlled trial.

BACKGROUND: Young adults who commit low-level offences commonly have a range of health and social needs and are significantly over-represented in the criminal justice system. These young adults may need to attend court and potentially receive penalties including imprisonment. Alternative routes exist, which can help address the underlying causes of offending. Some feel more should be done to help young adults entering the criminal justice system. The Gateway programme was a type of out-of-court disposal developed by Hampshire Constabulary, which aimed to address the complex needs of young adults who commit low-level crimes. This study aimed to evaluate the effectiveness and cost-effectiveness of the Gateway programme, issued as a conditional caution, compared with usual process. METHODS: The Gateway study was a pragmatic, parallel-group, superiority randomised controlled trial that recruited young adults who had committed a low-level offence from four sites covering Hampshire and Isle of Wight. The primary outcome was mental health and well-being measured using the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes were quality of life, alcohol and drug use, and recidivism. Outcomes were measured at 4, 16 and 52 weeks postrandomisation. RESULTS: Due to issues with retention of participants and low data collection rates, recruitment ended early, with 191 eligible participants randomised (Gateway 109; usual process 82). The primary outcome was obtained for 93 (48.7%) participants at 4 weeks, 93 (48.7%) at 16 weeks and 43 (22.5%) at 1 year. The high attrition rates meant that effectiveness could not be assessed as planned. CONCLUSIONS: Gateway is the first trial in a UK police setting to have a health-related primary outcome requiring individual data collection, rather than focusing solely on recidivism. We demonstrated that it is possible to recruit and randomise from the study population, however follow-up rates were low. Further work is needed to identify ways to facilitate engagement between researchers and vulnerable populations to collect data. TRIAL REGISTRATION NUMBER: ISRCTN11888938.

Using risk of crime detection to study change in mechanisms of decision making.

Perceptions of crime detection risk (e.g., risk of arrest) play an integral role in the criminal decision-making process. Yet, the sources of variation in those perceptions are not well understood. Do individuals respond to changes in legal policy or is perception of detection risk shaped like other perceptions-by experience, heuristics, and with biases? We applied a developmental perspective to study self-reported perception of detection risk. We test four hypotheses against data from the Dunedin Longitudinal Study (analytic sample of N = 985 New Zealanders), a study that spans 20 years of development (Ages 18-38, years 1990-2011). We reach four conclusions: (1) people form their perception of detection risk early in the life course; (2) perception of detection risk may be general rather than unique to each crime type; (3) population-level perceptions are stable between adolescence and adulthood; but (4) people update their perceptions when their life circumstances change. The importance of these findings for future theoretical and policy work is considered. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Legal actors' and laypersons' utility judgments of eyewitness lineup procedures and outcomes.

OBJECTIVE: Recent attempts to model the relative performances of eyewitness lineup procedures necessarily include theoretical assumptions about the various costs/benefits, or utilities, of different identification outcomes. We collected data to incorporate empirically derived utilities into such modeling as well as data on various stakeholders' views of lineup procedures as tertiary objectives. HYPOTHESES: This research was exploratory; therefore, we did not have a priori hypotheses. METHOD: We surveyed judges' (n = 70), prosecutors' (n = 28), police officers' (n = 82), and laypersons' (n = 191) opinions about eyewitness identification procedures and the utilities of outcomes of eyewitness identification procedures. We incorporated the utility judgments into models comparing the desirability of various lineup reforms and compared policy preferences between our samples. RESULTS: All samples frequently mentioned estimator and system variables in open-ended evaluations of lineup procedures, but legal samples mentioned system variables more often than did laypersons. Reflector variables (e.g., confidence) were mentioned less often across the board, as was the scientific basis/standardization of identification policy (especially among laypersons). Utility judgments of various identification outcomes indicated that judges adopt values more closely aligned with normative legal ethics (i.e., the Blackstone ratio), whereas other stakeholders (especially laypersons) depart significantly from those standards. Utility models indicated general agreement among samples in lineup procedure preferences, which varied as a function of culprit-presence base rates. CONCLUSION: Although legal stakeholders vary in how they value eyewitness identification outcomes, their values imply relatively consistent policy preferences that sometimes depart from scientific recommendations. Nonetheless, all samples expressed support for using scientific research to inform legal policy regarding eyewitness evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The public health impacts of supervised injection sites in Canada: Moving beyond social acceptability and impacts on crime.

Canada has been a pioneer in adopting a harm reduction approach to address risks associated with drug use for people who inject drugs. Today, Canada is home to 39 supervised injection sites spread throughout the country. The scientific literature demonstrates, unequivocally, that these sites have numerous health benefits for people who inject drugs, namely by decreasing risks of blood-borne diseases, overdose, and mortality. Yet, a lack of clear guidelines on optimal locations for the implementation of such sites and NIMBYISM ("Not In My Back Yard") have been stumbling blocks for planned and operating sites. Various Canadian governments have introduced their own policies to overcome the lack of national public health guidelines on community planning. Namely, policies aim to limit the exposure to sites and drug use for vulnerable populations, such as children. However, there is a veritable lack of research on the public health impacts of supervised injection sites for local communities, who tend to be disadvantaged. The existing literature fails to address the broader and differential impacts of such sites for local vulnerable and disadvantaged populations, including use of active transportation, psychological distress, perceived safety, and social cohesion. Moreover, existing research, largely focusing on assessing pre-implementation social acceptability and post-implementation impacts on crime, faces important methodological limitations. The following commentary reviews the existing literature and makes recommendations for future public health research on the impacts of supervised injection sites.

RéSUMé: Le Canada a été un pionnier dans l'adoption de l'approche de réduction des méfaits liés à la consommation de drogues pour les personnes utilisatrices de drogues par injection. Aujourd'hui, le Canada compte 39 sites d'injection supervisée répartis sur l'ensemble du territoire. La littérature scientifique démontre sans équivoque que ces sites présentent de nombreux avantages pour la santé des personnes utilisatrices de drogues par injection, notamment en réduisant les risques de maladies transmises par le sang, de surdoses et de décès. Toutefois, l'absence de lignes directrices claires sur les emplacements optimaux pour l'implantation de ces sites et le phénomène du « pas dans ma cour ¼ ("Not In My Back Yard") représentent des défis pour les sites existants et futurs. Plusieurs gouvernements canadiens ont introduit des politiques pour pallier l'absence de lignes directrices nationales en matière de santé publique et de planification communautaire. Ces politiques visent à limiter l'exposition aux sites d'injection supervisée et à la consommation de drogues pour les populations vulnérables, comme les enfants. Cependant, il y a un véritable manque de connaissances quant aux impacts en matière de santé publique des sites d'injection supervisée pour les communautés locales, qui ont tendance à être défavorisées. La littérature existante n'aborde pas les impacts élargis et différentiels de ces sites pour les populations vulnérables et défavorisées résidant à proximité, particulièrement sur l'utilisation des transports actifs, la détresse psychologique, la perception de sécurité et la cohésion sociale. En outre, la recherche existante, qui se concentre principalement sur l'évaluation de l'acceptabilité sociale avant l'implantation des sites et sur les impacts sur la criminalité après l'implantation des sites, se heurte à d'importantes limites méthodologiques. Ce commentaire fait état de la littérature existante et formule des recommandations pour de futures recherches sur les impacts en matière de santé publique des sites d'injection supervisée.

Interrupted Time Series Analysis of Bar/Tavern Closing Hours and Violent Crime.

Importance: It is well established that alcohol outlets (ie, places that sell alcohol) attract crime, particularly during late-night hours. Objective: To evaluate the association of Maryland Senate Bill 571 (SB571), which reduced the hours of sale for bars/taverns in 1 Baltimore neighborhood from 6 am to 2 am to 9 am to 10 pm, with violent crime within that neighborhood. Design, Setting, and Participants: This controlled interrupted time series analysis compared the change in violent crime density within an 800-ft buffer around bars/taverns in the treatment neighborhood (ie, subject to SB571) and 2 control areas with a similar mean baseline crime rate, alcohol outlet density, and neighborhood disadvantage score in the City of Baltimore between May 1, 2018, and December 31, 2022. The interrupted time series using Poisson regression with overdispersion adjustment tested whether the violent crime density differed before vs after the policy change in the treatment neighborhood and whether this difference was localized to the treatment neighborhood. Exposure: Statutory reduction of bar/tavern selling hours from 20 to 13 hours per day in the treatment neighborhood. Main Outcomes and Measures: The primary outcome was all violent crime, including homicide, robbery, aggravated and common assault, and forcible rape. Secondary outcomes were homicides and assaults. All violent crime measures summed the monthly incidents within 800 ft of bars/taverns from 8 pm to 4 am. For each outcome, a level change estimated the immediate change (first month after implementation), and a slope change estimated the sustained change after implementation (percent reduction after the first month). These level and slope changes were then compared between the treatment and control neighborhoods. Results: The treatment neighborhood included 26 bars/taverns (mean [SD] population, 524.6 [234.6] residents), and the control neighborhoods included 41 bars/taverns (mean [SD] population per census block, 570.4 [217.4] residents). There was no immediate level change in density of all violent crimes the month after implementation of SB571; however, compared with the control neighborhoods, the slope of all violent crime density decreased by 23% per year in the treatment neighborhood after SB571 implementation (annualized incidence rate ratio, 0.77; 95% CI, 0.60-0.98; P = .04). Similar results were seen for homicides and assaults. Several sensitivity analyses supported the robustness of these results. Conclusions and Relevance: This study's findings suggest that alcohol policies that reduce hours of sale could be associated with a reduction in violent crimes. Given these findings, SB571 may serve as a model for other cities looking to create safer neighborhoods.

Smoking out Australia's growing illicit tobacco market: Current trends and future challenges.

Data from the Australian Taxation Office and Australian Border Force show notable recent increases in illicit tobacco seizures across Australia. The illicit tobacco market results in substantial losses in tax revenue, funds organised crime, and perpetuates tobacco use, threatening to undermine Australia's ability to achieve its national commercial tobacco endgame goal of 5 % or less smoking prevalence by 2030. This commentary discusses recent trends in Australia's illicit tobacco trade, reasons why this is of concern, potential drivers of Australians' illicit tobacco use, and policy measures that could be implemented to mitigate increasing illicit tobacco trade such as implementing a track and trace system, increased investment in the Australian Border Force to enhance detection of illicit tobacco shipments at Australia's borders, and encouraging public tip-offs of illicit tobacco sales.

Towards a social harm approach in drug policy.

In this paper, we explore how the social harm approach can be adapted within drug policy scholarship. Since the mid-2000s, a group of critical criminologists have moved beyond the concept of crime and criminology, towards the study of social harm. This turn proceeds decades of research that highlights the inequities within the criminal legal system, the formation of laws that protect the privileged and punish the disadvantaged, and the systemic challenge of the effectiveness of retribution and punishment at addressing harm in the community. The purpose of this paper is to first identify parallels between the social harm approach and critical drug scholarship, and second to advocate for the adoption of a social harm lens in drug policy scholarship. In the paper, we draw out the similarities between social harm and drug policy literatures, as well as outline what the study of social harm can bring to an analysis of drug policy. This includes a discussion on the ontology of drug crime, the myth of drug crime and the ineffective use of the crime control system in response to drug use. The paper then discusses how these conversations in critical criminology and critical drugs scholarship can be brought together to inform future drug policy research. This reflection details the link between social harm and the impingement of human flourishing, explores the role of decolonizing drug policy, advocates for the centralization of lived experience within the research process and outlines how this might align with harm reduction approaches. We conclude by arguing that the social harm approach challenges the idea that neutrality is the goal in drug policy and explicitly seeks to expand new avenues in activist research and social justice approaches to policymaking.

Drugs, guns, and violent crime in California.

BACKGROUND: There is evidence linking use of controlled substances with perpetration of interpersonal violence. While the United States constitution protects the right to own a firearm, federal law prohibits firearm purchase and possession by persons believed to be at high risk for violence, including those who use controlled substances unlawfully. METHODS: We report here the results of a 13-year prospective observational study on the risk of violent crime associated with a history of criminal drug charges in a cohort of 79,678 legal purchasers of handguns in California in 2001. The main outcomes were post-purchase charges for any violent crime, violent Crime Index crimes (murder, rape, robbery, aggravated assault), and firearm-related violent crimes. The main exposure of interest was a history of pre-purchase charge(s) for drug-related offenses; we examined as a secondary exposure a history of marijuana-related charges. We estimated adjusted hazard ratios (aHR) with 95 % confidence intervals (CI) using Cox proportional hazards multiple events models. RESULTS: We found that legal handgun purchasers in California with a history of drug-related charges, even those with marijuana charges only, had triple the risk of a post-purchase violent crime charge compared to purchasers with no criminal charges (drug charges only: aHR=2.9, 95 % CI 2.2-3.8; marijuana charges only: aHR=3.3, 95 % CI 1.8-6.0). In addition, a criminal history of drug charges only vs. no criminal history was associated with increased risk of one or more violent crime charges after the first post-purchase arrest event (aHR=1.6, 95 % CI 1.2-2.3). CONCLUSION: It is incumbent on researchers and policy makers to understand the nature and causes of this risk in order to take effective steps towards mitigation.

The Hamas massacre of Oct 7, 2023, and its aftermath, medical crimes, and the Lancet commission report on medicine, Nazism, and the Holocaust.

BACKGROUND: The report of the Lancet Commission on medicine, Nazism, and the Holocaust, released in November 2023, calls for this history to be required for all health professions education, to foster morally courageous health professionals who speak up when necessary. MAIN BODY: The report was released a month after Hamas' October 7 invasion of Israel, with the accompanying massacre of over 1200 people, taking of civilian hostages, and gender-based violence. These acts constitute crimes against humanity including genocide. Post-October 7, war in Gaza resulted, with a legitimate objective of Israel defending itself within international law. The authors discuss an accompanying Statement to the report condemning Hamas crimes and denouncing the perpetrators' use of their own civilians as human shields, including in healthcare facilities, and with the Hamas attack unleashing immense and ongoing suffering in Israel and beyond. With some exceptions, the medical literature shows a marked absence of condemnation of Hamas atrocities and includes unsubstantiated criticisms of Israel's military. A significant surge in global antisemitism including on university campuses since October 7, 2023, has occurred; and health professionals, according to the Commission, have a special responsibility to fight antisemitism and discrimination of all kinds. In this context, the authors discuss the controversy and criticism regarding diversity, equity, and inclusion education programs ("DEI") including such programs failing to protect Jews on campuses, especially as the U.S. President Biden's "The U.S. National Strategy to Counter Antisemitism," released in May 2023, calls for the inclusion of issues of antisemitism and religious discrimination within all DEI education programs. The authors support an evidence-based approach to the Hamas massacre, its aftermath and its relevance to health professionals both within medicine and their global citizenship, including refuting the international community accusations and anti-Israel libel. CONCLUSIONS: The report of the Lancet Commission on medicine, Nazism, and the Holocaust has striking relevance to the Hamas massacre of October 7, 2023 and its aftermath. This is further conveyed in an accompanying Statement, that describes the report's implications for contemporary medicine, including: 1) provision of skills required to detect and prevent crimes against humanity and genocide; (2) care for victims of atrocities; (3) upholding the healing ethos central to the practice of medicine; and (4) fostering history-informed morally courageous health professionals who speak up when necessary.