Facilitators and barriers to Children's Advocacy Center-based multidisciplinary teamwork.

BACKGROUND: Children's Advocacy Centers (CACs) use a multidisciplinary team (MDT) approach to initiate, coordinate, and provide essential multisector services for children and families who experience child abuse. Despite rapid dissemination of the CAC model across the world, little is known about characteristics associated with CAC-based teamwork. OBJECTIVE: Given that teamwork characteristics may impact the outcomes of child and families who interact with CACs, the purpose of this qualitative study was to explore experiences, facilitators, and barriers to CAC-based multidisciplinary teamwork. PARTICIPANTS, SETTING, & METHODS: We conducted semi-structured interviews with members of a MDT at a Midwestern CAC. RESULTS: Findings suggest that MDT teamwork was fostered by clear communication, responsiveness, commitment, openness, and appropriate resources whereas MDT teamwork was hindered by role confusion, conflicting perspectives, poor communication, low staffing, complex politics, and structural barriers. CONCLUSIONS: Characteristics of CAC-based teamwork may vary from the teamwork of other types of child protection teams. Interventions that enhance CAC-based teamwork may optimize the function of CAC MDTs and improve outcomes for children and families who engage with CACs.

Homicide-Suicide in Cuyahoga County, Ohio, 1991-2016.

Research on homicides followed by suicides has relied heavily on small samples and relatively short time spans of data. This study helps to fill this gap by examining 26 years of homicide-suicide data from Cuyahoga County, Ohio, between 1991 and 2016. The main data source for the study is medical examiner files. Analyses of the data indicate the rate of homicide-suicide in Cuyahoga County is consistent with other studies but fluctuates considerably across years studied. The majority of victims are female while perpetrators are overwhelmingly male. Black people are overrepresented as victims and offenders. Use of drugs and/or alcohol leading up to the incident is common among perpetrators. Both the homicides and suicides were overwhelming committed with firearms. When comparing our results to the typology of murder-suicides developed by Marzuk, Tardiff, and Hirsch (JAMA 1992;267:3179), we find amorous jealousy is a significant motivating factor in a many cases, including those involving nonintimate partners. Our findings underscore the importance of widespread use of lethality assessment instruments.

Comparing Homicide-Suicides in the United States and Sweden.

Research on homicides followed by suicides has largely relied on very localized samples and relatively short time spans of data. As a result, little is known about the extent to which patterns within cases of homicide-suicides are geographically specific. The current study seeks to help fill this gap by comparing twenty years of homicide-suicide data for Sweden and a large U.S. county. Although some of the underlying patterns in the two countries are similar (e.g., decreasing rates), a number of important differences emerge, particularly with respect to incidence, weapons used, perpetrator age, and relationship of the perpetrator to the victim.

Crowding in context: an examination of the differential responses of men and women to high-density living environments.

This study examines the question of gender-equivalent outcomes of mental health and social behavior in the context of crowding stress. It tests the hypothesis that gender will influence the exhibition of stress outcomes resulting from exposure to high-density living environments, with women displaying internalized responses and men responding with externalized styles. Expanding on the types of gender-appropriate disorders examined in this area of research, I selected depression, aggression, and withdrawal as gender-specific disorders based on theory and prior research. Multilevel analyses of data from a survey of Toronto residents indicate that, while the effects of household density are conditioned by gender, support for the existence of gender-equivalent outcomes is mixed. While women living in crowded homes are more likely to be depressed, men exposed to high-density living environments do not report increased aggression. However, men report higher levels of withdrawal, and some males respond with both aggression and withdrawal.