Post-January 6th deplatforming reduced the reach of misinformation on Twitter.

The social media platforms of the twenty-first century have an enormous role in regulating speech in the USA and worldwide1. However, there has been little research on platform-wide interventions on speech2,3. Here we evaluate the effect of the decision by Twitter to suddenly deplatform 70,000 misinformation traffickers in response to the violence at the US Capitol on 6 January 2021 (a series of events commonly known as and referred to here as 'January 6th'). Using a panel of more than 500,000 active Twitter users4,5 and natural experimental designs6,7, we evaluate the effects of this intervention on the circulation of misinformation on Twitter. We show that the intervention reduced circulation of misinformation by the deplatformed users as well as by those who followed the deplatformed users, though we cannot identify the magnitude of the causal estimates owing to the co-occurrence of the deplatforming intervention with the events surrounding January 6th. We also find that many of the misinformation traffickers who were not deplatformed left Twitter following the intervention. The results inform the historical record surrounding the insurrection, a momentous event in US history, and indicate the capacity of social media platforms to control the circulation of misinformation, and more generally to regulate public discourse.

Drogue, violence et résilience : consommateurs de drogue en cure et anciens délinquants violents à Dakar.

In Senegal, violent delinquency and illicit drug use are on the increase. This study focuses on two distinct groups: drug users (DUs) undergoing rehabilitation and violent ex-offenders (VEs). The methodology adopted includes a quantitative survey of the general population (n=1009), followed by a qualitative survey of fifteen participants, including eight DUs undergoing treatment at the Centre de prise en charge intégrée des addictions de Dakar (CEPIAD) (Integrated Addictions Management Center of Dakar) and the Centre Jacques Chirac de Thiaroye, and seven former VEs from the Grand Yoff district. This neighborhood, known for its violence, is juxtaposed with the Grand Yoff social housing estate, a residential area also affected by outbreaks of violence. This study aims to establish the link(s) between drug use and criminal violence by analyzing the life stories of young adults who have managed to leave drug use and delinquency behind. It then looks to identify the determinants of resilience in certain young people. The study revealed delinquent violence among young people does not systematically result from drug use. Rather, drug use is a factor conducive to violence. The links between drugs and violence depend on individual predisposition, the type of drugs used, and the level of addiction. Resilience results from a web of individual, sociocultural, and environmental factors. It is not static, but rather the result of a series of successes, failures, and even relapses.

Extreme Risk Protection Orders in Connecticut, 2013-2020.

Twenty-one states and the District of Columbia have enacted Extreme Risk Protection Order (ERPO) statutes, which allow temporary removal of firearms from individuals who pose an imminent risk of harm to themselves or others. Connecticut was the first state to enact such a law in 1999. The law's implementation and use between 1999 and 2013 were previously described, finding that ERPOs were pursued rarely for the first decade and that most orders were issued in response to concerns about suicide or self-harm rather than about interpersonal violence. The current study analyzes over 1,400 ERPOs in Connecticut between 2013 and 2020 in several domains: respondent demographics, circumstances leading to ERPO filing, type of threat (suicide, violence to others, or both), number and type of firearms removed, prevalence of mental illness and drug and alcohol use, and legal outcomes. Results are similar to the earlier study, indicating that ERPO respondents in Connecticut are primarily White, male, middle-aged residents of small towns and suburbs who pose a risk of harm to themselves (67.9%) more often than to others (42.8%). Significant gender differences between ERPO respondents are discussed, as are state-specific trends over time and differences between Connecticut and other states with published ERPO data.

Game-theoretic agent-based modelling of micro-level conflict: Evidence from the ISIS-Kurdish war.

This article delves into the dynamics of a dyadic political violence case study in Rojava, Northern Syria, focusing on the conflict between Kurdish rebels and ISIS from January 1, 2017, to December 31, 2019. We employ agent-based modelling and a formalisation of the conflict as an Iterated Prisoner's Dilemma game. The study provides a nuanced understanding of conflict dynamics in a highly volatile region, focusing on microdynamics of an intense dyadic strategic interaction between two near-equally- powered actors. The choice of using a model based on the Iterated Prisoner's Dilemma, though a classical approach, offers substantial insights due to its ability to model dyadic, equally-matched strategic interactions in conflict scenarios effectively. The investigation primarily reveals that shifts in territorial control are more critical than geographical or temporal factors in determining the conflict's course. Further, the study observes that the conflict is characterised by periods of predominantly one-sided violence. This pattern underscores that the distribution of attacks, and target choices are a more telling indicator of the conflict nature than specific behavioural patterns of the actors involved. Such a conclusion aligns with the strategic implications of the underlying model, which emphasises the outcome of interactions based on differing aggression levels. This research not only sheds light on the conflict in Rojava but also reaffirms the relevance of this type of game-theoretical approach in contemporary conflict analysis.

Extremists of a feather flock together? Community structures, transitivity, and patterns of homophily in the US Islamist co-offending network.

Prior research suggests that members of terrorist groups prioritize forming network ties based on trust to improve their organizational and operational security. The homophily principle, which postulates that individuals tend to form relationships based on shared characteristics, can be a key mechanism through which people identify trustworthy associates. Next to homophily, the mechanism of establishing interconnected relationships through transitivity is also well-known to serve this purpose and shape community structures in social networks. We analyze the community structures of the Islamist co-offending network in the United States, which is highly violent, to assess whether homophily and transitivity determine which extremists form co-offending ties. We rely on a new database on the individual attributes and the co-offending relationships of 494 Islamist offenders radicalized in the United States between 1993 and 2020. Using community detection algorithms, we show that the US Islamist co-offending network is highly clustered, modular, and includes many small but only a few large communities. Furthermore, results from exponential random graph modeling show that transitive relationships as well as spatial proximity, ideological affiliation, and shared socio-cultural characteristics drive co-offending among US Islamist extremists. Overall, these findings demonstrate that the processes of homophily and transitivity shape violent social networks.

Violence outcomes in later adolescence with the Good School Toolkit-Primary: a nonrandomized controlled trial in Uganda.

BACKGROUND: We sought to determine whether the Good School Toolkit-Primary violence prevention intervention was associated with reduced victimisation and perpetration of peer and intimate partner violence four years later, and if any associations were moderated by sex and early adolescent: family connectedness, socio-economic status, and experience of violence outside of school. METHODS: Drawing on schools involved in a randomised controlled trial of the intervention, we used a quasi-experimental design to compare violence outcomes between those who received the intervention during our trial (n = 1388), and those who did not receive the intervention during or after the trial (n = 522). Data were collected in 2014 (mean age 13.4, SD 1.5 years) from participants in 42 schools in Luwero District, Uganda, and 2018/19 from the same participants both in and out of school (mean age 18, SD: 1.77 years). We compared children who received the Good School Toolkit-Primary, a whole school violence prevention intervention, during a randomised controlled trial, to those who did not receive the intervention during or after the trial. Outcomes were measured using items adapted from the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional. We used mixed-effect multivariable logistic regression, with school fitted as a random-effect to account for clustering. RESULTS: 1910 adolescents aged about 16-19 years old were included in our analysis. We found no evidence of an average long-term intervention effect on our primary outcome, peer violence victimization at follow-up (aOR = 0.81, 95%CI = 0.59-1.11); or for any secondary outcome. However, exposure to the intervention was associated with: later reductions in peer violence, for adolescents with high family connectedness (aOR = 0.70, 95% CI 0.49 to 0.99), but not for those with low family connectedness (aOR = 1.07, 95% CI 0.69 to 1.6; p-interaction = 0.06); and reduced later intimate partner violence perpetration among males with high socio-economic status (aOR = 0.32, 95%CI 0.11 to 0.90), but not low socio-economic status (aOR = 1.01 95%CI 0.37 to 2.76, p-interaction = 0.05). CONCLUSIONS: Young adolescents in connected families and with higher socio-economic status may be better equipped to transfer violence prevention skills from primary school to new relationships as they get older. TRIAL REGISTRATION: Clinicaltrials.gov, NCT01678846, registration date 24 August 2012. Protocol for this paper:  https://www.researchprotocols.org/2020/12/e20940 .

Adverse Childhood Experiences and Associations with Mental Health, Substance Use, and Violence Perpetration among Young Adults in sub-Saharan Africa.

Background: Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA). Objective: To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA. Participants and setting: Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years. Methods: Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated. Result: ACEs prevalence ranged from 7.8% (emotional violence) to 55.0% (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes. Conclusion: ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.

Violencia y maltrato infantil. El aporte del médico radiólogo al abordaje integral multidisciplinario / Child maltreatment and violence. Contributions from radiologists to a comprehensive multidisciplinary approach

El maltrato infantil es definido por la Organización Mundial de la Salud (OMS) como "el abuso y la desatención que sufren los niños menores de 18 años. Incluye todo tipo de maltrato físico y/o emocional […] que resulte en un daño real o potencial para la salud, la supervivencia, el desarrollo o la dignidad del niño". Al examinar los rastros corporales del maltrato físico, siguiendo los mecanismos de lesión más frecuentemente implicados, es posible detectar patrones radiológicos típicos. La evaluación imagenológica del hueso en reparación permite inferir cronologías para correlacionar con los datos obtenidos en la anamnesis. Los profesionales de la salud deben detectar oportunamente lesiones radiológicas sospechosas y activar de forma temprana el resguardo del menor. Nuestro propósito es realizar una revisión sobre las publicaciones recientes referidas al estudio imagenológico en niños de quienes se sospeche que puedan ser víctimas de violencia física.

The World Health Organization (WHO) defines child maltreatment as "the abuse and neglect that occurs to children under 18 years of age. It includes all types of physical and/or emotional ill-treatment [...], which results in actual or potential harm to the child's health, survival, development or dignity." By examining the bodily traces of physical abuse, following the most frequently involved mechanisms of injury, it is possible to identify typical radiological patterns. The imaging studies of the bone under repair allows inferring a timeline that may be correlated to the data obtained during history taking. Health care providers should detect suspicious radiological lesions in a timely manner and promptly activate the safeguarding of the child. Our objective was to review recent publications on the imaging studies of children suspected of being victims of physical violence.

Experiences of stigma, discrimination and violence and their impact on the mental health of health care workers during the COVID-19 pandemic.

Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.

Protocol for a nationwide case-control study of firearm violence prevention tactics and policies in K-12 schools.

BACKGROUND: Most U.S. K-12 schools have adopted safety tactics and policies like arming teachers and installing metal detectors, to address intentional school gun violence. However, there is minimal research on their effectiveness. Furthermore, sociodemographic factors may influence their implementation. Controlled studies are necessary to investigate their impact on gun violence and related disciplinary outcomes. OBJECTIVE: The paper outlines the protocol for a case-control study examining gun violence prevention policies in U.S. K-12 schools. The study aims to investigate if there is an association between the total number and type of specific safety tactics and policies and the occurrence of intentional shootings in K-12 public schools, student disciplinary outcomes, and if urbanicity, economic, and racial factors modify these associations. METHODS: We will create a nationally representative dataset for this study and ascertain a full census of case schools (schools that experienced intentional gunfire on the campus during school hours since 2015) through national school shooting databases. Matched control schools will be randomly selected from U.S. Department of Education's national database of all public schools. We will analyze 27 school safety strategies organized into seven key exposure groupings. RESULTS: Supported by the National Institutes for Child Health and Development (R01HD108027-01) and having received Institutional Review Board approval, our study is currently in the data collection phase. Our analytical plan will determine the association between the number and type of school safety tactics and policies with the occurrence of intentional shootings and suspensions and expulsions in a national sample of approximately 650 K-12 public schools. Additional analyses will investigate the effect modification of specific covariates. CONCLUSION: As the first national, controlled study, its results will provide novel and needed data on the effectiveness of school safety tactics and policies in preventing intentional shootings at K-12 public schools.

Prisoner, Sailor, Soldier, Spy: Hobbes on Coercion and Consent.

This article examines Thomas Hobbes's notorious claim that "fear and liberty are consistent" and therefore that agreements coerced by threat of violence are binding. This view is to a surprising extent inherited from Aristotle, but its political implications became especially striking in the wake of the English Civil War, and Hobbes recast his theory in far-reaching ways between his early works and Leviathan to accommodate it. I argue that Hobbes's account of coercion is both philosophically safe from the most common objections to it and politically superior to the seemingly commonsensical alternatives that we have inherited from Hobbes's critics.

The politics of allyship: Multiethnic coalitions and mass attitudes toward protest.

Recent work finds that nonviolent resistance by ethnic minorities is perceived as more violent and requiring more policing than identical resistance by ethnic majorities, reducing its impact and effectiveness. We ask whether allies-advantaged group participants in disadvantaged group movements-can mitigate these barriers. On the one hand, allies can counter negative stereotypes and defuse threat perceptions among advantaged group members, while raising expectations of success and lowering expected risks among disadvantaged group members. On the other hand, allies can entail significant costs, carrying risks of cooptation, replication of power hierarchies, and marginalization of core constituencies. To shed light on this question we draw on the case of the Black Lives Matter (BLM) movement, which, in 2020, attracted unprecedented White participation. Employing a national survey experiment, we find that sizeable White presence at racial justice protests increases protest approval, reduces perceptions of violence, and raises the likelihood of participation among White audiences, while not causing significant backlash among Black audiences. Black respondents mostly see White presence as useful for advancing the movement's goals, and predominant White presence reduces expectations that protests will be forcefully repressed. We complement these results with analysis of tens of thousands of images shared on social media during the 2020 BLM protests, finding a significant association between the presence of Whites in the images and user engagement and amplification. The findings suggest that allyship can be a powerful tool for promoting sociopolitical change amid deep structural inequality.

Digital media use, depressive symptoms and support for violent radicalization among young Canadians: a latent profile analysis.

BACKGROUND: Despite the prominent role that digital media play in the lives and mental health of young people as well as in violent radicalization (VR) processes, empirical research aimed to investigate the association between Internet use, depressive symptoms and support for VR among young people is scant. We adopt a person-centered approach to investigate patterns of digital media use and their association with depressive symptoms and support for VR. METHODS: A sample of 2,324 Canadian young people (Mage = 30.10; SDage = 5.44 ; 59% women) responded to an online questionnaire. We used latent profile analysis to identify patterns of digital media use and linear regression to estimate the associations between class membership, depressive symptoms and support for VR. RESULTS: We identified four classes of individuals with regards to digital media use, named Average Internet Use/Institutional trust, Average internet use/Undifferentiated Trust, Limited Internet Use/Low Trust and Online Relational and Political Engagement/Social Media Trust. Linear regression indicated that individuals in the Online Relational and Political Engagement/Social Media Trust and Average Internet Use/Institutional trust profiles reported the highest and lowest scores of both depression and support for VR, respectively. CONCLUSIONS: It is essential to tailor prevention and intervention efforts to mitigate risks of VR to the specific needs and experiences of different groups in society, within a socio-ecological perspective. Prevention should consider both strengths and risks of digital media use and simulteaneously target both online and offline experiences and networks, with a focus on the sociopolitical and relational/emotional components of Internet use.

Violent and prosocial music: Evidence for the impact of lyrics and musical tone on aggressive thoughts, feelings, and behaviors.

Although there is a large research base on the psychological impacts of violent and prosocial visual media, there is little research addressing the impacts of violent and prosocial music, and which facets of the music have the greatest impact. Four experiments tested the impact of lyrics and/or musical tone on aggressive and prosocial behavior, and on underlying psychological processes, using purpose-built songs to avoid the effect of music-related confounds. In study one, where mildly aggressive, overtly aggressive and violent lyrics were compared to neutral lyrics, any level of lyrical aggression caused an increase in behavioral aggression, which plateaued for all three aggression conditions. Violent lyrics were better recalled than other lyrics one week later. In studies two-three no significant effects of lyrics, or of aggressive versus nonaggressive musical tone, were found on aggressive or prosocial behavior. In terms of internal states, violent lyrics increased hostility/hostile cognitions in all studies, and negatively impacted affective state in three studies. Prosocial lyrics decreased hostility/hostile cognitions in three studies, but always in tandem with another factor. Aggressive musical tone increased physiological arousal in two studies and increased negative affect in one. In study four those who listened to violent lyrics drove more aggressively on a simulated drive that included triggers for aggression. Overall, violent lyrics consistently elicited hostility/hostile cognitions and negative affect, but these did not always translate to aggressive behavior. Violent music seems more likely to elicit behavioral aggression when there are aggression triggers and a clear way to aggress. Implications are discussed.

Prefrontal tDCS modulates risk-taking in male violent offenders.

Detrimental decision-making is a major problem among violent offenders. Non-invasive brain stimulation offers a promising method to directly influence decision-making and has already been shown to modulate risk-taking in non-violent controls. We hypothesize that anodal transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex beneficially modulates the neural and behavioral correlates of risk-taking in a sample of violent offenders. We expect offenders to show more risky decision-making than non-violent controls and that prefrontal tDCS will induce stronger changes in the offender group. In the current study, 22 male violent offenders and 24 male non-violent controls took part in a randomized double-blind sham-controlled cross-over study applying tDCS over the right dorsolateral prefrontal cortex. Subsequently, participants performed the Balloon Analogue Risk Task (BART) during functional magnetic resonance imaging (fMRI). Violent offenders showed significantly less optimal decision-making compared to non-violent controls. Active tDCS increased prefrontal activity and improved decision-making only in violent offenders but not in the control group. Also, in offenders only, prefrontal tDCS influenced functional connectivity between the stimulated area and other brain regions such as the thalamus. These results suggest baseline dependent effects of tDCS and pave the way for treatment options of disadvantageous decision-making behavior in this population.

Hospital Based Violence Intervention Programs Using Peer Support Specialists: A Concise Review.

BACKGROUND: Interpersonal violence remains a significant public health problem in the United States. The toll of violence has spurred the development of hospital-based violence intervention programs that use peer support specialists or navigators. Yet, their effectiveness remains uncertain. This study aims to concisely review the recent literature on the effectiveness of hospital-based violence intervention programs using the peer support specialist role. METHODS: A systematic search of articles from PubMed, OVID, and Google Scholar was performed for this review. Peer reviewed studies addressing hospital-based violence intervention programs using peer support specialists between 2017 and 2022 were selected. Key data points were extracted and analyzed by consensus of the authors. RESULTS: Eight of the 232 studies reviewed met eligibility requirements. Across these studies, the recidivism rate was reduced between 43% and 95% in victims participating in hospital-based violence intervention programs with peer support specialists. CONCLUSION: The peer support specialist (navigator) role is central to the success of the violence intervention programs. This role guides and coordinates health services for victims of violence, extending after discharge into the community. Programs showed the most success with helping victims reach short-term goals focused on immediate basic needs but are more challenged meeting longer-term goals, such as education or relocation. This review reveals that hospital-based violence intervention programs using peer support specialists (navigators) lead to the achievement of meeting victim goals and reduce recidivism rates.

Prevalence of school related violence in seven countries: A cross-sectional survey.

Violence against children in schools harms the affected children, limits their learning and educational attainment, and extends its harms to families and the broader communities. However, to date, comparable cross-country data on violence against children in schools has not been available. We utilize the Violence Against Children and Youth Surveys (VACS) to estimate school-related violence against children in seven countries (Honduras, Kenya, Malawi, Nigeria, Tanzania, Uganda, and Zambia). Leveraging the unique comparability of the surveys, we are able to estimate both physical and sexual violence experienced in childhood and adolescence among youth aged 13-24. Where possible, we also disaggregate by gender and perpetrator type. Overall, within our sample seven countries, we find that 12.11-44.63% of females and 14.28-53.85% of males experienced at least one form of violence. Males experience higher levels of school-related violence and a significant portion of this is due to experiencing physical violence perpetrated by male classmates.

Persecution as stigma-driven trauma: Social determinants, stigma, and violence in asylum seekers in the United States.

OBJECTIVE: Existing literature documents high rates of experienced violence in asylum seekers. Despite this high prevalence, experiences of traumatic stress are neither necessary nor sufficient grounds for claiming asylum, without documented experiences of persecution. The aim of the current study is to better understand the role of co-occurring pre-migratory social determinants, stigma, and trauma on the experiences of persecution among asylum seekers in the United States. METHOD: We conducted a retrospective file review of legal declarations submitted by 25 asylum seekers who participated in forensic mental health evaluations at a pro-bono asylum clinic. We coded de-identified data for co-occurring events of trauma, social determinants of health, and components of "discrimination" from the legal definition of persecution - conceptualizing persecution as stigma-driven infliction of violence. Data was analyzed using a tiered deductive and inductive reflexive thematic analysis. RESULTS: Findings suggest pre-migratory social determinants included demographics, neighborhood, economic, environmental, and social and cultural level disparities across various grounds for seeking asylum, and experiences of stigma were associated with the specific acts of violence and harm. CONCLUSIONS: Our findings - specific to asylum seekers who have obtained legal representation and completed applications for asylum in the United States - describe the co-occurrence of social determinants, stigma and traumatic experiences among asylum seekers. To our knowledge, this study is the first of its kind to bridge the existing legal framework of asylum to a psychological construct incorporating trauma, stigma, and social determinants of health, lending support for the conceptualization of persecution as stigma-driven trauma.

Public health intervention amidst conflict: Violence, politics, and knowledge frames in the 2018-20 Ebola epidemic in Democratic Republic of the Congo.

Research, policy, and donor interest in health systems in conflict environments has grown rapidly in recent years. The 2018-20 Ebola outbreak in Democratic Republic of the Congo is a critical case of healthcare militarization. The first-ever such outbreak in an active conflict zone, it grew notorious for violence against response teams, with attacks aggravating the spread of disease. However, while medical responders observed physical attacks, the causes of the violence remained largely unknown. Drawing on interviews and participant observation, we contribute civilian vantages of the way health intervention grew militarized, or associated with conflict. The argument builds in two core steps. A first reconstructs civilian experiences of conflict prior to Ebola to trace how the response took on a political meaning. We find that relationships linking state forces with the health response inadvertently tethered Ebola to what civilians perceived as security threats and that by repeating government statements about conflict, response teams unintentionally endorsed a version of the truth that silenced local voices. A second step addresses a central paradox: residents communicated these concerns directly, repeatedly, and via official response channels, yet healthcare teams failed to apply these insights. We locate this gap in the knowledge structures, or frames, accompanying intervention. Medical emergencies in warzones operate with dual sets of frames casting conflict players as "non-state" and public health resistance as "ignorance." Both frames intersect in ways that amplify invisibilities in each, clouding understandings of the nature of conflict and humanitarians' role in it. We suggest this places intervention teams at heightened risk of mis-stepping on political fault lines-and not understanding why. The study advances work on community engagement by showing that instead of simply providing scientific knowledge, effective engagement requires adjusting socio-political lenses within the response. It contributes to studies on health intervention, humanitarian emergencies, and the limits of medical neutrality.

Public health framing of firearm violence on local television news in Philadelphia, PA, USA: a quantitative content analysis.

BACKGROUND: Firearm violence is an intensifying public health problem in the United States. News reports shape the way the public and policy makers understand and respond to health threats, including firearm violence. To better understand how firearm violence is communicated to the public, we aimed to determine the extent to which firearm violence is framed as a public health problem on television news and to measure harmful news content as identified by firearm-injured people. METHODS: This is a quantitative content analysis of Philadelphia local television news stories about firearm violence using a database of 7,497 clips. We compiled a stratified sample of clips aired on two randomly selected days/month from January-June 2021 from the database (n = 192 clips). We created a codebook to measure public health frame elements and to assign a harmful content score for each story and then coded the clips. Characteristics of stories containing episodic frames that focus on single shooting events were compared to clips with thematic frames that include broader social context for violence. RESULTS: Most clips employed episodic frames (79.2%), presented law enforcement officials as primary narrators (50.5%), and included police imagery (79.2%). A total of 433 firearm-injured people were mentioned, with a mean of 2.8 individuals shot included in each story. Most of the firearm-injured people featured in the clips (67.4%) had no personal information presented apart from age and/or gender. The majority of clips (84.4%) contained at least one harmful content element. The mean harmful content score/clip was 2.6. Public health frame elements, including epidemiologic context, root causes, public health narrators and visuals, and solutions were missing from most clips. Thematic stories contained significantly more public health frame elements and less harmful content compared to episodic stories. CONCLUSIONS: Local television news produces limited public health coverage of firearm violence, and harmful content is common. This reporting likely compounds trauma experienced by firearm-injured people and could impede support for effective public health responses to firearm violence. Journalists should work to minimize harmful news content and adopt a public health approach to reporting on firearm violence.