Far from Oblivion: the Nanking Massacre in Japanese historical writing for children and young adults

The Nanking Massacre of 1937 frequently has been described as a forgotten genocidal act or "Holocaust." Concentrating on atrocity as reflected in Japanese popular historical writing for children and adolescents since the 1960s, this essay argues that such war crimes are far from ignored. Representations of the Nanking Massacre in particular, and of Japanese World War II atrocities in general, have been widely mobilized in Japan to inculcate an anti-war philosophy.

Violence: a priority for public health? (part 2)

Violence continues to grow as a priority for public health practitioners, particularly as its causes and consequences become better understood and the potential roles for public health are better articulated. This article provides the context to "Violence: a glossary (part 1)" published in the last issue of this journal, and updates some of the data, concepts and population approaches presented in the 2002 World report on violence and health. The paper addresses the following questions: What is the magnitude and global burden of injury from violence? What causes violence? Is resilience important? What is the role for public health? What are the key challenges and opportunities? We aim to engage the general reader and to increase understanding of violence as a potentially preventable issue.

A cost-effectiveness analysis of alcohol prevention targeting licensed premises

BACKGROUND

A multi-component alcohol prevention programme targeting licensed premises has been ongoing in Stockholm since 1996. An earlier study has established that this led to a 29% reduction in police-reported violence. The objective of the present study is to calculate the programme's cost-effectiveness from a societal perspective; the cost of implementation, the savings made as a result of fewer assaults, unlawful threats and violence towards officials, and the health gains in terms of quality-adjusted life-years (QALYs).

METHODS

The costs included administration, studies of alcohol serving practices, community mobilization, responsible beverage service training and stricter alcohol law enforcement. For the purpose of estimating how the decrease in violence affected savings and health gains, a survey among victims of violence (N=604) was performed.

RESULTS

The cost of the programme was estimated at Euro 796,000. The average cost of a violent crime was estimated at Euro 19,049, which implies overall savings of Euro 31.314 million related to the judicial system (78%), production losses (15%), health care issues (5%) and other damages (2%). Accordingly, the base case cost-saving ratio was 1:39. The average loss of health state weighting among the victims at 0.09 translates into 236 gained QALYs for society as a whole, which should be compared with the modest proportion of savings in the health sector.

CONCLUSION

The most significant concern is the low response rate (35%), and caution needs to be exercised when interpreting our results. Yet, a reasonable conclusion is that the monetary and human benefits have been considerable.

Surveillance and assessment of workplace assault injuries: analysis of Rhode Island workers' compensation claims 1998-2002

OBJECTIVE

To analyze workplace assault by rate, injury severity, and trends using Rhode Island workers' compensation claim data.

METHOD

A total of 6402 workers' compensation assault claims from Rhode Island for the period of 1998 through 2002 was analyzed. Data from the U.S. Department of Labor was used to derive estimates of injury rates.

RESULTS

An average rate of 27.7 assaults per 10,000 workers was found and varied only marginally across years. Females filed 75% of all assault claims, though injuries to males resulted in longer periods of indemnification. The total cost of workplace assaults was 7,025,997 dollars, averaging 1097 dollars per claim, and average indemnification duration was 16.8 days per claim. While the assault rate was relatively stable, a notable decline in both cost and indemnification periods over time was discovered.

CONCLUSION

The assault rate found was among the highest reported to date, demonstrating that workplace violence remains a significant threat to employee safety. While a decline in incident severity was discovered over time, many outcomes were still serious. Preventive interventions to reduce incidents of workplace assaults among groups at the highest risk should be given highest priority.

The welfare cost of violence across countries

The cost of violence goes beyond its material dimension, including also the welfare loss due to higher mortality. A given mortality, and its distribution across age groups, determines a reduction in life expectancy that can be valued using the marginal willingness to pay approach. We estimate the health dimension of the welfare cost of violence for 73 countries. On average, 1 year of life expectancy lost to violence is associated with a yearly social cost of 3.8% of GDP. The health dimension increases the estimated social costs of violence by 40% in the United States and by 57% in Latin America.

Societal Costs of Underage Drinking

OBJECTIVE

Despite minimum-purchase-age laws, young people regularly drink alcohol. This study estimated the magnitude and costs of problems resulting from underage drinking by category-traffic crashes, violence, property crime, suicide, burns, drownings, fetal alcohol syndrome, high-risk sex, poisonings, psychoses, and dependency treatment-and compared those costs with associated alcohol sales. Previous studies did not break out costs of alcohol problems by age.

METHOD

For each category of alcohol-related problems, we estimated fatal and nonfatal cases attributable to underage alcohol use. We multiplied alcohol-attributable cases by estimated costs per case to obtain total costs for each problem.

RESULTS

Underage drinking accounted for at least 16% of alcohol sales in 2001. It led to 3,170 deaths and 2.6 million other harmful events. The estimated $61.9 billion bill (relative SE = 18.5%) included $5.4 billion in medical costs, $14.9 billion in work loss and other resource costs, and $41.6 billion in lost quality of life. Quality-of-life costs, which accounted for 67% of total costs, required challenging indirect measurement. Alcohol-attributable violence and traffic crashes dominated the costs. Leaving aside quality of life, the societal harm of $1 per drink consumed by an underage drinker exceeded the average purchase price of $0.90 or the associated $0.10 in tax revenues.

CONCLUSIONS

Recent attention has focused on problems resulting from youth use of illicit drugs and tobacco. In light of the associated substantial injuries, deaths, and high costs to society, youth drinking behaviors merit the same kind of serious attention.

Public hospitals in China: privatisation, the demise of universal health care and the rise of patient-doctor violence

Ensuring the safety of staff and patients has become a major problem for hospitals in China. This article examines whether one of the reasons for this violence may be the emerging injustice and inequality that have manifested in the Chinese health care system as a result of privatisation reforms since the early 1980s. It considers approaches to these issues that may assist the Chinese Government, and other nations contemplating similar policy changes, to create efficient but equity-based health care systems that minimise collateral trauma to patients and their families.

Emerging aspects of psychosocial risks: violence and harassment at work

In the last twenty years, psychosocial risks have become crucial in Occupational Health. Particularly, there is an increasing interest about psychological and physical violence at the workplaces. Psychological violence (mobbing or workplace bullying) is described as a situation in which the person has been the victim of negative acts directed to the person and work, with offences, discriminations and isolation. Physical violence at work, still underestimated in many parts of the world, is becoming a topical subject both for its frequency and its pathogenic potential and consist of violence among workers (internal violence) and between workers and external persons (external violence). Examples of external violence are bank robberies, which are prevalent in many European countries, particulary in Italy. The costs of psychological and physical workplace violence are very high at all levels; individual, for the implication of violence for health and quality of life as well as organizational, for the increase of absenteeism, turnover and health care demands and claims. The Medical Centre for Occupational Stress and Harassment (CDL) of the "Clinica de Lavoro Luigi Devoto" was set up in 1996 with a day-hospital service for the diagnosis, rehabilitation and prevention of work related psychological diseases. From its opening, about 5000 patients have been examined.

Cost-Effective Violence Prevention through Targeted Family Interventions

Efforts in violence prevention can focus on individual youth, their families, their schools, or the communities in which they live. Among the small number of program models that have been proven effective in repeated replications, those that focus on improving family management and child care have been found to be the most cost-effective. The four model programs include Nurse Home Visitation, Functional Family Therapy, Multi-systemic Therapy, and Multidimensional Foster Care. All of these programs involve detailed protocols, extensive staff training and supervision, and quality-assurance procedures. The factors limiting their wider adoption include staff resistance to their structured approach, cost-sharing issues between local and state levels of government, and the political power of existing programs.

Service costs for women with co-occurring disorders and trauma

Several aspects of costs related to health care and other service use at 6-month follow-up are presented for women with co-occurring mental health and substance abuse disorders with histories of physical and/or sexual abuse receiving comprehensive, integrated, trauma-informed and consumer/survivor/recovering person-involved interventions (n = 1023) or usual care (n = 983) in a nine-site quasi-experimental study. Results show that, controlling for pre-baseline use, there are no significant differences in total costs between participants in the intervention condition and those in the usual care comparison condition, either from a governmental (avg. US dollars 13,500) or Medicaid reimbursement perspectives (avg. just over US dollars 10,000). When combined with clinical outcomes analyzed in other works in this issue by Cocozza et al. (2005) and Morrissey et al. (2005), which favored the intervention sites, these cost findings indicate that the treatment intervention services are cost-effective as compared with the usual care received by women at the comparison sites.

The effect of firearm deaths on life expectancy and insurance premiums in the United States

Despite recent gains, the U.S. remains behind most other affluent countries in life expectancy. Even within the U.S., the gap between the life expectancies of Caucasians and African-Americans remains significant. At the same time, firearm deaths in the U.S. far exceed peer nations, and disproportionately affect African-American males. In this Issue Brief, Dr. Lemaire explores whether deaths from firearms explain some of these international and racial disparities in life expectancy. He uses actuarial techniques to calculate the "cost" of firearm deaths in the U.S., both in terms of reduced life expectancy and increased life insurance premiums.

Women, Co-occurring Disorders, and Violence Study: Evaluation design and study population

The Women, Co-occurring Disorders, and Violence Study (WCDVS) was a multi-site cooperative study to evaluate new service models for women with co-occurring mental health and substance use disorders and a history of physical and/or sexual abuse. Despite common features in the service interventions and evaluation procedures, diversity across the nine sites plus differences introduced by non-random assignment led to numerous methodological challenges. This article describes the design, measurement, and analysis decisions behind the WCDVS and lays the foundation for understanding participant-level outcomes and service costs. This article also describes the study population, as recruited and following attrition at the 6-month follow-up, in order to address the threat of selection bias to inferences drawn from this multi-site study.

The costs of interpersonal violence--an international review

This article reviews evidence of the economic impact of interpersonal violence internationally. In the United States, estimates of the costs of interpersonal violence reach 3.3% of GDP. The public sector-and thus society in general-bears the majority of these costs. Interpersonal violence is defined to include violence between family members and intimate partners, and violence between acquaintances and strangers that is not intended to further the aims of any formally defined group or cause. Although these types of violence disproportionately affect poorer countries, there is a scarcity of studies of their economic impact in these countries. International comparisons are complicated by the calculation of economic losses based on foregone wages and income, thus undervaluing economic losses in poorer countries.

Common fate, different experience: gender-specific aspects of the Armenian Genocide, 1915-1917

Violence against women was a central feature of the Armenian Genocide. Even before the mass killings, sexual humiliation was used to intimidate the Armenian community. After the murder of the Armenian leadership and men of military age, Ottoman authorities and Ittihadist supporters deported surviving Armenians from Anatolia into the Syrian desert. During this ethnic cleansing, rape, kidnapping, sex slavery, and forced re-marriage became de facto instruments of genocide. Eyewitness accounts and diplomatic reports shed light on the place of gender during genocidal persecution. Although scholarship has only recently begun to explore the issue, the Armenian Genocide offers opportunities for comparative gender studies.