Violence Against Health Care: Research Analysis

ambulanceAs part of the International Committee of the Red Cross (ICRC) Health Care in Danger Initiative, RAND Europe in collaboration with Elrha published a new report, Researching Violence Against Health Care: Gaps and Priorities.” The report identifies key elements that are currently missing in research on violence against health care. As such, the authors aim to highlight “key barriers” in identifying effective interventions to resolve this issue. According to the report’s findings, “attacks against healthcare are a complex problem defying simple solutions.” Accordingly, necessary solutions are “context-specific and technical, requiring high-level policy change and health system reform.”

The primary goal of this report is to assess the existing evidence, identify research gaps, and identify areas for future research. Significantly, the review of evidence attempts to provide a qualitative analysis of available data, including research design, data collection and interpretation. In addition, the report provides an outlook into areas of insufficient and/or contradictory evidence.

Based on the existing research, the report identifies main threats to healthcare as physical (70 per cent) and/or psychological (82 per cent) violence, followed by sexual, deprivation/neglect, and cyberattacks. The most common subject of violence appears to be healthcare workers, with only a small proportion of research focusing on violence against patients and healthcare facilities. Significantly, the most common type of perpetrator identified in 43 per cent of all studies is the patient, followed by other healthcare workers and affiliated third parties.

The report identifies 23 research gaps divided in the following categories:

  • Nature of violence;
  • Impacts of violence;
  • Interventions to reduce violence;
  • Specific research methods;
  • Specific contexts of violence; and
  • Data collection.

Furthermore, the report addresses the current gaps in learning across the global community, thus pointing out to additional resources necessary to “support meaningful research.”

For more information, visit the HSDL selection of research on healthcare violence. Please note that an HSDL login is required to view some of these resources.

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Author: Julia West

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A Different Kind of Infektion

Typewriter with paper coming out of the top with Fake News typewritten on itGraphika‘s latest report, Secondary Infektion, is named after a sophisticated Russian disinformation operation that specializes in drumming up discord between Russia and their perceived enemies and critics.

The organization’s negative effects span dozens of countries, in seven different languages, and across more than 300 web-based platforms. While the ramifications are many, the group has a relatively small content focus, which Graphika has condensed into the following themes:

  • Ukraine as a failed state or unreliable partner
  • The United States and NATO as aggressive and interfering in other countries
  • Europe as weak and divided
  • Critics of the Russian government as morally corrupt, alcoholic, or otherwise mentally unstable
  • Muslims as aggressive invaders
  • The Russian government as the victim of Western hypocrisy or plots
  • Western elections as rigged and candidates who criticized the Kremlin as unelectable
  • Turkey as an aggressive and destabilizing state
  • World sporting bodies and competitions as unfair, unprofessional, and Russophobic

The Graphika team admits that while their investigation has been successful in fleshing out the works of Secondary Infekction and causing them to (seemingly) retreat, identifying the individual(s) behind the organization remains the top priority.


For more information on topics related to this piece, visit the HSDL Featured Topics on Cyber Crime and National Security, Cyber Infrastructure Protection, Cyber Policy, Global Terrorism, and Pandemics and Epidemics. Please note: An HSDL login is required to view some of these resources.

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Author: Emily Bruza

2020 Trafficking in Persons Report Released

The United States Department of State has released the 20th edition of the Trafficking in Persons Report, which provides an overview of the impacts these reports have had over the past 20 years through-out the world. Over time, these reports have developed a ranking system that divides countries into 3 tiers based on their “governments’ efforts to combat human trafficking.” Countries falling into the Tier 3 category, those not fully meeting or making significant efforts to meet the TVPA’s (Trafficking Victims Protection Act of 2000) minimum standards, risked restrictions and the loss of U.S. assistance. By 2009, 173 countries were being analyzed and ranked. As of the release of the 20th edition report, 12 full aid restrictions are in place for tier 3 countries. This number, while still exceeding most past restrictions, is down from last years 17 full aid restrictions.

Countries in this report are given detailed narratives which provide an overview of that countries current anti-trafficking laws, law enforcement efforts, human trafficking prevention methods, victim protection procedures, current tier ranking, and recommendations going forward. It is important to note, that according to the report, there are three special case countries which have not received rankings. These countries, Libya, Somalia, and Yemen, were seen as being unable to develop government policies and practices to combat human trafficking due to the severity of civil unrest, humanitarian disasters, and instability which effected their ability to govern altogether.

2019 saw a rise in the identification of human trafficking victims as well as a rise in offender prosecutions and convictions. According to the 20th edition report, countries should focus on the following issues in their fight against human trafficking: ending state-sponsored forced labor; increasing “labor trafficking prosecutions”; repealing “laws that require force, fraud, or coercion for child sex trafficking”; and ending victim penalties “for unlawful acts their traffickers compel them to commit.”

The HSDL offers many additional resources related to human trafficking, public safety, and international relations. Visit the Featured Topics for more on information. Please note: HSDL login is required to view some of these resources.

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Author: Victoria Vanderzielfultz

State Department Releases 2019 Country Reports on Terrorism

Terrorists with AK47The Department of State has released the Country Reports on Terrorism for 2019, an annual report prepared for Congress that examines terrorist activity by country in compliance with Title 22 of the United States Code, Section 2656f. Additionally, the report details on Foreign Terrorist Organizations across the globe and identifies state sponsors of terrorism along with terrorist safe havens.

Nearly 100 individual countries are profiled in the report, with each profile providing an overview of recent terrorist activity and describing any known terrorist incidents that took place in 2019. Also reported are the legislation, law enforcement, and border security measures each country has implemented, as well as information pertaining to countering violent extremism and the financing of terrorism. Each country profile concludes with a description of steps taken, if any, towards international and regional cooperation on combating terrorism.

In light of the global threat of terrorism, the report also highlights the following counterterrorism successes achieved in 2019:

  • In March, the United States completed the destruction of the so-called “caliphate” in Iraq and Syria;
  • In October, the United States launched a military operation that resulted in the death of Abu Bakr al-Baghdadi, the self-proclaimed “caliph” of ISIS [Islamic State of Iraq and Syria];
  • The United States and our partners imposed new sanctions on Tehran and its proxies;
  • The United States designated Iran’s Islamic Revolutionary Guard Corps (IRGC), including its Qods Force, as a Foreign Terrorist Organization (FTO); and
  • A number of countries in Western Europe and South America joined the United States in designating Iran-backed Hizballah as a terrorist group in its entirety.

For more information on topics related to this piece, visit the HSDL Featured Topics on Domestic (U.S.) Terrorism, Global Terrorism, Lone Wolf Terrorism, and Suicide Bombers.

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Author: Vincent Milano

In Focus: Police Reform

New In Focus now available on Police Reform.

A collection of reports focused on the assessment of current policing procedures and recommendations for reform, in response to longstanding concerns over excessive use of force, disproportionate application to people of color, and how improved policing practices can promote effective crime reduction while building public trust.

Please Note: An HSDL account may be required to view some resources.

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Author: Jenna Hillhouse

CRI-TAC Law Enforcement Solutions Second Annual Review

The Department of Justice’s (DOJ) Office of Community Oriented Policing Services (COPS Office) has released Law Enforcement Solutions by the Field, for the Field: Collaborative Reform Second Annual Review, its second report focused on the Collaborative Reform Initiative Technical Assistance Center (CRI-TAC). CRI-TAC provides technical assistance for law enforcement personnel, either at the request of an agency or via an invitation from a requesting agency. Technical assistance is provided for a variety of law enforcement issues, including: “school safety, active shooter response, de-escalation, crisis intervention, and information sharing.” This assistance may be provided through web-based training, in-person training, virtual coaching, meeting facilitation, on-site consultation, and resource referral.

“Overall, the five most popular topics which agencies have sought to address through Collaborative Reform are as follows:police

1. De-escalation
2. Active Shooter Response
3. Intelligence and Information Sharing
4. Public Sector Coordination and Partnerships
5. Officer Safety and Wellness”

According to 93% of participating agencies, CRI-TAC provided training was “effective in meeting the goals and objectives of the course.” More than half of these agencies (52%) were small sized agencies with less than 50 personnel sworn in.

In 2020, CRI-TAC is implementing additional focus on the following: coronavirus pandemic assistance, border sheriff training, national de-escalation training, national hate crimes training, and expanding tribal law enforcement assistance. For more information on the previous year see Law Enforcement Solutions by the Field, for the Field: Collaborative Reform Annual Review or explore the Law Enforcement Solutions by the Field series.

The HSDL offers many additional resources related to the issue of Law Enforcement Training, Law Enforcement and StatisticsCrisis Management, and Coronavirus Disease (COVID-19). Visit the Featured Topics for more on information. Please note: HSDL login is required to view some of these resources.

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Author: Victoria Vanderzielfultz

In Focus: Moral Injury

New In Focus now available on Moral Injury.

A collection of reports focused on the recognition, assessment, and recommendations of coping with Moral Injury in first responders. The National Center for PTSD states moral injury can occur when, “in traumatic or unusually stressful circumstances, people may perpetrate, fail to prevent, or witness events that contradict deeply held moral beliefs and expectations.” It can have long-lasting psychological and emotional impact, which can show on-the-job as well as in personal life.

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Author: Jenna Hillhouse

Global Peace in 2020

The Institute for Economics and Peace has released the 2020 Global Peace Index as well as a consolidated briefing The 14th edition of the Global Peace Index ranks the state of peace in 163 countries based on 23 different indicators.  According to the results, global peace has deteriorated in 2020.

The Global Peace Index incorporates factors across three domains: 1) the level of Societal Safety and Security; 2) the extent of Ongoing Domestic and International Conflict; and 3) the degree of Militarisation. The report also explores trends in civil unrest, the economic impact of violence, and the impact of ecological threats on positive peace.

While the 2020 Global Peace Index analyzes the impact of the COVID-19 pandemic on peace, the Institute for Economics and Peace released a separate report which explores the ramifications of the global health crisis in more detail COVID-19 and Peace explores the pandemic “through the lens of socio-economic development and peacebuilding”. The report discusses a number of ways that the COVID-19 crisis has impacted global peace including specifically: 

  • Impact on violence;  
  • Economic impact and early responses;  
  • Impact on Positive Peace; and  
  • Rebuilding the socio-economic system  

For more information on related topics view other resources included in the COVID-19 Special Collection or in the Global Peace Index SeriesPlease note that an HSDL login is required to view some of these resources.  

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Author: Emily Christian

Information Operations: An Evidence-Based Approach

fake newsThe role of hostile information campaigns is becoming increasingly apparent in most contemporary events. In particular, a working paper by the National Bureau of Economic Research on social media use during the US elections and UK Brexit suggests that information diffusion can amplify public’s sentiments, thus contributing to the voter outcomes. Furthermore, as emphasized in Demos report on hostile actions in the information domain, “the past decade has seen democracies around the world become a target of a new kind of information operations[.]”

In response to the lack of appropriate definitions, descriptions, and labels, the authors propose a framework that explains the aims, strategies, tactics, and actors who play essential roles in these hostile operations. Underscoring the complexity of this subject, the authors aim to facilitate better understanding of how information operations shape popular opinions and global politics.

The report provides the following key findings:

  • Information operations go beyond “fake news” in scale, chosen targets, strategies, and tactics;
  • Much of shared information is not “fake”; instead it involves selectively truthful agenda-driven information based on amplification of reputable media sources;
  • Many cases of information operations do not contain fact statements, thus making fact-checking a tool of only limited effectiveness;
  • Information operations typically appear in erratic bursts of activity and are likely to exploit preexisting cultural and social divisions;
  • While most information operations are coordinated, they are also inconsistent across language, timing, subject-matter and geography; and
  • Both non-state and state-aligned actors engage in information operations.

Currently, the responses to such operations lack broader understanding of the evolving threat and fail to engage various levels of policymakers, society, and governments. As the objectives of information operations can involve social, political, or economic gains, any successful preventative action will require a much broader approach to the problem. Specifically, the campaigns involving weaponization of information will require “a coalition across government, the military, technology and civil society to predict, identify, take precautions against, and if necessary respond to their use.”

For more information, visit the HSDL Featured Topics or our In Focus topics on Cyber Crime & National SecurityCyber Infrastructure Protection, and Cyber Policy. Please note that an HSDL login is required to view some of these resources.

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Author: Julia West

New COVID-19 Resource Archive is Available

In response to a growing need for reliable information on the COVID-19 pandemic, the Center for Homeland Defense and Security (CHDS) launched a new COVID-19 Resource Archive. Geared to help emergency managers and homeland security experts, this platform provides access to a publicly available collection of COVID-19 resources. To provide the most comprehensive overview of the pandemic, the Archive is updated daily as new documents become available.

The Archive, carefully curated by the Homeland Security Digital Library (HSDL), is a repository of national and international responses to the coronavirus featuring documents on preparedness, response and recovery, as well as the current debates on a medical, economic and social response. The collection includes documents from agencies and organizations tasked with the development and implementation of public health policies, including the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), Federal Emergency Management Agency (FEMA), U.S. Food and Drug Administration (FDA), and many others. Furthermore, the collection includes federal, state, local, and tribal guidance on public safety and reopening procedures, Congressional Research Service (CRS) reports, as well as other materials published by domestic and international think tanks and research institutes.

This user-friendly platform highlights specific topics, ranging from public health to national security. Each topic includes a more nuanced selection of COVID-19-related resources. In addition to documents included in this collection, users can do an advanced search on the HSDL website for more information.

For more information on related topics visit the HSDL Featured Topic on Pandemics and Epidemics or view other resources included in the COVID-19 Special Collection. Please note that an HSDL login is required to view some of these resources. Need help finding something?  Ask one of our librarians for assistance!

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Author: Julia West