Years For Victims Research Articles

Suicide firearm deaths in El Paso, Texas, USA: A retrospective study

<strong><em>Introduction:</em></strong><em> </em>Firearms are often used to commit suicide, especially in countries where firearms are easily available. This research was conducted to identify the patterns of suicide firearm deaths; socio-demographic profile, past history, circumstantial facts, weapons used, autopsy, and toxicology analysis. <em></em> <strong> </strong> <strong><em>Methodology:</em></strong><em> </em>A descriptive-cross-sectional study was conducted. All autopsy reports with investigative narratives, police reports, scenes, and autopsy photographs were perused from 2016 to 2012 using data collection forms. Purposive sampling was used to collect 200 suicide firearm deaths.<em></em> <strong><em>Results:</em></strong><em> </em>Out of 3150 deaths, 12% (n=391) were suicides. Of them, 200 (51%) were suicide firearm deaths. There were 90% males. Ages ranged from 13 to 91 years and 51% were less than 40 (&lt;40) years victims. According to circumstances, 13% notified by suicide letters, 74% occurred at home, and eye witnessing (p=0.003) and hearing (p=0.021) of the suicide were significantly associated with age &lt;40 years. Past history included; medical illnesses (19%), suicide attempts (10%), domestic issues (31%), and occupational familiarity with firearms (31%). Occupational familiarity was significantly associated with whites (p=0.034) and &lt;40 years victims (p=0.001&lt;0.05). Automatic pistols were used by 57% and revolvers by 27%. The use of handguns was significantly associated with females (p=0.029). The Head was the commonest region involved (88%) and the entry wound in the head was significantly associated with &lt;40 years of victims (p=0.003&lt;0.05). Blood for alcohol was positive at 16%. Performing toxicology tests significantly associated with age &lt;40 years (p=0.000), occupational familiarity (p=0.001) and absence of medical illnesses(p=0.018). A full autopsy was performed on 66%. Head injury as the cause of death is significantly associated with age &lt;40 years (p=0.018&lt;0.05).<em></em> <strong><em>Conclusion</em>:</strong> Age, gender, race, medical conditions, and occupational familiarity are significantly associated with suicide firearm deaths. The white race is significantly associated with familiarity with firearms. Females have more predilection to handguns. Performing toxicology is higher with the absence of medical illnesses, occupational familiarity, and age &lt;40 years.

Human bite as a weapon of assault.

Human bite is a growing public health concern. It may be seen in both victims and aggressors following assault. Effects of human bite are both social and medical. This study aims to determine the prevalence and characteristics of assault-related human bite injuries in Enugu, Nigeria. In this prospective study, an objective structured questionnaire was administered to assault victims attending the Forensic unit of ESUT Teaching Hospital between November 2013 and October 2014. Obtained data was analyzed. Out of 219 patients presenting with clinical injuries, 29 (13.2%) sustained human bite wounds. Average age was 32.2±11.30 years and 34.3±12.4 years for victims and biters respectively. Females were more involved than males. Severe injuries resulted more in bites involving females than males. Contusion (47.6%) and laceration (31.0%) were the commonest. Upper limbs were mostly affected (44.7%) followed by the face (29.0%). Romance-related injuries affected breasts and thighs. Most incidents (62.1%) occurred within home/living quarters. Most biters were known to their victims. Human bite is a common outcome of assault and so should be anticipated in cases of assault. Patterns of location of bites seem related to nature of crime.

Aspects épidémiologiques, cliniques et judiciaires des violences physiques faites aux femmes dans la région de Tambacounda (Sénégal)

IntroductionTo contribute to the fight against physical violence against women, this work aimed to make a 10-year review of cases treated at the Regional Court of Tambacounda. MethodologyThis observational, retrospective, descriptive and analytical study was conducted from 15 October 2014 to 15 April 2015. It covered all the court records of victims of intentional injury from 2006 to 2015. The data was entered and analyzed using Epi info 3.3.2 software. ResultsIn all, 113 cases were treated. The mean age was 26.5±10.08 years for victims versus 32.5±13.8 years for the aggressors. The victims were all female, and 77.9% of offenders were male. The assaults took place mostly during the day (57.5%), and especially in the homes of victims (61.0%), in the street (16.8%) in the bush (12.4%). The consultation period was less than 24hours for 54.9% of the victims. Clinical examination differentiated: fractures (15%); contusions (13.5%); penetrating wounds (10.6%); bruises (9.7%); eye injuries (7.9%); broken teeth (7.9%); diffuse pains (7.1%), 6.2% polytrauma (6.2%), and 5.3% of trauma on pregnancies. Among the violence, 33.6% were domestic; 11.5% were associated with rape (7.1%); psychological violence (3.6%); rape and death threat (1.8%). Rape was statistically more common among child victims [OR=10.7 (3.2–35.5)] and/or educated victims [OR=5.8 (1.7–19.9)] and aggression in the bush [OR=7.5 (2.2 to 14.2)]. The attackers were lonely and imprisoned in 94.7% and 73.5% of cases respectively. The sentence was firm imprisonment for 89.2% of cases. ConclusionIn Tambacounda, health and judicial authorities should enhance public awareness concerning the risk of violence. The extension of this type of study to the national level would have enabled better orientation of control strategies against this scourge.

Working in resource-poor settings

I have now been recovering from resource-poor settings for several years. It has been a slow recovery from 22 years of victims of motor vehicle accidents arriving at midnight, the 2h00 child with acute asthma and the 4h00 Caesarean section in various rural hospitals.

Mental Health Interventions for Survivors of Torture

Although there is no consensus on how to define and operationalize torture (Green, Rasmussen, & Rosenfeld, 2010), there is general agreement that torture is one of the most devastating human experiences. Indeed, a growing body of evidence on the implications of torture and atrocities experienced by prisoners of war or survivors of political violence presents a consistent picture of multifaceted injuries and long-lasting emotional and functional difficulties, including posttraumatic stress disorder (PTSD) (Neria et al., 2000; Steel et al., 2009), anxiety (Keller et al., 2006), depression (Steel et al., 2009), endured shame and guilt (Wenzel, Griengl, Stompe, Mirzaei, & Kieffer, 2000), disability (Thapa, Van Ommeren, Sharma, & de Jong, 2003) and impaired quality of life (Eisenman, Gelberg, Liu, & Shapiro, 2003), and increased interpersonal aggression (O’Donnell, Cook, Thompson, & Neria, 2006). Exposure to prolonged and repeated intentionally inflicted aggression not only evokes substantial distress but also affects victims’ personality (Herman, 1992), resulting in dissociation and an impaired sense of identity (Herman, 1992) as well as profound changes in attachment and relationship (Solomon, Dekel, & Mikulincer, 2008) and victims’ core belief system (Magwaza, 1999). In light of the complexity and severity of the human response to such atrocities, a number of interventions were developed over the years for victims of torture (for an extensive review, see Campbell, 2007; McIvor & Turner, 1995). Some models are based on a psychodynamic approach (Holmquist, Andersen, Anjum, & Alinder, 2006) or a relational/interpersonal perspective (Stepakoff et al., 2006). Others, such as ‘‘insight therapy’’ (Somnier & Genefke, 1986) and narrative exposure therapy (Bichescu, Neuner, Schauer, & Elbert, 2007; Neuner, Schauer, Klaschik, Karunakara, & Elbert, 2004), are cognitive-emotive in their nature. Cognitive-behavioral therapy (CBT) techniques, which were shown to be effective with survivors of other forms of traumatic experiences, are also employed in the treatment of torture survivors (Basoglu, Ekblad, Baarnhielmc, & Livanou, 2004; Palic & Elklit, 2009). However, none of these models have received sufficient empirical support. Most reports on the effectiveness of the various interventions are descriptive or impressionistic, and the intervention studies are frequently limited by a small sample size (e.g., Bichescu et al., 2007), low response rate or high attrition (e.g., Tol et al., 2009), lack of control group or randomization (e.g., Palic & Elklit, 2009; Stepakoff et al., 2006), and unstandardized measures (e.g., Manneschmidt & Griese, 2009). Overall, most of the studies to date in torture survivors show small to moderate effect size. That is, many of the participants continued to demonstrate high levels of disability or did not reach subclinical levels of distress following the intervention (e.g., Palic & Elklit, 2009; Tol et al., 2009). While the intervention models described above are quite different from each other, they all share a common and important therapeutic feature, namely the motive of testimony. As previously suggested, the healing relationships rely on truth telling and full disclosure (Herman, 1992). Many survivors enter therapy after a long period of silence and denial. In these cases, the clinical setting is the first place in which the complete story of the humiliation and atrocities is told and heard. The therapist’s role as a witness carries a special significance in the case of extreme cruelty and injustice. Indeed, there are various indications for the therapeutic power of testimonies, in which survivors’ stories are being recorded and documented, as part of therapeutic or legal procedure (Agger & Jensen, 1990; Agger, Raghuvanshi, Shabana Khan, Polatin, & Laursen, 2009; Cienfuegos & Monelli, 1983; Igreja et al., 2004; Weine, Kulenovic, Pavkovic, & Gibbons, 1998). Testimony therapy has both private and public elements. The private aspect relates to the survivor’s need to create an integrative narrative of his or her traumatic experiences. The public aspect relates to the survivor’s striving for justice, thus may serve political or judicial purposes. As previously suggested by Agger and colleagues (2009), it links the healing process at the individual or micro-level to the societal or macro-level. To the best of our knowledge, no study to date has examined the relative unique contribution of the private and public aspects of this therapy to survivors’ healing. Yet, of special interest is the fact that one of themost effective therapeutic procedures is often conducted by nonprofessionals, Opinion

Long-term Recovery from Recent Disasters in Japan and the United States

Long-term Recovery from Recent Disasters in Japan and the United States

Women Who Kill Their Children

The killing of a newborn on the day of its birth is known as neonaticide. A child aged 1 through 16 has a different role in the family, and their murder is perceived differently. We would expect mothers charged with filicide to be drawn from a slightly different population than other child-killing mothers. Our study was carried out at the Institute of Forensic Medicine in Angers over a 10-year period. All the victims were autopsied at the Institute of Forensic Medicine in Angers. Information concerning the mothers was collected from forensic medical files, police reports, and legal files. Interviews and forensic psychiatric examinations were available for consultation. Our study concerns 17 observations of child-killing mothers and 19 child autopsies. In 2 cases, the issue was in fact a double murder, with the mother killing all the siblings. The mean age was 3.5 years for victims and 29.5 years for the women. The majority of the mothers were married or lived with their partners. They often had an occupation. Generally the economic status was average. Head trauma, strangulation, suffocation, and drowning were the most frequent means of filicide. However, some mothers used more active methods such as striking and shooting. Disturbed or disturbing behavior was documented in 15 perpetrators. Seven women tried to commit suicide. It was often possible to identify apparent motivation for the offense. In our study, we can distinguish 2 types of killer mothers. We distinguished a first group made up of 5 mothers. These 5 women killed their children in a general context of abused children and present similarities with the neonaticide mothers (young, immature). The other group of filicide mothers is different. They are generally older, married, and employed. The crime is usually premeditated, committed with the direct use of hands and sometimes very violent. To understand the motives or the source of the impulse to kill, we can use a classification such as Resnick's classification: mothers from the first group fall within the framework of accidental filicides: the risk and prevention factors are those of infanticide and ill treatment. For the other mothers, we can distinguish altruistic filicides (8 cases) and spouse revenge filicides (2 cases). Few of the mothers suffered from real psychiatric problems; however, most of them presented troubles which could have been taken into account. A lot of women showed signs of suicidal tendencies prior to the event, displaying aggressive and angry behavior. In general, suicide attempts tend to prevail. These offenders act out of an acute sensitivity to social regulation. A variety of psychosocial stresses appears to have been a major factor. These stresses include lack of social or marital support, economic difficulties, family stress, and unrealistic expectations of motherhood. The precipitating stress may have been a dispute. Prevention begins with the identification of potential perpetrators. Therefore, medical doctors have a significant role in relation to the prevention of child murder.