Homicidio por combinación de métodos de asfixia / Homicide by combination of methods of asphyxiation

Introducción el homicidio por combinación de métodos de asfixia se observa mayoritariamente en las personas de edad avanzada o con algún impedimento físico capaz de contrarrestar la agresión. Material y métodos se realizó un estudio observacional retrospectivo sobre 634 autopsias, cinco cumplían las características de homicidios por combinación de métodos de asfixia. Resultados dos hombres y 3 mujeres, con edad promedio de 69 años, con estudios toxicológicos negativos, víctimas de un solo agresor, presentaron lesiones cutáneas periorificiales (bucales y nasales), hemorragias musculares en el tórax, fracturas costales, lesiones contusas en la cabeza, interpretadas como de sometimiento. Discusión en la combinación de métodos de asfixia, los hallazgos que deben ser vistos en conjunto son: traumatismos craneoencefálicos para someter a la víctima, lesiones cutáneas en el cuello, la cara, la cara interna de los labios, fracturas costales y lesiones por contrapresión en la espalda, los glúteos o los codos. Contextualizados en conjunto pueden explicar la dinámica de esta modalidad homicida. (AU)

Introduction Homicide by combination of suffocation methods is observed mainly in elderly people or with some physical impediment capable of counteracting the aggression. Material and methods A retrospective observational study was carried out on 634 autopsies. Five met the characteristics of homicides by combination of asphyxiation methods. Results Two men and three women, average age 69 years, with negative toxicological studies, victims of a single aggressor, presented peri orificial skin lesions (mouth and nose), muscle hemorrhages in the thorax, rib fractures, blunt injuries to the head interpreted as like submission. Discussion In the combination of asphyxia methods the findings that must be seen together: Head injuries to subdue the victim, skin lesions on the neck, face, inner face of the lips, rib fractures, and counter-pressure injuries to the back, buttocks, or elbows. Contextualized together, can explain the dynamics of this homicidal modality. (AU)

What is suicide? Classifying self-killings.

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is 'self-killing,' rather than 'intentional self-killing.' Adopting this understanding of suicide performs several functions: (1) We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. (2) Following such a taxonomy differentiates types of suicides. (3) This approach has application in addressing negative connotations about suicide. (4) As a robust view, adding intention is an unnecessary complication. (5) It is more consistent with psychological and sociological assessments of suicide than 'intentional self-killing.' (6) It has useful applications in informing public policy. This paper's focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour.

Migración de proyectil en vía aérea. Reporte de un caso / Bullet migration in the airway. Case report

A propósito de un caso de migración de un proyectil de arma de fuego en la vía aérea, en el contexto de una agresión con múltiples lesiones por proyectil de arma de fuego, se analiza la ubicación final del proyectil en el bronquio lobar inferior derecho tras ingresar en la región escapular izquierda, y las posibles causas de su trayecto por la vía aérea. Se remarca el concepto de «proyectil errante», el conocimiento de tal fenómeno y su importancia en la búsqueda y hallazgo de los mismos

Concerning the case of the migration of a firearm projectile in the airway, in the context of an attack that produced multiple projectile impacts on the body; this analysis includes the study of the final location of the projectile in the lower right lobar bronchus, after entering the left scapular region, and of the possible causes of its wandering course through the airway. This essay focuses on the concept of 'wandering bullets', the knowledge surrounding the phenomenon and the importance of searching and finding them during autopsy

Cluster analysis of child homicide in South Korea.

BACKGROUND: There has been an insufficient in-depth analysis of the nature and prevalence of the typologies of child homicide in Asia, particularly in South Korea. OBJECTIVE: In the current study, we sought to determine the prevalence and identify the heterogeneity of the child homicide phenomenon in South Korea. PARTICIPANT AND SETTINGS: All 341 original case files (i.e., hospital, police, and autopsy reports) of homicide incidents involving children aged 0-18 in 2016 were obtained from the forensic autopsy archives of the National Forensic Service (NFS), which handles 100 % of the medico-legal autopsies in South Korea. These were examined and reclassified based on our definition. METHOD: A cluster analysis using Gower's distance was applied, which has rarely been utilized in this field of research. By performing a qualitative analysis, we first extracted 70 (numerical, logical, categorical) crime, victim, perpetrator, and household relevant variables, which were later utilized in the cluster analysis. RESULTS: Among the 341 cases from 2016, 95 were judged to be at least suspicious child homicide cases. When applying the cluster analysis, eight sub-clusters were extracted: child torture, maternal filicide, neonaticide, death not related to previous abuse, paternal filicide, paternal infanticide, maternal infanticide, and psychotic killings. CONCLUSIONS: The commonality and the unique aspect of the child homicide phenomenon in South Korea, in comparison with the results from previous research from other countries, are discussed.

Urban violence and risk factors for femicide in the Brazilian Amazon. / Violência urbana e fatores de risco relacionados ao feminicídio em contexto amazônico brasileiro.

Femicide has received relatively little research attention, despite its severity. Estimates of femicide depend on the strategies used to define it within the sociocultural and political context. This study aimed to assess intentional homicides of women, focusing on femicides, highlighting the characteristics and risk factors. This was a cross-sectional study based on daily surveillance of homicides in the press and mortality records. The study considered fatal victims of assault in women over 11 years of age in Manaus, Amazonas State, Brazil, in 2016-2017. Classification of femicide was based on Brazil's Law n. 13,104/2015. Relative risk was estimated by Poisson regression, and a hierarchical model was used to include variables in the models. Analyses were performed in the R statistical package. Of 138 fatal victims of assault, 52 were cases of femicide, or 37.7% (CI: 29.4-45.5). Each unit addition of age reduced the risk of femicide by 3% (CI: 0.95-0.99). Risk of femicide was 40% lower (CI: 0.40-0.90) in women with up to seven years of schooling, when compared to those with eight years or more. Women killed by bodily force showed 5.5 times higher risk (CI: 2.6-11.3) of femicide, compared to those killed with firearms. Relative risk of femicide was 1.4 (CI: 1.1-2.7) in women killed in daytime, compared to those killed at night. The proportion of femicide in this study was lower than in previous estimates in Brazil, and the local burden of urban crime appears to explain part of this discrepancy. This study showed that age, schooling, use of bodily force, and time of day when the assault occurred are associated with femicide.

Apesar de sua gravidade, o feminicídio é pouco investigado e suas estimativas dependem das estratégias usadas à sua caracterização, do contexto sociocultural e político. Este estudo teve como objetivo avaliar os homicídios intencionais de mulheres, com enfoque nos feminicídios, destacando suas características e fatores de risco. Estudo transversal, baseado em vigilância diária de homicídios na imprensa e em registros de mortalidade. Foram consideradas vítimas fatais por agressões, mortes de mulheres maiores de 11 anos, residentes em Manaus, Amazonas, Brasil, em 2016-2017. A classificação de feminicídios baseou-se na Lei nº 13.104/2015. O risco relativo foi estimado mediante regressão de Poisson e um modelo hierárquico foi empregado para a introdução das variáveis nos modelos. As análises foram efetuadas no software R. De 138 vítimas fatais por agressões, 52 foram feminicídios, 37,7% (IC: 29,4-45,5). A cada acréscimo unitário de idade o risco de feminicídio reduzia em 3% (IC: 0,95-0,99). O risco de feminicídio foi 40% menor (IC: 0,40-0,90) nas mulheres com até sete anos de escolaridade, em comparação às que tinham oito anos ou mais; as mulheres agredidas mediante força corporal tiveram risco 5,5 (IC: 2,6-11,3) vezes maior de feminicídio, em comparação às que foram agredidas com arma de fogo; e risco de feminicídio de 1,4 (IC: 1,1-2,7) nas que foram mortas durante o dia, em relação às que morreram de noite. A proporção de feminicídio deste estudo foi inferior a estimativas prévias no Brasil e a carga local da criminalidade urbana parece explicar parte desta divergência. Este trabalho demonstrou que idade, escolaridade, uso da força corporal e turno da agressão estão associados ao feminicídio.

A pesar de su gravedad, el feminicidio ha sido poco investigado y sus estimaciones dependen de las estrategias usadas para su caracterización, así como del contexto sociocultural y político. El objetivo de este estudio fue evaluar los homicidios intencionales de mujeres, centrándose en los feminicidios, destacando sus características y factores de riesgo. Se trata de un estudio transversal, basado en la vigilancia diaria de homicidios en prensa y en registros de mortalidad. Se consideraron víctimas fatales por agresiones, muertes de mujeres mayores de 11 años, residentes en Manaus, Amazonas, Brasil, entre 2016-2017. La clasificación de feminicidios se basó en la Ley nº 13.104/2015. El riesgo relativo se estimó mediante regresión de Poisson y se empleó un modelo jerárquico para la introducción de las variables en los modelos. Los análisis se efectuaron en el software R. De 138 víctimas fatales por agresiones, 52 fueron feminicidios, un 37,7% (IC: 29,4-45,5). Con cada aumento unitario de edad, el riesgo de feminicidio se reducía en un 3% (IC: 0,95-0,99); el riesgo de feminicidio fue un 40% menor (IC: 0,40-0,90) en las mujeres con hasta siete años de escolaridad, en comparación con las que tenían ocho años o más; las mujeres agredidas mediante fuerza corporal tuvieron un riesgo 5,5 (IC: 2,6-11,3) veces mayor de feminicidio, en comparación con las que fueron agredidas con arma de fuego; y un riesgo de feminicidio de 1,4 (IC: 1,1-2,7) quienes fueron asesinadas durante el día, en relación con quienes murieron de noche. La proporción de feminicidio de este estudio fue inferior a las estimaciones previas en Brasil y la carga local de la criminalidad urbana parece explicar parte de esta divergencia. Este estudio demostró que la edad, escolaridad, uso de la fuerza corporal y período del día de la agresión están asociados al feminicidio.

Sex Worker Homicide Series: Profiling the Crime Scene.

Contrary to popular misconceptions, offenders who kill sex workers as part of their series exhibit substantial variability in their victim selection and behavioral patterns, thus creating additional issues for the investigation of these crimes. This article first aims to outline differences in the demographics of crime scene actions present in homicide series with exclusively sex worker victims and series that includes both sex worker and non-sex worker victims, with the aim of understanding the crime scene aetiology of these two different types of series. Second, the research aims to determine between-series differences of victimology as well as crime scene action between sex worker series and mixed-victim series. Third, the research focuses on mixed-victim series and aims to determine the within-series similarities of victimology and crime scene actions, that is, what factors link sex worker victims and non-sex worker victims in the same series. Data were collected through a large-scale review of international media sources to identify solved serial homicide cases that have included at least one sex worker. Of the 83 series looked at, 44 (53%) included sex worker victims only, and 39 (47%) of the series included both sex worker and non-sex worker victims. The findings highlight the challenges that these types of crime present for investigation and the implications they have on current crime analysis research and practice, and results are discussed in line with theoretical and psychological issues relating to understanding differentiation and similarity, as well as investigative implications relating to linkage blindness and linking of serial crimes.

MATCH: A New Approach for Differentiating & Linking Series of Sex Worker Homicides and Sexual Assaults.

Sex workers as a group are one of the more common targets in serial homicide, yet the most likely to go unsolved. Part of the reason for this is the difficulty in linking individual crime scenes to a series, especially in those series where offenders not only target sex worker victims but also target non-sex worker victims. Inconsistencies in both victim targeting and behaviors engaged in across series add to the difficulties of linking and solvability in these types of crimes. The current study aimed to add to the current body of literature on serial crime linkage by examining not only the most salient behavioral indicators useful for crime scene classification of serial homicides that involve sex worker victims but also examine the trajectories of behavioral change that can help link apparently inconsistent crime scenes and proposes the new Model for the Analysis of Trajectories and Consistency in Homicide (MATCH). The study examines 83 homicide series, including 44 (53%) series where all victims were sex workers and 39 (47%) series that included a mix of sex workers and non-sex worker victims. Using the MATCH system allowed for the majority of series to be classified to a dominant trajectory pattern, over half as many as a traditional consistency analysis that focusses on behavioral similarity matching. Results further showed that Sex Worker Victim series were almost three times more consistent across their series than Mixed-Victim series, not only in victim selection but also in the overall behavioral patterns. Findings are discussed in line with theoretical and psychological issues relating to understanding the nature of behavioral consistency and the importance of going beyond simple matching toward a model that allows for the identification of consistency in seemingly inconsistent series, as well as investigative implications relating to linking serial crimes.

An Updated Sexual Homicide Crime Scene Rating Scale for Sexual Sadism (SADSEX-SH).

The Sexual Homicide Crime Scene Rating Scale for Sexual Sadism (SADSEX-SH) is a rating scale which dimensionally measures the degree of offender sexual sadism in suspected sexual homicide cases. Scoring is accomplished using crime scene and related investigative information. Preliminary norms for the SADSEX-SH prototype indicate that it correctly classified offenders with and without sexual sadism. This study further assessed SADSEX-SH sensitivity, specificity, and inter-rater reliability by comparing a larger sample of male sexual homicide offenders with (n = 20) and without (n = 20) sexual sadism. Two items generally undetectable at crime scenes were removed from the originally proposed 10-item scale, resulting in a final 8-item version. SADSEX-SH total scores for the two groups significantly differed (7.7 ± 3.5, range = 2-14 vs. 2.6 ± 2.0, range = 0-7, t = 5.58, p < .001). Inter-rater reliability was excellent (intraclass correlation coefficients [ICCs] = 0.6-1.0). Using a revised cutoff score of 6, sensitivity was 70.0% and specificity was 90%. This revised scale may prove useful for investigators, clinicians, and institutional professionals in helping to identify and address sexual sadism in sexual homicide offenders.

Sexual Homicide of Children: A New Classification.

The sexual homicide of a child is an unusual event, and very few studies have been conducted on the topic. Previous studies have mainly focused on the differences between sexual homicide of child and adult victims. The current study aims to identify a typology of sexual homicide of children based on modus operandi, offenders' and victims' characteristics. Using two-step cluster analysis on a sample of 72 cases of extra familial sexual homicide of children (aged 16 years or below) from France, six clusters have been identified on the basis of eight modus operandi variables: intentional/prepubescent, inadvertent/prepubescent, intentional/preteen, inadvertent/preteen, indiscriminate/teen, and intentional/teen. External validity of the classification was tested using 51 additional variables related to victims, offenders, and other modus operandi characteristics. Findings showed that sexual homicide of children is a heterogeneous phenomenon, largely influenced by the actual age of the victim and the type of violence used. Implications of the findings are discussed considering prevention, criminal investigation, and correctional practices.

The Unusual Suspects: Multiple-Perpetrator and Multiple Concurrent Victim Sexual Homicide.

Sexual homicide typically implies a crime involving two people: perpetrator and victim. Thus, multiple-perpetrator and multiple concurrent victim sexual murderers are unusual, empirically invisible due to their exclusion from (or burying within) research samples. The present study examines 21 such cases of male sexual murderers having perpetrated at least one sexual homicide either together with a co-offender or alone but killing two victims at once. The aim was to investigate just how unusual, or not, these cases may be in relation to current scientific understanding of sexual murderers and their crimes. A descriptive analysis of offenses (co-offender and offender-victim dynamics, modus operandi) and offender characteristics is presented. Main findings, that multiple-perpetrator and multiple concurrent victim sexual murderers are not so unusual in that they are well conceptualized through application of the established sexualized, grievance, and rape murderer typology, are discussed in relation to clinical and empirical implications.

Sexual Homicide Targeting Children: Exploring Offender, Victim, and Modus Operandi Factors.

Sexual child homicides are rare, even among sexual homicides, and no previous study has compared sexual child homicide with nonsexual child homicides. To address this gap in research, this study aims to compare sexual child homicide offenders (n = 8) with two comparison groups: sexual adult homicide offenders (n = 89) and nonsexual child homicide offenders (n = 176) regarding victim, offender, and modus operandi factors. Using bivariate analysis, the results show that although sexual child homicide offenders appear more similar to other sexual homicide offenders than to homicide offenders, sexual offenders targeting children differ from both groups on certain variables. Sexual child homicide offenders more often used strangulation as a method of killing, had intoxicated victims, used multiple locations, and destroyed evidence after the murder. The study concludes that sexual homicide offenders targeting children should be considered distinct from other offenders and that the salient characteristics linked to sadism and instrumentality should be further examined.

The Preference for Strangulation in a Sexually Motivated Serial Killer.

The existing literature on the killing method of choice for sexually motivated serial killers suggests strangulation as the preferable means of homicide, when the victim is female. When homicide victims are male, however, existing research suggests that firearms and blades are preferable methods of causing death. A case is presented here of a sexually motivated male serial killer who exclusively targeted males and who chose strangulation as his means of killing. Analysis suggests that not only is the psychological constitution of the killer an important factor in understanding how they kill victims but, also, the nature of the sexual act is an important determinant in the method of killing in male on male sexually motivated killing.

Violência urbana e fatores de risco relacionados ao feminicídio em contexto amazônico brasileiro / Violencia urbana y factores de riesgo relacionados con el feminicidio en el contexto amazónico brasileño / Urban violence and risk factors for femicide in the Brazilian Amazon

Resumo: Apesar de sua gravidade, o feminicídio é pouco investigado e suas estimativas dependem das estratégias usadas à sua caracterização, do contexto sociocultural e político. Este estudo teve como objetivo avaliar os homicídios intencionais de mulheres, com enfoque nos feminicídios, destacando suas características e fatores de risco. Estudo transversal, baseado em vigilância diária de homicídios na imprensa e em registros de mortalidade. Foram consideradas vítimas fatais por agressões, mortes de mulheres maiores de 11 anos, residentes em Manaus, Amazonas, Brasil, em 2016-2017. A classificação de feminicídios baseou-se na Lei nº 13.104/2015. O risco relativo foi estimado mediante regressão de Poisson e um modelo hierárquico foi empregado para a introdução das variáveis nos modelos. As análises foram efetuadas no software R. De 138 vítimas fatais por agressões, 52 foram feminicídios, 37,7% (IC: 29,4-45,5). A cada acréscimo unitário de idade o risco de feminicídio reduzia em 3% (IC: 0,95-0,99). O risco de feminicídio foi 40% menor (IC: 0,40-0,90) nas mulheres com até sete anos de escolaridade, em comparação às que tinham oito anos ou mais; as mulheres agredidas mediante força corporal tiveram risco 5,5 (IC: 2,6-11,3) vezes maior de feminicídio, em comparação às que foram agredidas com arma de fogo; e risco de feminicídio de 1,4 (IC: 1,1-2,7) nas que foram mortas durante o dia, em relação às que morreram de noite. A proporção de feminicídio deste estudo foi inferior a estimativas prévias no Brasil e a carga local da criminalidade urbana parece explicar parte desta divergência. Este trabalho demonstrou que idade, escolaridade, uso da força corporal e turno da agressão estão associados ao feminicídio.

Resumen: A pesar de su gravedad, el feminicidio ha sido poco investigado y sus estimaciones dependen de las estrategias usadas para su caracterización, así como del contexto sociocultural y político. El objetivo de este estudio fue evaluar los homicidios intencionales de mujeres, centrándose en los feminicidios, destacando sus características y factores de riesgo. Se trata de un estudio transversal, basado en la vigilancia diaria de homicidios en prensa y en registros de mortalidad. Se consideraron víctimas fatales por agresiones, muertes de mujeres mayores de 11 años, residentes en Manaus, Amazonas, Brasil, entre 2016-2017. La clasificación de feminicidios se basó en la Ley nº 13.104/2015. El riesgo relativo se estimó mediante regresión de Poisson y se empleó un modelo jerárquico para la introducción de las variables en los modelos. Los análisis se efectuaron en el software R. De 138 víctimas fatales por agresiones, 52 fueron feminicidios, un 37,7% (IC: 29,4-45,5). Con cada aumento unitario de edad, el riesgo de feminicidio se reducía en un 3% (IC: 0,95-0,99); el riesgo de feminicidio fue un 40% menor (IC: 0,40-0,90) en las mujeres con hasta siete años de escolaridad, en comparación con las que tenían ocho años o más; las mujeres agredidas mediante fuerza corporal tuvieron un riesgo 5,5 (IC: 2,6-11,3) veces mayor de feminicidio, en comparación con las que fueron agredidas con arma de fuego; y un riesgo de feminicidio de 1,4 (IC: 1,1-2,7) quienes fueron asesinadas durante el día, en relación con quienes murieron de noche. La proporción de feminicidio de este estudio fue inferior a las estimaciones previas en Brasil y la carga local de la criminalidad urbana parece explicar parte de esta divergencia. Este estudio demostró que la edad, escolaridad, uso de la fuerza corporal y período del día de la agresión están asociados al feminicidio.

Abstract: Femicide has received relatively little research attention, despite its severity. Estimates of femicide depend on the strategies used to define it within the sociocultural and political context. This study aimed to assess intentional homicides of women, focusing on femicides, highlighting the characteristics and risk factors. This was a cross-sectional study based on daily surveillance of homicides in the press and mortality records. The study considered fatal victims of assault in women over 11 years of age in Manaus, Amazonas State, Brazil, in 2016-2017. Classification of femicide was based on Brazil's Law n. 13,104/2015. Relative risk was estimated by Poisson regression, and a hierarchical model was used to include variables in the models. Analyses were performed in the R statistical package. Of 138 fatal victims of assault, 52 were cases of femicide, or 37.7% (CI: 29.4-45.5). Each unit addition of age reduced the risk of femicide by 3% (CI: 0.95-0.99). Risk of femicide was 40% lower (CI: 0.40-0.90) in women with up to seven years of schooling, when compared to those with eight years or more. Women killed by bodily force showed 5.5 times higher risk (CI: 2.6-11.3) of femicide, compared to those killed with firearms. Relative risk of femicide was 1.4 (CI: 1.1-2.7) in women killed in daytime, compared to those killed at night. The proportion of femicide in this study was lower than in previous estimates in Brazil, and the local burden of urban crime appears to explain part of this discrepancy. This study showed that age, schooling, use of bodily force, and time of day when the assault occurred are associated with femicide.

Encapretamento: un mecanismo homicida importado / Incaprettamento: An imported homicide method

No disponible

Taxonomía de los homicidios de mujeres en las relaciones de pareja / Taxonomy of homicides of women in intimate partner relationships

La prevención de la violencia contra la pareja supone un problema que ha suscitado gran interés a nivel internacional. El homicidio de pareja es el exponente más grave, aunque su prevalencia sea baja y su etiología compleja. Este trabajo revisa brevemente la descripción del problema desde la perspectiva de género y la existencia de asimetría, la perspectiva de la violencia y su descripción de factores de riesgo diferenciales y el modelo ecológico que relaciona variables personales, contextuales y comunitarias, presentando una propuesta más integradora. Se describen los estudios que analizan y comparan perfiles de homicidas, así como la situación en materia de evaluación del riesgo, todo ello con especial atención a las implicaciones para el contexto español. Por último, por su relevancia se discute la existencia de tipologías de homicidas y perfiles más próximos a patrones o dinámicas suicidas (en los homicidios diádicos y los familicidios). La información disponible pone de manifiesto la necesidad de ampliar el estudio de los homicidas de pareja y la dificultad de anticipar muchos de estos casos

Intimate partner violence prevention is a challenge that has received wide international interest. Homicide is the most serious result of this type of violence, although its prevalence is low and its etiology is complex. This paper briefly reviews the description of the problem from a gender perspective and the existence of asymmetry, the perspective of violence and its description of differential risk factors, and the ecological model that connects personal, contextual, and societal variables, presenting a more integrative proposal. Studies analyzing and comparing homicide profiles are described, as well as the state of the art regarding risk assessment, with special attention to the implications for the Spanish context. Finally, due to its relevance, the existence of typologies of homicides as well as profiles closer to suicidal patterns are discussed (in dyadic homicides and familicides). The available information highlights the need to expand the study of intimate partner homicides and the difficulty of anticipating many of these cases

Drowning mortality by intent: a population-based cross-sectional study of 32 OECD countries, 2012-2014.

OBJECTIVE: To compare the drowning mortality rates and proportion of deaths of each intent among all drowning deaths in Organisation for Economic Co-operation and Development (OECD) countries in 2012-2014. DESIGN: A population-based cross-sectional study. SETTING: 32 OECD countries. PARTICIPANTS: Individuals in OECD countries who died from drowning. MAIN OUTCOME MEASURES: Drowning mortality rates (deaths per 100 000 population) and proportion (%) of deaths of each intent (ie, unintentional intent, intentional self-harm, assault, undetermined intent and all intents combined) among all drowning deaths. RESULTS: Countries with the highest drowning mortality rates (deaths per 100 000 population) were Estonia (3.53), Japan (3.49) and Greece (2.40) for unintentional intent; Ireland (0.96), Belgium (0.96) and Korea (0.89) for intentional self-harm; Austria (0.57), Korea (0.56) and Hungary (0.44) for undetermined intent and Japan (4.35), Estonia (3.70) and Korea (2.73) for all intents combined. Korea ranked 12th and 3rd for unintentional intent and all intents combined, respectively. By contrast, Belgium ranked 2nd and 15th for intentional self-harm and all intents combined, respectively. The proportion of deaths of each intent among all drowning deaths in each country varied greatly: from 26.2% in Belgium to 96.8% in Chile for unintentional intent; 0.7% in Mexico to 57.4% in Belgium for intentional self-harm; 0.0% in nine countries to 4.9% in Mexico for assault and 0.0% in Israel and Turkey to 38.3% in Austria for undetermined intent. CONCLUSIONS: A large variation in the practice of classifying undetermined intent in drowning deaths across countries was noted and this variation hinders valid international comparisons of intent-specific (unintentional and intentional self-harm) drowning mortality rates.

Characterising violent deaths of undetermined intent: a population-based study, 1999-2012.

OBJECTIVES: Violent deaths classified as undetermined intent (UD) are sometimes included in suicide counts. This study investigated age and sex differences, along with socioeconomic gradients in UD and suicide deaths in the province of Ontario between 1999 and 2012. METHODS: We used data from the Institute for Clinical Evaluative Sciences, which has linked vital statistics from the Office of the Registrar General Deaths register with Census data between 1999 and 2012. Socioeconomic status was operationalised through the four dimensions of the Ontario Marginalization Index. We computed age-specific and annual age-standardised mortality rates, and risk ratios to calculate risk gradients according to each of the four dimensions of marginalization. RESULTS: Rates of UD-classified deaths were highest for men aged 45-64 years residing in the most materially deprived (7.9 per 100 000 population (95% CI 6.8 to 9.0)) and residentially unstable (8.1 (95% CI 7.1 to 9.1)) neighbourhoods. Similarly, suicide rates were highest among these same groups of men aged 45-64 living in the most materially deprived (28.2 (95% CI 26.1 to 30.3)) and residentially unstable (30.7 (95% CI 28.7 to 32.6)) neighbourhoods. Relative to methods of death, poisoning was the most frequently used method in UD cases (64%), while it represented the second most common method (27%) among suicides after hanging (40%). DISCUSSION: The similarities observed between both causes of death suggest that at least a proportion of UD deaths may be misclassified suicide cases. However, the discrepancies identified in this analysis seem to indicate that not all UD deaths are misclassified suicides.

Modeling the Movement of Homicide by Type to Inform Public Health Prevention Efforts.

OBJECTIVES: We modeled the spatiotemporal movement of hotspot clusters of homicide by motive in Newark, New Jersey, to investigate whether different homicide types have different patterns of clustering and movement. METHODS: We obtained homicide data from the Newark Police Department Homicide Unit's investigative files from 1997 through 2007 (n = 560). We geocoded the address at which each homicide victim was found and recorded the date of and the motive for the homicide. We used cluster detection software to model the spatiotemporal movement of statistically significant homicide clusters by motive, using census tract and month of occurrence as the spatial and temporal units of analysis. RESULTS: Gang-motivated homicides showed evidence of clustering and diffusion through Newark. Additionally, gang-motivated homicide clusters overlapped to a degree with revenge and drug-motivated homicide clusters. Escalating dispute and nonintimate familial homicides clustered; however, there was no evidence of diffusion. Intimate partner and robbery homicides did not cluster. CONCLUSIONS: By tracking how homicide types diffuse through communities and determining which places have ongoing or emerging homicide problems by type, we can better inform the deployment of prevention and intervention efforts.