The suicide mortality rates between 1997-1998 and 2000-2001 in Nantou County of Taiwan following the earthquake of September 21 in 1999.

The paper aims to show the different suicide mortality rate between 1997-1998 and 2000-2001 in Nantou County of Taiwan with earthquake on September 21 (often referred to as the "9-21 earthquake") in 1999. In additional, it also identifies the preventive strategies for the high-risk suicide population. The age-standardized mortality rates for suicide in Nantou County were calculated for the years 1997-1998 and 2000-2001. The suicide standardized mortality ratio (SMR for townships in Nantou were calculated by "type of township" as the standard rate). There is a statistically significant difference in male suicide rates for the years prior to the earthquake (1997-1998) when pooled and compared to the suicide rates for the years after the earthquake (2000-2001). The rate for four age groups (under 25, 25-44, 45-64, 65 and above) all increased, yet all but one (the group of age 45-64) was not statistically significant. The male SMR has slightly increased after the 9-21 earthquake. Yet there are no statistical significances in most townships, except in Kaohsiung and Puli after the 9-21 earthquake. The Kaohsiung SMRs were 1.36 (95% CI: 0.54-2.80) before the earthquake (1997-1998) and 2.01 (95% CI: 1.04-3.52) after the earthquake (2000-2001). The SMRs before and after the earthquake in the Puli Township were 1.51 (95% CI: 0.95-2.29) to 1.56 (95% CI: 1.03-2.27). This study suggests that monitoring high-risk population, especially males or 45-64 years of age who experienced the highest statistically significant suicide rate in this study. The study provides support for providing both the psychological restoration program and, to the extent feasible, financial support for the unemployed as useful public health strategies for suicide prevention in Taiwan.     

Female homicide offenders have greatly increased mortality from unnatural deaths

The mortality of female homicidal offenders has scarcely been studied. Our aim was to examine the mortality of homicidal women in Finland using a representative nation-wide material. The data consisted of all 132 women who underwent forensic psychiatric examinations after committing homicide or attempted homicide in 1982-1992. We analysed their rate and cause of death during follow-up using standardised mortality ratios (SMRs) and the official classification of death. The mean follow-up time for dead subjects was 7 years (S.D. 4), and for the rest 11 years (S.D. 3). There were 22 observed deaths, the expected value being 1.3 (SMR 17.4). The SMR for unnatural deaths was 226 and for suicides 425. The SMRs for women below 40 years were over 220. In conclusion, homicidal women have an over 200-fold risk of unnatural death, rising to over 400-fold for suicide. This should be taken into consideration in planning discharge programmes for homicidal offenders.     

Using Student Risk Factors in School Violence Surveillance Reports: Illustrative Examples for Enhanced Policy Formation, Implementation, and Evaluation

This article presents information about the range and type of violent and associated behaviors that occur on American school campuses. We argue that the prevailing practice of reporting single‐item population estimate trends from school violence surveillance surveys provides an incomplete basis upon which to form and evaluate public policy related to school violence. The presentation draws upon information derived from the 1993, 1995, 1997, and 1999 Centers for Disease Control's Youth Risk Behavior Surveillance (YRBS) surveys (CDC 1995, 1996, 1998, 2000) and the 1997–1998 California Student Survey (CSS) (Austin et al. 2001). Secondary analyses using the YRBS and the CSS are used to illustrate the importance of considering risk and school adjustment patterns when examining school violence trends to formulate public policy agendas.     

Manners of Death in Drug‐Related Fatalities in Florida

To understand the mortality patterns among drug users and potential risk factors, we evaluated drug‐related deaths reported to the Florida Medical Examiners Commission from 2001 to 2013, by substances, demographics, and manner of death. The annual drug‐related fatalities increased by 57% from 2001 to 2013 (total n = 100,882); 51.8% were accidental, 7.9% homicide, 18.6% natural, and 19.6% suicide. The different manners of death exhibited distinct demographic profiles and drug composition. The gender gap was more prominent in homicide. Age ≥55 years was more closely associated with natural death and suicide. Age <35 years and central nervous system (CNS) stimulants including amphetamines and cocaine showed higher relative risks for accidental death and homicide, whereas CNS depressants including benzodiazepines, carisoprodol, opioids, and zolpidem were more strongly associated with accidental death and/or suicide. The findings aid in identifying populations more vulnerable to drug‐related deaths, developing targeted interventions and thereby improving efficiency of preventive efforts.     

Suicide in Police Work: Exploring Potential Contributing Influences

Police officers are considered at increased risk for suicide. The objective of this study was to explore potential influences on suicide ideation among 105 randomly selected men and women urban police officers. Depression, gender, and marital status appeared to be most strongly associated with police suicidal ideation. Depressive symptoms were higher among women than men officers (12.5 percent vs. 6.2 percent). For each standard deviation increase in depressive symptoms, the prevalence ratio (PR) of suicide ideation increased 73 percent in women (PR?=?1.73, 95% CI?=?1.32–2.27) and 67 percent in men (PR?=?1.67, 95% CI?=?1.21–2.30). The association between depression and ideation was stronger among unmarried women officers (PR?=?4.43; 95% CI?=?2.19 – 8.91) than married women officers (PR?=?1.39, 95% CI?=?1.09 – 1.79). While depression has previously been associated with suicide, such results are unusual in a healthy working population such as the police.     

Changes in the Frequency and Clinical Features of Suicide Attempts in the Midwestern Area of Kanagawa after the Great East Japan Earthquake

The aim of this study was to investigate the relationship between the clinical features of suicide attempts and the Great East Japan earthquake in Kanagawa. We enrolled 592 patients who attempted suicide and were hospitalized for inpatient treatment. Clinical features were compared between before the earthquake (A) and after the earthquake (B) groups. The number of suicide attempts increased from 286 to 306. The rate of increase in suicide attempts in men was the highest in the age group of 40–59 years. The frequency of joblessness, family psychiatric histories, precipitating event, and alcohol intake at suicide attempt was significantly higher in the B group than in the A group. The number of patients in serious condition in the B group was significantly higher than that in the A group. Other clinical features related to suicide in people who were indirectly affected by the earthquake disaster should be investigated to develop targeted prevention strategies.     

Suicide Among Children and Adolescents in a Province of Turkey

Abstract:  Despite well-documented increases in completed suicides among children, accurate knowledge of the characteristics of these suicides is very limited. The aim of this study was to investigate general characteristics of suicide among children and adolescents in the province of Istanbul and to evaluate obtained results in the light of the literature. Data were collected from autopsy records of the Morgue Department of Institute of Forensic Medicine, Istanbul. General characteristics of completed suicides among children and adolescents between 2001 and 2005 were retrospectively reviewed. The study included 176 suicides aged 9–19 years. The overwhelming majority of the suicides (92%) were aged 15–19 years. More than half of the suicides (60%) were male. The most frequent means of suicide was hanging (55%) followed by firearms (20%) and jump or descent from height (15%).     

Application of operational psychology to assessment of inmates

Abstract

The newly developed actuarial risk instruments, Static-2002 (Hanson & Thornton, 2003a) and Risk Matrix 2000 (RM2000) (Thornton et al., 2003), were cross-validated and compared with Static-99 (Hanson & Thornton, 2000) in a retrospective follow-up study of 304 forensic psychiatrically evaluated sexual offenders (mean time-at-risk=14.8 years). All instruments predicted any sexual, non-sexual violent and any violent recidivism moderately for child molesters [area under the curve (AUC) of the receiver operating characteristic (ROC)=0.67 (95% CI=0.57–0.77) to 0.76 (95% CI=0.68–0.85)] but poorly for rapists [AUCs=0.64 (95% CI=0.51–0.70) to 0.68 (95% CI=0.59–0.77)]. The instruments also predicted severe sexual recidivism moderately for child molesters [AUCs=0.74 (95% CI=0.63–0.86) to 0.79 (95% CI=0.70–0.89)] but were of no value in informing on this outcome for rapists [AUCs=0.58 (95% CI=0.47–0.68) to 0.63 (95% CI=0.53–0.73)]. AUC estimates were generally higher for Static-2002 and RM2000 than for Static-99, but no single instrument demonstrated statistical superiority. The study provides support for implementing actuarial instruments in applied risk assessments of child molesters.     

A Long‐term Study of the Association between the Relative Poverty Rate and Suicide Rate in Japan

The annual number of suicides in Japan totaled around 23,000 in 1997 and abruptly increased to around 31,000 in 1998. This figure has remained high since then. This abrupt increase in the number of suicides was primarily due to an increase in suicides occasioned by economic concerns. The association between various economic factors and suicide must be studied in detail and over the long term in order to ascertain the association between economic concerns and suicide. This study examined the relative poverty rate and the suicide rate in Japan over 30 years and discussed the association between those two rates. The results suggest that the relative poverty rate may be associated with the suicide rate for both sexes. This association is true for men in particular. The organizations and professionals involved in implementing suicide prevention measures should be cognizant of the current findings and consider formulating additional specific measures.     

Temporal Trends in Rainwater Tank Suicides in Rijeka,Croatia—A 30‐year Study

Although drowning in rainwater tanks is a generally rare phenomenon, this method for suicide has been observed in parts of Croatia. Review of autopsy records at the University of Rijeka, Croatia, was undertaken from 1987 to 2016 to examine this phenomenon. Of 469 drowning deaths, there were 35 suicides in rainwater tanks (7.5%). Overall drowning deaths showed no temporal trends. In contrast, suicidal drownings in rain water tanks showed a marked decline over the years, with 15 cases in 1987–1991, seven in 1992–1996, six in 1997–2001, six in 2002–2006, one in 2007–2011, and none in 2012–2016. Thus, suicidal drowning cases as a percentage of overall drownings dropped from 18% to zero (p<0.001). This study reports a very unusual method of suicide that may have occurred because of the ready availability of large water reservoirs in homes. The recent fall in numbers may relate to less reliance on domestic reservoirs of water.     

The Relationship between Homelessness and Behavior Problems among Youth in North Texas: a Brief Report

This study sought to examine the relationship between homelessness and behavior problems among a community-based sample of youth in North Texas. Data were obtained from a cross-sectional, probability sample of households and a targeted sample of homeless families in Dallas, Texas, with children older than 5 years old (N?=?5232). Parents were asked to report five behavior problems on behalf of their children including arrest or trouble with police, academic problems, behavior problems at school, suspension, and suicide attempts. Logistic and negative binomial regression procedures were used to examine the relationship between homelessness and behavior problems. Youth exposed to homelessness were 36% (OR?=?1.63; 95% CI 1.00–1.85) more likely to exhibit any kind of behavior problems than youth who had never experienced homelessness. Homeless youth had 5.51 times the odds of arrest (95% CI 2.60–11.68), 1.74 times the odds of academic problems (95% CI 1.24–2.43), and more than 3 times the odds of suicide attempts (95% CI 1.46, 7.61) than youth who had never been homeless. Homelessness was associated with higher rates of problem behavior, including arrests, academic problems, and suicide attempts. Because homeless youth are commonly enrolled in school and present at health care clinics and emergency departments, clinics and schools may aid in the identification of homeless youth, as well as referral to care. In this way, clinicians may help reduce the burden of behavioral problems that disproportionately affect homeless youth.     

Congressional Constitutional Interpretation and the Courts: A Preliminary Inquiry into Legislative Attitudes, 1959–2001

Through theoretically informed inquiry into congressional attitudes toward the Constitution and the courts as well as survey research of two modem Congresses, this study considers the prospects and implications of a more salient legislative role in constitutional affairs. By analyzing survey responses from the 86th (1959–61) and 106th (1999–2001) Congresses, and the political context in which these views were formed, this essay explores the legislature's evolving conception of its role and capacities as a constitutional interpreter. Among other findings, Congress demonstrates a persistent and somewhat surprising interest in asserting an independent, distinctive constitutional voice, although it has somewhat conflicted and underdeveloped views about how to achieve this objective. While this essay points to significant barriers to fostering a coherent and forceful congressional presence in constitutional decision making, it also suggests institutional organizations and strategies that may be promising bases for promoting this goal.     

Natural rubber-containing medical devices; user labeling; cold seal adhesives partial stay--FDA. Final rule

The final rule for user labeling requirements for natural rubber-containing medical devices, 21 CFR 801-437, was published on September 30, 1997, and becomes effective on September 30, 1998. The Food and Drug Administration (FDA) is adding a note to that rule to stay, for 270 days from the effective date, paragraphs (f) and (g) as those final rule requirements relate to device packaging that uses "cold seal" adhesives. Labeling changes required by other paragraphs of this final rule must be incorporated in the labeling of devices distributed after September 30, 1998, even if the devices are packaged in "cold seal" packages. Device packaging that uses natural rubber only on adhesives contained in the flaps of device packaging is not considered subject to the rule. Manufacturers of devices packaged with "cold seal" adhesives may, if necessary, submit a petition for an extension of the 270-day stay.     

Acute Influence of Alcohol,THC or Central Stimulants on Violent Suicide: A Swedish Population Study

Alcohol and substance abuse in general is a risk factor for suicide, but very little is known about the acute effect in relation to suicide method. Based on information from 18,894 medico‐legal death investigations, including toxicological findings and manner of death, did the present study investigate whether acute influence of alcohol, tetrahydrocannabinol (THC), or central stimulants (amphetamine and cocaine) was related to the use of a violent suicide method, in comparison with the nonviolent method self‐poisoning and alcohol‐/illicit drug‐negative suicide decedents. Multivariate analysis was conducted, and the results revealed that acute influence of THC was related to using the violent suicide method–– jumping from a height (RR 1.62; 95% CI 1.01–2.41). Alcohol intoxication was not related to any violent method, while the central stimulant‐positive suicide decedent had a higher, albeit not significant, risk of several violent methods. The study contributes with elucidating suicide methods in relation to acute intoxication.     

Hypothermia-related Deaths: A 10-year Retrospective Study of Two Major Metropolitan Cities in the United States*

Hypothermia-related deaths affect vulnerable populations and are preventable. They account for the vast majority of weather-related deaths in the United States. The postmortem diagnosis of hypothermia can be challenging, as there are no pathognomonic signs. The electronic databases of the New York City Office of Chief Medical Examiner and Harris County Institute of Forensic Sciences were searched for all fatalities where the primary cause of death included hypothermia, between January 2009 and July 2019. There were 139 hypothermia deaths in New York City (NYC) with an average annualized rate of 1.7 per million. During this same time, there were 50 hypothermia deaths in Houston with an average annualized rate of 2.4 per million. Males were more likely to die of hypothermia compared to females in both cities. The rate ratio (RR) in NYC was 3.55 (95% CI 2.40, 5.25), while the RR in Houston was 2.83 (95% CI 1.50, 5.32). Age- and sex-specific standardized hypothermia mortality rates were 18.2 (95% CI 15.1, 21.2) per million in NYC and 30.1 (95% CI 21.7, 38.6) per million in Houston. The comparative hypothermia death ratio was 1.66 (95% CI 1.19, 2.30), indicating hypothermia mortality in Houston was 66% higher than in NYC. There was no correlation between zip code poverty rates and hypothermia-related deaths. The most consistent autopsy finding was Wischnewski spots (56.6%), and ethanol was the most common toxicological finding (36.5%). Local agencies can use this data to target these higher-risk populations and offer appropriate interventions to try to prevent these deaths.     

Bodies found in the waterways of New York City

We reviewed the case records for all decedents recovered from the waterways of New York City over a three year period (1997-2000). The epidemiological profile, circumstances, toxicology findings, putrefactive changes, date of recovery, length of immersion, and injuries were examined. There were 123 deaths: 52 suicides, 50 undetermined, 16 accidents, and five homicides. The causes of death included: 97 drownings, 13 undetermined, and 13 other. Of all the floating decedents, 27% were without putrefactive change. All found after two or more weeks of immersion were recovered from November to May. The detection of ethanol and illicit drugs was 53% in the accident, 41% in the suicide, and 33% in the undetermined groups. Detection of ethanol and/or drugs of abuse is not a reliable criterion to distinguish suicide from accident. The identification of the deceased is pivotal for determining the manner of these deaths. Therefore, a great reliance is placed upon the medical investigator and the police (including the missing persons bureau) to determine the circumstances and identification of the decedent.     

An ecological study of factors associated with rates of self-inflicted death in prisons in England and Wales

This study describes ecological associations between self-inflicted death rates and prison-level environmental indicators over the period 2000-2002 in England and Wales. The objective was to assist in the development of interventions for reducing the incidence of self-inflicted deaths in prisons in England and Wales, by identifying risk factors, including overcrowding, positive drug tests, the number of assaults, purposeful activity, offending behaviour programmes, and cost per prisoner. Poisson regression was used to estimate associations between self-inflicted death rates and these potential risk factors, controlling for different categories of prison. The annual rate of self-inflicted death during 2000-2002 was 1.14 per 1000 (95% CI 0.98 to 1.34), with no evidence for a difference in the two years. Highest rates were in the Male Local and Women's prisons at 1.86 (95% CI 1.42 to 2.26) and 2.27 (95% CI 1.35 to 3.84) per 1000 respectively. In a multivariate analysis, overcrowding, assault rate and purposeful activity were significant. In an analysis controlling also for prison category, only purposeful activity remained independently significant, as a protective factor (RR 0.57, 95% CI 0.35 to 0.92, p=0.02) with weaker evidence for a positive association with positive drug tests (RR 1.41, 95% CI 0.96 to 2.05, p=0.08). Despite concerns about the quality of routinely collected data and the interpretation of ecological associations, this study suggests that a higher level of purposeful activity is independently associated with lower rates of self-inflicted death, whatever the prison category. This adds support to other studies conducted at the level of the individual prisoner.     

Ordinary Heroes vs. Failed Lawyers—Public Interest Litigation in Erin Brockovich and Other Contemporary Films

Although feature films may overpraise lawyers and civil courts as means of securing justice, they caricature lawyers and litigation. Analysis of Erin Brockovich (directed by Steven Soderbergh and produced by Danny DeVito, et al., 2000) reveals four motifs—two favorable and two unfavorable to public‐interest litigants and litigation—that characterize similar films in the last decades: Class Action (1991), The Rainmaker (1997), The Sweet Hereafter (1997), A Civil Action (1998), The Insider (1999), Runaway Jury (2003), and North Country (2005). These filmic populist romances promote ordinary heroines (mostly) who redeem a problematic system through common sense and everyday virtue rather than through laws, lawyers, and litigation.