Epidemiology of homicide-suicide events: Oklahoma, 1994-2001

In Oklahoma, all nonnatural deaths must be reported to the Office of the Chief Medical Examiner (ME), whose trained investigators report cause of death using a centralized, statewide, standardized reporting system. The purpose of this study was to determine temporal trends of Oklahoma homicide-suicide events and characterize the epidemiology of these events. By reviewing all ME reports of homicides and suicides from 1994 through 2001, we identified 73 homicide-suicide events resulting in 73 suicides and 89 homicides. Suicidal perpetrators of homicide-suicide events were most often white men aged >or=30 years who killed a current or ex-spouse or intimate partner. Homicide victims tended to be younger women the same race as their killer. Firearms were the predominant method of death in both homicides and suicides, with handguns used most frequently. Divorce/estrangement was the main contributing factor to these events, and the most common relationship type was possessive. The existence of a statewide, centralized, and computerized ME system and the ability to access the detailed information in the ME narratives were critical to identifying homicide-suicide events and obtaining the type of detailed information necessary to fully investigate these events.     

Origin and development of forensic medicine in India

CONTEXT:: The medical profession is one of great antiquity in India. However, the history of medicine and, in particular, the role of medicine in the administration of justice in India has not been discussed very much. The present paper attempts to fill in this lacuna and traces the medicolegal practice from ancient times to British India. SOURCE:: This paper is based on archival materials collected from the Tamilnadu State Archives, Chennai, and Madras Medical College Library, Chennai, and University of Madras Library, Chennai. MAIN OBSERVATIONS:: The medical men in ancient India were considered as men of wisdom, and one of the ancient Tamil hymns equates the doctor-patient relationship to that of the dedicated love of a devotee to God. Kautilya's Arthashastra gives a list forensic evidence for establishing the cause of death and describes the necessity of autopsy in establishing the cause of death.In British India, the early incidence of custodial death and its certification by medical practitioners, issuance of medical certificate and wound certificate, and medicolegal autopsy are documented. The most outstanding contribution of India to legal medicine during this period is modern dactylography. It is recorded that there was a high ratio of homicidal poisonings in India.     

Advances and future directions in the study of children's neurobiological responses to trauma and violence exposure

One of the most exciting developments to emerge from the field in the past 20 years is the increasing attention to neurobiological responses to violence and trauma exposure. Although researchers have yet to identify a consensual pattern of neurobiological response to violence and trauma exposure, it does appear that some type of alteration in the hypothalamic pituitary adrenal (HPA) axis is likely. This article briefly reviews the multiple moderating factors that help account for the divergent patterns in HPA function as well as methodological advances that will continue to improve the assessment of HPA function in youth exposed to violence and trauma.     

"No way out": Russian-speaking women's experiences with domestic violence

This article explores the experience of domestic violence and utilization of domestic violence resources among immigrant women who were Russian speaking. Participants, many of whom came to the United States as so-called mail-order brides, reported diverse forms of abuse, including isolation and financial restrictions, and were reluctant to get outside help because of embarrassment about their circumstances. Survivors stressed the importance of language- and culture-appropriate outreach and services and urged that women receive information about domestic violence services and laws on immigration. Assistance with housing, child care, and job searches is integral to safe transitions out of abusive relationships.     

"Like a bird in a cage": Vietnamese women survivors talk about domestic violence

In recent years, a growing literature has emerged that explores the role of culture in domestic violence for ethnic minority populations, including immigrants and refugees. This article presents qualitative data collected from Vietnamese refugee women through a research project in partnership with the Refugee Women's Alliance in Seattle, Washington. Through the women's stories, their own self-awareness of domestic violence as Vietnamese women residing in the United States is available for reflection and review. Issues of acculturation, changing gender roles, examples of strength, and cultural persistence constitute the thematic structure within which these women articulate their needs for creating and sustaining a life free of abuse for themselves and their children.     

Contextualizing community violence and its effects: an ecological model of parent-child interdependent coping

This article presents an integrated conceptual framework that contextualizes exposure to community violence and the interpersonal and interdependent processes of parent and child response to community violence. This model posits that parental distress, including post-traumatic stress disorder (PTSD) and depression, is a significant mediator of child distress symptomatology and behavior problems. The model advances understanding of the impact of community violence in the lives of parents and children through various mechanisms, including social capital. This article underscores the need for a fundamental shift in the study of community violence, in the delivery of mental health services, and in prevention efforts from focusing on the individual child to concentrating on the parent, family, and community-level factors and processes. This article highlights important areas to address in future research, including investigation and specification of the mechanisms and processes by which neighborhoods affect and influence human development outcomes.     

Stark II and physician compensation models: integrating business and legal issues

In March of 2004, the Centers for Medicare & Medicaid Services released new regulations that interpreted the Federal Physician Self Referral Act, otherwise known as Stark II. The new regulations, commonly referred to as the Phase II regulations, must be carefully considered when structuring physician compensation models. Stark II generally holds that physicians may not make a referral for designated health services to an entity with which they have a direct or indirect financial relationship. This Article outlines the provisions of Stark II that are applicable to physician compensation methodologies. In addition, the authors evaluate hypothetical transactions involving physician groups seeking viable compensation schemes and explore the validity and risks of each.     

Design of an algorithm to identify persons with mental illness in a police administrative database

North American police maintain a database to track events and information related to their involvement with the public that contain a series of electronic caution/dependency flags attached to an individual's name for internal communication. To identify persons with mental illness in a police administrative database, an algorithm was developed that was composed of (a) caution/dependency flags, (b) addresses, and (c) key search words indicative of mental illness. Based on the level of confidence of the algorithm, persons with mental illness (PMI) were then assigned to one of three categories: Definite, Probable and Possible PMI. Results for 2000 include the sociodemographic characteristics of PMI and non-PMI in the database. The mean number of contacts, types of interactions, re-involvement with a year, charges and dispositions are described. The algorithm provides a cheap, quick method to identify PMI for North American police. It enables police to monitor the effectiveness of pre-arrest diversion programs and allows researchers to analyze questions of criminalization and mental illness.     

Domestic violence and minoritisation: legal and policy barriers facing minoritized women leaving violent relationships

This article on service responses to women of African, African-Caribbean, Irish, Jewish and South Asian backgrounds facing domestic violence draws on our recently completed study based in Manchester, UK () [Batsteeler, J., Burman, E., Chantler, K., McIntosh, S.H., Pantling, K., Smailes, S., Warner, S., et al. 2002. Domestic violence minoritisation: Supporting women to indepence. Women's Studies Centre: The Manchester Metropolitan University]. We frame our analysis of domestic violence and minoritisation around the question that is frequently posed in relation to women living with domestic violence: 'why doesn't she leave?' In response, we highlight the complex and intersecting connections between domestic violence, law, mental health provision, entitlement to welfare services, which function alongside constructions of 'culture' and cultural identifications, structures of racism, class and gendered oppression. All these contribute to maintain women, particularly minoritized women, in violent relationships. Further, we illustrate how leaving violent relationships does not necessarily guarantee the safety of women and children escaping domestic violence. Despite many recent legal and social policy initiatives in the UK that have usefully brought domestic violence into the public domain, there have also been counter-measures which have made leaving violent relationships correspondingly more difficult, in particular for women from minoritized communities. We offer an analysis of how state practices, particularly facets of immigration law in the UK (although , provides an equivalent U.S. analysis), interact with domestic violence. These not only equip perpetrators with a powerful tool to oppress minoritized women further, but it also indicates how state structures thereby come to impact directly on women's distress (Chantler et al, 2001). In addition, we highlight how other aspects of state policy and practice which enter into the material well-being of survivors of domestic violence, for example, housing, levels of state benefits, and child-care also pose significant obstacles to minoritized women leaving violent relationships. Whilst women from majority/dominant groups also face many of these barriers, we illustrate how the racialized dimensions of such policies heightens their exclusionary effects. It is argued that legal and psychological strategies need to address the complexity of how public, state and institutional practices intersect with racism, class and gender oppression in order to develop more sensitive and accessible ways of supporting minoritized women and children living with domestic violence.