Motor vehicle exhaust gas suicide in Victoria, Australia 1998-2002

Motor vehicle exhaust gas suicide (MVEGS) is the second most frequent method of suicide in Victoria, Australia. It is a highly lethal method of suicide with 1.5 deaths for every hospital admission. Australian regulations require all vehicles manufactured since 1998 to have a maximum carbon monoxide exhaust emission level of 2.1 g/km, reduced from the previous level of 9.6 g/km. Information surrounding all Victorian MVEGS between 1998-2002 was analyzed to determine whether suicides occurred in vehicles with the lower emission levels. Between 1998-2002, 607 suicides by this means were recorded while just 393 hospital admissions were recorded for the same period. Mean carboxyhaemoglobin levels were significantly lower in fatalities using vehicles manufactured from 1998, however suicide still occurred in these vehicles (n = 25). The extent to which the new regulations contributed to the relatively low rate of suicide in vehicles less than 5 years old compared to their frequency in the fleet remains unknown. Based on international experience and the age of the Victorian vehicle fleet, it may take well over a decade until substantial decreases in MVEGS are observed in the absence of active preventive measures.     

Toward a more comprehensive understanding of violence against impoverished women

Research and knowledge of violence against impoverished women continues to be limited. To achieve a more comprehensive understanding of violence against impoverished women and therefore inform prevention and intervention efforts for this population, the authors report on recent (past 6 months) physical, sexual, and psychological violence among 898 women who were randomly sampled from temporary shelter settings (n = 460) and low-income housing (n = 438) in Los Angeles County. Women experienced notable rates of violence during the past 6 months (e.g., 23% of sheltered women and 9% of housed women reported physical violence). Perpetrators were diverse, particularly for the sheltered women, including sexual partners, family, and strangers. These findings, and others suggesting that the different types of violence are distinct and severe, may call for more comprehensive screening and intervention efforts to enhance the safety of impoverished women.     

Cardiac rupture in acute myocardial infarction: a reassessment

Cardiac rupture as a complication of acute myocardial infarction (AMI) has been described as occurring infrequently. Because of the recent dramatic decrease in autopsy rates, the authors believe that current studies do not accurately represent the frequency of this catastrophic complication. Autopsy protocols and archived histologic slides of patients with AMI were retrospectively reviewed to determine whether the frequency of cardiac rupture, as a complication of AMI, is altered when a non-hospital-based patient cohort after autopsy is evaluated. This review yielded 153 cases of 41 women and 112 men, whose postmortem examinations revealed gross and histologic evidence of AMI. Cardiac rupture was present in 30.7% of these cases. Of the 47 patients with rupture, 35 had no relevant medical history. The remaining 12 patients had various medical conditions. None of the patients in the rupture group had previously treated symptoms related to coronary artery conditions. Whereas women constituted 26.8% of the total AMI group, they had a cardiac rupture rate of 61%. By contrast, men with AMI had a cardiac rupture rate of 19.6%. All patients in the cardiac rupture group had heart weights over the predicted expected weight as a function of body weight. Age, gender, and heart weight were significant factors associated with cardiac rupture, whereas body mass index was not significantly related. When these factors were evaluated jointly, age was a significant explanatory factor for rupture among both men and women, whereas body mass index and heart weight were significant for men but not for women. When the rupture sites occurred on the left ventricular myocardium, the anterior wall was affected in 21 cases (45%), the posterior wall in 18 (38%), the lateral wall in 4 (9%), and the apex in 3 (6%). The right ventricular myocardium ruptured in 1 case (2%). Most of the patients had severe multivessel coronary artery disease. Histologic study of the specimens showed that the majority of ruptures occurred between 24 and 72 hours after myocardial infarction. This study showed a frequency of cardiac rupture of 30.7% in patients with AMI and sudden death according to medical examiner's records. These findings confirm and reinforce the importance of postmortem examination and autopsy as an adjunct to clinical medical practice.     

Juvenile sex offenders: a group on its own?

There is some debate about whether sex offenders are similar to non-sex offenders. It is known that sex and non-sex offenders are heterogeneous groups. Comparative studies must take this heterogeneity into account. Based on an aggregated database, a study was conducted among adjudicated juvenile (sex) offenders. The sample consisted of juvenile male sex and non-sex offenders who had been subjected to a psychological assessment at the request of the judge or district attorney. The central question focused on the differences between juvenile sex offenders, in particular rapists and sexual assaulters (n = 57), child molesters (n = 55), and non-sex offenders: violent (n = 85) and nonviolent offenders (n = 80). The results demonstrated that sex offenders differ from non-sex offenders with regard to demographic characteristics, problem behavior, and personality traits. Some reference is made regarding future research.     

Vertical Competition in the Spanish National Health System (NHS)

In unitary states, competitive decentralisation structures can take place by increasing the visibility of politically accountable jurisdictions in certain policy responsibilities such as health care. Drawing from the Spanish decentralisation process we examine the mechanisms (and determinants) of vertical competition in the development of health policies in the Spanish National Health System. The Spanish example provides qualitative evidence of vertical competition that assimilates government outcomes of unitary states to that of federal structures. The Spanish experience indicates that the specific vertical competition mechanisms in place until 2002 are likely to be responsible for significant policy innovation and welfare state development.     

Data sharing

Many kinds of events are subsumed under the rubric of data sharing. Given the range of meanings or contexts of data sharing, several conclusions follow: (1) Some kinds of data sharing are more problematic than others. (2) Objections to data sharing typically are bolstered by examples from the more difficult end of the spectrum. (3) Constrained sharing, including possible contractual and licensing agreements rather than merely handing over the data, is a likely norm to emerge at the more difficult end of the spectrum. (4) Given various tools for constrained sharing, even the most difficult cases may yield to constrained sharing solutions that benefit all parties involved. (5) If research is conducted with eventual sharing in mind, and if the scientist is acquainted with the tools of constrained sharing, then the kinds of dilemmas that currently pose as arguments against sharing will occur rarely.     

Death penalty attitudes and conviction proneness

Attitudes toward the death penalty are consistently predictive of jurors' verdicts in criminal trials. Two studies were conducted to find out why. In Study 1, eligible jurors viewed a videotape showing conflicting testimony by a prosecution and defense witness in an assault case. Death-qualified subjects (those permitted to serve on capital juries) interpreted testimony in a manner more favorable to the prosecution than excludable subjects (those excluded from serving on juries in capital cases due to their opposition to the death penalty), suggesting that differing interpretations of evidence may mediate the relationship between attitudes toward the death penalty and verdicts. In Study 2, the same jurors indicated their reactions to a number of hypothetical situations in which a jury had convicted an innocent defendant or acquitted a guilty one. Death qualified subjects expressed less regret concerning erroneous convictions and more regret concerning erroneous acquittals than excludable subjects. Theoretical interpretations of this pattern of results suggest that death qualified subjects may have a lower threshold of conviction than excludable subjects; thus the relationship between attitudes toward the death penalty and verdicts may also be mediated by differing thresholds of conviction.During the course of this research, William C. Thompson was supported, in part, by a National Science Foundation graduate fellowship.