Schizophrenia and suicide: a 10-year review of Kentucky medical examiner cases

The risk of suicide is significantly increased in schizophrenics; it is estimated that 10-13% of individuals suffering from schizophrenia commit suicide. Schizophrenia is marked by psychotic exacerbations and remissions, with persistent deterioration in baseline functioning with each relapse. We present a 10-year (1993-2002) retrospective review of Medical Examiners' cases of suicide of schizophrenic victims. Twenty-nine cases were between the ages of 20 and 75 (mean age of 41.6 years). The majority of victims were male (62.1%) and Caucasian (86.2%). The leading method of suicide for both males and females was firearm injury (48.3%) mostly of the head, followed by overdose (20.7%), and hanging (13.8%). A comprehensive investigation of the biopsychosocial factors is warranted in cases of schizophrenics who commit suicide. This study offers an insightful analysis pertaining to the determination of intent in formulating the manner of death in this unique population.     

Mental health, quality of life, and health functioning in women veterans: differential outcomes associated with military and civilian sexual assault

The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes were obtained through structured interviews and questionnaires. Women veterans with CSA histories reported significantly poorer physical, psychiatric, and quality-of-life functioning compared to those without a history of sexual assault. Furthermore, women veterans with an MSA history demonstrated additional negative consequences above and beyond the effects of CSA. The study sample was comparable to a national random sample of women veterans who access care in the Veterans Affairs healthcare system, increasing the generalizibility of the results.     

Serving those Who Served: Outcomes from the San Diego Veterans Treatment Review Calendar (SDVTRC) Pilot Program

Veterans Treatment Courts (VTCs) are a type of specialty treatment, problem-solving, criminal court. Though the number of VTCs has increased over the past decade, few research studies have examined their effectiveness. This paper examines the data collected concerning a particular VTC experience, the first 82 Veterans enrolled in the Veterans Treatment Review Calendar Pilot Program conducted by the California Superior Court of the county of San Diego from February 2011 until July 2014 (SDVTRC.) The evidence presented herein concerns the nature of this cohort’s population, the SDVTRC program structure in which these Veterans participated, and the outcomes of participation. SDVTRC participants showed a significant decrease in symptoms on 11 of 12 clinical measures from baseline to 12 months. Particular outcomes of the SDVTRC program were related to factors of military service, such as length of service, number of awards, and discharge status. There were also significant relationships between symptom decrease and court process factors, such as length of time in program and sanctions imparted. This court has a 0% recidivism rate, which is believed to be related to its systematic data collection process that was used to inform individualized treatment plans for participants. Implications for other VTCs are provided.     

Green for gold: social and ecological tradeoffs influencing the sustainability of the Brazilian soy industry

In this study we assess the sustainability of the Brazilian soy industry over the past 40 years in comparison to alternative land uses. We conclude that Brazilian soy production performs as well as or better than sugarcane or cattle production in a number of areas, including macroeconomic contributions, local economic development and land use efficiency, though it involves similar tradeoffs between growth and equity, and food production and conservation. While there is no evidence that soy has reduced food security in Brazil, tax redistributions and value-added activities from soy remain limited, particularly in comparison to sugarcane production. Emerging environmental governance measures have helped to reduce the land cover impacts from soy; however, little effort has been taken to minimize the impacts of intensification.