An Analysis of The Morbidity and Mortality of Diabetes Mellitus in a Forensic Context

To investigate the spectrum of diseases seen in diabetes mellitus in a forensic context, all autopsy reports of diabetic individuals who presented to Forensic Science, South Australia (FSSA), over a 5‐year period from 2005 to 2009 were studied. The leading cause of death was cardiovascular disease (55.0%), followed by unnatural deaths (15.4%) and infections (9.4%). In type 1 diabetics, principal causes of death included cardiovascular disease (44.7%), acute metabolic complications (18.7%), unnatural deaths (17.9%), and infections (8.9%). However, frequencies of these diseases differed in type 2 diabetics, with cardiovascular events responsible for 56.6% of cases, followed by unnatural deaths (15.0%) and infections (10.9%). A larger number of male deaths were seen in all disease categories, except respiratory and gastrointestinal where the frequencies were similar to females. Cardiovascular disease was the leading overall cause of death across all ages except in those under the age of 30 where metabolic complications were more common.     

Urban infant mortality and religion at the end of the nineteenth and in the early twentieth century: the case of Ekaterinburg,Russia

Modern demographers analyse regional and other infant mortality differentials as important factors behind the current life expectancy of Russian citizens. Historically, however, the Russian Empire is simply displayed as one block with high infant mortality rates. Also with respect to cultural background factors, Russia is often perceived as religiously homogeneous with the Orthodox Church dominating the country. In reality, Russia has a long history of coexisting religious traditions. This includes both provinces with a majority of Catholics, Muslims, Buddhists or shamanistic populations as well as territories characterized by religious diversity and significant minority religions. Our project studies minority religious groups in the Urals, a province by the Ural Mountains stretching into Asia. While no territory can claim to be truly representative of this mega-country, we believe that this centrally located province is well suited to show some of the Russian variety, including differential infant mortality among the followers of minority religions, which is the topic of this article. We employ church record microdata to study Catholics, Jews and Old Believers in the main metal-producing city of Ekaterinburg.     

Child Fatalities in Dammam: A Call for Child Fatality Reviews in Arab Countries

Identifying children's risk exposure is the first step toward mortality prevention. This retrospective study determined the causes of child fatalities in Dammam, Saudi Arabia. Death reports of children and adolescents from 1999 to 2015 (N = 157) were analyzed. Boys represented most cases (69%) and there were two age peaks (1–5 years and 16–18 years). Accidents (typically immersion) defined the main death circumstance (51%) followed by homicide (25%). Only 33% of cases underwent autopsy, and the most common cause of death was head injury (27%) followed by firearm injury. Only one immersion death underwent autopsy. This study revealed important data about the risk exposure of children in Dammam and emphasizes deficient investigative procedures. Child fatality reviews comprise systematic data collection by multidisciplinary teams to determine the true risks toward children in a community. Such teams do not exist in Arab countries; therefore, strategies should be implemented to initiate them.     

Clinical and Autopsy Characteristics of Fatal Methamphetamine Toxicity in Australia

Characteristics of death attributed solely to methamphetamine toxicity (MT, n = 93) by forensic pathologists were examined and compared to cases of multiple drug toxicity (MDT, n = 634). The mean age of MT cases was 36.7 years, and 86.0% were male. Strenuous activity was reported in 12.9%. The most common witness observations were: collapse (60.3%), difficulty in breathing (36.2%), and hyperthermia (27.6%). MT cases had higher blood methamphetamine (0.54 vs. 0.11 mg/L) and amphetamine (0.04 vs. 0.02 mg/L) concentrations and lower likelihoods for opioids (12.5% vs. 80.9%), hypnosedatives (27.3 vs. 60.7%), antidepressants (14.8 vs. 29.8%), and antipsychotics (9.1 vs. 19.7%). MT cases had significantly heavier hearts than MDT cases (423.4 vs. 385.8 g) and were more likely to have cardiomegaly (37.1 vs. 20.4%) and replacement fibrosis (25.7 vs. 14.5%). The clinical picture was of a sudden cardiac event in a middle‐aged man with a high methamphetamine concentration. Cardiovascular signs of heavy methamphetamine use are frequently seen.     

Birth spacing as a family strategy: evidence from 19th century Leuven,Belgium

This article investigates the hypothesis that 19th-century working class families in Leuven, Belgium, were controlling their fertility by means of birth spacing for household economic reasons. Detailed life-course data were collected in order to construct, on one hand, a set of covariates that represent the influences of natural fertility on birth intervals and, on the other, a number of family variables that represent the hypothetical, household economic motivation to space births. The findings strongly suggest that birth intervals were not merely a function of natural fertility differences and that family strategic spacing behavior also played a role.     

Public health measures against neonatal tetanus on the island of Vestmannaeyjar (Iceland) during the 19th century

The article presents a study of neonatal tetanus on the tiny island of Vestmannaeyjar (Iceland) during the 18th and 19th centuries. At an early date, Vestmannaeyjar was known for its high levels of mortality from neonatal tetanus. This appalling mortality is analysed, inter alia, on the basis of parish registers at the individual family level. During the late 18th and early 19th centuries, more than three out of four newborns on the island died during the first 2weeks of life. At the beginning of the 19th century, Icelandic and Danish authorities had already showed great interest in improving infant survival on Vestmannaeyjar. In 1827 a physician was appointed to the island and by the late 1840s the disease was successfully fought on the island. The achievement on Vestmannaeyjar is a good example of how the sanitary movement was able to bring about important improvements in infant survival long before the breakthrough of the bacteriological revolution.     

Birth and death in a new land attitudes to infant death in colonial Australia

The goldrush colony of Victoria, Australia, was a favoured destination for aspirational emigrants from nineteenth-century Britain. Yet the persistence of high rates of infant mortality blighted the happiness of many first and second generation immigrant families alone in a new land. Drawing on birth, death and inquest records this paper interrogates the experience of infant death amongst the poorest families in the capital city popularly known as ‘Marvellous Melbourne’ during the second half of the nineteenth century. Although few infants died alone, the familial and community networks in which they were enmeshed were not always committed to their survival. While the paper argues that there was a hierarchy of value which determined the degree to which the death of a child would be welcomed or mourned, it also contests popular notions that evil baby farmers and unfeeling mothers were a major cause of infant death.     

Is breast best? Evaluating breastfeeding patterns and causes of infant death in a Dutch province in the period 1875–1900

In the Dutch province of Noord-Brabant, infants experienced extremely high mortality risks towards the final decades of the nineteenth century. It has been stated that infant survival in the past highly depended upon the fact whether a child was breastfed or not. In this article we will reflect on this perceived importance of infant diet in order to explain the high mortality risks of Brabant infants in the period 1875–1900. Using local aggregated cause of death data, a change in breastfeeding practices can indeed be detected. Between 1875/79 and 1895/99 there was an increase in the relative and absolute number of infants deaths as a result of diarrhoea and other digestive disorders indicating deficient hygiene and that fewer infants were breastfed frequently. By discussing differences between urban and rural settings, and between Catholic and Protestant regions, we will shed more light on possible mechanisms for this change in breastfeeding practices.     

Rethinking the medical causes of infant death in early modern Europe: a closer look at church registers and medical terminology

The historical roots of the prevailing hypothesis about the main causes of high infant mortality in Europe in the last four centuries are presented in detail focusing on German sources and publications. Assumptions about infections being the main cause of deaths during infancy clearly need to be reevaluated. The terminology of early sources has passed many steps of translation and interpretation. In the old church registers, wording in the local vernacular merely described the most visible symptoms before the final stages of diseases. Scientific medicine and its terminology repeatedly went astray before real pediatric competence was acquired in the nutritional physiology of infants. The combination of different kinds of evidence points to serious flaws in the prevailing hypothesis, while source data and publications confirm a different conclusion: inadequate nutrition due to early weaning and unsuitable substitute food caused the specific set of symptoms described in the historical sources. Medical evidence about infant malnutrition in developing countries supports this new interpretation.     

An assessment of risk factors for early death among a sample of previously incarcerated youth

Most previous research regarding early death prior to, or during, young adulthood among previously detained delinquent youth has focused predominantly on males or on their cause of death. This study extends previous research by evaluating potential factors that are associated with early death in a random sample (N?=?999) of formerly detained youthful offenders in New York stratified by gender (50% female). Existing case records were referenced with the National Death Index to determine if the formerly detained youth were deceased by the time they would have reached age 28. Regression analyses were run to determine if any of 16 sociodemographic, offense history, weapons/gang involvement, mental health, substance use, child maltreatment, child welfare, or family environmental risk factors measured in their childhood or adolescence were associated with early death. Two additional regression analyses were run to determine if those risk factors differentially impacted early death for males vs. females. Of the variables measured, however, only gender was significantly related to early death – compared to females, males were 2.3 times more likely to have prematurely died. Additionally, in the model run separately for females, being an African-American female was protective against early death. These findings are compared to findings from the existing literature.