Les liens entre le statut parental et les infanticides des enfants de douze ans et moins

Mondialement, l’infanticide est une cause importante de mortalité infantile. Dans ce mémoire, les infanticides sont analysés en fonction du statut parental, du mode de décès et de l’âge de l’enfant. La première hypothèse de ce mémoire propose qu’il y ait une surreprésentation des parents non biologiques dans les cas d’infanticides chez les enfants de moins de douze ans, et ce, en regard des taux de base de la population. L’hypothèse 2 prédit que les infanticides des parents biologiques devraient revêtir un caractère plus létal (utilisation d’arme à feu, empoisonnement, etc.) que ceux des parents non biologiques qui devraient être caractérisés principalement par des mauvais traitements et de la négligence. D’autres hypothèses sont examinées en fonction des taux de suicide et du sexe de l’agresseur. La présente étude porte sur les cas d’infanticides d’enfants de douze ans et moins sur le territoire du Québec provenant des archives du bureau du coroner pour la période se situant entre 1990 et 2007 (n=182). Les résultats obtenus appuient partiellement l’hypothèse 1 et confirment l’hypothèse 2. En ce sens, les résultats de cette étude viennent appuyer les hypothèses évolutionnistes qui soutiennent une influence du statut parental sur le comportement de l’infanticide. De façon générale, ces résultats mettent en lumière les différences qualitatives qui existent entre les parents biologiques et les parents non biologiques dans les cas d’infanticides. Les implications des résultats obtenus sont discutées.

Quand le désespoir cache l’innommable : une étude des critères de suspicion pour distinguer les suicides par pendaison des homicides déguisés

L’objectif de la présente étude est d’étudier les différences entre les homicides par strangulation et les suicides par pendaison ainsi que l’importance du rôle que jouent les lésions dans la détermination du mode de décès dans les cas apparents de pendaison, et ce dans l’optique d’établir un outil permettant de renseigner le coroner ou médecin légiste sur le mode de décès probable dans les cas apparents de pendaison. Deux cent quatorze cas de suicide par pendaison ont été révisés rétrospectivement et comparés à 51 cas d’homicide par strangulation. La fréquence d’ecchymoses (6,1 %), d’abrasions (4,7 %) et de lacérations (0,5 %) était significativement plus faible chez les victimes de suicide par pendaison que chez les victimes d’homicides par strangulation (58,8 %, 51,0 % et 5,9 % respectivement). Les ecchymoses, chez les victimes de suicide par pendaison, se trouvent habituellement sur les membres supérieurs antérieurs et postérieurs ou sur les membres inférieurs antérieurs. Elles se situent généralement soit sur les membres supérieurs, soit sur les membres inférieurs, et non aux deux endroits à la fois. Les abrasions sont davantage susceptibles de se trouver sur la face postérieure des membres supérieurs et sur la face antérieure des membres inférieurs. Cette concentration préférentielle n’est pas observée chez les victimes d’homicide par strangulation. De possibles critères de suspicion et des modèles de prédiction du mode de décès sont évalués.

Child Abuse: il ruolo del medico legale nell'assistenza, nella prevenzione e nella preparazione di linee guida

Con questo mio lavoro di tesi ho voluto esplorare il fenomeno del maltrattamento e dell’abuso sui minori delineandone, sulla base della letteratura scientifica nazionale ed internazionale, gli aspetti clinici, epidemiologici ed i fattori di rischio. Un breve excursus giuridico illustrerà, poi, gli articoli di legge relativi alla tutela dei minori; in particolare, ci si soffermerà ad illustrare quegli articoli che normano i doveri dei sanitari nei confronti dell’autorità giudiziaria nel caso si sospetti un abuso su minori. La conoscenza della semeiotica dell’abuso, il suo riconoscimento all’interno di una diagnostica differenziale clinico-forense, la corretta repertazione e la consapevolezza che, un approccio autenticamente tutelante verso la vittima, deve sempre realizzarsi all’interno di una cornice giuridica fanno si che, il ruolo della medicina legale, competente in tutti questi ambiti, diventi senza ombra di dubbio “primum inter pares” all’interno dei team multidisciplinari ed interistituzionali che si occupano di minori vitti. Il gruppo scientifico in cui sono stata inserita e con cui si è proceduto alla redazione del manuale è il Gruppo di lavoro per l’abuso e il maltrattamento dell’infanzia coordinato dalla dott.ssa Maria Rosa Giolito ed ha coinvolto professionisti italiani afferenti a tre differenti aree sanitarie: quella ginecologica, quella medico-legale e quella pediatrica. Il testo elaborato è stato immaginato come un aiuto ai professionisti medici che si trovano a valutare un soggetto prepubere con sospetto di abuso sessuale. Non costituisce una linea-guida per la diagnosi di abuso sessuale, ma definisce alcuni requisiti essenziali e diffonde alcune conoscenze per evitare errori che possano ripercuotersi negativamente sulla valutazione clinica e sull’eventuale conseguente iter giudiziario.

Sudden death among young people with first-episode psychosis: An 8-10 year follow-up study

Individuals with first episode psychosis (FEP) experience high rates of premature mortality, in particular due to suicide. The study aims were to: a) Estimate the rate of sudden death among young people with FEP during an 8-10 year period following commencement of treatment; b) Examine and describe the socio-demographic and clinical characteristics associated with sudden death; and c) Examine the timing of death in relation to psychiatric treatment.This was a cohort study. The sample comprised 661 patients accepted into treatment at the Early Psychosis Prevention and Intervention Centre between 1/1/1998 and 31/12/2000. Demographic and clinical data were collected by examination of the medical files. Mortality data were collected via a search of the National Coroners Information System; the Victorian State Coroner's office and clinical files. Nineteen patients died and just over two thirds of deaths were classified as intentional self-harm or suicide. Death was associated with male gender, previous suicide attempt and greater symptom severity at last contact. People with FEP are at increased risk of premature death, in particular suicide. A previous suicide attempt was very common amongst those who died, suggesting that future research could focus upon the development of interventions for young people with FEP who engage in suicidal behaviour.

Neck injury assessment protocol. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

The effect of a reduction in heroin supply on fatal and non-fatal drug overdoses in New South Wales, Australia

Objective: To examine the impact of a sudden and dramatic decrease in heroin availability, concomitant with increases in price and decreases in purity, on fatal and non-fatal drug overdoses in New South Wales, Australia. Design and setting: Time-series analysis was conducted where possible on data on overdoses collected from NSW hospital emergency departments, the NSW Ambulance Service, and all suspected drug-related deaths referred to the NSW Coroner's court. Main outcome measures: The number of suspected drug-related deaths where heroin and other drugs were mentioned; ambulance calls to suspected opioid overdoses; and emergency department admissions for overdoses on heroin and other drugs. Results: Both fatal and non-fatal heroin overdoses decreased significantly after heroin supply reduced; the reductions were greater among younger age groups than older age groups. There were no clear increases in non-fatal overdoses with cocaine, methamphetamines or benzodiazepines recorded at hospital emergency departments after the reduction in heroin supply. Data on drug-related deaths suggested that heroin use was the predominant driver of drug-related deaths in NSW, and that when heroin supply was reduced overdose deaths were more likely to involve a wider combination of drugs. Conclusion: A reduction in heroin supply reduced heroin-related deaths, and did not result in a concomitant increase, to the same degree, in deaths relating to other drugs. Younger people were more affected by the reduction in supply.

Death by Suicide: A Report Based on the Northern Ireland Coroner’s Database

Funded by HSC R&D Division, Public Health Agency Why did we start? Potentially new information, especially relating to the characteristics of those who had died by suicide was made available through the Coroner’s Office.  The information made available to us covered deaths that occurred in the years 2005 to the end of 2011. What did we do? First we addressed the descriptive characteristics associated with this group of individuals. These descriptive characteristics included information relating to (1) means by which the death occurred (2) gender, age and employment status of the person (3) prior attempts (4)  alcohol and prescription use around time of death (5) adverse events (6) use of health services and (7) mental and physical health problems. Second we examined area level residential location in terms of Local Government Districts, and Wards within Northern Ireland. To address this area level of analysis, standardised mortality ratios (SMRs) were used.