Coroner-reviewed infant and toddler deaths. Many "undetermineds" resemble homicides

Although homicide is a leading cause of death of infants and toddlers, there is some suspicion that an unknown number of additional deaths are unrecognized homicides. The authors used California mortality data from 1969 to 1991 to examine 12,246 injury deaths that occurred before age 5. Characteristics of the dead child, injury event, and postmortem were compared for accidents, homicides, and undetermined deaths. A logistic model was developed to differentiate homicides from accidental deaths and then was used to predict whether undetermined deaths were likely to be homicides or accidents. Unlike accidental deaths, undetermineds and homicides had similar distribution patterns of age, race, sex, and place of injury. The predictive model indicates that 43.8% of the undetermined injury deaths were similar to homicides on several characteristics. True rates of homicide for infants and toddlers may, unfortunately, be nearly one fifth and one tenth higher, respectively, if the undetermined deaths that resemble homicides are taken into account.     

Meditations on a Bullet: Violently Injured Young Men Discuss Masculinity, Disability and Blame

Violently-acquired spinal cord injury (VASCI) has recently emerged as a significant disability category. Identity formation following such a serious injury is important for psychosocial recovery. However, research examining individuals with VASCI is largely limited to epidemiological work prior to the injury and rehabilitation outcomes following the injury. This article details the results from a qualitative study to understand how young men with violently-acquired spinal cord injuries integrate the injury into their sense of self, as well as how the disability interacts with other aspects (e.g., racial/ethnic, gender, etc.) of their identity. Eleven men in this study were all former or current gang members, paralyzed because of their activities. Throughout the interviews four major themes emerged: environmental effects, making sense of the injury, living life on a split-screen, and challenges to masculinity. For the men in this study, the negative associations between disability and dependency affected their ability to integrate their injury positively into their identity.

‘Violent’ deaths of children in England and Wales and the major developed countries 1974–2002: possible evidence of improving child protection?

Child protection services are criticised for failing to prevent abuse but demonstrating successful prevention is impossible as it is trying to prove a ‘negative’. The alternative is to examine ‘failures’, i.e. the ‘violent’ deaths of children (0–14 years) to indicate whether matters are improving or deteriorating. This paper uses the latest World Health Organisation data to compare children's ‘violent’ deaths in England and Wales with those in other major developed countries. To account for possible ‘hidden’ under‐reported abuse deaths, undetermined, i.e. ‘other external causes of death’ (OECD) and fatal accidents and adverse events (AAE), deaths are also analysed along with homicides, to compare all ‘violence‐related’ deaths between 1974–76 and 2000–02. England and Wales infant (<1 year) homicide rates were annually 57 per million but fell to 17 per million, a 74% fall. Infant AAE deaths fell in every country with England and Wales falling from 341 per million to 71 per million, a 76% reduction. Both these results were significantly better than those of eight other major developed countries, although England and Wales infant OECD at 26 per million, were high compared to the major developed countries. In the 1970s, combined ‘violent’ deaths of all children (0–14 years) (homicide, OECD and AAE) in England and Wales were 203 per million, they are now 61 per million, a 70% decline with only Italy having lower rates. The worst rates were in the USA which had the highest combined ‘violent’ death rate. These overall results in the major reductions of ‘violence‐related’ deaths in England and Wales can be a boost to the morale of front‐line staff and provide the public with an indication of the progress being made. Copyright © 2008 John Wiley & Sons, Ltd.     

Cost analysis of global road traffic death prevention: Forecasts to 2050

Road traffic safety initiatives are gaining momentum worldwide as more governments and international organizations recognize the implications of traffic accidents on economic and human development. In 2015, as part of its Sustainable Development Goals, the United Nations Development Programme set a global target (3.6) to halve the number of traffic deaths and injuries by 2020. This article uses the International Futures integrated forecasting system to explore the plausibility of achieving that goal and the potential forward linkages of such an intervention. We find that halving annual deaths caused by road traffic accidents is likely to be overly ambitious, and examine more reasonable road traffic death‐rate targets using an approach derived from road traffic death rates relative to income level.     

Improving medicolegal death investigative gaps of fatal elder abuse

The purpose of this brief is to present several case vignettes that illustrate omissions in the investigation of elder deaths. These vignettes demonstrate the need for a standardized approach in the conduct of medicolegal investigations of fatal elder abuse. For each of the described oversights, a recommendation is offered to address the gap in investigation processes, which in turn could improve the determination of cause and manner of elder death. Inherent limitations of resources and practical realities of death investigation are discussed and recommendations are made for future research. Viewed broadly, deficiencies in elder death investigations can lead to the underreporting of elder abuse and the reduction of legal options for victims, which may reflect a systemic pattern of social injustice.     

The internal death of Japanoise

Japanese noise music (Japanoise) has strong associations with death. In the early stages of Japanoise’s development, practitioners would often make reference to eroticism, violence and death in their performances and album artwork to help visualise the “excess” of their sound. The discourse of Japanoise also draws on these associations, through concepts such as disembodiment, to help frame this transgressive enterprise. Death becomes a way of visualising and conceptualising a subversive style of music that attempts to leave the world of limits and meaning. Paul Hegarty and Eugene Thacker both account for Japanoise in these terms. Although death is only implicit in their writing, it will be argued that this understanding of death is essential to what Hegarty means by failure and what Thacker means by disembodiment. This paper will show how, for both theorists, death names a paradoxical yet extreme form of possibility that enables Japanoise to test limits. However, the problem with this understanding is that it holds Japanoise to a limited framework. It essentialises the concepts of negativity and subversion to the economy of Japanoise. This paper will argue that Japanoise cannot be limited to these concepts if it hopes to be more than an oppositional form of music and a tired form of transgression. This requires that its relationship with death not be reduced to a form of production or act of will. By arguing that Hegarty and Thacker’s accounts of noise can be read as Heideggerian, this essay will critique this understanding by drawing on Maurice Blanchot’s account of death. This critique will show how a different understanding of death enables a more nuanced understanding of Japanoise.     

Relationships with death: the terminally ill talk about dying

This article describes a qualitative study exploring the experiences of terminally ill patients and their families as they lived with the inevitability of death. Frustrated by the dominant discourse surrounding the culture of dying--namely that of Elisabeth Kübler-Ross's stage theory--I sought to revisit the experiences of the terminally ill by talking directly with them. Instead of focusing on how people reacted to the introduction of death into their lives, this research attended to how the dying began relating to life and death differently as a result of death's presence. Through an analysis of ethnographically collected data, the meanings participants constructed around their experiences were explored--culminating in the creation of seven "relationships" that participants shared with death.     

Once in Parkland,a Year in Hartford,a Weekend in Chicago: Race and Resistance in the Gun Violence Prevention Movement

Generally ignoring firearm‐deaths by suicide, “common sense” divides gun violence into two distinct types of phenomena: urban gun violence and mass shootings. At a cursory level, these phenomena seem distinct because of the difference in the number of victims killed during a particular shooting, rather than subtypes co‐creating a master category defined by gun violence. As a result, gunshot deaths of black and brown bodies in urban settings, which constitute the majority of deaths by gun violence after suicide, are viewed as routine whereas gunshot deaths in suburban settings are extraordinary and worthy of outrage. In this article, we draw on ethnographic observation to compare protest vigils in urban communities comprised predominantly of people of color, in suburban areas that are mostly white, and at the national level in order to uncover the racialized processes of symbolic classification by which this “commonsense” view is produced and how it is challenged by activists. We use the framework of cultural pragmatics to analyze these vigils, making visible the racialized forms of domination that structure activism and, we contend, ultimately divide gun violence into two distinct phenomena rather than constituting a master category. We argue that cultural pragmatics provides a way to understand what it means to challenge culture as emphasized by the multi‐institutional politics approach to social movements.     

Socialization to dying: social determinants of death acknowledgement and treatment among terminally ill geriatric patients.

Although the vast majority of deaths occur among terminally ill geriatric patients, little is known about the etiology of these patients' death acknowledgement and ultimate type of treatment. Based on interviews with 76 triads composed of physicians, terminally ill patients, and primary caregivers, this study uses the socialization perspective to identify the actors and actions that most strongly affect the patient's death acknowledgment and receipt of exclusively palliative care (i.e., socialization to the dying role). Whereas patient preferences and sociodemographic characteristics do not influence significantly the patient's odds of death acknowledgment, these odds are increased if their primary caregivers accept death, their physicians are not affiliated with a teaching hospital, and the terminal prognosis is disclosed to them and disclosed "matter-of-factly." Patients who acknowledge death, whose agents value pain alleviation over life-prolongation, and whose physicians are not affiliated with a teaching hospital, are substantially more likely to receive exclusively palliative rather than curative terminal treatment.     

Risk factors for involvement in cyber bullying: Victims, bullies and bully-victims

Objectives

The purpose of the current study was to examine the frequency of cyber bullying among youth by distinguishing among the three categories of involvement in cyber bullying: victims, bullies, and bully-victims, to compare these to a fourth category of students who are not involved in the three categories of cyber bullying and to explore the factors that contribute to involvement in cyber bullying.

Method

This study utilized a large and diverse sample of 2186 middle and high school students, who completed self report questionnaires during class time. We performed a Multinomial Logistic Regression to examine the relationship between the cyber bullying categories and our independent variables (gender, age, technology use, parental involvement and safety).

Results

Over 30% of the students in this study identified as involved in cyber bullying, as victims or perpetrators, and one in four of the students (25.7%) reported having been involved in cyber bullying as both bully and victim during the previous three months. Students who were involved in cyber bullying were more likely than others to report perpetration of violence toward peers, to use computers for more hours a day, and to give their password to friends. Other risk factors, such as gender, age and safety, were found to be specific only for one category of cyber bullying.

Conclusion

The findings revealed that students are highly involved in cyber bullying. Several unique characteristics emerged regarding the frequency and risk factors of students' involvement in cyber bullying. In traditional bullying the category of bully-victims represents the smallest and most vulnerable group of children, whereas in the current study the bully-victims category emerged as common. In addition, females were more likely than males to be bully-victims, in contrast to research on traditional bullying, in which more males than females are typically involved as bully-victims. In addition, several risk factors were common among the three groups of children, including the amount of hours per day students use the computer, and giving passwords to a friend. These results point to the need for further examination and to focus on the risk factors for students' cyber bullying involvement in each of the three categories.     

He's in a New Neighborhood Now: Religious Fantasy Themes About Mister Rogers' Neighborhood

Fred Rogers' death prompted many of his fans to post tributes to him and his show, Mister Rogers' Neighborhood, on the PBSkids.org Web site. Fantasy theme analysis was conducted for specifically religious themes on tributes posted during the 1st week after his death. Themes fell into one of three broad classifications. The first category, religious attribution, included applying directly religious meaning to Rogers and the program. Fans spoke of Rogers as "saintly," an "angel," and "sent from Heaven," along with other fantasy chains. The second category, religious language, included comments about prayers and blessings and the use of religious phrases. The third, religious ideals, provided a category for themes related to the program's moral values and Rogers' "compassion" and "personal character." Findings suggest long-term impact of the program's values on viewers of many ages. They also show that a group of fans reflected on Rogers' noble character by participating in a social reality constructed of religious metaphors.     

Counseling issues related to maternal substance abuse and subsequent sudden infant death syndrome in offspring

Recent reports linking maternal prenatal drug use to SIDS in offspring raise six specific issues related to professional intervention: (1) blaming addicted parents compounds the normal guilt experienced after SIDS; (2) low self-esteem often underlies drug usage; (3) punitive intervention by child protective agencies may lead to parental mistrust of health professionals, reducing access to help; (4) society's increasing tendency to criminalize drug use during pregnancy may expose women to prosecution if a SIDS death occurs; (5) the debate over monitoring at risk infants is further complicated if caretakers use drugs; and (6) recent articles have suggested that the majority of SIDS deaths may be the result of homicide, neglect, environmental hazards, etc. For addicted parents, a SIDS death increases the risk of social fragmentation and poses challenges to professional interventions.The destructive effects of the Sudden Infant Death Syndrome go far beyond the lost lives of infants. The psychiatric morbidity among surviving family members can be severe and prolonged. Professional counseling seems vital in the prevention and treatment of a disabling guilt that follows the death of a child. (Bergman et al., 1969)     

Extended evaluations in cases of child sexual abuse: how many sessions are sufficient?

This article provides new findings from a national study involving 18 forensic interview sites of 137 children who were randomly assigned to a four or eight session extended evaluation. Cases assigned to the eight session protocol were significantly more likely to be classified "credible disclosure" of sexual abuse (56.6%) than cases assigned to the four session protocol (29.5%) and significantly less likely to be classified "credible nondisclosure" of sexual abuse (9.2%) than cases in the four session protocol (24.6%). When four versus eight sessions, demographic variables, and case characteristics were entered into a regression, variables that predicted likelihood of sexual abuse were eight session protocol, older victim age, and caretaker belief the child had been sexually abused. When new disclosures were examined by session in the eight session protocol, 95% of new disclosures occurred by the sixth session.     

"A KNOCK ON THE DOOR": Managing Death in the Israeli Defense Forces

This paper discusses death that occurs within organizations through an analysis of how deaths of soldiers are handled by the Israel Defense Forces (IDF). While such deaths challenge the military's organizational order and legitimacy, the IDF handles them through the institution of a "moving bureaucracy": a combination of fixed administrative procedures and intense emotional work carried out by liminal military personnel (reserve officers). This arrangement enables the military to construct a highly controlled "buffer zone" around the deceased soldier's family, and thus to reconstitute its organizational order and the IDF legitimacy. The army as a palpable organization "reappears" on the scene, but that reappearance is gradual and takes place only after the funeral, when death is certain and finalized.     

The circumstances surrounding the death of 105 elders as a result of resident-to-resident incidents in dementia in long-term care homes

Resident-to-resident incidents in dementia in long-term care homes resulting in deaths represent a growing concern among residents, family members, care providers, care advocacy organizations, and policy makers. Despite these concerns and experts’ predictions by which injurious and fatal incidents will increase in the coming years due to the projected growth in the number of people with dementia, no studies have been conducted in North America on these fatal incidents. This exploratory pilot study makes first steps towards bridging this major gap in research and practice. Using publicly available information (primarily newspaper articles and death review reports), practically useful patterns were identified pertaining to the circumstances surrounding the death of 105 elders as a result of these incidents. The findings could inform various efforts to prevent future deaths in similar circumstances, keep vulnerable and frail residents safe, and encourage researchers to examine risk and protective factors for these incidents.     

Attitudes of nursing students toward death and dying: A research note

Fear, denial, and the avoidance of death and dying appear to be products of life in modern society. While society insulates most people from contact with the death and dying of others, there are professions that come into repeated contact with dying individuals. The present study uses the Collett‐Lester Fear of Death Scale to analyze the Fear of Death and Dying for Self and Others (four subscales) among a sample of registered nurses (BA level). Over a 10‐year period, nurses’ fears concerning death and dying were measured at three points—before a course on death and dying (Pretest), after the course (Posttest), and at a point in their professional nursing practice (Retest). The results suggest that these nurses’ fears of death for self and others change at a statistically significant level over the Pretest and Posttest observations; however, the changes are temporary. The Fear of Dying for Self and Others tends to decline significantly over the Pretest and Retest observations. Age, religion, religiosity, and employment factors were also analyzed vis‐à‐vis the Fear of Death and Dying Subscales. Some directions for additional research into nurses’ fears about death and dying are given.     

A minor office: the variable and socially constructed character of death certification in a Scottish city

Those doctors in a Scottish city who had completed the most death certificates in 1985 were identified, interviewed about their certifying practices, and asked, for comparative purposes, to complete a series of dummy death certificates, based on case summaries. Analysis of the dummy certificates indicated substantial inter-practitioner variations in practice. From the interview data it is clear that the completion of death certificates is a very minor office: for most certifying doctors, death certification is an unsupervised, unreported, invisible, and unconsidered activity. It is argued that doctors who write large numbers of certificates conduct their certifications in Schutz's "world of routine activities" (Schutz 1970). It is this routinized orientation to certification that allows the practitioner to dwell within the "habitus" (Bourdieu 1977) of the medical collectivity but outside a normative order. Death certification may stand as an exemplar of a large number of medical activities, where wide and largely unacknowledged variations in practice occur with each practitioner investing his or her own practices with moral worth. Routinization ensures a moral order in the habitus, but not a normative order.     

“Blood,Guts, and Gore Galore:” Bodies,Moral Pollution,and Combat Trauma

This article is based on interviews with U.S. veterans diagnosed with combat‐related posttraumatic stress disorder (PTSD). In remembering war, the veterans consistently described grotesque death and injury. These stories of “blood, guts, and gore” were often closely associated with negative moral evaluations of war, which included outright moral claims, moralistic allusions, and expressions of moral emotions. I argue that memories of grotesque death and injury “code” combat as moral pollution, and as these veterans present it, combat pollutes every soldier who passes through it. Furthermore, this classification represents a modern moral culture in which the body is sacred, subject to sustained ritual cleanliness and to strict prohibitions against encroachment by others. A mutilated body is severely disordered and filthy, and when a product of human design, it represents an extremely cruel trespass. Consequently, mutilated bodies are doubly polluted and can code combat as negative in the extreme. This article illustrates that personal traumatic memories are sociologically and historically organized, that the traditional religious ideas of purity and pollution still order moral life, and that autobiographical memory can be approached as a classificatory structure.