Colchicine poisoning: Case report of three homicides in a family.

Background: Colchicine is a common therapeutic agent for inflammatory conditions such as gout, yet its narrow therapeutic range frequently results in cases of overdose and subsequent poisoning. Acute colchicine poisoning can be difficult to identify due to its nonspecific clinical manifestations, posing a diagnostic challenge for emergency physicians without a clear history of colchicine ingestion. Case presentation: This report describes a tragic case of acute colchicine poisoning that resulted in three familial homicides. The patients presented with fever, abdominal pain, and diarrhea, which rapidly escalated to shock during their emergency department visits. Laboratory tests revealed a marked leukocytosis, mild elevation in procalcitonin (PCT), significantly elevated creatine kinase (CK) and CK-MB levels, and liver function abnormalities. Despite treatment with carbapenem antibiotics and aggressive fluid resuscitation, the patients' condition deteriorated, marked by a progressive decline in leukocytes and neutrophils. Initially misdiagnosed as septic shock, the ineffectiveness of the standard treatment protocols led to a fatal outcome for all three individuals. Conclusion: Emergency physicians should consider acute colchicine poisoning as a differential diagnosis in patients presenting with shock and the following clinical indicators: (1) pronounced increase in peripheral leukocytes with a disproportionate rise in neutrophils; (2) discordance between the level of serum procalcitonin and the severity of presumed septic shock; (3) early increase in serum creatine kinase (CK) and CK-MB; (4) poor response to antibiotics and resuscitative efforts, accompanied by a continuous decrease in white blood cells and neutrophils. This case underscores the critical need for awareness of colchicine toxicity in the emergency setting, particularly when the clinical presentation mimics septic shock but fails to respond to standard treatments.

Reduced Violence-Related Burden and Mortality at Higher Altitudes: Examining the Association between High Altitude Living and Homicide Rates in Ecuador.

Esteban Ortiz-Prado, Juan Sebastian Izquierdo-Condoy, María G. Dávila-Rosero, Jorge Vásconez-González, Ana M. Diaz, Carla E. Moyano, Vanessa Arcos-Valle, Ginés Viscor, and Joshua H. West. Reduced Violence-Related Burden and Mortality at Higher Altitudes: Examining the Association between High Altitude Living and Homicide Rates in Ecuador. High Alt Med Biol. 00:000-000, 0000. Background: Homicides are a major public health concern and a leading cause of preventable deaths worldwide. The relationship between altitude and homicides remains unclear, and evidence of the possible effects of living at high altitudes on homicide rates is limited. This research aimed to investigate the mortality rates resulting from various types of aggression that culminated in homicides in Ecuador and to explore potential differences associated with altitude. Methods: An ecological analysis of homicide rates in Ecuador was conducted from 2001 to 2022. Homicide cases and the population at risk were categorized based on their place of residence according to two altitude classifications: a binary classification of low (<2,500 m) and high altitude (>2,500 m), and a detailed classification according to criteria by the International Society for Mountain Medicine, which includes low (<1,500 m), moderate (1,500-2,500 m), high (2,500-3,500 m), and very high altitude (3,500-5,500 m) categories. Both crude and directly age-sex standardized mortality rates were calculated for each altitude category. Results: We analyzed a total of 40,708 deaths attributed to aggressions (ICD-10 codes X85-Y09). The total homicide rate for men was 21.29 per 100,000 (95% confidence interval [CI]: 9.55-32.37), whereas for women, it was 2.46 per 100,000 (95% CI: 1.44-3.27). Average rates across the 22 analyzed years were higher at low altitudes (men: 13.2/100,000 and women: 1.33/100,000) as compared with high altitudes (men: 5.79/100,000 and women: 1.05/100,000). Notably, the male-to-female rate difference was more pronounced at low altitudes (898%) than at high altitudes (451%). Conclusions: Our study revealed a higher prevalence of homicides in certain provinces and significant disparities in mortality rates between men and women. Although we cannot establish a direct relationship between altitude and homicide rates, further research is needed to explore potential confounding factors and a better understanding of the underlying causes for these variations.

Intimate partner femicide (IPF): Medico-legal investigation at the Institutes of Legal Medicine of Freiburg (Germany) and Padova (Italy).

Violence against women is a significant public health concern, with femicide as its most extreme manifestation. This crime is often perpetrated by current or former intimate partners, thus taking the name of intimate partner femicide (IPF). Although international comparisons are essential for prevention policies, cross-country comparative studies are scarce in this context. The aim of this study was to evaluate and compare clinical, epidemiological and medico-legal characteristics of IPF autopsy cases investigated at the Institutes of Legal Medicine of two Western European cities, in order to identify a potential medico-legal pattern of IPF. Autopsy and police reports of IPF cases occurred in the judicial district of Freiburg (Germany) and Padova (Italy) from 2000 to 2022 were analyzed. Data relating to victims, perpetrators, relationship context, and circumstantial and pathological-forensic characteristics of the homicide were collected. Statistical analyses were performed to explore potential relationships between the data collected. Additionally, a review of the literature dealing with autopsy-based studies on IPF was performed. Overall, 82 cases of IPF were analyzed, 39 from Freiburg and 43 from Padova. A total of 6 papers fulfilled the review inclusion criteria. Our study identified a medico-legal pattern of IPF and demonstrated that it did not vary substantially between the two European Countries considered, suggesting that certain IPF characteristics are shared at the European level. However, a significant finding emerged regarding the higher prevalence of firearm-related IPFs in Italy compared to Germany. Forensic pathology research might contribute to developing targeted prevention policies to protect women from this lethal form of violence.

Characterization of Homicides in Mexico: Analysis of 2015-2022.

BACKGROUND: In Mexico, homicides are the leading cause of death among men aged 15 to 44 years; however, despite their increase in recent decades, the study of this issue is insufficient, given its magnitude and impact. Therefore, this study aimed to characterize the spatial and temporal patterns and associated factors of homicides in Mexico from 2015 to 2022. METHODS: An analytical cross-sectional study was conducted, analyzing death records from the National Institute of Statistics and Geography's general mortality databases. Simple frequencies and incidence rates per 100,000 inhabitants by sex, year, and state of the Mexican Republic were calculated. Mortality was evaluated by age groups and geographic areas, and bivariate logistic regression models with sociodemographic variables were performed. RESULTS: Records of 229,182 homicides in Mexico were analyzed, with a median age of 33 years, interquartile range 18. A total of 203,898 (88.96%) were men and 25,284 (11.04%) were women. The majority of deaths occurred in public places and were caused by firearms; women had a higher percentage of homicides at home. States with high incidence rates for both sexes were Chihuahua, Zacatecas, Michoacán, Colima, and Estado de México. The total years of life lost were 9.19 million years. The national incidence of homicides in men showed an upward trend from 2015 to 2019; however, in the case of women, this incidence increased in various age groups during the study period. Occupation, education, marital status, and place of occurrence had significant associations in the logistic regression models. CONCLUSIONS: This study provides a spatial-temporal characterization of homicides in Mexico between 2015 and 2022, highlighting the high incidence in men and the upward trend in certain age groups among women. These findings underscore the need for preventive measures and public policies to address this issue in a multisectoral manner.

Race, disadvantage, and violence: A spatial exploration of macrolevel covariates of police-involved homicides within and between US counties.

Efforts to explore the macrolevel determinants of police-involved homicides have expanded in recent years due in part to increased scrutiny and media attention to such events, and increased data availability of these events through crowdsourced databases. However, little empirical research has examined the spatial determinants of such events. The present study extends the extant macrolevel research on police-involved homicides by employing an underutilized spatial econometric model, the spatial Durbin model (SDM), to assess the direct and indirect county effects of racial threat, economic threat, social disorganization, and community violence on police killings within and between US counties from 2013 through 2020. Results indicate a direct inverse relationship between racial threat and police-involved homicides, no support for economic threat, and a direct positive association with two measures of social disorganization. Additionally, we find firearm availability exhibits significant direct and indirect spatial dependence on focal county police-involved homicides, reflecting spatial spillover processes. In essence, as firearm availability in neighboring counties increases, police-involved homicides within a focal county increase. The implications of these findings for racial threat, economic threat, social disorganization, and community violence are discussed.

Finding the here in where: Keatley's Winthropping in missing persons and no-body homicide cases.

No-body homicide cases are typically difficult to investigate, owing to the lack of forensics and leads. Researchers in the fields of forensics, criminology, and psychology have attempted to provide assistance to these investigations through their respective disciplines. The focus of the current case study review is on a combined approach to assisting in no-body homicides and cold cases. The proposed approach will outline a geographical profiling technique that has previously been used in no-body homicide investigations, Winthropping. Alongside this, forensic linguistic analyses will be outlined to show how a combination may provide fresh leads and investigative avenues for further exploration. A series of 4 real-world cases in which bodies were moved, dumped, and hidden by a suspect, who subsequently revealed knowledge of the clandestine grave are given. The aim is that readers from related fields and disciplines might synergistically collaborate to develop the area and further help in these cases.

Sex work-related homicides: Insights from the National Violent Death Reporting System, 2012-2020.

Homicide is a prevalent cause of death among sex workers, given their increased risk of violence due to proximity to criminal activities such as drug trade and human trafficking. This study analyzes homicide data from the National Violent Death Reporting System (NVDRS) covering 49 US states, the District of Columbia, and Puerto Rico from 2012 to 2020. Case inclusion criteria included: (1) manner of death of homicide, and (2) sex work-related circumstance. Descriptive analyses examined victim and injury characteristics, suspect information, and circumstances. The study identified 321 sex work-related homicides (54% female, 41% male, 6% transgender). Among female victims, 94% were sex workers, and 54% of their suspects were clients. Money conflicts (23%) and other crimes (30%), most often in progress, commonly precipitated homicides of female victims. Substance use problems were reported in 49% of female victims, with 25% of their suspected perpetrators reportedly using substances in the preceding hours. For male victims, 54% were clients and 9% were sex workers. Suspects in male homicides were primarily sex workers (34%) or individuals engaged in sex work-adjacent criminal activities (36%). Money conflicts (49%), other crimes (47%) most often in progress, and sex trafficking involvement (25%) commonly precipitated homicides with male victims. Transgender sex worker victims were mostly transfeminine (94%) and non-Hispanic black (89%). Money conflicts (78%) most commonly precipitated homicides among transgender sex worker victims. These findings can inform prevention strategies addressing underlying risk factors for persons involved in sex work.

Homicidios de niños, niñas y adolescentes en Colombia durante 2010-2020

Introducción: Los derechos de los niños, niñas y adolescentes prevalecen sobre los derechos de los demás. Sin embargo, países de ingreso medio como Colombia tienen una alta tasa de homicidios para este grupo poblacional, esto deja en evidencia que la sociedad no es capaz de proteger efectivamente su derecho fundamental a la vida. Objetivo: Describir la tendencia de los homicidios de los niños, niñas y adolescentes en Colombia para el periodo 2010-2020. Materiales y métodos: Se utilizaron los microdatos anonimizados de las defunciones no fetales de las estadísticas vitales del DANE y calcularon las tasas de homicidios para los menores de 19 años. Resultados: Durante el periodo analizado, los homicidios de los niñas, niñas y adolescentes en Colombia se redujeron, al pasar de 2485 en el año 2010 a 1360 en el 2020. Discusión: Los resultados de este trabajo muestran que los homicidios tienen diferencias significativas por grupo de edad, sexo y departamento, las cuales tienen determinantes que las explican, pero que es necesario abordar a profundidad en posteriores investigaciones. Conclusiones: Es indispensable seguir con esta tendencia decreciente para lograr garantizar el derecho a la vida de este grupo poblacional.

Introduction: The rights of children and adolescents prevail over others. However, middle-income countries such as Colombia have a high homicide rate for this population group, showing that society is not able to effectively protect their fundamental right to life. Objective: To describe the trend of homicides of children and adolescents in Colombia for the period 2010-2020. Materials and methods: We used anonymized microdata of non-fetal deaths from DANE vital statistics and calculated homicide rates for children under 19 years of age. Outcomes: During the period analyzed, homicides of children and adolescents in Colombia decreased from 2485 in 2010 to 1360 in 2020. Discussion: The results of this study show homicides have significant differences by age group, sex, and department, which have determinants that describe them but need to be addressed in depth in further research. Conclusions: It is essential to continue with this decreasing trend to guarantee the right to life for this population group.

The specifics of homicide-suicide in France.

BACKGROUND: Homicide and suicide are two causes of violent death. This study focuses on situations in which these two types of violent death occur at the same time, known as homicide-suicide. AIM: The aim of this study is to review the circumstances surrounding homicide-suicides as well as the features of the victims and perpetrators in France at a recent period. The article characterizes homicide-suicides by comparing them with simple homicides in order to determine whether they exhibit distinctive characteristics and significant links. METHODOLOGY: The data analyzed are based on detailed police operational information collected about 1622 homicides that occurred in France in 2019 and 2020. After presenting the characteristics of all homicide-suicides, this article specifically compares those that take place within the family, whether they result in the suicide of the perpetrator or not, using bivariate tests (chi-square). The tests are based on a distinction between domestic homicide-suicides within a couple and between other family members. RESULTS: Analysis shows that 7 % of them were followed by the suicide of the perpetrator (203 cases). Almost all of them take place within family (91 %), and most often within the couple (60 %). Apart from couple configurations, familial homicide-suicides target the children (21 %) or parents (5 %) of the perpetrators. The perpetrators are mainly men, while most of the victims are women. Analysis revealed significant links between certain variables and suicide (or attempted suicide by the alleged perpetrator) in the context of couple homicide: the modus operandi, the spatio-temporal setting, the gender and average age of the victim and history of domestic violence suffered by the victim, as well as all the variables relating to the alleged perpetrator (age, gender, police and psychiatric history, alcohol consumption, etc.). Among other family members, these variables do not have a significant influence on whether the perpetrator commits suicide following the homicide. Perpetrators of domestic homicide-suicides are less likely to be under the influence of alcohol (8 %), to be known to the police (19 %), and to have a psychiatric history (11 %) than those who do not commit suicide following the homicide (respectively 41 %, 54 %, 22 %). There is also less record of domestic violence when the perpetrator commits suicide (20 %) than when they do not (48 %). CONCLUSIONS: Homicide-suicides are to some extent similar to simple couple homicides. Women are therefore overrepresented among domestic homicide victims; likewise, they are also overrepresented among the victims of homicide-suicides, which are mostly committed in family circumstances. The most significant risk factors are the presence of firearms in the household and history of domestic violence within the couple. RECOMMENDATIONS: The results suggest two areas for action: the screening (interpersonal conflicts, alcohol, depression, domestic violence, presence of a firearm) and the prevention of intra-family homicides. Prevention should focus on screening specific elements: the presence of a firearm, domestic violence, interpersonal conflicts, depression, and alcohol. Prevention could also take place with elderly people at the end of their lives.

Impacto del proceso electoral 2021 en los homicidios dolosos en México: un análisis a través de series de tiempo interrumpidas / Impact of the 2021 electoral process on intentional homicides in Mexico: an interrupted time series analysis / Impacto do processo eleitoral de 2021 nos homicídios dolosos no México: uma análise por meio de séries temporais interrompidas

El presente trabajo de investigación analiza el impacto del proceso electoral 2021 en los niveles de homicidios dolosos. Se utilizaron series de tiempo interrumpidas para evaluar los cambios en el nivel y tendencia de los homicidios dolosos a partir del inicio del proceso electoral. Se analizaron los casos de tres estados de la república: Chihuahua, Sinaloa y Guerrero. Los grupos de control fueron conformados con los casos de los estados de Coahuila, Durango y Oaxaca. Los resultados muestran que el proceso electoral no derivó en un cambio estadísticamente significativo en las tendencias y/o nivel de los homicidios dolosos, pero sí es posible observar un aumento de homicidios dolosos un mes antes de la elección en cada uno de los casos. En otras palabras, aunque los cambios en los homicidios dolosos no son sostenidos, el mes anterior a la elección sí muestra un incremento significativo de este delito.

This research paper- analyses the impact of the 2021 electoral process on the levels of intentional homicides. Interrupted time series were used to evaluate changes in the level and trend of intentional homicides since the beginning of the electoral process. Three states were analysed: Chihuahua, Sinaloa and Guerrero. Control groups wereformed with cases from the states of Coahuila, Durango and Oaxaca. The results show that the electoral process did not lead to a statistically significant change in the trends and/or level of intentional homicides, but it is possible to observe an increase in intentional homicides one month before the election in each of the cases. In other words, although the changes in intentional homicides are not sustained, the month before the election does show a significant increase in this crime.

Este trabalho de pesquisa analisa o impacto do processo eleitoral de 2021 nos níveis de homicídios intencionais. Foram usadas séries temporais interrompidas para avaliar as mudanças no nível e na tendência dos homicídios dolosos desde o início do processo eleitoral. Foram analisados três estados: Chihuahua, Sinaloa e Guerrero. Foram formados grupos de controle com casos dos estados de Coahuila, Durango e Oaxaca. Os resultados mostram que o processo eleitoral não levou a uma mudança estatisticamente significativa nas tendências e/ou no nível de homicídios dolosos, mas é possível observar um aumento nos homicídios dolosos um mês antes da eleição em cada um dos casos. Em outras palavras, embora as mudanças nos homicídios dolosos não sejam sustentadas, o mês anterior à eleição mostra um aumento significativo desse crime.

Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022.

Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we use time series approaches to separate the direct contribution of SARS-CoV-2 infection on mortality from the indirect consequences of the pandemic in the United States. We estimate excess deaths occurring above a seasonal baseline from March 1, 2020 to January 1, 2022, stratified by week, state, age, and underlying mortality condition (including COVID-19 and respiratory diseases; Alzheimer's disease; cancer; cerebrovascular diseases; diabetes; heart diseases; and external causes, which include suicides, opioid overdoses, and accidents). Over the study period, we estimate an excess of 1,065,200 (95% Confidence Interval (CI) 909,800-1,218,000) all-cause deaths, of which 80% are reflected in official COVID-19 statistics. State-specific excess death estimates are highly correlated with SARS-CoV-2 serology, lending support to our approach. Mortality from 7 of the 8 studied conditions rose during the pandemic, with the exception of cancer. To separate the direct mortality consequences of SARS-CoV-2 infection from the indirect effects of the pandemic, we fit generalized additive models (GAM) to age- state- and cause-specific weekly excess mortality, using covariates representing direct (COVID-19 intensity) and indirect pandemic effects (hospital intensive care unit (ICU) occupancy and measures of interventions stringency). We find that 84% (95% CI 65-94%) of all-cause excess mortality can be statistically attributed to the direct impact of SARS-CoV-2 infection. We also estimate a large direct contribution of SARS-CoV-2 infection (≥67%) on mortality from diabetes, Alzheimer's, heart diseases, and in all-cause mortality among individuals over 65 years. In contrast, indirect effects predominate in mortality from external causes and all-cause mortality among individuals under 44 years, with periods of stricter interventions associated with greater rises in mortality. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups and in mortality from external causes. Further research on the drivers of indirect mortality is warranted as more detailed mortality data from this pandemic becomes available.

Seasonal and Temporal Patterns of Homicides and Suicides in Cali and Manizales, Colombia: A Times-Series Analysis 2008-2015.

OBJECTIVE: To identify seasonal and temporal variations in daily incidence of homicides and suicides in Cali and Manizales, Colombia during 2008-2015. MATERIALS AND METHODS: An ecological time series study was performed using negative binomial regression models for daily incidence of homicides and suicides; analyses were controlled for yearly trends and temporal autocorrelations. RESULTS: Saturdays, Sundays, December holidays as well as New Year and New Year's Eve were associated with an increased risk of homicides in both cities. Suicide risk increased during December holidays and New Year in both cities. In addition, the suicide risk increased on paydays, Saturdays, Sundays, and Mondays in Cali, and it decreased during the Holy Week holidays in Manizales. December patterns of suicides and homicides are the opposite in each city, and between cities. CONCLUSIONS: The incidences of homicides and suicides are not homogeneous over time. These patterns can be explained partially by alcohol consumption and changes in people's routine activities which may modify exposure to violent circumstances.

Legal Firearm Sales at State Level and Rates of Violent Crime, Property Crime, and Homicides.

INTRODUCTION: The effects of firearm sales and legislation on crime and violence are intensely debated, with multiple studies yielding differing results. We hypothesized that increased lawful firearm sales would not be associated with the rates of crime and homicide when studied using a robust statistical method. METHODS: National and state rates of crime and homicide during 1999-2015 were obtained from the United States Department of Justice and the Centers for Disease Control and Prevention. National Instant Criminal Background Check System background checks were used as a surrogate for lawful firearm sales. A general multiple linear regression model using log event rates was used to assess the effect of firearm sales on crime and homicide rates. Additional modeling was then performed on a state basis using an autoregressive correlation structure with generalized estimating equation estimates for standard errors to adjust for the interdependence of variables year to year within a particular state. RESULTS: Nationally, all crime rates except the Centers for Disease Control and Prevention-designated firearm homicides decreased as firearm sales increased over the study period. Using a naive national model, increases in firearm sales were associated with significant decreases in multiple crime categories. However, a more robust analysis using generalized estimating equation estimates on state-level data demonstrated increases in firearms sales were not associated with changes in any crime variables examined. CONCLUSIONS: Robust analysis does not identify an association between increased lawful firearm sales and rates of crime or homicide. Based on this, it is unclear if efforts to limit lawful firearm sales would have any effect on rates of crime, homicide, or injuries from violence committed with firearms.

The Opioid Epidemic: a Crisis Disproportionately Impacting Black Americans and Urban Communities.

The heroin epidemic has existed for decades, but a sharp rise in opioid overdose deaths (OODs) jolted the nation in the mid-twenty-teens and continues as a major health crisis to this day. Although the new wave of OODs was initially approached as a rural problem impacting a White/Caucasian demographic, surveillance records suggest severe impacts on African Americans and urban-dwelling individuals, which have been largely underreported. The focus of this report is on specific trends in OOD rates in Black and White residents in states with a significant Black urban population and declared as hotspots for OOD: (Maryland (MD), Illinois (IL), Michigan (MI), and Pennsylvania (PA)), and Washington District of Columbia (DC). We compare OODs by type of opioid, across ethnicities, across city/rural demographics, and to homicide rates using 2013-2020 data acquired from official Chief Medical Examiners' or Departments of Health (DOH) reports. With 2013 or 2014 as baseline, the OOD rate in major cities (Baltimore, Chicago, Detroit, Philadelphia) were elevated two-fold over all other regions of their respective state. In DC, Wards 7 and 8 OODs were consistently greater than other jurisdictions, until 2020 when the rate of change of OODs increased for the entire city. Ethnicity-wise, Black OOD rates exceeded White rates by four- to six-fold, with fentanyl and heroin having a disproportionate impact on Black opioid deaths. This disparity was aggravated by its intersection with the COVID-19 pandemic in 2020. African Americans and America's urban dwellers are vulnerable populations in need of social and political resources to address the ongoing opioid epidemic in under-resourced communities.

Scene of death investigation in apparent suicidal deaths in Rotterdam, the Netherlands.

Guidelines from the Netherlands describe that unnatural deaths should be investigated by a forensic physician and Crime Scene Technicians, but this is not always the case. In this study, we aimed to determine what predicts the non-attendance of the Crime Scene Technicians at the scene of the death of suicides in the police region in Rotterdam, the Netherlands. Data of 315 suicides (2016-2017) that have been externally examined by forensic physicians and reports from the Crime Scene Technicians were analysed. Statistical analysis was performed to determine the factors predicting the involvement of the Crime Scene Technicians at the scene of death. The Crime Scene Technicians were not attending in 23% (n = 72) cases, and over half of these cases were not found in the registration system of the Crime Scene Technicians. About some the Crime Scene Technicians was not informed. Predictors of the non-attendance of the Crime Scene Technicians were suicide by poisoning, the individual was found by an acquaintance or family, a history of suicide attempts and examination of the deceased in the hospital. In this study, we observed that the Crime Scene Technicians were sometimes not attending the investigation of apparent suicides. More research on this topic should be done to investigate the value of the presence of the Crime Scene Technicians at the scene before concluding that non-attendance of Crime Scene Technicians on-site influences the quality of the scene of death investigation and corresponding conclusions. Since 2017, several quality improvements were made, but an (inter)national conjoint protocol for uniform and structural suicide investigation could secure the quality of the scene of death investigation of suicides and would provide information useful for evaluation.

Do Sheriff-Coroners Underreport Officer-Involved Homicides?

Introduction: In the United States, each state sets its own standards for its death investigation system. These may require independent medical examiners and coroners or allow for the sheriff to assume the role of coroner. Motivated by the well-established fact that counts of officer-involved homicides in official data sets grossly undercount the number of these incidents, we examine the possibility that different death investigation systems may lead to different death classification outcomes. Methods: To examine the potential differences in officer-involved homicide underreporting by presence of sheriff-coroner and violent death type (gunshot, intentional use of force, pursuit, or other vehicle accident), we compare ratios of incidents from both the Federal Bureau of Investigation's Supplementary Homicide Reports and the restricted Multiple-Cause of Death files from the National Vital Statistics System to the Fatal Encounters data across coroner contexts in California between 2000 and 2018; we quantify differences descriptively and examine bivariate tests of means. Results: We find significantly greater underreporting of officer-involved deaths in sheriff-coroner counties in both official data sets for all incidents compared with non-sheriff-coroner counties, independently of the period considered. These underreporting differences in the National Vital Statistics System are robust to restricting to gunshot and intentional use of force deaths, the type of incident expected to be less prone to misclassification in that data set. Conclusions: Officer-involved death underreporting in sheriff-coroner counties necessitates further scrutiny. Disparities in officer-involved death reporting suggest political pressure may play a role in classifying deaths.

An empirical analysis of homicides in Mexico through Machine Learning and statistical design of experiments

Homicide is one of the most important mortality causes that has reduced the Mexican life expectancy. That is why the aim of this work is to identify some sociodemographic and economic factors that can help explain homicides in Mexico and measure their impact, assuming the current conditions prevail. To do that, several Machine Learning (ML) methods were evaluated. The C5.0 model is best suited for the data at hand. After fine-tuning the algorithm, we used the estimated model to identify the main factors that explain homicides. Among these factors, eleven were selected that can be influenced by direct changes in domestic public policy, laws and/or regulations. These were used as input in a two-level fractional factorial Statistical Design of Experiments (DOE) to estimate their main effects and possible interactions. Although several of these factors had statistically significant effects on homicide rate, the one that had the biggest and direct impact from a practical perspective, was the Rule of Law Index (RLI). In fact, if we assumed that all states had the median RLI of 0.37, implementing domestic policies and procedures to move them all to the best RLI level could significantly reduce homicide rates.

El homicidio es una de las principales causas de muerte que ha reducido la esperanza de vida de los mexicanos. El objetivo de este trabajo es identificar algunos factores sociodemográficos y económicos que puedan ayudar a explicar homicidios en México y medir su impacto, suponiendo que las condiciones actuales permanecen. Para lograrlo, comparamos diferentes métodos de Aprendizaje de Máquina (AM). Para tal fin, se encuentra que el modelo C5.0 es el más adecuado. Después de hacer una calibración final del modelo, lo utilizamos para determinar los veinticinco principales factores que explican el fenómeno de homicidios. Se seleccionan 11 factores que se consideran pueden ser influenciados directamente por cambios en políticas públicas, leyes y/o regulaciones. Estos predictores fueron utilizados como entrada en un diseño de experimentos factorial fraccionado con dos niveles para estimar los principales efectos principales e interacciones posibles. A pesar de que varios de estos factores tuvieron impactos estadísticamente significativos, el que mostró tener el mayor impacto directo desde una perspectiva práctica fue el Índice de Estado de Derecho (IED). De hecho, asumiendo que todos los estados tuvieran el valor de IED de 0.37, correspondiente a la mediana en todo el país, si se implementaran políticas y procedimientos para ubicar a todos los estados al nivel del mejor estado en términos de IED, se lograría una reducción altamente significativa en la incidencia de homicidios en México.

Do health sector measures of violence against women at different levels of severity correlate? Evidence from Brazil.

OBJECTIVE: To evaluate if characteristics of reports of violence against women at different levels of severity are similar and to test if their prevalence is correlated at the municipal level. METHODS: I use data from women ages 15-49 who were killed by homicide in Brazil's national death registry (N = 14,373), were hospitalized for aggression (N = 14,701), or were included in the medical mandatory reports of incidents of violence against women (N = 42,134) between 2011 and 2016 in select municipalities. I provide national level descriptive statistics from 2016 contrasting distributions of victims (age, education, and race) and distributions of the characteristics of the incidents (location and time of day). Then, for 63 municipalities with a high number of violent incidents, I calculate the correlation coefficients between measures of violence against women using quarterly data from 2011 to 2016. I use multiple regression of municipal characteristics at baseline to examine which factors (poverty, spending, health, and civic engagement) predict the correlation. RESULTS: Victim characteristics and incident characteristics are similar across the measures of violence at the national level. Despite these aggregate similarities, correlations at the municipal level are quite varied, ranging from - 0.69 to 0.83. I find no municipal characteristics that consistently predict these correlation coefficients. CONCLUSIONS: Despite some similarities at an aggregate level, these measures of violence against women do not have consistent patterns of correlation at the municipality level. Measures of severe levels of violence against women are not good proxies for incidence of violence at less severe physical levels. Lack of correlations could be due to differences in reporting, but may also be due to differences in underlying processes that share similar victims and event characteristics.

Demographic and Regional Factors Associated With Reporting Homicides of Transgender People in the United States.

INTRODUCTION: The American Medical Association recently declared homicides of transgender individuals an epidemic. However, transgender homicide victims are often classified as nontransgender. Our objective was to describe existing data and coding of trans (i.e., transgender) victims and to examine the risk factors for homicides of trans people relative to nontrans people across the United States. METHODS: A retrospective review of the Centers for Disease Control and Prevention's National Violent Death Reporting System for the years 2003-2018 identified victims defined as transgender either through the "transgender" variable or narrative reports. Fisher's exact tests and logistic regression models were run to compare the demographics of trans victims to those not identified as trans. RESULTS: Of the 147 transgender victims identified, 14.4% were incorrectly coded as nontrans despite clear indication of trans status in the narrative description, and 6% were coded as hate crimes. Relative to nontrans victims, trans victims were more frequently Black (54.4% versus 40.7%, P = 0.001), had a mental health condition (26.5% versus 11.3%, P < 0.001), or reported being a sex worker (9.5% versus 0.2%, P < 0.001). There were disproportionately few homicides of transgender people in the South (13.6% of trans victims versus 29.1% of nontrans victims, P < 0.001). Conversely, the West and Midwest accounted for a higher-than-expected proportion of trans victims relative to nontrans victims (23.1% of trans victims versus 16.2% of nontrans victims, P = 0.03; 24.5% of trans victims versus 16.8% of nontrans victims, P = 0.02, respectively). CONCLUSIONS: Though the murder of transgender individuals is a known public health crisis, inconsistencies still exist in the assessment and reporting of transgender status. Further, these individuals were more likely to have multiple distinct vulnerabilities. These findings provide important information for injury and violence prevention researchers to improve reporting of transgender status in the medical record and local trauma registries.