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Bujaroska Perkovikj M, Anastasova L, Stankov A, Zhivikj Z, Poposka V, Petrusevska-Tozi L. The role of alcohol and patterns of alcohol-related deaths in Republic of North Macedonia within the period 2007-2020. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00748-6. [PMID: 37946096 DOI: 10.1007/s12024-023-00748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
Excessive alcohol consumption is one of the most important factors in a substantial number of violent deaths. The aim of our study was to investigate alcohol-related deaths in the Republic of North Macedonia in the period from 2007 to 2020, in order to study the influence of elevated blood alcohol levels in violent deaths. Five hundred sixty-four post-mortem blood samples from alcohol-related death cases-natural deaths and violent deaths (suicides, accidents, and homicides)-were analyzed, and the results were evaluated according to sex, age, and cause of death. Among 564 cases, traffic accidents were the leading cause of violent death (54.3% of the cases) followed by suicides (19.9% of the cases). In the examined post-mortem samples, BAC values ranged from 0.15-6.20 g/L. The average age was 45 ± 16 years for the male and 49 ± 19 years for the female group. The biggest proportion of high BAC values was found in the group of accidents specifically road traffic accidents and accidental intoxication as well as in the group of bolus deaths. The analysis of BAC in the cases of violent deaths in the Republic of North Macedonia confirmed that consumption of alcohol is strongly related to violent deaths. The data obtained from this study could raise caution and give aid in a national strategy for the prevention of alcohol-related violent deaths.
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Affiliation(s)
- Marija Bujaroska Perkovikj
- Institute of Forensic Medicine, Criminology and Medical Deontology, Medical Faculty, Ss. Cyril and Methodius University in Skopje, Mother Theresa 19, 1000, Skopje, Republic of North Macedonia.
| | - Liljana Anastasova
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000, Skopje, Republic of North Macedonia
| | - Aleksandar Stankov
- Institute of Forensic Medicine, Criminology and Medical Deontology, Medical Faculty, Ss. Cyril and Methodius University in Skopje, Mother Theresa 19, 1000, Skopje, Republic of North Macedonia
| | - Zoran Zhivikj
- Institute of Applied Biochemistry, Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000, Skopje, Republic of North Macedonia
| | - Verica Poposka
- Institute of Forensic Medicine, Criminology and Medical Deontology, Medical Faculty, Ss. Cyril and Methodius University in Skopje, Mother Theresa 19, 1000, Skopje, Republic of North Macedonia
| | - Lidija Petrusevska-Tozi
- Institute of Applied Biochemistry, Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000, Skopje, Republic of North Macedonia
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Silva KDS, Sampaio AAS, Miguel ADQC. Contingency Management applied to Alcohol Use Disorder: Systematic Review. PSICOLOGIA: TEORIA E PESQUISA 2022. [DOI: 10.1590/0102.3772e38215.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This systematic review evaluated the efficacy of applying Contingency Management (CM) to Alcohol Use Disorder. We followed the PRISMA recommendation and consulted the following databases: Cochrane Library, MEDLINE Complete, PsycINFO and Pubmed. A total of eight randomized controlled trials were included in this review, all of them with good methodological quality. In seven of these, CM was more efficacious in promoting continuous abstinence. Both trials that evaluated treatment retention found statistically significant results favorable to CM. On two of the three trials presenting follow-up results, CM was more efficacious in promoting abstinence. The large-scale application of CM can promote substantial public health improvements and should be encouraged.
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Silva KDS, Sampaio AAS, Miguel ADQC. Manejo de Contingência Aplicado ao Transtorno por Uso de Álcool: Revisão Sistemática. PSICOLOGIA: TEORIA E PESQUISA 2022. [DOI: 10.1590/0102.3772e38215.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Resumo Esta revisão sistemática avaliou a eficácia do Manejo de Contingência (MC) no tratamento do Transtorno por Uso de Álcool. Para isso, foi utilizada a recomendação PRISMA e consultadas as bases de dados: Cochrane Library, MEDLINE Complete, PsycINFO e Pubmed. Foram incluídos oito ensaios clínicos randomizados nesta revisão. Em sete, o MC foi mais eficaz em promover abstinência continuada. Dos dois que avaliaram a retenção no tratamento, ambos encontraram resultados estatisticamente favoráveis ao MC. Dos três que apresentaram resultados de avaliação de seguimento, em dois o MC foi mais eficaz em promover abstinência. Todos apresentaram boa qualidade metodológica. A aplicação do MC em larga escala pode promover melhorias substanciais para a saúde pública e deve ser encorajada.
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Soares Filho AM, Merchan-Hamann E, Vasconcelos CH. [Expansion, displacement and interiorization of homicides in Brazil, between 2000 and 2015: a spatial analysis]. CIENCIA & SAUDE COLETIVA 2021; 25:3097-3105. [PMID: 32785545 DOI: 10.1590/1413-81232020258.32612018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
The scope of this paper is to analyze the variation of the spatial pattern of the homicide rate in Brazil between 2000 and 2015. It is an ecological study by micro-regions of homicides taken from the Mortality Information System, using Moran indexes, and critical area clusters (95% CI). The rate increased by 6% (to 29.1/100,000 inhabitants (95% CI 28.9, 29.4), and in 80% of the micro regions between 2000 and 2015. The areas with high rates (> 38.2/100,000) increased 2.7-fold. In 2000, the highest rates were concentrated in areas in Pernambuco, São Paulo, Mato Grosso and Rio de Janeiro; by 2015, it will affect most states in the North and Northeast. The coastal regions of the Northeast and borders of Pará and Maranhão in the Amazon are critical areas. The lowest rate (19.1/100,000) is in São Paulo and Santa Catarina micro regions, with less critical clusters in the Southeast and South regions. Homicides have expanded into the interior of Brazil, with displacement between regions, mainly gravitating towards the poorest, which exhibit more critical areas in several scenarios, such as state borders and the coast. Conversely, there is marked contraction of homicides in states of highly developed regions with the presence of less critical areas. Key words Homicide.
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Affiliation(s)
- Adauto Martins Soares Filho
- Departamento de Análise da Situação de Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde. SRTVN 701, Via W5 Norte, Ed. PO700/6º DANTPS, Asa Norte. 70723-040 Brasília DF Brasil.
| | - Edgar Merchan-Hamann
- Departamento de Análise da Situação de Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde. SRTVN 701, Via W5 Norte, Ed. PO700/6º DANTPS, Asa Norte. 70723-040 Brasília DF Brasil.
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Malta DC, Soares Filho AM, Pinto IV, de Souza Minayo MC, Lima CM, Machado ÍE, Teixeira RA, Neto OLM, Ladeira RM, Merchan-Hamann E, de Souza MDFM, Vasconcelos CH, Vidotti CCF, Cousin E, Glenn S, Bisignano C, Chew A, Ribeiro AL, Naghavi M. Association between firearms and mortality in Brazil, 1990 to 2017: a global burden of disease Brazil study. Popul Health Metr 2020; 18:19. [PMID: 32993706 PMCID: PMC7525968 DOI: 10.1186/s12963-020-00222-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017. METHODS We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables. RESULTS Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20-24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = -0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = -0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = -0.269, p = 0.005). CONCLUSIONS There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.
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Affiliation(s)
| | | | - Isabella Vitral Pinto
- Graduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Ísis Eloah Machado
- School of Medicine, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Renato Azeredo Teixeira
- Graduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | | | | | | | - Ewerton Cousin
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Scott Glenn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Adrienne Chew
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Antonio Luiz Ribeiro
- Telehealth Center, Hospital das Clínicas and Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
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El-Gabri D, Toomey N, Gil NM, de Oliveira AC, Calvo PRS, Tchuisseu YP, Williams S, Andrade L, Vissoci JRN, Staton C. Association Between Socioeconomic and Demographic Characteristics and Non-fatal Alcohol-Related Injury in Maringá, Brazil. Front Public Health 2020; 8:66. [PMID: 32269983 PMCID: PMC7109310 DOI: 10.3389/fpubh.2020.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Previous research has corroborated a high burden of alcohol-related injury in Brazil and the presence of socioeconomic disparities among the injured. Yet, individual-level data is scarce. To fill this gap, we examined the association between demographic and socioeconomic characteristics with non-fatal alcohol-related injury in Maringá, Brazil. Methods: We used household survey data collected during a 2015 cross-sectional study. We conducted univariate and multivariate analyses to evaluate associations of demographic (age, gender, race) and socioeconomic characteristics (employment, education, income) with non-fatal alcohol-related injury. Results: Of the 995 participants who reported injuries, 62 (6.26%) were alcohol-related. Fifty-three (85%) alcohol-related injuries were reported by males. Multivariate analysis indicated being male (OR = 5.98 95% CI = 3.02, 13.28), 15–29 years of age (OR = 3.62 95% CI = 1.72, 7.71), and identifying as Black (OR = 2.38 95% CI = 1.09, 4.95) were all significantly associated with increased likelihood of reporting an alcohol-related injury, whereas unemployment was significantly associated with decreased likelihood of reporting an alcohol-related injury (OR = 0.41 95% CI = 0.18, 0.88). Conclusion: Our findings suggest that in Maringá, being male, between the ages of 15 and 29, employed, or identifying as Black were characteristics associated with a higher risk for non-fatal alcohol-related injury. Individual level data, such as ours, should be considered in combination with area-level and country-level data when developing evidence-based public-health policies.
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Affiliation(s)
- Deena El-Gabri
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Nicole Toomey
- Duke Global Health Institute, Duke University, Durham, NC, United States.,Division of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
| | - Nelly Moraes Gil
- Department of Nursing, State University of Maringá, Maringá, Brazil
| | | | | | | | - Sarah Williams
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Luciano Andrade
- Department of Nursing, State University of Maringá, Maringá, Brazil
| | - Joao Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, Durham, NC, United States.,Division of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
| | - Catherine Staton
- Duke Global Health Institute, Duke University, Durham, NC, United States.,Division of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
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7
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Soares Filho AM, Duarte EC, Merchan-Hamann E. [Trend and distribution of the homicide mortality rate in accordance with the size of the population of Brazilian municipalities - 2000 and 2015]. CIENCIA & SAUDE COLETIVA 2020; 25:1147-1156. [PMID: 32159682 DOI: 10.1590/1413-81232020253.19872018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/19/2018] [Indexed: 11/22/2022] Open
Abstract
The scope of this study is to analyze the trends and distribution of homicide mortality rates (HMR) according to the population size of Brazilian municipalities between 2000 and 2015. It is an ecological study of deaths recorded in the Mortality Information System, with HMR standardized by the direct method and 95% confidence interval. HMR in Brazil grew 6% (to 29.1/100,000) in the period, with an increase in small municipalities (83%; 12.7 to 23.2/100,000) and mediumsized cities (52%; 19.7% to 30.1/100,000); which is true for both sexes, different ages, regions and firearm-related events. HMR decreased in major cities (19%; 40.6% to 32.9/100,000) and the Southeast region (55%; 45.6% to 20.6/100,000). The relative risk (RR) of small and medium-sized cities in relation to large cities is already greater than or close to 1 among women (RR 0.99; 1.03), people aged 60 years or older (RR 1.43; 1.36) and homicides by other means (RR 1.16; 1.18). The cities of São Paulo and Rio de Janeiro contributed the most to the reduction of HMR, especially in large cities (-37.6 and -22.3 homicides/100,000 inhabitants). Small and medium-sized municipalities have consistent trends of an increase in HMR even considering population subgroups.
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Affiliation(s)
- Adauto Martins Soares Filho
- Secretaria de Vigilância em Saúde, Ministério da Saúde. Esplanada dos Ministérios Bloco G/Térreo, Asa Sul. 70058-900, Brasília, DF, Brasil.
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8
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Gonçalves REM, de Carvalho Ponce J, Leyton V. Alcohol Consumption and Violent Deaths in the City of Sao Paulo in 2015. Subst Use Misuse 2020; 55:1875-1880. [PMID: 32460601 DOI: 10.1080/10826084.2020.1771596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Excessive alcohol consumption is a serious public health issue, because drunkenness affects critical judgment and self-control, making people more vulnerable to violence and accidents, with thus a potential association between alcohol consumption and violent deaths. Objective: To assess the association between alcohol consumption and violent deaths in the city of Sao Paulo, Brazil, in 2015, and its relationship with gender, age, cause of death and blood alcohol concentration (BAC) of victims. Methods: A cross-sectional retrospective study was conducted by collection of data from 2,882 victims of violent deaths subjected to examination of BAC from the archives of the Institute of Legal Medicine of the State of Sao Paulo, Brazil. Results: Alcohol was detected in blood samples of 27.06% of the victims and mean BAC levels were 1.92 ± 1.24 g/L. The mean age of the victims was 33.49 ± 15.19 years. The majority of the victims were male (84.14%) and the prevalence of positive BAC was higher amongst men (28.74%) than women (18.16%). Homicide was the most prevalent cause of death in the sample (36.57%), but there were a higher proportion of traffic accidents victims with positive BAC (32.01%), as well as higher BAC levels in these victims (46.77% in the range of 1.6-2.5 g/L). Conclusions: The results obtained in this study support a potential association between alcohol consumption and violent deaths in the city of Sao Paulo, mainly in traffic accidents victims.
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Affiliation(s)
| | - Júlio de Carvalho Ponce
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | - Vilma Leyton
- Department of Legal Medicine, Ethics and Occupational Health, University of Sao Paulo Medical School, Sao Paulo, Brazil
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Almeida-González M, Luzardo OP, Boada LD, Zaragoza E, Meilán MJ, Zumbado M, Henríquez-Hernández LA. Ethanol levels in legally autopsied subjects (2016-2017): Update of data and epidemiological implications in relation to violent deaths in Canary Islands (Spain). J Forensic Leg Med 2019; 68:101868. [PMID: 31585334 DOI: 10.1016/j.jflm.2019.101868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/24/2019] [Accepted: 09/08/2019] [Indexed: 11/25/2022]
Abstract
The aim of this study was to analyze the prevalence of ethanol in individuals (277) subjected to a mandatory medico-legal autopsy in the Institute of Legal Medicine of Las Palmas (Canary Islands, Spain) during 2016-2017, comparing the results with data published in 2015. Blood and/or vitreous humor samples were analyzed by gas chromatography. 31.8% of the individuals were positive to ethanol. We observed a decrease in the prevalence of ethanol among males (p = 0.002). While the prevalence of ethanol was reduced, the concentration among those positive subjects has increased. 11.9% of the series died in a traffic accident and the percentage of positive to ethanol decreased in relation to 2015 (64.3, 25.0, and 35.3%). The number of suicides remains constant, although the age of the suiciders has been significantly reduced (p = 0.022). The results of this study indicate that ethanol is still heavily involved in non-natural deaths.
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Affiliation(s)
- M Almeida-González
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016, Las Palmas de Gran Canaria, Spain.
| | - O P Luzardo
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016, Las Palmas de Gran Canaria, Spain.
| | - L D Boada
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016, Las Palmas de Gran Canaria, Spain.
| | - E Zaragoza
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain.
| | - M J Meilán
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain.
| | - M Zumbado
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016, Las Palmas de Gran Canaria, Spain.
| | - L A Henríquez-Hernández
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016, Las Palmas de Gran Canaria, Spain.
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10
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Auckloo MBKM, Davies BB. Post-mortem toxicology in violent fatalities in Cape Town, South Africa: A preliminary investigation. J Forensic Leg Med 2019; 63:18-25. [DOI: 10.1016/j.jflm.2019.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 11/29/2018] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
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Bordoni PHC, Santos DMMD, Teixeira JS, Bordoni LS. Deaths from abdominal trauma: analysis of 1888 forensic autopsies. ACTA ACUST UNITED AC 2018; 44:582-595. [PMID: 29267555 DOI: 10.1590/0100-69912017006006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/27/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE to evaluate the epidemiological profile of deaths due to abdominal trauma at the Forensic Medicine Institute of Belo Horizonte, MG - Brazil. METHODS we conducted a retrospective study of the reports of deaths due to abdominal trauma autopsied from 2006 to 2011. RESULTS we analyzed 1.888 necropsy reports related to abdominal trauma. Penetrating trauma was more common than blunt one and gunshot wounds were more prevalent than stab wounds. Most of the individuals were male, brown-skinned, single and occupationally active. The median age was 34 years. The abdominal organs most injured in the penetrating trauma were the liver and the intestines, and in blunt trauma, the liver and the spleen. Homicide was the most prevalent circumstance of death, followed by traffic accidents, and almost half of the cases were referred to the Forensic Medicine Institute by a health unit. The blood alcohol test was positive in a third of the necropsies where it was performed. Cocaine and marijuana were the most commonly found substances in toxicology studies. CONCLUSION in this sample. there was a predominance of penetrating abdominal trauma in young, brown and single men, the liver being the most injured organ.
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Affiliation(s)
| | | | - Jaísa Santana Teixeira
- - José Bonifácio Lafayette de Andrada Foundation, Faculty of Medicine, Barbacena, MG, Brazil
| | - Leonardo Santos Bordoni
- - José Bonifácio Lafayette de Andrada Foundation, Faculty of Medicine, Barbacena, MG, Brazil.,- Civil State Police of Minas Gerais, Forensic Medicine Institute, Belo Horizonte, MG, Brazil.,- University of Ouro Preto, School of Medicine, Ouro Preto, MG, Brazil
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12
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Gonçalves REM, Ponce JDC, Leyton V. Alcohol use by suicide victims in the city of Sao Paulo, Brazil, 2011-2015. J Forensic Leg Med 2017; 53:68-72. [PMID: 29197754 DOI: 10.1016/j.jflm.2017.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 11/02/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
Abstract
Excessive alcohol consumption is a serious public health issue, because drunkenness affects critical judgment and self-control which could trigger violent and self-harm behavior, with thus a potential association between alcohol consumption and suicide deaths. The objective of the present study was to assess the association between alcohol consumption and suicide deaths in the city of Sao Paulo, Brazil, from 2011 to 2015, and its relationship with socio-demographic characteristics of the victims and the circumstances of the suicide. A cross-sectional retrospective study was conducted by collection of data from 1,700 suicide victims subjected to examination of blood alcohol concentration (BAC) from toxicology reports from the Institute of Legal Medicine of the State of Sao Paulo, Brazil. Alcohol was detected in blood samples of 30.2% of the victims and mean BAC levels were 1.73 ± 0.08 g/L. The mean age of the victims was 39.90 ± 0.75 years. The majority of the victims were male (74.6%) and the prevalence of positive BAC was higher amongst men (34.7%) than women (17.1%), p<0.05. The majority of the victims were white skinned (64.7%), but there was a higher proportion of victims with positive BAC among mulatto and black individuals, p<0.05. Hanging was the most prevalent suicide method in the sample (48.7%) and amongst men (55.4%), but amongst women it was jumping from a height (35%), p < 0.05.
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Affiliation(s)
- Raphael Eduardo Marques Gonçalves
- University of Sao Paulo Medical School, Department of Legal Medicine, Avenida Doutor Arnaldo, 455, CEP 01246-903, Sao Paulo, SP, Brazil.
| | - Júlio de Carvalho Ponce
- University of Sao Paulo Medical School, Department of Preventive Medicine, Avenida Doutor Arnaldo, 455, CEP 01246-903, Sao Paulo, SP, Brazil.
| | - Vilma Leyton
- University of Sao Paulo Medical School, Department of Legal Medicine, Avenida Doutor Arnaldo, 455, CEP 01246-903, Sao Paulo, SP, Brazil.
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13
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Almeida-González M, Henríquez-Hernández LA, P Luzardo O, Zumbado M, Zaragoza E, Meilán MJ, Camacho M, D Boada L. Ethanol levels in legally autopsied subjects: Analytical approach and epidemiological relevance in a prospective study in the touristic region of the Canary Islands (Spain). J Forensic Leg Med 2017; 52:40-45. [PMID: 28858689 DOI: 10.1016/j.jflm.2017.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/17/2017] [Accepted: 08/23/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to analyze the presence of alcohol in individuals (137) that were subjected to a mandatory medico-legal autopsy in the Institute of Legal Medicine of Las Palmas (Canary Islands, Spain) during 2015. Blood and vitreous humor samples (232) were analyzed by gas chromatography. 46.0% of the individuals were positive for alcohol, being half of them tourists. Blood alcohol concentrations (BAC) was higher in men over 60 years (p = 0.041). 10.2% of the series died in a traffic accident, and victims had the highest proportion of positives to alcohol (64.3%) and the highest BAC (2.56 g/L, p = 0.048). The BAC:VHAC (alcohol in vitreous humor) ratio was higher among victims of traffic crashes (p = 0.036), suggesting a short elapsed interval between the alcohol intake and the fatal accident. The results of this study indicate that ethanol is still heavily involved in non-natural deaths.
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Affiliation(s)
- Maira Almeida-González
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Luis A Henríquez-Hernández
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Octavio P Luzardo
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Manuel Zumbado
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Enrique Zaragoza
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain.
| | - María J Meilán
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain.
| | - María Camacho
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Luis D Boada
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
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Carlini C, Andreoni S, Sanchez ZM. Environmental Factors Associated with Psychotropic Drug Use in Brazilian Nightclubs. J Urban Health 2017; 94:549-562. [PMID: 28484961 PMCID: PMC5533659 DOI: 10.1007/s11524-017-0149-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to identify environmental factors associated with patterns of psychotropic drug use in nightclubs. Mixed methods were used to investigate psychotropic drugs consumption among patrons of 31 nightclubs in São Paulo, Brazil. A total of 1822 patrons at the entrance and exit of the venues and 30 staff members of the nightclubs were interviewed. The observational data were collected through 307 h of observational research using a structured guide to register environmental measures. Psychotropic drug use in nightclubs was classified into three categories (1: no drugs; 2: legal drugs [e.g., alcohol and tobacco]; or 3: illicit drugs regardless of alcohol and tobacco use). Illicit drugs used were self-reported by patrons, and alcohol use was measured using a breathalyzer. The data were analyzed in clusters using correlated multinomial logistic regression models. The following environmental variables were associated with illicit drug use in nightclubs: all-you-can-drink service (adjusted odds ratio (aOR) = 11.84, 95%CI [4.06;34.57]) and light effects, such as laser and "disco lights" (aOR = 24.49, 95%CI [8.48;70.77]). The number of bouncers per capita × 100 and the presence of two or more dance floors were inversely associated with the use of illicit drugs (aOR = 0.26, 95%CI [0.11;0.65], and aOR = 0.13, 95%CI [0.06;0.29], respectively). Legal drug use was associated with all-you-can-drink service (aOR = 2.17, 95%CI [1.43;5.04]), the presence of two or more dance floors (aOR = 2.06, 95%CI [1.40;3.05]), and the number of bouncers per capita × 100 (aOR = 1.39, 95%CI [1.22;1.59]). These findings suggest that this is a multivariate phenomenon that would require an integrated approach involving the venue owners, staff members, patrons, local governments, and law enforcement agencies.
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Affiliation(s)
- Claudia Carlini
- Department of Preventive Medicine, Centro Brasileiro de Informações sobre Drogas Psicotrópicas (CEBRID), Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Solange Andreoni
- Department of Preventive Medicine - Section of Biostatistics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine - Section of Epidemiology, Universidade Federal de São Paulo, Rua Botucatu, 740, 4th floor, São Paulo, SP, 04023-900, Brazil.
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Andreuccetti G, Leyton V, Lemos NP, Miziara ID, Ye Y, Takitane J, Munoz DR, Reingold AL, Cherpitel CJ, de Carvalho HB. Alcohol use among fatally injured victims in São Paulo, Brazil: bridging the gap between research and health services in developing countries. Addiction 2017; 112:596-603. [PMID: 28044383 PMCID: PMC5339026 DOI: 10.1111/add.13688] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/23/2016] [Accepted: 11/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Most studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study based on a probability sample of fatally injured adult victims (n = 365) autopsied in São Paulo, Brazil. Victims were sampled within systematically selected 8-hour sampling blocks, generating a representative sample of fatal injuries occurring during all hours of the day for each day of the week between June 2014 and December 2015. MEASUREMENTS The presence of alcohol and blood alcohol concentration (BAC) were the primary outcomes evaluated according to victims' socio-demographic, injury context data (type, day, time and injury place) and criminal history characteristics. FINDINGS Alcohol was detected in 30.1% [95% confidence interval (CI) = 25.6-35.1)] of the victims, with a mean blood alcohol level (BAC) level of 0.11% w/v (95% CI = 0.09-0.13) among alcohol-positive cases. Black and mixed race victims presented a higher mean BAC than white victims (P = 0.03). Fewer than one in every six suicides tested positive for alcohol, while almost half of traffic-related casualties were alcohol-positive. Having suffered traffic-related injuries, particularly those involving vehicle crashes, and injuries occurring during weekends and at night were associated significantly with alcohol use before injury (P < 0.05). CONCLUSIONS Nearly one-third of fatal injuries in São Paulo between June 2014 and December 2015 were alcohol-related, with traffic accidents showing a greater association with alcohol use than other injuries. The sampling methodology tested here, including the possibility of adding injury context data to improve population-based estimates of alcohol use before fatal injury, appears to be a reliable and lower-cost strategy for avoiding biases common in death investigations.
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Affiliation(s)
- Gabriel Andreuccetti
- University of Sao Paulo Medical School, Sao Paulo, Brazil,Alcohol Research Group, Emeryville, California, United States of America,Correspondence author at: Department of Preventive Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455, 01246-903, Sao Paulo, Brazil.,
| | - Vilma Leyton
- University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Nikolas P. Lemos
- Forensic Laboratory Division, Office of the Chief Medical Examiner, San Francisco, California, United States of America,Department of Laboratory Medicine, School of Medicine, University of California, San Francisco, California, United States of America
| | - Ivan Dieb Miziara
- University of Sao Paulo Medical School, Sao Paulo, Brazil,Technical-Scientific Police Superintendency of the State of Sao Paulo, Sao Paulo, Brazil
| | - Yu Ye
- Alcohol Research Group, Emeryville, California, United States of America
| | | | | | - Arthur L. Reingold
- School of Public Health, University of California, Berkeley, California, United States of America
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Abstract
Although the misuse of firearms is necessary to the occurrence of firearm violence, there are other contributing factors beyond simply firearms themselves that might also be modified to prevent firearm violence. Alcohol is one such key modifiable factor. To explore this, we undertook a 40-year (1975-2014) systematic literature review with meta-analysis. One large group of studies showed that over one third of firearm violence decedents had acutely consumed alcohol and over one fourth had heavily consumed alcohol prior to their deaths. Another large group of studies showed that alcohol was significantly associated with firearm use as a suicide means. Two controlled studies showed that gun injury after drinking, especially heavy drinking, was statistically significant among self-inflicted firearm injury victims. A small group of studies investigated the intersection of alcohol and firearms laws and alcohol outlets and firearm violence. One of these controlled studies found that off-premise outlets selling takeout alcohol were significantly associated with firearm assault. Additional controlled, population-level risk factor and intervention studies, including randomized trials of which only 1 was identified, are needed. Policies that rezone off-premise alcohol outlets, proscribe blood alcohol levels and enhance penalties for carrying or using firearms while intoxicated, and consider prior drunk driving convictions as a more precise criterion for disqualifying persons from the purchase or possession of firearms deserve further study.
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Affiliation(s)
- Charles C. Branas
- Correspondence to Dr. Charles C. Branas, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104 (e-mail: )
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Chen D, Wu LT. Association Between Substance Use and Gun-Related Behaviors. Epidemiol Rev 2016; 38:46-61. [PMID: 26769722 DOI: 10.1093/epirev/mxv013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 01/23/2023] Open
Abstract
Gun-related violence is a public health concern. This study synthesizes findings on associations between substance use and gun-related behaviors. Searches through PubMed, Embase, and PsycINFO located 66 studies published in English between 1992 and 2014. Most studies found a significant bivariate association between substance use and increased odds of gun-related behaviors. However, their association after adjustment was mixed, which could be attributed to a number of factors such as variations in definitions of substance use and gun activity, study design, sample demographics, and the specific covariates considered. Fewer studies identified a significant association between substance use and gun access/possession than other gun activities. The significant association between nonsubstance covariates (e.g., demographic covariates and other behavioral risk factors) and gun-related behaviors might have moderated the association between substance use and gun activities. Particularly, the strength of association between substance use and gun activities tended to reduce appreciably or to become nonsignificant after adjustment for mental disorders. Some studies indicated a positive association between the frequency of substance use and the odds of engaging in gun-related behaviors. Overall, the results suggest a need to consider substance use in research and prevention programs for gun-related violence.
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Otieno G, Marinda E, Bärnighausen T, Tanser F. High rates of homicide in a rural South African population (2000-2008): findings from a population-based cohort study. Popul Health Metr 2015; 13:20. [PMID: 26300697 PMCID: PMC4545817 DOI: 10.1186/s12963-015-0054-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa has continued to receive increasing attention due to unprecedented high levels of violence. Homicide-related violence accounts for a significant proportion of unnatural deaths and contributes significantly to loss of years of expected life. We investigated levels and factors associated with homicide-related deaths and identify communities with excessively high homicide risk in a typical rural South African population. METHOD Data drawn from verbal autopsies conducted on all deaths recorded during annual demographic and health surveillance in KwaZulu Natal, South Africa were used to derive the cumulative probability of death from homicide over a nine-year period (2000-2008). Weibull regression methods were used to investigate factors associated with homicide deaths. A Kulldorff spatial scan statistic was used to identify spatial clusters of homicide-related deaths. RESULTS With 536 homicide-related deaths, and a median seven years of follow-up, the study found an overall homicide incidence rate of 66 deaths per 100, 000 person-years of observation (PYOs) (95 % CI 60-72) for the period under study. Death related to the use of firearms was the leading reported method of homicide (65 %) and most deaths occurred over weekends (43 %). Homicides are the second-most common cause of death in men aged 25-34 after HIV-related deaths (including TB) in this community, at 210 deaths per 100,000 PYOs, and was highest among 55-64 year old women, at 78 deaths per 100,000 PYOs. Residency status, age, socioeconomic status, and highest education level attained independently predicted the risk of homicide death. The spatial distribution of homicide deaths was not homogenous and the study identified two clear geographical clusters with significantly elevated homicide risk. CONCLUSION The high rates of homicide observed in this typical rural South African population - particularly among men - underscore the need for urgent interventions to reduce this tragic and theoretically preventable loss of life in this population and similar South African settings.
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Affiliation(s)
- George Otieno
- Kenya Medical Research Institute, P.O Box 1578, 40100 Kisumu, Kenya ; Centre for Disease Control and Prevention, Atlanta, GA USA ; School of Public Health, University of Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Edmore Marinda
- School of Public Health, University of Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Till Bärnighausen
- Wellcome Trust Africa Centre for Health and Population Studies, P.O Box 198, Mtubatuba, South Africa ; Department of Global Health and Population, Harvard School of Public Health, Boston, USA
| | - Frank Tanser
- Wellcome Trust Africa Centre for Health and Population Studies, P.O Box 198, Mtubatuba, South Africa
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Swart LA, Seedat M, Nel J. Alcohol consumption in adolescent homicide victims in the city of Johannesburg, South Africa. Addiction 2015; 110:595-601. [PMID: 25588696 DOI: 10.1111/add.12825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/25/2014] [Accepted: 12/01/2014] [Indexed: 11/30/2022]
Abstract
AIMS To describe the blood alcohol concentration (BAC) of adolescent homicide victims in Johannesburg, South Africa and to identify the victim and event characteristics associated with a positive BAC at the time of death. DESIGN Logistic regression of mortality data collected by the National Injury Mortality Surveillance System (NIMSS). SETTING Johannesburg, South Africa. PARTICIPANTS A total of 323 adolescent (15-19 years) homicide victims for the period 2001-9 who had been tested for the presence of alcohol. MEASUREMENTS Data on the victims' BAC level, demographics, weapon or method used, scene, day and time of death were drawn from NIMSS. FINDINGS Alcohol was present in 39.3% of the homicide victims. Of these, 88.2% had a BAC level equivalent to or in excess of the South African limit of 0.05 g/100 ml for intoxication. Multivariate logistic analysis showed that a positive BAC in homicide victims was associated significantly with the victim's sex [male: odds ratio (OR) = 2.127; 95% confidence interval (CI) = 1.012-4.471], victim's age (18-19 years: OR = 2.364; CI = 1.343-4.163); weapon used (sharp instruments: OR = 2.972; CI = 1.708-5.171); and time of death (weekend: OR = 3.149; CI = 1.842-5.383; night-time: OR = 2.175; CI = 1.243-3.804). CONCLUSIONS Excessive alcohol consumption is associated with a substantial proportion of adolescent homicides in Johannesburg, South Africa, and is more prevalent among male and older adolescent victims and in victims killed with sharp instruments over the weekends and during the evenings.
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Affiliation(s)
- Lu-Anne Swart
- Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa and Medical Research Council/University of South Africa Violence, Injury and Peace Research Unit, Tygerberg, South Africa
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Kristoffersen S, Lilleng P, Mæhle B, Morild I. Homicides in Western Norway, 1985–2009, time trends, age and gender differences. Forensic Sci Int 2014; 238:1-8. [DOI: 10.1016/j.forsciint.2014.02.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 01/23/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
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Soares Filho AM. Homicide victimization according to racial characteristics in Brazil. Rev Saude Publica 2011; 45:745-455. [PMID: 21739076 DOI: 10.1590/s0034-89102011005000045] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 02/06/2011] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To describe the temporal patterns of mortality by homicide in Brazil. METHODS A series of homicides in Brazil from 2000 to 2009 were studied. The explanatory variables were race/skin color, gender and education. The death statistics were obtained from the Mortality Information System. A trend analysis was performed by means of a polynomial regression for a historic time series (p < 0.05, 95% confidence interval). RESULTS The black population represented 69% of the homicide victims in 2009. The homicide rate increased in the black population, while it decreased in the white population in the period studied. The homicide rate increased in groups with both higher and lower education among blacks; among whites, the rate decreased for those with the lowest level of schooling and remained stable in the group with higher educational levels. In 2009, blacks had a higher risk of death than whites from homicide, regardless of education level. Between 2004 and 2009, the homicide rate decreased in the white population, while it increased in the black population. CONCLUSIONS The relative risk of falling victim to homicide increased in the black population, suggesting an increase in inequality. The effect of the anti-gun measures implemented in Brazil in 2004 was positive in the white population and less pronounced in the black population. Overall, race/skin color predicted the occurrence of homicide.
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de Carvalho Ponce J, Muñoz DR, Andreuccetti G, de Carvalho DG, Leyton V. Alcohol-related traffic accidents with fatal outcomes in the city of Sao Paulo. ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:782-787. [PMID: 21376866 DOI: 10.1016/j.aap.2010.10.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 10/01/2010] [Accepted: 10/24/2010] [Indexed: 05/30/2023]
Abstract
AIMS The aims of the present study were to characterize fatal traffic accident victims in a major urban center in Brazil and their association with alcohol consumption. METHODS Cross-sectional study of 907 fatal traffic accident victims in Sao Paulo, in 2005. RESULTS Adult males between the ages of 25 and 54 represented the majority of cases with positive blood alcohol concentrations (BAC). Overall, males had a higher proportion of BAC and mean BAC than females. Pedestrians, particularly those with no detectable BAC, were typically older than other victims. Most accidents (total and BAC-positive) happened on weekends between midnight and 6 a.m. Considering all victims, 39.4% were positive (BAC over 0.1g/l). When only drivers (automobile, motorcycle and bicycle) were evaluated, 42.3% had BAC over the legal limit (0.6g/l). CONCLUSIONS Alcohol is associated with nearly half of all traffic accident deaths in the city of Sao Paulo, especially for days and times associated with parties and bars (weekends between 12 a.m. and 6 a.m.).
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Affiliation(s)
- Julio de Carvalho Ponce
- Department of Legal Medicine, Faculty of Medicine, University of Sao Paulo, Av Dr Arnaldo, 455 Sao Paulo, SP 01246-903, Brazil.
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