| 1. |
- Munthe, Christian, 1962, et al.
(författare)
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The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening
- 2015
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Ingår i: Public Health Ethics. - : Oxford University Press (OUP). - 1754-9973 .- 1754-9981. ; 8:3, s. 270-283
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Tidskriftsartikel (refereegranskat)abstract
- The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy.
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| 2. |
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| 3. |
- Nilsson, Thomas, 1954, et al.
(författare)
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The precarious practice of forensic psychiatric risk assessments
- 2009
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527. ; 32:6, s. 400-407
-
Tidskriftsartikel (refereegranskat)abstract
- The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, “dangerousness” has been reworded into “risk”. Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of “mental disorder” and been used as grounds for coercive measures and integrity violations has somehow been accepted as a matter of course in the public and political debate. Even the basic question whether offenders with a mental disorder are really more prone to criminal recidivism than other offenders seems to have been treated light-handedly and dealt with merely by epidemiological comparisons between groups of persons with broad ranges of psychosocial vulnerability and the general population. Legal texts, instructions and guidelines from the authorities in charge are often vague and general, while actors in the judicial system seem to put their trust in psychiatric opinions. The exchange of professional opinions, general public expectations, and judicial decision processes poses a huge risk for misunderstandings based on divergent expectations and uses of terminology.
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| 4. |
- Trägårdh, Karin, et al.
(författare)
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Risk Profiles of Female Perpetrators of Severe Violence
- 2019
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Ingår i: 13th Nordic Symposium on Forensic Psychiatry. August 20-22, Gothenburg, Sweden.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Female offenders without a severe mental disorder show more criminogenic factors than those with. Both groups are characterized by mental health problems. We need to further characterize female offenders. Background Offenders of lethal/severe violence are in a majority of cases male, about 90% (Falk et al., 2014), and research has to a considerable extent focused on male violent offenders. Although less is known about female violent offenders than male offenders, previous research has indicated significant differences between male and female offenders of lethal/severe violence (Trägårdh et al., 2016; Yourstone et al., 2008). Since a majority of female perpetrators of lethal violence undergo a forensic psychiatric investigation (RPU/FPI), these documents contains important information about this group. Purpose The aim of this ongoing study is to characterize female perpetrators of severe violent crimes, and to compare female perpetrators sentenced to forensic psychiatric compulsory care with those sentenced to correctional treatment. Method This is an exploratory and descriptive study with a cross-sectional design. All forensic evaluations (FPI) made in Sweden between 2000-2014 (from The National Board of Forensic Medicine/RMV), and the subsequent court verdicts, in cases where women had used lethal/severe violence (n≈180) where used as the basis for data collection in this study. The present preliminary analyses (2-tests and ANOVA) contains approx. 26% (n=47) of the total group. Group differences were investigated regarding: Mental health (FPI) Risk factors (HCR-20 and PCL-R) Victim relation (FPI) Criminal behavior (FPI) Results Female offenders with and without a Severe mental disorder (SMD) seems to differ in some respects. For female offenders with a SMD, the crime was more likely to have been conducted in a less criminal context (see Table). For female offenders without a SMD, the following characteristics were more frequently present: Victim gender – male Substance abuse + Under the influence of substance (offender and victim) Previous violence between victim and offender Previous registered criminality Also, several common features between the SMD and non-SMD group of female offenders were found. The majority of all female offenders had: Previous psychiatric contact and diagnoses Previously attempted suicide No previously registered criminality Conclusions Preliminary results of the female perpetrators who had underwent a FPI seems to identify both substantial differences and similarities between those with versus without a SMD, where those without show more criminogenic factors. Both groups were also characterized by a high amount of mental illness. Also, these results supports previous research that female and male offenders of severe violence differ in important ways. Since a majority of female perpetrators of lethal violence undergo a forensic psychiatric investigation, these results should be generalizable to this group as a whole in Sweden. Based on these results, a great need to further characterize female offenders of severe/lethal violence remain.
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| 5. |
- Lindhe, Andreas, 1981, et al.
(författare)
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Användningen av MACRO-DB i tillståndsärenden och effekter av ny modellversion: Enkätstudie och samhällsekonomisk analys av arbetet med MACRO-DB
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I syfte att skydda dricksvattentäkter, dvs. yt- och grundvattenresurser, kan användningen av växtskyddsmedel regleras genom att exempelvis ställa krav på tillstånd för yrkesmässig användning inom vattenskyddsområden. Att bedöma när, hur och vilka växtskyddsmedel som kan spridas kan vara komplicerat. För att underlätta arbetet med att både ta fram och handlägga tillståndsärenden finns därför modellverktyget MACRO-DB. Verktyget har utvecklats av SLU Centrum för kemiska bekämpningsmedel i miljön (CKB) och används för att simulera bekämpningsmedelsläckage till yt- och grundvatten och bedöma om risken är acceptabelt låg eller inte. År 2018 gjordes en satsning där både Havs- och vattenmyndigheten (HaV) och CKB gjorde investeringar för att vidareutveckla MACRO-DB. Syftet med analysen som presenteras i denna rapport har varit att utvärdera om satsningen varit samhällsekonomiskt motiverad med hjälp av en kostnads-nyttoanalys (KNA). För att ta fram nödvändigt underlag och ge en bild av dagens arbete med tillståndsärenden för yrkesmässig användning av växtskyddsmedel på jordbruksmark inom vattenskyddsområden har en enkätundersökning genomförts. Enkäten skickades till samtliga svenska kommuner och syftade specifikt till att kartlägga användningen av MACRO-DB. Den genomförda enkätstudien besvarades av 58 % av Sveriges kommuner och bedöms baserat på detta och den geografiska spridningen ge en bra bild av dagens arbete med tillståndsärenden för användning av växtskyddsmedel på jordbruksmark inom vattenskyddsområden och specifikt användningen av MACRO-DB. Av de kommuner som besvarat enkäten är det 71 % som handlägger den aktuella typen av ärenden och av dessa är det 61 % som använder MACRO-DB som del av beslutsunderlaget. En majoritet av kommunerna använder såldes MACRO-DB. Bland de som inte använder MACRO-DB beror det framför allt på att man inte känner verktyget. Endast en mindre andel anser att det är inte rimligt att ställa krav på användning av MACRO-DB i den typ av ärenden de hanterar. Av de kommuner som använder MACRO-DB gör 55 % egna körningar för att kontrollera resultaten som lämnas in med tillståndsansökningarna. En stor andel (44 %) gör i stället granskningar av underlagsmaterial och antaganden. Enligt drygt hälften (53 %) av kommunerna tar dricksvattenproducenten del av uppgifter om vilka växtskyddsmedel som används inom vattenskyddsområden, i syfte att anpassa kontrollen av förekomst av växtskyddsmedelsrester i rå- och dricksvatten. Resultaten från enkäten visar också att majoriteten av kommunerna som använder MACRO-DB (93 %) anser att verktyget fungerar bra (61 %) eller mycket bra (32 %) som hjälpmedel. De förslag som lämnats på hur användningen skulle kunna förbättras innefattar bland annat behov av utbildning och annan stöttning men även behovet av mindre tidskrävande simuleringar. Att reducera simuleringstiden har varit ett av syftena med den uppdatering av MACRO-DB som gjorts och är en av de nyttor som ingår i den genomförda KNA:n. I analysen har fokus varit på följande kostnader och nyttor: (i) investeringarna som HaV och CKB gjort, (ii) tidsvinster som den nya modellversionen ger för kommuner, rådgivare och andra aktörer, (iii) möjliga effekter av en ökad livsmedelproduktion om det blir möjligt att söka tillstånd för spridning av växtskyddsmedel på odlingsmark där det idag råder förbud, och (iv) förlust av miljönyttor som en ökad spridning av växtskyddsmedel kan ge upphov till. Utifrån de antaganden som scenarierna i KNA:n bygger på bedöms nyttorna kunna överstiga kostnaderna, vilket alltså indikerar att satsningen på nya MACRO-DB kan vara samhällsekonomiskt motiverad. Skillnaden mellan nyttor och kostnader är samtidigt inte så betydande att ett annat resultat helt kan uteslutas, det vill säga att kostnaderna skulle kunna överstiga nyttorna. Scenarierna bygger på flera antaganden som är osäkra och de presenterade resultaten över samhällsekonomisk lönsamhet bör därför tolkas med viss försiktighet. Det kan dock konstateras att nyttorna till följd av tidsbesparingar är i samma storleksordning som investeringskostnaderna, vilket innebär att satsningen kan vara samhällsekonomiskt även om endast dessa aspekter beaktas. Osäkerheterna bedöms vara störst i de uppskattade nyttorna av ökad livsmedelsproduktion samt de minskade miljönyttorna. Dessa poster i KNA:n beskriver för- respektive nackdelarna som uppstår om det blir möjligt att söka tillstånd för spridning av växtskyddsmedel på odlingsmark där det idag rådet förbud. Resultaten visar att även dessa nyttor och kostnader är i samma storleksordning. Det kan därför konstateras att såväl möjligheten att bruka marken för livsmedelproduktion som skyddet av yt- och grundvattenresurser är förknippade med stora nyttor. Skyddet av yt- och grundvattenresurserna behöver därför säkerställas samtidigt som åtgärderna inte ska vara onödigt långtgående så att de ger orimliga restriktioner i markanvändningen och i detta fall effekter på livsmedelproduktionen. Verktyg och hjälpmedel som MACRO-DB är därför viktiga för att möjliggöra en rimlig avvägning när risken spridning av växtskyddsmedel kan tillåtas och när det inte är rimligt. I handläggningen av tillståndsärenden och avvägningar om det ska råda förbud eller krav på tillstånd är den inte bara spridningen av växtskyddsmedel som behöver beaktas utan även övriga förutsättningar och risker som hanteringen av växtskyddsmedel är förknippad med.
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| 6. |
- Munthe, Christian, 1962
(författare)
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Patient Collaboration and Person Centeredness in Forensic Psychiatric Care: An Ethical Map
- 2017
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Ingår i: 35th International Congress on Law and Mental Health, July 9-14, 2017, Prague. Abstracts of the XXX Vth International Congress on Law and Mental Health / David N. Weisstub Editor.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is increasing interest in applying ideas from person centred care (PCC) in forensic psychiatry, including increased room for patients to collaborate in the care design. However, standard ethical assumptions in PCC about capacities of patients, as well as a traditional health care ethical context, departs significantly from the forensic psychiatric situation. Forensic psychiatric care is beset with restrictions of personal freedom and motivated partly by patients' incapacity to take responsibility brought by mental ill-health, usually within limits from criminal law, public safety and court orders. The care is supposed to change patients to become more autonomous and responsible in order for the restrictions on freedom to be justifiably relaxed or removed. Doing so may involve some room for independent decision-making by patients, using their responsibility capacities, but PCC opens up for much more far-reaching empowerment of patients, e.g., regarding the goals of care and the acceptance of applied methods. Therefore, there is a manifold increase of the ethical complexity creating tensions for PCC already in standard health care. This presentation provides a map of these ethical complexities, focusing especially on the issue of how the central notions of patient empowerment and shared decision-making should imply within forensic psychiatric care.
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| 7. |
- Ahlm, Kristin, et al.
(författare)
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Suicidal drowning deaths in northern Sweden 1992-2009 : the role of mental disorder and intoxication
- 2015
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Ingår i: Journal of Forensic and Legal Medicine. - : Elsevier. - 1752-928X .- 1878-7487. ; 34, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- Suicides by drowning have received limited attention by researchers. A recent finding that almost onethird of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.
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| 8. |
- Kronstrand, Robert, et al.
(författare)
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Unintentional fatal intoxications with mitragynine and O-Desmethyltramadol from the herbal blend krypton
- 2011
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Ingår i: Journal of Analytical Toxicology. - 0146-4760 .- 1945-2403. ; 35:4, s. 242-247
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Tidskriftsartikel (refereegranskat)abstract
- The leaves of Kratom, a medicinal plant in Southeast Asia, have been used as an herbal drug for a long time. At least one of the alkaloids present in Kratom, mitraynine, is a mu-receptor agonist. Both Kratom and an additional preparation called Krypton are available via the internet. It seems to consist of powdered Kratom leaves with another mu-receptor agonist, O-desmethyltramadol added. O-desmethyltramadol is an acitve metabolite of tramadol, a commonly prescribed analgesic. We present nine cases of intoxication, occurring in a period of less than one year, where both mitragynine and O-desmethyltramadol were detected in the postmortem blood samples. neither tramadol nor N-desmethyltramadol was present in these samples, which implies that the ingested drug was O-desmethyltramadol. The blood concentrations of mitragynine, determined by ultra-performance liquid chromatography-tandem mass spectrometry, ranged from 0.02 to 0.18 μg/g, and O-desmethyltramadol concentrations, determined by gas chromatogtraphy with nitrogen-specific detection, ranged from 0.4 to 4.3 μg/g. We believe that the addition of the potent mu-receptor agonist O-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and conclude that intake of Krypton is not as harmless as it often is described on internet websites.
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| 9. |
- Rizzi, Maria C, et al.
(författare)
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The potential of different countermeasures to prevent injuries with high risk of health loss among bicyclists in Sweden
- 2020
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Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 21:3, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- Objective: As bicyclists account for the largest share of serious injuries in Sweden, focus to improve safety for bicyclists is needed. While knowledge about fatal bicycle crashes is rather extensive, the number of studies that have investigated non-fatal injuries is still rather limited. The aim of this study was to estimate the potential of different countermeasures to reduce crashes resulting in injuries with high risk of health-loss among cyclists in Sweden. A further aim was to describe the residual—that is, crashes that were not considered to be addressed by the analyzed countermeasures. Methods: A sample of individuals with specific injury diagnoses was drawn from the Swedish national crash database Strada. A survey form was used to collect additional information about the crash and the health-related outcomes. The potential of countermeasures currently included in the Swedish Safety Performance Indicators, as well as of countermeasures that could be described as “existing but not fully implemented” was assessed. The overall potential of all countermeasures assessed was calculated, giving a grand total without double counting. Cases that were considered not to be addressed by any of the countermeasures included (i.e., the residual crashes) were described in more detail. Results: The current Swedish Safety Performance Indicators that relate to safe cycling addressed 22% of crashes. Improved maintenance by deicing and removal of snow from bicycle infrastructure was found to have the highest potential (8%), followed by improved crashworthiness of passenger cars (5%) and safer bicycle crossings (4%). The potential for existing but not fully implemented safety improvements was 56%. The greatest potential was found for Autonomous Emergency Braking with cyclist detection for passenger cars (12%), followed by studded winter tyres for bicycles (12%), and improved maintenance on non-bicycle infrastructure (11%). In total, taking double counting into consideration, all safety improvements could address 64% of all crashes. Among the residual crashes, the majority (69%) were single bicycle crashes of which most were related to wheel locking during braking and losing balance at low speed or stationary. Conclusions: Compared with fatal crashes that involve a majority of bicycle-car crashes, the crashes leading to health-loss are mostly single bicycle crashes. Therefore, innovation and development of additional countermeasures to improve safety for bicyclists should focus on single bicycle crashes.
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| 10. |
- Timpka, Toomas, 1957-, et al.
(författare)
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Community-level football injury epidemiology : traumatic injuries treated at Swedish emergency medical facilities
- 2018
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 28:1, s. 94-99
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties.Methods: An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location.Results: Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries.Conclusions: One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted.
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| 11. |
- Ohlin, Maria, 1987, et al.
(författare)
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Duration of sickness absence following a bicycle crash, by injury type and injured body region: A nationwide register-based study
- 2018
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Ingår i: Journal of Transport & Health. - : Elsevier BV. - 2214-1405 .- 2214-1413. ; 9, s. 275-281
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Tidskriftsartikel (refereegranskat)abstract
- In recent years, bicycle injuries have increased but little is known about the relation of such injures to sickness absence (SA). The aim of this study was to investigate duration of SA > 14 days after a bicycle crash, in general and by injury type and injured body region. A population-based study was conducted, including all individuals living in Sweden, aged 16-64 years, who in 2009-2011 had in-or specialized outpatient medical care due to a new injury from a bicycle crash (n = 22,045), excluding those already on SA or full-time disability pension at the time of the crash. Crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for a new SA were estimated by logistic regression. In total, 4387 (20%) had new SA in connection to the crash. SA was most common among individuals aged 55-64 years (32%), and more common among women (23%) than men (18%). Fractures was the injury type with the highest OR for SA across all durations, but highest for 30-89 days (8.09; CI 6.30-10.39). Spine and back was the body region with the highest OR for SA >= 90 days (11.98; CI 7.38-19.46), followed by Traumatic Brain Injuries (6.64; CI 4.01-10.98), and injuries to lower extremities (5.28; CI 3.58-7.78). For 235 individuals (5%) the SA spell lasted >= 180 days. Among those cases, the most commonly injured body regions were lower leg (21%) followed by shoulder and upper arm (17%), and Traumatic Brain Injuries (15%). In conclusion, the duration of SA varied with type of injury and injured body region. Among the very long SA spells, common injuries were injuries to the lower leg, to the shoulder and upper arm, and traumatic brain injuries.
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| 12. |
- Bäckström, Björn, et al.
(författare)
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Homicid among the young
- 2012
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Ingår i: Scandinavian Journal of Forensic Science. - : Walter de Gruyter. - 1503-9552. ; 18, s. 82-83
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Ekman, Jonn
(författare)
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Deaths in custody in Sweden
- 2012
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Ingår i: Scandinavian Journal of Forensic Science. - : Walter de Gruyter. - 1503-9552. ; 18, s. 89-90
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Tidskriftsartikel (refereegranskat)
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| 14. |
- Eriksson, Anders
(författare)
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Asfyksi - kvaelning
- 2004. - 1
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Ingår i: Nordisk Laerebog i Retsmedicin. - Copenhagen : FADL. - 8777493230 ; , s. 125-144
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Bokkapitel (populärvet., debatt m.m.)
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| 15. |
- Eriksson, Anders
(författare)
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Asfyksi - kvaelning
- 2008. - 2
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Ingår i: Retsmedicin. - Köbenhavn : Foreningen af Danske Laegestuderendes Forlag Aktieselskab. - 9788777494994 ; , s. 131-147
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Bokkapitel (populärvet., debatt m.m.)
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| 16. |
- Eriksson, Anders, et al.
(författare)
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Rättsmedicin
- 2012
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Ingår i: Jourhandboken. - Lund : Studentlitteratur. - 9789144054131 ; , s. 928-941
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 17. |
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| 18. |
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| 19. |
- Johansson, Lars, 1961-, et al.
(författare)
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Teenage suicide cluster formation and contagion : implications for primary care
- 2006
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Ingår i: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 17:7, s. 32-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We have previously studied unintentional as well as intentional injury deaths among teenagers living in the four northernmost counties, forming approximately 55% of Sweden with 908,000 inhabitants in 1991. During this work, we found what we suspected to be a suicide cluster among teenagers and we also suspected contagion since there were links between these cases. In this present study, we investigate the occurrence of suicide clustering among teenagers, analyze cluster definitions, and suggest preventive measures. METHODS: A retrospective study of teenager suicides autopsied at the Department of Forensic Medicine in Umea, Sweden, during 1981 through 2000. Police reports, autopsy protocols, and medical records were studied in all cases, and the police officers that conducted the investigation at the scene were interviewed in all cluster cases. Parents of the suicide victims of the first cluster were also interviewed. Two aggregations of teenager suicides were detected and evaluated as possible suicide clusters using the US Centers for Disease Control definition of a suicide cluster. RESULTS: Two clusters including six teenagers were confirmed, and contagion was established within each cluster. CONCLUSION: The general practitioner is identified as a key person in the aftermath of a teenage suicide since the general practitioner often meet the family, friends of the deceased, and other acquaintances early in the process after a suicide. This makes the general practitioner suitable to initiate contacts with others involved in the well-being of the young, in order to prevent suicide cluster formation and para-suicidal activities.
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| 20. |
- Johansson, Lars, 1961-
(författare)
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Teenager fatalities : epidemiology and implications for prevention
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A significant number of teenagers are killed each year by unintentional or intentional injuries. A teenager is in a vulnerable phase of her/his life, going from being a child to adult. This transition often includes testing the limits of their capabilities, which can include, e.g., high speed driving, testing alcohol and other drugs, including drinking and driving. The development from child to adult includes different psychological stress factors, such as, e.g., school problems, broken love affairs and bullying. The demands – perceived or real – also increases over time and vulnerable individuals can turn to self-harm and in the most extreme case suicide.The aim of this thesis was to investigate teenager fatalities in the northern half of Sweden and to suggest preventive measures.A survey of teenager fatalities during a twenty-year period revealed that the incidence of unintentional (n=248) deaths decreased, while intentional (n=102) deaths were unaffected over time. Most unintentional deaths were transportation related (n=204) while most of the intentional deaths were suicides (n=88). Twenty-eight percent of the decedents were test-positive for alcohol at autopsy.In a series of three studies, teenager suicides were investigated in depth, firstly through an interview study with the investigating police officer in charge of the investigation of a teenager suicide. Most of the suicides occurred in rural and depopulated areas despite the fact that most teenagers live in the larger cities along the coastline. A majority of the suicides appeared to be planned. Females, contrary to males, often had a psychiatric history. One of the conclusions was that police officers provide essential information concerning the circumstances around a teenager suicide.Parents who had lost a child through suicide, and in some cases siblings, were interviewed 15-25 months after the suicide. It was striking how the life of the surviving family members were still affected by the devastating trauma of the suicide; most parents testified that they were still struggling with the question “why?” and that they were thinking of their lost child every day. Post suicide support was often badly timed and insufficient, especially for the younger siblings. The family doctor has an important role as a co-ordinator of a long-term individually formulated support scheme for the bereaved.Evidence of suicide contagion and suicide cluster formation, i.e., one teenager suicide led to another suicide, was found in these studies, and two suicide clusters were identified, with links between the victims in each cluster. Both clusters occurred within a geographical and timely proximity. Everyone involved in the well-being of the young should be aware of the risk of contagion and suicide cluster formation.The fifth study concerned 12,812 teenagers who visited the Emergency Room at Umeå University Hospital due to an injury during 1993 through 2006. Sixty-one of these were found dead through 2007, 49 by unnatural (of which 38 were included) and 12 by natural causes. The standard mortality rate for unnatural death was calculated to 1.44 (1.02-1.98), confirming an increased risk of premature death. In many of these deaths, alcohol and drugs may have contributed. By increasing the awareness among health professionals that injury can predict a premature death - primarily among those who develop substance abuse - some premature deaths may be prevented by early intervention.This thesis confirms that most teenagers die from unnatural causes, mostly in transportation-related events and by suicide. By studying these deaths, preventive measures that could save lives have been suggested.
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| 21. |
- Junuzovic, Mensura, et al.
(författare)
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Accidental firearm deaths during hunting
- 2012
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Ingår i: Scandinavian Journal of Forensic Science. - 1503-9552. ; 18, s. 97-97
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Tidskriftsartikel (refereegranskat)
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| 22. |
- Junuzovic, Mensura, et al.
(författare)
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Unintentional firearm hunting deaths in Sweden
- 2012
-
Ingår i: Forensic Science International. - : Elsevier. - 0379-0738 .- 1872-6283. ; 216:1-3, s. 12-18
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Tidskriftsartikel (refereegranskat)abstract
- This study examined all unintentional firearm fatalities while hunting that occurred in Sweden between 1983 through 2008. The circumstances as well as the impact of the hunter's exam on fatality frequency were analysed. During these 26 years, there were 48 such fatalities, representing 53% of all (n = 90) unintentional firearm deaths during the same period. The average annual number of fatalities decreased over the last few decades. Very restrictive firearm legislation in Sweden combined with the introduction of a mandatory hunter's exam since 1985 accounted, at least partly, for this finding. Moose hunting accounted for 46% of the fatalities and small game hunting for the remaining cases. The mean age of the victims was 50 years and 96% of them were males; all shooters were males. During moose hunting, most of the victims were mistaken for game, whereas in small game hunting most of the fatalities were related to falls and improper handling of the weapon. Human error was thus the main cause of these fatalities.
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| 23. |
- Lindqvist, Per, et al.
(författare)
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Teenage suicides in northern Sweden : an interview study of investigating police officers
- 2000
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Ingår i: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 6:2, s. 115-119
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To disclose recurrent, dynamic, and static factors in teenage suicide involving the suicidee, his/her family, and the community; and to investigate the feasibility of using police as informants for suicide studies.SUBJECTS: All deaths categorised as suicide 1993 through 1995 among teenagers in Northern Sweden (n=15).METHOD: Semiqualitative interviews with police officers, and, when applicable, general practitioners. Police reports, necropsy protocols, medical records, and conscription data were also analysed.RESULTS: Most suicides occurred in rural and depopulated areas. In contrast to males, females often had a history of overt psychiatric problems with suicide attempts. At least two thirds of the suicides were planned.CONCLUSION: Cultural and sociopolitical aspects are important in teenage suicide as well as gender differences. Police officers can provide essential information. Identifying teenagers at risk remains difficult, however, due to low baseline rates.
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| 24. |
- Pettersson, Gisela, et al.
(författare)
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Forensic medicine in legal decision making
- 2012
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Ingår i: Scandinavian Journal of Forensic Science. - : Walter de Gruyter. - 1503-9552. ; 18, s. 110-110
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Steinwall, David, et al.
(författare)
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Deaths at a level 1 trauma unit : a clinical finding and post-mortem correlation study
- 2012
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Ingår i: Injury. - : Elsevier BV. - 0020-1383 .- 1879-0267. ; 43:1, s. 91-95
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Missed injuries continue to cause deaths amongst trauma patients. Regardless of the definition of missed injuries, it is important to identify all injuries at any stage in the care of trauma patients in order to improve patient outcome. This study was performed to evaluate to what extent missed injuries contribute to a fatal outcome at a new Level 1 Trauma Unit.METHODS: The medical records and autopsy reports of all trauma patients who died at the IALCH trauma unit from March 2007 through August 2009 were reviewed. The mortality rate and incidence of missed injuries were determined. A missed injury was defined as one that was found at autopsy but was not mentioned in the medical records or in any ante mortem radiological report. This excluded minor injuries such as superficial contusions and minor lacerations, which are sometimes not included in the case notes during resuscitation. Deaths due to trauma are considered unnatural and legal provisions require that all unnatural deaths undergo medico-legal postmortem examination. The study was approved by the UKZN Biomedical Research Ethics Committee.RESULTS: Five hundred and forty-seven patients were admitted to the trauma unit of which 135 (24.7%) demised. Three patients were excluded, due to inability to retrieve their autopsy reports, leaving a study group of 132 patients in which there were 100 males and 32 females. The mean age was 33.2 years, mean ISS was 34.0. A total of 26 missed injuries were found in 14 patients, giving a total incidence of 10.6%. Three percent had missed injuries that were variously deemed to be possibly related, probably related, or related to the fatal outcome, whether the deaths were deemed preventable or not. Severe physiological derangement which precluded any imaging before death may have caused the injury to be overlooked. The thorax was the anatomical region where most injuries were missed.CONCLUSIONS: A number of injuries remain undetected in trauma care and are found only at autopsy, emphasizing that the autopsy remains an important tool in evaluating trauma care. However, in only a few patients did the missed injuries have a detrimental effect on outcome.
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| 26. |
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| 27. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.
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| 28. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Sickness absence and disability pension among injured working-aged pedestrians - a population-based Swedish register study
- 2021
-
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods: A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results: In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36). Conclusions: In this explorative nationwide study of the working-aged pedestrians injured in traffic-related accidents including falls, one fifth started a new SA spell >14 days. Fractures, internal injuries, collisions with motor vehicle, and falls related to snow and ice had the strongest associations with new SA.
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| 29. |
- Antona-Makoshi, Jacobo, et al.
(författare)
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Analysis of Traumatic Brain Injuries Sustained by Occupants in Japanese Brand Car Crashes in the US
- 2018
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Ingår i: International Journal of Automotive Engineering. - : Society of Automotive Engineers of Japan. - 2185-0992 .- 2185-0984. ; 9:3, s. 145-450
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Tidskriftsartikel (refereegranskat)abstract
- This study estimates, by means of an analysis of accident data from the US, the incidence and risk of car crash related traumatic brain injuries for occupants in Japanese brand cars. The study incorporated crash type, crash severity, car model year, belt use and the victim's age and sex. Concussion risk was the highest among all brain injury categories for all crash types and severities; females were at higher risks than males. When concussions were excluded, Subdural Haemorrhages, Intracranial Haemorrhages and Sub-Arachnoid Haemorrhages comprised the most frequent injury categories. Elderly occupants were at considerably higher risks than non-elderly for these bleeding injuries.
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| 30. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Diagnosis-specific sickness absence among injured working-aged pedestrians: a sequence analysis
- 2023
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1, s. 367-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian. METHODS: A nationwide register-based study, including all individuals aged 20-59 and living in Sweden, who in 2014-2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression. RESULTS: In total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster "No SA", all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters "Immediate SA", "Episodic SA" and "Both SA due to injury and other diagnoses" were also associated with higher odds of pedestrians who sustained a fracture. CONCLUSIONS: This nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.
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| 31. |
- Munthe, Christian, 1962
(författare)
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Hate Crime, Mental Disorder and Criminal Responsibility
- 2017
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Ingår i: Edward Dunbar, Amalio Blanco, Desirée A. Crèvecoeur-MacPhail, Christian Munthe, Michael Fingerle, David Brax (eds.), The Psychology of Hate Crimes as Domestic Terrorism: U.S. and Global Issues, vol. 1. - Santa Barbara, CA : Praeger. - 9781440845598 ; , s. 225-238
-
Bokkapitel (refereegranskat)
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| 32. |
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| 33. |
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| 34. |
- Strandroth, Johan, 1978, et al.
(författare)
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Correlation between Euro NCAP Pedestrian Test Results and Injury Severity in Injury Crashes with Pedestrians and Bicyclists in Sweden
- 2014
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Ingår i: SAE Technical Papers. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International. - 0148-7191 .- 2688-3627. ; 2014-November:November
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Tidskriftsartikel (refereegranskat)abstract
- Pedestrians and bicyclists account for a significant share of deaths and serious injuries in the road transport system. The protection of pedestrians in car-to-pedestrian crashes has therefore been addressed by friendlier car fronts and since 1997, the European New Car Assessment Program (Euro NCAP) has assessed the level of protection for most car models available in Europe. In the current study, Euro NCAP pedestrian scoring was compared with real-life injury outcomes in car-to-pedestrian and car-to-bicyclist crashes occurring in Sweden. Approximately 1200 injured pedestrians and 2000 injured bicyclists were included in the study. Groups of cars with low, medium and high pedestrian scores were compared with respect to pedestrian injury severity on the Maximum Abbreviated Injury Scale (MAIS)-level and risk of permanent medical impairment (RPMI). Significant injury reductions to both pedestrians and bicyclists were found between low and high performing cars. For pedestrians, the reduction of MAIS2+, MAIS3+, RPMI1+ and RPMI10+ ranged from 20-56% and was significant on all levels except for MAIS3+ injuries. Pedestrian head injuries had the highest reduction, 80-90% depending on level of medical impairment. For bicyclist, an injury reduction was only observed between medium and high performing cars. Significant injury reductions were found for all body regions. It was also found that cars fitted with autonomous emergency braking including pedestrian detection might have a 60-70% lower crash involvement than expected. Based on these results, it was recommended that pedestrian protection are implemented on a global scale to provide protection for vulnerable road users worldwide.
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| 35. |
- Söderberg, Andreas, et al.
(författare)
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Patients’ Experiences of Participation in High-Security, Forensic Psychiatric Care
- 2022
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 43:7, s. 683-692
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Tidskriftsartikel (refereegranskat)abstract
- The role of patient participation in forensic psychiatric care is unclear, but has been emphasised as important in recent research. This study aims to describe patients’ lived experiences of participation in high-security, forensic psychiatric settings. Sixteen patient interviews were performed in this phenomenological study and analysed with a Reflective Lifeworld Research approach (RLR). Results show that participation must be understood in relation to its opposite construct, non-participation. Participation can thus be explained as situations where non-participation is less visible. Actions to develop the training of patient-staff interactions for forensic psychiatric staff to promote patient participation are called for.
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| 36. |
- Greenbrook, Josephine T. V., 1984, et al.
(författare)
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Medical, Ethical, and Legal Risks in Forensic Age Assessment Procedures in Current Swedish Asylum Processes Involving Unaccompanied Minors
- 2019
-
Ingår i: Program and proceedings of the Oxford Global Health & Bioethics International Conference in Oxford, United Kingdom, July 1-2, 2019 (oral presentations).
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is a broad consensus surrounding the acutely vulnerable plight of asylum-seeking unaccompanied children, transcending international policy, academic literature, and expert opinion in both medicine and jurisprudence. Children migrating alone are at extreme risk of exposure to violence, exploitation, and poor health, and thus require extensive social, medical, and legal support, both during migration, and post migration whilst waiting for their asylum claims to be processed. The Swedish government has voiced intent to protect the human right to asylum in Europe, accenting that processes must be solidarity-based, legally certain, sustainable, efficient, and humane in facilitating reliable assessments protecting the rights of asylum-seekers. The present study explores current debate surrounding the deficient scientific reliability of recently introduced two step forensic age assessment procedures in Swedish asylum processes involving unaccompanied minors, and discusses the stakes involved from a medical, ethical, and legal perspective. The analysis included current policy documents, health professions unions' statements and reports, expert and media debate, and United Nations committee reports. Although the vast majority of forensic age assessment conducted thus far in Sweden have assessed biological age as 18 or above, expert consensus has decried methods applied as being unable to withstand the test of scientific scrutiny. Concerns surrounding the procedures’ medically unjustifiable and highly unethical nature, as well as the misuse of the medical profession' authority, expertise, and skill in forwarding political agendas have been noted. Furthermore, in disregarding the precautionary principle by default, current reductionist and pseudoscientific forensic methods risk facilitating the bypassing of laws intended to protect the human rights of children at their most vulnerable. These highly consequential forensic age assessments must yield results greater than chance, as the aftermath of failures are neither humane, sustainable, or legally certain. Flawed results can impede children from accessing foundational human rights, such as the right to health, to thrive, and to meet their full potential, raising resounding medical, ethical, and legal concerns. The social sciences must contribute with expertise and actively engage in this debate, and work toward developing and establishing a thorough and holistic age assessment process, including biomedical aspects such as growth curves, x-rays, and adding psychosocial components such as recollection of childhood memories, psychosocial maturity, along with reports from adults in the children’s social networks (such as teachers, social workers, and others) on how the assessed child handled everyday life.
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| 37. |
- Antona-Makoshi, Jacobo, et al.
(författare)
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Accident analysis to support the development of strategies for the prevention of brain injuries in car crashes
- 2018
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 117, s. 98-105
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Tidskriftsartikel (refereegranskat)abstract
- This study estimated the frequency and risk of Moderate-to-Maximal traumatic brain injuries sustained by occupants in motor vehicle crashes in the US. National Automotive Sampling System - Crashworthiness Data System crashes that occurred in years 2001–2015 with light vehicles produced 2001 or later were incorporated in the study. Crash type, crash severity, car model year, belt usage and occupant age and sex were controlled for in the analysis. The results showed that Moderate concussions account for 79% of all MAIS brain 2+ injuries. Belted occupants were at lower risks than unbelted occupants for most brain injury categories, including concussions. After controlling for the effects of age and crash severity, belted female occupants involved in frontal crashes were estimated to be 1.5 times more likely to sustain a concussion than male occupants in similar conditions. Belted elderly occupants were found to be at 10.5 and 8 times higher risks for sub-dural haemorrhages than non-elderly belted occupants in frontal and side crashes, respectively. Adopted occupant protection strategies appear to be insufficient to achieve significant decreases in risk of both life-threatening brain injuries and concussions for all car occupants. Further effort to develop occupant and injury specific strategies for the prevention of brain injuries are needed. This study suggests that these strategies may consider prioritization of life-threatening brain vasculature injuries, particularly in elderly occupants, and concussion injuries, particularly in female occupants.
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| 38. |
- Stigson, Helena, 1979, et al.
(författare)
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Incidence of Acute Injuries among Licensed and Non-Licensed Cyclists using Insurance Registry Data
- 2019
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Ingår i: 2019 IRCOBI Conference Proceedings. - : International Research Council on the Biomechanics of Injury.
-
Konferensbidrag (refereegranskat)abstract
- Few previous studies have examined acute injuries in competitive cycling or training as compared to other sports. By using nationwide insurance data including all injured cyclist registered in the Swedish Cycling Federation and all reported injuries during exercise race in Sweden, the objective was to examine acute injuries during competitive cycling or training for different types of cyclists. The injury incidence and injuries leading to permanent medical impairment were examined. All cyclists that were injured during 2008-2017 were included (n=1937).Among the 2666 licensed cyclists the incidence of cyclists injured during training or competition was 44 per 1000 licensed cyclists per year. Focusing on participants in exercise races, the incidence was annually 1.5 injured cyclists per 1000 participants per year. The most commonly injured body region was the upper extremity (41%), followed by head and neck (18%). In total 9.4% of all injured cyclists sustained a permanent medical impairment. Given an injury, non-licensed participants in exercise races were slightly older, and the proportion of females were higher (30% vs. 16%), than among licensed cyclists. The injury incidence among the cyclists was high, and to maintain a healthy and physically active population it is important to make efforts to prevent injuries.
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| 39. |
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| 40. |
- Ahlm, Kristin, et al.
(författare)
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Unnatural deaths in reindeer-herding Sami families in Sweden, 1961-2001
- 2010
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 69:2, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Unnatural deaths among Indigenous populations, including the Swedish Sami, occur more often than among the general population. To find prevention strategies, we explored the circumstances of the unnatural deaths of members of reindeer-herding Sami families.STUDY DESIGN: The number of deaths from among a cohort of 7,482 members of reindeer-herding Sami families were retrieved from the National Board of Health and Welfare for the years 1961- 2001.METHODS: An evaluation of the information from autopsy records at the National Board of Forensic Medicine, police reports, and available medical records identified 158 unnatural deaths. These were then analysed in detail.RESULTS: Transport-related deaths and suicides were the most common unnatural deaths among Swedish reindeer-herding Sami family members. Suicides contributed to 23% of all deaths, road traffic accidents to 16%, and snowmobile fatalities to 11%. The accidents generally reflected an "outdoor lifestyle" and the working conditions were characterized by the use of off-road vehicles such as snowmobiles. Half of the number of victims tested positive for alcohol and alcohol abuse was documented in 15% of all victims.CONCLUSIONS: The results indicate that alcohol is an important factor in preventing unnatural deaths among reindeer-herding Sami, together with increased safety of both on-road and off-road transportation.
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| 41. |
- Junuzovic, Mensura, 1970-
(författare)
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Firearm deaths in Sweden : epidemiology with emphasis on accidental deaths and prevention
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Prevention of firearm deaths and injuries is an important public health issue that may save human lives. The aim of this thesis was to investigate the epidemiology and attributes of accidental firearm fatalities in Sweden, and to provide a basis for further preventive measures. Data were obtained from the database of the National Board of Forensic Medicine, the National Patient Register, the Prescribed Drug Register, the Firearm Register, and from questionnaire responses.All 48 accidental firearm fatalities that involved hunting in 1983-2008 were investigated (Paper I). The victims’ mean age was 50 years, 96% were males. During moose hunting, most victims were mistaken for game (41%), whereas during small game hunting, fatalities were mostly related to falls (31%) and improper weapon handling (15%). Hunters’ habits and attitudes towards preventive measures and their experience of firearm incidents were investigated through a questionnaire, which was sent to 1,000 hunters (Paper II). The response rate was approximately 50%. The mean age of the respondents was 54 years and females accounted for 5%. One quarter of the respondents stated that they had witnessed a firearm incident caused by another hunter, of which more than half suggested that improper handling of the weapon and inappropriate hunting strategies were the main causes of these events.All 43 accidental non-hunting firearm deaths in Sweden 1983-2012 were investigated (Paper III). In 56% of cases, the fatality was caused by another person. Victims were mostly young males (mean age 25 years). The main cause of the incidents was human error. The majority of cases (63%) involved legal firearm. Most victims killed by illegal firearm (85%) were under the influence of alcohol and/or drugs at the time of death. Both the risk of being killed as a result of hunting (Paper I) and non-hunting accidental firearm injury (Paper III) decreased after the introduction of the mandatory hunter’s exam in 1985 (p < 0.001).Firearm deaths in Sweden including 52 accidental fatalities and 3 cases with undetermined manner of death in 1987-2013, as well as 213 suicides and 23 solved homicides in 2012-2013, were studied (Paper IV). The number of firearm suicides was positively correlated to the number of licensed firearm owners. Legal firearm use predominated in firearm suicides and accidental deaths, illegal in firearm homicides. The majority of the shooters in accidental deaths and suicides had no registered visits to inpatient care or specialized outpatient care. Less than half (42%) of all suicide victims had had a health care contact due to mental health problems. Physician’s mandatory reporting to the police of patients deemed unsuitable for possessing a firearm license did not include any of the suicide victims and the shooters in accidental deaths.This thesis confirmed that accidental firearm deaths are rare, and indicates that the firearm law changes in 1985 contributed to a decline of such fatalities. Human error was the main “cause” of the fatalities and future prevention measures should target improper weapon handling. Physician’s mandatory reporting to the police was suboptimal and barely contributed to the decline of accidental firearm deaths. If streamlined it may, however, represent an important prevention strategy in firearm suicides, claiming most lives among firearm deaths. A significant fraction of non-hunting fatalities, firearm suicides and homicides was associated with illegal firearm use, a fact calling for prevention issues targeting such firearm use.
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| 42. |
- Junuzovic, Mensura, et al.
(författare)
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Firearm deaths in Sweden
- 2019
-
Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 29:2, s. 351-358
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Sweden’s firearm legislation obligates physicians to report patients that are deemed unsuitable to possess a firearm. This study aimed to explore the involvement of firearm use in firearm fatalities and to evaluate physician reporting concerning cases of firearm deaths.Methods: Fatal firearm suicides and homicides in Sweden were studied for the years 2012–2013, accidental deaths and undetermined manner of deaths for the period 1987–2013. Police reports and autopsy protocols were collected from the National Board of Forensic Medicine, healthcare data in 1 year before the fatality from the National Board of Health, and information about physician reports and firearm licences from the Swedish Police.Results: A total of 291 firearm deaths (213 suicides, 52 accidental deaths, 23 solved homicides and 3 cases with undetermined manner of death) were identified. Firearm suicides were positively correlated with the number of licensed firearm owners. Legal firearm use predominated in firearm suicides and accidental deaths, illegal in homicides. No suicide victim or shooter in an accidental death was previously reported by a physician to the police according to the firearm law. The majority of the shooters in accidental deaths and suicides had no registered health care visits. Less than half (42%) of all suicide victims had a previous health care contact due to mental health problems. Conclusions: Not one single suicide victim nor any shooter in accidental deaths in the present study had been reported according to the firearm law, bringing the evidence of a suboptimal framework.
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| 43. |
- Junuzovic, Mensura, et al.
(författare)
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Unintentional non-hunting firearm deaths in Sweden, 1983-2012
- 2016
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Ingår i: Journal of Forensic Sciences. - : Blackwell Publishing. - 0022-1198 .- 1556-4029. ; 61:4, s. 966-971
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Tidskriftsartikel (refereegranskat)abstract
- We examined the association between unintentional nonhunting firearm deaths and changes in firearm legislation in Sweden. There were 43 fatalities during the study time frame 1983-2012, representing 46% of all unintentional firearm deaths during the same period. The victims were predominantly young males (mean age 25 years). Slightly more than half of the deaths were caused by another person and were inflicted at close range. The main cause of the incidents was human error. The majority of the involved firearms were legal; however, most victims killed with illegal firearms were under the influence of alcohol and/or drugs at the time. The death rate decreased significantly following the introduction of the hunter's examination in 1985. Education and training associated with the hunter's examination was at least partially responsible for the decline in fatalities after 1985. Future prevention should target the availability of illegal firearms.
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| 44. |
- Candefjord, Stefan, 1981, et al.
(författare)
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On Scene Injury Severity Prediction (OSISP) machine learning algorithms for motor vehicle crash occupants in US
- 2021
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Ingår i: Journal of Transport and Health. - : Elsevier BV. - 2214-1405 .- 2214-1413. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- A significant proportion of motor vehicle crash fatalities are potentially preventable with improved acute care. By increasing the accuracy of triage more victims could be transported directly to the best suited care facility and be provided optimal care. We hypothesize that On Scene Injury Severity Prediction (OSISP) algorithms, developed utilizing machine learning methods, have potential to improve triage by complementing the field triage protocol. In this study, the accuracy of OSISP algorithms based on the “National Automotive Sampling System - Crashworthiness Data System” (NASS-CDS) of crashes involving adult occupants for calendar years 2010–2015 was evaluated. Severe injury was the dependent variable, defined as Injury Severity Score (ISS) > 15. The dataset contained 37873 subjects, whereof 21589 included injury data and were further analyzed. Selection of model predictors was based on potential for injury severity prediction and perceived feasibility of assessment by first responders. We excluded vehicle telemetry data due to the limited availability of these systems in the contemporary vehicle fleet, and because this data is not yet being utilized in prehospital care. The machine learning algorithms Logistic Regression, Ridge Regression, Bernoulli Naïve Bayes, Stochastic Gradient Descent and Artificial Neural Networks were evaluated. Best performance with small margin was achieved with Logistic Regression, achieving area under the receiver operator characteristic curve (AUC) of 0.86 (95% confidence interval 0.82–0.90), as estimated by 10-fold stratified cross-validation. Ejection, Entrapment, Belt use, Airbag deployment and Crash type were good predictors. Using only a subset of the 5–7 best predictors approached the prediction accuracy achieved when using the full set (14 predictors). A simplified benefit analysis indicated that nationwide implementation of OSISP in the US could bring improved care for 3100 severely injured patients, and reduce unnecessary use of trauma center resources for 94000 non-severely injured patients, every year.
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| 45. |
- Fagerlind, Helen, 1975, et al.
(författare)
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Identifying individual-based injury patterns in multi-trauma road users by using an association rule mining method
- 2022
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575. ; 164
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Tidskriftsartikel (refereegranskat)abstract
- In many road crashes the human body is exposed to high forces, commonly resulting in multiple injuries. This study of linked road crash data aimed to identify co-occurring injuries in multiple injured road users by using a novel application of a data mining technique commonly used in Market Basket Analysis. We expected that some injuries are statistically associated with each other and form Individual-Based Injury Patterns (IBIPs) and further that specific road users are associated with certain IBIPs. First, a new injury taxonomy was developed through a four-step process to allow the use of injury data recorded from either of the two major dictionaries used to document anatomical injury. Then data from the Swedish Traffic Accident Data Acquisition, which includes crash circumstances from the police and injury information from hospitals, was analysed for the years 2011 to 2017. The injury data was analysed using the Apriori algorithm to identify statistical association between injuries (IBIP). Each IBIP were then used as the outcome variable in logistic regression modelling to identify associations between specific road user types and IBIPs. A total of 48,544 individuals were included in the analysis of which 36,480 (75.1%) had a single injury category recorded and 12,064 (24.9%) were considered multiply injured. The data mining analysis identified 77 IBIPs in the multiply injured sample and 16 of these were associated with only one road user type. IBIPs and their relation to road user type are one step on the journey towards developing a tool to better understand and quantify injury severity and thereby improve the evidence-base supporting prioritisation of road safety countermeasures.
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| 46. |
- Lynoe, Niels, et al.
(författare)
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An overview of the scientific controversy regarding the diagnostic accuracy of Shaken baby syndrome
- 2023
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Ingår i: Medicine and Law Journal. - New York : William S. Hein & Co., Inc.. - 0723-1393 .- 2471-836X. ; 42:4, s. 763-780
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Tidskriftsartikel (refereegranskat)abstract
- The process used to diagnose Shaken Baby Syndrome (SBS), a subgroup of Abusive Head Trauma (AHT) without signs of relevant trauma, is not reliable and remains uncertain. There is insufficient scientific evidence for any doctor or medical expert to conclude that if a child has three medical findings, the “triad”, then the infant must have been shaken or abused. All studies showing a ‘strong’ association between the triad and the diagnostic accuracy of the SBS diagnosis rely on circular reasoning., There is insufficient scientific evidence that the isolated triad can predict traumatic shaking, as there is a high risk of bias. There is an ongoing scientific controversy within the area. The aim of the present article is to facilitate a better understanding of this scientific controversy for those who are not themselves medical scientists -, such as lawyers, prosecutors, and judges. The legal and medical consequences of the current scientific controversy is that an incorrect diagnosis may delay the correct diagnosis, harm the infant and its family, and jeopardis e rule of law.
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| 47. |
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| 48. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages
- 2019
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash.MethodA nationwide register-based study, including all individuals aged 16-64years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA >14days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression.ResultsIn total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively).ConclusionsIn this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.
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| 49. |
- Doro, Kennedy O., et al.
(författare)
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Geophysical imaging of buried human remains in simulated mass and single graves : Experiment design and results from pre-burial to six months after burial
- 2022
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Ingår i: Forensic Science International. - : Elsevier. - 0379-0738 .- 1872-6283. ; 335
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we present an experiment design and assess the capability of multiple geophysical techniques to image buried human remains in mass and individual graves using human cadavers willingly donated for scientific research. The study is part of a novel, interdisciplinary mass grave experiment established in May 2021 which consists of a mass grave with 6 human remains, 3 individual graves and two empty control graves dug to the same size as the mass grave and individual graves. Prior to establishing the graves, we conducted background measurements of electrical resistivity tomography (ERT), electromagnetics (EM), and ground penetrating radar (GPR) while soil profiles were analyzed in situ after excavating the graves. All graves were also instrumented with soil sensors for monitoring temporal changes in soil moisture, temperature, and electrical conductivity in situ. Measurements of ERT, EM and GPR were repeated 3, 37, 71 and 185 days after burial with further repeated measurements planned for another twelve months. ERT results show an initial increase in resistivity in all graves including the control graves at 3 days after burial and a continuous decrease thereafter in the mass and individual graves with the strongest decrease in the mass grave. Conductivity distribution from the EM shows a similar trend to the ERT with an initial decrease in the first 3 days after burial. Distortion in linear reflectors, presence of small hyperbolas and isolated strong amplitude reflectors in the GPR profiles across the graves is associated with known locations of the graves. These initial results validate the capability of geoelectrical methods in detecting anomalies associated with disturbed ground and human decay while GPR though show some success is limited by the geology of the site.
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| 50. |
- Eriksson, Anders, 1951-, et al.
(författare)
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Rättsmedicin
- 2022. - 2
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Ingår i: Medicinsk rätt. - Stockholm : Norstedts Juridik AB. - 9789139025269 ; , s. 321-335
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Bokkapitel (refereegranskat)
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