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Spontaneous births into toilets.

Since inception of the Dade County Medical Examiner Department in 1956 and the end of 1982 a total of 18 spontaneous births into toilets were investigated. A retrospective review of these cases revealed a high degree of maternal denial of pregnancy and refusal of responsibility for the fetus by primiparous mothers of term births, the instances of most questionable manner of death. A consideration in the examination of these natal deaths should be investigation of maternal postnatal behavior along with the circumstances of birth and autopsy findings.

Adult↗

Some clinical and cultural correlates of violent death.

Forty-one patients admitted to hospital over a 5-year period because of charges arising from their having caused a violent death were studied. Data pertaining to the victim, the weapon used and the locality are analysed. The diagnostic categories for the patients are set out and the course and outcome are followed. Implications for future management are discussed, with particular reference to relevant social and cultural factors.

Black or African American↗

Protecting women and children from physical, sexual, and psychological abuse.

Domestic violence is a serious public health problem. The "epidemic" is becoming too obvious to hide, too widespread to deny, and too much of a health hazard to ignore. The victims are children, women, the elderly, and the society as a whole. Family members, government, educational and penal agencies, civic and medical societies, physicians, and citizens at large are all involved in domestic violence prevention. By having a high index of suspicion, physicians are in an ideal position to prevent, assess, identify, and treat victims of domestic violence and its associated problems.

Child Abuse↗

Child abuse: measuring a global problem.

Child abuse and neglect include four distinct conditions: physical abuse, neglect, emotional abuse and sexual abuse. The magnitude of the problem is not well defined. The lack of epidemiological data limits the extent to which sound public health and social welfare policies and intervention programmes could be developed, implemented and evaluated. In recent years two approaches have been developed to document the magnitude and nature of child abuse and neglect: regional or national case registers; and a screening instrument for suspected cases of child abuse and neglect (SCAN) for use in health service facilities. We are proposing an additional approach for monitoring presumed child abuse and neglect-related mortality. Applying this approach to regions or groups of countries for which there are sufficient data, the expected under-5 rate of presumed child abuse and neglect would be between 13 and 20 per 100,000 live births. These estimates are higher than those made either from community-based registers or forensic reporting systems. Differences in these estimates will need to be resolved through further research. Injury and injury-related mortality can be classified as intentional, unintentional or resulting from varying degrees of neglect. Death from physical abuse represents a willful act or series of actions. Death from neglect may arise from willful behaviour but may also arise from ignorance and irresponsible behaviour. These include failure to recognize hazardous circumstances or children's nutritional, health and developmental needs, and leaving infants and children unattended or inadequately supervised. Mortality data provide virtually no measure of sexual abuse.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Sudden infant and child death as a cultural phenomenon: a Tlaxcalan case study.

THE Sudden Death of infants and young children (SICD) constitutes a recurring problem in all societies. In contemporary industrialized societies, many factors known to cause these deaths have been clarified and controlled. Yet, as an outcome of such things as unrecognized disease, accidents, so-called crib death, and parental neglect or abuse, the prevalence of SICD remains relatively stable even in contemporary Western societies (Adams et al. 1990; Campbell 1989; Kyle et al. 1990). The pathophysiology of these human tragedies has received much attention. However, the social, cultural, and psychiatric implications have been relatively neglected. In large part this is because in our secular culture these deaths are explained naturalistically; namely, as the result of disease, biological anomalies, or physiological failures, the meaning of which is not attributed to human or other worldly intervention. A result of this is that such deaths are usually deprived of a framework of meaning that has spiritual and existential connection to everyday affairs. An impersonal, natural way of explaining SICD often deprives the mourner of a meaningful cultural rationale that can facilitate emotional release and spiritual significance.

Attitude to Death↗

Structural and cultural determinants of child homicide: a cross-national analysis.

Models of structural characteristics that may influence national infant and child homicide victim rates are derived from prior research. Expected effects of structural characteristics from a "social control" perspective are compared with expected effects from a "guardians, suitable target" perspective. Gartner's (1991) claim that structural factors influence victim rates only in nations with low social insurance expenditures is also evaluated. Statistical analysis of three infant and child age groups with homicide rates from 1965-1969, 1970-1974...1985-1988 fails to support the claim that high and low social insurance expenditure strata differ. Further, no independent effects of Gartner's (1991) three measures of family structure are found. Indicators of family stress/resources, female status, the culture of violence, and a proxy for unmeasured variables and measurement error all contribute to produce high levels of explained variance in each age group.

Adolescent↗