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  1. Article ; Online: The epidemiology of homicide among older adults: retrospective analysis using data from the Victorian Homicide Register.

    Kennedy, Briohny / Ibrahim, Joseph / Koppel, Sjaan / Bugeja, Lyndal

    International journal of legal medicine

    2023  Volume 137, Issue 5, Page(s) 1583–1593

    Abstract: Older adult homicide is unique and under-researched, requiring immediate attention due to the rapidly ageing population. The current study aims to contribute to the description of homicide at the individual, interpersonal, incident and community levels. ... ...

    Abstract Older adult homicide is unique and under-researched, requiring immediate attention due to the rapidly ageing population. The current study aims to contribute to the description of homicide at the individual, interpersonal, incident and community levels. This research comprised a whole of state jurisdiction population-based retrospective analysis of homicide deaths of older adults aged 65 years and older reported to the Coroner between 2001 and 2015. Descriptive statistical analyses were conducted to compare older adult homicides by sex and the deceased-offender relationship. There were 59 homicide incidents involving 23 female and 36 male deceased (median age=72 years) and 16 female and 41 male offenders (median age=41 years). Individual factors included the following: Deceased frequently had a recorded physical illness (66%), and over one-third were born overseas (37%) or had recent contact with general practitioners and human services (36%). Offenders frequently had a history of illicit drug or alcohol use (63%), diagnosed mental illness (63%) and historical exposure to violence (61%). Interpersonal factors included the following: The deceased-offender relationship tended to be intimate or familial (63%). Incidents factors included the following: incident predominantly occurred in the victim's home (73%), involving the use of a sharp object (36%), bodily force (31%) or blunt force (20%). The older adult homicide is characterised by poor health in the victim, mental illness, substance abuse or a history of conflict in the either the victim or the offender, familial deceased-offender relationship and the home as the incident location. The results identify future prevention opportunities in clinical and human services settings.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Adult ; Homicide ; Retrospective Studies ; Violence ; Suicide ; Mental Disorders
    Language English
    Publishing date 2023-05-29
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-023-03022-0
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  2. Article ; Online: Availability and quality of data related to cultural and linguistic diversity in the Victorian Suicide Register: A pilot study.

    Truong, Mandy / Dwyer, Jeremy / Chan, Jocelyn / Bugeja, Lyndal

    Australian and New Zealand journal of public health

    2023  Volume 47, Issue 5, Page(s) 100078

    Abstract: Objective: While people from culturally and linguistically diverse (CALD) backgrounds have been identified as a priority for suicide prevention in Australia, little is known about suicide in CALD communities. We aim to describe the availability and ... ...

    Abstract Objective: While people from culturally and linguistically diverse (CALD) backgrounds have been identified as a priority for suicide prevention in Australia, little is known about suicide in CALD communities. We aim to describe the availability and quality of CALD data in the Victorian Suicide Register (VSR).
    Methods: A retrospective consecutive case series review of suicides reported to the Coroners Court of Victoria during 2016 was conducted. Using the VSR, we identify suicides showing evidence of CALD identity and relevant variables were extracted and coded according to an adapted Australian Institute of Health and Welfare framework.
    Results: During 2016, 126 of 652 suicides (19.3%, 95% confidence intervals 16.4-22.6) were flagged as showing evidence of CALD. The two most frequent CALD indicators for which information was recorded were country of birth and year of arrival. There was less information pertaining to citizenship, residency/visa status, preferred language, English language proficiency and religious affiliation.
    Conclusions: This study demonstrates that the VSR, like other databases, has substantial gaps in availability and quality of CALD data.
    Implications: A framework to capture richer data on cultural, religious and linguistic diversity when coding suicides is needed to inform policy on suicide prevention initiatives designed for CALD communities.
    Language English
    Publishing date 2023-08-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1323548-5
    ISSN 1753-6405 ; 1326-0200
    ISSN (online) 1753-6405
    ISSN 1326-0200
    DOI 10.1016/j.anzjph.2023.100078
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  3. Article ; Online: Effectiveness of low dose computed tomography to detect fractures in paediatric suspected physical abuse: a systematic review.

    Doyle, Edel / Bugeja, Lyndal / Dimmock, Matthew R / Lee, Kam L / Ng, Jessica / Bassed, Richard B

    International journal of legal medicine

    2024  

    Abstract: Purpose: The skeletal survey X-ray series is the current 'gold standard' when investigating suspected physical abuse (SPA) of children, in addition to a non-contrast computed tomography (CT) brain scan. This systematic literature review synthesised ... ...

    Abstract Purpose: The skeletal survey X-ray series is the current 'gold standard' when investigating suspected physical abuse (SPA) of children, in addition to a non-contrast computed tomography (CT) brain scan. This systematic literature review synthesised findings of published research to determine if low dose computed tomography (LDCT) could detect subtle fractures and therefore replace the skeletal survey X-ray series in the investigation of SPA in children aged under 3 years.
    Methods: Five electronic databases and grey literature were systematically searched from their inception to 28 April 2022. Primary studies were included where the population comprised paediatric patients up to 16 years and LDCT was used to detect fractures associated with SPA. Studies involving imaging investigations of the head, standard dose CT examinations or accidental trauma were excluded.
    Results: Three studies met the inclusion criteria, all of which were case series. These studies did not report many of the criteria required to compare the accuracy of LDCT to X-ray, i.e. they did not meet the criteria for a diagnostic accuracy test. Therefore, it is difficult to conclude from the case series if LDCT is accurate enough to replace X-rays.
    Conclusion: Due to the gap in current literature, a phantom study and subsequent post-mortem CT study are recommended as the primary investigative methods to assess the ability of low-dose CT to identify the subtle fractures associated with SPA and to calculate how low the achievable CT dose can be.
    Language English
    Publishing date 2024-04-15
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-024-03214-2
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  4. Article ; Online: Gambling-related suicide in Victoria, Australia: a population-based cross-sectional study.

    Rintoul, Angela / Dwyer, Jeremy / Millar, Ciara / Bugeja, Lyndal / Nguyen, Huy

    The Lancet regional health. Western Pacific

    2023  Volume 41, Page(s) 100903

    Abstract: Background: Gambling is associated with serious harms to health, including suicide. Yet public health systems for recording the role of gambling in suicide deaths are relatively underdeveloped. This study contributes to the understanding of this ... ...

    Abstract Background: Gambling is associated with serious harms to health, including suicide. Yet public health systems for recording the role of gambling in suicide deaths are relatively underdeveloped. This study contributes to the understanding of this relationship.
    Methods: A population-based cross-sectional study of suicides reported to the Coroners Court of Victoria between 2009 and 2016 was performed to identify the incidence and characteristics of gambling-related suicides (GRS).
    Findings: From 2009 to 2016 there were 4788 suicide deaths in Victoria. Of these, 184 were identified as direct GRS and a further 17 were GRS by 'affected others'. Together, these GRS comprise 4.2% of all suicides in Victoria over this eight-year period. Direct GRS account for an annual average rate of 5.13 GRS per million Victorian adults. GRS were significantly more likely to be male (n = 153, 83%), than the Victorian population of total suicide deaths and significantly more likely to occur among those most disadvantaged. Family members and friends were more likely than clinicians to know about the deceased gambling.
    Interpretation: Given that gambling is not routinely investigated by coroners and may be hidden from family, friends, and health professionals, this is an underestimate of the true scale of the GRS in Victoria. A range of measures should be introduced to prevent, screen, support, and treat gambling harm. Family members and friends should also be provided with help services. Preventing gambling-related harm through public health measures could significantly reduce suicidality and suicide, both in Australia and globally.
    Funding: Federation University Australia, Coroners Court of Victoria, Suicide Prevention Australia.
    Language English
    Publishing date 2023-09-12
    Publishing country England
    Document type Journal Article
    ISSN 2666-6065
    ISSN (online) 2666-6065
    DOI 10.1016/j.lanwpc.2023.100903
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  5. Article ; Online: Quality Management in forensic science: A closer inspection

    Neuteboom, Wim / Ross, Alastair / Bugeja, Lyndal / Willis, Sheila / Roux, Cl / Lothridge, Kevin

    Forensic Science International. 2023 July 04, p.111779-

    2023  , Page(s) 111779–

    Abstract: An international survey was conducted on the benefits and limitations of accreditation to ISO17025 in forensic science, and how quality management could be improved to reflect the complexities of the end-to-end process. The survey was in response to ... ...

    Abstract An international survey was conducted on the benefits and limitations of accreditation to ISO17025 in forensic science, and how quality management could be improved to reflect the complexities of the end-to-end process. The survey was in response to growing concern within the forensic science community that the standard ISO17025 (and ISO17020), which is the backbone of forensic science accreditation, does not have sufficient depth and reach to properly address the quality of both the inputs (crime scene traces) and outputs (e.g., opinions in a report) of forensic science. The survey was developed around three themes: (1) fitness for purpose, (2) competences and (3) education & training. It targeted directors and senior managers, including quality managers, of forensic science laboratories/facilities. The survey was developed by the research team and disseminated with the cooperation of the International Forensic Strategic Alliance (IFSA) and six regional Networks: the American Society of Crime Laboratory Directors (ASCLD), the European Network of Forensic Science institutes (ENFSI), the Australian and New Zealand Forensic Executive Committee (ANZFEC) (formerly SMANZFL), Acadamia Iberoamericana de Criminalistica Estudios Forenses (AICEF), Asian Forensic Sciences Network (AFSN) and Southern Africa Regional Forensic Science Network (SARFS). What emerged for each of the three themes of the survey are areas of concern where the forensic science community should reconsider its approach to quality management if it is to have continuing value and relevance into the future. The results are evaluated and discussed. Briefly, the results include evidence of a lack of fitness for purpose of ISO17025 as a standard for the forensic science continuum, a lack of agreement on what forensic science is and poor levels of recognition of crime scene investigation, many competences, particularly cognitive competences, are not identified, monitored or assessed and the incentive to gain accreditation and maintain continuous improvement is intrinsic rather than customer driven.
    Keywords cognition ; crime ; education ; forensic sciences ; surveys ; New Zealand ; Southern Africa ; Quality management ; Fit for purpose ; Competences ; Education & training
    Language English
    Dates of publication 2023-0704
    Publishing place Elsevier B.V.
    Document type Article ; Online
    Note Pre-press version
    ZDB-ID 424042-x
    ISSN 1872-6283 ; 0379-0738
    ISSN (online) 1872-6283
    ISSN 0379-0738
    DOI 10.1016/j.forsciint.2023.111779
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  6. Article ; Online: Non-fatal strangulation and COVID-19 common symptoms and signs: considerations for medical and forensic assessment.

    Bugeja, Lyndal / Rowse, Janine / Cunningham, Nicola / Parkin, Jo Ann

    Forensic science, medicine, and pathology

    2022  Volume 18, Issue 2, Page(s) 165–169

    Abstract: Emerging evidence suggests that an onset or escalation of interpersonal violence has been occurring during the COVID-19 pandemic, particularly among persons in intimate or familial relationships. Strangulation (or neck compression) is a common form of ... ...

    Abstract Emerging evidence suggests that an onset or escalation of interpersonal violence has been occurring during the COVID-19 pandemic, particularly among persons in intimate or familial relationships. Strangulation (or neck compression) is a common form of interpersonal violence and can result in serious adverse health outcomes, including death. The identification and attribution of injuries from non-fatal strangulation are complex, as there may be an absence of external signs of injury and their appearance may be delayed by many days. There is a heavy reliance on clinician identification of 'red flag' symptoms and signs, the presence of which necessitates urgent further assessment. Additional challenges arise when acute non-fatal strangulation symptoms and signs are shared with other clinical conditions. In such cases, differentiating between the conditions based on the symptoms and signs alone is problematic. We present the diagnostic challenges faced when conducting forensic assessments of COVID-19-positive and suspected COVID-19 (S/COVID) patients following allegations of non-fatal strangulation in the setting of physical and sexual assaults. The implications of shared symptoms and signs, for forensic clinicians, primary healthcare, and emergency practitioners, as well as other frontline service providers, are discussed.
    MeSH term(s) Asphyxia/diagnosis ; COVID-19 ; Forensic Medicine ; Humans ; Pandemics ; Sex Offenses
    Language English
    Publishing date 2022-02-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2195904-3
    ISSN 1556-2891 ; 1547-769X
    ISSN (online) 1556-2891
    ISSN 1547-769X
    DOI 10.1007/s12024-022-00460-x
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  7. Article ; Online: Exertional heat fatalities in Australian sport and recreation.

    Fortington, Lauren / Gamage, Prasanna / Cartwright, Anna / Bugeja, Lyndal

    Journal of science and medicine in sport

    2021  Volume 24, Issue 8, Page(s) 787–792

    Abstract: Objectives: To describe the number and case characteristics of sport and recreation-related exertional heat deaths in Australia and summarise recommendations derived from case narratives.: Design: Descriptive, population-based, retrospective cohort ... ...

    Abstract Objectives: To describe the number and case characteristics of sport and recreation-related exertional heat deaths in Australia and summarise recommendations derived from case narratives.
    Design: Descriptive, population-based, retrospective cohort study.
    Methods: Cases were identified using the National Coronial Information System (NCIS) through multiple search strategies comprising queries, keywords and cause of death codes. Cases were included where there was evidence that the deceased was actively engaged in sport or recreation and exertional heat illness was causal or contributory to the death. Data extraction were performed independently, in duplicate, to ensure accuracy. Descriptive statistics are used to report deceased's socio-demographic characteristics, incident characteristics, type of sport/recreational activity and time sequence of events. Content analysis is used to summarise recommendations.
    Results: Thirty-eight deaths (males n = 29, 74%; median age = 40 years, range 8-77) were identified during the study period (2001 to 2018), with 22 recommendations for five cases. Two cases occurred during organised sport and 36 during active recreation, of which 27 were in hiking. Eleven (29%) individuals were international visitors. There were 22 recommendations across 5 cases presented, with a focus on education and training.
    Conclusions: Exertional heat deaths in outdoor recreation in Australia were far more prevalent than cases in organised sport. The largest proportion of deaths occurred in hiking with two populations featuring: males aged 15-45 years and international visitors. Considering the incident characteristics and time sequence of events, measures such as early recognition of symptoms, provision of first aid and timely access to emergency medical care are important to prevent fatalities.
    MeSH term(s) Adolescent ; Adult ; Aged ; Athletic Injuries/mortality ; Athletic Injuries/prevention & control ; Australia/epidemiology ; Child ; Female ; Health Education ; Heat Stress Disorders/mortality ; Heat Stress Disorders/prevention & control ; Hot Temperature ; Humans ; Humidity ; Male ; Middle Aged ; Recreation ; Retrospective Studies ; Time-to-Treatment ; Young Adult
    Language English
    Publishing date 2021-04-29
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1437829-2
    ISSN 1878-1861 ; 1440-2440
    ISSN (online) 1878-1861
    ISSN 1440-2440
    DOI 10.1016/j.jsams.2021.04.007
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    Zs.A 4926: Show issues Location:
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  8. Article ; Online: A population-based cross-sectional study examining homicides among community-dwelling older adults in Victoria, Australia: A study protocol.

    Kennedy, Briohny / Bugeja, Lyndal / Olivier, Jake / Koppel, Sjaan / Dwyer, Jeremy / Ibrahim, Joseph

    PloS one

    2023  Volume 18, Issue 10, Page(s) e0292837

    Abstract: Background: There is a need for both descriptive and analytical evidence on the factors associated with older adult homicide. The current landscape is insufficient because most published research is confined to the United States, and contains ... ...

    Abstract Background: There is a need for both descriptive and analytical evidence on the factors associated with older adult homicide. The current landscape is insufficient because most published research is confined to the United States, and contains insufficient data about the homicide context. This study protocol describes the proposed method for examining the characteristics and factors associated with older adult homicide in the Australian state of Victoria, using data generated for the criminal and coronial investigation into these deaths stored in the Victorian Homicide Register (VHR). Outcomes will support practitioners, policy makers and other key stakeholders to strengthen prevention strategies to reduce the risk of future homicides among older Victorians.
    Methods: This study will comprise a single-jurisdiction population-based cross-sectional design to analyse consecutive cases of homicide among community-dwelling older adults in Victoria, Australia for the period 2001 to 2015. All homicides of adults aged 18 years and older, and where the Coroner's investigation is completed at data extraction will be included. Variables will be selected in accordance with elements of the social-ecological model (i.e., individual, interpersonal, incident, and community). This will include: socio-demographic characteristics; presence of mental or physical illness; deceased-offender relationship; nature of any abuse between the deceased and offender; incident location and weapon used; the presence of alcohol or drugs; and criminal justice outcomes. Homicide rates per 100,000 population will be calculated for older adults (aged 65 years and older) and younger adults (aged 18-64 years), and compared as rate ratios using Poisson regression. Descriptive statistics and cross-tabulation will be generated for factors associated with homicide for older compared to younger adults. Homicide typologies based on deceased-offender relationship and motive will be explored within group and family homicides will be compared between older and younger adults.
    MeSH term(s) Humans ; United States ; Aged ; Homicide ; Cross-Sectional Studies ; Victoria/epidemiology ; Independent Living ; Criminals
    Language English
    Publishing date 2023-10-13
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0292837
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  9. Article ; Online: Effective Elements for Workplace Responses to Critical Incidents and Suicide: A Rapid Review.

    Pearce, Tania / Bugeja, Lyndal / Wayland, Sarah / Maple, Myfanwy

    International journal of environmental research and public health

    2021  Volume 18, Issue 9

    Abstract: Despite high rates of critical incidents (CIs) in working class occupations, there is a significant gap in our understanding of responses to these events. In this study, we aimed to inform a response training module by synthesising the key elements of ... ...

    Abstract Despite high rates of critical incidents (CIs) in working class occupations, there is a significant gap in our understanding of responses to these events. In this study, we aimed to inform a response training module by synthesising the key elements of pre-, during- and post-incident responses to CIs and suicide in the workplace. A rapid review identified studies on responses to CIs or suicide deaths in the workplace published between January 2015 and June 2020. A systematic search of six databases (Medline, CINAHL, PsycINFO, Sociology Collection, Academic Search and Business Search Complete) and grey literature was performed. Studies were excluded if the focus was on non-colleagues. Two reviewers independently conducted record screening, a review of the full text and assessed study quality. The existing evidence was synthesised and interventions were categorised using Haddon's Matrix. Five studies were included, reporting on CIs across a range of workplace settings, including railways, factories, police and military, along with external critical response units. Overall, study quality was assessed as being poor. Most of the evidence focused on the pre-incident and post-incident stage. There is little evidence on responses to CIs in the workplace. Evidence-based education and training is necessary to establish organisational responses to assist with supporting workers exposed to workplace CIs.
    MeSH term(s) Humans ; Occupations ; Suicide ; Workplace
    Language English
    Publishing date 2021-04-30
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph18094821
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  10. Article: Killing of Elderly Patients by Health Care Professionals: Insights From Coroners' Inquests and Inquiries in Three Cases.

    Nelson, Jordyn / Ibrahim, Joseph / Bugeja, Lyndal / Ranson, David

    Journal of law and medicine

    2021  Volume 28, Issue 3, Page(s) 620–631

    Abstract: As the world's population ages, a question of who can be trusted to look after the increasing elderly population arises. Health care professionals are commonly considered one of the group of people we entrust with our health care and maintenance of a ... ...

    Abstract As the world's population ages, a question of who can be trusted to look after the increasing elderly population arises. Health care professionals are commonly considered one of the group of people we entrust with our health care and maintenance of a good quality of life. Unfortunately, some abuse this trust. Harold Shipman, Elizabeth Wettlaufer and Roger Dean are three examples of health care professionals held responsible for multiple homicides of patients aged 65 years and older in their care. Harold Shipman, a United Kingdom doctor, is suspected of killing potentially 400 patients over 27 years. However, the true number may never be known. Elizabeth Wettlaufer, a Canadian nurse, admitted to killing eight patients over seven years and Roger Dean, an Australian nurse, killed 11 patients in one night by deliberately lighting a fire in a health care facility. The subsequent inquiry reports into their actions resulted in multiple recommendations which aimed to prevent similar occurrences and to protect the lives of this vulnerable cohort of people. These recommendations included restrictions on the hiring process of health care professionals and increasing the accountability of access to Schedule Eight drugs by doctors and registered nurses. The governments responsible for responding to the inquiry reports have done so in various ways, although not all recommendations have been implemented and some may not be practical with current residential care infrastructure provisions and requirements. More work is required to determine the types of countermeasures that could be implemented to protect the elderly from maverick health care professionals.
    MeSH term(s) Aged ; Australia ; Canada ; Coroners and Medical Examiners ; Homicide ; Humans ; Quality of Life
    Language English
    Publishing date 2021-08-08
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1236328-5
    ISSN 1320-159X
    ISSN 1320-159X
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