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  • 1.
    Mostad, Petter
    et al.
    Chalmers Univ Technol, Math Sci, Gothenburg, Sweden;Gothenburg Univ, Math Sci, Gothenburg, Sweden.
    Tamsen, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Error rates for unvalidated medical age assessment procedures2019In: International journal of legal medicine (Print), ISSN 0937-9827, E-ISSN 1437-1596, Vol. 133, no 2, p. 613-623Article in journal (Refereed)
    Abstract [en]

    During 2014-2015, Sweden received asylum applications from more than 240,000 people, of which more than 40,000 were termed unaccompanied minors. In a large number of cases, claims by asylum seekers of being below 18 years were not trusted by Swedish authorities. To handle the situation, the Swedish national board of forensic medicine (Rattsmedicinalverket, RMV) was assigned by the government to create a centralized system for medical age assessments. RMV introduced a procedure including two biological age indicators; x-ray of the third molars and magnetic resonance imaging of the distal femoral epiphysis. In 2017, a total of 9617 males and 337 females were subjected to this procedure. No validation study for the procedure was however published, and the observed number of cases with different maturity combinations in teeth and femur were unexpected given the claims originally made by RMV. We present a general stochastic model enabling us to study which combinations of age indicator model parameters and age population profiles are consistent with the observed 2017 data for males. We find that, contrary to some RMV claims, maturity of the femur, as observed by RMV, appears on average well before maturity of teeth. According to our estimates, approximately 15% of the tested males were children. These children had an approximate 33% risk of being classified as adults. The corresponding risk for an adult to be misclassified as a child was approximately 7%. We determine uncertainties and ranges of estimates under reasonable perturbations of the prior.

  • 2.
    Tamsen, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Homicide Injury Quantification: Measures of injury severity in homicide victims and associations with homicide characteristics2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Some previous studies have found that the amount and severity of injuries in homicide victims correlate with different homicide characteristics, such as the victim-offender relationship and drug influence of the offender. If such relationships exist, they may be used by homicide investigators as part of an offender profiling.

    Furthermore, injury severity may be helpful in understanding the nature of lethal violence. If the injuries change over time or differ between regions, this may say something about the underlying causes and thus help society to take preventive measures. However, measures of injury severity are often missing in homicide epidemiology. This may in part be due to a lack of standardized and accessible ways to quantify injuries in homicide victim.

    To address these issues, there is a need for methods to quantify injury severity in homicide victims. The aim of the current thesis was to investigate different types of injury measures and their applicability to homicide victims. The aim was also to use such measures to address research questions related to offender profiling.

    Starting off with injury scores used in trauma research and two scores developed specifically for homicide victims, these measures were applied to a general homicide population. Since there is no obvious “gold standard” for injury severity quantification on homicide victims, one had to be defined to validate the applied methods. Out of forensic experience and rational reasoning, the Sum of all AIS scores (SAIS) was proposed as a reference measure. The other scores were then evaluated through their correlations with the SAIS.

    In the following study, the injury severity in homicides from different time periods was measured. There were statistically significant increases over time with respect to excessive injuries and the number of lethal injuries per victim. These changes can reflect both a brutalization of homicidal violence, improved trauma care, or shifts in the methods by which people are killed.

    Next, the associations between injury severity and homicide characteristics were analysed. No relevant associations between injury severity and victim-offender relationship were found. Neither were there any connections between benzodiazepine influence in the offender and injury severity on the victim. Thus, the studies do not support the use of injury severity scores for offender profiling in a general homicide population.

    List of papers
    1. Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims
    Open this publication in new window or tab >>Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims
    2015 (English)In: Homicide Studies, ISSN 1088-7679, E-ISSN 1552-6720, Vol. 19, no 1, p. 88-100Article in journal (Refereed) Published
    Abstract [en]

    No generally accepted method exists for quantifying the degree of injury in homicide victims. This study explores six different injury severity scores with the goal to recommend a valid method that is reliable and easy to use. To investigate this issue, 103 homicides are examined regarding the correlations between these scores. This study concludes that the Homicide Injury Scale is valid, easy to use, and has a satisfactory inter-rater reliability.

    Keywords
    homicide, lethal violence, injury severity score, quantification
    National Category
    Forensic Science
    Identifiers
    urn:nbn:se:uu:diva-243424 (URN)10.1177/1088767914558142 (DOI)000346910300005 ()
    Available from: 2015-02-17 Created: 2015-02-09 Last updated: 2019-05-21Bibliographically approved
    2. Quantifying Homicide Injuries:: A Swedish Time Trend Study Using the Homicide Injury Scale
    Open this publication in new window or tab >>Quantifying Homicide Injuries:: A Swedish Time Trend Study Using the Homicide Injury Scale
    2017 (English)In: Scandinavian Journal of Forensic Science, ISSN 2353-0707, Vol. 23, no 2Article in journal (Refereed) Published
    Abstract [en]

    Studies report that the homicide rate has decreased considerably in most Western countries since the 1990s. However, few studies have examined the level of injury in homicides. The injury severity in homicide victims was studied in the Stockholm area using both the Homicide Injury Scale (HIS) and the number of lethal injuries per victim. Cases were included from four periods; 1976-78, 1986- 88, 1996-98, and 2006-08. The number of homicides with overkill according to the HIS was significantly higher in 1996-98 compared to 1976-78. Compared with 1976-78, the number of lethal injuries per victim was significantly higher both in 1986-88 and 1996-98. There are various possible reasons for the changes, including a brutalization of lethal violence or a more effective trauma care. More in-depth analysis of individual cases together with research on victims of attempted homicides is needed to explain these shifts in injury severity.

    National Category
    Forensic Science
    Identifiers
    urn:nbn:se:uu:diva-383632 (URN)10.1515/sjfs-2017-0005 (DOI)
    Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-09-03Bibliographically approved
    3. Homicide injury severity in association with the victim-offender relationship
    Open this publication in new window or tab >>Homicide injury severity in association with the victim-offender relationship
    2019 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 300, p. 151-156Article in journal (Refereed) Published
    Abstract [en]

    There are previous studies that have found associations between specific injury patterns and different victim-offender relationships (VORs) in homicides. We have used quantitative injury severity scores to further investigate this issue. The amount and severity of injuries were assessed in 178 Swedish homicide victims, retrospectively included from the years 2007-2009. We analyzed whether different injury measures could be used to predict the VOR. In addition to a deeper understanding of violent behavior, such associations may be of help to homicide investigators for offender profiling. The victims' injuries were assessed with eleven different methods. The cases with known VORs were divided into four categories: partner, relative, acquaintance, and stranger. The injury seventies were then compared between these categories. No relevant differences were found. Thus, the current study does not support the claim that the VOR can be predicted from the injury severity in a general homicide population. These findings are in contrast to the results of some previous studies but confirm those of others.

    Keywords
    Homicide, Injury score, Injury quantification, Offender profiling
    National Category
    Forensic Science
    Identifiers
    urn:nbn:se:uu:diva-383634 (URN)10.1016/j.forsciint.2019.05.012 (DOI)000470903500030 ()
    Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-07-05Bibliographically approved
    4. Homicide injury severity in association with benzodiazepine influence
    Open this publication in new window or tab >>Homicide injury severity in association with benzodiazepine influence
    (English)Manuscript (preprint) (Other academic)
    National Category
    Forensic Science
    Identifiers
    urn:nbn:se:uu:diva-383635 (URN)
    Note

    Submitted to Homicide Studies

    Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-05-21
  • 3.
    Tamsen, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Logan, Fia Klötz
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Addendum to "Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims."€ Volume 19, Issue 1, pp. 88-1002016In: Homicide Studies, ISSN 1088-7679, E-ISSN 1552-6720, Vol. 20, p. 342-343Article in journal (Other academic)
  • 4.
    Tamsen, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Logan, Fia Klötz
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims2015In: Homicide Studies, ISSN 1088-7679, E-ISSN 1552-6720, Vol. 19, no 1, p. 88-100Article in journal (Refereed)
    Abstract [en]

    No generally accepted method exists for quantifying the degree of injury in homicide victims. This study explores six different injury severity scores with the goal to recommend a valid method that is reliable and easy to use. To investigate this issue, 103 homicides are examined regarding the correlations between these scores. This study concludes that the Homicide Injury Scale is valid, easy to use, and has a satisfactory inter-rater reliability.

  • 5.
    Tamsen, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Sturup, Joakim
    Swedish Police Authority.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Homicide injury severity in association with benzodiazepine influenceManuscript (preprint) (Other academic)
  • 6.
    Tamsen, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Sturup, Joakim
    Swedish Police Author, Stockholm, Stockholm Regio, Sweden;Swedish Natl Board Forens Med, Dept Forens Psychiat, Stockholm, Sweden.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine. Swedish Natl Board Forens Med, Dept Forens Med, Stockholm, Sweden.
    Homicide injury severity in association with the victim-offender relationship2019In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 300, p. 151-156Article in journal (Refereed)
    Abstract [en]

    There are previous studies that have found associations between specific injury patterns and different victim-offender relationships (VORs) in homicides. We have used quantitative injury severity scores to further investigate this issue. The amount and severity of injuries were assessed in 178 Swedish homicide victims, retrospectively included from the years 2007-2009. We analyzed whether different injury measures could be used to predict the VOR. In addition to a deeper understanding of violent behavior, such associations may be of help to homicide investigators for offender profiling. The victims' injuries were assessed with eleven different methods. The cases with known VORs were divided into four categories: partner, relative, acquaintance, and stranger. The injury seventies were then compared between these categories. No relevant differences were found. Thus, the current study does not support the claim that the VOR can be predicted from the injury severity in a general homicide population. These findings are in contrast to the results of some previous studies but confirm those of others.

  • 7.
    Tamsen, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Sturup, Joakim
    Karolinska Institute, Stockholm, Sweden.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Quantifying Homicide Injuries:: A Swedish Time Trend Study Using the Homicide Injury Scale2017In: Scandinavian Journal of Forensic Science, ISSN 2353-0707, Vol. 23, no 2Article in journal (Refereed)
    Abstract [en]

    Studies report that the homicide rate has decreased considerably in most Western countries since the 1990s. However, few studies have examined the level of injury in homicides. The injury severity in homicide victims was studied in the Stockholm area using both the Homicide Injury Scale (HIS) and the number of lethal injuries per victim. Cases were included from four periods; 1976-78, 1986- 88, 1996-98, and 2006-08. The number of homicides with overkill according to the HIS was significantly higher in 1996-98 compared to 1976-78. Compared with 1976-78, the number of lethal injuries per victim was significantly higher both in 1986-88 and 1996-98. There are various possible reasons for the changes, including a brutalization of lethal violence or a more effective trauma care. More in-depth analysis of individual cases together with research on victims of attempted homicides is needed to explain these shifts in injury severity.

  • 8.
    Tamsen, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Thiblin, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
    Deaths during apprehensions of agitated persons: A review of proposed pathophysiological theories.2013In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 1, no 1, p. 1-6Article in journal (Refereed)
    Abstract [en]

    The pathophysiology of sudden death during apprehension remains largely unclear. The most frequently discussed mechanisms are excited delirium, positional asphyxia, metabolic acidosis, acute and chronic drug abuse, and autonomic instability. As in most areas of forensic medicine, much of the knowledge comes from case reports, which are of little use in understanding causality. Experimental studies of some aspects have been performed, and they show somewhat divergent results and interpretations. The aim of this review is to summarize the different proposed theories, and to point out important issues for further research.

1 - 8 of 8
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