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Objective: Non‐fatal strangulation assessment is challenging for clinicians as clear guidelines for evaluation are limited. The prevalence of non‐fatal strangulation events, clinical findings, frequency of injury on computed tomography angiogram (CTA) and outcomes across two trauma centres will be used to improve this assessment process. Methods: This is a retrospective observational study of adult presentations during 2‐year period to two major‐trauma referral hospitals and subsequent 12 months to identify delayed vascular injury. Patients included using standardised search terms. Demographic data, clinical findings, radiological reports and outcomes were included for review. Results: A total of 425 patients were included for analysis. Self‐inflicted injury comprised 62.1%, with domestic violence (28.5%) and assault (9.4%) the remainder. Manual strangulation events 36.7% of overall presentations and 63.3% following ligature strangulation (ligature strangulation, incomplete and complete hanging). On examination soft signs present in 133 (31.2%) cases, commonly neck tenderness in isolation. No hard signs suggesting vascular damage. Vascular injury was demonstrated in three cases (0.7% of the total cohort and 1.5% of CTA scans completed), and all occurred in ligature strangulation events as a result of hanging. No patients had delayed vascular injury in the 12‐month period post‐initial presentation. Conclusions: In non‐fatal strangulation presentations, the majority have subtle signs of neck injury on examination with inconsistent documentation of findings. Low rate of vascular injury overall (0.7%), and entirely in hanging events. No longer‐term vascular sequalae identified. Improving documentation focusing on hypoxic insult and evidence of airway trauma is warranted, rather than a reliance on computed tomography imaging to delineate a traumatic event in non‐fatal strangulation. [ABSTRACT FROM AUTHOR]

A gunfight between police and a gang of men led by the self-styled "Captain Moonlite", a.k.a. George Scott, occurred on 16th November 1879 at a farmhouse near Wantabadgery Station in the colony of New South Wales. The skirmish resulted in the deaths of two bushrangers and one police officer. As a result, Captain Moonlite and Thomas Rogan were hung in Sydney's Darlinghurst Gaol on 20 January 1880 for the murder of Constable Edward Webb-Bowen. Culpability for firing the fatal shot, however, has remained a source of controversy. Information obtained from an analysis of historical records was used to guide an archeological excavation at the scene of the shooting in which Terrestrial Laser Scanning (TLS) technology was employed to produce a digital (3D) terrain model of the siege location. Utilizing the terrain model, the relative positions of Moonlite, Webb-Bowen, and the other gang members were established with possible projectile trajectories plotted. This, in combination with inquest evidence from a gun maker and the medical practitioner who examined Constable Webb-Bowen's wound, indicates that the most likely shooter was Gus Warnicke, aged 15 years, the youngest member of the gang, who was also killed in the exchange of fire. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine (1) suicide trends by most prevalent methods in Queensland, Australia, during 2000–2015, and (2) characteristics of people by choice of suicide method in 2000–2013. Data were obtained from the Queensland Suicide Register, which includes police and toxicology reports, post-mortem autopsy and Coroner's findings. Poisson and Joinpoint regression were used to study the first aim, and uni-variate and multi-variate logistic regression analyses were applied to investigate the second aim. Suicide method trends showed a significant increase in hanging for both sexes and poisoning with drugs for females, while there was a decline for poisoning by other means for both sexes, and ‘other methods’ decreased for males. Changes in the trends have altered the order of suicide methods, especially in males. Analyses of 8140 suicides were composed by the choice of method, distinguishable profiles by their demographic, clinical and social characteristics, such as having mental or physical illness or different recent life stressors were identified. This suggests that socio-cultural acceptability, and availability are the key drivers in the choice of suicide methods. Continuing increases in hanging is a big challenge in suicide prevention due to its lethality, easy realisation and its increasing acceptability. [ABSTRACT FROM AUTHOR]

Objective: Our study examined the characteristics of individuals who survived attempted hanging and compared this group to a randomly selected comparison group of patients with non-fatal self-poisoning., Method: Non-fatal hanging cases were identified from case files from an Australian public hospital. They were matched by age, sex, and month of presentation with double the number of non-fatal self-poisoning cases. Patients were compared on demographic and clinical characteristics, as well as length of stay in hospital and discharge plan., Results: Most non-fatal hanging patients were males with medium suicidal intent, and a significant proportion misused alcohol. In this group, women were more likely than men to have past psychiatric care, and men were more likely to misuse alcohol and stimulants. In comparison to the self-poisoning group, the non-fatal hanging group had higher suicidal intent but proportionally lower history of self-harm and psychiatric care, or benzodiazepine misuse., Conclusion: People who self-harm by hanging have higher suicidal intent, misuse alcohol more often, and are less likely to be in psychiatric care. They may benefit from a general community intervention, rather than one based upon interventions with people already in psychiatric care.

Although the overall suicide rate worldwide has changed minimally over the past 100 years, different trends have been observed over time in the USA, Australia, and New Zealand (NZ). However, few studies have focused on suicides in children (< 18 years), making evaluation of possible trends difficult. The last 20 years has also seen an increase in childhood obesity, eating disorders, and body image issues for children in many developed nations; however, few studies have shown whether a significant proportion of child suicides have an abnormal BMI. The current study evaluates child suicides (from 2008 to 2017) in South Australia (Australia), compared with the jurisdictions of Auckland (NZ) and Hennepin County (USA). Demographic data (age, sex, ethnicity), body mass index (BMI), the number of cases of youth suicide, and the method of suicide from these three regions were collected and analyzed. Across the 10-year period, the jurisdiction of Auckland had a downward trend, while Hennepin County and South Australia had increasing numbers of cases. The most common method of child suicide in all centers was hanging, occurring in > 80% of cases in South Australia and Auckland and 56% in Hennepin County. Hennepin County had a greater proportion of suicides using firearms (28%), compared to 1.9% in Auckland and 5.1% in South Australia. Unusual means of suicide were used less frequently by youth than previously., (© 2022. The Author(s).)

In Australia from 1997 to 2006, there were 23,254 suicides recorded, with suicide being the 14th leading category of death in 2008. Of 2191 deaths in that year there were 1151 hangings (53% of cases), 506 poisonings (23%), 170 firearm deaths (8%), 121 falls from heights (6%), 45 drownings and submersions (2%), 43 deaths due to intentional contact with sharp objects (2%), and 155 deaths due to other methods (7%). However, the interpretation of data is not always straightforward. For example, problems arise in comparing Australian data with that from overseas due to different systems for reporting, gathering and classifying cases. Research that relies on national, international and/or large city suicide data may obscure specific local issues and trends, and care should be exercised when interpreting suicide data over particular time periods, as the number of 'open' coronial cases at the time of annual data collection may alter the number of suicide deaths reported yearly by central authorities. The conduct and quality of autopsies in different countries is also variable. Thus, when data are analysed and apparent trends discerned these issues should be born in mind. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to characterize suicide in the Northern Territory (NT) for the 6 year period 1 January 2001-31 December 2006. Method: Suicide death rates by area (Australia, NT), sex, and Indigenous status for the period of 2001–2006 were obtained from the National Coroners Information System through the Victorian Institute of Forensic Medicine. Population f gures were obtained from the Australian Bureau of Statistics. Results: For this period the suicide rate of NT (21.6 per 100 000) was double the national rate (11), and the rate for NT Indigenous people (36.7) was signif cantly higher (p < 0.001) than that of NT non-Indigenous people (14.7). There was a decline in the suicide rate for Australia of -8.6%; for NT, -6.3%; for NT non-Indigenous, -3.3%; and for NT Indigenous, -9.0%. The sex difference was signif cant (p < 0.001) for both Australia and the NT with male subjects having a higher suicide rate than female subjects. With respect to age group, some evidence suggested an earlier peak for NT Indigenous compared to NT non- Indigenous people. Hanging was more common in NT than in the rest of the country and accounted for 87% of Indigenous suicide. Conclusion: Suicide is more common in NT than in Australia generally, and more common in NT Indigenous than NT non-Indigenous people. There is evidence of a decline in suicide rates across the board. [ABSTRACT FROM AUTHOR]

Retrospective review of 100 consecutive, non decomposed cases of suicide because of hanging was conducted at Forensic Science SA, Australia. Alcohol was detected in 38 cases (38%). The percentage of victims who had ingested alcohol significantly decreased with age (r2 = 0.81), with alcohol detected in 57.1% of those aged ￡24 years, compared to 28.5% of those aged between 55 and 64 years, and 0% of those aged ‡65 years. A similar linear relationship between alcohol ingestion and age was found for cases with blood alcohol levels >0.05 g ⁄ 100 mL (r2 = 0.73). The mean ages of those with detectable alcohol (35.2 years) levels >0.05 g ⁄ 100 mL (35.1 years) and levels >0.1 g ⁄ 100 mL (37.2 years) were all significantly less than in those with no detectable alcohol (44.4 years) (p < 0.005, <0.005, <0.05 respectively). A clear relationship between alcohol ingestion and younger age was shown in hanging suicides. [ABSTRACT FROM AUTHOR]

In 2017 Australia saw the highest overall suicide rate in the past 10 years, with male suicide rates three times higher than in women. Since the mid-1980s there have been major changes in suicide epidemiology in Australia with large shifts in method of suicide among both men and women. This study examined method-specific suicide trends in Australian men over the past 40 years by state. Suicide mortality data for the period 1978 to 2017 was obtained from the Australian Institute of Health and Welfare (AIHW) National Mortality Database and log-linear Poisson regression analysis was used to analyse suicide mortality. This study found large differences between states in patterns and trends in suicide mortality from 1978 to 2017. Hanging, gas and firearms were the most common methods of suicide in Australia. We found statistically significant increasing trends in hanging suicide among men in all six states. The study findings highlight the growing concern of hanging-related suicide in all states in Australia since the late 1970s. New suicide prevention strategies focusing on the ubiquity and ease of hanging as a method will be needed in order for Australia to reduce suicide mortality in future.

Forty-eight deaths occurring in prisons in South Australia were identified between January 1996 and December 2010, including 25 cases of suicide (mean age = 37 years; median age = 34 years; age range = 24-70 years). Most suicides were due to hanging (23/25; 92.0%) with victims using bedding, belts, or shoelaces attached to cell shelves, air vents, doors, or other accessible projections. There were no suicides attributed to drug overdose or sharp force injury. Over a third of all suicides (39.1%) occurred during the first month of confinement, with 26.1% of cases occurring within the first week. There was one suicide reported after 2 years of imprisonment. Given that suicide in state prisons currently occurs at a rate approximately eight times that of the general South Australian community, it appears that the subset of incarcerated individuals represents a group in need of effective preventive strategies to enable more appropriate provisions of existing prisoner resources., (© 2014 American Academy of Forensic Sciences.)