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This paper presents the first conceptual framework for understanding 'honour'-based abuse (HBA), violence and killing: the Three Phase Model of Perpetration. Positioned within priorities of prevention and intervention, the model situates HBA within a public health framework, distinguishing it from other forms of child abuse, family violence and domestic homicide. Narrative review and conceptual analysis. A synthesis of academic and grey literature, statutory reviews, victim case studies, and survivor and perpetrator accounts identified recurring patterns in perpetrator behaviour and systemic responses. The Three Phase Model maps HBA perpetrator behaviour across the lifespan through three interconnected phases - Control, Punish and Protect - showing how honour codes are socialised, enforced and justified within families and communities through collective coercive control and victim-shaming by multiple perpetrators. HBA is a public health crisis requiring a targeted response. Its persistent framing through cultural identity rather than biopsychosocial processes has created a public health blind spot, limiting effective prevention. The Three Phase Model offers a framework to strengthen practitioner insight, enhance cultural competence, and inform training and policy reform for multi-agency safeguarding.

Violence is a social determinant of health, and hospitals are well-positioned to promote patient well-being by addressing its root causes. Understanding factors associated with hospital engagement in community violence prevention can guide intervention development and capacity building. To examine hospital and county-level factors associated with the presence of community violence prevention programs (CVPPs) in U.S. hospitals. This cross-sectional study linked data from the 2022 American Hospital Association Annual Survey with county-level socioeconomic and demographic data from the US Census Bureau and all-cause homicide rates from the US Centers for Disease Control and Prevention. The sample included general medical and surgical hospitals with Medicare identification numbers. Survey-adjusted logistic regression assessed associations between hospital CVPP presence and all-cause homicide. Our response variable was whether or not the hospital had a CVPP, and our explanatory variable was county-level all-cause homicide rates. We adjusted for hospital characteristics and county-level socio-demographics. Of 4,374 hospitals, 990 (22.6%) reported having CVPPs. Compared to those without CVPPs, hospitals with CVPPs were more likely to be nonprofit (85.0% vs. 62.9%), large (>&#x2009;500 beds; 16.9% vs. 4.7%), have more annual ED visits (51,873.9 vs. 26,224.5), and be urban (81.1% vs. 51.8%) (all p&#x2009;<&#x2009;0.001). They also more frequently offered outpatient psychiatric (86.1% vs. 46.9%), substance use (74.4% vs. 23.2%), and pain management (93.1% vs. 65.2%) services. In adjusted models, homicide rates were not associated with CVPP presence (aOR&#x2009;=&#x2009;1.01, 95% CI [0.99, 1.04]). CVPP presence was independently associated with nonprofit ownership, larger size, trauma designation, and lower social deprivation in urban counties. Hospital and community characteristics, rather than homicide rates, predict CVPP presence. CVPPs are concentrated in larger, urban, well-resourced hospitals rather than in areas with the highest homicide rates, highlighting potential misalignment between program placement and community need.

Violence associated with schizophrenia is typically restricted to a small proportion of patients experiencing acute psychosis, impaired insight, or abrupt discontinuation of antipsychotic medication. Longitudinal forensic cases demonstrating recurrent severe violence across multiple decades are rarely documented. This report describes a 48-year-old man with chronic schizophrenia who committed two major violent acts-spousal homicide and attempted parricide-each following abrupt cessation of antipsychotic medication. Despite long-term legal supervision under Article 57 of the Turkish Penal Code and continuous follow-up via a Community Mental Health Center, medication nonadherence triggered rapid psychotic relapse and targeted interpersonal violence. This multi-decade trajectory offers rare insight into the chronic and fluctuating nature of violence risk in schizophrenia. The case highlights system-level challenges in community-based adherence monitoring and emphasizes the essential role of long-acting injectable antipsychotics, dynamic risk assessment, and structured relapse-prevention strategies in forensic psychiatric populations. It contributes new understanding to an underrepresented area of forensic science by identifying a predictable but underrecognized mechanism of recurrent violence, demonstrating that long-term remission does not eliminate risk among high-liability individuals.

Objectives. To describe rates and characteristics of homicides of women across racial/ethnic groups, and describe intimate partner violence (IPV)-related and non-IPV-related homicide circumstances across racial/ethnic groups. Methods. We used National Vital Statistics System data to calculate homicide rates by racial/ethnic group of US women (aged&#x2009;&#x2265;&#x2009;18 years) who were homicide victims from 2018 to 2022. We used National Violent Death Reporting System data to characterize the circumstances and suspects in these homicides by racial/ethnic group and IPV involvement. Results. The age-adjusted homicide rate was 3.2 per 100&#x2009;000 women. Rates for non-Hispanic Black women and non-Hispanic American Indian/Alaska Native women were more than twice as high as those for other races/ethnicities. Most women were killed by a firearm (67.9%), fatally injured in a residence (64.8%), or killed by a male (92.5%). About half (47.3%) of homicides were IPV related. Non-IPV-related homicides were often perpetrated by family members (39.0%). Circumstances differed by racial/ethnic group. Conclusions. Homicide disproportionally affects certain racial/ethnic groups of women, and the characteristics of homicides differ across groups. Thorough examination of these differences could aid in effective, targeted homicide prevention. (Am J Public Health. Published online ahead of print April 2, 2026:e1-e12. https://doi.org/10.2105/AJPH.2026.308461).

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In Dutch euthanasia practice, the relationship between healthcare professionals, patients, and, when present, the patient's close circle plays an important role. However, neither the Dutch Euthanasia Act nor current guidelines or empirical studies provide detailed insight into how these actors navigate the process or experience decision-making. Therefore, we aim to explore how these relationships are experienced throughout the euthanasia process. We conducted a phenomenologically inspired, multiperspective and longitudinal study. Nine groups consisting of a patient, relative and one or two healthcare professionals were included (n&#x202f;=&#x202f;31). A total of 43 interviews and 18 observations of the assessment of the euthanasia request were conducted. Analysis was done using a phenomenological guide for multiperspective and longitudinal research. Participants experienced the emerging relationship in diverse ways, reflecting an ongoing process of relational enactment rather than fixed outcomes. They reported experiences of feeling support, care, empowerment, instrumentalization, guidance, and legal or procedural framing. These experiences varied in intensity and could shift over time, differing between participants and across groups. Participants' experiences were shaped by how the euthanasia request was assessed, rather than by what was assessed. Euthanasia practice should thus not solely be understood in terms of compliance with legal criteria, but shaped by how these criteria are enacted and experienced within relational encounters. This highlights that the euthanasia process unfolds within a relational field in which legal, professional, and interpersonal dimensions are inextricably intertwined, and is best understood as a triadic configuration involving patients, their close circle, and healthcare professionals.

Different disciplinary and socio-geographical approaches to counting, reporting, and categorizing death can yield divergent and often contradictory values of risk, harm, and mortality. This article examines historical and contemporary ways of recording and narrating the incidence of female homicide in South Africa (one of the countries with the highest femicide rates in the world), from state and police statistics to medical studies and media reports, and explores how each of these uses both common and discrete necrodata to construct specific narratives that reveal the [dead] body as a site of conflicting assertions of power.

Whether bipolar II disorder (BD-II) is associated with increased long-term mortality remains uncertain because most studies have not distinguished BD-II from bipolar I disorder (BD-I). To examine whether BD-II is associated with elevated all-cause and cause-specific mortality compared with population controls, unaffected siblings, and those with BD-I. This population-based, retrospective cohort study used data from Taiwan's National Health Insurance Database from January 1, 2000, to December 31, 2022. Individuals 12 years or older with 2 or more psychiatrist-assigned BD-II diagnoses were individually matched to 4 controls without BD-II by sex and birthdate. Additional comparisons included unaffected biological siblings and a BD-I cohort. Follow-up was from the index date to death or December 31, 2022. Data were analyzed from June to August 2025. Clinical diagnosis of BD-II. Primary outcome was all-cause mortality; secondary outcomes were natural-cause and unnatural-cause mortality. Cox proportional hazards regression models estimated adjusted hazard ratios (AHRs) with 95% CIs, controlling for age, sex, income, urbanization, health care use, and comorbidity. The study included 11&#x202f;427 individuals with BD-II (mean [SD] age, 39.6 [16.6] years; 7073 [61.9%] female) and 45&#x202f;708 matched controls (mean [SD], 39.6 [16.7] years; 28&#x202f;292 [61.9%] female). During a mean (SD) follow-up of 7.3 (5.1) years, 1089 patients with BD-II and 1879 controls died (AHR, 1.62; 95% CI, 1.47-1.78). Excess mortality in BD-II was observed for natural causes (AHR, 1.37; 95% CI, 1.23-1.52) and for unnatural causes (AHR, 4.46; 95% CI, 3.53-5.64). Natural-cause deaths included mental and behavioral disorders; circulatory, respiratory, digestive, and skin or subcutaneous diseases; and symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified. Unnatural-cause deaths were predominantly unintentional injuries, suicide, and assault or homicide. Findings were consistent across sex, age, and psychiatric comorbidities. In within-family analyses, BD-II remained associated with higher all-cause (AHR, 1.31; 95% CI, 1.00-1.72) and unnatural-cause mortality (AHR, 2.05; 95% CI, 1.43-2.95) but not natural-cause mortality. Compared with BD-I, BD-II had higher all-cause (AHR, 1.24; 95% CI, 1.01-1.53) and natural-cause mortality (AHR, 1.45; 95% CI, 1.14-1.86) but not unnatural-cause mortality. In this cohort study, BD-II was associated with a significant risk of premature mortality across multiple causes; even after accounting for shared familial factors and relative to BD-I, all-cause mortality remained elevated. These findings underscore the importance of comprehensive psychiatric care for individuals with BD-II.

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To investigate the relationship between the legacy of slavery and contemporary racial disparities in homicide rates at the county level in the United States. Cross-sectional, multilevel, spatial dependence regression analysis. County-level crude homicide rates and racial homicide disparities during the period 2000-2020 were obtained for the overall, non-Hispanic Black, and non-Hispanic White populations. We explored the relationship between the percentage of enslaved persons in each county in 1860 and contemporary racial disparities in homicide using a multilevel, spatial dependence model. Controlling for a range of county- and state-level factors, counties in the South had a White homicide rate that was 16.3% higher than in the non-South, a Black homicide rate that was 21.3% lower, and a Black-White homicide rate ratio that was 32.4% lower. Higher White homicide rates and lower Black homicide rates in the South were only observed for firearm-related homicide. Within the South, the percentage of enslaved persons in 1860 was not associated with homicide rates in adjusted analyses. Even after controlling for a range of homicide-related factors, counties in the South had higher White firearm homicide rates, lower Black firearm homicide rates, and lower Black-White racial disparities in homicide. These results suggest that while the White population in the South gained socioeconomic advantage due to slavery, this came at the expense of increased levels of violence resulting in higher White homicide rates.

Juveniles and infants are often believed to decompose faster than adults due to smaller body masses, yet research on juvenile decomposition rates remains limited. Studies examining body size and decomposition yield contradictory results and typically rely on human analogues of adult-like proportions. Thus, whether smaller or larger cadavers decompose more rapidly remains unclear. Limited research exists on juvenile decomposition rates, despite their relevance to forensic investigations. In the UK, 46% of homicides involving victims under 16 remained unsolved in the year ending March 2022, compared to 30% across all homicides. Moreover, from 2012 to 2022, children under 1 year old had the highest homicide rate. Increased forensic understanding of juvenile decomposition could improve case resolution and investigative accuracy. This study investigated the relationship between cadaver size and decomposition rates using juvenile-sized domestic pigs in the UK. Over 18 weeks, total body score and percentage mass change were recorded. Given the subjective nature of visual scoring, three independent observers assessed the total body score to evaluate inter-rater reliability. Larger cadavers (12.3-16.1&#x2005;kg) decomposed faster in early stages, while smaller cadavers (6.6-7.1&#x2005;kg) showed an accelerated rate between weeks 4 and 12 based on total body score. Inter-rater analysis confirmed strong reliability in the scoring system. Both total body score and percentage mass change showed strong positive correlations with time, indicating that each measure reliably tracks the progression of decomposition.

Haiti's unprecedented sociopolitical upheavals have severely impacted health care services. Limited research exists on HIV clinic operations under such strain. We examined the potential interruptions to antiretroviral treatment (ART) provision through discrete time periods using Haiti's national HIV surveillance system. We analyzed weekly count data from HIV clinics (January 2018-December 2024). Time segments were bounded by the COVID-19 emergency period (April 2020-September 2020), hospital strikes (November 2020), the presidential assassination (July 2021), protests over increases in fuel prices (September 2022), and intensifying gang violence (March 2024). We accounted for autocorrelation in weekly time series and measured immediate, level, and trend changes in new ART enrollment. We triangulated this series with Google's weekly cell phone mobility reports to cross-validate our event selection. In Haiti, ART enrollment declined 25% from 13,304 (CY2018) to 11,773 (CY2024) people per year (mean = 222 people/week in 2024). Only the fuel protests had an immediate impact on ART enrollment (&#x3b2; = -111.1 [95% CI: -179.3, -42.9]) and this was isolated to the largest clinical electronic medical record. Mean weekly ART enrollment in most periods was lower. Trend visualization suggests that historical patterns of disruption followed by numerical rebound may have changed after the gang violence in 2024. ART enrollment declined substantially in Haiti from 2018 to 2024. Future work should discern whether the epidemiology of HIV transmission is changing after accounting for these health systems disruptions.

In this article, we explore survivor strategies for safety and the development of resilience in the context of domestic and intimate partner violence (D/IPV) experienced in rural Canada. Through the thematic analysis of 24 qualitative interviews, this paper identifies several ways that survivors sought safety on individual, relational, and community levels. Engaging a social ecological understanding of resilience, we highlight how the close-knit nature of rural cultures presents opportunities and challenges when seeking safety for survivors of D/IPV. The findings of this study inform broader academic and policy discourses on rural D/IPV as well as D/IPV service provision in rural communities by deepening an understanding of the unique strategies for safety of rural survivors and the role of informal support in their resilience as they navigate extreme forms of D/IPV in rural Canada. Dans cet article, nous examinons les strat&#xe9;gies mises en &#x153;uvre par les survivantes pour assurer leur s&#xe9;curit&#xe9; et d&#xe9;velopper leur r&#xe9;silience dans le contexte de la violence domestique et conjugale (D/IPV) subie dans les zones rurales du Canada. &#xc0; travers l'analyse th&#xe9;matique de 24 entretiens qualitatifs, cet article identifie plusieurs moyens par lesquels les survivantes ont cherch&#xe9; &#xe0; se mettre en s&#xe9;curit&#xe9; aux niveaux individuel, relationnel et communautaire. En nous appuyant sur une conception socio&#x2010;&#xe9;cologique de la r&#xe9;silience, nous mettons en &#xe9;vidence comment la nature tr&#xe8;s soud&#xe9;e des cultures rurales pr&#xe9;sente &#xe0; la fois des opportunit&#xe9;s et des d&#xe9;fis pour la recherche de s&#xe9;curit&#xe9; des survivantes de D/IPV. Les r&#xe9;sultats de cette &#xe9;tude alimentent les discours acad&#xe9;miques et politiques plus larges sur la D/IPV en milieu rural ainsi que sur la prestation de services li&#xe9;s &#xe0; la D/IPV dans les communaut&#xe9;s rurales, en approfondissant la compr&#xe9;hension des strat&#xe9;gies de s&#xe9;curit&#xe9; propres aux survivantes rurales et du r&#xf4;le du soutien informel dans leur r&#xe9;silience alors qu'elles font face &#xe0; des formes extr&#xea;mes de D/IPV dans les r&#xe9;gions rurales du Canada.

Civilian justifiable firearm homicides (CJFH), an important component of defensive gun use, are central to debates on gun policy and ownership but have received limited scholarly attention. This study examines the prevalence and characteristics of CJFH across two national datasets, with a focus on understanding differences across datasets in the relationship of decedent race with the determination of justifiability. This cross-sectional study used data from 2016 to 2022 from the National Violent Death Reporting System (NVDRS) and Supplementary Homicide Reports (SHR). Descriptive statistics and logistic regressions assessed the association between coded decedent race and the likelihood that a firearm homicide was coded as justifiable. After geographically harmonizing the datasets, CJFH incidents were more common in NVDRS (n&#x2009;=&#x2009;1887) than SHR (n&#x2009;=&#x2009;1576). NVDRS had a lower proportion of Black CJFH decedents (58%) compared to SHR (67%). Restricting to a more closely matched set of incidents, adjusted models showed higher odds of coding the decedents of CJFH as Black in SHR (OR: 1.17; 95% CI: 0.93-1.46) than NVDRS (OR: 1.00; 95% CI: 0.82-1.22). Discrepancies in the racial composition of CJFH across NVDRS and SHR do not arise for other decedent characteristics or among non-CJFH cases. Differences in the coding of CJFH highlight potential issues with evaluating racial disparities and the need to address biases in firearm data infrastructure.

Firearm violence ranks among the leading causes of death in Mississippi. Understanding its demographic, circumstantial, and geographic patterns is essential to inform prevention efforts. To describe demographic, circumstantial, and geographic patterns of firearm-related homicides and suicides in Mississippi during 2021-2023 using Mississippi Violent Death Reporting System (MSVDRS) data. Percentages and crude rates of firearm-related homicides and suicides were analyzed by demographic characteristics for 2021-2023. z tests assessed rate differences between years. Chi-square (&#x3c7;&#xb2;) tests compared proportions of decedents with specified precipitating circumstances for 2022 versus 2021 and 2023 versus 2021. County-level crude rates were mapped to visualize geographic disparities. Firearm-related homicides were concentrated among younger Black males, most often precipitated by arguments, crime-related activity, or intimate partner problems, with the highest rates in the capital area and western Mississippi, particularly the Delta region. Firearm-related suicides primarily involved older White males and were frequently associated with mental health problems, depressed mood, or substance use. These deaths were most common in central, northeastern, and southwestern rural and mixed rural-suburban counties. Firearm-related deaths remain a major public health concern in Mississippi, highlighting the importance of community-based prevention, mental health support, and ongoing MSVDRS surveillance to guide targeted interventions.

Gentrification is present around the world. Little of suicide and homicide has been studied in relation to gentrification. The objective of this study was correlate the suicide and homicide rates with the percentage of gentrification by gender and by municipalities of Mexico City. This descriptive and observational study collected data from suicide and homicide of the Attorney General's Office of Mexico City, Mexico to calculate the suicide and homicide rate in Mexico City, Mexico. The gentrification percent by municipalities of Mexico City were taken from Airbnb platform. Spearman's correlation and scatterplots were created to show suicide correlation between gentrification percentage and suicide and homicide. A significant negative correlation was obtained between gentrification percentage and suicide (r= -0.51, p=0.04). Also, a significant negative correlation was observed between gentrification percentage and suicide in women (r= -0.58, p=0.01). Indicative that in municipalities when the gentrification increases, suicide rate decreases. No correlations were observed between homicide and gentrification percentage by municipalities or by sex. Our results show that in Mexico City, the gentrification percentage is negatively correlated with suicide rates, but it is not correlated with homicide rates. This suggests that gentrification could be linked to the prevention of suicide especially in women. However, further studies are needed to achieve conclusive results.

The assassin bug genus Epidaus St&#xe5;l, 1859 (Hemiptera, Reduviidae, Harpactorinae) includes 28 species mainly distributed in the Oriental and Palaearctic Regions, with China being a major diversity hotspot, hosting nine known species. Epidaus nanlingensis Wang Z, Liu & Cai, sp. nov. from Nanling National Nature Reserve, Guangdong, China, is described and illustrated, based on both male and female specimens. A comparative study of the new species and its morphologically similar species is presented. An updated identification key to all ten Chinese species of the genus Epidaus is provided.

Adolescent homicide is a major public health challenge in Brazil. This study investigates the association between school dropout and homicide death in S&#xe3;o Paulo, exploring justice-system involvement as a potential mediator. A population-based case-control study was conducted. Cases (N&#x2009;=&#x2009;939) were adolescents (10-19 years) killed by homicide (2015-2020), identified via police records and linked to school databases. Controls (N&#x2009;=&#x2009;939) were randomly selected after stratification of the cases by sex. Data were analyzed using conditional logistic regression to estimate Odds Ratios (OR). Mediation analysis estimated natural direct (NDE) and indirect effects (NIE) through court proceedings. Most victims were male (94.7%) and out of school at the time of death (68.8% males; 50.0% females). In adjusted models, school dropout was strongly associated with homicide for both males (ORadj&#x2009;=&#x2009;5.54; 95% CI 4.33-7.09) and females (ORadj&#x2009;=&#x2009;5.23; 95% CI 1.60-17.07). For males, a history of court proceedings showed a high association with homicide (ORc&#x2009;=&#x2009;16.74; 95% CI 12.75-21.98). Mediation analysis indicated that court proceedings accounted for 24% of the total association (NIE OR&#x2009;=&#x2009;1.48; 95% CI 1.34-1.64). The proportion mediated was higher for males (25%) than for females (14%). School dropout is a significant marker of vulnerability associated with adolescent homicide. Although justice-system involvement explains part of this association, particularly for males, the direct association remains predominant across sexes. These results indicate that school disengagement and conflict with the law are interlinked exploratory pathways in the trajectories of lethal victimization among adolescents. Keywords: Homicide, Adolescent, Vulnerability, Secondary Data Analysis, Data Linkage, Violence .

Territorial conflicts in animals can inform aspects of human warfare, but civil war, with its shifting group identities, has not been previously observed. We report a rare, permanent fission in the largest-known group of wild chimpanzees (Pan troglodytes). Using 30 years of behavioral observations and network analyses, we describe a transition from cohesion to polarization in 2015 and the emergence of two distinct groups by 2018. Over the next 7 years, members of one group made 24 attacks, killing at least seven mature males and 17 infants in the other group. These findings indicate that group identities can shift and escalate into lethal hostility in one of our closest living relatives in the absence of the cultural markers often thought necessary for human warfare.