bluuebunny/crossref_metadata_2025 huggingface dataset:
Conducting Tissue Changes in Sudden Death
Authors: Ferris James A. J.
Published: July 2017

Four cases of sudden death are reported in which examination of the conducting system revealed: ( a) an old occlusion of the atrioventricular nodal artery, ( b) two cases of calcific destruction of nodal tissue, and (c) a haemorrhage in the His bundle. It is suggested that these findings are of significance in the cause of death.
Safety Aspects of the Rubber-Bursting CS Grenade
Authors: Ballantyne Bryan , Johnston W. G.
Published: July 2017

Sheep were used to assess the likelihood of injury from the slow-burning pellets which are explosively scattered from the rubber-bursting CS grenade. Compared with the numbers of pellets scattered, there was a very low incidence of minor damage to the eye. The total number of burns on the body was small, and most were scorches of wool with little actual damage to the skin. Sequential sacrifice of sheep after exposure revealed only slight congestion of nasal and tracheobronchial mucosa of twenty-four hours' duration. The results suggest that, in comparison with the total number of pellets scattered, the possibility of serious trauma resulting from the use of the grenade to disperse aggresive mobs is remote.
A Description of a New Community Forensic Psychiatric Service for Doctors
Authors: Craft M.J.
Published: July 2017

This essay describes an area of clinical interest explored by a consultant psychiatrist who was appointed for one purpose and developed another. It describes a new community forensic psychiatric service for an area which was Welsh speaking and had no penal units. As a result of the discharge of 500 in-patients from 8 psychiatric hospitals in 1961–63 a ‘spare' hospital became available as the centre piece of a service which is now described.
Human Seminal Orosomucoid and its Possible Use in Medicolegal Investigation
Authors: Sayce M. D. , Rees B.
Published: July 2017

Semen from men attending a fertility clinic and from men attending a post-vasectomy clinic have been studied for differences in orosomucoid (α1 acid glycoprotein) constitution. Semen samples from 400 individuals have been studied by immunodiffusion. The results of immunodiffusion and immunoelectrophoretic tests show that 14 per cent of men exhibit a high level of serum orosomucoid in their semen. The possible use of this difference as a marker in medicolegal investigation is discussed.
An Unusual Case of Carbon Monoxide Poisoning
Authors: Flanagan N. G. , Wootton D. G. , Smith G. , Goff D. K.
Published: July 2017

A case of suicidal carbon monoxide poisoning by car exhaust inhalation is described. It is unusual in that the subject at the beginning of the incident switched on a cassette tape recorder and recorded his dying sounds. The circumstances of the death were reconstructed experimentally and a correlation between the recorded sounds and experimental concentrations of carbon monoxide in the vehicle has been obtained.
An Epidemic of Antifreeze Poisoning
Authors: Walton E. W.
Published: July 2017

An incident is reported in which seven young garage employees consumed an antifreeze solution containing ethylene glycol, mistaking it for cherry brandy: one died and a second required haemodialysis. Within the succeeding few months, 11 persons were admitted to hospitals in the same locality having deliberately consumed antifreeze and of these, five were fatal. A brief review of the history and features of ethylene glycol poisoning is given and attention is drawn to the possible adverse effects of publicity given to unusual forms of death.
Fatal Pulmonary Embolism Due to Thrombosis of a Hepatic Cavernous Haemangioma
Authors: Dennis P. M.
Published: July 2017

A 19-year-old salesman developed severe right upper abdominal and back pain, 13 days prior to his death. On the day of his death he became acutely dyspnoeic and died shortly afterwards. A Coroner's autopsy showed bilateral massive pulmonary thromboembolism with widespread thrombosis in a hepatic cavernous haemangioma.
Disaster Victim Identification—The Transmission of Antemortem Dental Records by Telephoto
Authors: Churton M. C.
Published: July 2017

The purpose of this paper is to show how tele-photography may be used to allow for the speedy transmission of a wide variety of ante mortem data from its point of collection to the DVI personnel at the ID centre. It demonstrates a means of transmitting precise, detailed information of use for identification by dental and medical teams. In particular the procedure offers major advantages; the reduction in the hitherto unavoidable time lapse following collection of ante mortem information; the ability to transmit radiographs without loss of definition or diagnostic detail; and the ability to send forward detailed AM information without the necessity to transcribe or encode material prior to transmission.
The Resistance of Human Skin to Compressive Cutting
Authors: Careless C. M. , Acland P. R.
Published: July 2017

Tests to examine the resistance to cutting of several samples of post-mortem human skin have been conducted. The strength of the tissue is compared to that of a commonly used skin simulation, chamois leather.

Several effects are noted relating to the physical behaviour of skin and skin simulations in sharp edge contacts likely to produce tissue damage. Particular reference is made to the minor trauma suffered as a consequence of head to windscreen contact in road traffic accidents.
‘Dieseling’—A Potentially Lethal Phenomenon in Air Weapons
Authors: Buchanan J. D.
Published: July 2017

Air weapon injuries are well recognized for their potentially serious consequences. A fatal case of skull penetration by an airgun pellet it reported. The weapon was a standard −177 calibre air rifle that had been kept well oiled but unused. ‘Dieseling’ of oil in the barrel of an air weapon can produce muzzle energies far in excess of the legal maximum for an ‘uncertified’ weapon.
Apparent Suicide by Carbon Monoxide Poisoning in a Case of Insulinoma
Authors: Jenkins David , Fletcher Stephen M. , Hoole Alan
Published: July 2017

A woman, found dead in her garage, had a fatal level of carboxyhaemoglobin in her blood. Her recent medical history tended to support a suspicion of suicide but at autopsy a small islet cell tumour was discovered in her pancreas. Further investigations indicated that she had a high blood insulin level, sufficient to produce lethargy or coma, at the time of death. In the light of these findings it was concluded that her death was accidental. The techniques available for investigating the significance of islet cell tumours found at post-mortem are discussed.
Accidental Death in Fermentation Tanks: Report of Two Cases
Authors: Pedersen Mogens Bach , Simonsen Jørn
Published: July 2017

Two cases of accidental drowning in fermentation tanks are described. During the fermentation different toxic gases are generated among which carbon dioxide is supposed to be most dangerous since it is colourless and odourless. Special problems concerning fermentation of slurry are pointed out and precaution during work with these tanks is recommended.
Firearm Fatalities in Jordan
Authors: Abu Al Ragheb Sameeh Y.
Published: July 2017

During the 8-year period from 1973 through 1980 there were 221 firearm deaths autopsied and investigated by both departments of Forensic Medicine in Amman, Jordan. Although restrictions for legal possession of firearms are minimal, more illegal arms are possessed. Fifty-one per cent of such deaths were homicides, 31 per cent accidents and 18 per cent suicides, with a sharp increase in the incidence of homicides and accidents over the years. Firearms rank as the fourth cause of death of all cases of unnatural death, and homicidal firearm deaths constitute 29 per cent of all homicides in general.

All assailants and 80 per cent of the victims were males. Females were most commonly the victims of homicide. Police and armed forces comprise 20 per cent of the subjects studied and most of the fatalities involved children and young adults.
A Unit for ‘Psychopathic Disorder’ Patients in Broadmoor Hospital
Authors: Grounds Adrian T. , Quayle Marie T. , France Jennifer , Brett Timothy , Cox Murray , Hamilton John R.
Published: July 2017

Although the number of ‘psychopathic disorder’ patients admitted to special hospitals has declined over the last decade, a small number of such offenders continues to be admitted from the courts under hospital orders. One ward in Broadmoor hospital which admits young male patients in this category is described. An approach which integrates psychodynamic, behavioural and cognitive principles, and which attempts to understand patients' personality difficulties and offences in terms of their emotional and cognitive development, is adopted as a useful framework for formulating treatment needs and objectives. Within the ward setting a variety of psychological treatments are offered. However, the social environment within the hospital limits opportunities for realistic assessment and rehabilitation.
Identification of Spermatozoa through Fluorescent Microscopy
Authors: Banerjee P. K.
Published: July 2017

Ten fluorochromes and one ordinary double stain (for contrast) have been used to stain spermatozoa, both fresh and old, out of which Coriphosphin O yields the best result. When counterstained with eosin, it exhibits a very distinctive, characteristic F-body which can open a new avenue in the cytological differentiation of sex. For medico-legal examination of semen it can also clear confusion in identifying intact, degenerated or disintegrated spermatozoa from similar microparticles which may not be possible with ordinary stains.
Contact with the Police in Early Schizophrenia: Its Nature, Frequency and Relevance to the Outcome of Treatment
Authors: Macmillan J. Fiona , Johnson A. L.
Published: July 2017

The nature and frequency of contacts with the police were documented in a sample of 253 patients, prior to hospitalization for treatment of a first schizophrenic illness. Contact had occurred in nearly 22 per cent of the sample, and was related to male sex, unemployment and disturbed behaviour. Those with police contact did not differ from their peers in terms of race, mother tongue or duration of hospitalization, but there is a suggestion of an increased liability to relapse.
Simultaneous Determination of FUC and PGM1 by Isoelectric Focusing
Authors: Kido A. , Komatsu N. , Oya M. , Sekiyama S.
Published: July 2017

This paper describes a simple procedure for the simultaneous detection of FUC and PGM1 in semen, seminal stains, dental pulps and hair roots after separation by isoelectric focusing using Ampholine pH 5–7. The gel plate was first stained for FUC using an agarose overlay with a buffer of pH 7.5. After reading the FUC types, the FUC overlay was removed and replaced with an agarose overlay for PGM. The results show that the method is useful in medicolegal individualization of seminal stains and teeth when only small samples have to be examined.
The Police as a Referral Agency for Psychiatric Emergencies—A Review
Authors: Fahy Thomas A.
Published: July 2017

The expansion of community based psychiatric care and the discharge of long-stay psychiatric inpatients may lead to an increase in police contacts with the mentally ill. This paper describes the demographic and clinical profiles of these patients and reviews the problems which may be encountered by the police in the recognition, management and appropriate referral of the mentally ill.
GC-NPD and GC-MS Analysis of Preserved Tissue of Bhopal Gas Disaster: Evidence of Methyl Carbamylation in Post-Mortem Blood
Authors: Sriramachari S , Rao G J , Sharma V K , Jadhav R K , Saraf A K , Chandra Heeresh
Published: July 2017

Twenty-five preserved autopsy blood samples of Bhopal toxic gas exposed victims were analysed by gas chromatography (GC) coupled with either Nitrogen-Phosphorous detector (NPD) or mass spectrometer (MS) for the presence of methyl carbamyl valine in terms of valine methyl hydantoin (VMH). 84% of these samples showed a positive test for VMH on GC-NPD and the identity of the peaks were further confirmed on GC-MS. The concentration of VMH in the gas-affected positive blood samples ranged from 2.56 to 51.28 nanomoles. These results indicate entry of methyl isocyanate (MIC), one of the constituents of the toxic cloud caused by the disaster, into the blood stream of victims who had inhaled gas.
GC-MS Identification of MIC Trimer: A Constituent of Tank Residue in Preserved Autopsy Blood of Bhopal Gas Victims
Authors: Chandra Heeresh , Rao G J , Saraf A K , Sharma V K , Jadhav R K , Sriramachari S
Published: July 2017

Based on the external and internal findings of Bhopal gas disaster victims, it was apparent that the gases and particulate matter came out as an aerosol. This was possibly the pyrolysed, reformulated, reconjugated suspension of constituents of the tank E-610 of Union Carbide India Limited, Bhopal, while it was claimed to be methyl isocyanate (MIC) only. It was postulated by the manufacturer of MIC, that the material inhaled by the victims of the Bhopal gas disaster does not cross the lung barrier (UCC press conference on 14th December 1984). It was observed that the more the victims ran, the more aerosol they inhaled and the fatalities were observed in such victims.

The tissues, which were preserved in the deep freeze, were randomly selected and analysed by GC coupled with MS (ITD) Finnigan MAT, UK. 14 out of 34 autopsy cases showed MIC trimer peak in extracts of blood. This was one of the constituents of the aerosol and was also located in the tank residue, thereby proving that the trimer had passed the lung barrier
Hospital and Police Procedure When a Patient Absconds from a Mental Hospital
Authors: Andoh B
Published: July 2017

Despite several studies of absconding from mental hospitals, what the hospitals and the police do following a patient absconding from a mental hospital has been largely ignored. This article fills that gap. It looks at the procedure followed by three conventional mental hospitals in south-east England and the procedure followed by the three Police Forces in those hospitals' catchment areas. It is based on twelve months of fieldwork, during which period the policy files of all the hospitals were studied and, among other things, interviews were carried out with a cross-section of both the hospitals' staff and police officers. The crucial factors determining the type of action taken by the hospitals or the police were found to be whether the matter was one of grave concern and whether the absconder was a compulsory patient. Certain aspects of the procedure were found to be unsatisfactory and suggestions for improving them are made.
Is Diversion Just a Diversion?
Authors: Prins Herschel
Published: July 2017

This paper examines the diversion of the mentally disordered offender against a background of the treatment of the mentally disordered in general. Some myths about incarceration are explored and the proposal is made that diversion is not a new idea. Finally, caution is expressed in the espousal of diversion in an uncritical fashion.
The Criminal Procedure (Insanity and Unfitness to Plead) Act, 1991
Authors: Dolan M C , Campbell A A
Published: July 2017

Procedures relating to Insanity and Fitness to Plead are reviewed with special emphasis on the problems encountered with previous legislation.

The introduction of the new Criminal Procedure (Insanity and Unfitness to Plead) Act 1991, on 1 January 1992, offered greater discretion in the disposal of these defendants, but fell short of many of the recommendations made by those advocating reform. As yet, too few cases have passed through the courts to highlight particular deficiencies in the unreformed parts of the Act, but the benefits are already apparent. Finally, some of the potential pitfalls of supervision and treatment orders and other disposals are discussed and an insanity case, dealt with under the new legislation, is presented.
Age Estimation by Chinese Permanent Teeth with Image Analysis
Authors: Xiaohu Xu , Jiazhen Zhu , Philipsen H P , Pang K M
Published: July 2017

A total of 567 human teeth except third molars were studied to estimate age, using a combined method of multiple regression analysis of data from a scoring system, direct measurements with image analyser, and logarithmic transformation. As a result, the standard errors of estimate were 4.8–5.4 years in the working sample, and 2.9–5.4 years in the control sample respectively, by using a single tooth. By testing the formulae on forensic autopsy cases in Guang Dong and Guang Xi, (People's Republic of China), it is demonstrated that the standard error of estimate is 3.7 and 2.6 years respectively for any single tooth (incisor, canine, premolar or molar) except the third molar.

Age determination from multiple teeth of the same individual has also been studied. As a result, according to the different age grouping, the standard errors of estimate ranged from 0.8 to 2.6 years (2 teeth from the same individual) and 0.6 to 2.3 years (3 teeth from the same individual). It is concluded that the method presented here is helpful in improving the accuracy of age determination from teeth.
What Price the Concept of Psychopathic Disorder?
Authors: Prins Herschel
Published: July 2017

The current concept of psychopathic disorder is reviewed against a short historical background. Aetiology is commented upon briefly and key characteristics described. Support is provided for the view that the concept has a degree of usefulness in clinical management provided it is viewed in a focused and restricted fashion.

‘And thus I clothe my naked villainy … and seem A saint when most I play the devil.’

Richard III (Act I. Sc.iii)
The Coroner's System and Under-Reporting of Suicide
Authors: Cooper P N , Milroy C M
Published: July 2017

This study investigates the under-reporting of suicide with particular reference to differences between sex and age groups and the various modes of suicide. The study was performed retrospectively using the files of H M Coroner for South Yorkshire (West) over the years 1985 to 1991. There were 536 deaths judged on the balance of probability to be suicidal in nature. Only 60 per cent of these deaths received a suicide verdict and would therefore register in official suicide statistics. A significantly smaller proportion of females (51.7 per cent) received a suicide verdict than males (64.5 per cent). Of the young females (<45) 61.7 per cent were given a suicide verdict compared to 46.6 per cent of older females (45+).

These differences are explained by different preferences for mode of suicide, in particular for poisoning using solids or liquids. Only 40 per cent of cases within this category received a suicide verdict. Drowning showed an even smaller percentage (24 per cent). Self-immolation (42 per cent) and jumping from a height (51 per cent) were also under-represented. Of these, self-poisoning, drowning and jumping from a height were relatively popular among females. In contrast, common causes of death favoured predominantly by males — hanging and carbon monoxide poisoning — received a high percentage of suicide verdicts (81 per cent and 90 per cent).

Thus official suicide statistics produce a distorted view of the suicide population with relative underreporting of females, particularly older females, and marked under-reporting of some causes of death, notably poisoning using solids or liquids, drowning, self-immolation and jumping from a height.
Violence in Clinical Forensic Medicine
Authors: Schnieden Vivienne , Stark Margaret , Payne-James Jason
Published: July 2017

Objective: to investigate the levels of physical and verbal violence experienced in the preceding year by doctors working in clinical forensic medicine.

Design and subjects: anonymised questionnaire sent to all full members of the Association of Police Surgeons.

Results: 517 eligible questionnaires were returned; 18.2 per cent of respondents had experienced physical violence, a total of 150 incidents. Of those incidents ‘warning signs’ of violence had been present in only 25 per cent. A total of 54 working days were lost. Injuries included a fractured wrist and corneal scarring.

Of the respondents, 65.5 per cent had experienced verbal violence (of which the most common type was obscenity); 11.8 per cent had received training in dealing with verbal violence and 10.4 per cent in dealing with physical violence; 88 per cent believed that training on how to deal with violence should be part of police surgeon/forensic medicine training.

Conclusion: verbal and physical violence are common in clinical forensic medicine. Training in dealing with these issues should be introduced.
1. Factitious Post Traumatic Stress Disorder: A Case Report
Authors: Neal Leigh A , Rose Cpl Michael C
Published: July 2017

A 24-year-old man presented with a convincing history of Post Traumatic Stress Disorder (PTSD). He claimed to be the victim of a widely publicized ‘human bomb’ attack by the IRA in Northern Ireland when he was serving with the armed forces. Psychometric tests for PTSD confirmed his symptoms. A subsequent check of public and military records demonstrated that he was a serviceman at that time, but showed conclusively that he could not have been present at the terrorist incident.
3. Sudden Death caused by Testicular Germ Cell Tumour
Authors: Dada Mahomed A , Van Velden D J J
Published: July 2017

Most cases of sudden unexpected ‘natural’ death are due to primary disorders of the cardiovascular, respiratory and central nervous system. Sudden death due to a previously undiagnosed malignancy is rare in young, apparently healthy subjects. We report an unusual cause of sudden unexpected death due to pulmonary tumour embolism complicating an undiagnosed germ cell tumour of the testis in a 37-year-old white male. Although death due to testicular tumours is not uncommon in young adult males, it rarely follows pulmonary embolism secondary to inferior vena cava (IVC) tumour invasion. A review of the literature revealed four other cases with a similar mechanism of death.
Chronic Alcoholism in a Forensic Material. 1. Social Parameters in Alcoholics
Authors: Thomsen Jørgen L.
Published: July 2017

An investigation was performed on material from deceased from the Copenhagen County, examined at the Institute of Forensic Medicine during the period 1985–1989.

The basis and the reliability of the diagnosis of chronic alcoholism in a forensic post-mortem material is discussed. The frequency of alcoholics in the autopsy material varied between 25 per cent and 30 per cent annually.

The frequency of women was significantly lower than that of men. The alcoholics were generally younger than controls, they were more often divorced, but cohabited with the same frequency as controls. Both the alcoholics and the controls belonged mainly to the lowest social classes.

Alcoholics lived in flats and died in the living room more often than controls.

Special attention is given to persons dying in bathtubs and on staircases.

The interval between‘last seen alive’ and‘found dead’ was significantly longer in alcoholics, signifying loss of social network.

Both alcoholics and controls generally lived under poor social conditions, more pronounced in the former.
Can the Law Serve as the Solution to Social Ills? The Case of the Mental Health (Patients in the Community) Act, 1995
Authors: Prins Herschel
Published: July 2017

The background to the Mental Health (Patients in the Community) Act, 1995 is reviewed briefly. Some problems concerning the Act's provisions for‘supervised discharge’ are then discussed. Some more general extrapolations follow concerning the problems of legislating for social and personal‘ills’.
Deaths among Drug Abusers in South-East Scotland (1989–1994)
Authors: Bentley A J , Busuttil A
Published: July 2017

A survey of deaths of chronic drug abusers who came to medico-legal autopsy in the South-east of Scotland revealed a total of 179 fatalities in the six-year period between 1989 and 1994 inclusive. There was an almost linear increase in the number of such deaths reported to the Procurator Fiscal per year over this period, rising from 14 in 1989 to 45 in 1994. The majority of deaths (86%) were seen in males and the peak age at death was in the third decade of life. In the majority of cases (60%) death was deemed to be accidental and most were due to accidental drug overdoses, with methadone being the drug most commonly detected on toxicological analysis. The number of HIV-positive cases peaked in the years 1991 and 1992 with a decline over the subsequent two years.
Predictors of Coroner's Verdict: A Logistic Regression Model
Authors: Salib E
Published: July 2017

This study is an attempt to understand the effect of various factors that are likely to have influenced North Cheshire's Coroners during a five-year period in their decision to return a‘suicide’ or an‘open’ verdict.

Based on the logistic model, the main factors that appeared to have influenced a Coroners decision are: intimation of intent, method of death and alcohol problem.
A Study of Admissions to an Independent Medium Secure Hospital
Authors: Moss Katrina R , Green Christopher M , Naismith Laurence J
Published: July 2017

A study was conducted of 142 admissions to Stockton Hall Hospital, a private hospital offering medium secure psychiatric treatment. The study examines the characteristics of patients admitted to Stockton Hall Hospital in comparison with patients admitted to National Health Service secure psychiatric facilities. Stockton Hall Hospital demonstrated an increased flexibility as to the types of patients it was prepared to accept, particularly relating to difficult and non-offender patients. There is discussion of how the private sector may be meeting a national need, resulting from the inadequacies within the National Health Service, for psychiatric patients requiring treatment in conditions of security.
1. Accidental Intraventricular Vincristine Administration: An Avoidable Iatrogenic Death
Authors: Lau Gilbert
Published: July 2017

A patient with acute lymphoblastic leukaemia was mistakenly given vincristine intraventricularly, as part of an intensified course of chemotherapy. Despite a CNS washout and supportive treatment, the patient developed progressive ascending paralysis, gradually lapsed into coma and died some 10 days later. Autopsy and post-mortem histological examination showed evidence of brain death caused by florid encephalomyelitis, apparently induced by the intraventricular administration of vincristine.
Disorders of Sexual Preference, or Paraphilias: A Review of the Literature
Authors: Gayford J J
Published: July 2017

By their very nature, disorders of sexual preference (ICD-10) or paraphilias (DSM IV) are bizarre patterns of sexual behaviour that have diverse manifestations and are of complicated sexual orientation. Some are harmless, others are sad, robbing sufferers and possibly their partners of loving sexual relationships. Psychopathology within this group of disorders may lead to criminal behaviour, ranging from infringement of decency to some of the most heinous crimes known. In a lifetime of practice no professional in any sphere of law or medicine will see a full cross-section of these conditions, as some are rare and they do not all present to one professional group. The nomenclature is confusing, with its Greek, Latin, French and Portuguese origins, together with eponymous terms. At least 40 different paraphilias have been named (Money, 1988) but these do not cover the full extent of the field.
Compensation Claims following Road Accidents: A Six-Year Follow-Up Study
Authors: Bryant Bridget , Mayou Richard , Lloyd-Bostock Sally
Published: July 2017

Systematic information was obtained on 96 subjects who were all those seeking compensation from a cohort of 172 consecutive road accident injury victims. Subjects were interviewed immediately after the accident, and again at three months and one year. Further telephone or postal information was obtained about compensation proceedings for up to six years.

Compensation proceedings were often prolonged and final settlements were modest and late in relation to the losses suffered. Awards were largely used to make up financial losses. However, they failed to meet needs, especially the considerable early financial problems. There was no evidence that subjects exaggerated their losses; many preferred not to claim or to settle early. There was no evidence that settlement was followed by significant change in clinical state. There was considerable dissatisfaction with the procedures for obtaining compensation. Subjects were often more concerned with recognition of their distress and suffering than with the size of financial settlements. Seeking compensation was not a major predictor of medical and social outcome.
1. Suicidal Attempt with a Handsaw
Authors: Betz P , Eisenmenger W
Published: July 2017

The case of a 54-year-old male suffering chronic schizophrenia is reported. The deceased was found in the workshop of his house lying in a pool of blood. The blood loss was caused by several stab wounds, in particular to the neck, due to the use of a screwdriver. Additionally, two superficial cuts were detected at the front of the neck, with a wave-like course consisting of several linear scratches apparently caused by the teeth of a handsaw found near the corpse.
Detention of In-Patients under Section 5(2) of the Mental Health Act 1983
Authors: Salib Emad , Iparragirre Boni
Published: July 2017

All applications of s.5(2) of the Mental Health Act 1983, allowing the emergency detention of voluntary in-patients in North Cheshire between 1985 and 1995, were reviewed to examine general trends in its use and to assess variables likely to influence its outcome. Of the 877 applications implemented (4% of all admissions), 500 (57%) were converted to longer-term detention under the Act, 396 (45%) were converted to s.2 and 104 (12%) to s.3. The other 377 (43%) detained patients under s.5(2) regained informal status. The review found that time of application of section, length of hospital stay prior to application, medical officer's grade, use of s.5(4) and clinical diagnosis are best predictors of s.5(2) outcome.

The results are similar to other published studies and seem to reflect a national pattern, possibly implying that patients detained under this short-term detention order have an almost equal chance of either regaining their voluntary status or being detained under another section by the end of the 72 hours. This may raise questions about the purpose of s.5(2) as expressed by the Mental Health Act Commission.
An Analysis of When Absconders from Mental Hospitals in England and Wales May Be Retaken
Authors: Andoh Benjamin
Published: July 2017

Clear statutory authority for retaking absconders from mental hospitals has always existed since county asylums, the forerunners of mental hospitals, were first built in the nineteenth century. This article analyses the period within which such absconders may be retaken. It considers both offenders and non-offenders who abscond or go absent without leave and looks critically at the concept of ‘discharge by operation of law', a rule of practice (rather than a statutory rule) now eradicated by s.2(1) of the long overdue Mental Health (Patients in the Community) Act 1995.
The Effect of a ‘One for the Road’ Drink of Hard Liquor, Beer or Wine on Peak Breath Alcohol Concentration in a Social Drinking Environment with Food Consumption
Authors: Breen Martin H , Dang Qui T , Jaing Joseph T , Boyd Greta N
Published: July 2017

Thirteen healthy subjects (seven men and six women) participated in three drinking studies to examine the maximum increase of breath alcohol concentration (BrAC) and the time taken to reach the maximum BrAC (peak) after a subject finished a ‘one for the road’ drink in a social environment with food consumption. They consumed hard liquor in the first study, beer in the second and wine in the third. Each study consisted of two days. Day 1 served as a control in which the subjects were monitored by breath tests to establish their basic BrAC curves. Day 2 was a repeat of Day 1 with the addition of the final drink ‘for the road’ consumed by the subjects once their BrAC started to decline.

The average increase in BrAC was 0.017 ± 0.009% for hard liquor, 0.016 ± 0.008% for beer, and 0.016 ± 0.007% for wine. The average time to peak was 18 ± 8 minutes for hard liquor, 16 ± 2 minutes for beer, and 20 ± 10 minutes for wine. The BrAC increase and the time to peak seemed to be independent of the type of alcoholic beverage consumed.
Psychiatric Disorders in First-Degree Relatives of Patients with Opiate Dependence
Authors: Ahmed A. G. , Salib Emad , Ruben Sue
Published: July 2017

High rates of psychiatric disorders, particularly major depression, alcoholism, drug-use disorder and antisocial personality disorder in the relatives of opiate-dependent patients compared with normal controls, have been reported in some previous studies. This study was designed to evaluate the prevalence rates of drug-use and other psychiatric disorders in the first-degree relatives of opiate-dependent patients and compare these with rates in the first-degree relatives of surgical and psychiatric patients.

A case-control study was conducted to compare the prevalence of psychiatric and drug-use disorders (which were estimated by the Family History Method) in 241 biological first-degree relatives of 50 opiate-dependent patients to that in 235 and 222 first-degree relatives of 50 surgical and 50 psychiatric patients respectively. The main outcome measure was the relative risk (expressed as odds ratio) of psychiatric and drug-use disorders.

First-degree relatives of opiate-dependent patients were found to have significantly higher rates of drug-use and antisocial personality disorders, compared with relatives of surgical and psychiatric probands. The odds ratio for alcoholism appeared significantly higher only in first-degree female relatives of opiate users, suggesting effect modification by sex.

The study provides further evidence for the higher rate of drug-use disorder in the first-degree relatives of opiate-dependent patients. These findings suggest that familial drug-use disorder contributes to a vulnerability to opiate misuse.

Implications of these findings for the classification and treatment of opiate dependence are discussed.
A Study of Methadone in Fatalities in the Strathclyde Region, 1991–1996
Authors: Cooper Gail A.A. , Seymour Alison , Cassidy Marie T. , Oliver John S.
Published: July 2017

There was a substantial increase in the percent of drug screens testing positive for methadone between 1991 and 1996 in the Strathclyde region of Scotland. Seventy-nine per cent (n=136) of these deaths were drug-related, involving methadone either alone or in combination with other drugs such as diazepam, temazepam, alcohol and morphine. The involvement of methadone in the majority of these fatalities was due to diversion of legitimate supply. This paper highlights the dangers of resuming methadone consumption following a period of abstinence or when taken in combination with other drugs.
With Free Health Services, Why Does the Brazilian Working Class Delay in Seeing the Doctor?
Authors: Paine P , da Gloria Wright M
Published: July 2017

The length of delay in seeing a physician was related tp perceived difficulty in access to services and to scepticism and doubt about the effectiveness of medical care. Attention is called to the importance of the doctor-patient relationship in fostering prompt patient action.
The Role of Doctors in Influencing Infant Feeding Practices in South India
Authors: Fidler Katy , Costello Anthony
Published: July 2017

Infant feeding practices are influenced by many factors including culture, household income, literacy, advice from health care workers and advertising. In South India doctors play a very significant role in influencing a mother's decision about when or whether to supplement breastfeeding with formula feeds. Doctors exert their influence on mothers both directly and indirectly, and they are increasingly targeted by commercial infant food companies. Doctors need continuing education about nutrition education, lactation management, and a greater awareness about the influence of inappropriate promotional practices by companies.
Antipersonnel Mine Injuries in Somaliland: The Pattern of Injury
Authors: De Wind Christina M
Published: July 2017

Twenty patients injured by antipesonnel mines are described, with the emphasis on the relationship between the pattern of injuries, type of accident and age of the patients. Particularly severe injuries were seen in patients who travelled in the front seat of cars. Practical advice is given for the treatment.
Skin Cancer in Zaria, Nigeria
Authors: Yakubu Alkassim , Mabogunje Oluwatope A
Published: July 2017

Skin cancer from 775 patients in the savannah showed a preponderance of squamous cell carcinoma (SCC) of the leg related to neglected, poorly managed and chronic ulcers or scars from burns or injuries. SCC of the head and neck had no predisposing factor. Malignant melanoma overwhelmingly affected the feet, dermatofibrosarcoma affected the trunk and Kaposi sarcoma affected the limbs. Basal cell carcinoma (BCC) comprised only 2% of all skin cancers. The 18 albino patients had a higher frequency of both SCC and BCC mostly on the head and neck. Excisional surgery was generally effective, the wounds being closed primarily or by means of flaps and skin grafts. However, 98 patients required amputation below the knee for tibial involvement by SCC. The prognosis and health care costs of skin cancer will only be improved if burns and injuries are adequately treated.
Surgical Ascariasis in Children in Kashmir
Authors: Pandit Satish Kumar , Zarger Habib Ullah
Published: July 2017

A retrospective study of 85 children aged 3–12 years revealed 25 cases who needed surgical intervention due to ascariasis. The surgical conditions found at laparotomy were intestinal obstruction (18) appendicitis (3), ileal perforation (2), biliary ascariasis (2). The study highlights the high incidence of surgical ascariasis among children with abdominal complaints in an endemic area.
Non-Specialist Management of Tropical Talipes
Authors: Scott R , Evans S
Published: July 2017

Talipes equinovarus (clubfoot) is a complex deformity which in the West is usually treated by trained orthopaedic surgeons. In developing countries, however, most clubfeet will need to be treated by medical officers lacking specialist training. We report one author's experience in treating clubfeet in a small, rural East African hospital and review the literature in order to assist other non-specialists in managing this difficult condition in the face of poverty and poor parental compliance.
Observed versus Expected Obstetric Complications: An Assessment of Coverage of Obstetric Care in Developing Countries
Authors: Pittrof Rudiger
Published: July 2017

The objective of this study was to evaluate access to obstetric care in a rural district in East Africa using easily collected and evaluated data and avoiding expensive field surveys, complicated study design or statistical methods.

The number of observed obstetric complications occurring during 12 months in a rural East African district hospital (the only institution with surgical facilities and access to blood transfusion in the district) were compared to the number of expected complications the district should ‘generate’.

Of the expected > 10 000 deliveries <25% took place in the district hospital. The place of confinement for the other deliveries was not determined. As compared to the total number of expected conditions within the study district <25% of the breech and <45% twin deliveries took part in the district hospital and < 10% of pregnancies complicated by placental abruptions and < 5% of the pregnancies complicated by placenta praevia were managed in the district hospital.

Comparing the number of serious pregnancy complications which were managed in the hospital to the total expected number for a particular region allows a simple assessment of the accessibility of obstetric care. This ratio might be more useful when evaluating obstetric care than traditional parameters as it stresses the importance of accessibility of care for the whole community.
Why Wait so Long for Child Care? An Analysis of Waits, Queues and Work in a South African Urban Health Centre
Authors: Bachmann Max O , Barron Peter
Published: July 2017

Long waits at large urban clinics obstruct primary care delivery, imposing time costs on patients, deterring appropriate utilization and causing patient dissatisfaction. This paper reports on an innovative attempt by staff in a large South African urban health centre to analyse a system of queues and preventive and curative services for pre-school children, and thereafter to evaluate changes. The study had a cross-sectional work study design, with repeated measurement of waiting times after 13 months. At baseline the preventive clinic was found to have several inessential processes and waits; these were eliminated or overlapped, and clinic sessions per week were increased. A year later median waiting times had decreased substantially in the preventive clinic, but had increased in the curative clinic. Simple research can explain long waits, inform and measure changes, and provide evidence to justify primary care integration and would be useful in health centres and hospital outpatient departments in developing countries.
Prevalence of Hepatitis B Surface Antigen and HCV Antibodies in Hepatocellular Carcinoma Cases in Karachi, Pakistan
Authors: Mujeeb Syed Abdul , Jamal Qamar , Khanani Rafique , Iqbal Nayyer , Kaher Shahnaz
Published: July 2017

Hepatocellular carcinoma (HCC) is a common cancer the world over. In Pakistan it has an incidence of 8/100 000 per annum. To assess the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in biopsy proven cases of HCC a serological study was conducted at Screening Laboratory of Blood Transfusion Services, Jinnah Postgraduate Medical Centre. Of 54 sera of HCC tested for HBV and HCV infections, 67% showed HBV infection, and 33% HCV infection. Among them 24% were positive for both HBV and HCV infections. No HBV and HCV infection was found in 24% cases of HCC. Our findings suggest viral association for most of the HCC cases reported in the country. We suggest an immediate intervention strategy to prevent the spread of HBV and HCV infections by mandatory screening of blood for HBV and HCV infections, and the use of disposable/sterilized needles, instruments for all invasive procedures. For the prevention of vertical transmission of HBV infections all pregnant women should be screened and vaccinated and HBV vaccination should also be included in EPI (expanded programme for immunization).
A 3-Year-Old Boy with Tuberculous Epididymo-Orchitis
Authors: Mbala L. , Ilunga N , Kadinekene K
Published: July 2017

The authors report the case of a 3-year-old child with tuberculous epididymo-orchitis. The only presenting symptom was testicular, epididymis and scrotal swelling and pain. Diagnosis was reached after histopathological examination of epididymis and testis tissues. The response to antitubercular drugs given with prednisolone was rapid. This case emphasizes the importance of considering tuberculosis in differential diagnosis of testicular and epididymal enlargement in young children in an endemic area despite the absence of systemic, pulmonary and urinary manifestations.
Television Violence, Conflict, Realism, and Action: A Study in Viewer Liking
Authors: Diener Ed , Woody Lisa W.
Published: July 2017

In three studies, the liking for various types of television content within adventure programs was examined In studies one and two, measures of college students' personalities were used to predict liking for program content varying on four dimensions: violence, action, realism! and conflict. In study three, families from diverse socioeconomic backgrounds were shown adventure shows that were high or low in violence and matched on other content dimensions. The findings from these studies suggest that the average viewer somewhat dislikes the typical violence portrayed in adventure shows; however, conflict seems to enhance liking for adventure shows.
Housewives and Daytime Serials in Japan: A Uses and Gratifications Perspective
Authors: Miyazaki Toshiko
Published: July 2017

This research attempts to clarify the social end psychological circumstances of housewives which lead to daytime television serial viewing. The utility of one aspect of the uses and gratifications approach presented by Rosengren and Windahl (1972) is tested. A total of 183 housewives in Tokyo were surveyed, and the associations between serial or television viewing and 23 main variables were obtained and analyzed. The results suggest that psychological factors such as dissatisfaction in family relationships and personality variables are more related to serial viewing than social-structural variables such as Interaction Potential. However. contrary to the theoretical expectation. Interaction Potential shows a positive association with television viewing in general. This result is discussed from socioeconomic. cultural. and theoretical viewpoints. Based on the results. some suggestions ere mode for the future development of audience analyses.
Fitting Information Presentation Formats to Decision-Making: A Study in Strategies to Facilitate Decision-Making
Authors: Bybee Carl R.
Published: July 2017

A theoretical approach to structuring communication messages is outlined and an initial test of the approach is performed. The research question addressed is whether the job of decision makers can be made any easier by providing them with information organized to fit the decision-making strategy they intend to execute. An experiment employing a three-factor randomized design was executed (N = 211). The three independent variables were decision-making strategy employed (disjunctive vs. maximax). information format (alternative-by-alternative vs. attribute-by-attribute), and complexity of decision made (high vs. low). The dependent variables were several dimensions of decision-making facilitation (information recall, satisfaction, time and cognitive strain). Planned comparisons were used to directly test four hypotheses derived from the research question. The results provided some limited support for the hypothesized importance of matching information presentation formats to decision-making strategies to facilitate decision-making. However, the most effective pattern of matching turned out to be in the opposite direction of prediction. Several methodological and conceptual explanations for the results are discussed.
Audience uses and Gratifications: An Expectancy Model
Authors: Galloway John J.
Published: July 2017

Investigations as to why people attend to mass communications have generally not dealt with one of the assumed basic concepts of uses and gratifications research, namely, expectations about gratification. Nor have studies i n the area shown much concern for the question of whether gratifications sought from exposure to media are subsequently obtained; and if so, or if not, how this affects later expectations and patterns of exposure. This article describes a cognitive theory of motivation, expectancy-value theory. It then derives an expectancy model of media exposure in the framework of uses and gratifications research-a model which utilizes expectancy-value measures of audience gratifications in order to be able to predict subsequent levels of exposure to media. The model is illustrated by a small set of three-time panel data, the results of which support the view that the model has predictive validity. The article concludes that expectancy-value theory holds promise for extending uses and gratifications research beyond studies of the “charting and profiling” of reasons for attending to the media.