bluuebunny/crossref_metadata_2025 huggingface dataset:
The Detection of the HLA-A1 Antigen in Bloodstains
Authors: Hodge D.G. , Wolf E. , Lincoln P.J. , Festenstein H. , Dodd B. E.
Published: July 2017

The wealth of antigens in the HLA white cell blood group system makes their detection in bloodstains a fascinating possibility for the forensic serologist. The work presented in this paper is concerned with the detection of the HLA-A1 antigen in bloodstains. The essence of the technique employed is the inhibition of the lymphocytotoxic activity of anti-HLA-Al antisera by HLA-A1 bearing bloodstains.

A 4 cm length of bloodstained thread was used for each test and incubation with the HLA antisera was overnight at 4°C. An inhibition of the cytotoxic activity of the HLA-A1 antiserum of 55–100 per cent was taken as indicative of the presence of the HLA-A1 antigen in the stain, while an inhibition of 0–45 per cent indicated the absence of the antigen. Inhibitions in the range 46–54 per cent were regarded as indeterminate.

Three antisera were used in parallel as these produced more satisfactory results than those of a single antiserum. The HLA-A1 antigen appeared to show little loss of activity in stains up to 230 days old.

The additional finding that whole blood samples could be successfully typed for the HLA-A1 antigen using this inhibition technique is of particular importance because, in forensic casework, fresh blood samples taken into the media ideal for normal HLA typing may not always be available.

Lawyers should take note that, although the HLA system promises to be of great value in forensic problems, owing to the highly specialized nature of the techniques employed it will not be immediately applicable to routine case-work.
Diatoms and Drowning—A Review
Authors: Peabody A.J.
Published: July 2017

The use of diatoms in the diagnosis of cause of death by drowning is reviewed. The arguments for and against the method are described, and the possible reasons for divergent opinions explored. Attention is drawn to the observations of some workers that the organs of non-drowned subjects may contain diatoms. Important papers in Hungarian, German, Russian and French particularly relevant to this subject have been translated and their essence presented here.
Injuries Caused by Falls from Heights
Authors: Goonetilleke U. K. D. Albert
Published: July 2017

The pattern of injury in deaths from falls from heights is described. The mechanisms of injury are compared with the primary site of impact and the heights from which the victims fell.
Suicide by Home-Made Gun
Authors: Goonetilleke U. K. D. Albert
Published: July 2017

A case of suicide by bullet injury to heart caused by home-made gun is reported.
Ante-Mortem Injury or Post-Mortem?—Diagnosis Using Histamine as a Marker
Authors: Sivaloganathan S.
Published: July 2017

A relatively simple method for differentiating ante-mortem from post-mortem injuries is described. It involves the demonstration of an increase in free histamine at sites of injury by fluorescent microscopy on the basis that release of free histamine is a very early vital reaction to injury.
Effect of Ethanol on Drug Levels in Blood in Fatal Cases
Authors: King L. A.
Published: July 2017

The cumulative frequency distributions of postmortem blood levels of four centrally-acting drugs (pentobarbitone, amitriptyline, chlormethiazole and dextropropoxyphene) have been derived from fatalities involving either the named drug only or the drug in association with ethanol only. For each drug, the presence of ethanol markedly reduced the concentration at which a given proportion of fatalities occurred.
A Morphometrical Study of Laryngeal Cartilages
Authors: Watanabe Hiroshi , Kurihara Katsuyoshi , Murai Tatsuya
Published: July 2017

Morphometrical examinations of the triticeous and thyroid cartilages were carried out on 232 autopsy cases, the age of which was between 0 and 90 years.

1. The triticeous cartilage was more frequently found in males than in females. Bilateral presence was more frequent than unilateral presence.

2. The length of superior horn was usually shortened by the presence of triticeous cartilage. This was notable in the cases of unilateral presence.

3. The inclined angle of superior horn was not constant with age and while ageing it showed antero-medial inclination in male, whereas postero-lateral inclination in female.

4. Only some of the male cases over the age of 39 years showed anterior inclination of less than 90°.

5. Most of the superior horns were straight as a whole, but in some cases over the age of 19 years the horns were bent forward or backward.

Our result that the length of superior horn was related to the presence of triticeous cartilage, and that the inclined angle of it was varied by age and sex serves not only to identify a body but also to consider the fracture of superior horn at cervical oppression.
Forensic Pathology in Nigeria: The Ife Experience
Authors: Odesanmi W. O.
Published: July 2017

A review of 400 consecutive medico-legal autopsies in the Ife-Ijesha zone of Western Nigeria is reported to highlight the medico-legal problems in Nigeria. The majority of these cases (71 per cent) were accidental deaths. There were only 44 sudden natural deaths out of which 18 were children under 15 years old. In only 16 cases (4 per cent) were the circumstances consistent with suicide; and there were 15 homicidal deaths. There were 9 cases in which it was not possible to determine the cause of death, and 2 deaths from criminal abortions. The results were compared to those from other parts of Africa.
Chlorate Poisoning—Two Cases Diagnosed at Autopsy
Authors: Cunningham Nancy E.
Published: July 2017

Two cases of chlorate poisoning presenting as unexpected sudden deaths are described. Both cases had previous psychiatric histories but poisoning was not seriously considered as the cause of death prior to autopsy, when the finding of chocolate-coloured fluid blood alerted the pathologist to the cause of death.
Estimation of Postmortem Interval from Rectal Temperature by Use of Computer (III)—Thermal Conductivity of the Skin
Authors: Kuroda Fusakuni , Hiraiwa Kouichi , Oshida Shigemi , Akaishi Suguru
Published: July 2017

The postmortem rectal temperature fall is the most reliable objective finding for estimation of the postmortem interval within one or two days. However, the thermal properties of human corpses are little known when applying the heat transmission theory to the temperature fall of a human corpse, which is assumed theoretically to be an infinite cylinder. Therefore, the thermal conductivity of excised human skin was measured by the transient hot-wire method. The values in 12 specimens averaged 0.30 Kcal/m.h.°C. The theoretical error due to the experimental conditions such as the size of specimen or heating probe was within about five per cent, and the deviation of three measurements for each material was slight. Accordingly, the deviation of thermal conductivity in 12 materials was considered to be due to the individual disparity in age, sex and postmortem changes.
Insects Associated with Exposed Human Corpses in Auckland, New Zealand
Authors: Smeeton W. M. I. , Koelmeyer T. D. , Holloway B. A. , Singh P.
Published: July 2017

The association of various insect species with dead bodies is being recognized increasingly as a potentially useful source of forensic information. This study was made to determine which species of insects developed on corpses in Auckland, New Zealand (latitude 37° South). The study was extended to determine whether certain species were consistently associated with the time elapsed after death, and, if so, to determine their uses and limitations as forensic indicators.
Pulmonary Fat Embolism as an Ante-Mortem Reaction in Traumatic Immediate Death
Authors: Suzuki T. , Ikeda N. , Umetsu K. , Kashimura S.
Published: July 2017

This study is based on the investigation of lungs from 21 traumatic and non-traumatic death cases without any specific disease, including 4 traumatic immediate death cases with fracture. According to our investigation definite fat embolism develops, even in an immediate death case, with severe fracture and it is easily distinguishable from that of non-traumatic causes. In cases of traumatic immediate death, widespread pulmonary fat embolism can be a very useful marker of ante-mortem reaction.
Murder Revealed by a Broken Piece of Glass Bangle: A Case Report
Authors: Mehrotra V. K. , Yadav A. Y.
Published: July 2017

A small piece of broken glass was of considerable help in differentiating the culprit from another suspect in an interesting murder case.

Indian women often wear glass bangles for religious and social reasons. In Europe and Asian countries, these ornaments are increasing in popularity. Because women are becoming more frequently involved in criminal acts, and these bangles are fragile, fragments are being found more often at scenes of crime. Establishing the association between recovered fragments of bangle and their owners is a difficult, time-consuming process.
Attitudes towards the Mentally Disordered
Authors: Prins Herschel A.
Published: July 2017

The implementation of the Mental Health Act, 1983 affords an opportunity to re-examine some of the background to the new legislation and to place it within a wider historical context of public and professional attitudes towards the mentally disordered. No attempt is made to chart these developments in detail, but sufficient source material is provided for those who wish to pursue the study of this important topic further.
A Possible Morphological Sexual Dimorphism in the Human Gastrocnemius Muscle
Authors: Mysorekar V. R. , Nandedkar A. N.
Published: July 2017

In the literature, there is no information about sexual dimorphism in human muscles. The present work attempts to establish sexual dimorphism in the human gastrocnemius muscle.

In the females, the femora are more oblique at the lower end due to a broader pelvis. To counteract this obliquity, presumably, at the knee joint a stronger muscle mass would be needed on the medial side. To test this assumption the gastrocnemius muscle was studied in 26 male and 25 female cadavers. In each case, the two heads of the muscle were detached from their origins and the length of each head was measured. The study showed that in the female, on the right side, the medial head of the muscle was significantly longer.
Suicide among the Elderly—The Metro-Dade County Experience, 1981–83
Authors: Copeland Arthur R.
Published: July 2017

A study of suicide victims in those aged 65 years or more was done from the case files of the Medical Examiner Department of Metropolitan Dade County, Miami, Florida, during the years 1981, 1982, and 1983. A total of 222 cases were collected and analysed as to the age, race, sex, and cause of death of the victim along with blood alcohol content, toxicology, locale of the terminal incident, whether or not there was a suicide note, and the reason for depression. The latter most frequently was the victims' concern over their health.
Psychiatric Court Referrals in Sweden
Authors: Averland A.-M. , Öjesjö L. , Soothill K. L.
Published: July 2017

In an international comparison Sweden has a high proportion of pre-trial psychiatric evaluations. The purpose of the study was to look for the most likely reasons for such a referral in the Linköping region. The basic material came from court records and from medical and social reports. It was found that the courts' knowledge of previous psychiatric treatment was the most important reason (44 per cent), followed by nature of the offence (31 per cent), management problems (14 per cent) and awkward behaviour at the proceedings (12 per cent). The results support the view that forensic psychiatric evaluations may serve different social functions in different countries.
The West German Experience in Drink Driver Improvement Courses
Authors: Schneider Walter
Published: July 2017

The last 15 years has seen the development of educational group therapy courses for West German drink/drive offenders. Two types of course, the one for first offenders and the other for recidivists are described. The courses are specifically targetted at social drinkers. Problem and heavy drinkers and those with significant social and domestic problems are selected out by pre-course medical and psychological assessment. Most course failures are attributed to failing to accurately complete the sift. The German courts have come to accept successful completion of a course as evidence for reducing the period of disqualification either at the time of initial sentence or on appeal. The licensing authorities are more inclined to grant a licence after completion of sentence where the offender has successfully completed the course. The aim is to teach social drinkers to separate drinking from driving. When compared against the non-treated group, the treated group have a highly significant lower reconviction rate within two years. The need to employ qualified psychologists as course leaders and also special training is emphasised. A more comprehensive range of courses to rehabilitate all types of drink/drivers including alcoholics and those who have difficulty in learning in a group situation is called for.
Things are Not Always What They Seem! Joule Burns in Electrocution—A Report of Four Cases
Authors: Odesanmi W. O.
Published: July 2017

The police dispersed a crowd of University undergraduates with tear gas, and four of these students were later found dead around an advertisement pole carrying a plastic encasement displaying the picture of ‘Gold Leaf’ cigarette. It was alleged that the students were killed by the police. Autopsy of the four students revealed electric burns scattered all over the body. These burns were later found to be situated at points where the body had made contact with the advertisement pole. The pole was later examined by a team of electrical engineers and found to have a severe earth fault which on test resulted in a potentiation of 175 volts between the body of the sign post and the immediate surrounding. It was the source of the electric current that caused the death of the students.
Gamma-Glutamyl Transferase: Applications in Forensic Pathology II: Histochemical Study of Post-Mortem Human Liver Samples
Authors: Piette M. , Devos Ch. , Prest B. De
Published: July 2017

In part I of this paper the role of a serum gamma-glutamyl transferase (GGT) determination as a marker of chronic alcoholism in the course of a forensic autopsy was analysed and discussed. To enhance the reliability of this GGT determination in cadaver serum, the suitability of a histochemical method for detecting chronic alcoholism by means of this enzyme in human liver tissue was analysed.

As a preliminary test, the post-mortem stability of the GGT enzyme was observed by storing liver samples in vitro. Subsequently, correlations between liver-staining and the degree of fatty liver degeneration and fibrosis (both ethanol-induced lesions) were searched for. A comparison was then made between selected groups of alcoholics and non-alcoholics. Finally, the correlation between serum GGT activity and liver tissue staining was made.

We conclude that, keeping in mind the possibility of both false positive and false negative results, a histochemical test for GGT in hepatic tissue is a further tool for detecting chronic alcoholism at the forensic autopsy. The combined examination of GGT in serum and in liver tissue is emphasized.
Changing Patterns of Suicide in Leeds, 1979 to 1985
Authors: Bradley M. C.
Published: July 2017

This study involves an investigation of deaths due to suicide occurring in Leeds. It is based upon data collected by the Department of Forensic Medicine at the University of Leeds and covers the period 1979 to 1985 inclusive. Use is also made of information obtained from the Coroner's office. A total of 467 cases were identified using clinical criteria. Results show a marked fall in the number of suicide deaths during the period 1980 to 1985, this being largely accounted for by a drop in the number of deaths due to self-poisoning. A small but steady increase in the use of carbon monoxide inhalation as a means of suicide is also noted. Further analysis reveals that there has been a fall in the use of barbiturates and ‘distalgesic’ (dextropropoxyphene/paracetamol) as a means of self-poisoning. Examination of verdicts returned at inquest from 202 selected cases reveals that only 66 per cent were classified as suicide. Attempts are made to relate these local changes to trends occurring nationally, and the problems involved when using data drawn from inquest verdicts are highlighted.
Local Dental Anaesthesia and Evidential Breath Testing: The Effect of Injection of Local Anaesthetic on Lip Seal
Authors: Pearson G.J. , Keys W. Campbell
Published: July 2017

The effect of local anaesthetic infiltration on the ability of subjects to provide adequate specimens of breath for analysis using an evidential breath testing device was assessed. The results showed that in ten out of the fourteen cases there was no impairment of the ability to provide the specimens of breath at any time. Within two hours of the administration of a local anaesthetic all subjects were able to provide the requisite samples.
A Case of Fatal Suffocation during an Attempt to Swallow a Pool Ball
Authors: Fernando Gyan C. A.
Published: July 2017

An unusual case of accidental death from suffocation during an attempt to ‘swallow’ a pool cue ball is presented.
Pseudologia Fantastica: A Case Study of a Man Charged with Murder
Authors: Sharrock R. , Cresswell M.
Published: July 2017

A case of Pseudologia Fantastica is presented in a man charged with murder. Psychological assessment revealed him to be highly compliant and suggestible, consistent with early research (Healy and Healy, 1915) which showed pathological liars to be suggestible to misleading information. A specific dyslexic disorder is also demonstrated, and the possible mechanisms behind the man's lying considered. Some implications regarding the reliability of the man's varying confessions to the police are discussed, and parallels are drawn between this case and that of Timothy Evans, who in 1950 was hanged for murder.
Injury Severity Score (ISS) as a Yardstick in Assessing the Severity and Mortality of Various Abdomino-Pelvic Trauma Hospitalized Victims—A Clinical Vis-à-Vis Autopsy Study
Authors: Kumar Bishnu , Paul George , Sharma Ashok Kumar
Published: July 2017

A summary of 51 cases of vehicular accident showing abdomino-pelvic trauma, along with associated other regional injuries, were studied at the Department of Forensic Medicine at MAM College and Associated Hospitals in New Delhi during 1986. A detailed Injury Severity Score (ISS) was done in all the cases and the relationship of ISS during their clinical treatment phase and after death was studied, keeping in mind factors such as age, survival periods, etc.
Some Aspects of Sex Offending — Causes and Cures?
Authors: Prins Herschel
Published: July 2017

Selected aspects of sexual offending are considered against a background of general observations about sexuality in contemporary society. It is suggested that sexual offending may appear in a variety of guises, that it is more realistic to talk about management than ‘cure’ and that success in management is highly dependent upon the professional's capacity to form a non-judgemental view and act with this constantly in mind.
Gunshot Suicide in the County of Avon, England
Authors: Nowers M
Published: July 2017

A study of 51 consecutive gunshot suicides in the County of Avon, England, between 1974 and 1990 is presented. All cases were male. The majority were married and lived with their spouses. Most suicides occurred in the setting of a domestic dispute, although at least nine had a significant past psychiatric history. Possible implications of firearm legislation and psychiatric treatment on firearm suicide rates are discussed.
Isolation of an Unknown Compound, from Both Blood of Bhopal Aerosol Disaster Victims and Residue of Tank E-610 of Union Carbide India Limited — Chemical Characterization of the Structure
Authors: Chandra H , Saraf A K , Jadhav R K , Rao G J , Sharma V K , Sriramachari S , Vairamani M
Published: July 2017

A total of more than 28 chemical entities/reaction products in the form of gases, vapour and particulate matter were reported from the tank E-610 of methyl isocyanate (MIC) storage tank of Union Carbide India Limited on the night of 2/3 December 1984 in Bhopal. In earlier studies, methyl isocyanate and its trimer, with a few other compounds, were reported in the human victims preserved in deep freeze. Randomly selected samples were analysed by gas Chromatograph coupled with mass spectrometer (ITD-800, Finnigan MAT, UK). Four of the cases showed the peaks and fragmentation pattern identified with one of the unidentified compound of molecular weight 269 amu in the Tank Residue, which constituted about 0.2 area per cent on GC-ITD. After isolation by column chromatography and being exposed to characterization, it was identified as a Spiro compound. It was possibly formed by the polymerization of five molecules of methyl isocyanate.
The Pitfalls of Making a Categorical Diagnosis of Post Traumatic Stress Disorder in Personal Injury Litigation
Authors: Neal Sqn Ldr L A
Published: July 2017

Since it first became possible to diagnose Post Traumatic Stress Disorder (PTSD) categorically with the advent of DSM-III (American Psychiatric Association, 1980), its use in the American Courts to substantiate civil claims has burgeoned. This situation may be set to repeat itself in the UK Mental health professionals need to be aware that there is a substantial body of evidence supporting the validity of the concept of a DSM diagnosis of PTSD. However, the reliability of such a diagnosis can be called into question. There are legal and ethical issues involved in assessing and interpreting the DSM criteria, some of which may lead the expert witness to make authoritative pronouncements that are outside his legitimate field of expertise. There is a danger that the legal profession will adopt the DSM as a ‘gold standard’ against which to judge expert testimony. The multiaxial classification of the DSM can be a useful framework for presenting a diagnosis of PTSD, but over-rigid adherence to the criteria at the expense of clinical judgement and experience should be avoided.
The Use of the ‘Appropriate Adult’ Scheme (A Preliminary Report)
Authors: Nemitz T , Bean P
Published: July 2017

Details of a research study, funded by MENCAP, on the use of Appropriate Adults are given. A great deal of attention has been given recently to diverting the mentally disordered from the criminal justice system. This preliminary report discusses what happens to those who stay in the system — i.e. who are kept in police custody and eventually appear at court. Facilities are available under the Appropriate Adult Scheme for offenders seen to be mentally disordered or handicapped to have with them a ‘responsible person’ when they are interrogated by the police. The questions now posed are: does such a scheme work, and is the offender given protection under it?
Scientific Fraud: The McBride Case — Judgment
Authors: Humphrey G F
Published: July 2017

Dr W G McBride, who was a specialist obstetrician and gynaecologist and the first to publish on the teratogenicity of thalidomide, has been removed from the medical register after a four-year inquiry by the Medical Tribunal of New South Wales. Of the 44 medical practice allegations made against him by the Department of Health only one minor one was found proved but 24 of the medical research allegations were found proved. Of these latter, the most serious was that in 1982 he published in a scientific journal, spurious results relating to laboratory experiments on pregnant rabbits dosed with scopolamine. Had Dr McBride used any of the many opportunities available to him to make an honest disclosure of his misdemeanour, his conduct would have been excused by the Tribunal. However, he persisted in denying his fraudulent conduct for several years, including the four years of the Inquiry. The Tribunal unanimously found Dr McBride not of good character in the context of fitness to practise medicine. The decision to deregister was taken by a majority of 3 to 1. Since research science is not organized as a profession, there are no formal sanctions which can be taken against his still engaging in such research.
Deaths from Hanging in the Eastern Province of Saudi Arabia
Authors: Elfawal M A , Awad O A
Published: July 2017

An analysis of cases of hanging in the Eastern Province of Saudi Arabia over a period of five years is presented. Of 61 victims investigated there was a high incidence of suicidal hanging among expatriate males of lower socio-economic classes especially Asians, and in particular, Indians. Two distinct patterns of suicidal hanging were observed in this series. The first used a seemingly popular plastic clothes line, with complete body suspension. This produced a narrow ligature mark, commonly deep and high up in the neck, often with internal cervical injuries. In the second, soft cotton cloth was used with partial suspension of the body, which produced a broad, low, ill-defined ligature mark with facial congestion and petechial haemorrhages, but minimal or absent deep neck injuries. Classical external injuries of asphyxial death (congestion of the face and petechial haemorrhages) were more common in cases of partial suspension than in complete suspension. While the mechanism of death in the majority of cases of partial suspension was apparently due to airways or vascular obstruction, death in cases of complete suspension appeared to result from, in addition to obstruction (airways or vascular), vagal stimulation or carotid sinus pressure, or a combination of these. No fracture of the hyoid bone, thyroid cartilage or cervical vertebrae was detected in any of the victims in this series.
Recorded Psychiatric Morbidity in a Large Prison for Male Remanded and Sentenced Prisoners
Authors: Mitchison S , Rix K J B , Renvoize E B , Schweiger M
Published: July 2017

The purpose of the study was to establish the proportion of remanded and convicted prisoners who were known from their records to have a psychiatric history. The inmate medical records of 834 out of 864 inmates resident on one day at HM Prison, Leeds, were studied. There was a recorded history of 23 per cent having seen a psychiatrist, 15 per cent having taken drugs and 16 per cent having a history of depression or self-harm. Out of 43 inmates interviewed, 18 admitted to failing to report such a history upon reception. There were eight former long-stay psychiatric patients, but only two of these had been in a hospital other than a special hospital or Regional Secure Unit. Out of the 36 residents of the hospital wing, 33 had psychiatric disorders and 10 were awaiting transfer to NHS or private psychiatric services. Various recommendations are made which may lead to an improvement in the medical reception procedure, more informed screening for suicide risk and mental disorder, greater understanding of the psychiatric histories of patients, an audit of prison health care and more effective planning of aftercare.
1. Suicidal Chloroquine Poisoning: Report of Two Cases
Authors: Obafunwa J O , Al-Oqleh A M A H , Busuttil A
Published: July 2017

Two cases of suicidal chloroquine poisoning are presented. The autopsy, toxicological findings and strategies for preventing self-destruction by this method are discussed.
3. Fatal Classic and Exertional Heat Stroke — Report of Four Cases
Authors: Hiss Jehuda , Kahana Tzipi , Kugel Chen , Epstein Yoram
Published: July 2017

Heat stroke is the outcome of impaired heat dissipation which is aggravated by hot and humid environmental conditions. The very young and debilitated on the one hand and healthy individuals under considerable physical stress on the other are vulnerable to heat stroke. Post-mortem findings will depend on the time lapse between the stroke event and death. We report on the deaths resulting from heat stroke in a 12-month-old baby and three 19-year-old soldiers. Reconstruction of the environmental conditions enables elucidation of the circumstances that precipitated exogenous hyperpyrexia. The Discomfort Index presents reliable criteria for the assessment of heat load: values above 28 units are considered as severe heat load and are life threatening. Awareness of the hazards related to severe heat load on the body is helpful in preventing avoidable calamities.
4. Monosymptomatic Hypochondriacal Psychosis and Prolonged Solitary Confinement
Authors: Humphreys Martin , Burnett Frances
Published: July 2017

A man previously imprisoned for 11 years developed unremitting and treatment-resistant monosymptomatic hypochondriacal psychosis following a period in excess of 12 months in solitary confinement. We are unaware of any other reported incidences of this disorder arising in such circumstances.
5. Treatment of a Man with a Mild Learning Disability Who was Sexually Assaulted Whilst in Prison
Authors: Davison F M , Clare I C H , Georgiades S , Divall J , Holland A J
Published: July 2017

The aim of this study is to describe the psychological effects on a man with a mild learning disability who was sexually assaulted whilst in prison, and the treatment which was carried out. J. suffered Post-Traumatic Stress Disorder (PTSD), as defined in DSM-III-R, combined with associated features of depression and anxiety. Treatment involved imaginal exposure to the assault, followed by systematic de-sensitization to the traumatic experience of imprisonment preceding the assault. Activities were also carried out to develop J.'s self-esteem, coping strategies and anxiety management. The successful outcome of treatment is discussed in relation to models of emotional processing. Some discrepancies between scores on self-evaluation questionnaires and behavioural observations raise issues concerning the best way of assessing treatment outcome for people with learning disabilities.
6. Occipital Contrecoup in a Case of Hallervorden-Spatz Disease
Authors: Williams David J , Johnson Mark I
Published: July 2017

This case report describes the unusual complications of a simple fall in a person with a profound neurological disorder, Hallervorden-Spatz disease. The fall produced a laceration of the forehead, skull fractures and severe occipital contrecoup contusions. Such contrecoup contusions are rare and may be a feature of this case because of the abnormal limb rigidity displayed in Hallervorden-Spatz disease. The mechanisms of injury are discussed.
Post Traumatic Stress Disorder: Turning the Tide without Opening the Floodgates
Authors: McCulloch Malcolm , Jones Chris , Bailey John
Published: July 2017

The development of the legal concept of nervous shock represents a compromise between the need to compensate those suffering psychiatric damage and the need to protect a defendant from unlimited liability. The criteria which have developed to achieve this balance are arbitrary ones, which take little account of psychological or physiological knowledge about post traumatic stress disorder. It is suggested that recent developments in scientific understanding of this condition could usefully inform the legal process, and that some aspects of the dilemma could be avoided.
A Review of Diagnostic Inaccuracy
Authors: Kingsford Douglas P W
Published: July 2017

A review is presented of autopsy evidence demonstrating clinical diagnostic inaccuracy. Startling results emerge: the major clinical diagnosis is not confirmed in up to 45 per cent of cases, with typical error rates of up to 30 per cent; autopsy reveals unexpected major findings in up to 33 per cent of cases; management should have been different in up to 24 per cent of cases; clinicians cannot identify which patients are likely to have errant diagnoses; clinically ‘certain’ diagnoses still have a high error rate. These error rates have not changed significantly since an early study in 1912 despite the current widespread use of advanced investigation modalities.
Unnatural Deaths in Delhi during 1991
Authors: Bhattacharjee J , Bora D , Sharma R S , Verghese T
Published: July 2017

An analysis was undertaken of 3623 post-mortems conducted in the Civil Hospital, Delhi, during 1991, covering 75 per cent of civil police stations and all three railway police stations. The study showed that the death rate was highest in the age group of 30–39 years (29.6%), road traffic accidents being the most common cause (33.9%). In general four times more deaths occurred in males than in females. However, in deaths by burning it was three times higher in females. The attention of all concerned should be drawn to this huge, untimely and tragic loss of lives.
A Survey of Male Homicide Cases Resident in an English Special Hospital
Authors: Dolan M , Parry J
Published: July 2017

The study examines a sample of 120 male special hospital patients whose index offence was one of homicide. Demographic, criminological and psychiatric details are described and the characteristics of those committing psychotic and non-psychotic homicides are compared.

The results generally confirmed most of the findings reported in international studies of abnormal homicide. Compared with other studies on in-patient populations we found a greater than expected proportion of non-psychotic homicide offenders, the majority of whom had a clinical diagnosis of personality disorder. Key factors distinguishing psychotic from non-psychotic homicide included a pre-offence criminal history, the objective relationship between perpetrator and victim and the behaviour after the offence. Psychotic men were less likely to have a prior history of criminality and substance abuse than their non-psychotic peers but they were more likely to have had previous contact with the psychiatric services and to have known their victims. Compared with the non-psychotic group the majority of psychotic offenders remained at the crime scene or summoned help. A marked age differential between psychotic and non-psychotic offenders was not apparent in this study.
2. Shoplifting and Robbery in a Fugue State
Authors: Tang C P , Pang A H T , Ungvari G S
Published: July 2017

The case of a 26-year-old Chinese woman with a history of benzodiazepine dependence and shoplifting who committed an act of robbery is presented. The various aetiological factors implicated in this complicated case are discussed in the light of the recent literature.
4. Homicide by Strychnine Poisoning
Authors: Benomran Fawzi A , Henry J Don
Published: July 2017

Homicide by strychnine has become very rare during the last decades. Its bitter taste and the violent mode of death commonly aroused suspicion of poisoning and this, together with its ease of chemical detection, deterred criminals from using it.

We present the case of an elderly woman who arrived at the hospital casualty department in extremis and with severe convulsions. Her death was certified nevertheless as due to natural causes and she was buried without the death being reported to the Director of Public Prosecutions. It was not until a month later that investigation led to the exhumation of the body. Biological samples were found to contain strychnine sulphate. The perpetrator was charged and later confessed.
Euthanasia and International Human Rights Law: Prolegomena for an International Debate
Authors: Van Den Akker Britt , Janssens Rien M J P A , Have Henk A M J Ten
Published: July 2017

In this paper we examine in what respects international human rights law can provide a basis for the establishment of an international debate on euthanasia. Such a debate seems imperative, as in many countries euthanasia is considered taboo in the context of medical practice, yet at the same time, supposedly, decisions are taken to intentionally shorten patients' lives. In the Netherlands, the act of euthanasia will not lead to the prosecution of the physician involved if the physician has complied with certain procedures. The Dutch debate centres on procedures marginalizing important moral aspects of euthanasia. An international debate, addressing the fundamental morality of euthanasia and of other medical decisions involving the end of life, will eventually enhance medical practice in the Netherlands as well as in other countries.
HIV Serophobia in the Mortuary: An Algorithm System for Handling High-Risk Forensic Cases
Authors: Patel F
Published: July 2017

A serophobia of the human immunodeficiency virus type 1 (HIV-1) is very noticeable in mortuaries handling high-risk cases. The morbid anxiety about occupationally acquired HIV infection in the forensic practice has made mortuary workers unduly overcautious. Despite the availability of codes of practice and informed principles of health and safety, there is considerable anxiety that an HIV carrier with no identifiable risk factors may be overlooked or a seronegative body may be inadvertently assumed to be uninfected. In contrast, a false sense of safety can pose a health hazard and has public health implications.

An algorithm system is outlined for selective handling of unsuspected or unrecognized high-risk cases. It is necessary that guidelines are reasonably simple and incorporate statutory health and safety regulations and local safe working practice in the mortuary. Although it is not a legal obligation, approval by the coroners should facilitate consistent implementation of a protocol.

A common experience in public and NHS hospital mortuaries in the London coroners' jurisdictions is characterized.
Alcohol and House Fire Fatalities in Scotland, 1980–1990
Authors: Squires T , Busuttil A
Published: July 2017

The association between house fire fatalities and high blood-alcohol concentrations has been recognized as a particular problem in Scotland. Alcohol intoxication increases the risk of the outbreak of fire and decreases the intoxicated individual's ability to effect an escape. This survey investigates the reported blood-alcohol concentrations from all Scottish fire fatalities during the 11-year period 1980–90 and analyses the data by age, sex, year and geographical location. Alcohol intoxication in fires is shown both to be a national problem and one relevant to females as well as males. Fire prevention campaigns must continue to emphasize the risk of consuming excessive quantities of alcohol in the home whilst parallel efforts to reduce the objective risk should be encouraged.
Does Funeral Preference Influence Clinical Necropsy Request Outcome?
Authors: Start R D , Dube A K , Cross S S , Underwood J C E
Published: July 2017

Attitudes towards necropsy have been shown to be more favourable amongst those relatives preferring cremation as a method of disposal compared to those with a preference for burial. In a two-year retrospective study, no significant relationship was found between funeral preferences (burial or cremation) and clinical necropsy request outcome when age, sex and religion were taken into account. Potential religious objections to necropsy were infrequent and cremation was found to have become the most popular method of disposing of the dead during a period when local clinical necropsy rates have continued to decline. Funeral preference is unlikely to have been a significant factor in the decline in clinical necropsy rates.
Homelessness, Mental Illness and the Law
Authors: Abdul-Hamid Walid , Cooney Colm
Published: July 2017

One major difficulty that faces both researchers and practitioners who work with the homeless is the lack of definitions and frameworks that assist better understanding of such people's problems and society's response to them. This article reviews the legislation dealing with homeless people's social, civil and legal problems. We tried to give this legislation's historic and social background, including a section on psychiatric disorders in this group because of then-relevance to current debate on homeless offenders. We then reviewed the legislation relevant to homeless people in general and the homeless mentally ill in particular, including the recently introduced court diversion schemes.
2. Intussusception: Agonal Phenomenon or Cause of Death?
Authors: Cox Diana E
Published: July 2017

This paper describes two cases of small intestinal intussusception, one in a child and one in an adult, where the findings at autopsy were atypical. The significance of intussusception in this situation is discussed and the literature related to deaths accompanied by acute small intestinal intussusception in the adult and paediatric population is reviewed. It is concluded that the findings represent a true pathological entity and not an ‘agonal’ event.
Comparability of Gestational Age Values Derived from Diaphyseal Length and Foot Length from Known Forensic Foetal Remains
Authors: Huxley Angie Kay
Published: July 2017

A partially macerated human male foetus was submitted to the Human Identification Laboratory at The University of Arizona for the purpose of gestational age determination. This paper compares radiographic diaphyseal length of most long bones to foot length as measured from the forensic case submitted for analysis. The methods included radiography of complete antebrachial and crural segments and foot length measurements. As calculated from ulnar, radial, tibial and fibular diaphyseal length, gestational age was estimated to be between 25 and 28 lunar weeks (between 22 and 25 gestational weeks), while age determined from foot length was between late 23 and early 26 gestational weeks. These results highlight a general correspondence in age estimation between these two techniques. Case history obtained after this analysis confirmed an age of 23 weeks and 6 days based on ultrasonographic criteria. The correspondence between these techniques is significant, since either technique yields approximately the same gestational age. Accuracy of gestational age determination is essential to assess foetal viability. While national laws vary regarding foetal remains, courses of appropriate medicolegal action are contingent upon the determination of foetal viability.
Digoxin-Like Immunoreactivity in Early Infantile Death
Authors: Couper R T L , Aldis J J E , Byard R W
Published: July 2017

The aim of this study was to determine if the level of digoxin-like immunoreactivity in post-mortem sera obtained from infants differs according to the cause of death and if the level is related to age, post-mortem interval, cardiac pathology or adrenal weight. Twelve infants whose deaths were attributed to sudden infant death syndrome (SIDS), and 11 infants who died from other causes, had blood sampled between 3 to 53 hours post-mortem from their right atrial cavity. Digoxin-like immunoreactivity was measured, using a specific and sensitive digoxin radioimmunoassay, and was detected in 7 of the infants who died of SIDS and 7 of those who died from other causes. The highest levels were seen in two patients who died from meningococcal sepsis and haemorrhage, hyperpyrexia and encephalopathy syndrome, respectively. No correlation was detected between the digoxin-like immunoreactivity level, gender, age at death, post-mortem interval or cardiac pathology. Digoxin-like immunoreactivity levels correlated with adrenal weight. It is concluded that digoxin-like immunoreactivity is frequently found in infant sera, but levels are not specific to and are no higher in SIDS infants than infants dying of other conditions.
Alcohol in Medicolegal Cases Seen at Jordan University Hospital
Authors: Hadidi K A , Battah A H , Hinnawi S
Published: July 2017

The magnitude of alcohol-associated incidents in relation to medicolegal cases, including road traffic accidents and acts of violence, has not been evaluated in Jordan. Between 1993 and 1995, 825 such cases received at Jordan University Hospital were screened for the presence of alcohol. Blood alcohol was positive in 9.1% of vehicle passengers, 9.6% of pedestrians, 12.4% of cases involving violence, 13.6% of drivers, 65% of cases brought by police and in 12.5% of other cases. Blood alcohol concentrations (BAC) ranged from 10–350 mg/dL. BAC of more than 50 mg/dL was found in 65% and 55% of driver and violence cases respectively, and in 33% to 69% of the other categories. Alcohol may have contributed to some of these incidents. In cases with positive BAC, prior alcohol intake was frequently denied. There was no association between cases with positive BAC and a particular time, date or occasion.
Sexual Assault of Men: American Research Supports Studies from the UK
Authors: Isely Paul J
Published: July 2017

Incident reports and prevalence research on sexual assault, conducted in the United States, indicate that men may be at greater risk from sexual victimization than previously realized. These studies support the efforts of mental health professionals in the United Kingdom who have argued that sexual assault of men is an underreported crime which can result in significant biopsychosocial dysfunction. Given the increasing evidence that men are victims of sex crimes, future research studies on the prevalence of sexual assault should include adult males in their samples.
2. Hyperpyrexia Associated with Fatal Paramethoxyamphetamine (PMA) Abuse
Authors: James R A , Dinan A
Published: July 2017

Investigation of a suspicious death became confused when apparently contradictory findings arose on examination of the body. Subsequent identification of amphetamine abuse including PMA resolved these issues. The reported case highlights some atypical features which may cause difficulty in this small but increasing group of deaths. Three rapid deaths attributed to PMA have been identified in Adelaide in the 12 months before June 1996.
3. Massive Pulmonary Embolism by Liver Tissue
Authors: Michalodimitrakis M , Tsatsakis A
Published: July 2017

An unusual accidental death due to acute massive occlusion of the right pulmonary arteries by liver tissue is reported. A 17-year-old motorcyclist was run over by a heavy truck, resulting in multiple injuries. Multiple lacerations of the liver and tears in the wall of the inferior vena cava resulted in the complete occlusion of the right pulmonary artery by liver tissue. Although the victim sustained other potentially lethal injuries, the final mechanism of death is attributed to pulmonary embolism.
Changes to Section 2 of Sexual Offences Act 1976
Authors: Baird Vera
Published: July 2017

Rape complaints are at their highest since statistics began, whilst the rape conviction rate is at an all-time low. The frequency with which the complainant's previous sexual history is admitted at trial is perceived as a major factor. The government intends to legislate to reduce this, in accordance with either the Scottish or the New South Wales' legislative models. This article analyses the case law, argues that neither proposed model will suffice and advocates that the Canadian legislation should, with adaptations, be enacted in England.
Section 25 Aftercare under Supervision: The First Eighteen Months' Experience
Authors: Davies Steffan , Bruce Janet , Fallows Steve
Published: July 2017

Supervised discharge was introduced, against much professional opposition, in the Mental Health (Patients in the Community) Act 1995. All patients subject to supervised discharge (SD) in a large health district were identified by medical records departments, and the outcome of their SD on 1 October 1997, eighteen months after the legislation came into effect, was assessed. In that first eighteen months, half of the general, rehabilitation and forensic psychiatrists in the trust used SD for 22 patients. Of the 12 orders in effect for over six months, six were renewed at six months and three at one year. In spite of professional hostility and scepticism about the clinical practicalities of SD, the use of the new power has gradually increased with experience. Outcomes to date seem generally positive, but further definitive research is needed.