bluuebunny/crossref_metadata_2025 huggingface dataset:
The Soviet Union and Population
Authors: DiMaio Alfred J.
Published: July 2017

Until the important public dialogue on Third World population issues began in the Soviet Union in 1965, ideological limitations and bureaucratic interests prevented policy makers from recognizing the existence of a world or national “population problem.” Since then, freer discussions of the Soviet Union's surprising decline in birth rate and labor shortages have led to serious policy questions. Conflicting policy goals, however, have resulted in only modest pronatalist policies.

The Soviet population problem is a result of interregional disparities in population growth rates between the highly urbanized Soviet European populations with low birth rates and the least urbanized Central Asians with dramatically higher birth rates. As a result, these essentially Muslim people will provide the only major increases in labor resources and an increasing percentage of Soviet armed forces recruits. Policy planners are thus faced with difficult options. Current policies stressing technological transfers from the West and greater labor productivity, however, are unlikely to solve further labor shortages and regional imbalances. Ultimately, non-European regions will be in an improved bargaining position for more favorable unionwide economic policies and for a greater role in policy-planning.
Happiness in Hell: The Case of Dr Mivart
Authors: Scotti Dom Paschal
Published: July 2017

Hell is a strait and dark and foul smelling prison, an abode of demons and lost souls, filled with fire and smoke… It is a neverending storm of darkness, dark flames and dark smoke of burning brimstone, amid which the bodies are heaped one upon another without even a glimpse of air… All the filth of the world, all the offal and scum of the world we are told, shall run there as to a reeking sewer when the terrible conflagration of the last day has purged the world… The very air of this world, that pure element, becomes foul and unbreathable when it has been long enclosed. Consider then what must be the foulness of the air of hell. Imagine some foul and putrid corpse that has lain rotting and decomposing in the grave, a jellylike mass of liquid corruption. Imagine such a corpse a prey to flames, devoured by the fire of burning brimstone and giving off dense choking fumes of nauseous loathsome decomposition. And then imagine this sickening stench, multiplied a millionfold and a millionfold again from the millions upon millions of fetid carcasses massed together in the reeking darkness, a huge and rotting human fungus. Imagine all this and you will have some idea of the horror of the stench of hell.
Between Echo and Narcissus The Role of the Bible in Feminist Theology
Authors: Stroup George W.
Published: July 2017

In the struggle to free themselves from the perceived androcentrism of the biblical witness, feminist theologians have not yet achieved clarity on the role of that witness in their theology.
The Impossible Possibility Evaluating the Feminist Approach to Bible and Theology
Authors: Achtemeier Elizabeth
Published: July 2017

The question is not whether women should enjoy equal status but how that God-given freedom is to be gained-or perhaps better, regained-in a Christian community that needs to be faithful to the liberating message proclaimed by and in Jesus Christ.
A Fruitful Field
Authors: Gasque W. Ward
Published: July 2017

One conclusion that unites nearly all recent study of Luke-Acts is that Conzelmann's classic formulation of the purpose of the Lukan writings, put forward in The Theology of St. Luke, was incorrect.
The Historical Abraham
Authors: McCarter P. Kyle
Published: July 2017

Unlike the other prominent patriarchs of Israel, whose names also function as tribal or local designations, the Abraham who stands at the beginning of the patriarchal traditions appears to have been a historical individual before he became the subject of tradition and legend.
Abraham, the Friend of God
Authors: Anderson Bernhard W.
Published: July 2017

It is God's covenant with Abraham, freely initiated by God, that constitutes Israel as a people who gratefully recall the past, who live obediently in the present, and who face the future in the assurance of God's promises.
The Measurement of Duration of Speech
Authors: Ramsay R.W. , Law L.N.
Published: July 2017

The investigation of certain non-content aspects of speech—the lengths of utterances and pauses in speech—have always suffered from difficulties of measurement. The methods used have been laborious, sometimes expensive, and no study so far has investigated the magnitude of error involved in measurement. This paper describes a relatively inexpensive method for recording and measuring lengths of utterances and pauses in speech, and shows the amount of error involved in these measures.
An Experimental Analysis of the Relative Importance of Pitch, Quantity, and Intensity as Cues to Phonemic Distinctions in Southern Swedish
Authors: Westin Kjell , Buddenhagen R.G. , Obrecht Dean H.
Published: July 2017

This paper, following introductory comments on previous experiments involving prosodic features of speech, reports an experiment designed to indicate the relative importance of pitch, quantity, and intensity as cues for syllabic prominence in Southern Swedish. Spectrographic analysis of the particular minimal pair used in this experiment revealed that one, or any combination, of three possible prosodic features, pitch, quantity, and intensity, could account for the contrast in meaning of the pair, the written representation of which is HÄLSA PA. Stimuli were prepared in which all possible binarily opposed combinations of pitch, quantity, and intensity in the last syllable were represented. Additional stimuli were prepared to test whether the contrastive pitch level of the first syllable might also contribute to the identification of the minimal pair. Native speakers of Swedish were asked to identify each stimulus item as either greet or visit, the two concepts which the written form HÄLSA PA represented.

Analysis of the results showed that pitch provided the primary cue for identifications. Significantly, the pitch of the first syllable was the most potent cue, overriding opposing cues of pitch, quantity, and intensity on the final syllable. Accordingly, the conclusion was drawn that perception followed primarily the first syllable, that subjects made their identifications on the basis of the pitch of the first syllable, and that they could not be dissuaded in their identifications by contradictory information present in the prosody of the final syllable. It could not be established with certainty which of the two remaining cues, quantity or intensity, was the more important.
Processing of Anaphoric Nouns in Extended Texts: The Role of Surface Information
Authors: Williams John N.
Published: July 2017

Four experiments were conducted to determine the role played by surface information in the interpretation of repeated noun anaphors. The experiments examined priming effects from repeated noun anaphors to probe words, where a complex conceptual relationship existed between anaphor and probe. The probe referred to the end-point of a process which had changed the state of the original referent of the noun anaphor (for example, a car was introduced early in the text, it was subsequently crushed into a package of metal, the word car occurred as an anaphoric expression, and the word PACKAGE was presented as the probe). Such effects on probe responses that were obtained were inhibitory in nature, and were interpreted as due to the focussing effect of the anaphor at the conceptual level of representation. There was also evidence that the surface level representation of the text played a role in mediating access to the conceptual level, since inhibition of probe responses was only obtained when the antecedent of the repeated noun anaphor appeared in that part of the surface form which expressed the change of state.
On the Theoretical Status of “the Baseline” in Modelling Intonation
Authors: Ladd D. Robert
Published: July 2017

The “baseline”, as an aspect of fundamental frequency (Fo) declination, is commonly defined as a straight (often logarithmic) line fitted to the valleys in the Fo contour. In a recent study, in line with a good deal of past work on declination, Terken (1991) assumed that the baseline so defined would represent a reference value for normalizing the perceived prominence of pitch accents. The results of the study did not bear out this assumption, but the assumption was not called into question, and instead certain paradoxical conclusions were suggested. In this paper it is shown that the paradoxical conclusions are unnecessary if the reference value is not equated with the traditional baseline, but is assumed to be more abstract, i.e., less overtly manifested in the actual contour. This has already been proposed in a number of recent models of intonational phonology.
A Crosslinguistic Study of Postposing in Discourse
Authors: Birner Betty J. , Ward Gregory
Published: July 2017

In this paper we examine constraints on the use of seven sentence-types permitting the non-canonical appearance of the logical subject in post-verbal position: inversion in English and in Farsi, presentational and existential there-sentences in English, presentational ci-sentences and subject inversion in Italian, and es+subject postposing in Yiddish. We show that these sentence-types share a common discourse constraint: each requires the NP in non-canonical (i.e. postposed) position to represent information that is unfamiliar in some sense. The discourse function of postposing is contrasted with that of another sentence-type involving post-verbal subjects: right-dislocation in English. Unlike postposed NPs, the marked NP of English right-dislocation represents information that is familiar within the discourse; concomitantly, a pronoun coreferential with the marked constituent appears in this constituent's canonical position. We argue, then, that the function of postposing is to place subjects representing unfamiliar information in sentence-final position. On this analysis the functional difference between these sentence-types and English right-dislocation can be straightforwardly accounted for. Given that the marked NP of right-dislocation is coreferential with an intrasentential pronoun, we would expect this NP to represent a discourse-old entity, as do anaphoric pronouns in general. Thus, it is not accidental that right-dislocation does not serve to keep unfamiliar information out of subject position; the presence of the pronoun rules out such a function.
Inferring Acceptance and Rejection in Dialog by Default Rules of Inference
Authors: Walker Marilyn A.
Published: July 2017

This paper discusses the processes by which conversants in a dialog can infer whether their assertions and proposals have been accepted or rejected by their conversational partners. It expands on previous work by showing that logical consistency is a necessary indicator of acceptance, but that it is not sufficient, and that logical inconsistency is sufficient as an indicator of rejection, but it is not necessary. I show how conversants can use information structure and prosody as well as logical reasoning in distinguishing between acceptances and logically consistent rejections, and relate this work to previous work on implicature and default reasoning by introducing three new classes of rejection: IMPLICATURE REJECTIONS, EPISTEMIC REJECTIONS, and DELIBERATION REJECTIONS. I show how these rejections are inferred as a result of default inferences, which, by other analyses, would have been blocked by the context. In order to account for these facts, I propose a model of the common ground that allows these default inferences to go through, and show how the model, originally proposed to account for the various forms of acceptance, can also model all types of rejection.
Effects of Training in Directionality on Reversals in Reading and Writing
Authors: Steen Marcia , Sowell Virginia
Published: July 2017

The purpose of this study was to demonstrate that children over seven years of age who are reversing letters or words while reading or writing do not have a perceptual problem reflecting impaired neurological processes or developmental deficits. Instead, these investigators espouse the premise that the tendency to reverse stems from a lack of training about directionality. A thorough review of the literature has indicated that most studies which use such training to alleviate reversals have been done with children under 7 yr. of age. 24 children between 8 and 9 yr. of age were randomly assigned to either the control or experimental groups. The experimental group was given 15 additional min. of training in directionality each day for 4 wk. An analysis of covariance was conducted to assess effects of such training on the number of letter or word reversals. Analysis showed that the training did not significantly affect the number of reversals.
Cognitive Capacity Demands of Two Addition Algorithms
Authors: Dashiell William , Killian Paul W.
Published: July 2017

18 college students solved addition problems with either an addition algorithm that requires a written record of intermediate results and running sums or with the standard algorithm which does not require such a written record. Students who used the experimental algorithm had significantly faster reaction times to a tone than those who used the traditional algorithm. This result supports the view that arithmetic tasks are composed of several subtasks which are performed simultaneously. A capacity model of attention is suggested as an appropriate paradigm to use in investigating arithmetic processing.
Coronary Sinus Pacing in an Elderly Patient with Bjork-Shiley Tricuspid Valve Replacement
Authors: McGavigan Ad , Morley-Davis A , Hogg Kj , Dunn Fg
Published: July 2017

We report the first case of permanent pacing via the coronary sinus in a patient with a Bjork-Shiley tricuspid valve replacement. This may be the route of choice in this group of patients.
Chromosome 2 Reciprocal Congenic Strains to Evaluate the Effect of the Genetic Background on Blood Pressure
Authors: Carr F.J. , Negrin C.D. , Clark J.S. , Graham D , Mcbride M.W. , Anderson N.W. , Dominiczak A.F.
Published: July 2017

The localisation of quantitative trait loci (QTL) is the first step towards gene identification. This is then verified by the construction of reciprocal congenic strains. The hypertensive SHRSP and normotensive WKY strains were used in a speed congenic approach to confirm the existence of a QTL on rat chromosome 2. Systolic baseline and salt loaded blood pressures were measured by radiotelemetry. Transfer of the chromosome 2 blood pressure QTL region from WKY into an SHRSP background significantly reduced blood pressure, with the increased significance at the salt loaded period, compared to the SHRSP. The reciprocal congenic blood pressure showed a significantly increased baseline systolic pressure compared to the WKY, with no change in significance at the salt loaded period. Thus we have successfully captured a gene(s) which contribute to blood pressure regulation in both congenic strains. This will facilitate further positional cloning of the causative genes first in this model and then in human essential hypertension.
Developments in Imaging an Historical Review
Authors: Mcmillan N.C.
Published: July 2017

Following the discovery of X-rays by Roentgen in 1895, it was 70 years later that the specialty of imaging really took off, with ultrasound, CT, Nuclear medicine, and MRI now an integral part of all large departments. The recent progress has been accelerated by advances in computer technology which aided the development of imaging techniques that do not use ionising radiation. Some imaging techniques are replacing other more hazardous diagnostic procedures, (eg MRCP v ERCP, and MRA v catheter angiography) while some are able to provide almost perfect anatomical detail e.g.brain MRI. Techniques using radioisotopes provide more functional information which can be used to complement the morphological studies. We have witnessed the birth and maturation of Interventional Radiology. This is a highly skilled subspecialty enabling some surgical procedures to be replaced by minimally invasive methods using image guidance. These range from simple drainage procedures and guided biopsies to complex aortic bifurcation stent graft insertions. The potential for digital storage of all images is already established and the filmless radiology department in the more developed countries could be the norm by 2020.
Jewish–Muslim dialogue in light of Jewish–Christian relations
Authors: Kessler Edward
Published: July 2017

Interfaith dialogue, as we understand it today, has been taking place between Christians and Jews for nearly a century, but Jewish–Muslim dialogue is a more recent phenomenon. Jews and Muslims have much in common, but relations are overshadowed by the failure to address the impact of the Middle East conflict. For most Jews, the creation of the State of Israel is an ancient promise fulfilled – the ingathering of exiles and a guarantee of physical and spiritual security. Yet many Muslims term the same events ‘The Disaster’, a time when an Islamic society was uprooted and became a minority. In Jewish–Muslim dialogue it is essential to be prepared for conflicting views.
Teenage pregnancies and their obstetric outcomes
Authors: Trivedi S S , Pasrija Shikha
Published: July 2017

This study was conducted to evaluate the obstetric performance of teenage women in India. In total, 13,210 women were included in the study, of whom 840 were teenagers (<19 years) and 12,370 were > 20 years. Antepartum, intrapartum and postpartum events were recorded and comparative analysis was done. We found that teenage women were at a significantly higher risk for development of severe anaemia (relative risk [RR] 1.61, P value < 0.02), eclampsia (RR 1.95, P value < 0.05), preterm labour (RR 1.25, P value < 0.001), intrauterine growth retardation (RR 2.29, P value < 0.001) and low birth weight (RR 1.24, P value < 0.001). Assisted delivery (11.78% versus 2.23%, P value < 0.001) was significantly more common and caesarean delivery (9.64% versus 17.18%, P value < 0.001) was significantly less common in teenagers. Moderate anaemia, mild pregnancy-induced hypertension, preeclampsia, premature rupture of membranes, antepartum haemorrhage and post dates were all significantly higher in ≥ 20 years group. To conclude, we found that teenage women are a high-risk group, which is aggravated by social and cultural factors. Special attention is required to educate these women for more positive outcomes.
Reasons for gynaecological consultations in children in Calabar, South Eastern Nigeria
Authors: Abasiattai Aniekan M , Etuk Saturday J , Asuquo Etetim E , Udoma Edem J , Bassey Emem A
Published: July 2017

Childhood gynaecological disorders as seen in the University of Calabar Teaching hospital (UCTH), Calabar, Nigeria, over a 10-year period were studied. The aim was to establish the incidence and pattern of presentation of these disorders. Childhood gynaecological disorders constituted 3.1% of gynaecological admissions in UCTH. Vaginal laceration following rape was the most common disorder accounting for 54.8% of the cases. This was most common in the 8 to 11-year age group (52.2%). Vaginal bleeding was the most common presenting symptom (63.1%) and repair of vaginal laceration the most common procedure performed (54.8%).
Influence of acute renal failure in patients with cerebral malaria - a hospital-based study from India
Authors: Mishra Saroj K , Dietz Klaus , Mohanty Sanjib , Pati Sudhansu S
Published: July 2017

We analysed 110 adult patients with cerebral malaria, 38 of whom had serum creatinine above 3 mg%, to study the effect of acute renal failure (ARF) on survival. Patients with cerebral malaria had an increased risk of death (39.5% versus 13.9%) when also suffering from ARF. For each one log unit increase of creatinine at admission, odds of death increased by a factor of 10.8 (95% confidence interval 3.0-39.4).
The Best Interests of the Village Children
Authors: DeClue Gregory
Published: July 2017

This article tracks a practicing forensic psychologist's efforts to develop a scientifically based framework for doing child custody evaluations. To apply knowledge from the field of developmental psychology to questions considered by the courts, a search was made for an empirically validated list of effective parenting behaviors. Contrary to expectations, no such list was found. A new developmental theory, group socialization theory, suggests that this is because parents are much less influential than has been assumed. Implications for child custody evaluators are explored. Other psychologists, particularly child development researchers, are encouraged to comment.
Testimony by Proxy: The Use of Expert Testimony to Provide Defendant Testimony without Cross-Examination
Authors: Miller Robert D.
Published: July 2017

Much has been written about forensic psychiatry experts skewing their opinions and their testimony to suit the attorneys who retain them. In this article the author discusses a less common but even more problematic use of experts by attorneys: using them to present their clients' or victims' testimony in court without their having to undergo cross-examination. Courts have disagreed over the admissibility of such testimony; a number have permitted victim testimony by proxy (particularly in the case of child victims of sexual abuse, to protect them from retraumatization). Fewer have allowed criminal defendants' testimony to be presented through experts. The legal issue is whether the medical records exception to the hearsay rule in the federal and state rules of evidence permits the testimony; those courts that have barred such testimony have held that the purpose of the testimony was not to explain diagnosis or legal conclusions, but simply to avoid cross-examination. Cases illustrating this issue are discussed. Much of the discussion involves Colorado cases because, according to a computer search of the relevant case law, the issue has been litigated there more often than in other states.
Asian American Defendants: A Study of Psychiatric, Psychosocial and Legal Factors
Authors: Paradis Cheryl M. , Solomon Linda Z. , O'Neill Cynthia S. , Hernandez Maritza , O'Rourke Thomas
Published: July 2017

There is little empirical research on the association between mental illness and violent behavior in the Asian American (AA) community. The present study gathered information, through a retrospective review of approximately 3,500 charts from a 25-year period, on 51 AA defendants referred for competency to proceed evaluations. A comparison group of 127 defendants of other ethnic backgrounds (non-AA's) was selected randomly. The present study found many demographic, psychiatric and legal differences between AA and non-AA defendants. The AA group included significantly more women and older defendants. Only one AA was born in the United States and was fluent in English. Eighty percent had immigrated within the previous 15 years. The AA's were significantly more likely to be diagnosed with a severe psychiatric illness and charged with rape. The non-AA's were significantly more likely to be diagnosed with a personality disorder and to be charged with robbery and criminal sale of a controlled substance. The low number of AA's identified from psychiatric-court records suggests that court personnel are overlooking serious mental illness in AA defendants with less obvious psychiatric symptoms. This is likely due to a language barrier and possibly to AA's reporting primarily somatic symptoms. The high number of older and female AA defendants may be due to a variety of factors. They might have received more attention from court personnel or experienced more stress secondary to incarceration.
True Lies: Delusions and Lie-Detection Technology
Authors: Langleben Daniel D. , Dattilio Frank M. , Guthei Thomas G.
Published: July 2017

Legally relevant lying is an intentional attempt to convince another of the truth of a proposition the liar believes to be false. Delusion is an unintentional product of impaired reality testing that occurs in a range of psychiatric conditions and psychological states, some of which could be clinically subtle. Since deception, truth and delusion differ in the intent rather than reality testing criterion. Deception and delusion are influenced by the degree of congruence between subjective and objective reality and are probably mutually exclusive. Thus, a delusion could lead to an objectively false statement, that could nevertheless be subjectively true and indistinguishable from truth by its psychophysiological (i.e., the polygraph) signature. This article presents a relevant case as a starting point of an examination of the current and future role of neurophysiological (i.e., functional brain imaging) measurements in the detection of deception. The authors incorporate the recent data on functional brain imaging to the neuroanatomical mechanisms of true and false recall, behavioral regulation and deception into a testable model that could redefine deception and separate it from delusions on the basis of objective functional brain imaging measures.
The Forensic Psychologist as Consultant: Examples from a Jurisprudent Science Perspective
Authors: Drogin Eric Y.
Published: July 2017

Forensic psychological consultants can employ “jurisprudent science” analyses to examine the science, practice, and role domains of expert witness work product. Examples of relevant issues include “scientific certainty” versus “probability” as understood and expressed by the expert witness (science); test scoring, administration, and interpretation errors-including those committed by students and other trainees (practice); and the accessibility of verifiable information concerning the potential for inadequate licensure, failed board certification attempts, and prior disciplinary sanctions (roles). Taking care to address each of these three domains in a thorough, balanced, and scientifically valid fashion, forensic psychological consultants enable counsel to place expert mental health evidence in its appropriate context with an optimal degree of transparency and detail.
Forensic Consultation in Litigated Custody Disputes
Authors: Martindale David A.
Published: July 2017

In the context of litigated custody disputes, there are important differences between forensic consultants and expert witnesses. They address different subject matter, the discoverability of their files is different, and their expressed opinions are aimed at different targets. Once reviewers convey their initial impressions of an evaluator's work, retaining counsel must decide in which one of these two conflicting roles the reviewer will be most useful. Forensic consultants can provide invaluable assistance to counsel regarding an evaluator's background, methodology, opinion formulation, opinion communication, and possible multiple roles. Principles of the forensic consultation process require that consultants: (1) identify the required expertise; (2) identify the relevant forensic issue; (3) use multiple sources of data; and (4) focus on relevance, reliability, and sufficiency.
Sex Offender Risk Assessment and the Law
Authors: Witt Philip H. , DelRusso Joseph , Oppenheim Jessica , Ferguson Glenn
Published: July 2017

After discussing the historical, legal, and criminal justice context, the article reviews risk assessment principles for sex offenders. Issues of actuarial vs. clinical prediction, base-rate considerations, and duration of prediction are reviewed. The article next addresses specific factors found to predict sex offender recidivism, factors such as indicators of deviant sexual interest and an antisocial, psychopathic lifestyle. Finally, the article provides a current application in the form of New Jersey's Registrant Risk Assessment Scale to illustrate the risk assessment principles.
A Comparison of Correctional and Mental Health Referrals in the Juvenile Court
Authors: Thomas W. John , Stubbe Dorothy E.
Published: July 2017

This article presents the results of the first study to compare only court-referred adolescents in the mental health and criminal justice systems. The study reviewed the files of all 93 adolescents whom the Connecticut juvenile courts referred from July 1, 1993, to June 30, 1994, to Connecticut's only state-run psychiatric hospital for adolescents, and the files of all 241 adolescents whom the same courts referred that same year to the state's only juvenile correctional facility. The study analyzed the relationship between seven independent variables—gender, age, race, severity and other aspects of the alleged criminal offense, the court making the referral, family constellation, and the population size of the subject's home town—and referral for a mental health evaluation. Four of the independent variables—race, whether the subject was charged with a sex offense, age, and severity of the alleged offense—were significantly related to referral.
Claims of Forgotten Trauma
Authors: Harris G. Christian
Published: July 2017

Background:

A review of the literature was made concerning repressed memory phenomena and recovered memory therapy, and data from six psychiatric case histories were examined specifically with regard to repressed memory phenomena. The ramifications of repressed memory phenomena were examined regarding cultural origins and legal consequences, the role of the therapists in such cases, and the effects of repressed memory claims on the patients.

Methods:

A discussion of the literature regarding repressed memory phenomena and their cultural significance and legal applications precedes an examination of six cases involving repressed memory claims—three clinical psychiatric case histories and three forensic psychiatric case histories. Each case was evaluated with regard to its ultimate forensic resolution and/or its psychological impact on the patients and their families.

Results:

Repressed memory claims have gained cultural ascendancy during the last decade and have proliferated within the legal system, beginning with the late 1980s. Claims of repressed memory phenomena and methods of recovered memory therapy at the present time have shown little regard for substantiated proof or sound critical thinking in the pursuit of assigning blame for a wide array of adult mental illnesses and disorders.

Conclusions:

A method must be developed as a standard for repressed memory cases that will preserve the best interests of the patient and the integrity of the therapist's treatment plan. Recommendations are made for safeguarding the well-being of the patient and for defining the objective and credible role of the therapist in repressed memory cases.
Dual Commitments to Forensic Hospitals and Prisons: Rational Disposition or Political Compromise?
Authors: Miller Robert D. , Olin Jonathan , Ball Elissa M. , Johnson David S. , Reynolds James B. , Covey Jonathan
Published: July 2017

Society continues to struggle with what to do with persons who are both “mad” and “bad” (i.e., mentally disordered persons who commit criminal acts). The first attempt to differentiate between them occurred in the 19th century with the simultaneous establishment of the prison and state mental hospital systems and the formalization of the insanity defense. In the past two decades, the trend has been to return to imprisonment mentally disordered persons who commit crimes, but with provision of psychiatric treatment in the prison system. This article addresses a rarely discussed consequence of this trend: the simultaneous commitment of such persons to the prison and hospital systems.
Forensic Assessment, Witness Credibility and the Search for Truth through Expert Testimony in the Courtroom
Authors: Gutheil Thomas G. , Sutherland Pamela K.
Published: July 2017

In the legal system's search for truth, determination of the credibility of any witness is left to the fact finder. The widely recognized bar on any witness's attesting to the credibility of any other witness or claimant, however, exists in tension with certain ethical and technical requirements of the forensic psychiatric witness's role. These requirements include the need to perform an initial credibility threshold determination; the need to consider malingering in all forensic evaluations; and the need to utilize standard criteria for diagnosis, even if some diagnoses have acquired pejorative connotations. After examining the impact of Daubert v. Merrell-Dow on admissibility of scientific testimony, this article reviews the conflicts and concepts impinging on the legal system's search for truth through fairness and offers suggestions for coping with the testimonial and theoretical pitfalls that may occur during the process.
Litigating Posttraumatic Stress Disorder: Effects on the Family
Authors: Vesper Joyce H. , Cohen Larry J.
Published: July 2017

This article focuses on the effect of attorney litigation styles on clients who suffer from posttraumatic stress disorder and on the families of these clients. We look first at “environmental factors” affecting how the family experiences the client's reaction to the traumatizing event and how different types of families respond to litigation. We then turn to the different styles attorneys employ when processing claims in litigation and the common family responses to these styles. Next we explore the implications of these kinds of reactions for the effectiveness of the attorney-client relationship. We conclude with recommendations for fostering a productive working relationship among the client, the family, the attorney, and the mental health care provider.
Book Section: Essay and Review: The Right to Refuse Mental Health Treatment
Authors: Marson Stephen M.
Published: July 2017

Although Bruce J. Winick does not include a preface in The Right to Refuse Mental Health Treatment, it is obvious that the appropriate readership for this monograph includes judges, lawyers (both defense and plaintiff), psychiatrists, psychologists, clinical social workers, and counselors. The Right to Refuse Mental Health Treatment can best be described as a comprehensive assessment of the decision-making process regarding involuntary clients, patients and, of course, prisoners. With 20 chapters divided into three sections, it offers a significant contribution both to law and to clinical mental health intervention. The sections include Mental Health Treatment Techniques (seven chapters); Constitutional Limitations on Involuntary Mental Health and Correctional Treatment (eight chapters); and Evaluating and Implementing the Right to Refuse Treatment (four chapters).
Osteoporosis services in secondary care: A UK survey
Authors: Rowe R E , Cooper C C
Published: July 2017

A 1994 survey indicated that only 13 health authorities in the UK were purchasing access to dual X-ray absorptiometry (DXA), the most accurate measure of osteoporosis risk. By 1998 the number of centres (including private facilities providing DXA) was 161. All these were sent a questionnaire concerning their activities. 124 (77%) responded, and the survey found that DXA machines operate, on average, for only 3.6 days a week. Funding of and access to diagnostic services for osteoporosis varies greatly. There is clear scope for greater efficiency in the use of existing DXA machines and more equitable access to diagnostic services is required for effective management of osteoporosis.
Underutilization of antithrombotic therapy in atrial fibrillation
Authors: Adhiyaman V , Kamalakannan D , Oke A , Shah I U , White A D
Published: July 2017

Most patients with atrial fibrillation should be considered for antithrombotic therapy. In a retrospective survey we investigated practice in two hospitals. For patients at high risk, established guidelines recommend warfarin, or aspirin if anticoagulants are contraindicated; for those at medium risk, either may be used. Of 156 with atrial fibrillation (acute, chronic or paroxysmal), 119 were at high risk, mean age 79 years. According to the guidelines, 89 of these were suitable for anticoagulation but only 49 (55%) received warfarin; 27 received aspirin and 13 neither. Of 27 patients at medium risk (mean age 70 years), 6 were not prescribed any antithrombotic therapy. This survey indicates that guidelines on antithrombotic therapy are commonly disregarded and that, in particular, warfarin is underutilized in the group for whom it is most indicated.
A randomized controlled study of reviewer bias against an unconventional therapy
Authors: Resch K I , Ernst E , Garrow J
Published: July 2017

A study was designed to test the hypothesis that experts who review papers for publication are prejudiced against an unconventional form of therapy. Two versions were produced (A and B) of a ‘short report’ that related to treatments of obesity, identical except for the nature of the intervention. Version A related to an orthodox treatment, version B to an unconventional treatment. 398 reviewers were randomized to receive one or the other version for peer review. The primary outcomes were the reviewers’ rating of ‘importance’ on a scale of 1-5 and their verdict regarding rejection or acceptance of the paper. Reviewers were unaware that they were taking part in a study. The overall response rate was 41.7%, and 141 assessment forms were suitable for statistical evaluation. After dichotomization of the rating scale, a significant difference in favour of the orthodox version with an odds ratio of 3.01 (95% confidence interval, 1.03 to 8.25), was found. This observation mirrored that of the visual analogue scale for which the respective medians and interquartile ranges were 67% (51% to 78.5%) for version A and 57% (29.7% to 72.6%) for version B. Reviewers showed a wide range of responses to both versions of the paper, with a significant bias in favour of the orthodox version. Authors of technically good unconventional papers may therefore be at a disadvantage in the peer review process. Yet the effect is probably too small to preclude publication of their work in peer-reviewed orthodox journals.
Who looks after people with diabetes: Primary or secondary care?
Authors: Khunti Kamlesh , Ganguli Sumita
Published: July 2017

Because the prevalence of type 2 diabetes has increased greatly over the past decade, UK general practitioners have been encouraged to develop services for people with diabetes and to offer structured diabetes care. The resultant shift from secondary care can place considerable demands on primary health care teams. Data were obtained from 108 practices in two English health districts followed up in primary and secondary care. Nearly two-thirds of the people with diabetes were being followed up only in general practice, the remainder in hospital or both. The proportion managed in primary care varied from 5.6% to 94.6%. The settings where diabetes care was most likely to be offered were training practices, practices with good nursing support, practices with a high prevalence of diabetes, and practices in which a high proportion of diabetic patients were controlled by diet or hypoglycaemic agents. Tight control of glycaemia and blood pressure is now seen as important in diabetes, and is best achieved in general practice. This survey revealed large variations in delivery of general-practice diabetes care that need to be addressed by better organization and funding.
Slimming on the Internet
Authors: Miles John , Petrie Catherine , Steel Michael
Published: July 2017

The first 50 websites identified on searching the Internet for ‘weight loss diets’ were assessed systematically and their content compared with published clinical guidelines for management of obesity. The relevance and quality of the sites varied enormously. Only 3 confined themselves to sound dietary advice. Most promoted dietary supplements or other ‘slimming aids’, often of uncertain composition and based on dubious physiological principles. Potential hazards—for example, those of very low calorie diets—were rarely highlighted and certain regimens on offer were potentially dangerous.
Amphetamine abuse and intracranial haemorrhage
Authors: Buxton Neil , McConachie Norman S
Published: July 2017

Amphetamines taken by any route can cause cerebral vasculitis and intracranial haemorrhage. 8 cases were seen in a neurosurgical unit over 3.5 years. The published work indicates that those who experience these complications, mainly young adults, have poor outcomes.
The Kendrick-Eldering-(Frost) pertussis vaccine field trial
Authors: Marks Harry M
Published: July 2017

Additional material for this article is available from the James hind Library website [ http://www.jameslindlibrary.org ], where this article was previously published.
Bufale Spotting, part 7: Assessing an advert
Authors: Jefferson Tom , Zarra Lucia
Published: July 2017

This is the eighth in a series of articles on making evidence-based medicine work for you. The series is based on the book ‘Attenti Alle Bufale’ by Tom Jefferson ( www.attentiallebufale.it )
Hyperglycaemia and mortality
Authors: Asadollahi Khairollah , Beeching Nicholas , Gill Geoffrey
Published: July 2017

Several studies over the last decade have linked hyperglycaemia on hospital admission with subsequent mortality risk. The evidence is strongest for patients with myocardial infarction or acute coronary syndromes, but evidence also links hyperglycaemia with mortality from stroke and other medical illnesses. The effect seems independent of a previous diagnosis of diabetes mellitus; indeed, some studies suggest that mortality may be higher in patients with hyperglycaemia and no previous diabetes diagnosis compared with known diabetic patients. The effect on outcome of therapeutically lowering blood glucose levels has been considered in a small number of studies, but so far the results are conflicting. Further work is needed, focusing on more standardized surveys—previous studies vary in their use of blood or plasma, as well as cut-off levels for hyperglycaemia—and larger intervention studies.
Bufale Spotting, part 8: Assessing a letter to a journal
Authors: Jefferson Tom , Zarra Lucia
Published: July 2017

This is the ninth in a series of articles on making evidence-based medicine work for you. The series is based on the book ‘Attenti Alle Bufale’ by Tom Jefferson ( www.attentiallebufale.itb )
The Lazarus phenomenon
Authors: Adhiyaman Vedamurthy , Adhiyaman Sonja , Sundaram Radha
Published: July 2017

Even though Lazarus phenomenon is rare, it is probably under reported. There is no doubt that Lazarus phenomenon is a reality but so far the scientific explanations have been inadequate. So far the only plausible explanation at least in some cases is auto-PEEP and impaired venous return. In patients with PEA or asystole, dynamic hyperinflation should considered as a cause and a short period of apnoea (30–60 seconds) should be tried before stopping resuscitation. Since ROSC occurred within 10 minutes in most cases, patients should be passively monitored for at least 10 minutes after the cessation of CPR before confirming death.
Adapting to International Patient Education
Authors: Weiss Mary
Published: July 2017

When challenged with the problem of instructing a non-English speaking Saudi Arabian, I thought it would be simple to utilize the interpreter. This was not true. I felt that the interpreter did not realize the importance of the instruction and the instructions were interrupted frequently, destroying the continuity of the instructions. To as sure myself that the information was being translated correctly, I had a sim ple module translated into Arabic for the patient to follow. Using a combina tion of English-Arabic translation, an interpreter, family member, demon stration, and pantomine was a more satisfactory method of instruction. Our success with this has encouraged us to develop further foreign language in structions.
Rural Gifted Education: A Comprehensive Literature Review
Authors: Lawrence Barbara Kent
Published: July 2017

This review of literature about gifted rural education reveals not only important information but the need for further work. The concepts presented have applicability that is not exclusively rural, but they derive from studies done with rural students and take rural culture, history, and circumstances into account. Understanding the context of gifted rural students is essential if educators are to identify and teach them effectively. The author notes that doing so is critical for the sustainability of rural communities. These communities need gifted and talented students who understand and love them to invest their own lives in caring for such places. The author groups the studies reviewed into sections about rural values and culture, being gifted, identifying gifted rural students, options for educating gifted rural students, and teaching teachers to teach gifted rural children.
Altered Hepatic Foci in Rat Liver as Weight of Evidence of Carcinogenicity: The Canadian Perspective
Authors: Mahon Desmond C.
Published: July 2017

The use of AHF in the rat as a predictive lesion for carcinogenesis has been frequently suggested. Regulatory agencies require that the data used to determine carcinogenic potential and for estimating risk cannot be open to different interpretations. The degree of uncertainty in establishing relationships between the different foci phenotypes, their fate, and the difference in results with different protocols precludes the use of these data is establishing carcinogenic hazard or in quantitative risk estimation.
Impact of Helicobacter hepaticus Infection in B6C3F1 Mice from Twelve National Toxicology Program Two-Year Carcinogenesis Studies
Authors: Hailey James R. , Haseman Joseph K. , Bucher John R. , Radovsky E. , Malarkey David E. , Miller Richard T. , Nyska Abraham , Maronpot Robert R.
Published: July 2017

Male and female B6C3F1 mice from 12 National Toxicology Program (NTP) 2-yr carcinogenesis studies were found to be infected with Helicobacter hepaticus. Many of the male mice from 9 of these studies had an associated hepatitis (affected studies). Helicobacter hepaticus has been reported to be associated with an increased incidence of hepatitis and hepatocellular neoplasms in the A/JCr male mouse. We attempted to determine if the data from the Helicobacter-affected NTP B6C3F1 mouse studies were compromised and unsuitable for cancer hazard identification. The incidences of neoplasms of the liver (both hepatocellular and hemangiosarcoma) but not of other organs in control male B6C3F1 mice were increased in affected studies as compared with control males from unaffected studies. The increased incidence of hepatocellular neoplasms was observed in those males exhibiting H. hepaficus-associated hepatitis. Other observations further differentiated control male mice from affected and unaffected studies. H- ras codon 61 CAA to AAA mutations were less common in liver neoplasms from males from affected studies as compared with historical and study controls. In addition, increases in cell proliferation rates and apoptosis were observed in the livers of male mice with H. hepaticus-associaled hepatitis. These data support the hypothesis that the increased incidence of liver neoplasms is associated with H. hepaticus and that hepatitis may be important in the pathogenesis. Therefore, interpretation of carcinogenic effects in the liver of B6C3F1 mice may be confounded if there is H. hepaticus-associaled hepatitis.