bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Blood Viscosity with Heavy and Light Exercise
Authors: HITOSUGI MASAHITO , KAWATO HITOSHI , NAGAI TOSHIAKI , OGAWA YOSHINORI , NIWA MUNEHIRO , IIDA NAOKO , YUFU TETSUO , TOKUDOME SHOGO
Published: February 2010

To clarify the relationship of the intensity of acute exercise to sudden cardiac death, we examined the effects of short-term heavy and light exercise on whole blood viscosity. Nine healthy sedentary male volunteers performed ten minutes of heavy (more than 95% of maximum oxygen consumption) or light (60% to 65% of maximum oxygen consumption) exercise. Blood samples were obtained before, immediately after, and one hour after exercise. The whole blood viscosity was immediately examined with an oscillation-type viscometer and was found to increase significantly after exercise and subsequently return to baseline levels within one hour after exercise. The whole blood viscosity increased by a similar degree after heavy or light exercise. Therefore, our results suggest that there is a similar risk of sudden cardiac death, due to increased whole blood viscosity, after short-term heavy or light exercise.
Childlessness in Elderly Suicide: An analysis of coroner's inquests of 200 cases of elderly suicide in Cheshire 1989-2001
Authors: SALIB EMAD , EL-NIMR GEORGE , HABEEB BASSEM , THEOPHANOUS MARK
Published: February 2010

Child bearing has been reported to be protective for women in terms of suicide risk. However, it is not clear whether the protective effect of having children diminishes in old age. A literature search has not found studies which examined childlessness as a possible risk factor in elderly suicide. In this study we attempt to explore whether childlessness has any significant association with elderly suicide and whether this differs between women and men.

Data was extracted from the records of coroners' inquests into all unexpected deaths of persons aged 60 and over, in Cheshire, over a period of 13 years from 1989-2001. The study found no significant gender difference in childlessness in elderly suicide victims (P>.05). Significantly fewer widowed men who committed suicide were childless (OR 0.1, 95% CI 0.02-0.3 P<.001). A history of deliberate self-harm (DSH) and being previously known to services were found to be significantly lower in childless female victims compared to elderly mothers (OR 0.4, 95% CI 0.1-0.9 P<.05). Leaving suicide notes and the method of suicide did not appear to be significantly influenced by a childless status in either of the sexes (P>.05). The protective effect of having children appears to diminish in old age. Childless females appear to be at a higher risk of succeeding in their first suicide attempt and more importantly, can easily escape the attention of services.
The Effect of Clozapine on the Social Behaviour Schedule in Patients Attending a Forensic Psychiatry Day Hospital
Authors: SMITH HELEN , WHITE TOM
Published: February 2010

This study examined the difference in the functional capacity of patients receiving clozapine, compared with those prescribed other antipsychotic medication, who attend the forensic psychiatry day hospital at Murray Royal Hospital, Perth. (This facility caters for 34 patients. It provides a number of advantages such as access to therapies and supervision of mental state and medication at this critical time in the care pathway.)

This study was cross-sectional in nature and examined the patients' demographic details, diagnosis and medication. A functional assessment was carried out using the social behaviour schedule (SBS) for each patient.

We discovered that there was a marked difference in the hostility scores between clozapine patients and non-clozapine patients. Only 10.5% of clozapine patients had a severe score (more than two) on the SBS whereas 61.5% of those not receiving clozapine had a severe score. The non-clozapine group had more socially unacceptable habits and were more destructive than patients receiving clozapine, as scored by the SBS. The slowness and under-activity items were more severe in the clozapine patients. The non-clozapine group scored higher in the category of other behaviours that might impede progress, particularly drug-taking.
Life After Clozapine
Authors: BAKER MELANIE , WHITE TOM
Published: February 2010

We consider the reasons underlying clozapine withdrawal in a group of hospitalised schizophrenic inpatients and review clinical outcome following clozapine withdrawal. A retrospective case note study was undertaken of all patients (n=41) registered at the State Hospital, Carstairs, with the Clozaril Patient Monitoring Service between 1990 and 2001 whose clozapine therapy had either been withdrawn or never initiated following registration. Twelve patients refused to commence clozapine following registration: twenty-nine patients were subsequently studied. Thirteen patients stopped clozapine owing to non-compliance, whereas seven had clozapine withdrawn due to a clinically inadequate response. Eleven patients were withdrawn primarily because of an unacceptable side-effect burden, although only four had a ‘red alert’. In twenty patients, abrupt clozapine withdrawal resulted in a marked, immediate deterioration in their mental state. Twenty-three patients remained at the State Hospital at a mean follow-up period of 75 months.

The study highlights the relevance of psychoeducation for clozapine patients in the maintenance phase of treatment, the importance of minimising the side-effect burden by clozapine monotherapy, the effectiveness of clozapine serum level monitoring and the evidence base for adjuvant treatment.
Section 5(2) of the Mental Health Act: Local and national use over a twelve-year period
Authors: GRANT WILLIAM
Published: February 2010

The pattern of use of Section 5(2) of the Mental Health Act 1983 was examined over a 12-year period at one psychiatric hospital. Although there was a national trend for Section 5(2) to be used more frequently, the local pattern was of a fluctuating number of patients being placed on this Section, but without there being any upward trend towards its increased use. As has been seen in other studies, Section 5(2), however, tended to be used for a younger group of patient who had often only been admitted within the previous 24 hours.
Suicide by Gunshot in the United Kingdom: A review of the literature
Authors: HAW CAMILLA , SUTTON LESLEY , SIMKIN SUE , GUNNELL DAVID , KAPUR NAVNEET , NOWERS MIKE , HAWTON KEITH
Published: February 2010

This paper reviews the research literature on gunshot suicide in the United Kingdom and the international literature with reference to strategies aimed at preventing gunshot suicides. Trends in gun ownership and changes in firearm legislation in the UK over the past 20 years are described.

Most UK gunshot suicides are male, middle-aged and living with a partner and involve the use of shotguns. They are less likely to have current or past mental health problems, or a previous act of self-harm, than people who commit suicide by other methods, and their suicide is more likely to have been precipitated by a relationship dispute. Where alcohol is consumed the amount tends to be large.

The international literature provides evidence of a strong association between rates of gun ownership and gunshot suicide, and some evidence of a reduction in firearm suicide rates following the introduction of restrictive firearm legislation. Over the past 20 years the number of gunshot suicides in the UK has declined by over 50% to a little over a hundred deaths per annum. At the same time, firearm legislation has become progressively more restrictive and rates of gun ownership have declined.

Measures, which might further reduce the prevalence of gunshot suicides in the UK, are discussed.
‘Here There Be Monsters’:The public's perception of paedophiles with particular reference to Belfast and Leicester
Authors: McCARTAN KIERAN
Published: February 2010

This research study sought to investigate the public perception of paedophiles. It was undertaken in Belfast (Northern Ireland) and Leicester (England) in an attempt to determine whether or not regional variations existed in relation to the public's perception of paedophiles. In doing this, the study sought to test four hypotheses;

(1) That the press affects the public's perception of paedophiles;

(2) that the public's perception of paedophiles is not congruent with legal and clinical definitions;

(3) that the Sarah Payne case has helped to reinforce the public's perception of a predatory paedophile; and

(4) that the public's perception is based on fear and irrationality.

These hypotheses were tested via the distribution of a questionnaire to an opportunistic sample on the streets of Belfast and Leicester.

Although the results did not support the hypotheses, they did yield some very interesting information. The study indicated that the public is quite well-informed about paedophilia; its recurrence rates, practices and in particular the influence of the media. Furthermore, the study indicated quite significant differences between the cities of Belfast and Leicester. In conclusion, the results indicated that a moral panic connected to paedophilia is very present in our contemporary society.
Cloning Controversies: An overview of the science, ethics and politics
Authors: Sharma B R
Published: February 2010

Man's quest for knowledge is boundless. It is because of this quest and his untiring efforts to acquire it, that we have made such tremendous breakthroughs in the fields of science and medicine. Vaccines for hitherto incurable diseases, genetic engineering, and the correction of congenital and hereditary diseases are a few of these. With the successful cloning of `Dolly', `Molly' and `Polly' we are now standing at the threshold of another major breakthrough – human cloning. However, are we ethically, morally and politically mature enough to `go all the way' in a purely scientific manner, for the benefit of the human kind? A review of the scientific, ethical and political events in this field may be pertinent in trying to answer this important question.
Accidental Ligature Strangulation Deaths in East Delhi (India)
Authors: Verma S K , Aggarwal N K , Kohli A
Published: February 2010

Ligature strangulations are usually homicidal. Accidental cases are quite uncommon, especially among adults. A retrospective ten-year study conducted in East Delhi revealed that in a total of 98 cases of death due to strangulation, five cases (∼5%) among all medico-legal deaths were of fatal ligature strangulation, involving adults who were neither intoxicated nor indulging in paraphiliac activity. The causative agent in three cases was a cycle rickshaw, in one case it was a rotatory part of a machine, and the fifth case occurred due to entanglement while tying up a cow. The cases and their autopsy findings have been described in this paper, together with the review and preventive aspects of such cases.
Birth Order and Fratricide: An evaluation of Sulloway's hypothesis
Authors: Marleau Jacques D.
Published: February 2010

Sulloway (1996) suggested that older siblings were more likely to be fratricidal than younger ones. Our data, based on 113 case studies found in the psychiatric, psychological and criminological literature since 1959, confirms his hypothesis. In 72 out of the 92 cases (78%) where age could be determined, the aggressor was older than the victim. The same held true even when the age of aggressor, sex of aggressor and victim, presence or not of a blood tie, and presence of one or more victims are taken into account. Surprisingly, most of the aggressors in our sample were under the age of 18 years. Also, firstborns were more often the aggressor than the victim. This result seems to confirm the Adlerian theory of dethronement. Some suggestions and hypotheses are advanced for future research to improve our understanding of this phenomenon.
Criminal Abortion and Concealment of Birth in Transkei Region, South Africa
Authors: Meel B L
Published: February 2010

The objective was to estimate the incidence of criminal abortions and concealment of births in Transkei. This paper presents a review of the records of the medico-legal register at Umtata General Hospital from 1993-2003.

There were 37 cases of premature concealed births and conceptus material brought to the attention of medico-legal investigators between1993 and 2003. Of these, 26 (70.3%) were concealed births, and 11 (29.7%) were abortion products. There is great variability in the incidence of abortion and concealment of births during this period. There were nine cases in 1993 and three in 2003. No case was reported in 1994. There was only a single case reported in each of the years 1995, 1997 and 2001, and four cases in each of the years 1996, 1998 and 2002. In 1998 there were eight cases, the highest for any year after promulgation of the Abortion Act.

There is no significant difference in the number of cases reported for medico-legal investigation of criminal abortion and concealment of births before and after the Abortion Act which came into effect in 1997.
Laboratory Evaluation of a New Evidential Breath-Alcohol Analyser Designed for Mobile Testing – the Evidenzer
Authors: Fransson M , Jones A W , Andersson L
Published: February 2010

The Evidenzer is a new kind of forensic breath-alcohol analyser, designed for use both at a police station (stationary) and also in a police vehicle (mobile) at the roadside. In this paper we report the accuracy and precision of the Evidenzer, determined under controlled laboratory conditions. The results were compared with a well-established breath-alcohol instrument (Intoxilyzer 5000S) and also with the concentration of alcohol in venous blood. Twenty healthy volunteers (10 men and 10 women) consumed ethanol (0.4 g/kg) in 15 minutes starting two to three hours after their last meal. Venous blood and breath were obtained for determination of ethanol at 15-30 minute intervals for up to four hours post-dosing. There was a good overall agreement between the two breath-alcohol instruments and the mean bias was only 0.003 mg/L (95% limits of agreement of -0.016 to 0.023 mg/L). The standard deviation (SD) of measuring ethanol in breath was about the same for both instruments, being 0.006 mg/L, and this corresponds to a relative precision or coefficient of variation (CV) of 4.7%. When the Evidenzer was used to analyse ethanol vapour (0.50 mg/L) generated from a wet-bath simulator, i.e. in-vitro conditions, the coefficient of variation was 0.7% indicating high analytical precision. The concentration of ethanol in venous blood and breath were highly correlated (r=0.95) although systematic differences existed depending on time after drinking when comparisons were made. Both breath-alcohol instruments gave results higher than venous blood alcohol in tests made at 15 minutes after the end of drinking whereas at all later times the venous blood-alcohol concentration was higher than the breath instrument readings. These observations can be explained by the time necessary for ethanol to equilibrate between arterial blood and tissue water and by the resulting arterial-venous differences. The time-course of alcohol concentration in arterial blood runs closer to the breath-alcohol concentration rather than the venous blood draining the forearm muscle tissue. The new Evidenzer instrument was easy to operate and gave accurate and precise results compared with Intoxilyzer 5000S.
3. Potential Contamination of Forensic Entomology Samples Collected in the Mortuary
Authors: Archer M S , Ranson D L
Published: February 2010

Carrion insects originating from infested bodies may establish small mortuary populations. Two Victorian Institute of Forensic Medicine cases are presented to illustrate how these insects can potentially contaminate forensic entomology samples collected in the mortuary. The first case proves that bodies can be colonised in the mortuary: when a decomposed body in freezer storage was thawed for a procedure in the main mortuary, it was colonised within five minutes of exposure by the beetle Necrobia rufipes De Geer (Cleridae, Coleoptera). The second case illustrates that immobile juvenile insects can be transferred between bodies, and describes the transfer of an Eristalis sp. (Syrphidae, Diptera) pupa from a decomposed to a fresh body. While the contamination risk is slight, it can be further minimised by checking mortuary-collected samples against those taken from the body discovery site, by mortuary pest control, and by checking previous mortuary admittance records for possible contamination sources.
The Impact of Trends in Psychotropic Prescribing on the Method of Suicide in the Elderly
Authors: Shah Ajit , Lodhi Lubbaba
Published: February 2010

Suicide rates in the elderly have declined in many countries in recent years. This decline has been reported to be associated with increased prescribing of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), antipsychotics and antimanic drugs and reduced prescribing of barbiturates, hypnotics and sedatives. This study examined the relationship between prescribing patterns of individual psychotropic drugs and suicide rates by specific methods of elderly suicides.

There was a negative correlation between the prescription of tricyclic antidepressants, selective serotonin reuptake inhibitors, antipsychotics, antimanic drugs and non-opiate analgesics and a decline in elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. There was a positive correlation between the prescription of barbiturates, hypnotics and sedatives and elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places.

This study demonstrated that changes in prescribing patterns of individual psychotropic drugs do influence elderly suicide rates of the commonly used methods of suicide and suggest that this may be due to more accurate diagnostic-specific prescribing of psychotropic drugs.
Cross-Sectional Survey of the Use of Section 5(2), Mental Health Act 1983, Within a Psychiatric Hospital
Authors: Jacob Caroline , Freer Tegwedd
Published: February 2010

A survey of the use of section 5(2), Mental Health Act 1983 within a psychiatric hospital was carried out between January and December 2001.

Using computer-based patient records, it was found that 89 patients were placed on a section 5(2) between January and December 2001. Data on patient demographics, hospital admission date, date of implementation of section 5(2), date of reassessment after section 5(2) and outcome of the assessment was obtained from these records. In addition, the medical case notes of those patients identified (total of 81 case notes obtained) were studied with regard to the reasons for use of section 5(2), the process of implementing the section, the documentation of reassessments and the notification to the patient of his/her rights whilst under section.

It was found that the conversion rates to a further section after implementation of section 5(2) were significantly higher amongst patients who are over 65 years than amongst patients under the age of 65 years (Yates corrected chi-square test 3.87, p=0.04.df=1. Risk ratio 0.68 (0.51-0.92, 95% CI). 53% of patients detained under section 5(2) were male, 47% were female. Sixty-four per cent of section 5(2)s were converted to a further section, 37% to a section 2 and 27% to a section 3. A longer period of time until reassessment of the patients led to a lower conversion rate to a further section. Fifty-four per cent of section 5(2)s were implemented within 24 hours of the patient's admission.

Many current areas of practice do not meet with standards recommended by the Code of Practice. Higher conversion rates of section 5(2) to a further section may imply increasing psychiatric inpatient morbidity, hence higher numbers of patients being eligible for detention under the Mental Health Act 1983.
Study of the Relationship between a Person's Stature and the Height of an Ear Imprint from the Floor
Authors: Van Der Lugt C , Nagelkerke N J D , Maat G J R
Published: February 2010

Occasionally ear prints are found at crime scenes. The height of the ear imprint may provide the police with information regarding the stature of the perpetrator and may therefore help to narrow down the number of suspects. The research provides calculations for the determination of stature from the height of the tragus imprint found at crime scenes. It takes into account various variables such as age, stature and gender.
Needs Assessment in Forensic Learning Disability
Authors: Crossland Sue , Burns Mick , Leach Chris , Quinn Patrick
Published: February 2010

This paper gives the results of a needs assessment of a group of learning-disabled forensic patients from two Strategic Health Authority areas in the north of England. The patients were found to be a heterogeneous group with wide-ranging psychiatric needs. The majority were cared for outside their geographical area of origin, either in specialist NHS facilities or the independent sector. Those with an additional diagnosis of mental illness were most likely to be detained in NHS facilities within the region: a diagnosis of personality disorder was associated with placement in either a high secure setting or the independent sector. Individuals with a clinical diagnosis of mental retardation were most likely to be detained in services provided by specialist learning disability/mental health trusts out of area. There was a small group of females who were all placed outside the region. Offending behaviour was most likely to consist of violence against the person, sexual offences and arson. The majority assessed were felt to have long term needs. The study raised important implications for future provision of forensic services in the area, particularly the need to offer services with treatment programmes tailored to the needs of the population under review.
2. An Unusual Death due to the Impalement of a Gear Stick into the Brain Stem through the Nasal Cavity
Authors: Nozawa Hideki , Watanabe Kanako , Suzuki Osamu , Seno Hiroshi
Published: February 2010

A 59-year-old male was driving a car on the road and was involved in a traffic accident, colliding with a tanker and a big lorry. When an ambulance arrived at the scene, he was in a state of cardiopulmonary arrest and was bleeding profusely from his right nostril. He was confirmed dead at hospital. The autopsy showed a laceration of the right upper lip extending to the right nostril. In the basal skull there was a notable perforation at the ethmoid bone together with the central part of the sphenoid bone including the sella turcica. In accordance with the basal skull bone fractures, there were pronounced contusion injuries at the brain stem and a contusion injury was also observed in the right part of the cerebellum. After careful investigation of a causative stick-like item that was present inside the car, it was concluded that a severe movement of the man's body, as a result of the traffic collision, caused the gear stick which was fixed to the steering wheel to become impaled in the man's right nostril. The gear stick passed through the nasal cavity and into the basal skull bones, resulting in fatal brain stem injuries.
A Study of Burns for Wound Ageing reveals Changes in Unburnt Skin with Implications for Future Research
Authors: Langlois Neil E I , Tarran Sarah , Dziewulski Peter
Published: February 2010

Thirty-three punch biopsy sets of burn wound edge and adjacent unburnt skin from burn wounds aged six hours to 23 days were obtained from 18 patients. Immunohistochemical staining was performed for transforming growth factor beta receptor, epidermal growth factor receptor and MIB-1 (which stains the cell cycle associated antigen ki-67) in addition to integrins alpha V, 5 and 3 to assess for temporal patterns that might assist in the ageing of burn wounds. There was an early (12 hr-4 day) rise in integrin alpha V expression, an increasing expression of transforming growth factor beta receptor from 12 hours onwards, and increased expression of MIB-1 commencing at 2 days. In biopsy samples from the edge of the burn there was a trend for an early (6 hr-4 day) rise in epidermal growth factor receptor expression. There were no discernable changes in integrin alpha 5 or 3. The striking feature was that biopsy samples from the adjacent, unburnt skin showed similar temporal staining patterns. A further study would be required to determine if the effect was generalised or local, but the observation of changes in unburnt tissue implies that careful consideration must be given to selecting control tissue.
HIV/AIDS Post-Exposure Prophylaxis (PEP) for Victims of Sexual Assault in South Africa
Authors: Meel B L
Published: February 2010

An earlier study (Meel, 2003) showed that more than 90% of victims of sexual assault in Transkei region, South Africa, were HIV-seronegative at the time of the incident. This was despite the fact that the community had a high prevalence of HIV. In sexual assault cases post-exposure prophylaxis (PEP) is recommended to prevent HIV transmission. Therefore, therapy with zidovudine (AZT) and lamivudine (3TC) is justified. The purpose of this study is to describe the demographic characteristics of the victims, to assess the outcome of HIV transmission and to evaluate the success of PEP after its implementation in Transkei.

There were 594 victims of sexual assault during the study period at Sinawe Centre from 2000-2003. Of these, 346 (58.2%) were children under the age of 15 years. Seventeen children (2.9%) were found to be HIV positive at the first test. Among the adults, 58(9.8%) tested HIV positive. Of the 225 who attended after PEP was introduced, only two were found to be HIV seropositive at the time of the incident. A second test was recommended after four weeks and a third after 12 weeks. The majority of the victims did not report for the second test, but all 35 who did come to be tested were seronegative. Seventeen of those were between 11-15 years of age. Only seven victims came for the third test, and they, too, were negative. Nausea and vomiting were the commonest side effects of PEP treatment in four patients and one developed a generalized rash. Only one victim seroconverted.
Further Aspects of Male-on-Male Rape and Sexual Assault in Greater Manchester
Authors: McLean Iain A , Balding Val , White Cath
Published: February 2010

The purpose of this paper is to describe pertinent non-medical circumstances around male-on-male sexual assault, and supplements the earlier article in this journal regarding forensic medical aspects of this population. As services (medical, policing and judicial) see more males they will need to adapt themselves to their needs as well as those of their female clients. St. Mary's Sexual Assault Referral Centre (Greater Manchester, UK) opened in October 1986. Up to May 2003 it had seen 376 male (370 individual clients) and 7,789 female cases (7,403 clients). Of these, significantly fewer males reported to the police than females, although this difference has disappeared in recent years. There were also significant differences between the sexes regarding relationship, number of assailants, and assault location. There were no statistically significant differences between the sexes for age of the client, and presence in the assault of weapons or additional violence.
2. Haemorrhoids leading to Post-Mortem Artefact
Authors: Bhardwaj D N , Sharma S K , Gupta S
Published: February 2010

Any change produced, or feature introduced, in a body after death which is accidentally or physiologically unrelated to the natural state of the body is termed as an artefact. Since artefacts may lead to misinterpretation of post-mortem findings, it is important to rule them out. Artefacts may be produced for a variety of reasons. We present a case report where a young male in his late twenties committed suicide by hanging. He was suffering from haemorrhoids. Because of his posture, there was post-mortem bleeding, which was interpreted by the police as bleeding due to the self-cutting of his veins. Hence, we felt the need to report this case.
3. Positive Identification of a Decomposed Body using a Trilogy of Identification Criteria
Authors: Wilcher Glenn W , Hulewicz Bogdan
Published: February 2010

A case of roentgenographic identification of a decomposed, visually unidentifiable, edentulous deceased person is reported. Comparative evaluation of ante-mortem and post-mortem plain radiographs provided positive identification, confirming the presence of a transitional lumbar vertebra with concordance in dysmorphic features of a spinal dysraphism, and the configuration of sternotomy sutures used for surgical reconstruction of the sternum post-coronary artery bypass surgery. In addition, comparison of ante-mortem and post-mortem dental orthopantomograms confirmed the presence of iatrogenic dental evidence, in the form of amalgam tattooing.

The use of amalgam tattooing in establishing identification has only been reported once previously in the literature (Slabbert et al., 1991).

The stability in morphology and the location of the amalgam particle was sufficient to confirm the identification of the deceased as a single trait or as an adjunct to other identification criteria.
Homicide in the Canadian Prairies: Spousal killers, amnesia and self-harm
Authors: Menzies Robin P D
Published: February 2010

This study identifies the incidence of claims of amnesia in homicide offenders and explores the associations with other psychopathology. It is a retrospective file review and analysis of 901 non-selective, adult men convicted of homicide.

Claims of amnesia occurred in 31% (280) of the total homicide population and 46% of spousal killers compared to 28% of non-spousal killers. Claims in both groups were significantly associated with alcohol use and in the spousal group with actual or threats of self-harm at the time of the killing. Spousal killers were more likely to claim some degree of amnesia for the homicide and engage in or threaten self-harm after the killing. These and other features suggest that some spousal killers may have borderline personality traits/disorders. This study proposes a new classification for spousal homicides.
The Galbraith Judgment and the Defence of Diminished Responsibility in Scotland
Authors: Hodelet Nicola , Darjee Rajan
Published: February 2010

New case law on diminished responsibility in Scotland ( Galbraith v. HM Advocate 2001) re-defined the defence and clarified the role of expert witnesses. We examined how this judgment affected the use of the defence, provision of expert evidence and the outcome of trials. We studied homicide cases in one area of Scotland in the year before and the year after the new judgment. Results indicated little change in the number of cases where the defence was used, but a difference in how psychiatrists set out their opinions.
An Audit of Urgent Referrals by the Procurator Fiscal to the Tayside Forensic Psychiatric Service
Authors: White T , Rutherford H
Published: February 2010

This study describes the demographic, offence and diagnostic characteristics of subjects referred by the Procurators Fiscal operating from three courts in Tayside, Scotland. A comparison is made of referrals made between 1988 to 1995 and 1997 to 1998. There was an increased rate of referral on an urgent basis over time, primarily involving patients already in contact with the psychiatric services, 37% of whom were detained and admitted to hospital. This urgent assessment ensured that mentally-disordered offenders were not remanded in custody simply for the preparation of a report, and it allowed an early assessment to be made regarding the suitability for diversion from prosecution. This outcome is compatible with guidelines issued by the Home Office in 1990 (Home Office, 1990).
Shoplifting in the Mentally Ill: The role of bipolar affective disorder and mental retardation
Authors: Cheng Rachel S Y , Lin Candy , Fok Marcella L Y , Leung Chi-Ming
Published: February 2010

This study explores shoplifting behaviour in mentally ill patients, and evaluates the association between shoplifting and different mental illnesses in a local Chinese population. A comparison is made between shoplifting offenders and a matched control group of non-offenders among the psychiatric patients registered at a university department of psychiatry. Major depression, bipolar affective disorder (BAD) and mental retardation (MR) are the most common diagnoses among mentally ill shoplifters, while patients with a diagnosis of BAD or MR are at higher risk of committing an offence than patients with other diagnoses. Bipolar affective disorder has not been described as a risk factor for shoplifting behaviour in the psychiatric literature. Such a possibility should be seriously considered in the psychiatric assessment of shoplifting cases.
Neck Structure Injuries in Hanging – Comparing Retrospective and Prospective Studies
Authors: Sharma B R , Singh Virendar Pal , Harish D
Published: February 2010

Deaths due to hanging are common among suicides. Various studies in the forensic literature have reported considerable differences in the frequency of hyoid bone or thyroid cartilage fractures and injuries to the musculature and the vasculature of the neck. Some important reasons to which these variations could be attributed include: lack of a common method for examination of neck structures, varying degrees of thoroughness in examining the neck structures and lack of seriousness in the documentation of the findings (as cases of hanging are almost always suicidal) thus affecting the results of retrospective studies.

The present study was conducted retrospectively (1994 to 1999) and prospectively (2000 to 2003) on 108 cases of hanging. Seventy-one per cent of the cases were male and 29% female, aged between 15 to 60 years. Hanging was typical in 20% of cases and atypical in 80%; it was complete hanging in 46% of cases and incomplete in 54% of cases. Neck structure fractures were found to be more common in atypical complete hangings; the incidence was found to be 10% in the retrospective group and 27% in the prospective group. Contusions and lacerations of musculature were found in 20% of cases in the retrospective group and 34% in the prospective group, thus stressing the need for thorough postmortem examinations and meticulous documentation of the findings.
Traumatic Death from Rival Gang Violence in Rivers State, Nigeria
Authors: Seleye-Fubara D , Bob-Yellowe E
Published: February 2010

A prospective autopsy study in Rivers State, Nigeria, was undertaken to evaluate the patterns of death as a result of rival gang clashes and to highlight the menace of rival gang violence.

Between 1 January 1999 and 31 December 2003 medico-legally autopsied bodies in Rivers State, where death was the result of gang violence, were studied after being served with the coroner's form. In all cases, standard autopsy procedures were adopted and reports were issued.

A total of 58 bodies were autopsied for the study. Three (5.2%) were females and 55 (94.8%) were males, giving a female to male ratio of 1:18.3. The age group of 10-29 years recorded the highest frequency of death (65.6%) with a peak in the age group 20-29 years (39.7%). Gang violence and politically motivated mob action were the most common precipitating factors (60.3% and 20.7% respectively). Firearms (41.4%) was the most common method applied for the killing. Death was more common in the rural areas of Rivers State.

Gang clashes, volatile political rallies, illegal drug peddling and illegal oil bunkering should be banned and stringent laws be passed. Such laws should also cover gun handling and should be enforced.
The Clinical Duty of Care: Is it enough that the doctor did what all or many of the other doctors do?
Authors: SAMUELS ALEC
Published: February 2010

Who decides what is required in order to fulfil the duty of care, the doctors or the judges? This paper examines what the judges have been saying of late and gives an analysis of recent judgements. It also looks at the extent to which judges are challenging the medical experts. The trend away from medical paternalism to patient autonomy is discussed in the light of continuing uncertainty of the law and medical practice.
The Abbreviated Injury Scale and its Correlation with Preventable Traumatic Accidental Deaths: A study from South Delhi
Authors: RAUTJI R , BHARDWAJ D N , DOGRA T D
Published: February 2010

Anatomic trauma scoring systems are fundamental to trauma research. The Abbreviated Injury Scale (AIS) and its derivative, the Injury Severity Score (ISS), are the most frequently used scales.

In a prospective study, 400 autopsies of road traffic accident victims performed between January 2002 and December 2003 were coded according to the AIS and ISS methods. All the cases were classified into different injury groups according to the Injury Severity Scale. Fifty-eight cases (14.5%) were assigned an ISS value of <25; 244 (61%) cases were valued between 25-49; 38 cases (9.5%) were valued between 50-74 and 60 (15%) cases had a value of 75. On analysis of medical care, in cases with ISS<50, about 96% of the victims did not receive optimal care quickly enough with a lack of pre-hospital resuscitation measures and lengthy transportation time to hospital being of major importance.
Fatal Neglect of the Elderly by a Spouse
Authors: SAUVAGEAU A , RACETTE S
Published: February 2010

Neglect is one of the most common forms of elder abuse, along with physical and psychological abuse. It is defined as an elderly person alone who is not able to provide for him or herself the services necessary to maintain physical and mental health, or who is not receiving those services from a responsible carer. We present an unusual case of neglect where a 69-year-old diabetic man was left lying on the ground by his spouse after a sudden fall from a cerebral stroke. The man was not able to move or to get up and his spouse, unable to lift him up, did not seek help. Although the victim's spouse reported having taking care of him, the man died four days later from a fatal hyperglycaemia.
Air Gun — A Deadly Toy?
Authors: KULIGOD F S , JIRLI PRASANNA S , KUMAR PRADEEP
Published: February 2010

Air guns (air rifles) are used throughout the world as instruments of amusement such as toys in funfairs, for bird hunting and firearms training. In India and in many other countries, this instrument neither comes under the purview of the Arms Act, nor is there is any restriction on the user's age. This enables a person to gain access to this instrument quite easily. Sometimes serious and fatal injuries result when it is used by an ignorant person or by a criminal. There are reports which suggest that these ‘toys’ can cause painful injuries but only a few cases of death have been reported. There is no literature about the features of injuries that help to establish the range of fire by an air gun. Here we report a case where a boy was accidentally shot to death while watching bird shooting. We attempt to correlate the injury with the range of fire.
HIV/AIDS, Psychiatric Disorder and Sexual Assault in Transkei
Authors: MEEL B L
Published: February 2010

HIV infection and psychiatric disorders have a complex relationship. HIV infection could lead to psychiatric disorders, and psychiatric patients are more vulnerable to HIV infection. HIV is not only an illness which is associated with stigmatization and discrimination, but also has several risks attached including physical and sexual abuse. There is a scarcity of literature on HIV, mental illness and sexual assault although they are a common trio.

The author describes an HIV-positive woman with a psychiatric disorder. She suffered from AIDS and periodic psychotic epidsodes. On a day when she had such an episode she became a rape victim. The history, and physical and genital examination has been described. The need for further research in the area of HIV/AIDS and mental health has been discussed. Preventive strategies have been recommended for HIV-infected individuals in poor health resource settings.
Severe (Psychopathic) Personality Disorder: A review
Authors: MOSS KATE , PRINS HERSCHEL
Published: February 2010

The development of the concept, causes and management of severe (psychopathic) personality disorder is reviewed against the current background of government concern about the activities of a small group of individuals alleged to be showing the disorder to a dangerous degree. The authors acknowledge the problems involved in ‘labelling’ the disorder. The term psychopathic has a somewhat chequered history. It did not enter UK legislation until the Mental Health Act 1959. To this extent, it is a legal term and does not equate to any exact degree with the clinical descriptions currently in use. However, the term ‘psychopathic disorder’ will be used as a kind of shorthand for variants in everyday use. It is important to note that in this contribution we are only considering those ‘psychopaths’ who have come to the attention of the criminal justice and mental health systems. There are also ‘psychopaths’ who, for a variety of reasons, have not come to official attention and a recent contribution by Board and Fritzon (2005) highlights some interesting common characteristics in business managers and a sample of forensic patients detained in high security establishments.
Section 5(2) Mental Health Act 1983: Does teaching make a difference?
Authors: SCHOFIELD CHRISTOPHER J , ZIGMOND TONY
Published: February 2010

There have been well-documented misunderstandings about the use and powers of section 5(2) of the Mental Health Act (MHA)1983, however there are no published studies looking at how education of the clinicians involved affects any outcome measures. The aim of this study was to examine the impact of training junior doctors in the correct use and powers of section 5(2) of the MHA 1983. Data was collected before and after teaching junior doctors in Nottingham.

There were proportionally fewer section 5(2)s MHA 1983 implemented by junior doctors after the teaching. A suggested gold standard for reclassification rates was found and trends in better practice are also reported. Teaching junior doctors about section 5(2) MHA 1983 increases the proportion of senior doctors implementing the section and this should improve patient care. All junior doctors should receive specific teaching about section 5(2) at the start of their training.
A Fatal Fall from a Balcony? A biomechanical approach to resolving conflicting witness accounts
Authors: JONES M D , CORY C Z
Published: February 2010

An adult male was found below a third floor balcony having sustained fatal head injuries. An account provided by a witness described how the deceased had been in high spirits and had engaged in swinging from the third floor balcony rail in an attempt to swing onto a lower second floor balcony and whilst doing so had lost his grip and fallen (10.67 metres) to the ground below. A conflicting account was provided, some weeks later, by a second witness, who claimed to have observed an argument between two men on a third floor balcony, during which one had vigorously pushed the other over the balcony rail. The push, it was alleged, caused the man to move very quickly over the balcony rail and fall in an ‘upturned crucifix’ position to the ground. This paper describes a series of biomechanical experiments, conducted on a reconstruction of the third floor balcony and the second floor balcony rail, during which a volunteer was subjected to the two fall scenarios, in an attempt to resolve the conflicting witness accounts. Analysis of human movement was performed using a 3-D motion analysis system, markers were placed at the volunteer's key joint centres and were tracked to determine physical parameters. The parameter values were used to calculate what dynamic movements may have occurred had the volunteer been allowed to fall, not just a distance equivalent to the lower balcony rail but a greater distance, equivalent to that between the balcony and the ground. Calculations indicate that during the hanging-fall scenario a range of body rotation was produced between 159° and 249°, that is, an upturned head-first body orientation, consistent with that required to produce the described injuries and consistent with the description provided by the first witness. The push-fall scenario, however, produced a greater estimated body rotation of between 329° and 530°, equal to the body rotating, from the point of free-fall to the moment of impact, between almost 1 and 1.5 times. This was consistent with the described injuries but inconsistent with the description provided by the second witness. It was therefore concluded that although both the accidental and inflicted-push scenarios could produce a body orientation consistent with the reported injuries, only the accidental scenario produced a fall which could be described as an ‘upturned crucifix’, since the push scenario produced a significantly greater body rotation. The witness who alleged that the deceased had been pushed later retracted his statement.
The Future of Medium Secure Forensic Psychiatry in Britain: A survey
Authors: HILL SIMON A
Published: February 2010

The number of National Health Service (NHS) secure psychiatric beds is increasing. This survey asked forensic services about their plans for expansion. The survey indicated a large increase in medium secure provision over the next five years. The increase in the number of patients being detained in secure settings raises questions about whether there is in Britain an on-going process of ‘reinstitutionalisation’ of the mentally ill.
Migration Psychosis and Homicide in Singapore: A five year study
Authors: KOH KENNETH G W W , PENG GWEE KOK , HUAK CHAN YIONG , KOH BENJAMIN K W
Published: February 2010

Psychiatric research into violent offences, particularly murder, have been scant in the South East Asian region, with the last major review of homicides in Singapore and their association with psychiatric disorders being as far back as 1985. This study seeks to update the psychiatric community on individuals charged with murder in Singapore from 1997 to 2001 and particularly to further investigate the phenomenon of ‘migration psychosis’ in relation to foreigners in this sample who have committed homicide.

One hundred and ten individuals in Singapore were charged with murder between 1997 and 2001. Socio-demographic data, psychiatric diagnoses, offence and victim profiles and court outcomes were obtained. The group consisting of offenders who were Singapore citizens or permanent residents was compared with those offenders who were foreigners. Analysis was done using the statistical package, SPSS.

The proportion of foreigners in this study who committed homicide is significantly higher than the proportion of citizens / permanent residents in the general population. Foreigners who commit homicide also appear to (i) suffer from the more serious psychiatric illnesses of mood and psychotic disorders compared with locals, (ii) be less likely to have a known history of violence or a past forensic history and (iii) be more likely to be new to psychiatric services compared with the local homicide offenders.

Compared with locals, foreigners appear to have a higher risk for committing homicide. Yet, they are less likely to appear early enough before mental health services. Some form of basic education to employers of foreigners as well as to the foreigners themselves on the early signs of mental illness is recommended.