bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secure Units: Why They are Needed
Authors: Bullard Henrietta , Bond Michael 
Published: July 2017

ABSTRACT: The Beauchamp ISU based at Central Hospital, Warwick, has admitted 105 patients over a six-year period, 14 of these on more than one occasion, which has accounted for 121 admissions with 109 discharges. The opening of a pre-discharge unit in 1985 resulted in a 50 per cent increase in the number of patients admitted to the ISU. The majority of patients were male and had a diagnosis of schizophrenia, and 30 per cent of patients were of non-European origin. The mean length of stay was six months. The future role of secure units is discussed. There will be a need for the forensic psychiatric service to adapt to the changes resulting from the present government policy of community psychiatric care. The group of patients at present identified as requiring secure accommodation need a range of facilities and the number of patients requiring those facilities is likely to increase as psychiatric hospitals close. The special funding of the secure units must be maintained and any attempt to erode or to accept a lower level of funding must be resisted.
Medico-Legal Problems of Ischaemic Heart Disease and Myocardial Infarction
Authors: Al-Alousi L. M. 
Published: July 2017

The medicolegal importance of ischaemic heart disease and myocardial infarction is summarized and discussed. Some theories of pathogenesis and aetiology of ischaemic heart disease, specially those which are more important and relevant to the medicolegal practice, are discussed. Results of the study of 33 cases of coronary artery atherosclerosis and myocardial infarction at different stages of development are presented. The condition of the coronary arteries and the myocardium is examined on gross and microscopical levels. Pathological findings are correlated with the clinical data obtained from the case histories and the summaries of the necropsy requests. No good correlation exists between the observed pathological changes and the clinical age of the infarction and, in most instances, the latter appears younger than the age estimated on the pathological ground alone. As far as the age of the infarction is concerned, most special histochemical staining methods are not preferable to the routine haematoxylin and eosin method. However, the former are efficient in demonstrating and confirming certain aspects of the infarction which cannot be ascertained by the latter method of staining. Pathological alterations associated with myocardial infarction at successive ages are explained and various methods of estimating the time of the infarction are discussed. Thus, gross and microscopical appearances of the acute, organizing and healed myocardial infarction are illustrated by photographs and the forensic applications of these morphological changes are discussed. Lastly, a rare case of an acute myocardial infarction associated with a heat stroke is presented and the medicolegal problems resulting from this case are discussed.
Homicide Patterns in the West Midlands
Authors: Scott K. W. M. 
Published: July 2017

In order to determine the incidence of various types of homicide, a retrospective review of 140 homicide post-mortems was carried out. Four major causes of death — stabbing, asphyxia, blunt head injury and shooting — accounted, alone or in combination, for 89% of the deaths. Within each of these major groups an analysis was carried out of the pattern of injuries sustained by homicide victims. In particular the changes seen at post-mortem in the cases of asphyxial death were analysed. Ligature strangulation was twice as common as manual, and fracture of the bones of the neck occurred in 50% of the cases of ligature strangulations compared to 33% of manual strangulations. Petechial haemorrhages were found with equal frequency in the facial skin and eyes above the level of neck constriction and in the thoracic organs below the level of constriction. Of the victims, 54% were male and 46% were female, whereas 90% of the assailants were male and 8% were female. A ‘close’ family relationship existed between the victim and the assailant in 43% of cases and in only 4% of the cases was there a proven sexual motive for the homicide. In 4% of the cases natural pre-existing disease in the victim contributed to the death by homicide.
6. Diabetic Death Bed: Post-Mortem Determination of Hypoglycaemia
Authors: Patel F 
Published: July 2017

The post-mortem biochemical determination of hypoglycaemia in the practice of forensic medicine is notoriously imprecise and attracts perennial criticisms, particularly from those who may be alien to the peculiarities of medical jurisprudence. There has been re-emphasis recently on the neuropathological pathoclisis ascribed to prolonged hypoglycaemia. Unfortunately, the value perceived is limited by pathognomonic unreliability owing to agonal multifactorial influences and rapidly fatal nocturnal hypoglycaemia. The predicament is oppressive to a consideration of preponderant evidence and an unpopular diagnosis of perimortem hypoglycaemia, unless audacious, may be precluded simply because the proof is difficult. This is likely to contribute to diagnostic under-estimation of enigmatic diabetic deaths. A suspected case of lethal nocturnal hypoglycaemia in a young diabetic on ‘animal’ insulin is presented to restore some perspective to the clinico-pathological deference for an endangered post-mortem diagnosis of hypoglycaemia inferred from minimal evidence.
Rubber and Plastic Ammunition Lethal Injuries: The Israeli Experience
Authors: Hiss Jehuda , Hellman Fredric N , Kahana Tzipi 
Published: July 2017

Rubber and plastic ammunition was used by the Israeli Defence Forces between the years 1987 and 1993 (Intifada) almost exclusively as a deterrent to aggression by the Palestinian civilian population in the occupied territories of Gaza, Judea and Samaria. While designed to avoid the serious wounds and deaths caused by the use of conventional military ammunition, the firing of rubber and plastic bullets has resulted in extensive injuries and more than 20 deaths. The data from the autopsies of 17 of these victims, mostly teenagers, were analysed. Ten of the victims died from injuries inflicted by Improved Rubber Bullets, while the other seven succumbed to injuries caused by Plastic Bullets. In most instances, the cause of death was related to injuries to the brain. Ballistic features of non-conventional bullets are discussed, and suggestions to curtail the serious injuries and fatalities arising from their use are given, with emphasis on firing from a safe range. British and South African experience with this type of ammunition is compared with our observations.
Differentiating DSM-IV Anxiety and Depressive Disorders in the General Population: Comorbidity and Treatment Consequences
Authors: Ohayon Maurice M , Shapiro Colin M , Kennedy Sidney H 
Published: July 2017

Objective: To attempt, for the first time, to apply a positive and differential diagnosis process in the general population during interviews using DSM-IV classification to ascertain the profile and occurrence of concomitant mental disorders. Method: A representative sample of 1832 individuals aged 15 years or older living in the metropolitan area of Toronto were interviewed by means of telephone interviews. The participation rate was 72.8%. Results: Overall, 13.2% (n = 242) of the sample had either a mood disorder (n = 127; 6.9%) or an anxiety disorder (n = 770; 9.3%) at the time of their interview. The prevalence was higher among women (16.5%) than amongmen (9.7%), with an odds ratio of 1.8. The comorbidity of mood and anxiety disorders was found in 3%(n = 55) of the sample. Less than one-third of respondents with a mood and/or anxiety disorder were being treated by aphysician for a mental disorder. However, these individuals were greater consumers of health care services. Most of them consulted a physician an average of 5 times in the past year. Individuals on medication diagnosed with a mood and an anxiety disorder consulted a physician an average of 12 times in the past year. Only 13% of them were treated with antidepressants and under 9% with anxiolytics. Conclusions: More than 70% of subjects with a mood disorder also complained of insomnia. With the differential process, 12%> of the subjects manifesting a full-fledged anxiety disorder were diagnosed with only a mood disorder because the anxiety occurred only in the course of the mood disorder. About two-thirds of the subjects diagnosed in this study were undiagnosed and untreated by their physician.
Self-Reported Diagnoses of Schizophrenia and Psychotic Disorders May Be Valuable for Monitoring and Surveillance
Authors: Supina Alison L , Patten Scott B 
Published: July 2017

Objective: To examine whether a plausible estimate of the prevalence of schizophrenia can be obtained with a self-report item in a health survey. Methods: We estimated a self-reported prevalence of schizophrenia, using a grouped variable for all people who reported schizophrenia or any other psychotic disorder in the Canadian Community Health Survey: Mental Health and Well-Being ( n = 36 984). Estimates were stratified according to age, sex, and province of residence. Results: Of survey respondents, 411 (1.1%) reported having schizophrenia or other psychosis, as diagnosed by a health professional; the weighted and adjusted estimate was 0.9% (0.7% to 1.0%). There was no statistical evidence that the prevalence estimates of schizophrenia and other psychosis varied by age, sex, or province of residence. Conclusions: Additional studies incorporating a gold standard diagnostic interview should be carried out to determine the validity of the approach. However, responses to 2 self-report survey items provide what appears to be a plausible epidemiologic pattern.
Cost, Effectiveness, and Cost-Effectiveness of a Collaborative Mental Health Care Program for People Receiving Short-Term Disability Benefits for Psychiatric Disorders
Authors: Dewa Carolyn S , Hoch Jeffrey S , Carmen Glenn , Guscott Richard , Anderson Chris 
Published: July 2017

Objective: To examine the cost, effectiveness, and cost-effectiveness of a collaborative mental health care (CMHC) pilot program for people on short-term disability leave for psychiatric disorders. Method: Using a quasi-experimental design, the analyses were conducted using 2 groups of subjects who received short-term disability benefits for psychiatric disorders. One group ( n = 75) was treated in a CMHC program during their disability episode. The comparison group ( n = 51) received short-term disability benefits related to psychiatric disorders in the prior year but did not receive CMHC during their disability episode. People in both groups met screening criteria for the CMHC program. Differences in cost and days absent from work were tested using Student t tests and confirmed using nonparametric Wilcoxon rank sum tests. Differences in return to work and transition to long-term disability leave were tested using chi-square tests. The cost-effectiveness analysis used the net benefit regression framework. Results: The results suggest that with CMHC, for every 100 people on short-term disability leave for psychiatric disorders, there could be $50 000 in savings related to disability benefits along with more people returning to work ( n = 23), less people transitioning to long-term disability leave ( n = 24), and 1600 more workdays. Conclusions: CMHC models of disability management based on our Canadian data may be a worthwhile investment in helping people who are receiving short-term disability benefits for psychiatric disorders to receive adequate treatment.
Reduction in Psychiatry
Authors: Gold Ian 
Published: July 2017

Objective: To examine the doctrine of reductionism in psychiatry. Method: A selective review of the literature. Results: Two arguments offered in support of reduction in psychiatry are presented and found to be unsatisfactory. An argument supporting skepticism about reduction is described. Conclusion: Currently, there is little reason to think that any significant portion of psychiatric theory will be reduced to neuroscience or genetics.
No Association between Prenatal Viral Infection and Depression in Later Life—A Long-Term Cohort Study of 6152 Subjects
Authors: Pang Dong , Syed Saddaf , Fine Paul , Jones Peter B 
Published: July 2017

Objective: Previous studies have suggested a role for prenatal viral infections in the etiology of schizophrenia; however, little is known about depression. We examined whether in-utero viral infections result in increased risk of depression in later life. Method: We identified a cohort ( n = 3076) born between 1946 and 1980, whose mothers suffered known viral infections in pregnancy. Subjects were individually matched by birthdate, sex, and area of birth to another cohort ( n = 3076) from the UK National Health Service Central Register (NHSCR). These 2 cohorts, one exposed to viruses prenatally, the other not known to have been exposed, were then followed-up to June 1996 by sending a morbidity questionnaire to their primary care physicians. This included specific items on affective disorders, schizophrenia, mental handicap (mental retardation), epilepsy, as well as other central nervous system disorders and specified physical illness, all coded according to the International Classification of Diseases, Ninth Edition. Death certificates were supplied by the NHSCR. A method for matched-pair cohort data calculated the relative risk and 95% confidence intervals for depression in the exposed and unexposed cohorts by varying type of viral exposure. Results: The response to the questionnaire was high (85%). There was no overall increased risk for depression associated with viral exposure; a narrow confidence interval surrounded unity (RR = 1.0, 95% CI 0.8 to 1.2); effects for individual viral exposures were all scattered around unity. Conclusions: The results provide no support for the hypothesis that in-utero exposure to viral infection is associated with risk of subsequent nonpsychotic affective disorder. Further analyses on schizophrenia, bipolar disorder, and mental illness other than depression are required.
Newspaper Coverage of Autism Treatment in Canada: 10-Year Trends (2004–2013)
Authors: Lanovaz Marc J , Dufour Marie-Michèle , Shah Shalaka 
Published: July 2017

Objective: To compare trends in coverage of empirically supported and alternative autism treatments in Canadian newspapers during a 10-year period and to examine whether the portrayal of empirically supported and alternative treatments differed. Method: We searched a sample of 10 daily local and national Canadian newspapers using the word autism combined with intervention or treatment in the Proquest Canadian Newsstand and Eureka.cc databases, which yielded a total of 857 articles published between 2004 and 2013. In our subsequent analyses, we only included articles whose main topic was autism and that referred to at least one treatment. We then categorized the 137 remaining articles by treatment and rated whether each treatment category was portrayed in a favourable, unfavourable, or neutral manner. Results: In total, 46% of the articles discussed at least 1 empirically supported treatment, 53% at least 1 alternative treatment, and 12% at least 1 uncategorized treatment. Newspaper articles provided favourable, unfavourable, and neutral portrayals of empirically supported treatments in 75%, 10%, and 16% of cases, respectively. In contrast, alternative treatments were portrayed favourably in 52%, unfavourably in 32%, and neutrally in 16% of cases. Our analyses indicated that empirically supported treatments were portrayed more favourably than alternative treatments (X2 = 10.42, df = 2, P = 0.005). Conclusions: Despite some encouraging trends, our study has shown that researchers and clinicians must continue to clarify misconceptions about autism treatment. Families of people with autism spectrum disorders should be directed toward more reliable and accurate sources of information.
Short-Term Natural Course of Depressive Symptoms and Family-Related Stress in Adolescents after Separation from Father
Authors: Gobbi Gabriella , Low Nancy C P , Dugas Erika , Sylvestre Marie-Pierre , Contreras Gisèle , O'Loughlin Jennifer 
Published: July 2017

Objective: To determine if separation from a father is associated with short-term changes in mental health or substance use in adolescents. Methods: Every 3 months, during a 5-year period, we followed 1160 Grade 7 students participating in the Nicotine Dependence in Teens Study who were living with both parents. Participants who reported not living with their father for 6 or more consecutive months during follow-up were categorized as separated from father. Pooled regressions within the framework of generalized estimating equations were used to model the associations between separation from father and indicators of mental health (depressive symptoms, and worry and [or] stress about family relationships or the family situation) and substance use (alcohol use and cigarette smoking) 4 to 6 and 7 to 9 months postseparation, controlling for age, sex, and baseline level of the outcome variable. Results: Compared with adolescents living with both parents, adolescent offspring separated from their fathers were more likely to report depressive symptoms (β = 0.17, 95% CI 0.01 to 0.33) 4 to 6 months postseparation, as well as worry and (or) stress about their parents separating or divorcing (OR 2.39, 95% CI 1.29 to 4.43), a new family (OR 4.25, 95% CI 2.33 to 7.76), and the family financial situation (OR 2.35, 95% CI 1.53 to 3.60). Separation from father was also marginally significantly related to worry and (or) stress about their relationship with their father (OR 1.53; 95% CI 0.98 to 2.39). At 7 to 9 months postseparation, separation from father continued to be associated with worry and (or) stress about their parents separating or divorcing, a new family, and the family financial situation. Separation from father was no longer associated with worry and (or) stress about their relationship with their father, but it was associated with worry and (or) stress about their relationship with their mother. Separation from father was not related to use of alcohol or cigarettes. Conclusion: Adolescent offspring experienced family-related stress and transient depression symptoms in the 4- to 9-month period following separation from their fathers.
Increased Risk of Obesity and Metabolic Dysregulation following 12 Months of Second-Generation Antipsychotic Treatment in Children: A Prospective Cohort Study
Authors: Ronsley Rebecca , Nguyen Duc , Davidson Jana , Panagiotopoulos Constadina 
Published: July 2017

Objective: To determine the risk of developing obesity and related metabolic complications in children following long-term treatment with risperidone or quetiapine. Methods: This was a 1-year naturalistic longitudinal study conducted between February 2009 and March 2012. A total of 130 children aged 2 to 18 years without prior exposure to second-generation antipsychotics (SGAs) were enrolled at initiation of treatment with either risperidone or quetiapine. Metabolic parameters were measured at baseline and months 6 and 12. Data of 37 participants (20 treated with risperidone and 17 treated with quetiapine) who completed 12-month monitoring were used in the analysis. Results: After 1 year of SGA treatment, mean weight increased significantly by 10.8 kg (95% CI 7.9 kg to 13.7 kg) for risperidone and 9.7 kg (95% CI 6.5 kg to 12.8 kg) for quetiapine. Body mass index z score also increased significantly in both groups ( P < 0.001). There was a high incidence of children becoming overweight or obese (6/15 [40.0%] for risperidone-treated and 7/14 [50.0%] for quetiapine-treated). The mean levels of fasting glucose (for risperidone-treated) and ratio of total cholesterol to high-density lipoprotein cholesterol (for quetiapine-treated) increased significantly by 0.23 mmol/L (95% CI 0.03 mmol/L to 0.42 mmol/L) and 0.48 mmol/L (95% CI 0.15 mmol/L to 0.80 mmol/L), respectively. Conclusion: Children treated with risperidone or quetiapine are at a significant risk for developing obesity, elevated waist circumference, and dyslipidemia during 12 months of treatment. These data emphasize the importance of regular monitoring for early identification and treatment of metabolic side effects.
The Role of Vitality in the Relationship Between a Healthy Lifestyle and Societal Costs of Health Care and Lost Productivity
Authors: Hartman L. , van Dongen J. M. , Hildebrandt V. H. , Strijk J. E. 
Published: July 2017

Purpose: To examine the mediating effect of vitality in the relationship between healthy lifestyle characteristics and health-care and productivity-related costs. Design: Observational prospective cohort study with 2 measurements. Online questionnaires were filled out in 2013 (T0) and 2014 (T1). Setting: A random sample of a Dutch online interview panel was obtained. Subjects: Data of 4231 Dutch adults who had complete data at T0 and T1 were used in the present study. Participants were representative for the Dutch adult population in terms of age, gender, and having chronic disease(s). Measures: Healthy Lifestyle Index (HLI), vitality, and health-care and productivity-related costs. The HLI consisted of the sum of 6 healthy lifestyle characteristics, including a healthy BMI (yes/no), meeting physical activity, fruit, vegetable, and alcohol consumption guidelines (yes/no), and smoking status (yes: non or former smoker/no: current smoker). Health-care and productivity-related costs were measured using a utilization questionnaire. Analysis: Linear regression analysis. Results: The HLI was related to vitality. In addition, vitality was related to health-care costs and productivity-related costs. Furthermore, vitality was found to transmit 28.4% of the effect of HLI on health-care costs and 39.4% of the effect of HLI on productivity-related costs. Conclusion: Lifestyle was related to vitality and vitality to health-care and productivity-related costs. Vitality mediated the relationship between lifestyle and health-care and productivity-related costs. Therefore, we recommend to sustain and improve both vitality and lifestyle.