bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Shaking Alone Cause Fatal Brain Injury?
Authors: CORY C Z , JONES M D 
Published: February 2010

A biomechanical model of a one-month old baby was designed and tested by Duhaime and co-workers in 1987 in an attempt to assess the biomechanics of the shaken baby syndrome (SBS). The study implied that pure shaking alone cannot cause fatal head injuries, a factor which has been applied in criminal courts. In an attempt to test the validity of the model a preliminary study was undertaken in which a replica was constructed and tested. The broad description of the design and construction of the Duhaime model allowed for variations and therefore uncertainties in its reproduction. It was postulated therefore that differences in certain parameters may increase angular head accelerations. To further investigate this observation, an adjustable replica model was developed and tested. The results indicated that certain parameter changes in the model did in fact lead to an increase in angular head acceleration. When these parameter changes were combined and an injurious shake pattern was employed, using maximum physical effort, the angular head acceleration results exceeded the original Duhaime et al. (1987) results and spanned two scaled tolerance limits for concussion. Additionally, literature suggests that the tolerance limits used to assess the shaking simulation results in the original study may not be reliable. Results from our study were closer to the internal head injury, subdural haematoma, tolerance limits. A series of end point impacts were identified in the shake cycles, therefore, an impact-based head injury measure (Head Injury Criterion – HIC) was utilized to assess their severity. Seven out of ten tests conducted resulted in HIC values exceeding the tolerance limits (critical load value, Stürtz, 1980) suggested for children. At this present stage the authors conclude that it cannot be categorically stated, from a biomechanical perspective, that pure shaking cannot cause fatal head injuries in an infant. Parameters identified in this study require further investigation to assess the accuracy of simulation and increase the biofidelity of the models before further conclusions can be drawn. There must now be sufficient doubt in the reliability of the Duhaime et al. (1987) biomechanical study to warrant the exclusion of such testimony in cases of suspected shaken baby syndrome.
Detecting the Dangerous, Violent or Criminal Patient: An analysis of referrals to maximum security psychiatric care
Authors: PIMM J , STEWART M E , LAWRIE S M , THOMSON L D G 
Published: February 2010

Britain's high security hospitals provide care for mentally disordered patients who have dangerous, violent or criminal propensities. The State Hospital, Carstairs, takes referrals from the population of Scotland and Northern Ireland. This retrospective case-control study describes the sociodemographic and clinical characteristics of referrals (n=149) to the State Hospital during a 12-month period, and delineates differences between admitted (n=57) and rejected (n=92) patients. The referrals had an average age of 31.1 years, and were mostly male (86.6%), single (64.4%) and unemployed (90.6%). Admitted patients were more likely to have a criminal history, to be psychotic, to have a family history of mental disorder and to be viewed by the assessor as having psychotic beliefs which contributed to the behaviour or alleged offence leading to the referral. Rejected patients were more likely to have been remanded to prison or assessed by specialist registrars. Patients admitted to high security psychiatric care are more likely to show dangerous behaviour secondary to psychosis. These findings are in keeping with the requirements of mental health legislation and the admissions policy.
Burnt Wives: A study of homicides
Authors: KUMAR VIRENDRA , TRIPATHI C B 
Published: February 2010

The death of married females nowadays is very common in India, usually being associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 47 (31%) were homicidal burns and these cases were analyzed in view of epidemiological and medicolegal aspects. Homicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from extended families (i.e. multigenerational groups of related individuals living under a single roof) and the homicides occurred within the first few years of their marriages. The majority of the affected wives were 16-25 years of age (77%) at the time of the incident and sustained more than 70% total body surface area (TBSA) burn injuries. Many of them were doused with kerosene and set alight. Most died at the time of the incident or within the subsequent 24 hours, most commonly from shock.
Forensic Medical Aspects of Male-on-Male Rape and Sexual Assault in Greater Manchester
Authors: McLEAN IAIN A , BALDING VAL , WHITE CATH 
Published: February 2010

Male-on-male rapes and sexual assaults comprise fewer than 10% of such assaults reported to the police, and so many physicians seldom encounter them. This paper provides an overview of the nature of sexual assault encountered by males, ensuing injuries, and comparisons with male-on-female assault cases. The retrospective epidemiological study was on two cohorts seen at St. Mary's Sexual Assault Referral Centre, Manchester. The participants were Centre clients seen between October 1986 and mid-May 2003; 376 male cases (370 individual clients) and 7,789 female cases (7,403 individual clients). The main outcome measure was the presence of injury (abrasion, laceration, or bruise) to defined body areas. The results showed that 66% of male cases (when assault type was known) had been raped, significantly fewer than in female cases, (p 0.00, a 0.05, O.R. 0.474, 95% C.I. 0.357 to 0.63). Eighteen per cent of male cases that had a forensic medical examination presented with an anal injury, significantly more than in females (p 0.00, a 0.05, O.R. 6.101, 95% C.I. 4.216 to 8.829). Significantly fewer males than females sustained injuries to other body areas. The conclusion was that males were significantly more likely (six times) than females to receive at least one injury to the anal area. Even so, males are five times more likely to have no anal injury.
1. Fatality Following a Sternal Bone Marrow Aspiration Procedure
Authors: BHOOTRA B L 
Published: February 2010

A 58-year-old man was admitted to hospital for the investigation and treatment of pancytopaenia and anaemic heart failure but four days later he died following a sternal bone marrow aspiration procedure. The autopsy revealed a significant haemopericardium as a result of a puncture wound of the heart. The thickness the body of the sternum was 2 to 3 mm. No other significant pathology was noted and death was ascribed to a haemopericardium due to a puncture wound of the heart associated with bone marrow aspiration. An inquest was held at which the doctor who undertook the procedure was found not to be negligent.
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.
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.
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.
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.
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.
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.