bluuebunny/crossref_metadata_2025_split huggingface dataset:
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 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.
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.
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.
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.
Tsunami Disaster Victim Identification in Sri Lanka: Legal aspects
Authors: PERERA CLIFFORD 
Published: February 2010

Natural hazards amounting to disasters have almost become an endemic phenomenon during past decades throughout the globe, particularly affecting less resourced countries. The capabilities of the affected nations are stretched to the maximum in most of the disasters, thereby exposing deficiencies at various levels of the disaster mitigation mechanisms. A key factor identified through the human experience of all previous disaster scenarios is the requisite of effective and integrated local, national and regional disaster management mechanisms. The national and regional legal framework in this context can supplement disaster management enormously by drafting and implementing practical legislation which can be activated in disaster situations to co-ordinate the relief missions and minimize the damage. Thus, the existing legal systems and legislation at national and regional levels should be modified accordingly to yield proper disaster management policies. However, many less resourced countries are still lacking functional disaster management mechanisms in local legislation and are consequently highly vulnerable to heavy casualties in disasters. Sri Lanka is a typical example of a state which had an ineffective disaster management mechanism, not strengthened by legislation, when the Asian tsunami struck the country in December 2004, despite having frequently been affected by natural and man-made hazards during the past three decades. The net effect was total disarray in disaster victim identification, leading to drastic and irreparable consequences.
Pattern of Injuries in Fatal Falls from Buildings
Authors: KOHLI ANIL , BANERJEE K.K. 
Published: February 2010

When bodies are brought for autopsy it is sometimes unclear whether the injuries are due to a fall from a height or due to blunt trauma from other causes, especially when the bodies are found near buildings with no eyewitnesses available. Studies discussing the injury patterns in adults after falls exclusively from buildings are rare. A five-year retrospective study was carried out on 151 cases of fatal falls from buildings brought for autopsy. The aim was to assess the pattern of these injuries and identify features helpful in discriminating between these and injuries due to blunt trauma from other causes. The majority of cases comprised subjects who fell from heights of 10-20 feet (3-6 m) with most falls occurring late at night or in the early morning. The pattern that emerged is quite distinct from ground level falls and pedestrian injuries. Abrasions are the commonest injury and bruises very rare. Lacerations are mostly on the head and skull fractures are evenly distributed between the vertex, base and vertex plus base. Subarachnoid haemorrhage is the commonest intracranial lesion. Extradural haemorrhage alone is rare. Fractures of ribs and cervical vertebrae are common and fractures of thoracic vertebrae and long bones are uncommon. Safety measures to prevent such falls have been suggested.
Industrial Accidental Deaths in the Niger Delta Region of Nigeria: A study of 32 autopsies in Port Harcourt
Authors: SELEYE-FUBARA D , BOB-YELLOWE E 
Published: February 2010

Accidents in the oil industry in the Niger delta region of Nigera raise concerns about safety measures and the management of industrial sites. A total of 32 autopsies were performed after coroners' inquest forms were served on the authors by the State, which serve as consent and request. Standard procedures were adopted in all the cases and the reports were appropriately issued. Death from industrial accidents accounted for 2.5% and 6.1% of total autopsies and accidental death autopsies respectively. The youngest victim was a 19 year old male while the oldest was a 55 year old male. The age group 30-39 years was the most vulnerable. There was a male dominance; (male:female ratio = 9.7:1). The commonest accidents in their order of frequency were: falling from a height, explosion/fire, motor vehicle accidents and falling objects. Multiple injuries, head and neck trauma and drowning were the commonest cause of death at autopsy. Accidental deaths were commoner in the small-scale industries (81%) than in the large-scale industries (19%). This is the first time such a study has been carried out locally. The proportion of accidental deaths in the small scale industries relative to that of the large ones may be attributed to the poor enforcement of safety measures in the smaller industries
Elderly suicide rates in the United Kingdom: Trends from 1979 to 2002
Authors: Shah Ajit 
Published: February 2010

The proportion of elderly in the population is increasing due to a falling birth rate and increased life expectancy, and suicide rates increase with age. Trends in elderly suicide rates over a 24-year period, 1979 to 2002, were examined. Differences in suicide rates between elderly men and women and between the age-bands 65 to 74 years and 75+ years were examined. Data was ascertained from the WHO website. Suicide rates for men and women for the age-bands 65 to 74 years and 75+ years declined over the 24-year study period. Suicide rates were higher in men than women for both the age bands. In men, suicide rates were higher in the 75+ age-band than in the 65 to 74 years age-band. Various national initiatives may have contributed to the decline in suicide rates. The challenge will be to sustain the decline, given that the population is ageing and suicide rates generally increase with age.
Insomnia in places of detention: a review of the most recent research findings
Authors: Elger Bernice S. 
Published: February 2010

Up to 40% of prisoner patients in a general medicine outpatient service seek medical consultation for sleep problems. This paper provides a brief overview of what is known about insomnia and its treatment from studies on non-detained patients and discusses the relevance of the findings from studies in liberty for prison health care. The clinical and ethical issues of insomnia in prison are described, followed by a summary of the existing studies on insomnia in prison. The results of the reported studies show that insomnia in places of detention should not be reduced to a secondary problem related to substance abuse and mental illness, as it appears to be an independent situational problem. Correctional health care physicians' evaluation of insomnia is insufficient. Drug prescription works well in some patients, but has a limited effect on insomnia relief in others. A clear need exists for the education of prison health care professionals on insomnia evaluation and management. Additional non-pharmacological treatment in the prison health care setting should be used more frequently. Prison health care services should develop clear guidelines based on research evidence about insomnia and which contain treatment recommendations based on the principle of equivalence of health care outside and inside places of detention.
Rib fractures in infancy: establishing the mechanisms of cause from the injuries — a literature review
Authors: Worn M.J. , Jones M.D. 
Published: February 2010

In the absence of a history of a significant accidental event, the most likely diagnosis in an infant with rib fractures is non-accidental injury. Medical opinion is essential when deciding if child abuse has taken place or not and this requires a consideration of whether a proposed causal explanation fits with the observed injuries. To assist in the interpretation of injuries and inform medical practitioners, it is essential to develop a clear understanding of their biomechanical mechanism of causation. The types and ‘likely’ mechanisms of rib fracture are well-documented, however, what forces, deflections and loading rates are required to produce particular fractures are relatively unknown. This paper presents a review of the literature, from a biomechanical engineering perspective, to assess information regarding the various types of rib fracture and their likely mechanisms, paying particular attention to the likely forces, deflections and loading rates involved. The biomechanical parameters, applied during ‘two finger’ infant cardiopulmonary resuscitation (CPR), are identified and discussed, and are currently believed to be below the limit at which rib fracture may occur. However, a new ‘two thumb’ CPR technique is identified which involves a holding/gripping mechanism of the infant thorax, similar to that which is believed to occur in inflicted injury scenarios, such as shaking. The two thumb method may provide a greater magnitude of force and deflection, a greater rate of loading and may perhaps pose a greater risk of fracture, compared with the ‘two finger’ supine, anterior-posterior chest compression approach. It is proposed to introduce a force/deflection boundary condition into mechanical and computer/numeric infant models. Subject to the future inclusion of loading rate/response data, a three-dimensional (force/deflection/loading rate) boundary condition will be used to provide a minimum injury threshold for potentially injurious scenarios. A number of further studies are suggested, since this paper is intended to provide a first step to developing a more sophisticated understanding of the causes of infant rib fracture. Areas of further study include specific rib fracture mechanisms, as well as the effects of age dependent characteristics, positioning and area of force application. Such additional information would allow the proposed initial boundary condition to be further refined to provide an indication of the likelihood, type and number of fractures that might be expected.
Mentally disordered offenders in Zimbabwe and in England and Wales: a socio-demographic study
Authors: Menezes S.B. , Oyebode F. , Haque M.S. 
Published: February 2010

Our aim was to compare socio-demographic, clinical and criminal characteristics of mentally disordered offender patients in a special institution in a developing and a developed country. Zimbabwe data from 1980-1990 was obtained from a hospital patient survey, in a written semi-structured format. The English special (high security) hospital patients' data for the same period was obtained from the case register. The sample size for Zimbabwe was 367 patients (337 males, 30 females) and for England and Wales it was 1,966 patients (1,643 males, 323 females). The average age for Zimbabwean patients was 36 years, with standard deviation of 9.7; for England and Wales the average age was 29.7 with standard deviation of 9.6. There was significant difference in marital status in the two countries. Seventy-eight per cent of patients were single in England and Wales, compared with 49% in Zimbabwe. There were 20% illiterate patients in Zimbabwe, compared with 4% in England and Wales. Thirty-seven per cent of the patients in England and Wales had a diagnosis of personality disorder, compared with 6% in Zimbabwe. There were 53% of homicides in Zimbabwe, compared with 20% in England and Wales. Employment in the two countries was similar: 34% in Zimbabwe and 33% in England and Wales. There were differences in the socio-demographic characteristics in the two countries, except for employment status. Differences were also noticed in the diagnoses of the patients, types of crime and the methods of assault.
Challenges to implementation of the new Coroners' (Amendment) Rules 2005: experience from a tertiary paediatric pathology centre
Authors: Weber M.A. , Epstein J. , Simons J. , Malone M. , Ashworth M. , Sebire N.J. 
Published: February 2010

In the UK sudden unexpected childhood deaths are referred to Her Majesty's Coroner (HMC) for postmortem examination during which small tissue samples are obtained for diagnostic purposes. Recent changes to regulate tissue use include the Coroners' (Amendment) Rules 2005. We audited the impact of these at a specialist paediatric centre. A retrospective audit of HMC tissue forms for autopsies was performed between 1 June 2005 - 31 May 2006, with regard to the options provided to, and chosen by, parents. Of 213 coronial autopsies, 178 were non-forensic. Tissue forms were submitted pre-autopsy in 25 (14%). An additional 47 were received after sending follow-up letters for a total of 72/178 (40%). Forms varied between coroners, but most failed to distinguish between blocks, slides, and other tissue samples and 6/40 (15%) forms did not specifically allow an option for research consent. Forty-three (60%) parents opted for retention, with 34 (79%) also consenting to research. Only six (8%) requested return of tissue. A simple, unified tissue disposal form and information sheet for all HMC districts, which includes appropriate options, would ensure that parents' wishes are met, to achieve best practice, maximise sample availability for positive societal outcomes such as teaching and research, and to comply with new regulations.
Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes
Authors: Saint-Martin Pauline , Bouyssy Marie , O'Byrne Patrick 
Published: February 2010

We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medico-legal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.
Offending in the learning disabled population: a retrospective audit of Tayside learning disability service court reports
Authors: Smith Helen , White Tom , Walker Phyllis 
Published: February 2010

The literature regarding offending in the learning disabled population is limited; the effects of normalisation and deinstitutionalisation on offending behaviour is not yet determined. We retrospectively examined 93 court reports completed by the Tayside learning disability service since 1986. Twenty patients were not considered to be learning disabled. Sixty-four of the subjects deemed learning disabled faced charges, the most common being public order offences, which was in common with previous reports. Eighteen per cent of these had a co-morbid mental illness, the majority attracting a diagnosis of schizophrenia. Inpatient assessment, assessment as a day patient or probation were recommended for about two-thirds. Fewer than 50% of cases had no psychiatric recommendation made to the court. There was a predominance of arson and sexual offending. Arsonists were twice as likely as sex offenders to be recommended for inpatient treatment.