bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital bed related fatalities: a review
Authors: De Letter Els A , Vandekerkhove Bart N W , Lambert Willy E , Van Varenbergh Dirk , Piette Michel H A 
Published: February 2010

All medico-legal cases of unexpected death during hospitalisation or accommodation in rest or nursing homes, which were investigated at the Department of Forensic Medicine during a 30-year-period, have been reviewed. In the majority of cases, the fatal outcome was bedrail or restraint related, but falls out of bed or from a patient hoist lift can also trigger a death. As expected, the manner of death was mainly accidental. In about 70% of cases, mechanical asphyxia (such as smothering and thoraco-abdominal compression) was substantiated as the mechanism of death. A substantial number of the patients had important medical antecedents, such as cognitive impairment due to cerebro-vascular accidents. In about half of the cases, human negligence was clearly related to the event whereas in only 15% of cases was there a technical mistake. We believe that some sudden and unexpected fatalities, due to physical restraint or other devices (such as a patient hoist lift), are under-reported because of the medico-legal implications. However, reporting such events could induce better precautions and prevent recurrences. Therefore, this study may be important not only for forensic pathologists, but also for a larger group of social workers.
Section 5(2) MHA 1983: results of a three-year rapid cycle clinical audit
Authors: Rashid Ambreen , Musunuri Padmapriya , Coupe Tim 
Published: February 2010

The aim of this paper was to establish whether section 5(2) of the Mental Health Act 1983 was being used appropriately in an inpatient psychiatric unit in the UK. A clinical audit was conducted over three consecutive years. Peer review of decisions to use section 5(2) on the hospital's adult and old age wards was conducted by junior medical staff. Ninety-eight per cent of the uses of section 5(2) were felt to be appropriate and most were reviewed within 72 hours. Very few patients (5%) were placed on this section again during their admission. The number placed on section 5(4) prior to section 5(2) increased from 2% to 12%. The proportion reviewed within the first 24 hours of detention nearly doubled over the audit period and fewer patients subsequently went on to sections 2 or 3 by the third year. There was no evidence of inappropriate use of section 5(2). Changes in the shift system for junior medical staff may have inadvertently led to a more frequent use of section 5(4). The use of further formal detention after section 5(2) declined, although this decline was not statistically significant.
The use of multiple exostoses in the identification of incinerated human remains
Authors: Wilcher Glenn 
Published: February 2010

A case of roentgenographic medical identification of an incinerated deceased sixteen-year-old male is reported. Comparison of ante-mortem and post-mortem radiographs of the fibula, tibia and femur for purposes of identification was based on the deceased person's recent radiographic medical history, recorded less than two months prior to the death, with a diagnosis of multiple exostoses. Radiographic evaluation of the anatomic variants of the lower limb bones associated with this neoplastic process provided a positive identification in a visually unidentifiable person with no ante-mortem dental records, and an inability to fingerprint due to soft tissue destruction.
An investigation of the interface between the office of the police ombudsman for Northern Ireland and local forensic physicians
Authors: Cathcart Mark E.H. , McGrath Patrick , Goodall Edward , Moore Tara 
Published: February 2010

The interface between forensic physicians and the police ombudsman of Northern Ireland is an area where there is little published research. In particular there has been no attempt to inquire into the role of forensic physicians in the procedures employed to investigate alleged police maltreatment of prisoners at the time of arrest or later in the custodial setting. A questionnaire was distributed to all forensic physicians in Northern Ireland to assess their level of engagement with the ombudsman's office and shed light on the attitudes of forensic physicians to the police ombudsman's handling of the complaints procedure. The results published represent the opinion of the majority of forensic physicians in Northern Ireland and show a broadly supportive attitude to the role of the police ombudsman in the investigation of alleged police officer misconduct. However, a majority of forensic physicians felt that their involvement in the investigative process was an under-used resource.
Practitioner sex abuse: occurrence, prevention and disciplinary sanction
Authors: Jousset Nathalie , Gaudin Arnaud , Penneau Michel , Rougé-Maillart Clotilde 
Published: February 2010

Studies put forward figures for male practitioner sex abuse of around ten per cent. This practice, which is contrary to medical ethics, is highly reprehensible in ethical terms. The assaults range from uninvited meddling in patients' sexual lives to proven rape and inappropriate touching. The majority of this type of abuse is perpetrated by psychiatrists, but in more recent times a growing number of cases have been uncovered involving general practitioners or obstetric gynaecologists. For the most part, the abusers are men, aged between 45 and 64, who are insufficiently trained in terms of the “practitioner-patient” relationship, or who are suffering from a mental pathology or who are in a situation of personal or professional crisis. Raising awareness of this issue is the driving force behind the implementation of prevention strategies, based on initial and ongoing training for practitioners in France, whistle-blowing on fellow practitioners in the United States and professional help in Canada. Disciplinary sanctions are more severe than those given within the framework of non-sexual misconduct in the United States. In France, the Order of Practitioners does not appear to be taking its role of defending patients seriously, since it seldom issues anything more substantial than minor penalties.
Unnatural deaths among children in the Transkei region of South Africa
Authors: Meel B.L. 
Published: February 2010

Nearly 99% of the 10.9 million children worldwide under the age of five years who died in 2000 were from developing countries. This amounts to at least 29,000 deaths per day (UNICEF, 2005). This study aims to trace the pattern of unnatural deaths in the Transkei region of South Africa. It is a records review of the medico-legal autopsies carried out between 1996 and 2004 at Umtata General Hospital (UGH). All subjects aged 18 years or below were considered as children. Between 1996-2004, 7,303 unnatural deaths were recorded. Of these, 1,449 (19.8%) were children. Trauma accounted for 1,028 (70.9%) child deaths and 421 (29.1%) were deaths related to other causes such as hanging, burns, lightning strike, drowning, gas suffocation, falls from a height and poisoning. Motor vehicle accidents accounted for 469 (45.6%) deaths and homicides for 553 (54.4%) deaths. The homicides were firearms injuries, 196 (19%), stab wounds, 185 (18%), and blunt trauma, 178 (17.3%). Non-traumatic deaths were hanging, 81 (19.2%), drowning, 166 (39.4%), lightning strike, 38 (9%), burns, 51 (12.1%), gas suffocation, 24 (5.7%), poisoning, 33 (8.4%) and falls from a height 28 (6.7%). There is a high risk of unnatural death among children in the area of Mthatha. It threatens the survival of young children in this region of South Africa. Poverty is an underlying cause for these preventable deaths.
Appeals to the Mental Health Review Tribunal in an ageing population
Authors: Deshpande Nikhila , Morton Theresa , Haque Saeed , Oyebode Femi 
Published: February 2010

The United Kingdom (UK) population is ageing. This change is accompanied by an increase in the number of people aged over 65 who come into contact with psychiatric services. The use of the Mental Health Act 1983 (MHA) in patients above 65 years of age is limited. These patients are less likely to appeal against their detention and may vary in socio-demographic and clinical characteristics compared with younger patients who are more likely to appeal against their detention. All patients detained for the first time under the MHA in the ten-year period 1992-2002 at Queen Elizabeth Psychiatric Hospital, Birmingham, were studied for socio-demographic and clinical characteristics. More appeals against detention came from people below 65 years of age. Patients detained on section 2 (MHA) appealed more often than patients on section 3. Only a few patients with a diagnosis of dementia appealed against their detention. Additional safeguards should be introduced for this group. We recommend that the appeal process should be simpler and should provide information in all the major languages used in the UK.
Euthanasia and physician-assisted suicide in cases of terminal cancer: the opinions of physicians and nurses in Greece
Authors: Parpa Efi , Mystakidou Kyriaki , Tsilika Eleni , Sakkas Pavlos , Patiraki Elisabeth , Pistevou-Gombaki Kyriaki , Govina Ourania , Vlahos Lambros 
Published: February 2010

The aim of this study was to investigate the opinions of physicians and nurses on euthanasia and physician-assisted suicide in advanced cancer patients in Greece. Two hundred and fifteen physicians and 250 nurses from various hospitals in Greece completed a questionnaire concerning issues on euthanasia and physician-assisted suicide. More physicians (43.3%) than nurses (3.2%, p<0.0005) reported that in the case of a cardiac or respiratory arrest, they would not attempt to revive a terminally ill cancer patient. Only 1.9% of physicians and 3.6% of nurses agreed on physician-assisted suicide. Forty-seven per cent of physicians and 45.2% of nurses would prefer the legalization of a terminally ill patient's hastened death; in the case of such a request, 64.2% of physicians and 55.2% of nurses (p=0.06) would consider it if it was legal. The majority of the participants tended to disagree with euthanasia or physician-assisted suicide in terminally ill cancer patients, probably due to the fact that these acts in Greece are illegal.
Addiction and the pharmacology of cannabis: implications for medicine and the law
Authors: Lader Malcolm 
Published: February 2010

The topic of drug addiction or misuse of drugs has numerous far-reaching ramifications into areas such as neuroscience, medicine and therapeutics, toxicology, epidemiology, national and international economics and politics, and the law. The general principles of drug addiction are first summarised. A recurring and intrinsic problem is lack of adequate characterisation of the independent variable, namely the drug taken. Secondly, it is not feasible to allocate subjects randomly to treatments. Thirdly, the heterogeneity of different forms of addiction precludes facile generalisations. “A problem drug user is anyone who experiences social, psychological, physical, or legal problems related to intoxication, and/or regular excessive consumption, and/or dependence as a consequence of their use of drugs” (UK Advisory Council on Misuse of Drugs, 1982) Cannabis is a genus of flowering plants whose products are used as recreational drugs. Claims have been made for a range of therapeutic properties. Its two main active principles are Δ9 – tetrahydrocannabinol (THC) and cannabidiol (CBD). These compounds have contrasting pharmacological properties. THC is suspected of causing psychotic phenomena, but CBD seems more sedative and may even be antipsychotic. The past use of cannabis, particularly the concentrations of THC and CBD, can be monitored with hair analysis. Recent studies involving the administration of THC and CBD to human subjects are reviewed. Suggestions are made for further research into the pharmacology and toxicology of CBD. Such data may also point to a more rational evidence-based approach to the legal control of cannabis preparations.
Manufacturing fault causes a false negative for haematuria using Makromed m8l urinalysis test strips
Authors: Winstock G.B. 
Published: February 2010

A 35-year-old male patient presented with painful gross macroscopic haematuria. Urinalysis using Makromed test strips showed a negative reading for blood. Subsequent laboratory analysis showed the presence of gross haematuria. A referral to a consultant urologist confirmed a diagnosis of renal stones. Subsequent investigations by the author indicated that a manufacturing fault was responsible for this error. Discussion with the manufacturer identified a fault in the packaging which led to photosensitive light degradation of enzyme pathways, resulting in a false negative finding. In situations when gross clinical findings are not supported by on-site diagnostic tests, the clinician should consider the possibility that the diagnostic tool is at fault and not the clinician. Makromed urine tests strips (MUTS) have been used in this practice for several years. There had been no previous concerns raised by any clinician within the group practice, nor by the Primary Care Trust, or any authoritative professional body. Argyropoulos et al. (2004) reported that renal stones cause haematuria in 92.9% of cases.
Crossing the line: should the threshold for admission of mentally disordered offenders be lowered?
Authors: Aldridge Clare , Jones Chris 
Published: February 2010

Despite repeated support from central government, the policy of diversion from custody remains at best a partial success. One reason for this may be the conflict between this policy and the move towards community-based mental health services. This paper explores the criteria that might be applied when deciding whether or not to admit a mentally disordered offender to hospital, and the differences between these and the criteria which might apply in a community setting. The authors conclude that there are compelling reasons why the threshold for admission of offender patients should be different from that for non-offender patients, and that the principle of deinstitutionalisation of mental health services should be modified when applied to forensic populations.
Patterns of injury seen in deaths from accidental falls down a staircase: a study from South Delhi
Authors: Behera C. , Rautji R. , Dogra T. D. 
Published: February 2010

The present study is a retrospective analysis of 92 cases of death from an accidental fall down a staircase, which were autopsied at the All India Institute of Medical Sciences, New Delhi, India, during a ten-year period from 1996 to 2005. The cases were analysed with regard to age, sex, location, cause of death and pattern of injury. Males (62, 67.39%) outnumbered females (30, 32.61%). The commonest age group involved was 31-40 years (28.26%) followed by 21-30 years (18.47%) and 51-60 years (14.13%). The lowest number of cases (4.34%) was in the 11-20 years age group. All deaths were accidental in nature. The most common cause of death was head injury (80.43%) followed by haemorrhagic shock resulting from intra-abdominal and intra-thoracic visceral injuries (9.78%) and injury to the neck (4.34%). The parietal and temporal bones were those most frequently fractured in head injury cases. Cerebral oedema (n=56, 70.88%), followed by subdural haematoma (n=34, 43.03%) were the two most common intra-cranial injuries. Two females were accidentally hanged while descending stairs. The majority of accidents happened at home (n=90, 97.82%). Alcohol was detected in ten cases (17.54%). Fatalities from falls down a staircase were most often reported in the rainy season.
Evaluation of the Impact of a tele-ICU Pharmacist on the Management of Sedation in Critically III Mechanically Ventilated Patients
Authors: Forni Allison , Skehan Nancy , Hartman Christian A , Yogaratnam Dinesh , Njoroge Milka , Schifferdecker Christopher , Lilly Craig M 
Published: February 2010

Background: An organized and uniform approach to managing sedation in critically ill patients has been associated with improved outcomes, but the most effective means of optimizing sedative medication use in clinical practice has not been fully determined. Pharmacist interventions directed at improving sedation guideline compliance have been shown to reduce the duration of mechanical ventilation. Objective: To determine the impact that pharmacy staffing configurations that include a tele-ICU pharmacist have on compliance with an intensive care unit (ICU) sedation guideline in critically ill mechanically ventilated patients requiring continuous-infusion sedative medications. Methods: Compliance with an established ICU sedation guideline, the performance of daily sedative interruptions, and the number of sedative medication–related interventions were evaluated before and after expansion of the ICU pharmacist staffing model to include comprehensive off-hours pharmacist coverage supported with established tele-ICU resources. In both groups, sedation was managed by the primary ICU team. In the intervention group, a pharmacist working in the tele-ICU center performed electronic record audits and made sedative medication recommendations to the primary team. Results: The addition of third shift tele-ICU pharmacist support was associated with a significant increase in the percentage of patients who received a daily sedative interruption (45% vs 54%; p < 0.0001). This occurred in the context of significant increases in the total number of ICU pharmacist interventions (36 vs 49.4 per 100 patient days, p < 0.0001), the number of therapeutic interventions (20.4 vs 26.1 per 100 patient days, p < 0.001), and the number of sedative-related interventions (0.9 vs 4.4 per 100 patient days, p < 0.0001). Conclusions: Tele-ICU resources can be utilized to increase compliance with an established ICU sedation guideline and extend the benefits that daytime ICU clinical pharmacy services provide. Increased ICU pharmacist availability may have additional benefits not measured in this study.
Anodic oxidation of m-terphenyl thio-, seleno- and telluroethers: Lowered oxidation potentials due to chalcogen···π interaction
Authors: Ammam Malika , Zakai Uzma I. , Wilson George S. , Glass Richard S. 
Published: February 2010

The electrochemistry of m-terphenylthio-, seleno-, and telluroethers was studied using cyclic voltammetry in acetonitrile. All of the compounds studied showed irreversible oxidations. The first oxidation potentials for the thio- and selenoethers are less positive than expected. This facilitation in oxidation is ascribed to through-space S···π and Se···π inter-action, respectively, on removal of an electron. No evidence for a comparable effect was found for the phenyltelluro-ethers studied.
High-Sensitivity Cardiac Troponin T for Early Prediction of Evolving Non–ST-Segment Elevation Myocardial Infarction in Patients with Suspected Acute Coronary Syndrome and Negative Troponin Results on Admission
Authors: Giannitsis Evangelos , Becker Meike , Kurz Kerstin , Hess Georg , Zdunek Dietmar , Katus Hugo A 
Published: February 2010

Abstract
Background: We sought to determine the diagnostic performance of the new high-sensitivity cardiac troponin T (hs-cTnT) assay for early detection of non–ST-segment myocardial infarction (NSTEMI) in patients with acute coronary syndrome.
Methods: We enrolled patients with retrospectively confirmed unstable angina or NSTEMI and an initially negative cTnT concentration and compared the performance of baseline concentrations and serial changes in concentration within 3 and 6 h. Percentage change criteria included ≥20% δ change and ROC-optimized value.
Results: Based on the standard fourth-generation cTnT result of ≥0.03 μg/L, an evolving NSTEMI was diagnosed in 26 patients, and 31 patients were classified as having unstable angina. With the use of the hs-cTnT assay at the 99th-percentile cutoff, the percentage of NSTEMI cases detected increased gradually from 61.5% on presentation to 100% within 6 h, and the overall number of MI diagnoses increased by 34.6% (35 vs 26 cases). A δ change ≥20% or ≥ROC-optimized value of &gt;117% within 3 h or ≥243% within 6 h yielded a specificity of 100% at sensitivities between 69% and 76%. The standard cTnT at the 99th percentile was less sensitive than hs-cTnT for early diagnosis of MI on presentation, and follow-up samples obtained within the initial 3 h demonstrated very low specificity of cTnT compared with hs-cTnT.
Conclusions: The high-sensitivity cTnT assay increases the number of NSTEMI diagnoses and enables earlier detection of evolving NSTEMI. A doubling of the hs-cTnT concentration within 3 h in the presence of a second concentration ≥99th percentile is associated with a positive predictive value of 100% and a negative predictive value of 88%.
Tensile shear strength of UF- and MUF-bonded veneer related to data of adhesives and cell walls measured by nanoindentation
Authors: Stöckel Frank , Konnerth Johannes , Kantner Wolfgang , Moser Johann , Gindl Wolfgang 
Published: February 2010

Abstract
The tensile shear strength of veneer lap joints was characterised. The joints were produced with an Automated Bonding Evaluation System (ABES) using urea-formaldehyde (UF) as well as melamine-urea-formaldehyde (MUF) adhesive formulated for particleboard production. At a fixed heating temperature of 110°C, a systematic increase in bond strength was observed for both adhesives with increasing cure time. The absolute bond strength was significantly higher for MUF compared to UF. Nanoindentation experiments with the same specimens used for ABES revealed a very hard, stiff and brittle character of the UF resin, whereas the MUF proved significantly less hard and stiff, and less brit-tle. Wood cell walls in contact with adhesive, i.e., where adhesive penetration into the cell wall was assumed, showed significantly altered mechanical properties. Such cell walls were harder, stiffer and more brittle than unaffected reference cell walls. These effects were slightly more pronounced for UF than for MUF. Comparing UF and MUF, the micro-mechanical properties of cured adhesive and interphase cell walls confirm earlier observations that tougher adhesives can lead to higher macroscopic bond strength. In strong contrast to that, no obvious correlation was found between micromechanical properties and the strong cure time dependence of macroscopic bond strength.