Charles P. Dzamalala , Danny A. Milner , N. George Liomba
{"title":"Suicide in Blantyre, Malawi (2000–2003)","authors":"Charles P. Dzamalala , Danny A. Milner , N. George Liomba","doi":"10.1016/j.jcfm.2005.08.006","DOIUrl":"10.1016/j.jcfm.2005.08.006","url":null,"abstract":"<div><p>In an attempt to identify at risk individuals, we analysed available information for individuals who committed suicide in Blantyre, Malawi. A retrospective audit of suicides autopsied at the Queen Elizabeth Central Hospital and the University of Malawi College of Medicine mortuaries between January 2000 and December 2003 was analysed by age, sex, residential location, and mode of suicide. Eighty-four suicide cases (65 males, 19 females) represented 17% of all autopsies. The major mode of suicide in Blantyre was chemical poisoning using an agricultural pesticide, accounting for 66 cases (79%)–49 males (76%), 17 females (89%). There were no cases of poisoning by therapeutic medicines, self-immolation or incised wounds. The majority of cases were from one major urban area, Limbe, and one peri-urban area, Chileka. The demographics of suicide in Malawi differ from those reported for other African countries (e.g., lower proportion of females, no use of therapeutic medicine in poisoning, few gunshots). This audit highlights a need for investigations into the sale and use of agricultural pesticides. A prospective study of social and demographic factors around suicide should be undertaken to target groups at highest risk.</p></div>","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 65-69"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25674575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian Huchzermeier, Emelie Bruß, Nils Godt, Josef Aldenhoff
{"title":"Kiel psychotherapy project for violent offenders","authors":"Christian Huchzermeier, Emelie Bruß, Nils Godt, Josef Aldenhoff","doi":"10.1016/j.jcfm.2005.08.012","DOIUrl":"10.1016/j.jcfm.2005.08.012","url":null,"abstract":"<div><p>This study reports on a psychotherapy project for violent offenders. The project was established at a German prison by the Psychiatric and Psychotherapeutic Department at the University of Kiel. The overall aim of this project is to develop a scientifically based psychotherapy programme for violent offenders. As a first step the project’s systematic initial diagnostic procedures are presented. These procedures are carried out when new prisoners join the project to provide an empirical basis for the planning of therapy. Data are presented for the 60 prisoners who have so far taken part. These show high prevalences for some psychiatric disorders, namely substance related disorders (33% dependency, 55% abuse), personality disorders (58% had at least one personality disorder) and psychopathy according to Hare’s criteria (13%). The data also indicate that only a basal level of self-motivation existed to take part in psychotherapy (65% precontemplative). It is apparent that violent offenders constitute a heterogeneous group as far as mental disturbances are concerned. The data suggest that a psychotherapy programme for violent offenders needs to include both targeted interventions to raise motivation and, for those with substance-related and/or personality disorders, disturbance-specific interventions.</p></div>","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 72-79"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25687693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"Ronald C. Denney","doi":"10.1016/j.jcfm.2005.09.001","DOIUrl":"10.1016/j.jcfm.2005.09.001","url":null,"abstract":"","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 101-102"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"102550850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shahnavaz Manipady , Ritesh G. Menezes , Binaya Kumar Bastia
{"title":"Death by attack from a wild boar","authors":"Shahnavaz Manipady , Ritesh G. Menezes , Binaya Kumar Bastia","doi":"10.1016/j.jcfm.2005.08.007","DOIUrl":"10.1016/j.jcfm.2005.08.007","url":null,"abstract":"<div><p>Attacks on humans by wild animals causing fatal injuries are not uncommon in rural and forest areas of India. But death occurring due to attack by a wild boar is rare. As the victims of boar attack are usually recovered from dense forest areas, the investigating officers could be misled as to the nature of infliction of these multiple, fatal penetrating injuries to a possible homicide. Unlike the injuries inflicted by wild cats, canines and bulls, the hallmark of boar attack is the infliction of multiple penetrating injuries to the lower part of the body. This case is reported for its rarity, for the awareness of the possible injuries in such unnatural deaths, and for the factors predisposing to a boar attack.</p></div>","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 89-91"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25670039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Forensic issues and possible mechanisms of sudden death in Rett syndrome","authors":"Roger W Byard","doi":"10.1016/j.jcfm.2005.08.013","DOIUrl":"10.1016/j.jcfm.2005.08.013","url":null,"abstract":"<div><p>A 20-year-old female with an established diagnosis of Rett syndrome was found dead in bed. There had been no history of recent deterioration in health and at autopsy no acute lesions were found. There was no evidence of trauma. Toxicological analysis of blood revealed therapeutic levels of carbamazepine and clonazepam. Death was attributed to the complications of Rett syndrome, an uncommon developmental disorder characterized by autistic type behaviour, hypotonia, stereotyped movements, seizures and growth failure, caused by mutations in the MECP2 gene on the X chromosome. Establishing the precise cause of sudden death in individuals with Rett syndrome may be difficult as epilepsy, defective autonomic nervous system control and cardiac arrhythmias may relate more to functional problems rather than to defects that can be demonstrated at autopsy. Thus, although there are a variety of well-documented underlying mechanisms that may cause sudden death in this condition, determining the exact sequence of events in an unwitnessed death may be more by inference and elimination, given the absence of pathognomonic and acute lethal lesions that are able to be found histopathologically. ‘Complications of Rett syndrome’ may, therefore, be the most accurate designation when individuals with this condition are found unexpectedly dead and no anatomical cause of death can be identified at autopsy.</p></div>","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 96-99"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25670038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pulse oximetry in clinical forensic practice","authors":"Jonathan P. Wyatt","doi":"10.1016/j.jcfm.2005.08.011","DOIUrl":"10.1016/j.jcfm.2005.08.011","url":null,"abstract":"<div><p>The potential role of a hand held battery operated digital pulse oximeter was investigated on 270 consecutive patients seen by one forensic medical examiner. An oxygen saturation reading on air was obtained on 236 patients (87%). Of the patients in whom the pulse oximeter could not provide a reading, the principal reason for being unable to record a value was lack of patient cooperation (26 of the 34 patients). Of the 236 oxygen saturations recorded, 234 were 95% or higher. The two patients with lower readings (83% and 93%) required assessment and treatment at hospital: one for an opioid overdose, the other for pneumonia. The modern generation of hand held pulse oximeters can provide very useful information in a challenging environment and should occupy a definite corner of the forensic medical examiner’s medical bag.</p></div>","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 70-71"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25889509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Forensic considerations of surrogacy – an overview","authors":"B.R. Sharma","doi":"10.1016/j.jcfm.2005.08.002","DOIUrl":"10.1016/j.jcfm.2005.08.002","url":null,"abstract":"<div><p>In the past two decades, there has been a spectacular change in the field of reproductive technologies. Reproductive sciences have come in with techniques such as donor insemination; in vitro fertilization and embryo transfer methods, which have completely revolutionized the reproductive environment. These techniques have given hope to many infertile couples, who wish to have a child of their own. With the oncoming of surrogacy agreements, concepts of fatherhood and motherhood have been subject to much controversy. Motherhood was never under much scrutiny as it was rightly thought that childbirth was the natural and conclusive fact establishing it, though paternity was at times a controversial concept burdening legislators to provide for suitable tests. Medical sciences have now compartmentalized motherhood into the genetic, gestational and the social mother leading to a clash of interests. This paper reviews some medicolegal, ethical and social aspects of surrogacy.</p></div>","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 80-85"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25707210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Best , Siobhan Havis , J.J. Payne-James , Margaret M. Stark
{"title":"Near miss incidents in police custody suites in London in 2003: A feasibility study","authors":"David Best , Siobhan Havis , J.J. Payne-James , Margaret M. Stark","doi":"10.1016/j.jcfm.2005.08.004","DOIUrl":"10.1016/j.jcfm.2005.08.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Potentially preventable deaths in police custody include those which involve illicit drugs, alcohol and deliberate self-harm. Near miss incidents (NMI) that did not result in death have a crucial role in understanding risk factors in custody. Such research has not previously been undertaken. A program of research has been developed to study NMI, in order to better identify those at risk in police custody. For the purposes of this research, NMI have been defined as ‘an unplanned and unforeseeable or unforeseen event that could have resulted, but did not result, in human death or may have resulted in injury or other adverse outcomes’. It was intended that the definition although broad, would not include simple accidents (e.g. slipping on urine in a cell) or trivial injury.</p></div><div><h3>Aims and methods</h3><p>The two aims of the study are (a) to determine whether it is realistic to attempt to assess NMI with the intention of identifying information of use in enhancing detainee care and (b) to assess how frequently NMIs occur and whether there are specific patterns. Pilot interviews were conducted with three forensic physicians practising in London, UK to create a structured questionnaire for all forensic physicians working in London. The questionnaire provided the basis of a retrospective recall survey of all forensic physicians working in London as Forensic Medical Examiners. The questionnaire was designed to assess the numbers of NMI, patterns in occurrence and relevant learning points within the previous 6 months. A covering letter, background questionnaire (exploring the background of the medical practitioner), copies of the survey, and reply paid envelopes were sent to each Forensic Medical Examiner (<em>n</em> <!-->=<!--> <!-->134) in London, contracted to provide forensic medical services for the Metropolitan Police Service. Data about all incidents were anonymised.</p></div><div><h3>Results</h3><p>Ninety six (73%) Forensic Medical Examiners responded. Of these 18% were Principal grade, the remainder were Senior (24%), Standard (35%) and Assistant (23%). Thirty eight NMI were reported by 27 Forensic Medical Examiners (of all levels). The initial reason for police contact was recorded as alcohol (<em>n</em> <!-->=<!--> <!-->8), theft and robbery (<em>n</em> <!-->=<!--> <!-->7), warrants (<em>n</em> <!-->=<!--> <!-->4), violence (<em>n</em> <!-->=<!--> <!-->3), traffic violations (<em>n</em> <!-->=<!--> <!-->2) and single cases of drugs, murder and immigration offences. Of the main perceived cause of each NMI, illicit drugs were involved in 12/38, alcohol in 17/38, deliberate self-harm in 11/38, issues concerning searches, checks or rousing in 8/38, failure of inter-agency communications in 5/38, and possible resource issues in 4/38. In a number of cases more than one factor was involved.</p></div><div><h3>Conclusions</h3><p>The information established about NMI is broadly consistent with documented patterns o","PeriodicalId":87101,"journal":{"name":"Journal of clinical forensic medicine","volume":"13 2","pages":"Pages 60-64"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jcfm.2005.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25638019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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