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Hospital communication threats and intervention.

1. Threats are indirect acts of criminal behavior designed to weaken or injure individuals, institutions, or property. 2. All threats should be analyzed and investigated quickly and with high priority. 3. An interdisciplinary hospital team should conduct periodic reviews of threats received, threat management, and case outcome.

Adult↗

[Various problems concerning maternal mortality during pregnancy].

In the autopsy material of the Department of Forensic Medicine of the Semmelweis Medical University--90,000 cases in 25 years (1950-1975)--508 cases of death in the period of gestation have occurred. Author have analysed this material and have established, that in every second case the death occurred due to criminal abortion, in every fifth case due to the complications of the pregnancy and in every third case due to the complications of delivery. By means of trend-calculations it was further established that in the autopsy material of the Department the number of the sudden natural death of women in the reproductive age during the 25 years remained on the same level, but the number of death cases connected with gestation decreased. In the latter group: the number of death cases due to abortion and complications of pregnancy decreased significantly, number of lethal cases due to complications of delivery remained at the same level. Data of the analysis are compared to the data reported in the literature. Some questions--the cause of the death, the criminality when abortions are concerned, questions of the treatment and the responsibility of physicians are also discussed. These investigations seem to evidence that on the base of the evaluation of a large autopsy material the legal medicine can reveal valuable data for the preventive medicine.

Abortion, Illegal↗

Performance curve classification of invalid responding on the Validity Indicator Profile.

The purpose of this article is to provide evidence for the validity of performance curve classification on the nonverbal subtest of the Validity Indicator Profile (VIP-NV). A four-fold classification scheme of performance on cognitive testing is proposed. This scheme combines effort and motivation to generate four response classifications: compliant, careless, irrelevant, and malingering. Data are presented across six studies from cognitive and personality testing for 737 male pretrial criminal defendants. Additionally, computer-generated VIP-NV performances were subjected to four levels of randomization to investigate VIP-NV carelessness indicators. The findings support the validity of the four-fold classification scheme and support the classification of response on the basis of motivation and effort.

Journal Article↗

Association of stress, hostility and plasma testosterone levels.

OBJECTIVES: Many studies assessing the role of sex hormones, like testosterone, on stress and hostility factors have been primarily conducted in selected atypical populations such as violent criminals as well as androgen users and abusers. Therefore, the main aim of the current study was to investigate the association between testosterone levels and two psychosocial variables: stress and hostility in a cohort of healthy individuals who were members of a health maintenance organization (HMO). METHODS: At five quarterly visits, psychosocial scales and blood draws were collected. Psychological stress was measured by using several scales that assessed different types of stress, including daily hassles, major life events and perceived stress. Similarly, different aspects of hostility were measured, among them cynicism, hostile affect and aggressive responding. Plasma collected from each visit was used for testosterone level determinations. RESULTS: Testosterone levels were significantly associated with stress in both males and females. However, whereas this association exhibited a "threshold effect" in males, it demonstrated a direct and continuous linear relationship between these variables in females. Hostility was not correlated with testosterone levels in neither males nor females. CONCLUSIONS: These results suggest that testosterone levels in normal males and females may be more reflective of an intricate balance between physiological responding and emotional coping to stressors than the hostility profile of the individual.

Adaptation, Psychological↗

The clandestine drug laboratory situation in the United States.

Clandestine, or illegal, laboratories are operated by the criminal element to circumvent legal requirements with the goal of supplying drugs of abuse to the illicit market. Investigation of clandestine drug manufacturing laboratories is a high priority of the U.S. Drug Enforcement Administration (DEA) because elimination of these laboratories will prevent drugs of abuse from reaching the illicit drug traffic. One of the important responsibilities of forensic chemists assisting in investigations of clandestine drug laboratories is to be familiar with the methods of synthesis being used by clandestine laboratory operators. A review of clandestine laboratory seizures during the period of 1978 through 1981 will be provided to familiarize forensic chemists with current information on the types of laboratories being seized in the United States and the methods of synthesis being used.

3,4-Methylenedioxyamphetamine↗

An investigation of risk and protective factors in a sample of youthful offenders.

The study explored a set of potential risk and protective factors in relation to criminal activity and adjustment with a group of delinquent youths. The results indicated, first, that risk variables reflecting family relationship and parenting problems were associated with heightened rates of re-offending and lower overall adjustment. Second, the presence of protective factors relating to positive peer relations, good school achievement, positive response to authority and effective use of leisure time was associated with more positive outcomes with controls for the risk variables. Third, there was no evidence of interaction between risk and protective factors; the latter operated similarly at low and high levels of risk. These results are discussed in terms of their theoretical and applied significance.

Achievement↗

[The normative concept of guilt in criminal law between freedom of will and neurobiological determinism].

To make criminal conduct liable to punishment, criminal responsibility, defined as individual blameworthiness in terms of social ethics, is required as point of reference--both to create and limit the state's right to punish the offender. Neurobiological findings and more recent investigations in brain research have given rise to serious doubts regarding this "conditio sine qua non" of the state's power monopoly. As a result of preceding unconscious decisions, so the argument goes, Man is not free in his will, and the normative principle of culpability would need to be relinquished in favour of a "law of measures" detached from guilt. A detailed analysis of the underlying experimental setups, in particular the investigations by Benjamin Libet involving the measurement of the readiness potential, has shown, however, that the results of the test methods do not justify the demand for a profound change up to the point of a total revision of criminal law, and that they cannot invalidate the concept of freedom of will apostrophised on principle. The empirical data obtained fail to demonstrate if and why decisions of the will should not be free, the more so as the nomothetic method used ignores completely the idiographic understanding and interpretation of the always context-related and socio-structurally (pre)-moulded personality of the offender. Performed in a laboratory setting as individual actions with a comparatively simple structure and unrelated to a concrete situation, they can by no means be translated to the (more) complex situation under which an offence is committed including the decision-making processes determined by psychodynamic, motivational and intentional aspects as well as highly specific reciprocal interactions within the offender-victim constellation. Even if these experiments had shown the determined nature of human decisions, they would not necessarily have to bring about a conceptual change of paradigms of the normative concept of guilt, because as a result of self-attribution, the intra- and inter-subjective experience of the freedom of will renders the mere "illusion of freedom" sufficient to assign to an individual the appropriate sense of responsibility, which is also accepted by him. The alternative of a law of measures independent of guilt and culpability must be rejected because it is incapable of instituting sufficient protection, both in qualitative and quantitative terms, against prognostically diffuse and utilitarian hypertrophied prophylactic efforts on the part of the state up to the point of a revolutionised anthropological design, as shown quite clearly by the repressive and restrictive tendencies apparent in criminal policy since 11 September 2001. Consequently, the classic principle of guilt as one of the humanitarian foundations of punishment imposed by the state needs to be protected and upheld in the face of rash and inadequately considered law amendment endeavours. With its principles having slowly grown over the ages under democratic consent, criminal law is capable of immunising itself against uncritically generalised restructuring attempts based on inductive false conclusions and the confusion of coincidence, correlation and causality, let alone against the neurobiological "occupation tendencies" of normative premises. Regardless of their undeniable fascination, future brain research activities and the respective findings in the neurobiology of thinking, decision-making and acting as an indispensable empirical and epistemological starting point must always be reviewed in terms of their factual and normative implementation powers in favour of or against the human freedom of will.

Antisocial Personality Disorder↗

Long-term follow-up to a randomized clinical trial of multisystemic therapy with serious and violent juvenile offenders.

In this study, the authors examined the long-term criminal activity of 176 youths who had participated in either multisystemic therapy (MST) or individual therapy (IT) in a randomized clinical trial (C. M. Borduin et al., 1995). Arrest and incarceration data were obtained on average 13.7 (range = 10.2-15.9) years later when participants were on average 28.8 years old. Results show that MST participants had significantly lower recidivism rates at follow-up than did their counterparts who participated in IT (50% vs. 81%, respectively). Moreover, MST participants had 54% fewer arrests and 57% fewer days of confinement in adult detention facilities. This investigation represents the longest follow-up to date of a MST clinical trial and suggests that MST is relatively effective in reducing criminal activity among serious and violent juvenile offenders.

Adolescent↗

The scope of anthropological contributions to human rights investigations.

This paper examines the participation of anthropologists in international human rights investigations between 1990 and 1999 by surveying four of the most active organizations, including the Argentine Forensic Anthropology Team, the Guatemalan Forensic Anthropology Foundation, Physicians for Human Rights and the U.N.-sponsored International Criminal Tribunal for the former Yugoslavia. The education level, sex, nationality and primary role of the anthropological members of each team are quantified, as are the types of projects in which they contributed. The results show that 134 anthropologists from 22 nations investigated nearly 1300 sites in 33 countries during the study period. While involvement is not limited to those with advanced degrees and few obstacles are placed before anthropologists who wish to participate, full-time service within these organizations is rare and those interested in a career in forensic anthropology and human rights should understand the employment limitations.

Argentina↗

Ionising radiation (medical exposure) regulations (Northern Ireland) 2000 and their implications for Accident and Emergency (A&E) doctors in training.

With the introduction of the Ionising Radiation (Medical Exposure) Regulations (Northern Ireland) 2000 (IRMER) the medical practitioner faces greater accountability when requesting radiological investigations. The referrer (usually a doctor or dentist) must supply sufficient medical data to justify radiation exposure to a patient. These regulations can lead to criminal prosecution if breached. Our objectives were to identify the level of unjustified requests for plain abdominal radiography among A&E doctors and whether there is a statistically significant difference in the justification of request between doctors of differing experience. We reviewed and prepared statistical analysis of 100 A&E request forms for plain abdominal radiography. Royal College of Radiologist Guidelines were used as a "Gold standard" for justification of the investigation. A&E doctors of less than six months experience are at greater risk of breaching these regulations when requesting plain abdominal films, when compared to more experienced doctors. This is a serious issue which should be addressed at undergraduate and pre-registration level in addition to ongoing audit.

Adolescent↗

[Alcohol-dependent criminals: on the problem of their confinement according to paragraph 64 of the German federal law].

The article presents part of the results of a Federal German investigation of psychiatric confinement in cases of delinquency in accordance with German law. Among the 674 inmates whose case history could be included in the investigation, there was a predominance of alcohol dependence in two-thirds of them. Confinement occurred mostly only after addiction and delinquencies had been going on for a long time. In more than one-half of the patients no attempt had previously been made to treat and manage their alcohol addiction. Every fourth patient is confined without first consulting a psychiatric expert. Basing on sociobiographic characteristics it is possible to form two contrasting groups of patients: a smaller group where addiction has set in early and delinquency at a late stage, and a larger one with early onset of delinquency developing parallel to the abuse of alcohol. This leads to conclusions with regard to the development of specific treatment guidelines.

Adult↗

Detecting disorder: the treatment of mental illness among jail detainees.

This article investigates the extent to which mentally ill jail detainees are treated while they are in the custody of the criminal justice system. A random sample of 728 subjects were administered the National Institute of Mental Health Diagnostic Interview Schedule (NIMH-DIS) during jail intake and then followed up throughout their stay in jail. Of those subjects who met criteria for severe mental illness (psychosis or major affective disorder), only one third were given treatment within 1 week of intake. Log-linear analysis revealed that treatment decisions were influenced by treatment history (the strongest predictor), the type of mental disorder (schizophrenia vs. depression), type of crime, and whether symptoms were documented by jail intake personnel.

Adolescent↗

Child maltreatment histories among runaway and delinquent children.

The records of 378 children presenting to a juvenile court were reviewed for histories of child maltreatment, based on evidence from a formal investigative process by the Department of Social Services. The children came from two groups: delinquents, who had engaged in criminal activity, and status offenders, whose legal involvement was due to non-criminal behavior, such as running away and truancy. Fifty-five percent of the status offenders and 45% of the delinquents had substantiated histories of maltreatment. The percent of status offenders who had been sexually abused was seven times higher among runaways (35%) than among the other members of the group (5%). The percent of delinquents who had been physically maltreated was significantly greater among those convicted of committing violent crimes (27%) than among the non-violent delinquents (14%). Thus, maltreatment may contribute significantly to delinquent behavior.

Adolescent↗

Response to trauma in Haitian youth at risk.

In order to characterize undesirable behavior (drug use, fighting, criminal activity) among Haitian youth at risk and determine the relationship between traumatic experience and that kind of behavior, investigators recruited 292 Haitian youths via networks of informal social relations in two zones of Miami/Dade County strongly identified with Haitian ethnicity. Each recruit responded to an interview schedule eliciting sociodemographic information and self-reported activities, including involvement in youth-dominated groups. They also reported traumatic experience. Clinicians administered CAPS to a subset of those respondents who self reported traumatic experience. Staff ethnographers selected respondents for in-depth interviews and family studies to provide contextual depth for findings of the interview schedule and the CAPS assessments. Although traumatic experience may still play a role in mental health outcomes among children, childhood victimization among Haitian children does not appear to be related to the drug use and undesirable behaviors associated with unsupervised youth, including formation of gangs.

Adolescent↗

Suicide in the Northwest Territories: A descriptive review.

The incidence of suicide among the populations of the Northwest Territories (NWT) is notably higher than in the rest of Canada. A comparison of three five-year time periods between 1982 and 1996 reveals an increasing incidence rate, particularly for Nunavat, the eastern half of the NWT, occupied primarily by Inuit people. This is largely attributable to a rising use of hanging as opposed to other methods of suicide. A coroner's record review of suicides occurring between 1994 and 1996 demonstrates the preponderance of young males and of Inuit among those who committed suicide, the majority of whom committed suicide in familiar settings, usually their own homes, and often while others were on the premises. Thirty-six percent of those who committed suicide had experienced a recent family or relationship breakup, and twenty-one percent were facing criminal proceedings. Understanding the impact of these and other reported circumstances on the imminent risk of suicide requires further investigation.

Adolescent↗

Assassination in the United States: an operational study of recent assassins, attackers, and near-lethal approachers.

This study is the first operational exploration of the thinking and behavior of all 83 persons known to have attacked, or approached to attack, a prominent public official or public figure in the United States since 1949. In addition to data about each attack or near-attack and each subject's demographic and background characteristics, information was gathered about each subject's ideas and actions in the days and weeks before their attacks or near-lethal approaches. Questions were examined about each subject's movement from the idea of attack to actual attack, motives, selection of targets, planning, communication of threat and intent, symptoms of mental illness, and significant life experiences. In every case, the attack or near-attack was the end result of an understandable, and often discernible, process of thinking and action. Implications for protectors, investigators, and researchers are discussed.

Adolescent↗

[Cocaine: performance drug of the '90s? Morphologic and criminal sociologic aspects].

The drug fatalities handled by the Berlin forensic science institutes from 1992 to 1995 were analyzed with the help of post-mortem records and investigative files in order to ascertain the extent to which deaths showing positive proof of cocaine differ from previously-known drug fatalities from a morphological and a sociological point of view. Additionally, in numerous cases it was possible to have recourse to medical records and interviews with relatives. In analysing individual cases it could be established that only a small proportion of those who had died from drug-related causes and who were found with positive proof of cocaine had been affected by pure cocaine intoxication. In most cases consumption of cocaine was irregular. Predominantly, cases of combined intoxication involving opiate-containing substances were found. Cocaine has lost some of its exclusivity and met with wider acceptance among drug addicts of the opiate-type. Morphologically speaking, findings among drug addicts of the cocaine-type are becoming increasingly less specific; in particular, infectious diseases (e.g. hepatitis) are being observed more rarely. Our results point to the fact that the operating methods of appropriate treatment institutions must be modified with respect to their work with addicts using substitutes.

Adolescent↗