Neumeyer, Dieter: Hessisches Stra?engesetz (HStrG)

Ohne Zusammenfassung     

Psychiatric disorders and management of sexual offenders in the prison psychiatric consultation unit of Marseille

Since 2017, complaints of sexual violence have increased in France. At the same time, the management of sexual offenders has been at the center of international public health policies. The prevalence of mental disorders among sexual offenders is an essential field of research. There are some published studies on the prevalence of psychiatric disorders in sexual offenders in detention, but there are few recent published studies among French individuals who were detained. Our objectives were to determine the prevalence of psychiatric disorders among persons detained for sexual offenses and the level of care received according to their diagnosis. For this purpose, we carried out a retrospective observational study from January 2017 to October 2021 of all adult sexual offenders, whether accused or convicted, who were seen in the psychiatric consultation unit of Les Baumettes prison, Marseille, France. The primary outcome measure was the psychiatric diagnosis entered in the medical records. One hundred forty-two patients were included in analysis. All patients were men, and the majority (n = 97, 68.3%) of these patients presented with at least one psychiatric disorder, principally a personality disorder (31.7%). 10.6% presented with a schizophrenic disorder, 4.9% a bipolar disorder, 3.5% a depressive disorder, 5.6% pedophilic paraphilia, and 25.4% an addictive disorder. Their management and comorbid addictions were analyzed in subgroups for each psychiatric disorder. Patients appeared to receive an appropriate level of care for their diagnosed disorder. It seems important to develop structured assessment of recidivism risk for better management of sexual offenders.     

Distinct age-related differences among victims in cases of suspected child abuse

Evidence describing age-related differences among children with suspected physical and sexual child abuse is lacking. We describe findings in severe cases of suspected abuse. Cases with 756 children <15 years old were included during 2001–2013 at the Department of Forensic Medicine, Aarhus University, using forensic evaluation documents, medical records, and court proceedings. Eight percent of children <4 years old died from child abuse, 36% through violence resulting in death, and 64% by manslaughter, whereas 1% > 4 years old died, solely by manslaughter. External injuries were mainly located to head and torso in children <4 years old, changing to the upper and lower extremities in older children. Child sexual abuse was suspected in 52% of cases with living children <4 years old, 83% of children 4–7 years of age, 88% of children 8–11 years of age, and 93% of children >12 years old. Anogenital findings were mainly caused by other medical conditions in children <4 years old, hymenal clefts in the superior half of the hymenal rim were almost exclusively found in children between 8 and 11 years of age, whereas both superficial and complete hymenal clefts in the inferior half of the hymenal rim were found in children >12 years old. The present study describes age-related differences in victims of suspected child abuse. Fatal versus nonfatal child physical abuse and the significance of hymenal findings in child sexual abuse could be studied further.     

Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa,Southeast Turkey (2012–2022)

Electric shock injuries (EIs) have high rates of morbidity and mortality in both children and adults. The aim of this study was to examine autopsy cases resulting from EIs and to compare pediatric and adult groups with respect to sociodemographic data, clinical characteristics, location of the incident, electricity entry–exit wound characteristics, current direction, pathological effects of the electric shocks on the body, and cause of death. A total of 8075 autopsies conducted between 2012 and 2022 were retrospectively examined. Şanliurfa is a city in the southeast of Turkey with the highest birth rate in the country. Of 123 cases of death resulting from EIs in Şanliurfa, 58 (47.2%) were children (age < 18 years). In the majority of children (81%), a low-voltage injury resulted from a domestic appliance while the children were playing at home in a rural area. In the vast majority of adults, a high-voltage injury (HVI) resulted from a workplace accident due to working with HVI materials in an area outside the home. The manner of death was accidental in all the electric shock injuries. The electricity entry and exit wounds formed as a result of EIs had similar characteristics in both children and adults, with no significant difference identified. In the province of Şanliurfa, Turkey, which borders Syria and where the main occupation is agricultural activities, there is a need to increase electrical safety precautions within the home, educate parents, and increase electrical safety conditions and worker education in the workplace.     

An unusual case of a triple suicide pact at the time of the COVID-19 pandemic

In December 2020, the World Health Organization (WHO) declared SARS-CoV2 a global pandemic. Home confinement, low social contacts, and fear of virus transmission played a major role as risk factors for suicides during the following period. Suicide pacts, in particular, showed a different pattern. A rare case of a triple suicide pact among members of the same family nucleus is presented. The victims were an elderly, severely ill woman and her adult children (a son and daughter), linked by a morbid relationship. The last time the family was seen alive was 40 days before the discovery. All corpses presented decompositional changes. After a full autopsy, the cause of death was determined to be a lethal intake of morphine for the mother and acute blood loss due to self-stabbing at the neck for the siblings. The younger woman was under the effects of a large amount of heparin. Toxicological analysis was positive for opioids and alcohol in both siblings. Suicide pacts have rarely been described during the COVID-19 pandemic. In the few cases reported, the victims were more often relatives than people in a romantic relationship. The involvement of three people is unusual, as is the use of different suicide methods among the victims. In the presented case, the elderly mother's imminent death from terminal cancer, her concern over dying in a nondomestic environment, and the siblings' fear of being alone likely led to the conception of the suicide pact. Social isolation and economic difficulties also played a contributing role.     

Knowledge of child abuse and neglect in nursing students: Assessment and perspectives

Misdiagnosis of child abuse and neglect can delay early treatment. Some authors have pointed out that nurses can miss child abuse and neglect diagnoses due to a lack of knowledge. It is unclear whether the lack of knowledge is due to students' insufficient preparation in nursing school and/or a deficiency in continuing education. An 18-item questionnaire was administered to final-year nursing students to assess their degree of knowledge on child abuse and neglect and to evaluate if the lack of knowledge was due to insufficient teaching/training during nursing school. The students were also asked to evaluate themselves by assigning a score to their knowledge. A statistical comparison was performed to define whether sufficient/insufficient results were associated with the following variables: sex, pediatric or general nursing student, attending pediatric lectures, training in pediatric wards/ambulatories, and attending specific lectures on child abuse and neglect. The study population comprised 175 students (154 females, 20 males, 1 unknown). Exactly 66.3% of the participants had ≤9/18 correct answers. Of all students, 77.7% self-evaluated their level of knowledge as ≤5/10. The comparisons yielded statistically significant differences between the groups with sufficient objective knowledge and those unrelated to training in pediatric wards/ambulatories or pediatric nursing students. Overall, there was little objective knowledge on the subject, which may be related to insufficient teaching/training in nursing schools. Useful corrective strategies include further teaching on child abuse and neglect, preferably using a practical approach. Further, common teaching/training programs should be conducted by both pediatric and general nursing schools.     

A systematic approach to improve downstream single-cell analysis for the DEPArray™ technology

Most commercially available STR amplification kits have never been fully validated for low template DNA analysis, highlighting the need for testing different PCR kits and conditions for improving single-cell profiling. Here, current strategies rely mainly on adjusting PCR cycle number and analytical threshold settings, with a strong preference for using 30 amplification cycles and thresholds at 30–150 RFU for allele detection. This study aimed to (1) determine appropriate conditions for obtaining informative profiles utilizing a dilution series, and (2) test the outcome on single cells using the DEPArray™ technology. Four routinely applied forensic STR kits were compared by using three different amplification volumes and DNA dilutions down to 3.0 pg, while two well-performing kits were used for single/pooled leucocyte and sperm cell genotyping. Besides reduced costs, the results demonstrate that a 50%–75% PCR volume reduction was beneficial for peak height evaluation. However, this was counteracted by an increased artifact generation in diluted DNA volumes. Regarding profile completeness, the advantage of volume reduction was only prominent in samples processed with Fusion 6C. For single and pooled cells, ESIFast and NGMDetect provided a solid basis for consensus profiling regarding locus failure, although locus dropouts were generally observed as stochastic events. Amplification volume of 12.5 μL was confirmed as appropriate in terms of peak heights and stutter frequencies, with increased stutter peaks being the main artifact in single-cell profiles. Limitations associated with these analyses are discussed, providing a solid foundation for further studies on low template DNA.     

Accuracy of comparison decisions by forensic firearms examiners

This black box study assessed the performance of forensic firearms examiners in the United States. It involved three different types of firearms and 173 volunteers who performed a total of 8640 comparisons of both bullets and cartridge cases. The overall false-positive error rate was estimated as 0.656% and 0.933% for bullets and cartridge cases, respectively, while the rate of false negatives was estimated as 2.87% and 1.87% for bullets and cartridge cases, respectively. The majority of errors were made by a limited number of examiners. Because chi-square tests of independence strongly suggest that error probabilities are not the same for each examiner, these are maximum-likelihood estimates based on the beta-binomial probability model and do not depend on an assumption of equal examiner-specific error rates. Corresponding 95% confidence intervals are (0.305%, 1.42%) and (0.548%, 1.57%) for false positives for bullets and cartridge cases, respectively, and (1.89%, 4.26%) and (1.16%, 2.99%) for false negatives for bullets and cartridge cases, respectively. The results of this study are consistent with prior studies, despite its comprehensive design and challenging specimens.     

Quasi-static and dynamic bending stress of the pediatric femur for producing a femoral fracture

At the Institute of Forensic Medicine of the University of Heidelberg, in the years 1986-1988 thigh loading tests were conducted in order to produce fractures in a total of 28 cadavers of babies and children who had died at ages ranging from 1 day to 6 years. In 18 tests a universal strength testing machine was used and each thigh was loaded quasi-statically from the outside with a blunt edge applied to the middle of the femur, bending it to the point of fracture. The loading velocity amounted 50 mm/min with a defined support distance. The breakage load amounted to 470 N in a 6-day-old baby and increased about evenly up to 2920 N in a 6-year-old child; however, in a newborn 2720 N was needed and in a 15-month-old child, 5700 N. The total deformation way ranged from 16 to 60 mm. The main types of fracture that occurred were: complete and incomplete transverse fractures, oblique fractures, Messerer fractures, and spongiosa fractures. Ten children ranging in age from 2 months up to 27 months were submitted to dynamical thigh loading by means of a failing weight impactor and a horizontal impactor. Only in one case did a transverse fracture occur, when the lateral thigh impacted on an edge at a falling height of 70-93 cm. The forces set up amounted to 320-600 N with the falling weight impactor and to 2370 N with the horizontal impactor. These results suggest that fracture of the femur does not occur if a baby or small child falls from a changing table or from an adult's arm.