Maladaptive behaviors among military police personnel and implications for administrative policy

In the 1970s stress management programs were initiated by many police departments across the United States. Concern regarding police overreaction in stressful situations was a major impetus in the development of most of these programs. The United States Army's Military Police Corps followed the lead of major civilian police departments by endeavoring to improve community support through reducing “overreactive” incidents that inflamed public sentiment and lessened the morale and esteem of the Military Police Corps. In 1980, efforts were initiated to reduce “harrassment” of soldiers and provide greater service to military personnel and dependents (Author's Field Notes, 1980). In conjunction with this effort, classes on the awareness and effects of stress became standard offerings for students at the U.S. Army's Military Police School. Research on military police personnel was lacking, however, and it was not known if the findings regarding stress on civilian police officers were applicable to military police.This research represents an exploratory effort to identify and examine the determinants of three prominently identified correlates of high stress: family problems, alcohol abuse, and self-reported medical maladies. A path analytic model is postulated to provide an examination of the direct and indirect effects of several demographic variables upon an index of maladaptation that incorporates these three dependent variables into a single measure.     

The problems of personnel training for military forensic medical expertise under the current reform of the military forces in the Russian Federation

The educational sphere is becoming a major priority in the state policy. The Concept of national security for the Russian Federation regards intellectual impairment as a most serious internal threat to the military security. It declares that the operational efficiency of the armed forces should be based on high-quality education of specialists. The current reform of the military forces in the Russian Federation envisages the modification of the forensic medical expertise and the system of training relevant personnel. The post-diploma education of forensic medical experts encounters difficulties at all levels. In all probability, such education will be performed in the near future through the primary retraining mechanism. In the course of the ongoing reform, the Department of Forensic Medicine at the Military Medical Academy remains the sole facility for the post-diploma education of military forensic medical experts. The teaching staff of the department have sufficient qualification and experience for training highly skilled specialists as stipulated by the reform of the military forces in the Russian Federation.     

Fatal in utero salicylism

An aspirin overdose by an eight-month primigravida proved to be the mechanism of death for the fetus. Clinical progress of the mother and postmortem concentrations of salicylate in the fetus are listed exhibiting the fetal survival time of about 18 to 20 h post ingestion by the mother.     

Fatal assumption

This article questions the assumption that mentally disabled individuals are regularly afforded competent counsel. It finds that such counsel is frequently not available and that our failure to challenge this assumption threatens to make illusory reform efforts by lawyers and mental health professionals alike. The presence of vigorous, independent counsel is critical, especially since legal rights are not self-executing. Such counsel serves an educative function in the entire process, seeks to assure the implementation of collateral legal rights, and avoids the “underidentification” of mental disability cases. These functions have become more important as the political and social climate has changed and as the subject matter has become more complex. A series of reform recommendations is offered to litigators, policy makers, judges, and legislators.     

Fatal diphenhydramine intoxication in infants

Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.     

Fatal firearm accidents in Sweden

According to Swedish law, it is prohibited to possess and use firearms without a special permission (license), which is given only after a detailed personal investigation. This restrictive legislation accounts for the fact that deaths due to firearms in Sweden are rare in an international comparison. The number of accidental firearm fatalities in Sweden is 0.074/100,000 living persons. We have previously published a series of accidental firearm fatalities during hunting, and now we present an investigation on the non-hunting fatalities. The mean age of the victims was 27 years, and males predominated. Handguns, military rifles, and shotguns caused most of the accidents. The first published case of fatal thoracic airgun wound is also included. Slightly more than half of the accidents were caused by another person and were inflicted at close range. Unsafe handling of the guns, especially "playing" with the gun or during military training caused most of the accidents. It is doubtful that one could further decrease the low number of fatal firearm accidents in Sweden by even more restrictive legislation. Instead, it is concluded that the most important factor to stress is the safer handling of weapons.     

Fatal verapamil poisoning

A case of fatal verapamil poisoning is reported. The pathologic and toxicologic findings are discussed.     

Fatal cocaine poisoning

A case of lethal cocaine poisoning after parenteral application is described. The results of the quantitative gas chromatographic determination in blood, liver, urine, stomach contents and muscle are reported.     

Fatal bromethalin poisoning

Bromethalin is a neurotoxin found in some rodenticides. A delusional 21-year-old male presented to a hospital with altered mental status the day after ingesting a bromethalin-based rodenticide. He died 7 days after his self-reported exposure to c. 17 mg bromethalin (equivalent to 0.33 mg bromethalin/kg). His clinicopathologic course was characterized by altered mental status, obtundation, increased cerebrospinal fluid pressure, cerebral edema, death, and diffuse histologic vacuolization of the white matter in the central nervous system seen on microscopic examination at autopsy. The presence of a demethylated form of bromethalin in the patient's liver and brain was confirmed by gas chromatography with mass spectrometry. Clinical signs and lesions observed in this patient are similar to those seen in animals poisoned with bromethalin. This case illustrates the potential for bromethalin ingestion to result in fatal human poisoning.     

Fatal thyrotoxic crisis

Graves' disease is a form of hyperthyroidism. A rare complication of Graves' disease is thyrotoxic crisis. Although the crisis is frequently fatal, it is a distinctly unusual cause of sudden death. We investigated the case of a young woman with Graves' disease who died suddenly. Radioimmunoassay tests of thyroid function were used to establish the diagnosis.     

Fatal pedestrian-bicycle collisions

Although, fatal collisions between pedestrians and bicycles are relatively rare, they are still of forensic relevance because of the need to explore the circumstances of the accident. Based on three reconstructed cases, situation and injury patterns are presented that might prove useful in future cases: usually the person causing the accident is the cyclist while the pedestrian generally suffers more severe injuries; the situation at the site of accident is important for its reconstruction: end location of the persons involved in the accident, injuries and traces on pedestrians and cyclists, traces at the site of accident and on the bicycle; because of the lack of pre-crash traces and any eyewitness accounts, the pedestrian's injuries are the best starting point for the reconstruction of the accident; a characteristic wound on the lower leg of the pedestrian that reveals the initial impact between the front wheel and the leg is crucial not because of its seriousness, but because of its external morphology; the injuries that can be expected by the following impact between body and handlebar are unspecific and only minor; the most severe injuries to the pedestrian as a result of the accident are caused secondarily by falling and hitting the head on the road; the fall of the cyclist, however, corresponds to a throw-off followed by a sliding phase with less impact load when the head hits the ground [maximum abbreviated injury scale 1 (MAIS 1)]; the cyclists involved are mainly younger persons on fashionable bicycles (here: mountain bikes); in the great majority of cases, the injured pedestrians are frail, elderly people with a lower tolerance of trauma.     

Fatal arrow wounds

Two instances of fatal arrow wounds are described, one by a field-tip (target arrowhead), the other by a broadhead (large-game hunting arrowhead). The essential characteristics of the two types of wounds are discussed. In particular, the field-tip can closely simulate a bullet wound by causing a circular entrance hole with abraded margins, whereas the broadhead can create unusual radiating incised wounds.     

Fatal propane-butane poisoning

Two lethal poisonings by butane and propane are described, and the corresponding concentrations in the body fluids and organ tissues are evaluated. One case appeared to be an accident after deliberate inhalation for butane, one was a suicide. The mechanism of the inhalation could be reconstructed in both cases. The concentrations in the biological material agreed well with observations in similar cases.