Accuracy of cause of death determination without forensic autopsy examination

Medical examiners and coroners commonly determine cause and manner of death without an autopsy examination. Some death certificates generated in this way may not state the correct cause and manner of death. From the case files of the Department of Forensic Medicine in Sydney, Australia, the authors retrospectively reviewed investigative information of all cases in a 6-month period that were initially considered natural deaths (429). The authors, blinded to autopsy results, accepted 261 cases as appropriate for certification without autopsy and assigned a cause of death to each. Per standard local practice, all cases had been autopsied. The actual causes of death as determined by autopsy were then revealed and compared with the presumed causes of death. Most presumed and actual causes of death were cardiovascular (94% and 80%, respectively). The majority of presumed causes of death were listed as ASCVD as the cases lacked features of a more specific cardiovascular process. A large majority of cases had a presumed cause of death of ischemic heart disease based on individual case details. The actual causes of death demonstrated a large breadth of cardiovascular and noncardiovascular disease processes, even though ischemic heart disease accounted for 62% of deaths. The presumed cause of death was completely wrong in 28% of cases. A nonnatural manner of death was present in 3% of cases. This study demonstrates that experienced forensic pathologists may generate erroneous death certificates for cases that are not autopsied.     

Valuing Policy Alternatives: A Generalization

Those interested in political phenomena such as voting havefound random utility models, originally developed for decisionssuch as transportation choice, especially attractive, as theunderlying model can yield a statistical model with a few simple,realistic assumptions. Unfortunately, such models have provendifficult to apply to situations with more than two votes andthree alternatives or an unknown cutpoint. Additionally, aswe show, standard applications of such models to voting, whileproducing consistent parameter estimates, yield standard errorsthat are too small and, due to a failure to employ all relevanttheoretical information, biased ideal point estimates. We specifya general model applicable to any number of votes and alternatives,with correct standard errors and unbiased ideal point estimates.We apply this model to a number of cases studied by previousscholars involving legislative voting over the minimum wage:(1) when there are two votes and two known cutpoints (K. Krehbieland D. Rivers, American Journal of Political Science, 1988,32, 1151–1174); (2) when there are three votes and threeknown cutpoints (J. Wilkerson, American Journal of PoliticalScience, 1991, 35, 613–623); and (3) when there are threevotes but where one cutpoint is unknown given a lack of knowledgeabout the impact of a policy (J. Wilkerson, American Journalof Political Science, 1991, 35, 613–623) or the possibilityof sophisticated voting (C. Volden, Journal of Politics, 1998,60, 149–173). We show that in various contexts our analysisimproves on existing methods, yielding consistent and efficientideal point estimates and a better-fitting model with improvedpredictive accuracy.     

Violence and abuse in psychiatric in-patient institutions: a South African perspective

Institutionalisation of psychiatric patients was a prevalent treatment approach in the apartheid era of South Africa. Allegations of violence and abuse towards patients frequently arose during this time. The post-apartheid Department of Health prioritised improvements in mental health care by recommending, inter alia, deinstitutionalisation and reintegration of patients into the community. Ten years later, these interventions have proved difficult to institute and many patients are still hospitalised. The present study investigated whether currently hospitalised patients continued to experienced violence and abuse. This was an exploratory naturalistic study in which both qualitative and quantitative data were collected. Of the 127 who completed the study, more than 50% reported experiences of abuse. The main perpetrators were other patients, although violence by staff was reported. Reasons for the tardiness of implementation of deinstitutionalisation and the prevalence of ongoing violence and abuse in psychiatric hospitals are complex. Factors inherited from the pre-democratic system coupled with increased urban violence and financial constraints appear to be some of the major causes of ongoing dependency upon hospitalisation of mental health care users. The present study highlighted the urgency of implementing mental health care improvements.     

An ELISA method for the identification of salivary amylase

An ELISA method for the detection of salivary amylase in dried stains using a monoclonal anti-human salivary amylase antibody was developed. Studies demonstrated the assay to be sensitive down to 0.0002 Sigma units and showed a linear response between absorbance and salivary amylase activity between 0.002 and 0.2 units. The assay showed no cross reactivity with either commercially purchased human pancreatic or bacterial amylase. Sample studies utilizing swabs from several human body fluids showed that 100% of all saliva containing swabs (sixteen of sixteen) and 13% of non-saliva human body fluid swabs (eight of sixty-three) showed a net absorbance with the method. Of these eight non-saliva swabs yielding a net absorbance, none exceeded a salivary amylase activity of 0.003 units. In contrast, only three of the sixteen saliva-containing swabs (swabs produced from saliva diluted 1:5, 1:6, and 1:10, respectively) showed an activity below 0.2 units. Of these swabs, the 1:100 dilution showed the lowest activity (0.048). This value is still more than ten times that of the non-saliva containing swab with the highest activity.     

Maintenance of the ENFSI proficiency test program on identification of GSR by SEM/EDX (GSR2003)

Within the framework of the ENFSI Expert Working Group "Firearms," every second year, a proficiency test on the detection and identification of GSR by SEM/EDX is carried out. This proficiency test is a development and extension of the previous proficiency test GSR2001. The test material was again designed by the organization panel and manufactured by an external company for SEM accessories. This time the participating laboratories were requested to determine the total number of PbSbBa containing particles on a test sample following their own laboratory specific methods of automated GSR particle search and detection by SEM/EDX. One synthetic particle sample (SPS) with artificial GSR particles was dispatched to all participants. This paper summarizes the results of the study and assesses the overall performance of the participating laboratories. Furthermore an extended statistical evaluation and a comparison with previous studies was carried out.     

Bedroom rape: sequences of sexual behavior in stranger assaults

This article examines the sequential, temporal, and interactional aspects of sexual assaults using sequential analysis. Fourteen statements taken from victims of bedroom-based assaults were analyzed to provide a comprehensive account of the behavioral patterns of individuals in sexually charged conflict situations. The cases were found to vary in the sexual severity of assault, distinguishing a variety of motivations and behavioral repertoires of offender and victim. Two quite distinct styles of offense were identified: multiple and single, which may have very different implications for research into rapist taxonomies and rape prevention strategies.