Factors predictive of changes in the legal status of psychiatric inpatients

The objective of this study was to identify factors predictive of duration of involuntary hospitalization, i.e., factors that would predict early versus late conversion to voluntary status. Charts of 209 patients admitted involuntarily to an acute psychiatric inpatient unit were studied using a naturalistic, prospective design. Multivariate regression analysis was used to determine the effect of a number of variables in predicting duration of involuntary hospitalization. Of all variables studied, only smoking preference was found to be a statistically significant predictor of duration of involuntary hospitalization. Smokers were converted to voluntary status earlier than non-smokers. The authors concluded that clinicians may not be using commitment statutes as per recommended legal guidelines. Patients who smoke may be applying overt and covert pressure on clinicians with regard to conversion to voluntary status to gain smoking privileges.     

HIV-infected prisoners: what mental health services are constitutionally mandated?

State and federal correctional facilities currently have approximately 23,000 inmates who are infected with human immunodeficiency virus (HIV). These inmates suffer from the same mental health disorders as uninfected inmates but are additionally subject to mental health problems uniquely related to their HIV infection. Many prison systems are struggling to provide minimal mental health care to uninfected inmates. How will prisoners address the additional mental health needs of the staggering number of inmates being diagnosed with AIDS and HIV? This article describes the type of mental health services that are constitutionally mandated and discusses whether and how prisons will have to respond to the distinct mental health issues related to HIV infection.     

Allele frequencies and population data for 17 Y-chromosome STR loci in a Serbian population sample from Vojvodina province

Seventeen Y-chromosomal STR (short tandem repeat) loci were analyzed in a group of 185 healthy unrelated male individuals (n=185) from the population of Serbian province of Vojvodina. After minimal haplotype STR loci analysis we observed 129 different haplotypes. The most frequent haplotype was found in 13 copies, and total haplotype diversity was 99.11%. After analysis of additional eight Y-STR loci (DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635 and YGATAH4) there were 176 different haplotypes observed, out of which 168 appeared in single copies, and 7 haplotypes appeared twice. The most frequent haplotype was found in three copies. The haplotype diversity (99.94%) and discrimination capacity (95.13%) were calculated. Comparisons were made with previously published haplotype data on neighbouring population samples and significant differences were demonstrated at DYS19, DYS389II and DYS393 loci. Pairwise comparison of populations revealed that our sample was significantly different only from Hungarian sample (RST=23.98%, p=0.0091).     

Suicide by Intentional Air embolism

Venous air embolism occurs when air enters the venous system. The main causes of venous air embolism include medical procedures, neck and head trauma, and injuries of the genitals. Self‐induced suicidal (and intentional) air embolism is extremely rare. The authors report a rare case of a suicidal air embolism committed using a self‐made tool composed of a plastic bottle and an infusion set, injecting nearly 2000 mL of air into the cubital vein. The toxicological analysis suggested that midazolam, together with air, was also injected into the circulation using the same bottle and infusion set.     

Tractor driving and alcohol—A highly hazardous combination

Introduction

Approximately half of all injury-related fatalities in the agricultural industry are associated with farm tractors. Skill-based psychomotor tasks, such as driving and operating such machines, are easily impaired as a consequence of the use of alcohol. We have analyzed characteristics of fatal traffic accidents involving tractors in Zagreb County, with special accent to prevalence of alcohol use among drivers.

Subjects and methods

The material comprised all fatal accidents involving tractor drivers in Zagreb County between the years 2001 and 2005 where a medicolegal autopsy had been performed and samples taken for subsequent forensic toxicological analysis. The total of 47 cases were included. Data were collected on characteristics of the fatally injured as well as on circumstances and dynamics of the accident itself. The results are presented with absolute and relative frequencies.

Results

Ninety-one percent (43 out of 47 cases) of fatally injured were males. No person was under the age of 18, 70% were between 18 and 65 years of age and 30% were above 65 years of age. Blood alcohol reading was negative in only 13 out of 47 analyzed cases (28%). Six cases (13%) had blood alcohol concentration (BAC) below 0.50 mg/mL, further 6 between 0.50 and 1.49 mg/mL, 16 (34%) between 1.50 and 2.49 mg/mL and the remaining six had BAC between 2.50 and 3.49 mg/mL. Median BAC among 34 fatalities with positive blood alcohol level was 1.80 mg/mL, while the highest concentration observed was 3.49 mg/mL. Multiple injuries were the most common cause of death (43%) followed by crush asphyxia (26%). Most of the victims (81%) died at the scene of the accident and all of them died within the first 24 h. In the majority of accidents (79%), the tractor operator was a victim of the vehicle rollover.

Conclusion

High percentage of farm tractor users driving under influence and high median BAC indicates that legislation alone is not sufficient in preventing accidents. Further effort should be directed toward education aimed to increase awareness of the obvious risk that alcohol use represents to driving and workplace safety. Taking into account that the overwhelming majority of fatalities occurred from rollovers, strong encouragement should be given to implementation of rollover protecting structure (ROPS) devices in order to prevent such type of fatalities.