The role of cognition in fitness to stand trial: a systematic review

The aim of the current paper was to systematically review the quality and design of the literature examining cognition and fitness to stand trial (FST). Ten empirical studies published between 1970 and July 2013 met the inclusion criteria. All studies utilised cross-sectional designs and six were prospective. Study quality was appraised based on FST research guidelines. The study quality was highly variable. Intelligence was controlled statistically in only half of the included studies. Cognitive processes, specifically, processing speed, verbal memory and visuoperceptual skills differentiated fit and unfit groups. Aspects of executive functioning, including social knowledge and abstract thinking, influenced FST. Future studies should use prospective consecutive designs and multivariate statistical strategies that control for potential confounds. Comprehensive assessment across a number of cognitive domains is needed in order to validate research conducted to date and guide forensic assessment of FST.     

Actions taken in response to mental health screening at reception into prison

Screening for mental health problems on reception into custody has been criticised. However, there have been few studies on care pathways through custody as a result of screening identification. We aimed to identify what actions were taken as a result of screening positive for suicidal ideation and mental health problems. Case records for 2166 prisoners newly received into five prisons in England and documented contact with health care professionals in the following month were examined by hand over a four-month period. Altogether, 3% of prisoners were screened as having current suicidal ideas, of whom 30% had no contact with mental health services or risk assessment documentation. Another 21% of new receptions received psychotropic medication, for whom over 60% received no primary mental health assessment, and only 36% received psychotropic medication in prison. Care pathways need to be defined, and screening needs to be delivered as originally intended by initial screen for life-threatening matters, followed by a later, comprehensive assessment of health needs.     

Assessing reliability, validity, and clinical utility of the BEST-Index in measuring living skills among forensic inpatients

The assessment of behavioral change as a result of inpatient treatment in forensic psychiatry is an important precondition for violence risk prediction in forensic psychiatry. In relation to a multitude of diagnostically based risk assessment instruments, there is a shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments that are behaviorally based and therefore appropriate for use within varied psychiatric contexts. There is also a need for instruments which will offer assessors the opportunity to examine possible relationships between criteria of social risk and criteria of more general aspects of social functioning. Tapping the issues pointed out above, the authors present an overview of a normatively based social profiling instrument (the BEST-Index), and discuss evidence for its validity, reliability, and aspects of clinical utility.     

Inconsistency in 9 mm bullets measured with non-destructive X-ray computed tomography

Fundamental to any ballistic armour standard is the reference projectile that is to be defeated. Typically, for certification, consistency of bullets is assumed. Therefore, practical variations in bullet jacket dimensions can have far reaching consequences. Traditionally, internal dimensions could only be analysed by cutting bullets which rules out any subsequent ballistic assessment. Therefore, the use of a non-destructive X-ray computed tomography (CT) method is explored in this paper. A set of 10 bullets (9 mm DM11) was taken for analysing both intra and inter bullet jacket thickness variation. CT measurements of jacket thickness were validated with high resolution scanning electron microscope (SEM) images. An image based analysis methodology has been developed to extract the jacket thickness map and the centre of gravity. Thickness variations of the order of 200 μm were found commonly across all the bullets along the length and an angular variation of up to 100 μm was found in a few bullets. Jacket thickness and centre of gravity were also calculated for the same bullets after impact and the variations between the pre- and post-impacted bullets were compared, by establishing a common physical reference. The results show that the proposed CT scanning approach and subsequent image analysis method can bring out the statistical variations in bullet geometry pre- and post impact effectively.     

Massive systemic fat embolism detected by postmortem imaging and biopsy*

Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy.     

Reality bites--A ten-year retrospective analysis of bitemark casework in Australia

Criticism of forensic science, particularly that of bitemark analysis, has become increasingly common in the last decade. Much of the criticism directed at forensic odontology cites cases where miscarriages of justice have occurred when erroneous, over-confident or even false bitemark evidence has been tendered by odontologists. Despite Australia's own experience with such cases in the past, it is postulated that this does not represent the true nature of bitemark analysis as practiced by odontologists today-at least in this country. A review of 119 cases from the last 10 years confirms that 'identification' of a suspect is rarely, if ever, offered, and that conclusions reached by odontologists with respect to bitemark analysis are generally conservative. However, the results of this study also indicate that in a small but significant proportion of cases, there is still some tendency to reach conclusions that could be considered over-confident when considering the overall quality of the physical evidence offered. It is suggested that odontologists should avoid making conclusive remarks regarding the origin of the mark, or the identification of a perpetrator, when such comments are realistically precluded, given the low evidentiary value of the mark itself.     

An Examination of the Influence of Strength of Evidence Variables in the Prosecution’s Decision to Dismiss Driving While Intoxicated Cases

The majority of research examining prosecutorial discretion has focused on legal factors such as the seriousness of the offense or the extra-legal characteristics of the accused including race/ethnicity and gender. The amount of variance explained by court researchers, however, remains quite low. The present study extends previous research examining the primary determinants of prosecutor??s decision to dismiss or fully prosecute focusing on driving while intoxicated cases. We focus on the predictive contribution of the strength of evidence relative to legal and extra-legal variables. The data consist of 2,358 driving while intoxicated cases filed in Harris County, Texas during the first 8?months of 1999. The findings strongly support the inclusion of strength of evidence variables in court research and further suggest their past omission may have attributed significance to spurious relationships.