Characteristics of assaultive patients with schizophrenia versus personality disorder: six year analysis of the Assaulted Staff Action Program (ASAP)

Literature reviews of individual assaultive patients, repetitively violent patients, and restrained assaultive patients document that persons diagnosed with schizophrenia or personality disorder are at the highest risk to become assaultive. While there has been some initial research of possible predictor variables across diagnostic groups, this six-year retrospective study is the first to compare only persons with schizophrenia or personality disorder on basic demographic and the selected clinical variables of history of violence, personal victimization, and substance use disorder. In this study, the variance suggested that persons with schizophrenia and personality disorder were both likely to be assaultive. Assaults by persons with schizophrenia were somewhat proportional to their presence in the population studied. However, personality disordered patients represented a disproportional increase from the population studied. Younger females with a diagnosis of personality disorder and with histories of violence toward others and personal victimization appeared at increased risk to be assaultive and to require restraints. The findings and their implications for safety and clinical care are discussed.     

A Biomechanical Evaluation of Skull–Brain Surrogates to Blunt High‐Rate Impacts to Postmortem Human Subjects

The field of forensic injury biomechanics is an emerging field. Biomechanically validated tools may assist interdisciplinary teams of investigators in assessing mechanisms of blunt head trauma resulting in skull fractures. The objective of this study is to assess the biofidelity of spherical, frangible skull–brain (SB) surrogates. Blunt impacts were conducted at 20 m/s, using an instrumented 103 g rigid impactor, to the temporo‐parietal region of four defleshed cephalic postmortem human subjects (PMHS). Force–deformation response, fracture tolerance, and fracture patterns were recorded for comparison to spherical skull–brain surrogates. Three brain substitutes were assessed: 10% gelatin, lead shot with Styrofoam and water. Force–deformation response of the skull–brain surrogates was similar to defleshed PMHS up to the point of fracture; however, none of the surrogates fractured at tolerance levels comparable to the PMHS. Fracture patterns of the skull–brain surrogates were linear and radiating, while PMHS fractures were all depressed, comminuted.     

Psychometric Properties of the Trauma and Post-Trauma Well-Being Assessment Domains of the North Carolina Family Assessment Scale for General and Reunification Services (NCFAS G+R)

Two new domains of the NCFAS-G+R, trauma and post-trauma well-being, were tested for reliability and validity in relation to previous NCFAS-G+R domains. Three family preservation programs provided case level data on 170 in-home service families over six months. Domains were tested for reliability using Cronbach's alpha, factor structure was explored, and convergent validity was examined through correlations of new scale items with domain ratings on the NCFAS-G+R. Assessment ratings were cross tabulated with practice and outcome variables. Reliability of the new domains was established with Cronbach's alphas of .811 and .905, respectively, factor structure was confirmed, new scale items and domains correlated predictably and significantly with other NCFAS domains. Outcome variables were influenced by trauma assessment ratings. Displaying good psychometric properties, the trauma-focused assessment domains hold promise for assisting child welfare practitioners assess trauma symptomology, and post-trauma well-being following services.     

Antemortem records of forensic significance among edentulous individuals

The identification of edentulous individuals is problematic due to poor provision of labelled dental prostheses. Dental records may still provide useful information for odontologists in the comparative identification process. The purpose of this study was to determine the level of forensically significant information contained within the dental records of a population of denture wearers attending the University of Manchester School of Dentistry. Two hundred and two dental records were examined and a proforma completed. The mean age of the patients was 72 years. Medical history were absent in 4% of all records and only 67.8% of the written records were rated as good. Thirty-two percent of the records contained one or more panoramic radiographs but 30% of these were over 3 years old rendering their usefulness in identification procedures questionable. In total only 18% of the examined records contained antemortem information that would enable identification. These data suggest that the process of denture marking is an essential in order to ensure that the identification of this population can be undertaken expediently by dental means.     

Denture marking--patient preference of various methods

Dental forensic organizations world wide have recommended that dental prostheses should be labeled with at least the patient's (wearer's) name and preferably with further unique identifiers such as social security number. A range of methods are available and the purpose of this study was to determine, via the means of a visual questionnaire, which are the most preferable to those patients who wear complete dentures. One hundred edentulous patients attending the Manchester Dental Hospital were shown a range of denture labeling methods and asked to rank these according to their preference. The most preferred method was that of an embedded radio frequency identification microchip (38% rated this as first) and the second was an inclusion technique using onion paper (24% rated this as first). The least preferred method was the use of a groove cut into the denture flange with 71% of patients rating this as the poorest in terms of esthetics. The study demonstrates that the method of denture labeling is important to patients and to ensure that denture labeling is performed routinely esthetic preferences must be considered.