Assessing the Risk of Domestic Violence Reoffending: A Validation Study

Little research has been conducted to validate available instruments for assessing the risk of domestic violence reoffending, especially research using some form of prospective design. This study uses a prospective design to determine the reliability and validity of the Domestic Violence Screening Instrument (DVSI). The analysis is based on a sample of 1,465 male domestic violence offenders selected consecutively over a 9-month period. Data on reoffending were collected in a 6-month follow-up period from a subsample of the victims (N = 125) of these perpetrators and from official records for all perpetrators during an 18-month follow-up period. The empirical results suggest that the DVSI was administered reliably, and they provide significant evidence of the concurrent, discriminant, and predictive validity of this instrument. Implications for further research and utilization of the DVSI are discussed.     

Infectious endocarditis in drug addicts

Clinicomorphological features of infectious endocarditis (IE) were studied on autopsy material from chronic drug addicts. Of special interest were morphological changes in the lymphoid organs. The experience of the author and literature data suggest that IE in drug addicts is a manifestation of secondary immunodeficiency syndrome on the background of chronic narcotic intoxication.     

Instability of calcium channel antagonists during sample preparation for LC-MS-MS analysis of serum samples

1,4-Dihydropyridines calcium channel antagonists (1,4-DHP CCAs) are photolabile and the products of their photodecomposition have no pharmaceutical activity. In our previous work we have presented a screening procedure for eleven 1,4-DHPs in plasma by LC-MS-MS using multiple reaction motoring. The laboratory process includes preparation and storage of stock solutions, plasma storage, solid-phase extraction, reconstitution of extracts and storage time in an autosampler for LC-MS-MS analysis. Prior to validation of the analytical procedure, we have tested the stability of these compounds by exposure to light. Methanolic solutions have been exposed to laboratory and UV light and the stability of the compounds in plasma was tested by exposure of spiked plasma samples to laboratory light at room temperature. Stability during freeze-thaw cycles and stability during 2 month storage at -20 degrees C have been tested as well. Products of photodecomposition have been identified after forced degradation and the degree of degradation has been quantified using LC-UV-DAD and LC-MS-MS, respectively. A 96% degradation after only 2h has been observed when solutions of nifedipine or nisoldipine were exposed to laboratory light in clear glass vials. In plasma samples degradation was 25% in only 2h for both compounds. The main degradation product was produced by oxidation of the dihydropyridinic ring resulting in the pyridine analogue that has been described as the first metabolite in the metabolic pathway. Only minor degradation was found for the other tested compounds after 2h light exposure in methanolic solutions. Furthermore, lercanidipine and nicardipine were also degradated by esterhydrolysis. Several additional minor degradation products were found for the other tested 1,4-DHPs, however, some of them could not be identified. Preconditions for storage and handling of plasma samples prior to and during analysis for 1,4-DHP CCAs are suggested in order to avoid photodecomposition of the analytes.     

Survival of severe amlodipine intoxication due to medical intensive care

We report the case of attempted suicide with amlodipine, chlorthalidone and mefenamic acid and subsequent medical intensive care measures which resulted in total recovery of a 42-year-old male. After admission to the medical intensive care unit the intoxicated patient was deeply hypotensive and needed fluid replacement, dobutamine and norepinephrine. Additionally insulin and calcium gluconate were given. Since hypotension persisted and the patient developed oliguria, terlipressin was applied and finally showed an effect on blood pressure and on urinary output. A volume overload of 7 L in the first 24 h resulted in a pulmonary edema. The patient was started on non-invasive ventilation with continuous positive airway pressure (CPAP) and frusemide was added to the therapy with good success. Quantitative determination of amlodipine in plasma samples was performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The highest amlodipine concentrations was measured in the plasma sample collected approximately 8 h after ingestion of the drug, and was 393 microg/L. Four days later, it was possible to stop the treatment with catecholamines, at that time the amlodipine plasma concentration had declined to 132 microg/L, still tenfold higher than therapeutic (5-18 microg/L). Elimination half-life of amlodipine is approximately 55 h. After 6 days in the intensive care unit the patient was transferred to psychiatric treatment. Intensive care management and plasma levels in this intoxication case are compared to data from literature on other cases.     

Characteristics of married and unmarried adolescent mothers and their partners

In a middle-class, urban-clinic sample of 275, mostly Caucasian, adolescent mothers and their partners living in Utah, three groups were identified and their psychosocial characteristics were compared. Couples married at the time of conception (N=22) enjoyed more positive responses from prospective grandparents and earned more than couples not married at the time of conception. On the other hand, these initially married youths were much more likely to be high-school dropouts, which suggests limits in their lifetime earning capacities, and they were not more likely to identify one another as sources of emotional support. Couples who married between conception and delivery (N=110) reported that prospective grandparents responded less favorably to news of the pregnancy than did relatives of the initially married couples, but while their current salaries were lower, they were much more likely to be continuing with their education. Those who married after conception also had fewer antisocial and conduct disorders than young men and women who chose to continue in a dating relationship (N=29). Overall, the couples who married after conception appeared to face less severe problems than either the initially-married couples or the steady daters.This research was supported by grant number APR 000922-02-0 from the Office of Adolescent Pregnancy Programs to Drs. Elster and Lamb.where he and Dr. Lamb conduct research on pregnant teens, teenaged parents, and their children. Ms. Peters and Mr. Kahn are graduate students in School of Education at the University of Utah, while Ms. Tavare is a biostatistician at the University of Utah Medical Center.     

The utility of the State-Trait Anger Expression Inventory with offenders

Self-report instruments can provide useful information as part of a thorough clinical assessment. However, their use in forensic settings can be problematic. The State-Trait Anger Expression Inventory (STAXI) has recently been proposed as an effective instrument for screening and outcome measurement in anger management programs. This study evaluated the effectiveness of this instrument in a sample of both voluntary and court-ordered anger-management clients, all of whom were determined through diagnostic interviews to have significant anger problems. Contrary to findings in nonforensic samples, the STAXI Trait Anger scale identified only about half of the participants as having anger-management problems severe enough to require intervention. Supplemental analysis with two additional scales did not significantly improve sensitivity. In addition to thorough diagnostic interviewing, forensic use of the STAXI (like similar assessment methods) may require additional validity scales to detect denial or socially desirable response patterns.     

Univariate sex dimorphism in the Nepalese dentition and the use of discriminant functions in gender assessment

Sex dimorphism in the Nepalese dentition is described using univariate and discriminant analyses. Canines showed the greatest univariate sex dimorphism, followed by the buccolingual (BL) dimension of maxillary first and second molars. Overall, the maxillary teeth and BL dimensions showed greater univariate sex differences. However, less than half of the measured variables (46.4%) showed statistically significant differences between the sexes and the magnitude of sex dimorphism was reduced when compared to other populations. Moreover, reverse dimorphism--where females showed larger teeth than males--was observed in the mesiodistal dimension of mandibular second premolars. This reflects reduction in sexual dimorphism observed through human evolution and the consequent overlap of tooth dimensions in modern males and females. A specific purpose of the study was to develop discriminant functions to facilitate sex classification. A group of functions were developed considering the possibility of missing teeth and/or jaws in forensic scenarios. The functions permitted moderate to high classification accuracy in sexing (67.9% using maxillary posterior teeth; 92.5% using teeth from both jaws). The superior expression of sex dimorphism by means of discriminant functions is in contrast to the univariate results. This is due to discriminant analysis utilising the inter-relationship between all teeth within a dentition--these tooth correlations are not utilised in univariate analysis which results in a loss of information. It is inferred that large-scale statistically significant univariate differences are not a prerequisite for sex assessment.     

Identification and comparison of electrical tapes using instrumental and statistical techniques: I. Microscopic surface texture and elemental composition

Comparisons of polyvinyl chloride electrical tape typically rely upon evaluating class characteristics such as physical dimensions, surface texture, and chemical composition. Given the various techniques that are available for this purpose, a comprehensive study has been undertaken to establish an optimal analytical scheme for electrical tape comparisons. Of equal importance is the development of a quantitative means for sample discrimination. In this study, 67 rolls of black electrical tape representing 34 different nominal brands were analyzed via scanning electron microscopy and energy dispersive spectroscopy. Differences in surface roughness, calendering marks, and filler particle size were readily apparent, including between some rolls of the same nominal brand. The relative amounts of magnesium, aluminum, silicon, sulfur, lead, chlorine, antimony, calcium, titanium, and zinc varied greatly between brands and, in some cases, could be linked to the year of manufacture. For the first time, quantitative differentiation of electrical tapes was achieved through multivariate statistical techniques, with 36 classes identified within the sample population. A single-blind study was also completed where questioned tape samples were correctly associated with known exemplars. Finally, two case studies are presented where tape recovered from an improvised explosive device is compared with tape recovered from a suspect.