Appetitive aggression in former combatants--derived from the ongoing conflict in DR Congo

Soldiers and combatants often report that committing violence can be appealing, fascinating and exciting (Elbert, Weierstall, & Schauer, 2010). This appetite for aggression was investigated in a sample of 224 former combatants from different armed groups and forces in eastern DRC. In a semistructured interview they were questioned about their military history, exposure to violence and perpetrated violence. Appetitive aggression was assessed with a 15-item-scale (Weierstall & Elbert, 2011), which was successfully implemented in comparable samples (Weierstall, Schalinski, Crombach, Hecker, & Elbert, submitted for publication). A sequential multiple regression was conducted to determine possible predictors of appetitive aggression. Perpetrated violence types, recruitment type, and joining as a child were significant predictors and explained 26% of the variability in appetitive aggression. Duration or military rank within the armed group and exposure to violence did not play a significant role. Thus, combatants reporting high levels of appetitive aggression are characterized by perpetrating a high number of violent acts, joining armed groups on their own accord and as children. Joining an armed group on one's own accord indicates pre-existing appetitive aggression. However, joining young and perpetrating violence on a regular basis seem to intensify the appetite for aggression.     

Hair and urine testing to assess drugs of abuse consumption in couples undergoing assisted reproductive technology (ART)

For the first time in Europe hair and urine testing have been applied to assess drugs of abuse consumption in couples undergoing assisted reproductive technology and the eventual association of toxic habits with other lifestyle, health status and sociodemographic factors was also investigated. Couples attending five assisted reproduction centers in Rome were invited to join the study. When they presented at the Centre for the visit, they were asked to answer a structured questionnaire concerning sociodemographic characteristics and lifestyle habits, and at the same time to provide hair and urine samples. Hair and urine testing for drugs of abuse, urinary profile of principal endogenous steroids involved in fertility process (testosterone, epitestosterone, androsterone, etiocholanolone and dehydroepiandrosterone) and of alcohol and tobacco smoke biomarkers were performed with validated methodologies. Of the 594 enrolled individuals (297 couples), 352 (164 couples and 24 single individuals from the couple) completed the questionnaire and gave both hair and urine samples, apart from 3 bald men, who only gave urine samples. Urine testing showed an overall 4.8% (17 individuals) positivity to drugs of abuse: 4.2% to cannabinoids, 1.4% to cocaine and 0.85% to both drugs. Results of 4cm segment hair samples testing matched those from urine samples. Thus, taking together, results of urine and hair testing confirmed repeated use of cannabis, cocaine and both drugs in 3.7, 0.85 and 0.57% examined individuals, respectively. Drug consumers were in a statistically higher percentage active smokers and alcohol drinkers, less prone to physical activity and with a trend towards higher weight than non consumers. Finally, repeated drug consumption was associated with significant lower concentration of urinary testosterone in males and of urinary dehydroepiandrosterone in females. The findings of the present study confirm the suitability of urine testing to disclose recent drugs of abuse consumption and of hair analysis to verify repeated consumption. Association between different toxic habits and sedentary lifestyle is also substantiated by the obtained results in our cohort of couples attending assisted reproduction centers.     

Accidental potassium dichromate poisoning. Toxicokinetics of chromium by ICP-MS-CRC in biological fluids and in hair

Intoxications by chromium (Cr) compounds are very life threatening and often lethal. After oral ingestion of 2 or 3g of hexavalent Cr (Cr(VI)), gastrointestinal injury, but also hepatic and renal failure, often occurs which each leads to a fatal outcome in most patients. Cellular toxicity is associated with mitochondrial and lysosomal injury by biologically Cr(VI) reactive intermediates and reactive oxygen species. After Cr(VI) has been absorbed, there is not much that can be done except to control the main complications as the treatment is only symptomatic. The biotransformation of Cr(VI) to Cr(III) reduces the toxicity because the trivalent form does not cross cellular membranes as rapidly. In fact, more than 80% of Cr(VI) is cleared in urine as Cr(III). We report the case of a 58-year-old male patient who was admitted to hospital after accidental oral ingestion of a 30 g/L potassium dichromate (the estimated amount of ingested Cr is about 3g). ICP-MS equipped with a collision/reaction cell (CRC) and validated methods were used to monitor plasma (P), red blood cells (RBCs), urine (U) and hair chromium. For urine the results were expressed per gram of creatinine. After 7 days in the intensive care unit, the patient was discharged without renal or liver failure. P, RBC and U were monitored during 49 days. During this period Cr decreased respectively from 2088 μg/L to 5 μg/L, 631 μg/L to 129 μg/L and 3512 μg/g to 10 μg/g. The half-life was much shorter in P than in RBC as the poison was more quickly cleared from the P than from the RBC, suggesting a cellular trapping of the metal. Hair was collected 2 months after the intoxication. We report a very rare case of survival after accidental Cr poisoning which has an extremely poor prognosis and usually leads to rapid death. For the first time, this toxicokinetic study highlights a sequestration of chromium in the RBC and probably in all the cells.     

Social learning and self-control: assessing the moderating potential of criminal propensity

Social learning theory is one of the most prominent general theories of crime. Yet recent research has called into question its applicability to all offenders. Specifically, the influence of antisocial peers has been found to exert a stronger effect among those individuals evincing higher levels of criminal propensity (deemed social amplification), whereas other components of the theory have either not been shown to interact with criminal propensity or not been tested. This study examines several social learning theory components to determine whether its influence is dependent on an individual's level of self-control. Results suggest little support for the social amplification hypothesis as the components of social learning theory were found to operate similarly across individuals regardless one's level of self-control. Implications for criminological theory are discussed.     

Studying survivors of near-lethal suicide attempts as a proxy for completed suicide in prisons

Sex determination is a necessary step in the investigation of unidentified human remains from a forensic context. Teeth, as one of the strongest tissues in the human body, can be used for this purpose. Most studies of sexual dimorphism in teeth are based on the traditional mesiodistal and buccolingual crown measurements. The purpose of this study is to examine the degree of sexual dimorphism in permanent molars of modern Greeks using crown and cervical diagonal diameters, and to evaluate their applicability in sex determination. A total of 344 permanent molars in 107 individuals (53 male and 54 female) from the Athens Collection were examined. Crown and cervical diagonal diameters of both maxillary and mandibular molars were measured. It was found that males have larger molars than females and in 19 out of 24 dimensions measured male molars exceeded female molars significantly (P<0.05). The most dimorphic molars are the maxillary second molar, and the mandibular second and first molars. Although other molars were also sexually dimorphic they did not have a statistically significant difference in all dimensions. Cervical diagonal diameters have found to be more sexually diamorphic than crown diagonal diameters. In discriminant function analysis the variables entered more frequently were the cervical diagonal diameters mainly of mandibular molars. Classification accuracy was found to be 93% for the total sample, 77.4% for upper jaw, and 88.4% for the lower jaw. Accuracy rates were higher for cervical than crown diagonal diameters. The data generated from the present study suggest that this metric method can be useful and reliable for sex determination, especially when the traditional dental measurements are not applicable.     

Histological examination of the carotid bifurcation in case of violence against the neck

The carotid body and carotid sinus are localized in the area of the carotid bifurcation and respond to pressure fluctuations in the arterial blood vessel system. In case of irritation or stimulation, nervous impulses can reflexively increase the ventilation or slow down the heart rate and blood pressure, respectively. The external stimulation of the carotid sinus by neck compression with subsequent bradycardia or asystolia, especially in pre-existing heart-disease, is discussed controversially in the literature. Histological examination of the tissue of the carotid bifurcation, particularly with regard to haemorrhage as an indication of tissue trauma, should be carried out in terms of simple and easy feasibility in routine diagnostics. In 20 cases of violence against the neck and additionally 82 cases of a control group without neck trauma and variable causes of death, the carotid bifurcations were examined histologically. Only in one case of violence against the neck haemorrhage was found, which suggested a direct trauma to the tissue of the carotid bifurcation, but evidence of lethal cardiac reflex was not found in any case.     

Assessment of moral judgment and empathy in young sex offenders: a comparison of clinical judgment and test results

Professional decision making in forensic clinical practice may have lifelong consequences for offenders. Although information on moral development is important for prediction of reoffending and referral to adequate treatment, conclusions regarding moral development are still largely based on unstructured clinical judgment instead of assessment instruments. For this study, the authors examined to what extent unstructured clinical judgment of both moral judgment and victim empathy concurred with test results in a group of young sex offenders. Moral judgment was measured with the Sociomoral Reflection Measure-Short Form (SRM-SF), whereas victim empathy was measured with an extended version of the Basic Empathy Scale (BES). No significant associations were found between clinical judgment of moral judgment and the mean scores on the SRM-SF. However, clinical judgment of victim empathy was significantly associated with victim empathy on the Victim Empathy Scale but not consistently in the expected direction. Juvenile sex offenders, who were judged by clinicians to show little victim empathy, displayed lower mean scores on the Victim Empathy Scale than juvenile sex offenders who were evaluated to lack victim empathy or to have intact victim empathy. This study showed unstructured clinical judgment of moral development not to concur with test results. To improve decision-making processes regarding moral development, clinicians are advised to rely on instruments that assess moral development to inform clinical judgment. Further research is needed to examine which predictions are more accurate and to establish the predictive validity of moral development evaluations.     

Early criminal recidivism among mentally disordered offenders

Criminal recidivism was studied during 2 years in a Swedish population-based cohort (N = 318) of mentally disordered male offenders who had undergone a pretrial forensic psychiatric investigation, been convicted in subsequent trials, and been sentenced to forensic psychiatric treatment (FPT; n = 152), prison (n = 116), or noncustodial sanctions (n = 50). Recidivism was analysed in relation to index sanctions, levels of supervision, diagnoses, and criminological factors. Significantly lower recidivism in the FPT group was related to lower crime rates during periods at conditional liberty in this group alone, and recidivism was significantly more common among offenders with at least one of the two diagnoses of substance abuse disorder and personality disorder than among those with psychotic or other mental disorders alone. Age at index crime and number of previous crimes emerged as significant predictors of recidivism. The results of this study suggest that the relapse rates depend as much on level of supervision as on individual characteristics.     

How the pace of change affects the scope of reform: pharmaceutical insurance in Canada, australia, and the United kingdom

When policy change is considered, what determines its success or failure? Why do plans for broad reforms often fall short, and why do certain types of change become more difficult over time? This article addresses these questions by examining health policy development in Canada, Australia, and the United Kingdom - specifically, why Canada alone failed to adopt nationwide, public pharmaceutical insurance. It demonstrates that the pace of change has significant implications for the scope of policy development. It provides new mechanisms to explain why incremental reforms stall based on the reciprocal relationship between elite ideas and public expectations and suggests that similar factors can explain how barriers to policy change develop and the conditions under which those barriers may be overcome.     

Detection of hemorrhage source: The diagnostic value of post-mortem CT-angiography

The aim of this study was to compare the diagnostic value of post-mortem computed tomography angiography (PMCTA) to conventional, ante-mortem computed tomography (CT)-scan, CT-angiography (CTA) and digital subtraction angiography (DSA) in the detection and localization of the source of bleeding in cases of acute hemorrhage with fatal outcomes. The medical records and imaging scans of nine individuals who underwent a conventional, ante-mortem CT-scan, CTA or DSA and later died in the hospital as a result of an acute hemorrhage were reviewed. Post-mortem computed tomography angiography, using multi-phase post-mortem CTA, as well as medico-legal autopsies were performed. Localization accuracy of the bleeding was assessed by comparing the diagnostic findings of the different techniques. The results revealed that data from ante-mortem and post-mortem radiological examinations were similar, though the PMCTA showed a higher sensitivity for detecting the hemorrhage source than did ante-mortem radiological investigations. By comparing the results of PMCTA and conventional autopsy, much higher sensitivity was noted in PMCTA in identifying the source of the bleeding. In fact, the vessels involved were identified in eight out of nine cases using PMCTA and only in three cases through conventional autopsy. Our study showed that PMCTA, similar to clinical radiological investigations, is able to precisely identify lesions of arterial and/or venous vessels and thus determine the source of bleeding in cases of acute hemorrhages with fatal outcomes.