Injuries to law enforcement officers: the backface signature injury

In today's law enforcement community, one of the most vital tools an officer can possess is personal body armor. However, a recent Department of Justice investigation has raised important questions regarding the protection actually afforded officers through the use of personal body armor, and the current test methods used to assess the armor. Test results show that most Zylon-containing vests showed deformations in excess of the 0101.04 Standard's 44 mm backface signature limit. Such increased deformation can lead to serious injuries, including backface signature injuries, which have occurred in the field. Although the vest is successful in containing the round, it is not effectively dissipating the energy enough to prevent large amounts of vest deformation at the area of impact. Therefore, open, penetrating wounds occur even though the bullet did not penetrate the vest. The objective of the current study was to further define the backface signature injury through the use of case studies and laboratory experiments. Following the case study investigation, backface signature testing was conducted using a clay medium based on the NIJ 0101.04 Standard. The final component of this research involved the use of post-mortem human specimens (PMHS) for further investigation of the backface signature injury. Although the underlying cause of backface signature injuries is unknown, energy density is likely to play a role in the mechanism. Energy density (E/a) is defined as the energy per unit area and has been previously used in less lethal skin penetration research. Further research into the underlying causes of backface signature injuries is necessary. In addition to armor testing, the study of law enforcement personnel who have been shot while wearing soft body armor is also a valuable tool for determining the effectiveness of certification standards. Finally, it is important for medical personnel to recognize the backface signature injury and document this as a type of injury separate from blunt trauma or penetrating trauma behind armor injuries. Detailed knowledge of the injury, including the depth of the wound, would be beneficial to the scientific community.     

Postmortem Detection of Hepatitis B,C, and Human Immunodeficiency Virus Genomes in Blood Samples from Drug‐Related Deaths in Denmark*

Abstract: Blood‐borne viral infections are widespread among injecting drug users; however, it is difficult to include these patients in serological surveys. Therefore, we developed a national surveillance program based on postmortem testing of persons whose deaths were drug related. Blood collected at autopsy was tested for anti‐HBc, anti‐HBs, anti‐hepatits C virus (HCV), or anti‐human immunodeficiency virus (HIV) antibodies using commercial kits. Subsets of seropositive samples were screened for viral genomes using sensitive in‐house and commercial polymerase chain reaction (PCR) assays. Hepatitis B virus (HBV) DNA was detected in 20% (3/15) of anti‐HBc‐positive/anti‐HBs‐negative samples, HCV RNA was found in 64% (16/25) of anti‐HCV‐positive samples, and HIV RNA was detected in 40% (6/15) of anti‐HIV‐positive samples. The postmortem and antemortem prevalences of HBV DNA and HCV RNA were similar. Postmortem HIV RNA testing was less sensitive than antemortem testing. Thus, postmortem PCR analysis for HBV and HBC infection is feasible and relevant for demonstrating ongoing infections at death or for transmission analysis during outbreaks.     

Schizophrenia in a high-security hospital: long-term forensic,clinical, administrative & social outcomes

Objective: To determine forensic, clinical, social and administrative outcomes of high-security patients. Method: Prospective year follow-up study of 169 patients with schizophrenia, 1992–1993. Results: By the end of the study, 46 (27.2%) patients were in high security, 43 (25.5%) in medium- or low-secure units, 35 (20.7%) in an open ward, 3 (1.8%) in prison and 40 (23.7%) in the community. Violence occurred in 75% of patients over the 10-year follow-up period, and this was serious in 25%. Continuous positive symptoms of psychosis were present in over one-third. One-third had self-harmed during this period but there was only one known suicide and 11 (6.5%) deaths in total. At the end of the study, there was only one person in voluntary employment, 18 (12.7%) living independently and 10 (7.1%) in a relationship. Models were developed to determine factors relevant to these major outcomes. Conclusions: This is the first study providing comprehensive outcome data over a 10-year period. Forensic services appear good at managing the risk to the community but poor at promoting better social outcomes. The levels of violence within inpatient units are high.     

Women in the Czech Republic: Feminism, Czech Style

Many years after the Velvet Revolution, feminism remains close to a dirty word in the Czech Republic, even among women who share the views of Western feminists. Surprisingly, this may in part hark back to the negative views of bourgeois feminism propounded by the Communists. Equally surprising is the very high proportion of women who are employed, almost all of them full-time, although they continue to do the lion's share of homemaking. This strategy enables Czech women to have a high sense of personal efficacy and independence. This paper emphasizes the historical roots of women's position in Czech society, and the importance of the cultural and social context for the emergence of what we term Feminism, Czech Style.     

Mast cell tryptase and hemolysis after trauma

BACKGROUND: We have previously found increased mast cell tryptase in accidental deaths due to trauma, indicating that mast cell degranulation had occurred. The present study was designed to confirm the previous observation and to determine if tryptase release after trauma is acute or delayed. Furthermore, the importance of hemolysis and direct trauma to the mast cells was investigated. MATERIALS AND METHODS: Mast cell tryptase was measured in post-mortem blood from the femoral vein in 27 cases of death from trauma and in 27 control cases by means of a commercially available immunoassay. The trauma cases were further classified into groups with single versus multiple trauma, and groups with short survival time (i.e. death at the scene of the accident) versus longer survival time (death in hospital). In five multi-trauma deaths, blood was sampled locally from the sites of crush injury. RESULTS: The mean value of tryptase in femoral vein blood was 35.6+/-34.6 microg/l in the entire trauma group and 14.7+/-6.5 microg/l in the controls (P<0.005). In bloody liquid sampled from crush injuries, tryptase was substantially elevated in all cases, with a mean of 227+/-146 microg/l. In cases with short survival time, tryptase was significantly higher than in those who died after several hours or days in hospital (P<0.001). No statistically significant difference was seen between multi- and single-trauma cases. A correlation between hemolysis in the samples and elevated tryptase was found only in the trauma cases (P<0.05), but experimentally induced hemolysis in vitro was not found to influence the measurements. CONCLUSION: Mast cell tryptase becomes elevated in trauma deaths and this seems to be ascribable either to direct mechanical injury to tissue mast cells and/or to cell lysis. In patients initially surviving severe injuries, the effects of massive release of histamine and other mast cell mediators might be of importance for treatment strategies and prognosis.     

Offender characteristics in lethal violence with special reference to antisocial and autistic personality traits

The objective of the study is to assess the relationships between personality traits, lifetime psychosocial functioning, and crime scene behavior. Thirty-five male offenders referred for forensic psychiatric assessment in Sweden (1996-2001) and assigned a main diagnosis of either antisocial personality disorder (APD) or autism spectrum disorder (AUT) were retrospectively studied. APD were subcategorized into impulsive (APDi) and controlled (APDc). Those in the AUT group were less intoxicated at the time of the crime and did not often use knives or guns compared to the APD group. Males in the APDi group were older and had a higher proportion of abuse of alcohol and drugs in biological parents, physical abuse during childhood, psychiatric contacts, and suicide attempts compared to the APDc group. In the APDi group, knives were used in the homicide compared to the use of guns in the APDc group. The results suggest differences in psychosocial functioning and crime scene characteristics related to personality traits.     

"Women must endure according to their karma": Cambodian immigrant women talk about domestic violence

Asian populations living in the United States share similar cultural values that influence their experiences with domestic violence. However, it is critical to recognize how differential cultural beliefs in the context of immigration and adjustment to life in the United States affect attitudes, interpretations, and response to domestic violence. This article discusses findings from community-based participatory action research that explores how Cambodian immigrant women talk about domestic violence, what forms of abuse contribute to domestic violence, and what strategies they use to cope with and respond to abuse in their lives. The richness of this research lies in the stories that immigrant women tell about their struggle and their strength in addressing domestic violence.     

Culture and interpersonal violence research: paradigm shift to create a full continuum of domestic violence services

This article addresses the importance of culture within the context of domestic violence. It takes the position that to work more effectively with diverse cultural groups, the development of a full continuum of services that includes eliminating the violence and keeping families together is required. The authors believe that intervention models developed in the fields of HIV/AIDS may provide important examples for future work.