Criminal Behavior in Opioid‐Dependent Patients Before and During Maintenance Therapy: 6‐year Follow‐Up of a Nationally Representative Cohort Sample

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid‐dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long‐term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid‐dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow‐up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow‐up. Data on criminality at follow‐up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug‐related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow‐up, which was also reflected by a significant decrease in the EuropASI subscore “legal problems” from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid‐dependent patients in long‐term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics‐related and acquisition crime.     

Differential diagnosis: blue gastric mucosa. Post-mortem staining of the gastric mucosa with methylene blue

An intense discoloration of the gastric mucosa or the gastrointestinal tract found at autopsy gives rise to the question of its cause. Such discolorations are mostly described in the context of intoxications. However, traditional foods and diagnostic procedures using indicator dyes can also lead to an unusual discoloration of the mucous membranes. The authors report on the autopsy findings in a man who died from a bleeding gastric ulcer and whose gastric mucosa showed intense blue discoloration. Experimental postmortem examinations (on stomachs) were performed with methylene blue, a dye used in gastroenterology, resulting in a blue discoloration resembling the appearance of the stomach in the autopsy case. Together with the outcome of the toxicological analyses, the experiments pointed to a diagnostic procedure using methylene blue (chromoendoscopy).     

EU General Data Protection Regulation: Changes and implications for personal data collecting companies

The General Data Protection Regulation (GDPR) will come into force in the European Union (EU) in May 2018 to meet current challenges related to personal data protection and to harmonise data protection across the EU. Although the GDPR is anticipated to benefit companies by offering consistency in data protection activities and liabilities across the EU countries and by enabling more integrated EU-wide data protection policies, it poses new challenges to companies. They are not necessarily prepared for the changes and may lack awareness of the upcoming requirements and the GDPR's coercive measures. The implementation of the GDPR requirements demands substantial financial and human resources, as well as training of employees; hence, companies need guidance to support them in this transition. The purposes of this study were to compare the current Data Protection Directive 95/46/EC with the GDPR by systematically analysing their differences and to identify the GDPR's practical implications, specifically for companies that provide services based on personal data. This study aimed to identify and discuss the changes introduced by the GDPR that would have the most practical relevance to these companies and possibly affect their data management and usage practices. Therefore, a review and a thematic analysis and synthesis of the article-level changes were carried out. Through the analysis, the key practical implications of the changes were identified and classified. As a synthesis of the results, a framework was developed, presenting 12 aspects of these implications and the corresponding guidance on how to prepare for the new requirements. These aspects cover business strategies and practices, as well as organisational and technical measures.     

Fraud,Free Speech and Fossil Fuel: Lessons from Big Tobacco for Big Oil

Recent journalistic investigations revealed that ExxonMobil carried out research beginning in the 1970s indicating fossil fuel's dangerous role in global warming. Rather than heed the warnings of its research, for the next few decades, ExxonMobil instead chose to become a leader in climate change denial; stressing uncertainty, propagating misinformation, funding denial, and politicizing and undermining the expert scientific consensus. Exxon's behavior invoked the tactics used by the tobacco industry years earlier, tactics which wound up the subject of a successful federal government lawsuit under the Racketeer Influenced and Corrupt Organizations (RICO) Act. The parallels with the tobacco industry prompted legislators and environmentalists to call on the Department of Justice to use RICO again to hold the fossil fuel industry to account. This article will consider the legal issues associated with bringing such an action, and whether useful lessons can be drawn from the tobacco litigation.     

Rapid Separation of Organophosphate Pesticides using Micellar Electrokinetic Chromatography and Short‐end Injection,

Organophosphate (OP) pesticides are highly toxic substances and are frequently represented as poisons. In order to qualify and quantify the selected OP pesticides (methyl paraoxon, ethyl paraoxon, methyl parathion, fenitrothion, and ethyl parathion), micellar electrokinetic chromatography and short‐end injection were investigated. This is the first time that this combination has been used to separate OP pesticides. A capillary with 8.5 cm effective length was used, and the analytes were separated within 2.1 min. Separation conditions including buffer (type, pH, and concentration), sodium dodecyl sulfate concentration, and separation voltage were optimized. The limit of detection (LOD) was estimated in the range of 10–20 μM. The OP pesticides spiked in artificial saliva and drinking water gave superior peak profiles, and good average recoveries 95.6% and 62.3%, respectively. Overall, a rapid method with excellent resolution and efficiency was developed and successfully applied in the analysis of potential sample matrixes.     

The adoption of children from out-of-home care: how decision-makers explain the low rates of adoption in Victoria,Australia

The adoption of children from out-of-home care is uncommon in Australia and rarely occurs in the state of Victoria. This paper reports on how professionals involved in making decisions about the permanent placement of children explain the current rates of adoption from out-of-home care in Victoria. Interviews were conducted with eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers. The current low rates of adoption were attributed to the effect of current legislation, the impact of past adoption practices and the establishment of a culture in Victoria in which adoption is now rarely considered an option for children in out-of-home care.     

Author Index of Volume 14

Authors Index

Author Index of Volume 14     

Parenting,Marital Conflict and Adjustment From Early- to Mid-Adolescence: Mediated by Adolescent Attachment Style?

Contributions of 3 dimensions of parenting (psychological control, warmth, and behavioural control), marital conflict, and attachment style (anxiety and avoidance) to adjustment from early to middle adolescence were assessed. Mediation of marital conflict effects by parenting, and of parenting effects by attachment were examined. Adolescents (n = 175) initially age 13 years reported parenting practices, attachment styles, school grades, self-esteem, and internalizing and externalizing problems twice (T1, T2) 2 years apart. T1 marital conflict was associated with lower self-esteem, more externalizing symptoms, and lower academic achievement at T2, all but the latter mediated by parental warmth. T1 parental psychological control was associated with increases in internalizing symptoms over time, an effect not mediated by attachment insecurity, which contributed independently. T1 parental warmth was associated with decreases in externalizing symptoms and increases in self-esteem over time, the latter mediated by attachment security.Professor of Psychology, Concordia University, Montreal, QC, Canada, H4B 1R6. Received PhD in Developmental Psychology from Stanford University. Research interests include parenting, attachment, and adjustment in adolescence.Professor of Psychology and Applied Human Sciences, Concordia University, Montreal, QC, Canada, H3G 1M8. Received PhD in Social Psychology from Ohio State University. Research interests include close personal relationships and adjustment.     

Unexpected perinatal death and sudden infant death syndrome (SIDS): anatomopathologic and legal aspects

This work intends to be a review of the recent histopathological findings elicited by research into sudden and unexpected perinatal death and sudden infant death syndrome (SIDS) that have dictated a novel approach to the inherent problems by pathologists, especially those entrusted with forensic medical authority. The new approach stems from the recent advances made in the understanding of neuro- and/or cardiac-conduction-system diseases present in unexpected perinatal death and SIDS. These demand that an accurate morphologic examination be performed of these structures, which modulate respiratory, cardiovascular, digestive, and arousal activities, in all victims of sudden death. A histopathologic study of an ample register of cases of victims of sudden death, either perinatally or in early infancy, has demonstrated frequent alterations both of the autonomic nervous system (especially hypoplasia of the arcuate nucleus) and of the cardiac conduction system (accessory atrioventricular pathways). The present research provides an in-depth study of the many still-controversial aspects underlying perinatal unexpected death and SIDS and is recommended for professionals working in the forensic field, whose greater insight into this problem will allow more complete medicolegal documentation.     

Perianal and vulvar Crohn's disease presenting as suspected abuse

Misdiagnosis of sexual abuse may arise in cases of vulvar and/or perianal diseases such as lichen sclerosus et atrophicus, Behcet's syndrome, bullous diseases, contact dermatitis, or neoplastic lesions. We present the case of a 7-year-old girl who was referred by her general paediatrician to the local hospital for perianal fissures and swelling of the labia majora. A report to the judicial authorities was made, for suspected sexual abuse, and the patient was transferred to the department of paediatric surgery. Here, histopathologic examination of vulvar and rectal biopsies revealed multiple non-caseating and non-confluent epithelioid-gigantocellular granulomas, consistent with a diagnosis of Crohn's disease, with cutaneous involvement of the genitalia. In cases of suspected sexual abuse, examination of children should be performed by a specialist in legal medicine in collaboration with a gynaecologist or paediatric surgeon. If the patient is hospitalised and the question of protection does not arise, physicians should exclude dermatological diseases before reporting to the judicial authorities.