Suicide Attempts and Self-Image Among Turkish Adolescents

The objective of this paper is to report on the role of self-image as an internal factor in suicide attempts of adolescents. Three groups of adolescents, suicide attempters (n = 33), nonsuicidal psychiatric outpatients (n = 50), and normal controls (n = 50), were administered Offer Self-Image Questionnaire, Beck Depression Inventory, Symptom Check List-90-R, and a socio-demographic questionnaire. The factors discriminating suicidal adolescents from the other 2 groups were increased number of siblings, being the older children, and negativity in the familial aspect of the self-image. The self-image factor was specific for suicidal girls but not for boys. Disturbance in the development of the self-image, especially in its relationship with other family members is an important risk factor in attempted suicides by female adolescents. This brings up the importance of including the family in the treatment of suicidal adolescents. None of the factors evaluated in this study are significant in attempted suicides by males. This point needs further research.     

Morbidity and cause of death in homeless persons

The Hamburg Institute of Forensic Medicine analysed 388 deaths of homeless people between 1990 and 1998 considering demographic data, post-mortem results and autopsy findings. The manner of death was either unnatural or unascertained; the autopsy rate amounted to 43.8%. The results confirm the observation discussed in the last few years that homeless people are usually in a poor state of health. In relation to the average age of death, which is 44.5 years, the number of previous diseases is high. Unnatural causes (excluding homicides) account for a high percentage, viz. 62.6%, primarily intoxications. The most frequent natural cause of death is infection (16.8%). Women account for 8.5% of the deaths with their organ findings and causes of deaths being different from those of homeless men in terms of distribution and incidence. The data presented in this report may be helpful for the improvement of the present system of medical help in Hamburg.     

Determination of drug levels in larvae of Protophormia terraenovae and Calliphora vicina (Diptera: Calliphoridae) reared on rabbit carcasses containing morphine

Two species of blow flies (Diptera: Calliphoridae) were reared on tissues from rabbits administered different dosages of morphine. These species, Protophormia terraenovae and Calliphora vicina are among the first wave of insects colonizing a dead body. Two series of 3 rabbits were given dosages of 10, 20, and 40 mg/h of morphine over a 3 h period via ear artery perfusion. A morphine blood level plateau was attained after 1 h of perfusion. Two other rabbits were used as controls. Samples of tissues collected from rabbits using a coelioscopic technique were determined to have morphine concentrations similar to those encountered in human overdoses and were correlated with dosages of morphine administered. All samples from control rabbits were negative for morphine. Larvae and puparia of both species were regularly collected from each rabbit for toxicological analysis. Concentrations of morphine in larvae reared on rabbit carcasses containing morphine were significantly lower than concentrations found in the tissues. There was a decrease in concentration in morphine observed in transition from feeding 3rd instar larva to puparium. A correlation between larval concentration and tissue concentration was found only in feeding 3rd instar larvae.     

Once again: risk of injury caused by blank pistols

The nature and extent of the use of blank pistols in Hamburg (according to the Hamburg crime statistics about 300 to 400 such cases per year; 34 cases involving head and neck wounds from 1989 to 1999 were investigated at our institute; among these 8 suicides, no homicide) as well as patterns of injuries caused by close distance blank pistol shots were analysed. 7 of these cases are described in detail. The results of our studies corroborate the warning statements made by many criminological and medico-legal experts regarding the danger inherent in these allegedly harmless weapons. Blank cartridge pistols can, when shot from a close distance, cause most severe injuries involving penetration into body cavities and bodily organs (especially in the head and neck), and even perforation of the skull. Therefore, we call for a much stricter control of weapons of this kind.     

TBOR2 compliance plans: from rebuttable presumption to enforcement

This Article analyzes the implications and strategies of incorporating the Taxpayer Bill of Rights 2 ("TBOR2") into tax-exempt healthcare organizations' compliance plans. Beginning with a brief overview of TBOR2, the author examines the presumption of fair market value, how such organizations establish safe harbors, the current Internal Revenue Service (IRS or Service) position regarding enforcement of TBOR2, and the lurking potential for "whistleblowers" to start auditory procedures with an eye toward IRS bounties. Mr. Griffith concludes that the best advice for exempt organizations is to follow the rebuttable presumption procedure for all transactions involving potential disqualified persons, including staff and employed physicians, and seek to fit within the safe harbors for the less routine and larger of those transactions.     

The Role of EU Internal Policies in Implementing Greenhouse Gas Mitigation Options to Achieve Kyoto Targets

This paper reviews the role of internal European Union (EU) policies and measures in implementing the target for greenhouse gas mitigation in the Kyoto Protocol. It starts with a discussion of the EU Burden Sharing Agreement, which distributes the target between Member States. This leads to a review of the appropriate level of implementation of policies, i.e. at the EU level or Member State level. There is a role for the flexible mechanisms of the Protocol, particularly emission permit trading, in complementing Member State policies at the EU level. The implementation is to be done against the background of three major factors which may have an important bearing on the policies: the probable long-term requirement of substantial reductions in greenhouse gas emissions a changing structure of energy markets, following liberalisation of the gas and electricity markets EU enlargement to include economies in transition with the potential for further substantial reductions in emissions.The paper concludes with a discussion of ancillary benefits of the policies that may be substantial and a summary of the position as regards the "unfinished business" of the Protocol to be discussed at the Conference of the Parties in the Hague in November 2000.     

The New Water Legislation of Zimbabwe and South Africa – Comparison of Legal and Institutional Reform

Recently, several new pieces of water legislation have been promulgated in both Zimbabwe and the Republic of South Africa. The new acts are an attempt to correct injustices of a colonial past and to trigger development towards effective, equitable and efficient integrated water resources management influenced by the policy decisions in Agenda 21 and the need to respect economic and social human rights. This article aims at identifying and describing factors of prime importance in the process of legal and institutional reform. Major factors are earmarked and derived from the proceedings in Zimbabwe and are compared with the situation in South Africa. Thorough analysis by the author of proceedings, preambles, memoranda, legislation and addenda has induced roughly 5 major reform issues: The call for equitable water distribution based on a widely consented water resources management strategy; The need for effective and efficient integrated water resources management conducive to stakeholder participation through decentralisation processes; The redressing of legal shortcomings in former water legislation with the emphasis on the introduction of integrated approaches; The introduction of instruments of cost recovery for water resources management; The need to develop human resources capacity and institutional strength within the implementing agencies.For both Southern African states, these issues appear to be of comparable importance as major triggers for legal and institutional reform, although not always in the same sense.The resulting most important legal and institutional changes are presented, discussed and compared. Finally, prospects for and constraints on implementation of the new water legislation in these countries are compared.     

Delusional misidentification and aggression in Alzheimer's disease

Alzheimer's disease has been associated with serious behavioral disturbances including aggressive behaviors and agitation. Aggression in dementia of the Alzheimer's type may be associated with psychotic symptoms, particularly delusional misidentification phenomena. These phenomena are complex and varied in Alzheimer's disease and so far have been only rudimentarily described. In this paper, we explore the association of delusional misidentification and aggression in an individual suffering from Alzheimer's disease.