Predicting discharge in forensic psychiatry: the legal and psychosocial factors associated with long and short stays in forensic psychiatric hospitals

In Germany, both the number of patients treated in forensic psychiatric hospitals and the average inpatient treatment period have been increasing for over thirty years. Biographical and clinical factors, e.g., the number of prior offences, type of offence, and psychiatric diagnosis, count among the factors that influence the treatment duration and the likelihood of discharge. The aims of the current study were threefold: (1) to provide an estimate of the German forensic psychiatric patient population with a low likelihood of discharge, (2) to replicate a set of personal variables that predict a relatively high, as opposed to a low, likelihood of discharge from forensic psychiatric hospitals, and (3) to describe a group of other factors that are likely to add to the existing body of knowledge. Based on a sample of 899 patients, we applied a battery of primarily biographical and other personal variables to two subgroups of patients. The first subgroup of patients had been treated in a forensic psychiatric hospital according to section 63 of the German legal code for at least ten years (long-stay patients, n=137), whereas the second subgroup had been released after a maximum treatment period of four years (short-stay patients, n=67). The resulting logistic regression model had a high goodness of fit, with more than 85% of the patients correctly classified into the groups. In accordance with earlier studies, we found a series of personal variables, including age at first admission and type of offence, to be predictive of a short or long-stay. Other findings, such as the high number of immigrants among the short-stay patients and the significance of a patient's work time before admission to a forensic psychiatric hospital, are more clearly represented than has been observed in previous research.     

Analysis with the Combur-Test--special aspects in forensic trace examination

The Combur Test is a ready-made and easy-to-use pretest for blood. It is based on the oxidation of tetramethylbenzidine (TMB), which is catalysed by haemoglobin and its derivatives. Despite its high sensitivity, there are many known substances which are responsible for false positive and false negative test results. On the basis of experiments of our own, case reports and the pertinent literature special aspects of the application of the Combur Test in the forensic routine case work are discussed.     

Contested hybridization of regulation: Failure of the Dutch regulatory system to protect minors from harmful media

The hybridization of regulatory modes and instruments is currently a popular way to improve public regulation. However, it is still unclear whether combinations of hard law and soft law, co-regulation, and legally enforced self-regulation really make regulation more effective. Using the analytical framework of the “really responsive regulation” approach, in this article we explore effectiveness problems in a hybrid regulatory system that tries to protect minors from harmful media. In our analysis of low compliance rates in the context of system failures, we argue that effectiveness problems seem to arise from poorly informed staff members, lack of internal and external controls, low rule enforcement, insufficient overlap between public and private interests, poor social responsibility in the Dutch media sector, deficiencies in the institutional framework, an inconsistent regulatory strategy, and inadequate responses from responsible regulators. Furthermore, based on our case study we argue that institutional dynamics of standard-setting activities can be detrimental to regulatory goal achievement if there is no compensation at the systemic level. Ongoing “regulatory care” through control, corrective responses, and rule enforcement seems to be crucial for a hybrid regulatory system to perform well.     

Folgerungen aus dem Lissabonurteil des Bundesverfassungsgerichts

Das Lissabonurteil des deutschen Bundesverfassungsgerichts hat gro?e Aufmerksamkeit erzeugt, die keineswegs auf Deutschland beschr?nkt blieb. Der vorliegende Beitrag geht der Frage nach, ob die vom Bundesverfassungsgericht gezogenen Schlussfolgerungen auch die Rechtslage in ?sterreich tangieren. Insbesondere stellt sich die Frage, ob eine allf?llige Gesamt?nderung der Bundesverfassung durch den Vertrag von Lissabon neu zu diskutieren w?re. Schlie?lich behandelt der Beitrag auch die Frage, ob der Vertrag von Lissabon zwingend eine ?nderung der parlamentarischen Mitwirkungsrechte in ?sterreich erfordert.     

A new framework for testing the effect of government spending on growth and productivity

Does government spending have a positive or negative effect on economic growth? The results of earlier empirical studies give mixed results. In this study we suggest a new method for testing the effect of different kinds of government expenditure on productivity growth in the private sector. The focus on productivity in the private sector and the use of disaggregated data makes it possible to avoid or mitigate a number of methodological problems. The major conclusions, which are quite robust, are that government transfers, consumption and total outlays have consistently negative effects, while educational expenditure has a positive effect, and government investment has no effect on private productivity growth. The impact is also found to work solely through total factor productivity and not via the marginal productivity of labor and capital.     

Age estimation in small children: reference values based on counts of deciduous teeth in Finns

The eruption of teeth in the mouth is suitable for age estimations during the period when teeth are actively emerging, in the deciduous dentition phase approximately from the age of 6 months to 2.5 years. Estimations of age can be performed simply by counting the number of teeth in the mouth. Reliability of the estimates depends on the reference data available and each population group should preferably have its own standards. In the present study timing of eruption of successive deciduous teeth was studied longitudinally in 129 Finns. The dates of clinical eruption of deciduous teeth were recorded by mothers and checked by dentists. In 40 of the 129 children emergence ages of at the most the four last teeth were based only on semiannual registrations performed by dentists. The main purpose was to provide normal timetables of tooth eruption in small children in forms that are practical in estimations of dental age. No sexual dimorphism existed in the timing of clinical eruption of successive deciduous teeth. The mean age corresponding to the presence of one tooth in the mouth was 7.1 months (S.D.=1.78) and that corresponding to tooth count 19 was 27.8 months (S.D.=3.99). If the chronological age is known, the presented distributions and means with variations make it possible to estimate the degree of advancement or delay in a child's dental development. If the age of the child is not known, the mean and median ages can be used for estimations of chronological age. However, estimations of age should not be based only on tooth counts because of marked variation also within this homogeneous group.     

Benzodiazepine findings in blood and urine by gas chromatography and immunoassay

Gas chromatography (GC) and immunoassay techniques applied to blood and urine specimens were compared for the screening of benzodiazepines in postmortem forensic toxicology. Five hundred and six such successive postmortem cases in which both urine and peripheral blood was sent for toxicological analysis by the medical examiners were selected. The urine specimens were tested by the Emit((R)) d.a.u. Benzodiazepine Assay, and in parallel, the blood and urine specimens were screened for benzodiazepine drugs and their metabolites by an established automated dual-column GC method. The lowest number of positives (153) was obtained when immunoassay was performed without enzyme hydrolysis. When urine samples were hydrolysed before immunoassay, the number of positives increased to 175. The highest number of positives (200) was obtained in urine by GC, and the screening of blood by GC yielded 185 quantitative results. Despite the urine GC screening produced the most positives, the quantitative screening of the blood by GC appears to be the most efficient approach in postmortem forensic toxicology, considering the fact that although urine findings confirm the presence of the drug, quantitative results in urine are irrelevant to acute toxicity.     

Microscopic study of powders of hallucinogenic mushrooms--Psilocybe sp

The paper presents simple methods for microscopic examination and basic microchemical testing for the identification of suspect mushroom powders. The microscopic features of the most commonly cultivated and trafficked hallucinogenic genus Psilocybin are described and may serve for the decision whether any suspect material consists of such mushroom powder (and is therefore to be subjected to further analysis) or not.