DBT in an outpatient forensic setting

Literature shows that effective treatment of borderline personality disorder (BPD) has become possible. However, borderline patients in forensic psychiatry do not seem to benefit from this development. In forensic psychiatry, prevention of criminal recidivism is the main focus of treatment, not core borderline problems like parasuicidal and self-destructive behavior. A dialectical behavioral treatment program for BPD was implemented in an outpatient forensic clinic in The Netherlands. Sociodemographic, clinical, and treatment data were collected from ten male, and nineteen female forensic BPD patients, and compared with corresponding data from fifty-eight non-forensic BPD patients. The results show that it is possible to implement dialectical behavior therapy in an outpatient forensic clinic. The data indicate that the exclusion of forensic patients, and especially female forensic patients, from evidence-based treatment is unjustified given the highly comparable clinical and etiological characteristics they share with female BPD patients from general mental health settings.     

Fibromuscular dysplasia of the basilar artery: an unusual case with medico-legal implications

A 28-year-old male car driver was reported to suddenly loose the control over his vehicle, to hit the right and middle crash barrier, and to be unconscious as the car came to a halt in a position at right angles to the road. The car was hit in its left side by an automobile with high velocity, and the 28-year-old driver died. Examination of the brain revealed a massive isolated basal subarachnoid hemorrhage and a complete tearing of the basilar artery. A macroscopically detectable aneurysm was not found. However, histological examination of the large arteries at the base of the brain showed (i) fibromuscular dysplasia (FMD) mostly involving the basilar artery (ii) with a ruptured micro-aneurysm in its upper third part. The observations of the eye witnesses that the driver initially lost control over his car were judged in favour of the accused to be due to that rupture of the micro-aneurysm, while complete transverse tearing of the basilar artery occurred during the car crash due to hyperextension and rotation of his neck. Intracranial FMD is a rare cause in the differential diagnosis of isolated basal subarachnoid hemorrhage. The medico-legal implications of this entity are described in the presented case.     

The influence of staffing levels on the use of seclusion

This study focussed on the relationship between the use of seclusion and staff characteristics, such as number of nurses on shift, male-female staff ratio, level of education and level of work experience. A retrospective analysis of staff characteristics was applied to administrative data from ten wards in four mid-sized general psychiatric hospitals in the Netherlands. The data show that two variables were associated with seclusion rates: the male-female staff ratio and the variability in team's work experience. More female and less male nurses in a shift and less variability in team's work experience predicted an increase in seclusion rates.     

Compulsory treatment with clozapine: a retrospective long-term cohort study

BACKGROUND: Clozapine is the gold standard in treatment of treatment-resistant psychotic patients. We know little about the effects of compulsory treatment in patients unwilling to accept the necessary treatment. AIMS: To assess the effectiveness, tolerability and safety of compulsory treatment with clozapine (CTC). METHOD: A cohort of 17 consecutive patients given compulsory treatment with clozapine were rated retrospectively by their treating psychiatrists on the basis of their case notes. RESULTS: CGI-S decreased significantly over time until last observation after a mean of more than 15 months. No patient deteriorated as measured by CGI-I. At last observation as many as ten of the 11 patients still on clozapine were classified as much to very much improved. The degree of custodial restriction at last observation showed improvement in 11 patients and no change in six. No serious adverse events were observed. CONCLUSION: A trial of compulsory treatment with clozapine showed this treatment to be feasible, effective, safe and well tolerated.     

Allele frequency distribution for 21 autosomal STR loci in Nepal

The allele frequency distributions of 21 autosomal loci contained in the AmpFlSTR Identifiler, the Powerplex 16 and the FFFL multiplex PCR kits, was studied in 953 unrelated individuals from Nepal. Several new alleles (i.e. not yet reported in the NIST Short Tandem Repeat DNA Internet DataBase [http://www.cstl.nist.gov/biotech/strbase/]) have been detected in the process.     

The search for the Russian Mafia

After the fall of communism in the Soviet Union, newspapers, films, academic researchers and intelligence agencies warned against a new phenomenon in organized crime: the “Russian mafiya.” In fact, since the fall of the Berlin Wall, Western European countries have noted an increase in the number of criminals from Central and Eastern Europe. In the mid-1990s, the Dutch judicial authorities made the issue a priority and established a special team to investigate crime with links to Eastern Europe. From 1999 to 2005, the KT NON crime team published several studies and reports on serious crime of this nature. In this paper, the authors, who were assigned to the KT NON crime team, discuss the findings of the two most recent publications on the “causes, nature, scale and threat of Central and Eastern European crime” and “mobile banditry,” respectively. They come to the conclusion that among other forms of crime, the phenomenon of mobile banditry seems to be the most serious manifestation of crime from post-communist countries. The Russian mafia was not found.

I wonder if this is a Wunderbaum

The Court of First Instance, dismissing a Community trade markapplicant's appeal against the decision to allow an oppositionin part, affirms that the public's recognition of the opponent'searlier Community trade mark may be assessed in relation tothe degree of recognition achieved by that mark through itsclose similarity to an earlier national registered trade markbelonging to the opponent.     

The nature of the beast: are citizens’ juries deliberative or pluralist?

Citizens’ juries are a form of “minipublics,” small-scale experiments with citizen participation in public decision-making. The article presents a theoretical argument that improves understanding relating to the design of the citizens’ jury. We develop the claim that two discourses on democracy can be discerned: the deliberative and the pluralist. By looking at the design features of citizens’ juries we conclude that they are based on pluralist reasoning to a far greater extent than most authors seem to realize, and that the association with deliberative democracy is therefore one-sided. Based on empirical findings, we attempt to shed further light on the actual operation of citizens’ juries. Observations of two recent Dutch juries suggest on the one hand that a learning process and a positive effect on the sense of political involvement occurred. On the other hand, we saw a certain level of groupthink in one of the citizens’ juries, and found that the juries are not greatly representative in terms of political preferences. Our findings point firstly to a need for greater awareness among the organizers of juries of the two democratic discourses. This would lead to more consistent jury design. Secondly, our research emphasizes the need for more hands-on critical research of minipublics.

Marx and Engels’s theory of history: making sense of the race factor

ABSTRACT

This article argues that Karl Marx and Friedrich Engels’s theory of history contained racist components. In Marx and Engels’s understanding, racial disparities emerged under the influence of shared natural and social conditions hardening into heredity and of the mixing of blood. They racialized skin-colour groups, ethnicities, nations and social classes, while endowing them with innate superior and inferior character traits. They regarded race as part of humanity’s natural conditions, upon which the production system rested. ‘Races’ endowed with superior qualities would boost economic development and productivity, while the less endowed ones would hold humanity back. Marxist race thinking reflected common Lamarckian and Romantic-Nationalist assumptions of the era.