Increased adrenaline to noradrenaline ratio is a superior indicator of antemortem hypothermia compared with separate catecholamine concentrations

The significance of urinary catecholamines and small gastric mucosal bleedings, Wischnewsky's spots, in postmortem diagnosis of hypothermia deaths was evaluated. Autopsy cases (n=358) were divided into hypothermia, suspected hypothermia, and control groups. The catecholamine levels did not correlate with the length of the postmortem period. The adrenaline to noradrenaline ratio was most effective in detecting hypothermia (68.9% sensitivity, 78.1% specificity). The median adrenaline concentrations were significantly higher in hypothermia than in control groups. The control group containing mostly sudden cardiac deaths with no cold exposure had a noradrenaline level comparable to the hypothermia groups. The sensitivity and specificity of determining Wischnewsky's spots in hypothermia deaths were 63.9% and 88.3%, respectively. The adrenaline to noradrenaline ratio is more suitable in proving antemortem cold stress than either of these independently, and its diagnostic value is comparable to that of Wischnewsky's spots.     

Reading level and the prevalence of a dyslexic profile among patients in a forensic psychiatric clinic

This study aims to investigate Swedish language reading ability of forensic patients and the number of them that present a dyslexia profile. Another aim is to compare the reading level in different subtypes of psychiatric diagnoses. Assessments were made of 185 patients by a battery of reading tests. They were also interviewed about their schooling and their self-estimated reading and writing ability. The results show that the patients’ reading level is below average for grade six children in Swedish compulsory school, and that 16 per cent show a dyslexic profile. Male patients with an immigrant background and a diagnosis of psychosis and anxiety disorders perform the lowest when measuring literacy skills. This proportionately low reading ability can cause difficulties in understanding texts as presented in broadsheet newspapers, civic information and patient records, and might even jeopardize the understanding of adult spoken language.     

The negative relationships between employee resilience and ambiguity,complexity, and inter-agency collaboration

Employee resilience (ER) is often needed to face demands inherent in public sector work. Some types of demands, however, may hinder its development, rather than provide the type of challenging adversity from which resilience can develop. Public sector job demands have been a long-standing issue for public workplaces and employees but are also growing in salience as organisations face an increasingly variable, uncertain, complex, and ambiguous environment. Drawing on the Job Demands–Resources model and the challenge/hindrance stress literature, this multi-level study of Aotearoa New Zealand civil servants (n = 11,533) in 65 public sector organisations shows that ER is negatively affected by demands such as job insecurity, unclear job and organisational goals, and inter-agency collaboration. However, organisational resource constraints are positively associated with ER. This study identifies core PA job and organisational demands that hinder ER and offers practical implications and suggestions for further research.

Points for practitioners

• Job role ambiguity, job insecurity, unclear organisational goals, and inter-agency collaboration are common job and organisational demands in public sector workplaces.
• For employees, these demands are stressors that employees do not feel they control, and may therefore hinder employee resilience: the ability to learn, adapt, and leverage networks in the face of challenges.
• Surprisingly, resource constraints, where employees have to ‘do more with less’, might help employees develop ER.
• While inter-agency collaboration has potentially many benefits, it appears to have negative spillover effects on employees unaware of it or not involved in it.
• To encourage ER, agencies should clarify both organisational and job goals, and assure job security, control, competency development, and supervisor support.