Mentally challenged patients in a forensic hospital: a feasibility study concerning the executive functions of forensic patients with organic brain disorder, learning disability, or mental retardation

The past years have seen an increasing number of patients of lower intelligence or with organic brain disorder being committed into our forensic psychiatry. Our clinic has an ongoing scientific project to investigate the possibilities of reducing costs while at the same time guaranteeing adequate treatment and enforcement practice in forensic hospitals. This current project did not take these kinds of patients into consideration initially. This feasibility study is intended to examine if and to what extent these patients can be part of the scientific project. All patients of forensic psychiatry in Rostock (Mecklenburg-Western-Pomerania) with an IQ<80 (learning disorder) or a primary or secondary organic brain dysfunction that have been committed to the clinic since 2009 are included. These patients went through an extensive battery of neuropsychological tests. Furthermore, the treating psychotherapists had to rate the prognoses for criminal re-offending at discharge. Patients affected by lower intelligence or an organic brain dysfunction achieve lower results in neuropsychological testing than other patients participating in the main project. Nevertheless, participation in neuropsychological testing does not appear to overtax them. Future examination of the patients will be conducted to investigate to what extent certain therapeutic methods have been of noticeable benefit to this problematic group.     

Cannabis findings in drivers suspected of driving under the influence of drugs in Finland from 2006 to 2008

The authors examined driving under the influence of drugs (DUID) cases which were found to be positive in whole blood for cannabis in Finland from 2006 to 2008. Factors studied were the number of cases positive for any combination of Δ(9)-tetrahydrocannabinol (THC) and the metabolites 11-hydroxy-Δ(9)-tetrahydrocannabinol (THC-OH) and 11-nor-9-carboxy-Δ(9)-tetrahydrocannabinol (THC-COOH). Concurrent use of amphetamines, benzodiazepines and/or alcohol was also recorded, as well as the drivers' age and gender. Altogether 2957 cannabis positive cases were retrieved from the database of the Alcohol and Drug Analytics Unit, National Institute for Health and Welfare. Drug findings were examined in relation to the zero-tolerance policy operated towards DUID in Finland. The number of cannabis positive cases in each year was approximately 1000 and the main demographic of cases was males aged 20-30 years. In the majority of cases (51.6%) the inactive metabolite THC-COOH was the only indication of cannabis use, however, associated use of amphetamines (58.8% of all cases) and/or benzodiazepines (63.9%) in cannabis positive drivers was very common. Detections for amphetamines and/or benzodiazepines were especially common in drivers with THC-COOH only (92.8% of these cases). Combined use of alcohol (25.7%) was also prevalent. Suspect DUID cases generally arise from suspicion on behalf of the police and the zero-tolerance policy offers an expedient means to deal with the challenges presented in DUID, particularly in view of the high incidence of multiple drug use - the legislation is not unduly punitive when enforced in this manner.     

Early criminal recidivism among mentally disordered offenders

Criminal recidivism was studied during 2 years in a Swedish population-based cohort (N = 318) of mentally disordered male offenders who had undergone a pretrial forensic psychiatric investigation, been convicted in subsequent trials, and been sentenced to forensic psychiatric treatment (FPT; n = 152), prison (n = 116), or noncustodial sanctions (n = 50). Recidivism was analysed in relation to index sanctions, levels of supervision, diagnoses, and criminological factors. Significantly lower recidivism in the FPT group was related to lower crime rates during periods at conditional liberty in this group alone, and recidivism was significantly more common among offenders with at least one of the two diagnoses of substance abuse disorder and personality disorder than among those with psychotic or other mental disorders alone. Age at index crime and number of previous crimes emerged as significant predictors of recidivism. The results of this study suggest that the relapse rates depend as much on level of supervision as on individual characteristics.     

On non-invasive 2D and 3D Chromatic White Light image sensors for age determination of latent fingerprints

The feasibility of 2D-intensity and 3D-topography images from a non-invasive Chromatic White Light (CWL) sensor for the age determination of latent fingerprints is investigated. The proposed method might provide the means to solve the so far unresolved issue of determining a fingerprints age in forensics. Conducting numerous experiments for an indoor crime scene using selected surfaces, different influences on the aging of fingerprints are investigated and the resulting aging variability is determined in terms of inter-person, intra-person, inter-finger and intra-finger variation. Main influence factors are shown to be the sweat composition, temperature, humidity, wind, UV-radiation, surface type, contamination of the finger with water-containing substances, resolution and measured area size, whereas contact time, contact pressure and smearing of the print seem to be of minor importance. Such influences lead to a certain experimental variability in inter-person and intra-person variation, which is higher than the inter-finger and intra-finger variation. Comparing the aging behavior of 17 different features using 1490 time series with a total of 41,520 fingerprint images, the great potential of the CWL technique in combination with the binary pixel feature from prior work is shown. Performing three different experiments for the classification of fingerprints into the two time classes [0, 5h] and [5, 24h], a maximum classification performance of 79.29% (kappa=0.46) is achieved for a general case, which is further improved for special cases. The statistical significance of the two best-performing features (both binary pixel versions based on 2D-intensity images) is manually shown and a feature fusion is performed, highlighting the strong dependency of the features on each other. It is concluded that such method might be combined with additional capturing devices, such as microscopes or spectroscopes, to a very promising age estimation scheme.     

Suicide by multiple blunt head traumatisation using a stone

Apart from collisions with road or rail vehicles and falls from height, self inflicted blunt force is a rare suicide method and mainly seen in psychiatric patients. The paper presents a rare case of suicide by active blunt force. A 68-year-old man committed suicide by repeatedly hitting his head with a stone. He sustained a craniocerebral trauma and finally died from hypothermia due to the low outdoor temperature. According to the relatives, the man was not diagnosed with a mental disorder or suicidal tendencies. Uncommon manners of self-harm are challenging for those involved in the investigation, and a differentiation between suicide, accident and homicide can only be made in synopsis of all findings.     

Influence of CYP2D6 genotype on the disposition of the enantiomers of venlafaxine and its major metabolites in postmortem femoral blood

Venlafaxine (VEN) is an antidepressant drug mainly metabolized by the cytochrome P450 (CYP) enzyme CYP2D6 to the active metabolite O-desmethylvenlafaxine (ODV). VEN is also metabolized to N-desmetylvenlafaxine (NDV) via CYP3A4. ODV and NDV are further metabolized to N,O-didesmethylvenlafaxine (DDV). VEN is a racemic mixture of the S- and R-enantiomers and these have in vitro displayed different degrees of serotonin and noradrenaline reuptake inhibition. The aim of the study was to investigate if an enantioselective analysis of VEN and its metabolites, in combination with genotyping for CYP2D6, could assist in the interpretation of forensic toxicological results in cases with different causes of deaths. Concentrations of the enantiomers of VEN and metabolites were determined in femoral blood obtained from 56 autopsy cases with different causes of death. The drug analysis was done by liquid chromatography tandem mass spectrometry (LC/MS/MS) and the CYP2D6 genotyping by PCR and pyrosequencing. The mean (median) enantiomeric S/R ratios of VEN, ODV, NDV and DDV were 0.99 (0.91), 2.17 (0.93), 0.92 (0.86) and 1.08 (1.03), respectively. However, a substantial variation in the relationship between the S- and R-enantiomers of VEN and metabolites was evident (S/R ratios ranging from 0.23 to 17.6). In six cases, a low S/R VEN ratio (mean 0.5) was associated with a high S/R ODV ratio (mean 11.9). Genotyping showed that these individuals carried two inactive CYP2D6 genes indicating a poor metabolizer phenotype. From these data we conclude that enantioselective analysis of VEN and ODV can predict if a person is a poor metabolizer genotype/phenotype for CYP2D6. Knowledge of the relationship between the S- and R-enantiomers of this antidepressant drug and its active metabolite is also important since the enantiomers display different pharmacodynamic profiles.     

Der Abschluss von Swap-Geschäften durch Gemeinden und die Grenzen der Gemeindeautonomie

Gemeinden haben mit Swap-Geschäften zur Absicherung des Zinsrisikos teilweise erhebliche Verluste erlitten. Dieser Umstand führt mittlerweile auch zu Gerichtsverfahren, in welchen die Gültigkeit dieser Geschäfte streitgegenständlich ist. Im folgenden Beitrag werden die Voraussetzungen für die Gültigkeit von Swap-Geschäften der Gemeinden untersucht.     

Agilität als Chance für einen neuen Anlauf zum demokratischen Unternehmen?

There has been a long-standing discussion since the 1980s about the question whether new production models harbor a potential for extended employee participation and involvement, in most cases with disillusioning results. This paper is concerned with so called “agile methods”, which play an important part in the area of knowledge work in the course of the digital transformation. On the basis of two case studies from software development and industrial R&D, the paper examines the concrete implementation of these methods and the employees’ perspective upon them and their consequences. The result is that agile methods present a potential for extended employee participation and involvement; however, the realization of this potential depends on the concrete way how the agile concept of “empowerment” is implemented.