Serving those Who Served: Outcomes from the San Diego Veterans Treatment Review Calendar (SDVTRC) Pilot Program

Veterans Treatment Courts (VTCs) are a type of specialty treatment, problem-solving, criminal court. Though the number of VTCs has increased over the past decade, few research studies have examined their effectiveness. This paper examines the data collected concerning a particular VTC experience, the first 82 Veterans enrolled in the Veterans Treatment Review Calendar Pilot Program conducted by the California Superior Court of the county of San Diego from February 2011 until July 2014 (SDVTRC.) The evidence presented herein concerns the nature of this cohort’s population, the SDVTRC program structure in which these Veterans participated, and the outcomes of participation. SDVTRC participants showed a significant decrease in symptoms on 11 of 12 clinical measures from baseline to 12 months. Particular outcomes of the SDVTRC program were related to factors of military service, such as length of service, number of awards, and discharge status. There were also significant relationships between symptom decrease and court process factors, such as length of time in program and sanctions imparted. This court has a 0% recidivism rate, which is believed to be related to its systematic data collection process that was used to inform individualized treatment plans for participants. Implications for other VTCs are provided.     

Fat Transfer and Fatal Macroembolization

Fat embolism is usually associated with long bone fractures or other trauma. The diagnosis is usually clinical, and in most cases, emboli are not fatal and not usually seen on gross examination. At the Los Angeles County Coroner's Office, we autopsied the victim of fatal macroscopic fat embolization to the lungs. The patient died during buttock enhancement surgery when fat from liposuction was injected into her buttocks. Fat embolism from liposuction and fat injection is reportedly rare, and macroscopic embolization is rarer still. Varicose veins can occur in the area of the sciatic notch and are known to cause painful sciatica symptoms. We suggest them as a potential conduit for macroscopic fat to reach the lungs. Simple pre‐operative questioning for sciatica symptoms and possible radiologic study to rule out sciatic varices seem prudent before undertaking buttock‐enhancing surgery. Careful fat injection with pre‐aspiration is always advised.     

The use of neuroscientific evidence in the courtroom by those accused of criminal offenses in England and Wales

This examination of the extent of the use of neuroscientific evidence in England and Wales identifies 204 reported cases in which such evidence has been used by those accused of criminal offenses during the eight-year period from 2005–12. Based on the number of reported cases found, the use of such evidence appears well established with those accused of criminal offenses utilizing such evidence in approximately 1 per cent of cases in the Court of Appeal (Criminal Division). Neuroscientific evidence is used to quash convictions, to lead to convictions for lesser offenses and to lead to reduced sentences. In addition, cases are identified where neuroscientific evidence is used to avoid extradition, to challenge bail conditions and to resist prosecution appeals against unduly lenient sentences. The range of uses identified is wide: including challenging prosecution evidence as to the cause of death or injury, challenging the credibility of witnesses and arguing that those convicted were unfit to plead, lacked mens rea or were entitled to mental condition defenses. The acceptance of such evidence reflects the willingness of the courts in England and Wales to hear novel scientific argument, where it is valid and directly relevant to the issue(s) to be decided. Indeed, in some of the cases the courts expressed an expectation that structural brain scan evidence should have been presented to support the argument being made.     

Ideological Reorientation and Counterterrorism: Confronting Militant Islam in Egypt

During the 1990s, Egypt fought a bitter campaign against militant Islamist groups in which over a thousand people died. Since the end of the insurgency in 1997, Egypt's two fiercest Islamic terrorist groups, first the Islamic Group (Al-Gama‘a Al-Islamiyya) and then Islamic Jihad, not only ceased their violent activities but also produced and published texts revising their religious beliefs on the use of violence. Based on the counterterrorism experience of Egypt, this paper defines and describes a counterterrorism strategy of ideological reorientation. We define ideological reorientation as a counterterrorism approach that seeks to change core ideological or religious beliefs of the terrorist group, thus bringing the beliefs of group members in line with societal norms. While we cannot causally attribute the groups' decisions to lay down arms to ideological reorientation versus other regime actions (like repression), the Egyptian experience is highly suggestive. First, it indicates that the ideology of religiously-based groups is not exogenous and fixed, as is often assumed, but rather endogenous and flexible. Second, the Egyptian experience suggests that ideological reorientation may be more effective at stemming militancy in the long run compared to rival approaches.