Nitrous Oxide Determination in Postmortem Biological Samples: A Case of Serial Fatal Poisoning in a Public Hospital*

Abstract: In a public hospital, eight cases of fatal poisoning by nitrous oxide (N₂O) occurred under oxygen administration, due to an erroneous swapping of the lines in the gas system. The aim of the study was to clarify the factors involved in asphyxia by characterizing gases from different lines and measuring N₂O concentrations in postmortem biological samples from bodies exhumed. Analyses carried out on the gas system confirmed the erroneous substitution of O₂ line with N₂O and air line with O₂. Consequently, high N₂O amounts were revealed in several tissues and gaseous biological samples. All specimens were analyzed by headspace gas chromatography technique. A rigorous quantitative analysis was possible only in blood (11.29–2152.04 mg/L) and urine (95.11 mg/L) and in air samples from stomach and trachea (from 5.28 to 83.63 g/m³). This study demonstrates that N₂O can be detected in biological samples even 1 month after death.     

A four-phase process for translating research into police practice

ABSTRACT

This article presents a framework that extends the discussion of translational criminology and the dynamic process of translating research to practice. The goal is to provide an explicit dissection of the translation process into four phases to help outline a structured way of thinking about how to incorporate research into police practice. The four-phases include: Phase I: ‘Does it Work?’ Research and Evaluation; Phase II: ‘What Works?’ Synthesis and Dissemination; Phase III: ‘How to Make it Work?’ Implementation and Evaluation; and Phase IV: ‘Make it Work!’ Institutionalization and Sustainability. The process is founded in implementation science and the ‘Knowledge to Action’ model (KTA) used in the medical and public health fields, as well as current translation activities for policing, and the authors’ experience as practitioners, researchers, and ‘translators’ over the last 25 years. It is the hope that parsing out four distinct phases for the translation of research to practice will assist researchers and police leaders to identify and fill gaps in current and future translation activities.     

Stress-related temporary hearing loss--evaluation of bio-humoral parameters: forensic and criminological applications

The body-alarm reaction results from the activation of hypothalamic-pituitary-adrenal axis, which can lead to physio-psychological phenomena such as an exclusion/occlusion of the sense of hearing. One hypothesis to explain this alteration consists in a hydromechanical dysfunction of the internal ear attributable to antidiuretic hormone. In this study, we evaluated the perception of acoustic stimuli administered in stressful conditions in 14 phobic patients and in 20 healthy subjects, in order to assess the influence of stress on perceiving capabilities. We also measured the concentration of salivary cortisol and IL-1β and neurovegetative parameters to objectivise and quantify the physiological reactions. Our results show a worse perception of the frequencies of the human voice under stress; these findings could have a dual value: in the legal field, concerning criminal liability, and on the operative context, regarding the efficiency of verbal communication among law enforcement officers in situations inducing intense emotional stress.     

Law and Social Protests

This paper deals with the relationship between law and social protests, a topic that seems particularly relevant at this time, when recent public events show the existence of growing tension between citizens and public officers. The paper does not explore the ultimate causes that triggered these social protests, but rather the normative and legal questions raised by these conflicts. The main question that it addresses is the following: How should the law act in the face of these growing expressions of social discontent? The main point that it defends is that social protests are political expressions that, as such, deserve a special public (and particularly judicial) protection. The argument is particularly directed at studying the legal consequences of taking the expressive components of social protests seriously. The exploration may have a further theoretical interest for those who are interested in reflecting upon the scope and limits of the theory of deliberative democracy.     

Age estimation by pulp/tooth ratio in lower premolars by orthopantomography

Accurate age estimation has always been a problem for forensic scientists, and apposition of secondary dentine is often used as an indicator of age. Since 2004, in order to examine patterns of secondary dentine apposition, Cameriere et al. have been extensively studying the pulp/tooth area ratio of the canines by panoramic and peri-apical X-ray images. The main aim of this paper is to examine the relationship between age and age-related changes in the pulp/tooth area ratio in monoradicular teeth, with the exception of canines, by orthopantomography. A total of 606 orthopantomograms of Spanish white Caucasian patients (289 women and 317 men), aged between 18 and 75 years and coming from Bilbao and Granada (Spain), was analysed. Regression analysis of age of monoradicular teeth indicated that the lower premolars were the most closely correlated with age. An ANCOVA did not show significant differences between men and women. Multiple regression analysis, with age as dependent variable and pulp/tooth area ratio as predictor, yielded several formulae. R(2) ranged from 0.69 to 0.75 for a single lower premolar tooth and from 0.79 to 0.86 for multiple lower premolar teeth. Depending on the available number of premolar teeth, the mean of the absolute values of residual standard error, at 95% confidence interval, ranged between 4.34 and 6.02 years, showing that the pulp/tooth area ratio is a useful variable for assessing age with reasonable accuracy.     

Mineralization of mandibular third molars can estimate chronological age--Brazilian indices

Forensic age estimation is an important element of anthropological research, as it produces one of the primary sources of data that researchers use to establish the identity of a person living or the identity of unknown bodily remains. The aim of this study was to determine if the chronology of third molar mineralization could be an accurate indicator of estimated age in a sample Brazilian population. If so, mineralization could determine the probability of an individual being 18 years or older. The study evaluated 407 panoramic radiographs of males and females from the past 5 years in order to assess the mineralization status of the mandibular third molars. The evaluation was carried out using an adaptation of Demirjian's system. The results indicated a strong correlation between chronological age and the mineralization of the mandibular third molars. The results indicated that modern Brazilian generation tends to demonstrate an earlier mandibular third molar mineralization than older Brazilian generation and people of other nationalities. Males reached developmental stages slightly earlier than females, but statistically significant differences between the sex were not found. The probability that an individual with third molar mineralization stage H had reached an age of 18 years or older was 96.8-98.6% for males and females, respectively.     

Factitious disorder comorbid with bipolar I disorder. A case report

We describe a case of factitious disorder with physical and psychological symptoms comorbid with bipolar I disorder in a 37-year-old woman. Since the onset of bipolar disorder, which occurred at the age of 31, she increasingly complained of physical symptoms, compulsively seeking medical and surgical interventions. She has been hospitalised several times and her Munchausen-type factitious disorder recently appeared to be developing into Munchausen by proxy, involving her 11-year-old daughter. The patient adhered poorly to stabilising and antipsychotic drug treatment and did not improve through the years. We here analyse her mood phases, which were always associated with changes in the quality of factitious symptoms, according to whether the disorder was in its depressive phase (somatic complaints and suicidal ideation prevail), or in its manic or mixed phase (medical intervention-seeking and manipulation of clinicians to obtain surgical interventions). We also briefly discuss some important forensic issues to consider in similar cases, mainly stemming from the psychotic aspects of these two co-occurring disorders. Clinicians should be aware of some patients' ability to produce signs and symptoms of physical and/or psychological illness and consult psychiatrists before giving consent to invasive diagnostic procedures or surgery.     

Trends in involuntary psychiatric hospitalization in Israel 1991-2000

BACKGROUND: Though information about involuntary psychiatric hospitalizations (IPH) is crucial for the planning of Israel's National Mental Health Care Policy, very few studies have been carried out to date on this subject. AIMS: To identify trends in first IPH to all inpatient psychiatric settings in Israel. METHOD: The sample included all admissions of adults (18 years and older) over the ten-year period, 1991-2000, according to the registration of such admissions in the National Psychiatric Case Registry. RESULTS: A 2.4-fold increase was found in first IPH over the decade studied. The typical profile of the involuntarily admitted patient was that of a native-born Jewish male, aged 18-24 or 65 and older, single, with less than 8 years of education, and with a diagnosis of schizophrenia or delusional psychosis. CONCLUSIONS: These findings suggest the need for improving the interfaces between hospital and community services, and for preparing specific guidelines to extend the use of involuntary ambulatory treatment orders. Further study is needed to explore the respective roles of involuntary inpatient and outpatient treatment.     

Parties are always right: the effects of party cues and policy information on attitudes towards EU issues

Abstract

This article analyses the influence that political parties exert upon citizens’ opinions about European Union issues. By measuring at the same time the content and source effects on political attitudes, the article considers the possibility that voters pay less attention to the arguments used in a political message than to its source. Results from an online survey experiment in Spain show that partisan voters use a heuristic model of processing when taking positions on an unfamiliar EU issue, even though the prevalence of the source effect is moderated by the respondent’s political sophistication and party attachment. The results also indicate that some respondents tend to pay less attention to a message’s content when the message comes from their preferred party. Such findings raise concerns about the possibility for EU issue voting to guarantee the accountability of political elites and party–voter linkages.