Alternative Pathways to Violence in Persons with Schizophrenia: The Role of Childhood Antisocial Behavior Problems

Violence in schizophrenia patients may result from many factors besides the symptoms of schizophrenia. This study examined the relationship between childhood antisocial behavior and adult violence using data from the NIMH CATIE study. The prevalence of violence was higher among patients with a history of childhood conduct problems than among those without this history (28.2% vs. 14.6%; P < 0.001). In the conduct-problems group, violence was associated with current substance use at levels below diagnostic criteria. Positive psychotic symptoms were linked to violence only in the group without conduct problems. Findings suggest that violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia.     

Deliberate self-harm patients who discharge themselves from the general hospital without adequate psychosocial assessment

Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.     

Maltreatment of handicapped children: A critical review

Despite increased interest in child abuse and neglect in the past decade, little research attention has been focused on maltreatment in handicapped populations. This is surprising given that many handicapped children display characteristics (e.g., chronic and pervasive behavioral disturbances, decreased social initiations with caregivers) that are associated with high risk for assault and neglect in nonhandicapped children. Numerous investigations have found an overrepresentation of handicapped children in maltreated samples, and results of more recent efforts reveal a high incidence of abuse and neglect in handicapped populations. Although these data underscore the high risk for maltreatment in handicapped children, a number of important issues warrant further empirical examination. Moreover, generalizations and interpretations of findings from previous research have been obfuscated by methodological shortcomings. The present paper reviews the literature concerning abuse and neglect of handicapped children. Research strategies and issues are delineated and current problems in this field are discussed. Suggestions for directions future research might take are offered.     

Analysis of buprenorphine in urine specimens.

The simultaneous determination of buprenorphine (Temgesic) and its major metabolite, N-desalkylbuprenorphine, in urine samples has been studied. By using reversed-phase high-performance liquid chromatography (HPLC) with electrochemical detection, therapeutic concentrations of unconjugated buprenorphine down to 0.2 ng/mL, and 0.15 ng/mL for the metabolite, can be detected in urine samples. This method has been applied to a variety of urine samples from drug users. The possible analytical interference from several other regulated drugs has been studied. The results were also compared with those obtained from a commercial radioimmunoassay (RIA) test. This test is only capable of detecting buprenorphine concentrations higher than 1 ng/mL.     

The ‘new’ policy approach to housing: A review of the literature

A new convention of ‘self-help housing’ has become established over the past 20 years. However, a close examination of the literature shows that this approach is not widely implemented, but remains largely at the level of showcase projects; moreover the lowest income groups are usually not the principal beneficiaries of sites-and-service schemes. The literature gives evidence of powerful political, administrative and economic interests against the large-scale legal delivery of sites-and-services, and in favour of the continued dependence of the poor on illegal access.     

Emerging problems for staff associated with the release of potentially dangerous forensic patients

Mental health professionals have been concerned recently about their liability for the actions of patients in their outpatient practices. The history of suits against clinicians for negligent release of inpatients extends back several decades since before the Tarasoff decision. The authors suggest that the same consumerism/victims' rights trends that resulted in Tarasoff and its progeny are likely to rebound again on forensic clinicians and that such pressures are likely to add to other political and social pressures that already complicate the treatment of forensic inpatients. They present three cases to illustrate the dilemmas involved in the release of forensic patients and argue that clinicians must bear significant responsibility for their current plight because of overstated claims of capacities to predict and treat aggressive behavior.     

Rechtsschutz durch Verbandsklage

Umweltrechtliche Verbandsklagen werden nach wie vor als Fremdkörper im deutschen Verwaltungsrecht angesehen. Dies spiegelt sich in restriktiven Zulässigkeitsanforderungen und in einer beschränkten gerichtlichen Kontrolldichte wider. Durch aktuelle Entwicklungen des EG-Rechts wird der systembedingte Ausnahmecharakter deutscher Verbandsklagen in Frage gestellt: Die gemeinschaftsrechtliche Umsetzung der Aarhus-Konvention hat unter anderem zur Verankerung von Verbandsklagerechten in der UVP- und IVURichtlinie geführt, deren nationaler Umsetzungsbedarf nicht durch die im Bundes- und Landesnaturschutzrecht vorhandenen Verbandsklagen gedeckt wird. Neben Einzelanpassungen geht mit den europarechtlichen Anforderungen ein Funktionswandel umweltrechtlicher Verbandsklagen einher: Außer ihrer bisherigen materiellen umweltschützenden Zielrichtung erfüllen sie zukünftig auch eine Kontrollfunktion im Hinblick auf demokratische Beteiligungsrechte. Diese interessenbezogene und partizipatorische Doppelnatur altruistischer Verbandsklagen sowie systembedingte deutsche Inkohärenzen lassen eine Gesamtanpassung deutscher Verbandsklagen auf dem Niveau des Gemeinschaftsrechts sachgerecht erscheinen. Eine solche Ausweitung überindividuellen Rechtsschutzes muss nicht zu einer verfassungsrechtlich unzulässigen Einschränkung des Individualrechtsschutzes führen. Um den Ausnahmecharakter umweltrechtlicher Verbandsklagen im deutschen Individualrechtsschutzsystem aufzuzeigen, wird der Beitrag zunächst ihre gesetzlichen Voraussetzungen und ihre gerichtliche Prüfdichte analysieren (A), um anschließend den durch die europarechtlichen Vorgaben erforderlichen Umsetzungsbedarf aufzuzeigen (B). Der mit der gemeinschaftsrechtlichen Anpassung einhergehende Funktionswandel umweltrechtlicher Verbandsklagen (C) leitet über zu der Frage einer Fortentwicklung des umweltbezogenen Rechtsschutzsystems auf dem Niveau des Europarechts (D). Die hiergegen bestehenden verfassungsrechtlichen Einwände werden sodann diskutiert (E). Abschließend wird u. a. aufgrund der fortschreitenden Ausdehnung überindividueller Klagerechte in anderen Rechtsgebieten die Entwicklung eines Gesamtkonzepts überindividuellen Rechtsschutzes vorgeschlagen (F). * Die Verfasserin ist wissenschaftliche Assistentin am Lehrstuhl für Öffentliches Recht unter besonderer Berücksichtigung des Verwaltungsrechts an der Juristischen Fakultät der Universität Rostock. Der Beitrag beruht auf einem Vortrag, den die Autorin auf dem Rostocker Umweltrechtstag 2004: Effektiver Rechtsschutz im Umweltrecht? Stand, aktuelle Entwicklungen, Perspektiven gehalten hat und der im gleichlautenden Tagungsband in der Schriftenreihe des Ostseeinstituts für Seerecht und Umweltrecht erscheinen wird.     

Flow cytometric evaluation of postmortem pulp DNA degradation

During postmortem autolysis, cellular organelles and nuclear DNA break down into their constituent parts. DNA flow cytometric analysis was applied to study the denaturation of splenic cell DNA as a possible method for postmortem interval determination. DNA denaturation continued for 72 hours at a constant rate, with no intact DNA peaks thereafter. The value of using dental pulp tissue for flow cytometric determination of postmortem interval was investigated. The pulps of 57 routinely removed impacted third molars from patients 15 to 30 years of age were obtained. Pulp tissue was removed at 24, 48, 72, 96, 120, and 144 hours postextraction. Debris (degraded DNA) was defined as all signals left of the standardized mean 2n peak and expressed as a percentage of the total number of signals. In contrast to the splenic cell DNA, dental pulp tissue exhibited minimal DNA degradation by 144 hours postextraction, and no constant relation was found between time and DNA degradation during this time. In this study, pulp tissue was found to be unreliable to determine the early postmortem interval but might be of greater value in the later stages.