Hanging deaths with bound hands: what is the manner?

In Franklin County, Ohio, 3 cases of hangings with bound hands were reported in a 4-month period in 2005. All of the victims were men. In 2 of the 3 cases, the hands were bound behind the back. One victim bound his hands in front of his body. In each case, the police ruled the deaths "suspicious" due to the fact that the victims' hands were bound. Complete investigation is required. Only after a thorough scene investigation, medicolegal autopsy, and knowledge of recent circumstances of the decedent's life can a determination of manner be made.     

Compulsory treatment with clozapine: a retrospective long-term cohort study

BACKGROUND: Clozapine is the gold standard in treatment of treatment-resistant psychotic patients. We know little about the effects of compulsory treatment in patients unwilling to accept the necessary treatment. AIMS: To assess the effectiveness, tolerability and safety of compulsory treatment with clozapine (CTC). METHOD: A cohort of 17 consecutive patients given compulsory treatment with clozapine were rated retrospectively by their treating psychiatrists on the basis of their case notes. RESULTS: CGI-S decreased significantly over time until last observation after a mean of more than 15 months. No patient deteriorated as measured by CGI-I. At last observation as many as ten of the 11 patients still on clozapine were classified as much to very much improved. The degree of custodial restriction at last observation showed improvement in 11 patients and no change in six. No serious adverse events were observed. CONCLUSION: A trial of compulsory treatment with clozapine showed this treatment to be feasible, effective, safe and well tolerated.     

Medical malpractice reform and insurer claims defense: unintended effects?

In response to recent and past medical malpractice insurance crises, most states have implemented reforms meant to stabilize premiums and coverage availability. The importance of understanding whether these reforms implicitly affect the behavior and incentives of plaintiffs, attorneys, medical providers, and malpractice insurers in the intended way is crucial to policy makers, if they are to achieve their goal. This study specifically examines the effect of reforms on the claims defense efforts of insurers, given that defense expenses account for approximately 30 percent of malpractice premiums. Using state data for the period 1998-2002, we regress claims defense expenses against a variety of reform variables. These include seven tort reforms (noneconomic damage caps, punitive damage limits, attorney fee limits, modified collateral source rule, modified joint and several liability doctrine, mandatory pretrial screening, and statute of limitations) and two government-sponsored insurance mechanisms (joint underwriting associations and patient compensation funds). Claims defense expenses are found to be higher in the presence of noneconomic damage caps, punitive damage limits, and attorney fee limits--an unintended and counterproductive effect of reform--but are lower with mandatory pretrial screening and patient compensation funds.     

Uncertainty of calculation results in vehicle collision analysis

In the analysis of road accidents two types of calculation result uncertainty can be distinguished: modelling uncertainty and uncertainty in calculation results [R.M. Brach, M. Brach, Vehicle Accident Analysis & Reconstruction Methods, SAE International Publisher, Warrendale, 2005]. The problem becomes very important first of all when minor modifications of input parameters or application of different models of the phenomenon lead to a fundamentally different answer to the question posed by the court. The aim of the paper was to prove the necessity of including the problem of uncertainty in calculations related to vehicle collision mechanics and to justify the application of different error analysis methods recommendable in vehicle collision reconstruction. The data file from crash test No. 7 [H. Burg, M. Lindenmann, Unfallversuche, Verlag Information Ambs, Kippenheim, 1982] was used, the selection restricted to the range typical of average police records of collision place. Collision speeds were calculated using two methods: reconstruction and simulation. The analysis of uncertainty was carried out. Maximum and mean square uncertainty were calculated by means of total differential of relevant forms. Since the reconstruction resulted in very broad error intervals of uniform distribution, additional calculations were performed by the Monte Carlo method using algorithm described in [W. Wach, J. Unarski, Determination of vehicle velocities and collision location by means of Monte Carlo simulation method, Special Publication Accident Reconstruction SP-1999, SAE Paper No. 2006-01-0907, 2006].     

Quantitative indices for anti-human trafficking policies: based on reports of the U.S. State Department and the Council of Europe

Quantitative ratings of policies of national governments are an important tool for the monitoring of compliance with international standards in many domains. In this article we present a global index of anti-human trafficking policies developed by a research consortium using the TIP country reports of the U.S. State Department (the 3P index) and an index based on the reports of the monitoring body of the Council of Europe Convention against Human Trafficking (GRETA). Although the global 3P index gives more favorable ratings to most European countries than the GRETA-based index, a moderately strong correlation was found between the two indices. This is an encouraging result lending support to the validity of the assessments of both monitoring mechanisms as well as to their transformation into quantitative scores. We also demonstrate that the detailed GRETA-based index can be used to identify best practices in anti-trafficking policies and specific areas where these policies are most in need of improvement, e.g. legal aid and compensation for victims. Our analyses of the relationships between the various items of the index revealed positive correlations between the existence of units of specialized prosecutors and the numbers of convictions of traffickers. Our paper, then, demonstrates the potential of quantitative indices of counter human trafficking policies as tools for both effective monitoring of the implementation of international standards and for analytical purposes.