Medicine, science, and the law
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The term 'excited delirium' (ED) is used to explain sudden and unexpected restraint-related deaths. Since the 1990s, ED has often been identified as the principal cause of death in restrained individuals, rather than the restraint procedure itself. Forensic pathologists and psychiatrists attach different meanings to the term delirium. ⋯ Conversely, pathologists appear to be using the term ED to refer to restraint-related deaths in either highly disturbed cocaine users or psychiatric patients in a state of extreme agitation. In these cases, there is no underlying physical disorder other than a terminal cardiac arrhythmia. As the term ED has different meanings for psychiatrists and for pathologists, it would be helpful for these two professional groups to develop a mutually agreed terminology.
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The aim of this review was to study "female stalking" in the sense of the specific traits characterizing the phenomenon of stalking behaviour committed by women. The main medical databases were searched (Medline, Social Science Research Network, Apa Psyc Net), and 67 articles were selected, reporting studies conducted in clinical populations, case series, reports, reviews, retrospective studies and original articles. We outline a variety of different tactics adopted by female stalkers and a lesser propensity to pass on to physical violence. ⋯ In a significant proportion of female stalkers, the behavior is carried out in the occupational setting, especially in the field of psychotherapy, where the male-female ratio is reversed. No significant differences emerged between the motivations of heterosexual or homosexual stalkers. In the category of crimes of harassment committed by women, stalking, at least in Italy, seems to be among the most prominent.
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Section 136 of the Mental Health Act 1983 (amended) provides police officers in the United Kingdom with the authority to remove individuals who appear to be suffering from a mental illness from any public place to a designated 'place of safety' for appropriate assessment. A considerable amount of research has been dedicated to investigate who is detained under this section and how it is implemented. ⋯ There is a lack of qualitative research exploring detainee and professional experience of Section 136 and in particular the patient pathway to mental health care via Section 136 experienced by black detainees. Implications for clinical practice, multi-agency collaboration and future research are discussed.
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The burn wound healing process, which is reviewed in this paper, has features that differ from the healing of incised cutaneous wounds. This study used immunohistochemical staining and cell counting to examine the inflammatory cell response in biopsy samples of burn wounds from live human subjects obtained at six hours until 23 days after injury in order to determine how the age of a burn could be estimated. Acute inflammatory cells predominated in samples taken six hours to two days after injury. However, neutrophils were often minimal in early samples or could be present late. Elevated numbers of macrophages tended to be encountered from days 2 to 20, but it was not uncommon to observe a minimal or absent macrophage response. Unexpectedly, there was no trend in the number of lymphocytes. A small study was also made of burn wound samples that had been obtained at post-mortem examination of subjects that died in a fire or up to 77 days after injury from fire. This revealed a similar trend of neutrophil and macrophage accumulation. Additionally, it appeared that an increase in the number of lymphocytes occurred late, from 35 days. ⋯ If neutrophils predominate, the wound is probably less than a couple of days old. When macrophages are abundant the wound is probably a few days to weeks old. However, as expected from the review of the literature, the inflammatory cell infiltrate may be low or absent in burn wounds, which can render determination of the age of burn wounds difficult.