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A case of unnatural death was registered by the police as homicide due to the hue and cry made by the local people. The police could not locate the 'murderer'. The case was ultimately referred to the Forensic Science Laboratory at Shimla. Examination of the evidence proved that the case was one of accidental death. The victim had been hit and dragged along by a moving train. The forensic aspects of the case are presented and discussed in this article.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The King's Cross fire occurred at the end of the evening rush hour, on 18 November 1987. King's Cross station is within the department's health district and we felt a responsibility to respond to the psychological aftermath. The unique features of our intervention were the degree of inter agency coordination, the use of a systematic outreach and screening programme, the collection of psychotherapy outcome measures and the development of an ongoing clinic. The work represents a sustained attempt to assess the nature and prevalence of post-traumatic reactions and the most medically and economically effective form of intervention. In this paper we describe the way our team responded to the high level of psychological distress that we found, we present some preliminary results, outline two therapeutic trials, and refer to the longterm consequences for the work of our department.
The psychiatric response to the Clapham rail crash is described. The psychiatric input was short term, dealing with the 38 inpatients and over 200 hospital staff involved in the response. The need to evolve a compact, responsive team structure is noted. The value of a proactive approach and provision of psychological debriefing is defended. Incorporation of components of the psychiatric response into the Hospital's major incident plan is reported.
OBJECTIVE: To understand the characteristics of persons who commit suicide in the Montreal subway system (the Montreal Metro), their personal and psychiatric histories, and the nature of the event in order to develop better prevention strategies. METHOD: Systematic analysis of coroner's office investigations of the 129 suicides in the Montreal Metro from 1986 to 1996. RESULTS: Of the 129 people who committed suicide, 81% had expressed a prior suicidal intention, 66% had previously attempted suicide, and 9% had attempted suicide in the metro. One hundred and five of the victims had serious mental health problems, most frequently depression; 73% had had inpatient psychiatric treatment, and at the time of death, 27% resided in a mental health treatment institution. Recent adverse life events included failed relationships, work problems, and family difficulties. CONCLUSIONS: Suicide victims intentionally go to the metro to kill themselves, often tell others beforehand, and are generally in treatment for serious psychiatric problems. Possible prevention strategies include modification of the environment and procedures in the metro, changing public conceptions of metro suicides, and modifying practice in psychiatric facilities.
We describe a pilot study to investigate whether drawing "Thomas the Tank Engine" could be as effective a measure of developmental progress as the Goodenough-Harris Draw A Man test against the ThOMAs test (The Other Means of Assessment), with internal validation. The study included 95 children aged between 3 and 11 years of age, including a subgroup of 13 children with registered special needs from community and general pediatric clinics within Birmingham, UK, as a means of validation. There was no significant evidence that ThOMAS was either culturally or sex biased. Using regression analysis, nine items were found to correlate highly with actual age, and their total score gave a correlation of 0.563 with age. Adding further items did not increase this. After being converted into age-standardized scores, ThOMAS was as sensitive and specific as the Draw A Man test, and more so above a defined age-standardized threshold. This pilot study suggests that drawing Thomas the Tank Engine would appear to be as sensitive and specific a means of identifying children with special needs as the Goodenough-Harris Draw A Man test. The relatively small sample size means that further research is necessary to further define the age standardizations and to refine the ThOMAs test.
This article presents a case study of a health education process, community organization, that deals with an issue of health protection. The issue concerns herbicide spraying along rights-of-way in Leverett, Massachusetts. The intervention team consisted of the author and a graduate class in community organization. The case study provides a description of the community and history of the problem, the nature of the intervention team, the theoretical and conceptual model held by the intervention team, a description of the intervention, assessment of outcomes, and implications for theory and practice. The intervention extended over a period of 6 months. The intervention represented, for the intervention team, an opportunity to learn community organization and community education skills through active participation in the community. Both the nature and the effects of the intervention are described and discussed.
BACKGROUND: Previous studies have indicated an increased incidence of myocardial infarction among railway engine drivers. OBJECTIVE: To analyse whether somatic risk factors for myocardial infarction among male drivers in different geographical areas in Sweden differed from that in general population samples drawn from the same geographical areas. DESIGN: A cross-sectional study comparing drivers and men from the general population. METHODS: Engine railway drivers aged 25-59 years (n = 2318) were compared with randomly selected men (n = 3016) with respect to their serum cholesterol, systolic and diastolic blood pressures and smoking habits. RESULTS: The levels of the risk factors did not differ between engine drivers and the reference groups except for the Stockholm area which showed a higher percentage of tobacco smokers as well as higher means for systolic and diastolic blood pressures. The risk ratio compared with the reference samples was significantly elevated in Stockholm but not in any of the other areas. CONCLUSIONS: These somatic risk factors for myocardial infarction do not explain the approximately 40% reported increase in myocardial infarction incidence among railway engine drivers. In the following study, psychosocial factors will also be examined.
BACKGROUND: Several earlier investigations have found an increased incidence of myocardial infarction among male drivers and, not least, among railway engine drivers. In a previous study we found that increased serum cholesterol, blood pressure or tobacco smoking did not explain this increased risk. OBJECTIVE: To investigate psychosocial factors and primarily work-related factors among male engine drivers. DESIGN: Engine drivers were compared with random population samples in a cross-sectional study. METHOD: Two thousand three hundred and eighteen engine drivers aged 25-59 years were compared with 331 randomly selected men who were mainly from the Göteborg MONICA population study. Job demands and job decision latitude as well as social support were the main factors compared. RESULTS: Job demands were reported as being significantly lower by both younger and older engine drivers compared to their referents (P = 0.002 and P = 0.0001, respectively). Decision latitude was reported as being lower by both younger and older engine drivers than among controls (P = 0.0001 for both groups). Engine drivers experienced deficient support from their superiors compared to the referents (P = 0.0001 for younger as well as older engine drivers). Low decision latitude was associated with significantly higher diastolic blood pressure (r = -0.11 and P = 0.0001), but otherwise there were no significant relationships between psychosocial work characteristics and somatic risk factors. CONCLUSIONS: The combination of low decision latitude and low social support seems to be a key factor in the increased risk of myocardial infarction among railway engine drivers. They generally undertake shift work which may be an additional risk factor for myocardial infarction.
BACKGROUND: Railway engine drivers have had an increased risk of myocardial infarction which could be due to reported low decision latitude and low social support but not to elevated somatic risk factors. OBJECTIVE: To study somatic and psychosocial risk factors for myocardial infarction among railway engine drivers prospectively. DESIGN: A prospective study of 2318 drivers followed for 10 years. METHODS: Risk factors were surveyed in conjunction with periodic health checks at 15 different centres but with common methodology and commonly used questionnaires. Questionnaire and register information on myocardial infarction during follow-up was recorded. RESULTS: Within this group of engine drivers, age, family history of myocardial infarction, systolic blood pressure and low body height were independent predictors of myocardial infarction, but diabetes, elevated serum cholesterol and smoking were not. Neither were a longer time in the occupation or work-related psychosocial factors. The drivers were all at the lower end of the decision authority and latitude scale and had low social support. With this limited span, it may be difficult to detect these variables as risk factors within this group. CONCLUSIONS: Several well-known, somatic risk factors for myocardial infarction were documented in this study, whereas psychosocial working conditions, which were common to all the drivers, were not significantly related to outcome.
BACKGROUND: Public access defibrillators (PADs) are now available for more efficient and rapid treatment of out-of-hospital sudden cardiac arrest. PADs are used normally by untrained people on the streets and in sports centers, airports, and other public areas. Therefore, automated detection of ventricular fibrillation, or its exclusion, is of high importance. A special case exists at railway stations, where electric power-line frequency interference is significant. Many countries, especially in Europe, use 16.7 Hz AC power, which introduces high level frequency-varying interference that may compromise fibrillation detection. METHOD: Moving signal averaging is often used for 50/60 Hz interference suppression if its effect on the ECG spectrum has little importance (no morphological analysis is performed). This approach may be also applied to the railway situation, if the interference frequency is continuously detected so as to synchronize the analog-to-digital conversion (ADC) for introducing variable inter-sample intervals. A better solution consists of rated ADC, software frequency measuring, internal irregular re-sampling according to the interference frequency, and a moving average over a constant sample number, followed by regular back re-sampling. RESULTS: The proposed method leads to a total railway interference cancellation, together with suppression of inherent noise, while the peak amplitudes of some sharp complexes are reduced. This reduction has negligible effect on accurate fibrillation detection. CONCLUSION: The method is developed in the MATLAB environment and represents a useful tool for real time railway interference suppression.