Insulin in Forensic Medicine and Toxicology

Today insulin is used not only in medicine in the treatment of diabetes but also in sport as a doping agent and for criminal purposes. Suicides and homicides with insulin maybe are not so common, but are seen in the routine medicolegal and toxicological-clinical practice. Despite the often quite clear circumstances of death and a well-established mechanism of action of insulin and its analogs, it is difficult to analytically confirm its excessive exogenous administration in postmortem biological material. There are no uniform international standards of conduct in such cases, both at the stage of the material sampling during autopsy and forensic laboratory analysis and the final interpretation of the obtained results. The aim of the study is to present the current state of basic knowledge about nonmedical use of insulin, with particular emphasis on the possibility of postmortem diagnosis. The study also highlighted the little known clinical problem of insulin abuse for recreational purposes

Molecular neurochemistry of the lanthanides

Lanthanides, once termed rare‐earth elements, are not as sparce in the environment as their traditional name suggests. Mean litospheric concentrations are in fact comparable to the physiologically fundamental elements such as iodine, cobalt, and selenium. Recent advances in medical technology have resulted in accumulation of lanthanides presenting potential exposure to both our central and peripheral nervous systems. Extensive and detailed studies on these peculiar active metals in the context of their influence on neural functions are therefore urgently required. Almost all neurochemical effects of trivalent lanthanide ions appear to result from the similarity of their radii to the key signaling ion calcium. Lanthanides, especially La3+ and Gd3+ block different types of calcium, potassium, and sodium channels in human and animal neurons, regulate neurotransmitter turnover and release, as well as synaptic activity. Lanthanides also act as modulators of several ionotropic receptors, e.g., GABA, NMDA, and kainate and can also affect numerous signaling mechanisms including NF‐κB and apoptotic‐related endoplasmic reticulum IRE1‐XBP1, PERK, and ATF6 pathways. Several lanthanide ions may cause oxidative neuronal injuries and functional impairment by promoting reactive oxygen species production. However, cerium and yttrium oxides have some unique and promising neuroprotective properties, being able to decrease free radical cell injury and even alleviate motor impairment and cognitive function in animal models of multiple sclerosis and mild traumatic brain damage, respectively. In conclusion, lanthanides affect various neurophysiological processes, altering a large spectrum of brain functions. Thus, a deeper understanding of their potential mechanistic roles during disease and as therapeutic agents requires urgent elucidation

THE WAY YOUNG PEOPLE SEE THE MENTALLY ILL: A QUESTIONNAIRE STUDY

Background: The stigmatizing of the mentally ill is quite common and has numerous social and economical consequences for these individuals. Subjects and methods: The aim of this paper was to examine young peoples’ beliefs regarding the mentally disordered. The authors’ questionnaire regarding the interviewees’ age, gender, social background and their opinions on the mentally ill was conducted among a popular portal’s users. Results: 11900 people were questioned, including 71% women. 30% of the interviewees were under the age of 19, while 34% of them were between 19 and 24 years old and 36% were over 24. 39% of the interviewees stated they closely knew at least one mentally ill person. 44% of the questioned believed a lot of criminal offenders were mentally ill. 66% of interviewees would not mind sharing a flat with a mentally disordered person, 64% would agree to work with one. Those who personally knew a mentally disordered person were more inclined to share a flat or start a relationship with such an individual, than the rest of the interviewed (51% vs. 37% for flat sharing and 38% vs. 26% for starting a relationship, p<0.001). More questioned under the age of 19 believed that significant number of criminal offenders were mentally ill, than those over the age of 24 (50% vs. 37%, p<0.001). Conclusions: According to the acquired data, many young Poles believe that the mentally disordered are inclined to break the law and behave aggressively. These opinions seem to be related amongst others to age and gender, and they result in unwillingness to have relations with the mentally disordered

The problem of medical dispatchers' responsibility functioning in the emergency medical services system

Aim of the study : Deaths due to inappropriate functioning of the emergency medical services system, as recently described by Polish mass media, has drawn the attention of society to the activities of medical dispatchers. Legal regulations impose obligations on those persons associated with receiving phone calls and dispensing appropriate emergency medical teams. In this paper an analysis of chosen medicolegal opinions from the practice of the Department of Forensic Medicine and Forensic Toxicology, Medical University of Silesia in Katowice, towards malpractices committed by dispatchers of EMS, was performed. Material and methods: The authors analysed 12 of medicolegal opinions, issued from 2007 to 2012 by a team of experts. Results : The errors noted in the work of dispatchers consisted of delays in giving appropriate assistance due to the inability to properly converse, a propensity to downplay patients’ symptoms, and dispatchers crossing their own competences. Conclusions : The problem may be resolved by the subsidy of EMS, fine-tuning the algorithms for conduct, and proper education of both staff and public

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges