Many congratulations to our Director, Professor Vanezis OBE, who has been appointed as Honorary President of the Balkan Academy of Forensic Sciences!
Molecular autopsy is changing the practice of forensic pathology. Under some circumstances, one must contemplate the involvement of genetic factors to help explain why someone has died unexpectedly. Deaths that the forensic pathologist will be asked to investigation could involve natural disease that has a significant genetic underpinning. Elucidation of genetic mutations may not only further an understanding of the pathophysiology at hand, but also speak to underlying susceptibilities in an individual who dies that may not have been recognized. In addition, one may occasionally identify pathological findings that are confused for trauma that may actually be better explained by an underlying disease process. Using molecular medicine as a tool to explore such possibilities can improve the quality of death investigations and provide a new lens to probe challenging and contentious forensic cases that have proved resistant to traditional methods.
The finding that drugs and metabolites can be detected from fingerprints is of potential relevance to forensic science and as well as toxicology and clinical testing. However, discriminating between dermal contact and ingestion of drugs has never been verified experimentally. A commonly held belief is that the detection of metabolites of drugs of abuse in fingerprints can be used to confirm a drug has been ingested. This study shows that cocaine and its primary metabolite, benzoylecgonine, can be detected in fingerprints of non-drug users after contact with cocaine.
Experimental knowledge of human body decomposition in the deep ocean is very limited, partly due to the logistical challenges of deep-sea research. The literature on ecological responses to the arrival of naturally sunk and implanted whale carcasses on the seafloor represents a potential source of information relevant to questions of human body survival and recovery in the deep ocean. Whale falls trigger the formation of complex, localized, and dense biological communities that have become a point of interest for marine biologists for the past 2-3 decades. Researchers have documented whale falls by whale type, size, geographic location, water depth and water chemistry, and there have been some comparative analyses of decomposition rates and faunal presence on carcasses. The stages of whale carcass decomposition most relevant to human forensics are those characterised by mobile scavengers that strip the soft tissues from carcasses, and to a lesser degree, other biota that degrade skeletal material. Statistical models used the number of faunal taxa attracted to the whale carcasses as a measure of the ecological response and the potential rate of decomposition, and identified significant influences of carcass age and dissolved oxygen concentration on the ecological response. Applying a forensic lens to whale-fall studies provides a window into an otherwise unseen world from the standpoint of human forensic taphonomy.
"There has been a recent increase in deaths attributed to heroin in the North East of England. Some of these deaths have shown signs of being very sudden, potentially indicating an immediate and fatal overdose. Recent results from toxicology samples submitted for specific fentanyl screening generated ‘additional substance’ detections.
Separately, heroin tested from street seizures in the Yorkshire area confirm the presence of fentanyl. Additionally, a post-mortem on a victim of a heroin related death in April 2017 showed traces of the substance carfentanyl, a fentanyl analogue that is 100 times more powerful than fentanyl."
There has been extensive research on the value of closed-circuit television (CCTV) for preventing crime, but little on its value as an investigative tool. This study sought to establish how often CCTV provides useful evidence and how this is affected by circumstances, analysing 251,195 crimes recorded by British Transport Police that occurred on the British railway network between 2011 and 2015. CCTV was available to investigators in 45% of cases and judged to be useful in29% (65% of cases in which it was available). Useful CCTV was associated with significantly increased chances of crimes being solved for all crime types except drugs/weapons possession and fraud. Images were more likely to be available for more-serious crimes, and less likely to be available for cases occurring at unknown times or in certain types of locations. Although this research was limited to offences on railways, it appears that CCTV is a powerful investigative tool for many types of crime. The usefulness of CCTV is limited by several factors, most notably the number of public areas not covered. Several recommendations for increasing the usefulness of CCTV are discussed.
The subject of this Inquiry is the Coroner Service of England and Wales. The Ministry of Justice is responsible for Coroner Service policy and local authorities for funding 85 local coroner services. Coroners are judicial officers. Senior Coroners in each area are responsible with the relevant local authorities for the local coroner service and are aided by part-time Assistant Coroners. Larger areas may also have one or more full-time Area Coroners. All coroners are appointed by the local authority (with the consent of the Chief Coroner and the Lord Chancellor). Historically, coroners’ officers (who investigate deaths on behalf of coroners) have been seconded from local police forces. Other administrative support including accommodation is provided by the local authority.
Sodium nitrite is a common household product with a variety of uses such as curing meat, food additive, colouring agent, anti-freezing agent and disinfectant. We report a case of sodium nitrite intoxication for deliberate self-harm and discuss the increasing number of such cases in recent times.
The reduction of data collection of homicides committed by mental health patients is short-sighted and detrimental to the safety of patients and wider society, says Sarah Markham. Sarah Markham is an academic mathematician and patient representative currently pursuing a second PhD in theoretical computer science. She is a member of the BMJ Patient Advisory Panel.
Governments around the world restricted movement of people, using social distancing and lockdowns, to help stem the global coronavirus (COVID-19) pandemic. We examine crime effects for one UK police force area in comparison to 5-year averages. There is variation in the onset of change by crime type, some declining from the WHO ‘global pandemic’ announcement of 11 March, others later. By 1 week after the 23 March lockdown, all recorded crime had declined 41%, with variation: shoplifting (− 62%), theft (− 52%), domestic abuse (− 45%), theft from vehicle (− 43%), assault (− 36%), burglary dwelling (− 25%) and burglary non-dwelling (− 25%). We use Google Covid-19 Community Mobility Reports to calculate the mobility elasticity of crime for four crime types, finding shoplifting and other theft inelastic but responsive to reduced retail sector mobility (MEC = 0.84, 0.71 respectively), burglary dwelling elastic to increases in residential area mobility (− 1), with assault inelastic but responsive to reduced workplace mobility (0.56). We theorise that crime rate changes were primarily caused by those in mobility, suggesting a mobility theory of crime change in the pandemic. We identify implications for crime theory, policy and future research.
Trends in suicide during the covid-19 pandemic
An editorial from the BMJ, discussing the increasing trends in suicide during the Covid-19 pandemic. The article discusses the currently available data and suggests preventative measures.
Postmortem Diagnostic and Biosafety Considerations
As a result of the 2019 novel human coronavirus (COVID-19) global spread, medical examiner/coroner offices will inevitably encounter increased numbers of COVID-19–infected decedents at autopsy. While in some cases a history of fever and/or respiratory distress (eg, cough or shortness of breath) may suggest the diagnosis, epidemiologic studies indicate that the majority of individuals infected with COVID-19 develop mild to no symptoms. Those dying with—but not of—COVID-19 may still be infectious, however. While multiple guidelines have been issued regarding autopsy protocol in cases of suspected COVID-19 deaths, there is some variability in the recommendations. Additionally, limited recommendations to date have been issued regarding scene investigative protocol, and there is a paucity of publications characterizing COVID-19 postmortem gross and histologic findings. A case of sudden unexpected death due to COVID-19 is presented as a means of illustrating common autopsy findings, as well as diagnostic and biosafety considerations. We also review and summarize the current COVID-19 literature in an effort to provide practical evidence-based biosafety guidance for medical examiner-coroner offices encountering COVID-19 at autopsy.
Reconstructing the time since death using noninvasive thermometry and numerical analysis
The early postmortem interval (PMI), i.e., the time shortly after death, can aid in the temporal reconstruction of a suspected crime and therefore provides crucial information in forensic investigations. Currently, this information is often derived from an empirical model (Henssge’s nomogram) describing posthumous body cooling under standard conditions. However, nonstandard conditions necessitate the use of subjective correction factors or preclude the use of Henssge’s nomogram altogether. To address this, we developed a powerful method for early PMI reconstruction using skin thermometry in conjunction with a comprehensive thermodynamic finite-difference model, which we validated using deceased human bodies. PMIs reconstructed using this approach, on average, deviated no more than ±38 minutes from their corresponding true PMIs (which ranged from 5 to 50 hours), significantly improving on the ±3 to ±7 hours uncertainty of the gold standard. Together, these aspects render this approach a widely applicable, i.e., forensically relevant, method for thermometric early PMI reconstruction.
State of the art forensic techniques reveal evidence of interpersonal violence . 30,000 years ago
We are delighted to announce that the Virtual Forensic Middle East & Africa Virtual Conference has been accredited by the Academy for 23 CPD points. Registration for this event is free and there is only a simple registration required for attendance via the link below. We wish the Organisers our very best wishes for an effective, successful and productive Conference.
Full details and a press release can be found below.
THREE DAY VIRTUAL FORENSICS CONFERENCE KICKS OFF ON MONDAY
Forensic experts will gather and share their lessons learned during what has been some of the most challenging times seen in the forensics community.
Forensics Middle East & Africa will be held virtually on 12-14 October, as the 4th instalment of Clarion Defence & Security’s forensics conference series held in the MENA region. After previous successful editions in Abu Dhabi and Bahrain, the virtual event will bring together delegates from all specialities of forensic science looking to exchange knowledge and better practices for the sector. The conference is jointly organised with the Arab Union of Forensic Toxicology and Sciences, which has spearheaded the organising committee in an effort to produce an agenda with compelling scientific content.
The event will open with a day of collaborative sessions including four expert-led workshops covering DVI Interpol guidelines training, an International Committee of the Red Cross mass fatality response planning session, COVID-19 digital tracking demo and a forensics education online training platform solution. On the conference days, forensic science leaders from all over the world will deliver a total of 50 oral presentations in addition to two afternoon poster sessions containing rapid fire presentations on emerging research. On the final day, the conference will conclude with a 15 member, Arabic panel discussion covering challenges and opportunities in the region with representatives from Morocco to Iraq under the moderation of AUFT’s President – Dr. Dina Shokry.
Amongst the keynotes confirmed to present at the event are: Dr. Angel Carracedo, President of the International Academy of Legal Medicine; Professor Claude Roux, President of the International Association of Forensic Sciences; Dr. Duarte Nuno Vieira, Chairman of the Scientific Advisory Board of the Prosecutor of the International Criminal Court and Oran Finegan, Head of Forensics for the International Committee of the Red Cross. In addition to the highlighted keynotes and presenters, the conference is supported by commercial sponsors who will be sharing their latest research & development findings in sponsored conference sessions as well virtual sponsor booths.
The three day, free-to-attend event will offer a much-needed space where a community of forensic practitioners - many of who are frontliners in the current pandemic - a space to learn, train, discuss and network without needing to leave their home or office. This year has been one of the most challenging times seen in the forensics community and this will provide forensic experts a place to share their lessons learned and procure new equipment solutions.
Registration is simple and free via the website: www.forensics-mea.com.
Fingerprints are heavily used in forensic investigations and more recently have proven to be a mode of distinguishing between individuals who use drugs or handle them. In this publication of the Journal of Analytical Toxicology by Costa et. al, fingerprints are used to distinguish between users and nonusers of heroin using analytical chemistry methods including LC/MS.
Fingerprints have been proposed as a promising new matrix for drug testing. In previous work it has been shown that a fingerprint can be used to distinguish between drug users and nonusers. Herein, we look at the possibility of using a fingerprint to distinguish between dermal contact and administration of heroin. Fingerprint samples were collected from (i) 10 patients attending a drug rehabilitation clinic, (ii) 50 nondrug users and (iii) participants who touched 2 mg street heroin, before and after various hand cleaning procedures. Oral fluid was also taken from the patients. All samples were analyzed using a liquid chromatography—high resolution mass spectrometry method validated in previous work for heroin and 6-AM. The HRMS data were analyzed retrospectively for morphine, codeine, 6-acetylcodeine and noscapine. Heroin and 6-AM were detected in all fingerprint samples produced from contact with heroin, even after hand washing. In contrast, morphine, acetylcodeine and noscapine were successfully removed after hand washing. In patient samples, the detection of morphine, noscapine and acetylcodeine (alongside heroin and 6-AM) gave a closer agreement to patient testimony on whether they had recently used heroin than the detection of heroin and 6-AM alone. This research highlights the importance of washing hands prior to donating a fingerprint sample to distinguish recent contact with heroin from heroin use.
Link to full article: https://academic.oup.com/jat/article/44/3/218/5611271
The postmortem submerged interval (PMSI) is yet another parameter that is very challenging to estimate with a sufficient level of accuracy, during a forensic investigation. Mizukami et. al, 2020 published an insightful article in the Journal of Proteome Research, a study that looks at mouse carcasses submerged in different types of water and how those affect changes in a number of proteins in bones over set periods of time.
Full article can be found here:
Book written by Professor Peter Vanezis
Provides an invaluable distillation of key topics in forensic medicine for undergraduate, masters, and postgraduate students Essential Forensic Medicine covers the broad area of the forensic medical sciences, delivering core knowledge in the biomedical sciences, and the law and ethics surrounding them. Concise, accessible chapters cover a wide range of topics from basic forensic identification and examination techniques to forensic toxicology and psychiatry. Written by internationally-recognized experts in the field, this authoritative guide offers complete chapter coverage of the legal system, courts, and witnesses; investigation of the deceased and their lawful disposal; and the duties of a registered medical practitioner and the General Medical Council. It instructs readers on the general principles of scene examination and the medico-legal autopsy including how to interpret the many kinds of injuries one can suffer--including those from blunt impact and sharp force, firearms and explosives, asphyxia and drowning. Further chapters cover sexual offences, child abuse, and using DNA in human identification, mental health, alcohol and drug abuse. A fresh, accessible, up to date textbook on forensic medicine Written by a well-known experts with decades of experience in the field Includes numerous figures and tables, and detailed lists of key information Features numerous case studies to reinforce key concepts and ideas explored within the book Helps students to prepare for examinations and enables practitioners to broaden their understanding of the discipline Part of the "Essential Forensic Science" series, Essential Forensic Medicine is a highly useful guide for advanced undergraduate students, master's students, and new practitioners to the field.
The book is now available for preorder on Amazon and other sites: https://www.amazon.co.uk/Essential-Forensic-Medicine/dp/047074863X
We would like to congratulate Dr Jiun Yih Lee and Dr Muhamad Yazid Bin Yahya who have both just passed the DMJ(Path) examination. They have both studied very hard during their attachment with us for the past two years.
We are very happy to announce that our reaccreditation application has just been approved by the British Accreditation Council.
Following several deaths in custody, the then Home Secretary Theresa May on July 23, 2015 called for all deaths in custody and serious incident in police custody. The organization Inquest has recorded more than 5,600 deaths in prison and police custody in England and Wales, between 1990 and 20161. The report by Dame Elish Angiolini QC2 contains 110 recommendations for overhauling the way in which the police and health authorities deal with vulnerable people, and how the police complaints watchdog investigates such incidents when they occur. Many are still questioning what will be the outcome from these recommendations will be and how will the Home Office act on this?3.
Image courtesy of (https://www.theatlas.com/charts)
Many believed that Racial stereotyping may be a “significant contributory factor” in deaths that occur in custody across England and Wales. However, they feel the authority has not done much to address this situation
Mental health was a significant issue that was highlighted within the report.
Dame Elish Angiolini QC, in her report highlighted that a serious issue was an unduly high number of deaths of black men in restraint-related deaths, often in antagonistic circumstances. This she believes helps increase the negative perception of many within the Black, Asian and Minority Ethnic (BAME) communities of the police service within England and Wales3.
The report further went on to state “Where there is evidence of racist or discriminatory treatment or other criminality or misconduct, police officers must be held to account through the legal system.”
The recommendations also targeted the Independent Police Complaints Commission (IPCC), stating ex police officers should not be appointed at lead investigators within the IPCC so that integrity and full independence is maintained of those it investigates. A spokesperson from the IPCC was quick to respond stating: “We welcome this independent review, which examines not only these investigations but the wider issues that lie behind them.”
They did not address the issues of having ex-police officers as lead investigators. However, they went on to said: “We are extremely mindful that any subsequent investigation by the IPCC impacts on these groups further, and must be carried out in a way that is not only independent, thorough and effective but also conscious of the impact on all those affected 5.”
The statistics showed that in the UK, every prosecution over a death in police custody in the past 15 years ended with acquittal, to many this signify a system that is failing the families and public4.
The current Home Secretary Amber Rudd said: “This simply isn’t right, and is why the Government is taking steps to ensure that families bereaved in this way in future get the support and answers they need”. She further stated: “The Government is committed to tackling this issue and that when tragically deaths in police custody do occur, we are clear that they must be investigated thoroughly, and action taken to support families better in future 4”.
Since the report has been published, the relatives of those who died in custody called on the government to quickly implement its findings.
1. Dodd, Jamie Grierson and Vikram. The Gaurdian. [Online] 30 October 2017. [Cited: Friday October 2017.] https://www.theguardian.com/uk-news/2017/.
2. Independent report: Deaths and serious incidents in police custody https://www.gov.uk/government/publications/deaths-and-serious-incidents-in-police-custody
3. Hattenstone, Eric Allison and Simon. The Guardian . [Online] 2 November 2017. [Cited: 3 November 2017.] https://www.theguardian.com/.
4. Bulman, May. The Independent News. [Online] 30 October 2017. [Cited: 1 November 2017.] https://www.independent.co.uk/news/uk/home-news/racial-stereotyping-significant.
5. Mohdin, Aamna. In the UK, every prosecution over a death in police custody in the past 15 years ended with acquittal. [Online] 3 November 2017. [Cited: 3 November 2017.] https://qz.com/1117185/ipcc-report-in-the-uk-every-prosecution-over-a-death-in-police-custody-in-the-past-15-years-ended-with-acquittal/.
In 2015 the Government attempted to address the issues relating to knife crime incidents within England and Wales. With the current surge in knife crime within and around the capital, it has left many in London living in fear of leaving their houses. This high increase of knife related crime continues to rise and remains an important topic on the political agenda and social arena.
According to the Metropolitan Police, there is a significant increase for the first time in eight years in knife crime in London. At the end of March 2015, the Metropolitan Police recorded 9,680 offences (37%) involving knives and other sharp instruments. These figures also showed that there has been a 5% increase in knife injury to under 25 year olds, which earlier in the year this stood as a 22% increase.
As society changes, there seems to be a major rise within violence at home, schools and on the streets; some of which are gang affiliated. Whilst there are other weapons such as guns, swords, baseball bats etc, the knife seem to the preferable choice of weapon for many.
According to the Office for National Statistics (1), offences involving knives or sharp instruments also rose by 2% over the same period (to 26,374). A knife or sharp instrument was found to be involved in 10,270 (39%) robberies and 13,488 (51%) as part of offences of assault with injury or assault with intent to cause serious harm. These figures also reflect the fact that within England and Wales, there was a nine per cent (9%) rise in the number of people caught carrying a knife and a ten percent (10%) increase in knifepoint rapes and sexual assaults (2). Homicides involving a knife or sharp instrument made up around 1% of the total number of knife or sharp instrument offences.
crime being reported to the police. This would significantly affect the overall percentage, as before March 2011, there were a lot of inconsistencies in how knife (including sharp instruments) crime were recorded between the different police force. For example, the West Midlands police force would record broken bottles and glass offences before 2011, which is now excluded from the national data. However, such offences are still recorded within Surrey under knife and sharp instrument returns. John Flatley, head of crime statistics at the ONS believes that the rise in knife crime was real and unlikely to be due to changes in recording practices (3).
In a response to this rise, commander Dean Haydon, head of Scotland Yard’s homicide and major crime command, and commander Duncan Ball, head of combating gang crime, said four key factors were behind the rise (4) : “the dark web being used to purchase weapons, such as the zombie knife which has a foot-long blade, a cultural change among young people that is encouraging them to use knives, even for trivial disputes or minor theft,reductions in the use of stop and search and improved recording of knife crime statistics.”
In an interview with the Evening Standard newspaper (5), the Metropolitan Police Commissioner Sir Bernard Hogan-Howe, also admitted that limiting stop and search had gone too far and had contributed to the rise in knife offending. He further stated that “the policy would be reversed and more searches carried out.” Some gang members and young people told the police that the reduction of stop and search was no longer a deterrent to them, so carrying of knives and other weapons was much easier. This was after the now home secretary, RT Hon Theresa May called on the different forces to reconsider how they were using stop and search. She further stated (6) “nobody wins when it’s used poorly – particularly if used unfairly against young black men.”
Some officials fail to believe that there is a direct link between stop and search and knife offences as it has never been proven. According to Mark Castle from Victim Support, dealing with the devastating effect of knife crimes on the victims, particularly young people and their families first hand, more work needs to be done to educate people about the dangers of carrying knives (6).
This rise in knife crime can be attributed to a number of factors. Society is changing and there appears to be an increase in violence generally, whether in the home or on the streets. The ‘Stop Knife Crime’ campaign launched by the Met Police, highlighted that amongst some groups of young people there is an attitude that life is cheap and an increasing number seem prepared to carry a knife whether it is for protection or for use in crime (7).
According to the latest Metropolitan Police Service statistics, released on April 15th 2016, there were 46 more knife crime offences, 77 more knife injuries and three more gun crimes from April to March 2015/16 compared with April to March 2014/15.
The families of knife crime victims also work endlessly in promoting peace within their local communities and raising awareness around the tragic experience whether it is loss of a life or survivors of an assault. The call for tougher penalties for those perpetrators, led to new legislations that means that those convicted of carrying a knife for the second time will face a mandatory custodial sentence. In spite of major cut to the police budget, in July 2015, the Met Police launched Operation Sceptre that was designed to coincide with new legislation aimed at reducing knife crime across the whole of London. According to the Metropolitan Police, Operation Sceptre seeks to target not only those who carry and use knives, but also the supply, access and importation of weapons (7).
The Home Secretary Theresa May has recently announced a new agreement of principles between the major retailers and the government with the aim to tackle the knife crime epidemic. According to the agreement, Tesco, Lidl UK, Amazon UK, Wilko, Argos, Morrisons, Asda, Poundland, Sainsbury’s, John Lewis, and Waitrose have committed to continuous staff training, “safely displaying and securely packaging knives, raising public awareness of age restrictions, and robust age verification checks for knife sales whether in-store, or if ordered online, at point of collection or delivery.”(8)
Knives in one high street store kept locked in a thickened glass cabinet.
This voluntary principle will include a commitment for law enforcement to conduct follow-up test purchases of knives in 6 months and to provide feedback to retailers to take action to tackle breaches of the law. The government will work with the British Retail Consortium to extend this agreement to other retailers. Many acknowledge this as a significant step to reduce the easy access of acquiring a knife.
Home Secretary Theresa May follows up on the agreement by stating…. “Knife crime has a devastating impact on victims, families and communities, and I am determined to do all I can to prevent it.Retailers have a vital role to play in this fight and I welcome today’s commitment.Knives have no place on our streets.
In response to this escalating knife problem, MP and now the Mayor of London, Mr Sadiq Khan, expressed his concern regarding curbing the epidemic. Before being elected to the office of Mayor of London, he said, “I have a real plan to tackle knife crime – based on my experience working with the victims of crime and the police as a lawyer and MP (9).“He further states his plan would include, tougher and more effective sentences for those caught with knives, stop shops selling knives to kids, properly map London’s gangs and make our prevention programmes more effective.
With the latest knife stabbing victim dying, just yards away from Sadiq Khan’s house in Tooting South London, he expressed his sympathy ….” Obviously, as a dad that’s very worrying, but my thoughts are with the mum and family of the victim.” (10) Mr Khan called for tougher action to tackle people carrying knives in London and acknowledged that “knife crime is a growing tragedy in London – we must do more to stop it.” (11)
People leaving floral tributes to Mr Elwin, who was training to become an electrician at Merton College (Courtesy, The Mirror Newspaper, 19th April 2016).
Mr Sadiq’ and current MP Mr Goldsmith (Conservative mayoral candidate) also shared similar views calling for tougher checks to prevent the sale of ‘zombie knives’ online to under 18s. (9) The Government are working on new legislation to ban the so-called ‘zombie-killer’ knives.
Cuts to the Met Police force budget of over four million pounds, meant that there are limited resources available, including the police presence in high crime areas.
Fighting knife crime has to be a collective process, not only a problem for the police or the government. The impact of new policies, legislation and lengthy prison sentences will have slower longer term. However, we have to work with the community to reduce knife crime and knife violence – it will not happen overnight.
Police officers at the scene where a man was stabbed in Tooting (Courtesy Nigel Howard, The Evening Standard, 19th April 2016)
Flatley, J. Chapter3: Offences involving the use of weapons.
[Online]11 February 2016.[Cited: 18 February 2016.] https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice.
Martin,Bentham M. Evening Standard.
http://www.standard.co.uk/news.[Online]15 October 2015.[Cited: 18 Jnanuary 2016.] http://www.standard.co.uk/news/crime/knife-crime.
T, Alan. The Guardian. The Guardian. [Online] 16 July 2015. [Cited: 19 April 2016.] http://www.theguardian.com/uk-news/2015/jul/16/knife-in-england-and-wales-up-for-first-time-in-four-years.
D, Vikram. Metropolitan police say knife crime up 18% in London. [Online] 20 September 2015. [Cited: 22 February 2016.] http://www.theguardian.com/uk-news/2015/sep/20/metropolitan-police-say-knife-up-18-in-london.
Martin, Justin D. Evening Standard. Evening Standard. [Online] 15 October 2015. [Cited: 17 April 2015.] http://www.standard.co.uk/news/crime/knife-crime-in-britain.
London, BBC News. BBC. BBC. [Online] 16 July 2015. [Cited: 3 4 2016.] http://www.bbc.co.uk/news/uk-33547806.
Police, Metroploitan.Knives take lives. Find out how to help us StopKnifeCrime .[Website] London : s.n., 2016.
Office, Home. International Crime and Policing Conference 2016 and Knife, gun and gang crime. Home Office. [Online] 23 March 2016. [Cited: 18 March 2016.] https://www.gov.uk/government/news/government-and-major-retailers-unite-to-tackle-knife-crime.
P, Laura. Evening Standard. Evening Standard. [Online] Saturday January 2016. [Cited: 18 April 2016.] http://www.standard.co.uk/news/crime/the-15-teenage-victims-of-knife-crime-in-2015-a3143901.html.
John, Matt, Pippa and Justin D. Evening Standard News. Evening Standard. [Online] 19 April 2016. [Cited: 19 April 2016.] http://www.standard.co.uk/news/crime/tooting-stabbing.
E, Sophie. The Mirror News. The Mirror. [Online] 19 April 2016. [Cited: 20 April 2016.] http://www.mirror.co.uk/news/uk-news/tooting-murder-first-picture-trainee-7787629.
The collapse of premiership footballer Fabrice Muamba on a cold March night in 2012 during a FA cup quarter final between Bolton Wanderers and Tottenham Hotspurs was watched by millions. Despite ultimately spelling the end of a successful career as a professional footballer, thanks to the quick responses of the team doctors, the assistance of consultant cardiologist Dr Andrew Deaner (a Tottenham fan who ran on to the pitch to help), as well as the quick response of the ambulance service and emergency medicine crews, Fabrice Muamba was successfully resuscitated and made a slow but almost full recovery. Although the cause of his cardiac arrest was never revealed, it is thought that he may suffer from hypertrophic cardiomyopathy (HCM) which, coupled with the extreme physical exertions of premiership football, led to his cardiac arrest.
Other high profile cases in football include the deaths of Marc-Vivien Foé whilst representing Cameroon in the 2003 FIFA Confederation Cup during a game against Columbia, Antonia Puerta who collapsed and died whilst playing for Sevilla in a Spanish league game against Getafe in 2007 and Motherwell’s Phil O’Donnell who collapsed during a Scottish league game against Dundee United in 2009 and died later in hospital. Such cases receive a significant amount of media attention due to the nature of the death of a seemingly fit and well known individual in such a public forum, but thankfully such events are rare. A 2003 study by Corrado et al suggests an increased risk of sudden cardiac death of almost three times for athletes compared to their non-athletic counterparts[i] whilst more recent data suggests the opposite i.e. that athletes have a lower incidence of sudden cardiac death.[ii],[iii]
Overall there are around 60,000 cases of sudden cardiac death a year in the UK.[iv] However this figure includes all deaths, not just those of young athletes. A large and comprehensive 27-year registry of US athletes recorded 1866 sudden deaths in athletes between 1980 and 2006, 1049 of which were deemed to be cardiac in origin.[v] In this registry the most common cause of death was HCM (36%), followed by anomalous coronary arteries (17%). Other less common causes included myocarditis, arrhythmogenic right ventricular cardiomyopathy (ARVC), ion chanellopathies (such as Long QT syndrome) and premature coronary artery disease. Around 80% of the deaths occurred during or just after exercise, be it during a sporting event or practice session. Overall the incidence of sudden death was estimated at around 0.6 per 100,000 per year in this study. A recent comprehensive review by Sharma et al quotes a range of between 0.4-0.8 deaths per 100,000 per year in athletes when analysing only the studies with robust methodologies.[vi] Other studies of young individuals put the figure higher. An incidence of 1.8 deaths per 100,000 per year in the young (age < 35) was reported by the UK Office of National Statistics[vii] and in Italy, the figure was calculated at 2.1 deaths per 100,000 per year.1
Despite the relatively low incidence of sudden cardiac deaths, there is a strong body of opinion that believes more effort should be made to identify athletes with predisposing cardiac conditions prior to engagement in high level activities such as football. Following on from the case of Fabrice Muamba, strong voices from within football, the media and the medical profession at the time of his collapse were heard bemoaning the fact that such an event could have been prevented if more stringent screening measures were in place to identify cardiac diseases that increase the risk of sudden cardiac death.
Taking a broader perspective of competitive sport as a whole, there is considerable heterogeneity between different sports, the competitive level of the sport and the country in which the sport is taking place as to the nature, if any, of the screening programme on offer. Many point to the Italian system of screening for all competitive sport as a model to aspire to. Physician led ECG screening programmes in association with detailed medical histories and examinations have seen an absolute reduction in sudden cardiac death of 89% in competitive athletes since the programme was initiated over 30 years ago.3,[viii] Indeed the Italian system has influenced European Society of Cardiology (ESC) and International Olympic Committee (IOC) guidelines for competitive athletes which recommends an ECG as a minimum for anyone taking part in competitive sport.[ix],[x] In football, FIFA and UEFA drew up guidelines in 2008 that stipulate that every footballer involved in first team activity must have at least an ECG and one echocardiogram in their medical notes.
Prior to Muamba’s cardiac arrest, the English Premier League followed the ESC and IOC guidelines but in the wake of the events of 2012 and the backlash by media, the public and prominent voices within football, more recent guidelines have been introduced by the premier league requiring all players to have bi-annual screening with at the very least and ECG and an echocardiogram if deemed necessary by a consulting physician. Such screening programmes are costly however and there is considerable debate as to the best way to implement them. Wheeler et al analysed the economics of screening programmes and determined that screening with an ECG in combination with a history and medical examination was both reasonable and cost and effective at reducing mortality.[xi]
However screening in isolation is not fool proof. Indeed evidence suggests that the use of ECG and echocardiographic screening, as is standard practice now in the Premiership, can only pick up around 70% of conditions that may lead to sudden cardiac death.[xii],[xiii]Further difficulties can arise in this group when trying to distinguish the natural hypertrophied athlete’s heart to pathological conditions such as HCM.[xiv],[xv] Other such diagnostic grey areas can arise, and these pose problems for medical staff as to how to advise players and clubs, as well as posing problems with regard to future applications for life insurance and mortgages. Some conditions pose a slightly increased risk of sudden cardiac death and such screening tools may lead to exclusion of individuals from sports whose career risk of sudden cardiac death is only minimally increased.
A separate issue highlighted by the collapse of Fabrice Muamba is the availability automatic external defibrillators (AEDs) at football matches as well a proper training for staff to use the devices. At the 2014 FIFA congress, it was revealed that in the last 5 years, 84 reported cases of sudden cardiac arrest had occurred in football matches and training grounds. In 80% of these arrest no AED was available in the stadium and less than a quarter of those individuals were revived. The medical experts that presented this data called for an AED and appropriate medical staff to be available in every football stadium, a message echoed by Professor Jiri Dvorak, FIFA’s Chief Medical Officer who stated that ‘It is required at FIFA competitions to have appropriate medical staff around the pitch and a defibrillator in the stadium’.[xvi] Indeed in England a joint venture between the FA and the British Heart Foundation has led to £1.2 million being made available to provide over 900 AEDs to clubs in tiers 1 – 6 of the National League System and clubs in the Women’s Super League as well as providing training for two representatives from the club in their use.[xvii]
Whilst awareness of sudden cardiac death in football and in young athletes in general grows, the multitude and variety of conditions that can lead to sudden cardiac death, and the difficulty in diagnosis as well as risk stratification means that there will never be a perfect system that will completely eliminate such events as occurred in March 2012. However as both screening tools and our understanding of the disease processes develop, coupled with wider access to AEDs and trained medical staff, one hopes that the incidence of sudden cardiac death in football diminishes.
You may also like to visit Cardiac Risk in the Young (CRY) at: https://www.c-r-y.org.uk/about-us/
[i] Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sport activity enhance the risk of sudden death in adolescents and young athletes? J Am Coll Cardiol 2003;42:1959–63
[ii] Van Camp SP, Bloor CM, Mueller FO, Cantu RC, Olsen HG. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995;27:641– 647.
[iii] Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006;296(13):1593–601
[iv] National Institute for Health and Clinical Excellence (NICE). Implantable cardioverter defibrillators for arrhythmias. Review of technology appraisal 11. https ://www.nice.org.uk/nicemedia/pdf/TA095guidance.pdf
[v] Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin.2007;25(3):399–414
[vi] Harmon KG, Drezner JA, Wilson M, Sharma S.Br J Sports Med. Incidence of sudden cardiac death in athletes: a state-of-the-art review. 2014 Aug;48(15):1185-92.
[viii] Italian Ministry of Health, editor. Gazzetta Ufficiale della Repubblica Italiana: Serie generale 1982:63. 1982. Norme per la tutela sanitaria dell’attività sportiva agonistica (Rules concerning the medical protection of athletic activity) pp. 1715–19
[ix] Corrado D, Pelliccia A, Bjornstad HH, Vanhees L, Biffi A, Borjesson M, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2005;26(5):516–24. [PubMed]
[x]InternationalOlympic Committee Medical Commission . Sudden cardiovascular death in sport: Lausanne Recommendations: Preparticipation cardiovascular screening. Vol. 2008. Lausanne; Switzerland: 2004
[xi] Wheeler MT, Heidenreich PA, Froelicher VF, Hlatky MA, Ashley EA. Cost effectiveness of pre-participation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med. Mar 2, 2010; 152(5): 276–286.
[xii] de Noronha SV, Sharma S, Papadakis M, Desai S, Whyte G, Sheppard MN. Aetiology of sudden cardiac death in athletes in the United Kingdom: a pathological study. Heart 2009;95:1409-1414
[xiii] de Noronha SV, Behr ER, Papadakis M, Ohta-Ogo K, Banya W, Wells J, Cox S, Cox A, Sharma S, Sheppard MN. The importance of specialist cardiac histopathological examination in the investigation of young sudden cardiac deaths. Europace (2014) 16 (6): 899-907
[xiv] Pellicia A, Maron B J, Spataro A. et al The upper limit of physiological hypertrophy in highly trained elite athletes. N Engl J Med 1991. 324295–301.301
[xv] Maron B J, Pellicia A, Spirito P. Cardiac disease in young trained athletes. Insights into methods for distinguishing athletes heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy. Circulation 1995. 911596–1601.1601
It has recently been reported that there has been a reduction in violent crime (1) this could be a result of major changes in society, such as better and improved policing along with the increasing price of alcohol over the years. According to a study by Professor Jonathan Shepherd of Cardiff University, data examined from the NHS has shown a drastic reduction of around 12% in violent crime within England and Wales over the last five years (1). Professor Shepherd further stated that “violence is falling in many Western countries and we do not know all the reasons why”. Could this be the result of major changes in society, such as better and improved policing, along with sharp increases in the cost of alcohol over recent years?
However, many believe that the published figure is not a true representation of the actual number of crimes committed as a result of many criminal offences not being recorded. Surveys that were undertaken by the Crime Survey for England and Wales (CSEW) across the country (face- to –face) showed a significant difference from the number of crimes apparently reported by the police. Both the police and CSEW use different definitions for violent crime therefore this creates a large discrepancy in numbers. Crime such as robbery might be described as “an offence in which violence or the threat of violence is used during a theft”. This will not be classified as violence against a person within the police report but will be interpreted by the CSEW as a violent crime.
A recent release by the Office of National Statistics showed that between 1995 and
2001/02 there was a significant drop in violent crime from 4.2 million to 2.7 million. Since then, this decreasing trend has continued by 13% between the 2007/08 and 2012/13 survey (2), which is very similar to the figures published by the NHS. The Home Office report of 2009/10 compared data from the British Crime Survey (BCS) and police recorded crime showed a consistent fall in overall crime when compared to 2008/09, both by 9% and 8% respectively (3). They then went on to conclude that the recent period of economic recession did not have any effect on the increase in crime between the periods as expected.
These violent crimes are broken down into four major categories: (i) assault without injury (ii) assault with minor injury, (iii) wounding and (iv) robbery; it wasn’t startling to discover that those who are single and aged between 16-24 are twice as likely to be the victims of violent crime. As mentioned earlier, some particular violent crimes such as homicide and sexual assault are not fully covered within the BCS, although these are covered by the police (3).
The reduction within the size of the police force throughout the country also led many to believe there would be a drastic increase in violent crime, in particular property crime during the recession. Surprisingly, that was not the outcome and could be a result of improved policing according to Prof Shepherd. According to the BCS, their report has been regarded as controversial by many; some critics are saying the public does not believe that the crime statistics are right, even though, the BCS report from local areas confirmed that a larger proportion of people (51%) believed that crime had fallen and they’re living in a lower than average crime area (2). This they believed to be a more realistic view of crime within their local area. The UK Statistics Authority was not happy with the negative commentary by these critics and went on to release a statement quoting that they had “not seen any evidence of political interference in the production of the aggregate National Statistics on crime and we are satisfied that the Home Office statisticians responsible for this work are fully committed to maintaining that integrity”.
Max Chambers, Head of Crime and Justice Policy Exchange was also quick to point out and comment that the implementation of “Sensible policies balancing enforcement and prevention can have, and are having, an impact,” on crime reduction within society. The use of neighbourhood policing teams which are more visible within the local areas, particular in high risk crime communities, has shown to be more effective in preventing crime and help in speeding up the rehabilitation process of offenders more successfully.
The steady increase in alcohol prices which is one of the major factors fuelling violent crime within society, means there would be less people getting drunk. According to the study by Prof Shepherd, alcohol “has become less affordable” combined with a fall in the income of those between 18-30 years old. Many pubs and clubs also went out of business throughout the recession, thus forcing many drinkers to stay at home and drink, therefore reducing the risk of them getting into fights with other intoxicated revellers.
According to ‘The Guardian’ newspaper, there was a combined drop of violent crime, which has seen a 5% fall within the police recorded figures. Over the 2011/12 period, the amount of murders reported by the police dropped by 10%, gun crime 17% and an 11% drop in knife crime (4). No one entity can take the credit for this downward trend in crime, however Mark Bangs from the Office for National Statistics deputy head of crime, said…“after levels have crime peaked in the mid-90s, there were then substantial falls through to the 2004-05 survey, after which crime continued to fall at a slower rate, resulting in levels of crime being flat since 2009-10.”. With the crime figures being this low, this created an opportunity for then Crime Prevention Minister Jeremy Browne to announce that this was “the lowest level since the crime survey began in 1981 and in spite of working with a reduced budget many have achieved a significant reduction in crime”(4) .
Could the reduction of lead from car fuel cause a reduction of crime? According to the chief biological criminologist, lead which is highly toxic can cause aggressive or dysfunctional behaviour, resulting in poor decision making and aggressive behaviour within individuals(5). A range of biological studies was carried out on criminals by Dr Bernard Gesch, a physiologist at Oxford University, which included their type of diet combined with various other environmental factors. He further states that “lead is a very potent neurotoxin…..” which causes alteration in the brain. The first real statistical data to support this theory was collected by a housing consultant and economist Rick Nevin, when he calculated the rise and fall of the presence of lead in petrol and compared his results to the history of crime. His results were quite startling. As the amount of lead increased, this showed a corresponding rise in violent crime two decades later. Dr Gesch’s studies support this data and he clearly believed that “the lead could account for as much as 90% of the changing crime rate during the 20th century”.(5)
The total exclusion of lead from petrol or the replacement of all petrol cars with electrical or hydrogen powered vehicles would result in a steady drop in violent crime might only be ambitious thinking at the moment, as the theory is not accepted by everyone. Professor of Criminology, Roger Matthews of the University of Kent clearly rejects this theory. He states, “biological criminologists completely misses the point and he doesn’t see a link”. He believes criminals offend because of the different things that push them into crime and not in the nature of their brain tissue (5).
The events of August 6, 2011, called the “BlackBerry riots”, resulted in the Prime Minister David Cameron promise to rid the streets of the UK of all gangs; guilty culprits would be fast-tracked through the courts and sentenced quickly. This can be interpreted as a fear-driving procedure that would help to drive potential perpetrators of violent crime to reconsider their actions before committing a crime.
Even though there are calls for an increase in the number of police officers, since the last report by the Home Office where it showed the number of police officers had fallen below 130,000. Prime Minister David Cameron welcomed the results as “good news”. He further applauded them citing that “we have asked them to do more with less resources ….and they have performed magnificently”.
The number of full-time equivalent police officers in England and Wales was 129,584 in March 2013 – a 4,516 drop from the previous year.
The continual reduction of violent crime within the UK will always be a priority for the government and local authority with the help of the communities to achieve this goal. In a recent report from the Home Office, Home Secretary Theresa May, praised the value of the numerous amount of Special Constables and police volunteers who worked within the communities combatting crimes and re-emphasised the 10% reduction of crime under the present government due to the hard work by both the police and local residents, which would help to continue the downward trend (6).
Shepherd J. BBC NEWS UK. BBC. [Online] 1 August 2014. http://www.bbc.co.uk/news/uk-27119689.
Flatley J. Crime, Regional and Data Access Division. Office of National Statistics. [Online] 13 February 2014. [Cited: 4 August 2014.] www.ons.gov.uk.
Flately J, et al. UK Statistics Authority. Home Office Research, Development and Statistics .[Online] July 2010. [Cited: 20 July 2014.] www.homeoffice.gov.uk/rds.
Travis A.Surpise 8% fall in crime. London : The Guardian, (day and month) 2013 .
Casciani D.Did removing lead from petrol spark a decline in crime? London : BBC News Magazine (day, month) , 2014.
The Rt Hon Theresa May, Secretary of State. GOV.UK. [Online] 25 June 2013. [Cited: 10 August 2014.] www.gov.uk/government.
A spate of deaths at the end of 2013 sparked a huge uproar against the cycle lanes (mostly the
superhighways) and the risk of cycling in the city. This led to a widespread analysis by the public, media and politicians in to what can be done to prevent such occurrences in the future.
Until November, 2013 had been a ‘normal’ year for cyclists in London, with the appointment of Andrew Gilligan as London’s first Cycling Commissioner in January highlighting the increasing influence cycling is having on transport in London. This resulted in the release of ‘The Mayor’s Vision for Cycling in London’, an article which included an outline for a ‘Crossrail for bikes’, providing a fully segregated route across London from east to west. (1)
Whilst all was looking on the up for cyclists and their safety on London’s roads, the shocking events of November led to drastic statements and criticism of the system. Six cyclists were killed in less than a fortnight, taking the cycle related deaths to 14 for the 2013. The six deaths occurred in Mile End, Whitechapel, Bow, Holborn, Croydon and Camberwell. Three of these fall directly on or on roads adjoining cycle superhighway two, one of four active cycle superhighways in the city. Eight more are scheduled to be introduced by 2015. Cycle superhighway two covers a large stretch or road in East London, including: Whitechapel High Street, Whitechapel Road, Mile End Road, Bow Road, and the recently added section on Stratford High Street. (2)
Various investigations and research papers on the topic highlighted some common factors which are present in cycle fatalities. One of the most frequent incidences was that of a Heavy Goods Vehicle (HGV) turning left at a junction, with cyclists coming from the inside cycle lane with the intention of continuing straight on. A paper in the Emergency Medicine Journal highlighted that the most common accidents took place during the peak commuting time of 08:00 – 09:00 and within 20 m of a junction, generally on roads with a 30mph speed limit. (3)
A further study conducted at the Royal London Hospital found that over a six year period, the number of cyclist admissions gradually increased (assumed to be due to the increase in cyclists in London), with 82% being due to injury following a collision with a motor vehicle. Collision with HGV’s displayed characteristic patterns although traumatic brain injury was seen to be more commonly associated with collisions with cars. The majority of cyclists admitted after collisions with cars survived, with a small percentage needing longer term medical care. The individuals involved in collisions with HGV’s generally showed sever torso injuries, along with sever haemorrhaging. It was shown that the main cause of death was not necessarily due to the head injury, with the analysis of the non-survivor cases pointing to the surgical control of haemorrhaging being the vital factor. Another frequent method of death found with HGV collisions was exsanguination. The study at the Royal London Hospital showed that over 90% of all admitted for cycle accidents survived after treatment, but it was unable to link survival to the quality of life in the long term. (3)
In response to the deaths the cycling charity CTC stated that they were ‘sickened by the continuing failure to protect cyclists’ with British Cycling demanding and ‘urgent investigation’. The Mayor of London, Boris Johnson, stated:
“There’s no question of blame or finger-pointing. That doesn’t work in these circumstances. But unless people obey the laws of the road and people actively take account of the signals that we put in, there’s no amount of traffic engineering that we invest in that is going to save people’s lives.” He also stated that the riders had “…taken decisions that really did put their lives in danger.” (4)
He also followed these comments up in another interview, stating that cyclists were endangering their lives when not following road traffic laws, making it “very difficult for the traffic engineers to second-guess [their actions]“.
These comments were greatly condemned by both the public and the media, with politicians also criticising the Mayor for deflecting blame and insulting the victims of fatal collisions. Although the Mayor was quick to blame the cyclists for the deaths, it is important to note that statistic from TfL showed that cyclists breaking the law was only identified as a factor in only 6% of cases where there was a fatality or serious injury. (5)
The events of November 2013 also resulted in Operation Safeway, in which around 650 police officers were deployed at 60 junctions in central London during the morning and evening rush hours in order to ‘enforce’ and ‘educate’ the public on the laws and dangers of the road. This was also seen by riders as an attempt to blame riders irrespective of the circumstances as they operation was shown to mainly target cyclists with regard to helmets and high visibility clothing. An article in The Independent showed that studies had found helmets to reduce head, minor and severe brain injuries for cyclists of all ages by up to 58%. Although this shows they are visibly useful, other studies have shown that it is not head injuries that need to be prevented as they are very rarely fatal. When compared with the Netherlands (often cited as one of the safest countries for cyclists), it can be seen that helmets are not the most important factor. There is no mandatory law for cyclists to wear helmets. In fact, it is not uncommon to see moped/scooter riders without helmets. The Dutch have achieved their high standards of safety by providing well directed cycle lanes with their own dedicated rules using lights and signals. They also emphasise the awareness of cyclists to drivers and stress that cyclists must be given way when necessary. (6)
It seems that the most obvious was to improve the safety of cyclists on the road would be to separate them from the motor vehicles. Deputy Prime Minister Nick Clegg has called for the cycle superhighways to “physically separate the cyclists from roads”, which would in turn greatly reduce the number of cyclists hit by a HGV turning left at a junction for example. There have been calls for HGVs to be banned from the city during rush hours but Mr Johnson has refused to allow this, stating that it risks damaging London companies and creating a “serious influx as soon as the ban is over”. He also mentioned the fact that a ban would result in the HGVs having to operate during the night, leading to disruption in residential areas. This was backed up by the fact that only two of the 14 deaths last year could have been affected by the ban (the other 12 happened outside the rush hour, or did not involve lorries.) He did however, state that he is considering a ban on cyclists wearing headphones; a statement that drew criticism once again from cyclists due to the fact that the Metropolitan Police traffic division were unable to identify any serious cycling incidents in which headphone use could be identified as a contributing factor. According to a BBC poll taken in December 2013, the events had resulted in one fifth of regular cycle commuters giving up cycling to work (7), with 68% stating that they felt London’s roads were unsafe to cycle on. It is apparent that there is much to be done to improve safety, but the onus must be shifted from the cyclists to the drivers of both cars and HGVs to adhere to the rules and regulations laid out in order to allow the cyclists to ride safely. (8)
Mayor’s Vision for Cycling in London. Greater London Authority, London Assembly; 2013.
Walker P. The Guardian. [Online].; 2013 [cited 2014 February 7. Available from: http://www.theguardian.com/uk-news/2013/nov/18/sixth-london-cyclist-killed-camberwell-lorry.
Manson J, Cooper S, West A, Foster E, Cole E, Tai NRM. Major trauma and urban cyclists: physiological status and injury profile. Emergency Medicine Journal. 2012 February.
Jones S, Weaver M, Walker P, Wintour P. [The Guardian].; 2013 [cited 2014 February 7. Available from: http://www.theguardian.com/uk-news/2013/nov/14/fifth-london-bike-death-bus-superhighway.
Jones S, Walker P, Wintour P. [The Guardian].; 2013 [cited 2014 February 14. Available from: http://www.theguardian.com/uk-news/2013/nov/14/boris-johnson-london-cycling-deaths.
[BBC News London].; 2013 [cited 2014 February 7. Available from: http://www.bbc.co.uk/news/uk-england-london-25080427.
[BBC News London].; 2013 [cited 2014 February 7. Available from: http://www.bbc.co.uk/news/uk-england-london-25176031.
Brooke M. [London24 Online].; 2013 [cited 2014 February 7. Available from: http://www.london24.com/news/transport/get_rid_of_the_blue_paint_on_london_s_cycle_superhighways_if_the_lane_isn_t_segregated_1_3077254.
Most inquests in England and Wales will be completed within six months under a new code of standards for coroners which has come into effect.
The legal framework launched by the Ministry of Justice follows complaints that bereaved families in some areas have had to wait years for a hearing.
The service will be overseen by the first chief coroner Judge Peter Thornton QC.
All 96 coroners will also be subject to mandatory training requirements.
Coroners courts investigate the medical cause of death if it is not known, appears to be unnatural or resulting from violence, or if it happened in custody.
Inquests aim to establish who has died, and how, when and where the death occurred. They are not trials, and so do not determine civil or criminal liability.
The overhaul to the system follows a consultation and aims to make the inquest process more efficient.
The MoJ says it will end “past inconsistencies which led to criticisms of a postcode lottery with bereaved people in some areas facing long waits”.
Under the rules, coroners will have to complete inquests within six months of being informed of a death “or as soon as is reasonably practicable after that date”.
Inquests can be delayed by factors, such as waiting for criminal proceedings to be completed.
Any inquests that last more than a year must be reported to the newly-appointed chief coroner.
Each year more than 30,000 inquests are held in England and Wales and individual coroners have up to now been responsible for holding hearings “as soon as practicable”. Judge Thornton QC told the BBC that standards had been “a little uneven” and the new national rules would create a more “efficient, effective and modern” service for bereaved families. As chief coroner he said he would be able to “lead the service nationally and try to bring some consistency”, adding he would investigate any case where an inquest had not been carried out within 12 months of a death being reported to a coroner.
Commenting on the measures, justice minister Helen Grant said: “I want to see all coroners delivering the same efficient service across the board, and we have put these changes in law so people can be assured inquests are being conducted quickly, with adequate care and the right support available for those who lose loved ones.”
The new rules also mean coroners will have to release the body to the bereaved family as soon as they can, or inform them if it is going to take longer than 28 days.
The government’s consultation on changes noted that some faith groups – notably Muslims and Jewish people – had voiced concerns about releasing bodies for funerals.
Coroners will also have to notify the bereaved within a week of setting the date for the inquest and provide greater access to documents and evidence, such as post-mortem reports, before the inquest takes place.
The laws will also allow coroners to permit less invasive post-mortem examinations – another concern raised by faith groups.
he office of coroner dates back to 1184 and coroners are independent judicial office-holders, appointed and funded by the relevant local authority.
However, once appointed, the coroner is answerable only to the High Court for his or her judicial and administrative decisions.
Clive Coleman Legal correspondent, BBC News
Today’s overhaul of the coroners system is a huge step forward in addressing long-standing criticisms of delay and inconsistency among some of the 96 coroners in England and Wales.
However, concerns remain. Coroners are funded by local authorities and it will be challenging to maintain the new standards in an age of cuts to local services.
Also, campaigners worry that there is still no appeal to the Chief Coroner available over the decision of a coroner.
The only appeal lies to the High Court by way of judicial review, which can be both time-consuming and costly for bereaved families. The Chief Coroner, who is responsible for overseeing the reformed coroner system, has today issued a press notice which is available here:
Further information at: http://www.judiciary.gov.uk/media/media-releases/2013/ChiefCoronerImplementationOfRelevantPartsOfCoronersAndJusticeAct2009.
The statutory instruments that enable the reforms are available here: http://www.legislation.gov.uk/uksi/2013?title=coroner.
Forensic Scientists at Abertray University in Dundee have managed to unlock the key to recovering fingerprints from food which, Foods had previously proved to be difficult surfaces for obtaining fingerprints from and therefore evidence gathering in foods was overlooked. The new research has now been published in the forensic science journal: ‘Science and Justice’1, the results can now be replicated by others. will lead to a future breakthrough in gathering evidence for police investigations.
The Scientists modified an existing technique in order to obtain fingerprints from fruits and vegetables, something which has never been achieved in the UK before.
Dennis Gentles, a former crime scene examiner and forensic scientist, who has worked at Abertray University over the last 10 years stated:
Foods such as fruits and vegetables used to be in that category, because their surfaces vary so much – not just in their colour and texture, but in their porosity as well. These factors made recovering fingerprints problematic because some techniques, for example, work on porous surfaces while others only work on non-porous surfaces.
He also went to say that: “It may not seem like much, but a piece of fruit might just be the only surface that has been handled in a crime scene, so developing a trusted and tested technique to recover fingerprints from such surfaces is something to be valued by crime scene examiners.
The method of recovering fingerprints was initially designed to take prints from the sticky side of an adhesive tape. Mr Gentles finally stated:
We tried altering the formulation a bit, making it more dilute than that suggested by the Home Office, and found that it out-performed all the other methods we tested.
Although there’s still a considerable amount of research to do before we can recommend techniques for all types of foods, we’ve shown for the first time that it really is possible to recover fingerprints from them – something that was previously thought to be unachievable.
This means the police will now be able to gather even more evidence to present in court, adding more weight to their investigations.
Source: The Independent Newspaper, 26/04/2013
D. Gentles et al: A preliminary investigation into the acquisition of fingerprints on food: Science and Justice, Volume 53, Issue 1, March 2013, Pages 67–72
Mummifying Alan, the award winning documentary, which aired on Channel 4, involved a team of expert specialists attempting to mummify a specially- donated body of a man named Alan. In this documentary, we saw the successful process of mummification being carried out and this gave us a true insight into the ancient Egyptian mummification techniques.
The director of The AFMS and expert forensic pathologist, Professor Vanezis, was closely involved in the mummification process and was responsible for carrying out the autopsy on the deceased and in the extraction of the organs. As stated on the Channel 4 website:
Following ancient Egyptian procedure, he first made a small incision approximately 4 inches long on the left side of the abdomen. He then removed most of the organs through this small opening, cutting them away and removing them one by one.
The exception was the heart, which was left intact because the Egyptians believed it was the seat of intelligence and needed in the last judgement before the soul could enter the next life.
The intestines, stomach, liver and lungs were also regarded as an essential requirement for the body in the afterlife. So, after their removal, each was preserved seperately inside a ‘canopic jar’, protected by its own god whose head was represented on the jar lid.
Although the brain was often removed through the nose using a metal implement, x-ray evidence reveals that many of the best Egyptian mummies had their brains left in place. Therefore, Alan’s brain was left intact.”
Professor Vanezis gave a very detailed explanation of ‘Human Decomposition’, in relation to the work he carried out and this was posted on the main Channel 4 website:
From the moment we die our bodies start to break down. This process of decomposition involves a cascade of chemical processes involving enzymes and bacteria, which steadily digest the body.
No two humans decay in exactly the same way, as a number of factors affect both the rate and sequence of decomposition, including temperature, humidity and alkalinity. But, overall, the process follows the same key stages. Understanding these extraordinary and complex molecular events goes to the very heart of forensic science.
Decomposition begins just minutes after death. Early changes to the body include a drop in core temperature, stiffening of the limbs known as Rigor Mortis and a pooling of the blood under the pressure of gravity known as Post Mortem Lividity.
The onset of death also triggers a process called Autolysis, or self-digestion, whereby our own enzymes literally turn against us, digesting our cells from the inside out, and causing them to rupture and release fluids. This liquefying process rapidly spreads across the whole body, with the first visible signs appearing as blisters and loosening of the skin, known as ‘skin slippage’. As the cells rupture and fluids steadily build up, the body becomes a moist environment, and ideal breeding ground for bacteria and other micro-organisms.
This next stage in the decay process is called Putrefaction. As these micro-organisms break down the soft tissue, they produce a steady build up of gases including ammonia, methane, and carbon dioxide. As these gases accumulate the body becomes increasingly bloated, particularly around the bacteria-rich area of the intestines.
Chemical processes also turn the skin a distinct greenish colour, as sulphur-containing hemoglobin settles in the blood, and bacteria enter the veins creating a visible, dark marbling effect of the skin surface.
Insects play a major role in decomposition. First on the scene are blowflies, which can detect a dead body within minutes of death – from many miles away. They lay eggs within the first hour, and the blowfly larvae will feed on the tissues and liquids, and in turn a succession of other flies and beetles will appear, collectively breaking down different parts of the soft tissue.
In the active decay phase, bacteria and insects continue to break down the body proteins and fats giving the body a deflated and wet appearance, as well as a strong odour.
The final stage of decomposition is skeletonisation, when the flesh has been completely broken down and only dry bone remains. Depending on the environmental conditions, the body may never get to this stage – but instead can become naturally mummified.
Mummification occurs most commonly in dry conditions which slow down or arrest the process of putrefaction. Typical features of a mummy include dry, leathery skin that has been completed desiccated. In Ancient Egypt, the desert conditions naturally preserved bodies in this way – before embalmers started to develop the ‘artificial’ practice using natron salt to dry out the tissues.
But, deserts are not the only place where natural mummies have been found.
Dry, cold environments have also created extraordinary mummies, the most famous being Otzi the Iceman and the ‘bog bodies’ of Northern Europe, which have been preserved predominantly through a lack of oxygen and acidic environments that tan the tissues.
Although many ancient cultures preserved their dead in various ways, the Egyptians remain the best known and arguably the most successful mummy makers of all.
Their need to preserve the dead was part of a highly complex belief system which maintained that at death an individual’s soul was reborn into another stage of existence. Here it would be judged by the gods who would weigh the individual’s heart to find out if they had led a good life. If the heart was heavy with sin it was condemned and destroyed, when a second, final death occurred. Yet if their heart was pure, their soul was allowed to pass through into the Afterlife and live forever in a perfect environment, based on the Egyptian landscape. Here the soul could travel around at will, although it still needed to return to its original body which formed its permanent home.
This explains why the Egyptians went to such great lengths to preserve the body after death. This was particularly important in the case of their rulers, the pharaohs, each of whom contained within them a divine soul regarded as the essence of Egypt itself. With this soul maintained and nurtured by special temple rituals during life, it was essential that at death every pharaohs body was perfectly preserved to house this soul, the accumulated powers of which could be accessed in magical rituals to maintain Egypt’s well being.
Yet the most perfect levels of preservation were only achieved after centuries of experimentation and a considerable amount of trial and error.
Although the earliest bodies were buried in hollows in the desert, where the hot sand dried the skin and allowed corrosive bodily fluids to drain away, there is evidence that by c.4500 BC some were also wrapped in linen and coated in various oils and resins. These early bodies were often buried facing east toward the rising sun, with their arms and legs drawn up to the body in the ‘foetal’ position suggesting an early belief in rebirth.
As society developed, the wealthier classes wanted more elaborate burial to reflect their status so began to be buried in purpose-built stone tombs. Yet no longer in direct contact with the hot dry sand, their bodies soon decomposed, leading to the need to remove the internal organs by c.2600 BC. With the previously flexed body now laid out flat to give access to the abdominal area, there is also evidence that the Egyptians had begun to use naturally occurring natron salt as a preservative, in some cases mixing it in water to use as a solution, but most often in its dry form, piled over the body to draw out the body fluids and preserve the skin.
In this way the Egyptians produced mummies for centuries until the dawn of the 18th dynasty c.1500 BC when a new regime brought in dramatic political and religious changes. These changes were even reflected in the way this new dynasty’s royal dead were mummified, the life-like results they achieved now resurrected in the mummification of Alan Billis.