Providentia

"Cannibal" Inmate Sentenced

A 38-year old inmate, who has been dubbed "The Cannibal of Rouen", has been sentenced to thirty years in prison for the 2007 murder of a fellow inmate followed by his eating several of the victim's body parts.   The murder occurred on January 2, 2007 after the deceased, Thierry Baudry, gave him a "dirty look" over a shared toilet which caused Cocaign to fly into an "uncontrollable rage".  Cocaign, a married father of two, was on remand facing armed robbery charges while Baudry was awaiting sentencing for charges of extortion and sexual aggression.  After punching Baudry repeatedly, Cocaign then took a pair of scissors and stabbed him in the back, neck and chest.  He held a plastic bag over Baudry's face for five minutes "to make sure he was dead".  Cocaign then butchered the corpse and carved out Baudry's lung (he thought it was the heart).  Medical examiner, Patrick Laburthe-Tolra testified that, based on the blood found in Baudry's right lung, the victim was likely still alive when the body part was cut out. 

After removing Baudry's lung, Cocaigne then fried the lung with onions, olive oil, salt and pepper in his cell before eating it (the prison allowed inmates the use of portable camping stoves in their cells).  The murder was not discovered by prison officials until the following day.  In discussing his reason for committing the murder,  Cocaign blamed it on his history of psychological problems and stated that he had repeatedly asked prison officials for psychological treatment while incarcerated.  He has a history of psychiatric hospitalizations although a precise diagnosis was never made in his case.  After a forensic assessment determined that he was fit to stand trial, his defense attorney, Fabien Picchiotino argued that the murder represented a "failure of the psychiatric, penitentiary and social system".  During the trial, Cocaign testified that, "What I did, I liked doing" and that he was "curious to see what he tastes like".  A third cellmate, David Lagrue, had attempted to separate Cocaigne and Baudry before the murder. He was reportedly traumatized by witnessing the murder and cannibalism and committed suicide in another prison in November 2009. 

Members of Baudry's family were in the courtroom when the sentence was handed down.  Prosecutor Elisabeth Pelsez stated that she did not seek a life sentence due to Cocaign's psychiatric history.  He may be eligible for early release after serving twenty years.

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Telling Lies

Is it easier to tell lies when you're online?  According to Bandura's social cognitive theory of moral disengagement, people often release themselves from certain forms of moral obligation by distancing themselves psychologically.  A paper published in a recent issue of the Journal of Applied Psychology presented the results of three experimental studies that build on moral disengagement theory by exploring lying in online environments. Using samples of graduate-level business students in different experimental scenarios, the results indicated that, when e-mail is compared with pen and paper communication media (both of which are equal in terms of media richness, as both are text only), people are more willing to lie when communicating via e-mail than via pen and paper and feel more justified in doing so. The findings were consistent whether the task assured participants that their lie either would or would not be discovered by their counterparts. While the researchers acknowledge potential limitations involving experimental design, they discuss the implications of these results, both in terms of theory and practice

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Psychotropic Drug Use in Foster Care System Under Investigation

The US Senate Subcommittee on Federal Financial Management has asked the Government Accountability Office (GAO) to investigate the prevalence of prescribed psychotropic medications for children in foster care.  The estimated cost of prescribed medications, often used in the treatment of emotional and behavioural problems, may run to hundreds of millions of dollars each year in the United States alone.  To date, only limited reports are available to determine the actual prevalence of psychotropic medication in foster children.  Experts suggest that foster children are four times more likely to be prescribed antipsychotic or antidepressant medication than other children covered under Medicaid.  One 2003 study of foster children in Florida indicated that 55 percent of children in the foster care system are being administered psychotropic medication although forty percent of those medicated had no history of a psychiatric evaluation..  Another study has indicated that anti-psychotic medication used has increased 528 from 2000 to 2005.  A Texas study from 2004 showed that 34.7 percent of foster children were prescribed at least one psychotropic drug with some children taking five or more. 

Prescribing psychotropic medication for children is especially troubling given the potential risks associated with some types of antidepressant and antipsychotic medication which are believed to increase the risk of suicidal behaviour in adolescents.  The GAO investigation has focused on antidepressants which are often prescribed "off-label" to address symptoms for which the medication has not been approved by the Food and Drug Administration (FDA).     Although Congress has established formal guidelines for medications that qualify for Medicaid reimbursement, the potential for severe side-effects (and even death) remains high.  Medications that are commonly prescribed to children include Prozac, Phenobarbitol, Cymbalta, Mellaril, Effexor, Respiridal, Paxil, and many others.   Doctors prescribing medications to children tend to focus on behavioural problems although case histories are often unavailable when the children are being assessed.

Pharmaceutical companies have been implicated in the widespread use of psychotropic medication in foster children.  Drug companies engage in aggressive marketing campaigns which highlight the potential benefits of certain types of medication while minimizing potential risks for children.  The Law Project for Psychiatric Rights has launched several lawsuits aimed at calling drug companies to account for their marketing practices.  In one example, AstraZeneca has recently paid over $520 million in lawsuits over illegal promotion of off-label use of Seroquel (quetiapine).  A recent Justice Department action against Pfizer led to a $2.3 billion settlement (the largest in Justice Department history) although Pfizer maintains that it did not break the law.

There are no easy fixes for the complex problems that have led to the proliferation of prescription drug misuse in foster care.  Despite recent attempts at passing legislation to oversee the prescribing of medication, the ongoing use of psychotropic medications to control unruly behaviour in foster children seems likely to continue for the foreseeable future.  The long-term consequences of drugging children rather than providing more effective support services seem dire.

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Newton's Revelation

Nature and nature's laws lay hid in night.  God said "Let Newton be!" and all was light!  Alexander Pope

Sir Isaac Newton was a very complex individual.

Not only did he revolutionize physics and mathematics, but he also made groundbreaking contributions in various other areas of science including astronomy and natural philosophy.  His 1687 work Philosophiæ Naturalis Principia Mathematica is still considered one of the most influential books in the history of science.  It's hardly surprising that his scientific contributions have made his name so well-recognized by scientists and the general public alike centuries after his death.  

Perhaps not so well known were Newton's other accomplishments.  His lifelong fascination with alchemy seemed to be a natural extension of his wish to uncover how all things in nature were interrelated.  He was hardly unique in his alchemical research since many prominent intellectuals had been doing the same for centuries.  Still, there was a certain irony in the fact that the scientific revolution that Newton ushered in helped make alchemy obsolete.  Inspired by Elizabethan alchemist, John Dee as well as the Rosicrucians, Newton had one of the most extensive collection of alchemy texts in England.   The full extent of his research into alchemy will likely never be known given that Newton went to great lengths to keep it hidden.  His writings on the subject only surfaced long after his death and many of Newton's biographers tended to dismiss them as being a source of embarrassment for admirers of the great scientist. 

In writing about alchemy, Newton stated that "They who search after the Philosophers' Stone [are] by their own rules obliged to a strict & religious life. That study [is] fruitful of experiments" which certainly fit in with his empirical search for understanding.  There was also a touch of egoism at work since many of his contemporaries were also searching for the Philosopher's Stone (including Robert Boyle) and Newton didn't want one of them to discover it before him.  Considering that much of the laboratory equipment developed by alchemists would later become part of the standard tools for chemists, Newton's research was more practical than it seems today.  Suffice it to say, Newton never succeeded in finding the Philosopher's Stone but his lifelong fascination gave alchemists an added respectability that they might not have had otherwise.  Newton's work in alchemy may also have played a role in his death in 1727.  An autopsy on his body found elevated concentrations of mercury which may explain much of the eccentric behaviour he showed in life.

In his old age, Isaac Newton's interests turned in a new direction: theology.  As with his work on alchemy, many of his theological writings were only published after his death.  While he remained a devout Christian all his life, many of his ideas on religion were frequently at odds with the Church of England (and he might well have been considered a heretic in earlier times).  He railed against purely mechanistic views of the universe and argued that God created the basic rules that governed nature.  He also stressed that the Bible represented the source of all true wisdom and, towards the end of his life, Newton devoted himself to an in-depth examination of the books of Daniel and Revelation.  Although never published in his lifetime (Newton was reluctant to antagonize the powerful Church of England),Newton's Observations on the Prophecies of Daniel and the Apocalypse of St. John was one of his most ambitious works, at least in terms of providing a reasonable chronology for the events described throughout the Bible.  Drawing on other historical sources (such as Flavius Josephus) and using his own peerless mathematical skills, Newton carefully calculated, among other things, the Crucifixion as occurring on Friday, April 23, 34 CE. 

In analyzing the prophetic texts, Newton carefully broke down each book by applying the same principles to Biblical study that he devoted to studying the heavens.  Although some biographers dismissed his attempts as being a "rambling muddle", Newton used information from the book of Ezekiel and the writings of Maimonides to work out the dimensions of Solomon's Temple which he considered to be a key element in understanding Revelation.  He also developed a future timeline based on his knowledge of astronomy and predicted the Second Coming of Christ in 1948 (although the Last Judgment wouldn't occur until around 3370 CE).   Much of Newton's biblical work seemed to focus on hatred for the Catholic Church (which he considered to be the Antichrist) and the eventual coming of the "True Church" after the "Evil One" (Rome) was destroyed.   Part of this hatred of Catholic doctrine stemmed from his opposition to the idea of the Trinity which he considered false.  He also believed in a literal interpretation of Genesis by the way (although he did suggest that the seven days of creation may have been longer than twenty-four hours).  

If his biographers were apologetic about Newton's fascination with alchemy, they were even less accepting of the theological writings that largely consumed the last years of his life.  He always stayed true to the idea that the universe was inherently understandable and that theology, like science, was a reflection of God's meaning and plan for the human race.  As the chief patriarch of the Royal Society (he was known as "Le Grand Newton" across Europe), Newton's scientific reputation was secure enough but he was still reluctant to publish his conclusions about the Bible.  Weeks before his death, Newton burned a collection of papers at his house in Leicester Fields.  While historians dispute whether the papers he burned were historically significant, one witness later suggested that Newton had burned several manuscripts as well.  Considering the eccentric nature of the alchemical and theological works that did survive, it's hard not to wonder what else Newton was afraid would reflect poorly on him after his death.

Isaac Newton died on March 20, 1727 after a brief illness.  After a public funeral, he was buried in Westminster Abbey in what is now known as "Scientist's corner" (which he shares with Charles Darwin and James Clerk Maxwell among others).  A monument standing by one side of the Abbey shows Newton leaning on a pile of four books labeled "Divinity', 'Chronology', 'Optica' and 'Phil Princ. Math'".  His more, unconventional, works aren't mentioned.

Doctors Urged to Routinely Screen Patients for Self-injury

Non-suicidal self-inflicted injuries (NSSI) in adolescents has become the focus on increased media attention with some sources describing it as the "next teen epidemic".  Although the form that NSSI can vary, self-injury is typically defined as the "deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned".  While suicidal intent is often absent, it is statistically linked to suicide and can often lead to unanticipated fatalities or severe injuries.  Empirical research examining NSSI has found that the lifetime incidence of self-injury can range from 12 to 37.2 percent in US secondary school populations with an estimated 6 to 7 percent of adolescents reporting repetitive NSSI in the previous year.  In a recent review published in PLoS Medicine,  a team of Cornell researchers have advocated increased awareness of self-injury in primary care physicians dealing with adolescents.  These physicians are uniquely suited to detect signs of self-injury which may often be concealed by the patient. In the review article, the lead researcher, Janis Whitlock, recommended a five-step strategy for medical professionals to identify self-harming adolescents and arranging appropriate psychological intervention.

In the review, Whitlock adds that ""It is important to translate this research into practice so that clinicians better understand the nature of self-injury and the most effective treatment and prevention strategies since it is a common practice among adolescents,"  In addition to dealing with the underlying emotional problems that may lead to self-harm behaviour, Whitlock views appropriate intervention as an effective means of curbing behaviours that may later lead to suicide.  Specific forms of cognitive behavioural therapy have shown great promise in dealing with NSSI as well as the underlying risk factors (including childhood physical or sexual abuse) that may lead to it.  

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Arizona Man Blames Assault on Epileptic Seizure

A 49-year old Arizona man has been sentenced to a year of probation for an assault which he allegedly committed during an epileptic seizure.  David Stade of Kingman, Arizona was charged with aggravated assault following a March 2008 incident that occurred outside a Kingman truck stop. The victim, a 27-year old Girl Scout troop leader, confronted Stade after she observed him acting suspiciously while the girls in her troop were selling cookies to customers. During the confrontation, the woman was struck several times and sustained a chipped tooth and a black eye.  Bystanders restrained Stade until police arrived and he was arrested.

In his defense, Stade maintained that he suffered an epileptic seizure brought on by stress.  An examination by a Las Vegas neurologist several months after the incident confirmed that Stade suffers from complex partial seizure epilepsy (formerly known as temporal lobe epilepsy due to most cases involving the temporal lobe of the brain) and that he experienced a seizure during the course of the examination.  The seizures are often linked to automatism and amnesia in which sufferers may engage in complex voluntary behaviours with no knowledge of their actions afterward.  Actual forensic cases in which epileptic seizures have been linked to criminal violence remain rare (legal defenses involving automatism are more often associated with sleepwalking cases).  Stade's condition is reportedly linked to inoperable bilateral lesions in his brain and he has undergone surgery to implant a neurostimulator in his brain to control seizure activity. 

While Prosecutor Jace Zack has stated that he is sympathetic to Stade's plight, he maintained that it is still Stade's responsibility to remove himself from any situation in which he might harm another individual.  In making a plea deal with the court, Stade expressed remorse for his actions and has promised to be more vigilant concerning his condition.  He was given credit for nineteen days in jail.

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During the Pandemic

The massive flu pandemic which struck the world following the end of World War I was devastating.  Lasting from 1918 to 1920, an estimated 50 to 100 million people died across the world making it the deadliest epidemic in history.  The pandemic spread to virtually every continent on Earth and was especially lethal to young adults rather than the juvenile or elderly victims of other epidemics.  Triggering a cytokine storm reaction in the human immune system, victims often ended up virtually drowning from the rapid buildup of fluid in their lungs.  Considering that the world population of the time was only 1.6 billion, the 500 million cases worldwide quickly overwhelmed hospitals, doctors, and nurses. 

The epidemic first struck at Fort Riley, Kansas in March, 1918, (possibly jumping to troops from the fort livestock). It quickly spread to France with the American Expeditionary Force before reaching Spain three months later.  By June 29 1918, Dr. Martin Salazar of the Spanish Health Department reported to the Royal Academy of Madrid that there was no available evidence of the epidemic in other countries and "Spanish influenza" became a common nickname.of the disease.  Although it was first viewed as a minor epidemic and news coverage in other countries focused on the war, newspapers in Spain widely reported on the closing of theatres and the suspension of postal and telegraph services.   The King, Prime Minister, and many senior government officials were stricken with the disease and the press became preoccupied with covering the spread of "the soldier from Naples" as the disease was commonly called at first (nobody in Spain liked the "Spanish influenza" label).  

The epidemic in Spain came in three separate waves and the thousands of temporary workers from Spain and Portugal helped carry the disease to other countries.  Despite the economic prosperity brought on by its neutrality during World War I, Spain still had one of the highest death rates in Europe at the time so there was little alarm in the beginning.  Religious festivals were still held and thousands of pilgrims were exposed in the heavy crowds that gathered at the events.  By late August of 1918 when the second wave hit however, the death toll rose to 250 percent above the average for the first part of the year.  Despite some effort at quarantining suspected cases, harvest festivals and feast days for patron saints were still held in villages across Spain.  Dr. Garcia Duran, chief health inspector of Valladolid, traced the beginning of the epidemic in that province to the religious celebration for St. Antolin at the beginning of September.  As he stated, "In the midst of an epidemic, with a seriously ill person in most of the houses, with many families in mourning because of deaths already occurred … and by a majority of votes, the villagers agreed not to suspend the bullfight!".  When it came time for a similar festival in Valladolid, Dr. Duran gave in to pressure and delayed the official start of the epidemic until late September so that the week-long festival could be held. 

As the death toll began to rise, doctors were initially uncertain about the exact nature of the disease and used whatever medical tools they had at their disposal.  Bloodletting was still popular in Spain and was widely practiced.  Doctors also tried treating patients with injections of colloidal solutions of silver and platinum as well as various antitoxins and vaccines for other, better known, diseases.  Regardless of the effectiveness of these different measures, patients and their families were often reassured that the doctors were doing everything possible in treating the epidemic. Security was set up at railway stations across the country with passengers showing symptoms of the flu put into quarantine (the healthy ones were sprayed with disinfectants before being sent on their way).  French and Portuguese borders were closed periodically but never for long. 

Due to the severe shortage of doctors and nurses to treat patients, family members were often left with the burden of caring for patients themselves.  Medical authorities had to battle against unsafe sanitary practices and Church hierarchy to try containing the epidemic.  Churches stayed open throughout the epidemic despite the risks involved in spreading the disease.  In one classic example, the bishop of Zamora blamed the epidemic on "our sins and ingratitude" and called for a week-long series of religious services in honour of the Virgin Mary.  While medical officials protested the dangers of large public gatherings during an epidemic, the bishop later announced that the high public turnout during the vigil was "one of the most significant victories Catholicism has obtained".   Zamora had the highest mortality of all Spanish cities during the epidemic.  In fairness, Church-sponsored institutions also worked diligently in treating patients throughout the crisis.

By the time the third wave of the epidemic hit in 1919, mortality was lower (due to fewer infectious hosts).  Although fatalities continued into 1920, the greatest loss of life occurred between 1918 and 1919 with an official death toll of 165,024.  The breakdown of public health systems across Spain led to drastically higher death rates for all diseases during the epidemic years compared to the non-epidemic years that had gone before,  If you add in non-influenza deaths that can be linked to the epidemic, the death toll rises to 257,082 (12 per thousand).  That death toll almost equals the number of deaths occurring during the Spanish Civil War from 1936 to 1939.  As in the rest of the world, the largest number of deaths occurred in young adults between the ages of 20 to 40 years.  Infants represented the next highest demographic group to show increased fatalities during the epidemic.  Spain already had one of the highest infant mortality rates in Europe at the time but the increased number of infant deaths still represented a 20 percent increase from non-epidemic years.

The economic and social consequences of losing so many young adults in a few short years can't be underestimated. Spain was particularly hard hit due to the loss of thousands of workers in their prime earning years.  The harsh lessons learned during the epidemic were put to use in later outbreaks in 1957-1958 and 1968-9 with far fewer casualties.  The spectre of the Spanish flu epidemic still haunts the world today and is often invoked as new flu strains emerge.  Whatever the future holds remains to be seen.

Sex Differences in PTSD and Hippocampal Stimulation

While epidemiological studies have shown that women have a greater tendency than men to develop posttraumatic stress disorder (PTSD) following traumatic events, the reasons for this difference are not clearly understood.   Despite increasing interest in neurobiological factors in PTSD (including sustained amygdala and skin conductance responses to fear-provoking stimuli), sex differences in neural activations to threat have received little investigation. A study published in a recent issue of the Journal of Abnormal Psychology tested the prediction that trauma would heighten activity in automatic fear-processing networks to a greater extent in women than in men. Functional magnetic resonance imaging (fMRI) data were recorded in 23 participants with PTSD (13 women, 10 men) , 21 trauma-exposed controls (9 women, 12 men) , and 42 non-trauma-exposed controls (22 women, 20 men) while they viewed masked facial expressions of fear. Exposure to trauma was associated with enhanced brainstem activity to fear in women, regardless of the presence of PTSD, but in men, it was associated only with the development of PTSD. Men with PTSD displayed greater hippocampal activity to fear than did women. Both men and women with PTSD showed enhanced amygdala activity to fear relative to controls. Age, depression, and anxiety were ruled out as confounding variables. The authors concluded that greater brainstem activation to threat stimuli may contribute to the greater prevalence of PTSD in women, and greater hippocampal activation in men may be linked to an enhanced capacity for evaluating fear-related stimuli.

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Authorities Rescue 5 Cave-Dwelling Children in Colombia

Emergency service workers near the town of Turmeque, Colombia have reportedly rescued five children who had been living since birth in a series of caves that had been specially dug for them by their father. The children, ranging in age from 8 months to 11 years were described as being frightened by strangers and had virtually no adult contact except for their parents. Three of the children were found lying in one cave, huddling together for warmth, while the two older children were in an adjoining cave. According to Alirio Garzon, a local civil defense volunteer, "Since they had no contact with the outside world, transporting them and washing them wasn’t easy. When we turned on the television, they ran away". One of the children, a two-year old girl, was hospitalized due to malnutrition while the other children are said to be in reasonably good health. They have been placed in the care of the Colombian Institute for Family Well-Being.

The father of the children, who had developed mental problems following an accident years before, is still missing as is the children's mother.  While the actual rescue took place on May 14, information concerning the incident was not made available before this week. According to Turmeque mayor, Maria Ines Osorio, "I'm not the person to comment on the parents' mental state. They did not bring their children to civilization, did not register them nor sent them to school. I do not know if there was a resentment towards society," While authorities are hoping to reunite the children with their parents, there is ongoing litigation directed against the social worker who organized the children's rescue.

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Postconcussive Symptoms in Children

A study published in the March 2010 issue of Neuropsychology examines postconcussive symptoms (PCS) following  mild traumatic brain injury (mTBI) in children.  A sample of 186 children with mTBI and a comparison group with of 99 children with uncomplicated orthopedic injuries (OI), were recruited from two emergency departments (ages ranging from 8 to 15). Parent and child ratings of PCS and symptom counts were obtained within 3 weeks after injury baseline and at 1, 3, and 12 months postinjury. The mTBI group also completed magnetic resonance imaging at baseline. Group differences were examined using growth modeling, controlling for age at injury, sex, socioeconomic status, and for parent-based measures of preinjury symptom levels. Relative to the OI group, the mTBI group had higher ratings of post-concussive symptoms and parent counts of PCS at the initial assessments, but higher parent ratings of cognitive PCS and child counts of PCS throughout follow-up. Higher levels of PCS in the mTBI group were associated with motor-vehicle-related trauma, loss of consciousness, neuroimaging abnormalities, and hospitalization. The findings validate both transient and persistent PCS in children with mTBI and demonstrate associations of symptoms with injury and noninjury factors

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