List of Contributors Preface xix Chapter One: The new Medical Examiner System in England and Wales: its role in the medicolegal investigation of death 1 Introduction 1 Background 2 Structure and function of the Medical Examiner system in England and Wales 7 Medical Examiners 9 Medical Examiner Officers 11 How does a Medical Examiner Service work? 12 Relationships with other teams supporting the deceased and bereaved 16 Conclusion 16 References 17 Chapter Two: Who makes false allegations and why? The nature, motives, and mental health status of those who wrongly allege sexual assault 21 The nature of false allegations 21 Deliberate fabrication 22 Inadvertent allegations 27 Conclusion 33 References 34 Chapter Three: Disclosure of evidence in sexual assault cases 41 Introduction 41 Definition and interpretation 42 Disclosure and the medical professional 44 The Court of Appeal judgements in the context of forensic and legal medicine 49 Conclusion 51 References 52 Chapter Four: Current perspectives on the type and use of weapons used to police public assemblies around the world 55 Introduction 55 Less- lethal weapons 59 Kinetic impact projectiles 65 Conclusion 73 Acknowledgement 73 References 74 Chapter Five: Non- fatal strangulation 81 Introduction 81 Non- fatal strangulation and intimate- partner violence 81 Legal status of non- fatal strangulation 82 Non- fatal strangulation and assault 83 Symptoms and signs of non- fatal strangulation (acute and longer term) 86 Examples of findings and descriptions of NFS assaults 97 Management of non- fatal strangulation 104 Radiological imaging in non- fatal strangulation 104 Conclusion 106 References 106 Chapter Six: DNA: current developments and perspectives 109 Introduction 109 STR improved autosomal multiplexes used for criminal justice 110 Rapid DNA 113 DNA mixtures 116 Massively parallel sequencing 119 Forensic DNA phenotyping 124 Forensic genealogy 132 Conclusion 135 References 135 Chapter Seven: The utility of forensic radiology in evaluation of soft tissue injury 143 Introduction 143 Limitations 145 Types of cross- sectional radiological imaging 147 Types of injury 148 Injury patterns and causation 157 Gunshot injuries 160 Ligature soft tissue injuries 160 Conclusion 163 References 163 Chapter Eight: Abusive head trauma in children - a clinical diagnostic dilemma 167 Definitions 167 A brief history 168 Current hypothesis on the development of subdural haemorrhage, retinal haemorrhage, and hypoxic-ischaemic encephalopathy in AHT 170 The presentation and diagnosis of AHT 170 The development of a controversy 171 Clinical medicine and the medical diagnosis 173 Alternative hypotheses 173 Short- distance falls 174 The circular argument 175 Confession evidence 176 The missing biomechanical model 176 The clinician''s approach to a diagnosis of AHT 177 Terminology 179 Conclusion 182 References 182 Chapter Nine: The ageing population: needs and problems of the older person in prison 187 Overview 187 Introduction 187 Health and social care needs of older people in prison 188 Key steps in addressing the needs of the older person in prison 196 Where next? 201 References 201 Chapter Ten: Fitness to plead and stand trial - from the Ecclesfield Cotton Mill dam to Capitol Hill 205 Introduction 205 The application of the Pritchard test in England and Wales 212 Physical illness or disability and fitness to plead and fitness to stand trial in England and Wales 215 Related provisions in some other common law jurisdictions 215 A practical approach to assessment 220 Conclusion 220 Acknowledgements 221 References 221 Law reports 222 Chapter Eleven: Quality standards for healthcare professionals working with victims of torture in detention 225 Introduction 225 Why were quality standards needed? 226 Prevalence of torture 226 Clinical consequences of prior torture 226 Methods of torture 226 Detention in the United Kingdom and risks for patients'' health 228 Effects of detention on victims of torture 229 Professional responsibility 230 Outcomes 230 Conclusions 235 References 236 Chapter Twelve: A forensic approach to intimate partner homicide 239 Introduction 239 The ''crime of passion'' discourse 241 Coercive control discourse 242 Medical narratives and discourse 243 IPH and IPA as expert knowledge 244 Response practices 245 Conclusions 249 References 250 Chapter Thirteen: Non- lethal physical abuse in the elderly 253 Failure to diagnose 254 The ageing process 254 Acknowledgement 275 References 276 Chapter Fourteen: Physical intervention and restraint 279 Introduction 279 The organisational approach to managing challenging behaviour, aggression, and violence 279 Minimising the risk of injury and death 281 Use of force in therapeutic environments 282 The use- of- force hierarchy 282 Organisational approaches to managing challenging behaviour and violence 283 Physical interventions in other (non- policing) environments 284 The range and risks of physical interventions 286 Conclusions 291 Acknowledgement 292 References 292 Chapter Fifteen: Medical and toxicological aspects of chemical warfare: the nature, classification, and management of chemical agents used in warfare 293 Introduction 293 OPCW and control and schedules 294 Hazard/threat assessment 294 Environmental indicators and detection overview 294 Bioanalytical detection overview 295 Classes of chemical weapons and casualty management 297 Pulmonary agents: chlorine and phosgene 305 Asphyxiants: cyanide and hydrogen sulphide 309 Blistering agents/vesicants: sulphur mustard chlorine and lewisite 311 Other chemical warfare agents 315 Opiates and opioids 317 Perfluoroisobutene (PFIB) 319 Bioregulators 320 Endorphins and enkephalins 321 Neurokinins, including substance P 321 Endothelins 321 Bradykinin 322 Angiotensin 322 Neurotensin 322 Other Bioregulators 323 Summary 323 References 323 Index 327.