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A forensic mental health report is requested in about 30% of more serious cases presented to the criminal court. These reports can be used at sentencing and advise the judge on criminal responsibility, recidivism risk, and possible treatment measures, but is not a formal factor in decisions about guilt. The current study focuses on the (unwarranted) effect of forensic mental health information on conviction decisions. Using an experimental vignette study among 155 criminology students, results show that when a mental disorder is present, conviction rates are higher than when such information is absent. In line with the story model of judicial decision-making, additional analyses showed that this effect was mediated by the evaluation of guilt rather than by the evaluation of other physical evidence. Implications for further research and practice are discussed.

Persistent infections with high-risk Human papillomavirus (HPV) can lead to cervical cancer. This fact could imply that vaccination against HPV could prevent this disease. Such vaccines could be aimed at the prevention of HPV infections or the treatment of infections, cervical intraepithelial neoplasia (CIN) and cervical cancer. There are two prophylactic candidate vaccines against the high risk HPV types 16 and 18, which appear to be safe and effective in preventing incidental and persistent HPV infections. Phase III studies should reveal whether these vaccines will also have long-term effects by preventing the development of CIN and eventually cervical cancer. The introduction of such an HPV vaccine in the Netherlands, its cost-effectiveness and introduction into the existing national vaccination programmes needs to be studied. The vaccination of girls before they become sexually active seems to be the most effective approach, although older women can also profit from prophylactic vaccination. The current community-based screening, possibly complemented by an HPV test, needs to be continued to identify and treat presently HPV-infected women. In a population with an existing community-based screening program for cervical cancer, a vaccine preventing persisting infection with high-risk HPV will further reduce the incidence of HPV-related cervical cancer.

To describe the transmission of hepatitis C virus (HCV) in a dialysis centre in the Netherlands, to analyse risk factors and to redefine additional preventive measures.Descriptive.The data of patients attending the dialysis centre of the Deventer Hospital, the Netherlands, who had participated in a national prospective survey on the epidemiology of HCV among Dutch dialysis patients, were examined. In addition, patients who developed signs of hepatic failure in the ensuing year were included in this study. To diagnose an HCV-infection serology as well as polymerase chain reaction were used. Genotyping and sequence analysis were used to assess phylogenetic relations. Infection control practices were audited.In the dialysis centre a cluster of four almost identical HCV isolates genotype 2a was found. Within a period of one year another cluster of four HCV-infected dialysis patients was detected in the same centre. These four isolates were almost identical to a fifth isolate, genotype 2b, found in the earlier study from another patient dialysing in the same unit. It was observed that possibly contaminating procedures were not strictly separated. Some of the shared medical equipment was not sterilised but only cleaned. Also blood-contaminated gloves might have played a role in the transmission of HCV.Nosocomial transmission plays an important role in the epidemiology of HCV in dialysis patients. Shared medical equipment and blood-contaminated gloves may constitute a potential route of transmission. There is a need for stringent implementation and regular auditing of infection control measures.

To investigate the possibility of detecting melanoma metastases using molecular biological techniques in patients with a primary malignant melanoma.Descriptive.Reinier de Graaf Gasthuis Hospital Delft and diagnostic centre SSDZ Delft, the Netherlands.A melanoma specific tyrosinase mRNA was amplified using the reverse transcriptase polymerase chain reaction (RT-PCR) technique.A total of 23 sentinel nodes derived from 9 patients were examined. In 14 sentinel nodes metastases were found using RT-PCR. In microscopic slides stained with haematoxylin and eosin (HE) melanoma metastases were found in 2 sentinel nodes of 2 patients. With immunohistochemistry melanoma metastases were found in the same 2 sentinel nodes.It is possible to detect melanoma metastases in sentinel nodes using molecular biological techniques.