The role of beta-amyloid precursor protein (beta-APP) staining in the neuropathologic evaluation of sudden infant death and in the initiation of clinical investigations of subsequent siblings

This report highlights the importance of undertaking immunohistochemical staining of the brains of infants who die unexpectedly, as it may not only assist with the evaluation of the cause of death in an individual infant but may also help with the clinical management of subsequent siblings. A 5-month-old male infant who died suddenly was found to have diffuse beta-amyloid precursor protein (beta-APP) staining in the brain, with no unusual features in his history, death scene examination, routine autopsy dissection, and ancillary tests to suggest any definite cause of death. Due to the beta-APP staining, the possibility of previous episodes of occult trauma, apparent life threatening events (ALTEs), and accidental or inflicted suffocation was raised in the autopsy report. As detailed analyses and investigations provided no supportive evidence for trauma or inflicted injury, hypoxia was clinically considered the most likely cause. Because of these concerns, sleeping oxygen saturation levels were monitored following the birth of a subsequent sibling who had normal APGAR scores and no evidence of any health problems. Oxygen desaturation to 70% occurred in association with a color change while on the postnatal ward, and a subsequent polysomnogram showed multiple episodic significant desaturations to around 80% in association with central apnea. Other testing was unremarkable. These cases demonstrate that beta-APP staining of the brain may not only provide clues as to possible mechanisms of death in pediatric forensic cases but may indicate a need for careful clinical evaluation of subsequent siblings for possible central apnea requiring oxygen therapy.     

Substituting a judgment of best interests: dignity and the application of objective principles to PVS cases in the U.K

The mêlée that surrounded the last days of Terri Schiavo's life was reminiscent of a classical Greek tragedy. Much like Antigone, Ms. Schiavo became enmeshed in irresistible and opposite forces, resolved to use her situation as an arena for the determination of political and legal issues as diverse as the exercise of states' rights, the extent of individual rights, the role of the judiciary, the re-opening of the abortion debate, and the regulation of stem cell research. As Europeans watched the drama unfold, the forces at play in the United States clashed head-on, in a rhetorically inflammatory spectacle which, on this side of the Atlantic, left many aghast. Most unsettling was the prospect of individuals wielding the power of state and national legislatures in what was, ultimately, an intensely personal affair. In the United Kingdom, the struggle was a stark reminder of the differences, not only between British and American political culture, but between our approaches to legal issues which present themselves at the end of life. The existence of well-established procedures and principles, and the extensive involvement of neutral third parties and the courts in pursuit of an objective determination of an individual patient's 'best interests', are key to the conclusion that Terri Schiavo's case would have been handled at least as effectively and efficiently as it was by the courts in Florida and the United States. That issues of consent and capacity can be determined by British courts on the basis of generally applicable principles leads to the subsequent conclusion that a 'best interests' determination leaves significantly less scope for conflict than the individualistic, much more personal and determinative construct of the 'substituted judgment' test in the United States.     

Liberal Nationalism and Cultural Rights

Liberal nationalists such as Yael Tamir and Will Kymlicka have argued for an extravagant range of cultural rights based on respect for individual autonomy. I present an alternative account of the moral import of liberal autonomy for the status of cultural minorities. The article examines three pivotal aspects of Tamir's argument for cultural rights and argues that, in each case, Tamir's position fails to honour the value of individual autonomy, and in ways parallel to Kymlicka's argument. These shared difficulties point to some basic ontological and moral properties of a genuine autonomy-based defence of cultural rights.     

A method for calculating the strength of evidence associated with an earwitness's claimed recognition of a familiar speaker

The present paper proposes and demonstrates a method for assessing strength of evidence when an earwitness claims to recognize the voice of a speaker who is familiar to them. The method calculates a Bayes factor that answers the question: What is the probability that the earwitness would claim to recognize the offender as the suspect if the offender was the suspect versus what is the probability that the earwitness would claim to recognize the offender as the suspect if the offender was not the suspect but some other speaker from the relevant population? By “claim” we mean a claim made by a cooperative earwitness not a claim made by an earwitness who is intentionally deceptive. Relevant data are derived from naïve listeners' responses to recordings of familiar speakers presented in a speaker lineup. The method is demonstrated under recording conditions that broadly reflect those of a real case.     

Transitional narratives of identity among ethnic minority youth gangs in Denmark: from collectivism to individualism

Current literature often depicts the street cultures of ethnic minority youth as forms of collective cultural resistance to experiences of marginalization from mainstream society. Based on ethnographic fieldwork and qualitative interviews in 2014 with 23 young men attached to a rehabilitation centre for criminal offenders in Denmark, this article focuses on ethnic minority youth who desist from such street culture and their former gang life, criminality and drug use and how they describe this shift within their narratives. More specifically, we show how this shift can to some extent be characterized by a move from collective to more individualistic self-narratives re-articulating broader individualistic discourses existing in contemporary society. Among these more individualistic self-narratives, we find extensive reference to ideas of self-responsibility and also individual pragmatic interpretations of Islam. Such re-articulations can be seen as a way to create feelings of agency in severely disempowering circumstances.