Inflicted compressional asphyxia of a child

Compressional or traumatic asphyxia is a well recognized entity to most forensic pathologists. The vast majority of reported cases have been accidental. The case reported here describes the apparent inflicted compressional asphyxia of a small child. A review of mechanisms and related controversy regarding proposed mechanisms is discussed.     

Aestheticising Terrorism: Alternative Approaches to 11 September

This paper highlights the methodological difficulties of ascribing causation to events which are to some extent "irrational" and demanding of different forms of understanding — such as those provided in Romantic literature, or poetry, or art. It may be that the scientific urge to systematise diverts analytical attention from debates over values, and from existential complexities in the connections between (say) poverty and violent acts of (imagined) retribution. Official language also proffers distorting metaphors, sanitises facts and impedes the possibility of combating terrorism. "Non-analytical methods" may be essential to analysis.     

Distinguishing Between Legally and Illegally Produced Gold in South Africa

The identification of gold‐bearing material is essential for combating the theft of gold in South Africa. Material seized in police operations is generally a mixture of gold from different mines, and as such cannot be traced back to a single location. ICP‐OES analysis of material dissolved by acid dissolution provided a database of gold compositions comprising gold from South African mines, illegal gold stolen from the mines, and commercial gold alloys and jewelery. Discrimination between legal and illegal gold was possible due to the presence of Pb, As, Sb, Sn, Se, and Te in the stolen material, elements which are not present in legally produced gold. The presence of these elements is a quick and simple way to distinguish between gold alloys based on refined gold, such as in commercially manufactured jewelery, and gold alloys containing a proportion of unrefined and therefore illegally obtained gold.     

Metabolism and toxicological detection of the designer drug N-(1-phenylcyclohexyl)-3-methoxypropanamine (PCMPA) in rat urine using gas chromatography-mass spectrometry

Studies on the metabolism and the toxicological detection of the phencyclidine-derived designer drug N-(1-phenylcyclohexyl)-3-methoxypropanamine (PCMPA) in rat urine are described using gas chromatographic-mass spectrometric (GC-MS) techniques. Based on the identified metabolites, the following metabolic pathways could be postulated: N-dealkylation, O-demethylation partially followed by oxidation of the resulting alcohol to the corresponding carboxylic acid, hydroxylation of the cyclohexyl ring at different positions, and aromatic hydroxylation. The formed metabolites were identical to those of the homologue N-(1-phenylcyclohexyl)-3-ethoxypropanamine (PCEPA) with exception of the mono hydroxyl metabolites of PCEPA. All PCMPA metabolites were partially excreted in conjugated form. An intake of a common drug users' dose of PCMPA could be detected in rat urine by the authors' systematic toxicological analysis (STA) procedure using full-scan GC-MS after acid hydrolysis, liquid-liquid extraction and microwave-assisted acetylation. The STA should be suitable for proof of an intake of PCMPA also in human urine assuming similar metabolism.     

A comparison of hair colour measurement by digital image analysis with reflective spectrophotometry

While reflective spectrophotometry is an established method for measuring macroscopic hair colour, it can be cumbersome to use on a large number of individuals and not all reflective spectrophotometry instruments are easily portable. This study investigates the use of digital photographs to measure hair colour and compares its use to reflective spectrophotometry. An understanding of the accuracy of colour determination by these methods is of relevance when undertaking specific investigations, such as those on the genetics of hair colour. Measurements of hair colour may also be of assistance in cases where a photograph is the only evidence of hair colour available (e.g. surveillance). Using the CIE L^*a^*b^* colour space, the hair colour of 134 individuals of European ancestry was measured by both reflective spectrophotometry and by digital image analysis (in V++). A moderate correlation was found along all three colour axes, with Pearson correlation coefficients of 0.625, 0.593 and 0.513 for L^*, a^* and b^* respectively (p-values = 0.000), with means being significantly overestimated by digital image analysis for all three colour components (by an average of 33.42, 3.38 and 8.00 for L^*, a^* and b^* respectively). When using digital image data to group individuals into clusters previously determined by reflective spectrophotometric analysis using a discriminant analysis, individuals were classified into the correct clusters 85.8% of the time when there were two clusters. The percentage of cases correctly classified decreases as the number of clusters increases. It is concluded that, although more convenient, hair colour measurement from digital images has limited use in situations requiring accurate and consistent measurements.     

Culture,Sustainability, and Medicine in the Twenty-first Century. Re-grounding the Focus of Medicine Amidst the Current “Global Systemic Shift” and the Forces of the Market: Elements for a Contemporary Social Philosophy of Medicine

This article analyzes the role and the status of medicine within the “post-modern” culture(s) of the West. As we know, culture is a major factor that influences the perception, the interpretation, and the expectations toward medicine, medical institutions, medical politics, and the persons involved with them. When culture changes, the social construct called “medicine” changes. Today, the Western condition of “post-modernity” finds itself in a process of rapid change due to the “global systemic shift” that is manifesting since a couple of years within all four main systemic logics and discoursive patterns of Western societies: in culture, religion, politics, and economics. In this situation, the article tries to elaborate on crucial questions about how a contemporary social philosophy of medicine can be delineated within the current “global systemic shift” and what some consequences and perspectives could be. It pleas for an integrative philosophy of medicine which has to strive to re-integrate the “(de) constructivist” patterns of “nominalistic” post-modern thought (dedicated primarily to freedom and equality) with the “idealistic” patterns of “realistic” neo-humanism (dedicated primarily to the “essence” of human dignity and the possibility of intersubjective morality). Only the institution of a balanced “subjective-objective” paradigm can ensure medicine its appropriate place, role, and status within our rapidly changing society.     

Performance regulation in a networked healthcare system: From cosmetic to institutionalized compliance

This article studies the role of a public regulator in managing the performance of healthcare professionals. It combines a networked governance perspective with responsive regulation theory to show the mechanisms that have added to significant changes in medical cost management in the Netherlands. In a five-year period, hospital practices transitioned from cosmetic compliance with performance regulation and strategic upcoding to institutionalized compliance more in line with regulatory goals. The article demonstrates how policy changes transformed incentive structures, introduced new forms of accountability, and added actors to the network with technocratic disciplining tasks. The networked character of performance regulation offered opportunities for a responsive, non-coercive regulatory strategy that engaged various actors in a regulatory conversation about strategic coding. Responsive regulation can reduce strategic responses to performance regulation and manage the gap between administrative and clinical logics. The case study contributes to our understanding of the effectiveness of responsive, non-punitive regulation in networked settings.