Aboriginal women's healing lodge: Challenge to penal correctionalism?

This essay traces the development of a Healing Lodge (capacity 30) for Aboriginal women serving federal prison sentences in Canada. Representatives of Aboriginal bands across Canada shared in the planning of the Lodge, and they will operate it. Situated on Nekaneet land near Maple Creek, Saskatchewan, with no fences, locks, or bars, the Lodge has been designed to facilitate traditional First Nations healing practices. The author explores the contradiction of envisioning a spiritual sanctuary within a penal enterprise: as practiced, state correctionalism is the antithesis of the guiding philosophy of the Healing Lodge. This conundrum is articulated through the examination of a series of contextualizing events in the 1990s related to Canada's Prison for Women (P4W). These include a significant 1990 government report recommending closure of P4W, and a 1995 CBC-TV exposé of brutality against eight women at P4W, four of them Aboriginal. The brutality was committed ‘in the line’ of duty by the Emergency Response Team from the Kingston men's penitentiary. It is concluded that the Healing Lodge cannot de facto resolve the fundamental healing vs. punishment contradiction, but with vigilance it could prove to be a internal challenge to extant penal ideologies.     

Sudden death and Angelman syndrome

Angelman syndrome is a condition characterized by developmental delay due to abnormalities in the maternally derived chromosome 15q11-q13. Typical features include impaired expressive language, an ataxic gait, and seizures. Hyperactivity may result in accidental bruises and abrasions, raising issues of possible inflicted injury. A fascination with water may predispose to drowning. A 5-year-old boy with an established diagnosis of Angelman syndrome is reported who died of upper airway obstruction due to massively enlarged tonsils complicating infectious mononucleosis. Assessment of the severity of underlying illness in developmentally delayed children may be difficult due to failure to vocalize worsening symptoms and distress. In addition, signs of upper airway narrowing due to infection in Angelman syndrome may be masked by the sucking and swallowing difficulties that affected individuals may have with drooling and excessive chewing and mouthing behavior.     

监禁中猝死综合征

监禁中猝死综合征是由于高度紧张或躁动状态下,以及其他因素诸如酒精或其他药物的使用、犯人自身的生理情况、特定的强制性体位等因素共同作用下,发生被监禁人员死亡.由于其发生意外,缺乏特征性的尸检结果和毒物分析结果,而成为法医病理学工作者在法医鉴定实践工作中遇到的一个难题.本文总结了相关的危险因素,如犯人的精神状况、药物的使用、被擒拿时所处的体位以及肥胖等,为有效地预防此类事件的发生和法医鉴定工作提供参考.     

Unexpected perinatal death and sudden infant death syndrome (SIDS): anatomopathologic and legal aspects

This work intends to be a review of the recent histopathological findings elicited by research into sudden and unexpected perinatal death and sudden infant death syndrome (SIDS) that have dictated a novel approach to the inherent problems by pathologists, especially those entrusted with forensic medical authority. The new approach stems from the recent advances made in the understanding of neuro- and/or cardiac-conduction-system diseases present in unexpected perinatal death and SIDS. These demand that an accurate morphologic examination be performed of these structures, which modulate respiratory, cardiovascular, digestive, and arousal activities, in all victims of sudden death. A histopathologic study of an ample register of cases of victims of sudden death, either perinatally or in early infancy, has demonstrated frequent alterations both of the autonomic nervous system (especially hypoplasia of the arcuate nucleus) and of the cardiac conduction system (accessory atrioventricular pathways). The present research provides an in-depth study of the many still-controversial aspects underlying perinatal unexpected death and SIDS and is recommended for professionals working in the forensic field, whose greater insight into this problem will allow more complete medicolegal documentation.     

监禁中猝死综合征

监禁中猝死综合征是由于高度紧张或躁动状态下,以及其他因素诸如酒精或其他药物的使用、犯人自身的生理情况、特定的强制性体位等因素共同作用下,发生被监禁人员死亡。由于其发生意外,缺乏特征性的尸检结果和毒物分析结果,而成为法医病理学工作者在法医鉴定实践工作中遇到的一个难题。本文总结了相关的危险因素,如犯人的精神状况、药物的使用、被擒拿时所处的体位以及肥胖等,为有效地预防此类事件的发生和法医鉴定工作提供参考。     

Sudden infant death syndrome: Histological studies on adrenal gland and kidney

Histological observations were made on the adrenal glands and kidneys in ten cases of sudden infant death syndrome (SIDS). The amount of fetal cortex was excessive in the adrenal glands and many glomeruli of fetal form were observed in the kidneys. These findings suggest that the adrenal glands and the kidneys in SIDS cases are more or less immature in development. The immature development in these organs, especially in the adrenal glands, was considered to play a role in the cardiac or respiratory mechanisms in SIDS.     

Sudden infant death syndrome: diagnostic practices and investigative policies, 2004

Using a 2004 population-based survey of all US medical examiner and coroner offices, we examined the characteristics of offices accepting an infant death case and calculated the percentage of offices that had death scene investigation or autopsy policies for the investigation of sudden unexpected infant death (SUID). We also calculated the percentage of offices that used and did not use sudden infant death syndrome (SIDS) as a cause of death, and we compared differences in characteristics among those offices.Of medical examiner and coroner offices, 52% did not report an infant death in 2004. Of the 7957 infant deaths reported, 43% occurred in jurisdictions that experienced 1 or 2 infant deaths. Of the offices that used SIDS as a classification, 34% did not have policies for conducting death scene investigations and autopsies for SUID. At least 5% of offices that reported an infant death did not use SIDS as a cause of death classification. These findings have important implications for understanding recent trends in SIDS and SUID. Supporting the implementation of national standards for investigating and certifying infant deaths could provide guidelines for consistent practices in medical examiner and coroner offices.     

Simultaneous sudden infant death syndrome: a case report.

The first reported case of simultaneous sudden infant death syndrome (SSIDS) in Allegheny County, Pennsylvania, occurred on February 27, 1998. Two-month-old black fraternal twin girls were both found dead in their crib at the same time. After an in-depth death scene investigation, police investigation, toxicologic analysis, and complete autopsies, a specific cause of death could not be identified. The deaths of the two girls were therefore ruled simultaneous sudden infant death syndrome.     

Sudden infant death syndrome: a subject of medicolegal research

During the last decade, much attention has been paid to the risk factors of sudden infant death syndrome (SIDS). Many researchers have demonstrated that infant-care practices are linked to the risk of SIDS. Prone sleeping, bed sharing, maternal substance abuse, and cigarette smoking have been reported to be significant potentially modifiable risk factors for SIDS. Despite the reports that the incidence of SIDS has decreased by 38% in the United States, it remains the leading cause of death in the first year of life. Deaths resulting from child abuse or neglect inflicted or permitted by their caretakers being second only to SIDS in infant mortalities and some recommendations regarding the differentiation of SIDS and child abuse have generated speculation that some cases of infanticide were misdiagnosed as SIDS. To reach a proper conclusion as to the cause and manner of death of an infant who died suddenly and unexpectedly, investigation must be thorough and professional.     

Pathology of sudden infant death syndrome

This study is based on 15 cases examined by the author. The majority of the infants were found in a prone position. Thymus was enlarged in all cases. Its enlargement of the lower portion overlying the basal portion of the heart formed an unyielding, tense membrane. In prone position, the heavy ventricles fell forward, producing angulation and kinking against this membrane and inhibited the filling of the heart or irritated the heart, producing arrhythmia and cardiac arrest.     

Sudden infant death syndrome in Japan

Two autopsied cases are presented, one involving a 5-month-old infant, and a 6-month-old infant both of whom died suddenly and unexpectedly. The incidence of sudden infant death syndrome in Japan is 1.2 per 1,000 babies live births. Among all cases autopsied in the departments of legal or forensic medicine in 78 universities or colleges of Japan, the incidence was 15 (0.5%) per 3,329 in 1984 and 20 (0.6%) per 3,150 in 1985.     

Nonnatural death masquerading as SIDS (sudden infant death syndrome)

This article relates our experiences with accidental and homicidal deaths in reported sudden infant death syndrome (SIDS) cases. Our intent is to alert personnel in medical and health-related professions as well as death investigators (coroners, law enforcement officials, etc.) that a thorough scene investigation and history need to be obtained when a child's death has been reported, since this may modify the type of autopsy to be performed. It should not be assumed that all children less than 1 year of age who die suddenly die from SIDS.     

Sudden infant death syndrome (SIDS)--standardised investigations and classification: recommendations

Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety of heritable and idiosyncratic endogenous factors interacting with exogenous factors. This has been elegantly summarised in the "three hit" or "triple risk" model. Contradictions and lack of consistencies in the literature have arisen from diverse autopsy approaches, variable applications of diagnostic criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions and protocols will ensure optimal investigation of individual cases and enable international comparisons of trends.     

The differentiation of traumatic and heat-related fractures in burned bone.

Interpretations of antemortem and perimortem trauma are complicated when dealing with cases involving extreme exposure to fire. This investigation attempts to discern the signatures of perimortem trauma from heat related trauma. Femora of domestic pig, sus scrofa, with minimal soft tissue and articulated patellae were subjected to varying traumatic forces. Skeletal elements were impacted with blunt and sharp forces, cut with varying instruments, subjected to torsional forces of shot. Bones were burned in various situations in conjunction with Knox County Rural/Metro Fire Department training exercises conducted in Knox County, Tennessee. Following recovery, fragments were subjected to radiographic, macroscopic, and microscopic analyses. Skeletal elements were reconstructed to permit accurate comparison with pre-fire visual records. In addition, fracture surfaces were examined under both transmitted light and scanning electron microscopy in an attempt to discern surface signatures of the causal fracture (trauma, heat, or situational). Results indicate that signatures of sharp force trauma remain evident following incineration. Furthermore, radiopaque spatter was not observed in any shot specimen. However, these initial findings suggest that the interpretation of blunt force and torsional trauma requires a rigorous examination and comparison of fracture patterns in conjunction with surface morphology.     

Cardiac lesions in sudden infant death syndrome

Sequential morphological changes as found in the hearts of 250 sudden infant death syndrome (SIDS) infants are described. Detailed examination of macroscopic and microscopic lesions reveal that all SIDS infants had identifiable lesions at the time of their death. The lesions can best be described as selective focal anoxic muscle fibre necrosis at chronologically different developmental stages. The extent of these lesions vary markedly from case to case, from a minimal muscle fibre eosinophilia through contraction band formation, myocytolysis, stromal condensation to scar formation. The morphological variations in the lesions amongst individual cases can be interpreted as relating to the time interval of the development of the lesions. The intramural and coronary arteries in some cases are also affected showing intimal hyperplasia. Although these sequential morphological aberrations are not specific and typical to SIDS infants only, they were present in all SIDS infants in this series.     

婴儿猝死综合征的研究现状及其法医学检验

婴儿猝死综合征(dudden infant death s yndrome,SIDS)一直是法医学和儿科学领域的研究热点。相对于北美、欧洲、澳洲以及日本等地对SIDS广泛深入的研究,来自中国的报道相对较少。本文通过总结文献,介绍SIDS的发展历史、研究现状和新的发展趋势,并结合2004年各国学者在美国圣地亚哥公布的SIDS分型,讨论实际检案中需注意的问题以及推进其调查研究的可行性。     

青壮年猝死综合征的研究现状

青壮年猝死综合征（SMDS）是法医学研究的难点之一，其猝死机制尚未阐明。本文从SMDS的流行病学、心脏组织免疫学、心脏电生理、基因学等方面的研究进行综述，以期望为进一步研究获得启示。     

Sudden infant death due to asplenia syndrome

An apparently healthy 80-day-old boy died suddenly for no apparent reason. The autopsy revealed that the patient had had congenital asplenia, extensive cardiovascular anomalies, and other organ malformations, including trisegmented lungs, hypoplasia of the corpus callosum and cranial bones, a symmetrical liver, accessory hepatic tissue in the adrenal glands, malrotation of the intestine, and hypoplasia of the greater omentum.     

Shaken baby syndrome and the death of Matthew Eappen: a forensic pathologist's response

Subdural hemorrhage, retinal hemorrhage, and cerebral edema have been considered diagnostic for a "shaken infant" since the syndrome was described almost 30 years ago. However, the specificity of these findings has been disputed by defense witnesses in recent U.S. criminal prosecutions. This review examines the scientific basis for the shaken baby syndrome.     

Cardiac rhabdomyoma presenting as sudden infant death syndrome

A case of cardiac rhabdomyoma presenting as sudden infant death in a four-and-one-half month-old infant is reported. The child was the product of an essentially uncomplicated pregnancy and enjoyed good health before his unexpected, sudden death. Autopsy examination revealed the presence of multiple cardiac lesions which histologically were diagnosed as rhabdomyomas. Death was attributed to fatal cardiac arrhythmia caused by the tumor. To the authors' knowledge this represents the first reported case in the forensic science literature of death as a result of cardiac rhabdomyoma presenting as sudden infant death syndrome (SIDS).