Homicide by decubitus ulcers

Traditionally, the only penalties for poor treatment of nursing home patients have been civil lawsuits against nursing homes and their employees by families, or fines and license suspension by government organizations. Recently, government agencies have become much more aggressive in citing institutions for the development of decubitus ulcers (pressure sores) in their patients. A few government institutions have concluded that in some cases, the development of ulcers with resultant death is so grievous that there should be criminal prosecution of the individuals and/or institutions providing care. A leader in this concept has been the State of Hawaii. In November 2000, the State of Hawaii convicted an individual of manslaughter in the death of a patient at an adult residential care home (a form of nursing home) for permitting the progression of decubitus ulcers without seeking medical help, and for not bringing the patient back to a physician for treatment of the ulcers.     

Symmetrical fracturing of the skull from midline contact gunshot wounds: reconstruction of individual death histories from skeletonized human remains

This paper reports a bilaterally symmetrical cranio-facial fracture pattern that is observed in self-inflicted, midline gunshot wounds. Five cases of self-inflicted gunshots wounds are presented as follows: two high-powered rifle cases, two shotgun cases, and one handgun case. In all five cases the remains were either decomposing or skeletonized and submitted to forensic anthropologists. Following identification, the main focus of the anthropological examination was the analysis of perimortem trauma to the skeleton. In each case, the skull was submitted in a highly fragmented state. Nevertheless, by focusing on the pattern of perimortem cranio-facial fractures, the anthropologists contributed key information regarding the circumstances of death. The observed symmetrical cranio-facial fracture patterns in the above cases are described in detail and interpreted. The specific location of the linear fractures is discussed, as well as the theoretical rationale behind the location in terms of skeletal architecture, such as buttresses, struts, and sutures. The interpretive framework provided by this paper may prove helpful to others who are faced with similar cases of cranio-facial fracturing.     

Testing for GHB in hair by GC/MS/MS after a single exposure. Application to document sexual assault

Gamma-hydroxybutyric acid, or GHB, is a substance naturally present within mammal species. Properties of neurotransmitter or neuromodulator are generally given to this substance. GHB is therapeutically used as an anesthetic, but can be used for criminal offenses (date-rape drug). It appears that the window of detection of GHB is very short in both blood and urine, and therefore its presence is very difficult to prove after a rape case. In order to document single exposure, we investigated the use of hair. Hair was collected one month after the allegated event in order to sample the corresponding period after regular growing. After rapid (2 min) decontamination with dichloromethane, the hair shaft was cut into 3-mm segments. They were overnight incubated in 0.01 N NaOH in the presence of GHB-d6, followed by neutralization and extraction in ethyl acetate under acidic conditions. GHB (precursor ion m/z 233, product ions m/z 147 and 148) was tested by GC/MS/MS (Finnigan TSQ 700) after derivatization with BSTFA + 1% TMCS. Physiological concentrations (n = 24) were in the range 0.5 to 12.0 ng/mg, with no influence due to hair color. No variation of concentrations was observed along the hair shaft in controlled subjects, except for the proximal segment, due to an incorporation through sweat. This demonstrates that endogenous levels for each single subject are constant during hair growth. A controlled human administration of 25 mg/kg to a volunteer demonstrated that a single exposure to GHB is detectable in hair after segmentation. In a case of rape under influence, a clear increase of the corresponding segment (about 2.4 ng/mg) in time was observed, in comparison with the other segments (0.6 to 0.8 ng/mg). This study demonstrates that a single exposure to GHB in a case of sexual assault can be documented by hair analysis when collected about one month after the crime.     

Where to Begin?

If what goes on in human societies are viewed as "institutionalfacts"rather than "brutefacts," then basic issues are raised withregard to the meaning of federalism. Institutional facts areconstituted by reference to rules and rule-ordered arrangements.Such arrangements turn upon design concepts and their placein the constitution of order in human societies. Constitutingsocieties through patterns of covenantal relationships impliesthat federal societies cannot be understood by placing primaryreliance on forms of government. The question "where to begin?"raises basic ontological and epistemological problems bearingon the place of language and culture in the constitution ofcovenanting societies.     

L'information administrative au Québec: faits et interprétations

Sommaire. L'information administrative. dans nos sociétés. sodre de failles diverses. Une recherche, faite pour le compte du Ministère des Communications du Québec, a voulu éclairer ces failles en vue de les corriger. La principale composante de la recherche a consisté en 78 entrevues de groupe conduites auprès de hauts-fonctionnaires, de fonctionnaires de contact, et de clients privilégés de différentes entités administratives. De plus, 17 experts de différentes disciplines se réunirent pendant deux jours avec des fonctionnaires du Ministère des Communications et d'autres ministères pour tenter d'interpréter et de situer dans des contextes plus larges les problèmes de l'information administrative. Après avoir défini l'information administrative d'après un schéma de la communication empruntéà Roman Jakobson, l'article fait état des principales constatations qui ont été faites lors de la recherche. Ensuite sont présentées les diverses interprétations proposées par les experts: interprétations psychologiques, interprétations en termes de techniques de la communication, interprétations micro-économiques, et interprétations en termes de pouvoir. Les forces et les faiblesses de ces interprétations sont évaluées, après quoi est esquissée une analyse structurale, où l'insistance est mise sur la capacité qu'ont les acteurs d'imposer les contacts par où passe l'information administrative. Il est montré en conclusion comment cette analyse structurale permet d'intégrer les interprétations proposées par les experts, et comment elle pourrait être améliorée dans des recherches subséquentes. Abstract. Administrative information, in our societies, suffers from various shortcomings. A research project undertaken on behalf of the Quebec Department of Communications has tried to focus on these weaknesses in order to eliminate them. The main element of the research was 78 group interviews with senior officials, ‘contact’ civil servants, and privileged clients of various administrative entities. Furthermore, 17 experts in various disciplines met for two days with officials of the Department of Communications and other departments in an attempt to interpret and place in broader contexts the problems of administrative information. Administrative information having been defined according to a communication grid borrowed from Roman Jakobson, this article states the various facts established by the research. Then, the various interpretations offered by the experts are presented: psychological interpretations, interpretations in terms of communication techniques, micro-economic interpretations, and interpretations in terms of power. Strengths and weaknesses of these interpretations are evaluated, and then a structural analysis is attempted; it focuses on the actors' ability to impose the contacts channelling administrative information. In conclusion it is shown how this structural analysis allows an integration of the interpretations proposed by the experts and how it could be improved with further research.     

The relationship of observed maternal behavior to questionnaire measures of parenting knowledge,attitudes, and emotional state in adolescent mothers

Although relationships have been found between maternal psychological characteristics and cognitive and emotional outcomes in children, the behaviors which may mediate these relationships are seldom examined. This is especially true for adolescent mothers, whose children are thought to be at high risk for adverse outcomes. In this study, adolescent mothers in two special programs completed questionnaires measuring perception of the newborn (Neonatal Perception Inventory), knowledge of influences on child development (Infant Caregiving Inventory), and emotional state (General Health Questionnaire); they were also systematically observed while interacting with their infants in a naturalistic situation. Specific maternal behaviors were found to vary with the age of the mother and of the baby. Mothers with neutral or negative perceptions of their infants touched them less than did mothers with positive perceptions. Degree of emotional disturbance was inversely related to the amount of time that the mother looked at her infant while in physical contact.This research was supported in part by NIH Biomedical Research Support Grant No. BRS 507 RR 05445-19 to Johns Hopkins University School of Hygiene and Public Health.Received her Sc.D. in mental hygiene (comparative behavior) from Johns Hopkins University. Main interests include relationships between observable behavior and reported psychological states, and behavioral and emotional disorders of children.Received her Ph.D. in population dynamics from Johns Hopkins University. Main interests are adolescent health and pregnancy and population changes influencing perinatal health.Received her Ph.D. in psychology from George Peabody College. Main interests include parenting of infants and children's rights.Received her Ph.D. in anthropology from the University of Florida. Main interests include adolescent health and utilization of health services by children and adolescents.Received his Ph.D. in child psychology from the University of Iowa. Main interests are infant and child development, with focus on measurement of developmental status and its determinants.