History of Traumatic Abuse and HIV Risk Behaviorsin Severely Mentally Ill Substance Abusing Adults

Epidemiological studies in the United States estimate HIV seroprevalence rates ranging between 4% and 23% for serious mentally ill adults (SMIA; i.e., schizophrenia, bipolar disorder, and other chronic disorders with psychotic features), with substantially greater estimates for risky sexual behaviors. Among the most consistent factors linked to HIV risk in non-SMIA populations is a history of emotional, physical, or sexual abuse. The current study examined the intersection of abuse history and HIV sexual risk behavior in SMIAs with a group of men (n = 64) and women (n = 115) recruited from eight geographically diverse and representative clinical sites around Florida. A cross-sectional interview revealed a high prevalence of alcohol and other drugs problems, as well as a history of emotional, physical, or sexual abuse in 75% of the participants, with 68% of these reporting multiple types of abuse. Compared to nonabused counterparts, those with a history of abuse reported significantly greater: (a) lifetime and current psychiatric symptoms, (b) recent unprotected sexual intercourse, and (c) crack cocaine, heroin, and marijuana use. No gender differences were detected in the associations of abuse history and sexual risk behaviors. These results underscore the need for HIV prevention efforts targeted to SMIAs and the critical importance of addressing abuse history in interventions with this underserved population.     

Depression, responsibility, and criminal defenses

The concepts of voluntary action, agency, free will, and responsibility, while central to moral and legal institutions, are generally poorly understood. Philosophers of law such as H.L.A. Hart, Joel Feinberg, and Robert F. Schopp have contributed significantly to understanding of these concepts through their work on the foundations of criminal defenses, including excuses based on mental illness. In this paper, I summarize and present their valuable insights, in the context of an argument (influenced by personal experience) that clinical depression, even when non-psychotic, may in some cases constitute a legitimate excuse for criminal or otherwise immoral failures to act.     

Alprazolam-related deaths in Palm Beach County

Alprazolam is a commonly prescribed benzodiazepine. The abuse of benzodiazepines is most frequently seen in conjunction with the abuse of other drugs. Only rare fatalities have been attributed to alprazolam alone. We undertook a retrospective review of cases investigated by the Palm Beach County Medical Examiner's Office in which postmortem toxicologic studies indicated the presence of alprazolam, to further study the pattern of alprazolam abuse. Our review consisted of 178 cases, including 87 in which death was attributed to combined drug toxicity, 2 to alprazolam toxicity alone, 44 to trauma, 12 to natural causes, and 33 to another drug or drugs. Cocaine and methadone were the most common cointoxicants in the cases of combined drug toxicity, while heroin was less frequently detected. There was considerable overlap in the postmortem blood alprazolam concentrations among the groups. The overlapping ranges of concentrations of alprazolam detected indicate that it may be difficult to define a lethal alprazolam range, and that it may not be possible to determine the actual role of alprazolam as a causal factor in cases of combined drug toxicity. This study confirms that alprazolam alone is rarely a cause of death, and that alprazolam abuse usually occurs within a polydrug use pattern. The high incidence of cocaine as a cointoxicant has not been previously reported.     

Victim of a dictatorial regime: identification of Mr. Roberto Gomensoro Josman

Forensic cases are ideal to test osteological techniques developed by physical anthropologists. Forensic anthropology is a scientific discipline that applies population-based standards to individual skeletal remains. Many complex techniques are used in an attempt to make a positive identification. Several of these techniques, specifically digital video superimposition and DNA, were used to identify the victim in this case. The purpose of this paper is to describe anthropological techniques used to identify the remains of an unknown person who was later identified as Mr. Roberto Gomensoro Josman, the victim of a Uruguayan dictatorial regime. Mr. Gomensoro Josman disappeared after authorities of the Uruguayan dictatorial government (1973-1984) arrested him. Six days later an unknown body was found floating in Lake Rincon del Bonete. The corpse was found tied with wire and weighted with three large stones used to keep the body submerged. An autopsy was performed and the body was buried as an unknown person in the grave identified as number 10936 of Tacuarembo Cemetery. On December 2002 the Peace and Justice Service asked the local judge to authorize the exhumation of the remains. The exhumed body was headless. An investigation revealed that the local medical examiner who had autopsied the remains on March 1973 had retained the victim's skull in his office. Osteological analysis indicated the victim was a white male in his 20s. Four good quality photographs of Mr. Gomensoro who was known to be missing were compared with the skull. To confirm the identification from the video a DNA analysis was carried out comparing the victim with relatives. DNA typing confirmed the results of the earlier identification.     

Inference of human geographic origins using Alu insertion polymorphisms

The inference of an individual's geographic ancestry or origin can be critical in narrowing the field of potential suspects in a criminal investigation. Most current technologies rely on single nucleotide polymorphism (SNP) genotypes to accomplish this task. However, SNPs can introduce homoplasy into an analysis since they can be identical-by-state. We introduce the use of insertion polymorphisms based on short interspersed elements (SINEs) as a potential alternative to SNPs. SINE polymorphisms are identical-by-descent, essentially homoplasy-free, and inexpensive to genotype using a variety of approaches. Herein, we present results of a blind study using 100 Alu insertion polymorphisms to infer the geographic ancestry of 18 unknown individuals from a variety of geographic locations. Using a Structure analysis of the Alu insertion polymorphism-based genotypes, we were able to correctly infer the geographic affiliation of all 18 unknown human individuals with high levels of confidence. This technique to infer the geographic affiliation of unknown human DNA samples will be a useful tool in forensic genomics.     

Population data for 12 Y-chromosome STRs in a sample from Brescia (northern Italy)

Twelve Y-chromosome STRs--DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393, DYS385, DYS437, DYS438, DYS439--were typed in a population sample (n=104) of unrelated males from Brescia (northern Italy). A total of 91 haplotypes were identified by the 12 Y-STR loci. The haplotype diversity (98.68%), discrimination capacity (87.50%) and gene diversity were calculated.     

The effect of the burial environment on adipocere formation

Adipocere is a decomposition product comprising predominantly of saturated fatty acids which results from the hydrolysis and hydrogenation of neutral fats in the body. Adipocere formation may occur in various decomposition environments but is chiefly dependent on the surrounding conditions. In a soil burial environment these conditions may include such factors as soil pH, temperature, moisture and the oxygen content within the grave site. This study was conducted to investigate the effect of these particular burial factors on the rate and extent of adipocere formation. Controlled laboratory experiments were conducted in an attempt to form adipocere from pig adipose tissue in model burial environments. Infrared spectroscopy, inductively coupled plasma-mass spectrometry, and gas chromatography-mass spectrometry were employed to determine the lipid profile and fatty acid composition of the adipocere product which formed in the burial environments. The results suggest that adipocere can form under a variety of burial conditions. Several burial factors were identified as enhancing adipocere formation whilst others clearly inhibited its formation. This study acts as a preliminary investigation into the effect of the burial environment on the resultant preservation of decomposing tissue via adipocere formation.     

Dancing on the head of a pin? Foetal life and the european convention

The case of Vo v. France represents the latest phase of the European Court of Human Rights’ thinking on the scope of Article 2 of the European Convention on Human Rights (the right to life) in relation to foetal life where a foetus had been lost owing to a medical accident. The Court by a majority decided that, “even assuming” Article 2 applied to the instant case (albeit to the life of the pregnant woman rather than that of the foetus), it had not been violated. While the facts in Vo were extreme and exceptional, the Court will shortly hear the case of D v. Ireland concerning access to abortion for foetal anomaly, an application made under Articles 3, 8, 10 and 14 of the European Convention. If the case of D were declared admissible, the Court would then have to consider whether a denial of access to abortion for foetal anomaly constitutes inhuman and degrading treatment contrary to Article 3, or an interference with a pregnant woman’s right to respect for private life under Article 8 (and if so, how the doctrine of the margin of appreciation applies). The Grand Chamber precedent of Vo displays ambivalence about whether Article 2 should apply to foetal life, and its resort to the “even assuming” formula spared Member States the difficulty of having to justify their various abortion regimes, by reference to this Article. It remains to be seen whether in a case like D that is directly concerned with abortion, the Court will take a more definite stance on the correct balance to be struck between the State’s interest in protecting foetal life and the Convention rights of pregnant women. Vo v. France [G.C.], judgment of 8th -July 2004, no. 53924/00; D v. Ireland [4th section], no. 26499/02, oral hearing on admissibility and merits, 6 September 2005