A functional approach to sudden unexplained infant deaths

There is a great deal of variation in the methods and wording used by medical examiners in the medicolegal investigation and certification of infant deaths. This paper was created by the NAME Ad Hoc Committee on Sudden Unexplained Infant Death to address several specific issues, namely: * To establish a functional approach to the investigation of sudden unexplained infant deaths; * To outline a "bare minimum" set of recommendations to define the scope of investigation required; * To recommend methods and wording to be used when certifying infant deaths; * To develop a list of potential stressors or possible external causes of death that should be identified and reported on the death certificate and/or within a medical examiner/coroner office database. This paper was electronically posted for NAME member review and comment for a period of 30 days. The paper was further revised based on member comments and then submitted to the NAME board of directors in the fall of 2005 prior to the annual meeting. This text of this paper was officially approved and endorsed by the NAME board of directors on October 14, 2005, at the annual meeting in Los Angeles, CA.     

Acute pancreatitis presenting as sudden, unexpected death: an autopsy-based study of 27 cases

Acute pancreatitis represents a spectrum of disease, ranging from a mild, transitory illness to a severe, rapidly progressive hemorrhagic form, with massive necrosis and mortality rates of up to 24%. The reported incidence of acute pancreatitis diagnosed first at clinicopathologic autopsy ranges between 30% and 42%. To better describe outpatient fatalities due to acute pancreatitis that present as sudden, unexpected death, we retrospectively reviewed the autopsy files at the Institute of Legal Medicine, University of Hamburg, Germany, from 2000-2004. Individual cases were analyzed for sex, age, race, circumstances of death, social background of the deceased and previous medical history, seasonal occurrence of the disease, blood alcohol concentration at the time of death, body mass index, autopsy findings, histopathology, and etiology of acute pancreatitis. Among the 6178 autopsies carried out during the 5-year period evaluated, there were 27 cases of acute pancreatitis that presented as sudden, unexpected death. In all cases, the diagnosis was first made at autopsy. The male:female ratio was 1.7:1 and the mean age was 52 years (range, 30-91 years). Etiologies of acute pancreatitis included alcohol (n=19), gall stones (n=2), other identified etiologic factors (n=3), and idiopathic (n=3). Complications of acute pancreatitis included lung edema and/or acute respiratory distress syndrome, peritonitis, disseminated intravascular coagulation, and sepsis. At least 20 subjects (74%) had lived isolated, with no social contacts. Contrary to the clinical observations of a clear seasonal variation in the onset of acute pancreatitis, we found no correlation between death due to acute pancreatitis and a specific month or season. Many prior studies have suggested that the majority of deaths in severe acute pancreatitis occur in the late phase of the disease as a result of pancreatic sepsis. Conversely, in the present study, the majority of affected individuals died during the very early phase of the disease. While gallstones represent the main etiologic factor in most larger clinical series, biliary etiology seems to play only a minor role in outpatient deaths undergoing medicolegal autopsies. Data derived from medicolegal autopsy studies should be included in future population-based studies of acute pancreatitis.     

DNA extraction: an anthropologic aspect of bone remains from sixth- to seventh-century ad bone remains

In the archeological site of the early Christian Episcopal complex of Saint Peter, in Canosa di Puglia (Bari, Italy), during the operations of archaeological excavations, tombs were discovered. They were dated between the sixth and seventh centuries ad with carbon 14 methodology. Five skeletons were found in the 5 tombs: 28A: male individual, 43 years old. The height was 170 cm; the biomass was 65.7 kg. The analysis of the bones indicated several noteworthy pathologies, such as a number of hypoplasia lines of the enamel, the presence of Schmorl hernias on the first 2 lumbar vertebrae, and the outcome of subacromial impingement syndrome. 28E was a male individual, with a biologic age of death of between 44 and 60 years. The height was 177 cm. He had a posttraumatic fracture callus of the medial third of the clavicle, with an oblique fracture rima. 29B was a female individual, 44-49 years old. The height was 158.8 cm; the biomass was 64.8 kg. There was Wells bursitis on the ischial tuberosity on both sides. 29E was a male individual, 45-50 years old. The height was 169.47 cm; the biomass was 70.8 kg. The third and the fourth vertebrae showed Baastrup syndrome (compression of the vertebral spine). There were radiologic signs of deformity on the higher edge of the acetabula and results of frequent sprains of the ankles. 31A was a male individual, 47-54 years old. The height was 178.65 cm; the biomass was 81 kg. The vertebral index showed a heavy overloading in the thoracic lumbar region. There were bony formations under the periosteum on both on the higher and medium facets of the first metatarsus and on the higher and lateral facets of the fifth metatarsus on both sides. As the topography indicates, these small ossifications coincided with the contact points between the back of the foot and parts of the upper shoe. From the osseous remains, in particular from the teeth (central incisors), the DNA was extracted and typed to identify potential family ties among all the subjects. The extraction technique used came from the DNA Promega technique, partially modified by the authors. Stay times of the sample in the extraction buffer were increased and were increased the polymerase chain reaction (PCR) cycles.     

Working women making it work: intimate partner violence, employment, and workplace support

Partner violence may have significant consequences on women's employment, yet limited information is available about how women cope on the job with perpetrators' tactics and the consequences of her coping methods on employment status. This article investigates whether there is an association between workplace disclosure of victimization and current employment status; and whether there is an association between receiving workplace support and current employment status among women who disclosed victimization circumstances to someone at work. Using a sample of partner victimized women who were employed within the past year (N = 485), cross-tabulation and ANOVA procedures were conducted to examine the differences between currently employed and unemployed women. Binary logistic regressions were conducted to examine whether disclosure and receiving workplace support were significantly associated with current employment. Results indicate that disclosure and workplace support are associated with employment. Implications for clinical practice, workplace policies, and future research are discussed.     

The effect of childhood trauma on later psychological adjustment

This study examined whether adult attachment and cognitive distortion mediate the relationship between childhood trauma and psychological adjustment. The participants were 219 students (40 men and 117 women) enrolled in a university degree. Participants completed the Childhood Trauma Questionnaire, which assessed retrospective accounts of childhood trauma; the Relationships Scales Questionnaire, which measured two dimensions of adult attachment (model-of-self and model-of-other); the Cognitive Distortions Scale, which measured internal attributions and perceptions of controllability; and the Trauma Symptom Inventory, which assessed posttraumatic symptoms and was used in this study to measure psychological adjustment. Results supported the hypothesis that model-of-self and cognitive distortion are related constructs. The influence of model-of-self on psychological adjustment however was only via its effect on cognitive processes. In other words, a negative model-of-self influenced cognitive distortion, which in turn influenced the expression of symptoms in adults reporting a history of childhood trauma. The implications for therapy were considered.     

行政法的潮涨潮落

理论学派的法律是一个在认知上并不可靠的领域。它所采用的方法和视角已经受到当下政治和观念的冲击,并且因缺乏理论与实践的互动而显得摇摆不定。在本文中,我将阐述这一看似荒谬的结论,即:随着学术界与司法界不断改变对行政法形态和价值的塑造,法律将通过不断的去法化和日趋经     

Emotional distress in African American women with HIV

This study identified factors associated with emotional distress in 109 African American women with HIV. The relationship of personal factors (demographic, social conflict, social support, and spirituality), health-related factors (perception of health, physical and mental health problems, and years diagnosed), and cognitive/coping responses (stigma, worry, and emotion focused coping) on depressive symptoms and mood state was examined. Younger age, more social conflict, less social support, lower perception of health, and more HIV worry were associated with higher depressive symptom scores. Variables most often affecting various mood states included personal factors (public housing, unemployment, and social conflict) and worry about having HIV worry.     

Forensic anthropology: developments of a classical discipline in the new millennium

The present brief review is a survey of the role of forensic anthropology (FA) in the new millennium. After an introduction which deals with the expanding definition of the discipline and the issue of professionality and training, the author approaches the role and novel developments of the field, with particular reference to the past 5 years. Such developments are discussed in a sectorial manner, distinguishing the role of research in the areas of forensic anthropology which deal with human remains and those that deal with the living. As regards the "human remains" domain, advances and stalls still present in the fields of species and postmortem interval determination, sexing, aging and attribution of ancestry are stressed. The need for standards in facial reconstruction and positive identification by bone morphology are underlined, as well as the growing role of the anthropologist in detecting signs of trauma. Finally, the relatively new role of the forensic anthropologist in the domain of identification of the living is described, although this area is still underrepresented as regards research activity: these studies concern the strive to devise methods for identifying faces (e.g. in the case of crimes registered by videosurveillance systems), aging living individuals or juveniles represented in pedopornographic material.     

Y-chromosomal STR haplotypes in Kalmyk population samples

Seventeen Y-chromosomal short tandem repeats (STRs), DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS385ab, DYS437, DYS438, DYS439, GATA-H4, DYS448, DYS456, DYS458, DYS635 were typed in DNA samples from the Kalmyk population (n=99). The population is characterized by a high proportion of duplicated DYS19 alleles and deletions of the locus DYS448 on the background of the Central Asian haplogroup C*. AMOVA analysis reveals a close vicinity to Mongolian and Kazakh populations and large genetic distance to geographical neighbours from Russia, Ukraine and the Caucasus.