Death following injection sclerotherapy due to phenol toxicity

Prolapse rectum (PR) or protrusion of the rectum beyond the anus occurs frequently in populations at both extremes of age. In the pediatric population, in developed countries, the commonest cause for PR is thought to be cystic fibrosis (CF). Treatment options for CF include conservative management, surgical resection and fixation, suturing, and injection sclerotherapy (IS). The last is considered an attractive treatment option because it is minimally invasive. In this case report, the authors present the details about a 2-year-old female child, with PR and CF, who died after IS, using phenol as the sclerotherapeutic agent. Autopsy findings and toxicology tests performed to establish phenol toxicity are documented. The available literature is reviewed. This case report underscores the risks of using phenol for IS and emphasizes the point that the procedure is not innocuous and an adverse outcome including fatality is a possibility.     

Fingermark detection on non-porous and semi-porous surfaces using YVO4:Er,Yb luminescent upconverting particles

This article describes the use of an anti-Stokes luminescent material (upconverter), yttrium vanadate doped with ytterbium and erbium (YVO(4):Er,Yb), for the development of latent fingermarks on a range of non-porous surfaces. Anti-Stokes luminescent materials emit light at shorter wavelengths than the excitation wavelength. This property is unusual in both natural and artificial materials commonly found as exhibits in forensic science casework. As a result, fingermark detection techniques based on anti-Stokes luminescence are potentially extremely sensitive and selective. Latent fingermarks on non-luminescent and inherently luminescent substrates, including Australian polymer banknotes (a well-known 'difficult' surface), were developed with YVO(4):Er,Yb by dry powder and wet powder techniques. The effectiveness of YVO(4):Er,Yb for fingermark detection was compared with that of cyanoacrylate fuming and of sodium yttrium tetrafluoride doped with ytterbium and erbium (NaYF(4):Er,Yb). The results illustrate some benefit of luminescent up-converting phosphors over traditional luminescence techniques for the detection of latent fingermarks.     

Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

Observational Case Series: An Algorithm Incorporating Multidetector Computed Tomography in the Medicolegal Investigation of Human Remains after a Natural Disaster

An algorithm incorporating multidetector computed tomography (MDCT), digital radiographs, and external examination was used to triage cases for noninvasive or complete autopsy after a natural disaster. The algorithm was applied to 27 individuals who died during or soon after the earthquake that struck the Republic of Haiti on January 12, 2010. Of the 27 cases reviewed, 7 (26%) required a complete autopsy to determine cause and manner of death. In the remaining 20 (74%), cause and manner of death were determined with a reasonable degree of medical certainty after review of circumstances, an external examination, and postmortem imaging by MDCT and digital radiography (noninvasive autopsy). MDCT was particularly useful in detecting skeletal fractures caused by blunt force injury which were not evident on digital radiographs. The algorithm incorporating postmortem MDCT can be useful in the triage of human remains for autopsy after a natural disaster.     

Exploration of the Cyberbullying Victim/Offender Overlap by Sex

As usage of the Internet has grown to approximately 657 million users worldwide, criminality online has become more prevalent. Termed “cybercrime,” this form of criminal behavior can occur in several different. While cybercrime in general is fairly new comparably to crimes in the physical realm, one of the most recently recognized forms of cybercrime is cyberbullying. The present study will examine the victimoffender relationship. Results indicate that both males and females with lower levels of self-control were more likely to participate in cyberbullying by posting hurtful messages or pictures to Facebook. Second, both sexes were more likely to cyerbullying via Facebook if they had been cyberbullied as well.     

Mental health law and the UN Convention on the rights of persons with disabilities

People with a mental illness may be subject to the UN Convention on the Rights of Persons with Disabilities (CRPD), depending on definitions of terms such as ‘impairment’, ‘long-term’ and the capaciousness of the word ‘includes’ in the Convention's characterisation of persons with disabilities. Particularly challenging under the CRPD is the scope, if any, for involuntary treatment.     

The DNA of Conventions

This paper defends a moralized account of conventions, according to which conventional practices are necessarily normative reasons that are ultimately grounded on moral principles (such as fairness, respect or prevention of harm). It argues that a convention exists just in case the fact that others participate in some common practice as well as facts about their motivating reasons for doing so, justify conformity to that practice. The paper locates this moralized account within the relevant philosophical literature and argues that it does better than its rivals in explaining the presence of both motivating and normative reasons in our concept of convention.     

Hobbes on Political Authority,Practical Reason and Truth

The role of sovereign authority in Hobbes' political philosophy is to establish peace and stability by serving as a definitive and unambiguous source of law. Although these broad outlines of Hobbes' account of political authority are uncontentious, matters quickly become more complicated once one seeks its normative basis. This much is evident from recent debates on the normative status of the laws of nature and the related issue as to whether Hobbes is better categorised as an incipient legal positivist or as a heterodox natural law thinker. In this paper I argue that although the positivist and natural law commitments in Hobbes' theory of political authority can be partially reconciled, such a reconciliation points to the need for more substantive theories of practical reason and truth than are to be found in Hobbes' official statements on these topics. Section II examines the positivist and natural law dimensions in Hobbes' thought and suggests that the role of sovereign authority in providing the definitive interpretation of the laws of nature allows a partial reconciliation to be effected. In section III, I consider the tension between this reconciliation and Hobbes' instrumentalism about practical reason and equivocal separation of authority and truth.     

‘Our normal is different’: autistic adults’ experiences of the family courts

ABSTRACT

This article reports the findings of a small-scale qualitative study exploring the experiences of autistic adults who have had experience of the family justice system. While participants related some positive elements to their experiences, in particular with regard to the willingness of professionals to try to learn more about their clients’ needs, the overall picture showed significant concerns. The reports given showed significant misunderstandings about autism, and a system which struggled to make appropriate adjustments which would allow autistic court users to have access to justice on an equivalent basis to non-autistic litigants. This situation stands in contrast to the position regarding other disabilities in the Family Justice System, but also to the relatively greater level of provision for autistic people within the Criminal Justice System. Based on participants’ experiences and existing good practice in other areas, we make recommendations that could be adopted by the Family Court and practitioners.