A death due to subinvolution of the uteroplacental arteries

A 19-year-old G1P0 Caucasian woman died 8 days postpartum because of the subinvolution of the uteroplacental arteries. Microscopic examination of the placental implantation site revealed large, dilated spiral arteries containing partially occluding thrombi in the superficial myometrium. The presence of cytotrophoblasts within and surrounding the spiral arteries was confirmed by low molecular weight cytokeratin immunohistochemistry. Infection of the Cesarean section incision site was demonstrated by the growth of Staphylococcus aureus and Streptococcus agalactiae Group B in the wound as well as the intrauterine blood clot. Although subinvolution of the placental site may be a cause of delayed postpartum hemorrhage and significant morbidity, the underlying pathophysiologic mechanism is unknown.     

Suicide by asphyxiation due to helium inhalation

Suicide by asphyxiation using helium is the most widely-promoted method of "self-deliverance" by right-to-die advocates. However, little is known about persons committing such suicides or the circumstances and manner in which they are completed. Prior reports of suicides by asphyxiation involving helium were reviewed and deaths determined by the North Carolina Office of the Chief Medical Examiner to be helium-associated asphyxial suicides occurring between January 1, 2000 and December 31, 2008 were included in a new case series examined in this article. The 10 asphyxial suicides involving helium identified in North Carolina tended to occur almost exclusively in non-Hispanic, white men who were relatively young (M age = 41.1 T 11.6). In 6 of 10 cases, decedents suffered from significant psychiatric dysfunction; in 3 of these 6 cases, psychiatric disorders were present comorbidly with substance abuse. In none of these cases were decedents suffering from terminal illness. Most persons committing suicide with helium were free of terminal illness but suffered from psychiatric and/or substance use disorders.     

Interrater reliability of Risk Matrix 2000/s

Actuarial risk assessment instruments for sexual offenders are often used in high-stakes decision making and therefore should be subject to stringent reliability and validity testing. Furthermore, those involved in the risk assessment of sexual offenders should be aware of the factors that may affect the reliability of these instruments. The present study examined the interrater reliability of the Risk Matrix 2000/s between one field rater and one independent rater with a sample of more than 100 sexual offenders. The results indicated good interrater reliability of the tool, although reliability varies from item to item. A number of factors were identified that seem to reduce the reliability of scoring. The present findings are strengthened by examining interrater reliability of the tool in the usual practitioner context and by calculating a range of reliability statistics. Strategies are suggested to increase reliability in the use of actuarial tools in routine practice.     

Condliff v North Staffordshire Primary Care Trust: can human rights redress inequities in United Kingdom and Australian cost-containment-driven health care reforms?

A recent case from the English Court of Appeal (R (on the application of Condliff) v North Staffordshire Primary Care Trust [2011] EWCA Civ 910, concerning denial by a regional health care rationing committee of laparoscopic gastric bypass surgery for morbid obesity) demonstrates the problems of attempting to rely post hoc on human rights protections to ameliorate inequities in health care reforms that emphasise institutional budgets rather than universal access. This column analyses the complexities of such an approach in relation to recent policy debates and legislative reform of the health systems in the United Kingdom and Australia. Enforceable human rights, such as those available in the United Kingdom to the patient Tom Condliff, appear insufficient to adequately redress issues of inequity promoted by such "reforms". Equity may fare even worse under Australian cost-containment health care reforms, given the absence of relevant enforceable human rights in that jurisdiction.     

Women and Reparations

Reparations for victims of gross human rights violations arebecoming an increasingly acknowledged feature in post-authoritarianand post-conflict societies coping with the legacy of a violentpast. Despite some recent progress much more work needs to bedone for massive reparations programs to respond better to theneeds of women. This article, resting as it does on a comprehensiveconception of reparations, outlines both the procedural andsubstantive components of reparations programs necessary forthe programs to fulfill the goal of providing (partial) justiceto women.     

Cultural Cognition and Public Policy: The Case of Outpatient Commitment Laws

What explains controversy over outpatient commitment laws (OCLs), which authorize courts to order persons with mental illness to accept outpatient treatment? We hypothesized that attitudes toward OCLs reflect “cultural cognition” (DiMaggio, P. Annl Rev Sociol 23:263–287, 1997), which motivates individuals to conform their beliefs about policy-relevant facts to their cultural values. In a study involving a diverse sample of Americans (N = 1,496), we found that individuals who are hierarchical and communitarian tend to support OCLs, while those who are egalitarian and individualistic tend to oppose them. These relationships, moreover, fit the cultural cognition hypothesis: that is, rather than directly influencing OCL support, cultural values, mediated by affect, shaped individuals’ perceptions of how effectively OCLs promote public health and safety. We discuss the implications for informed public deliberation over OCLs.     

Cascading Bias of Initial Exposure to Information at the Crime Scene to the Subsequent Evaluation of Skeletal Remains,

Thirty‐eight participants took part in a study that investigated the potential cascading effects of initial exposure to extraneous context upon subsequent decision‐making. Participants investigated a mock crime scene, which included the excavation of clandestine burials that had a male skeletal cast dressed either in female or gender neutral clothing. This was followed by a forensic anthropological assessment of the skeletal remains, with a control group assessing the same male skeletal cast without any clothing context. The results indicated that the sex assessment was highly dependent upon the context in which participants were exposed to prior to the analysis. This was especially noticeable in the female clothing context where only one participant determined the male skeletal cast to be male. The results demonstrate the importance of understanding the role of context in forensic anthropology at an early stage of an investigation and its potential cascading effect on subsequent assessments.     

The suitability of visual taphonomic methods for digital photographs: An experimental approach with pig carcasses in a tropical climate

In the context of increased scrutiny of the methods in forensic sciences, it is essential to ensure that the approaches used in forensic taphonomy to measure decomposition and estimate the postmortem interval are underpinned by robust evidence-based data. Digital photographs are an important source of documentation in forensic taphonomic investigations but the suitability of the current approaches for photographs, rather than real-time remains, is poorly studied which can undermine accurate forensic conclusions. The present study aimed to investigate the suitability of 2D colour digital photographs for evaluating decomposition of exposed human analogues (Sus scrofa domesticus) in a tropical savanna environment (Hawaii), using two published scoring methods; Megyesi et al., 2005 and Keough et al., 2017. It was found that there were significant differences between the real-time and photograph decomposition scores when the Megyesi et al. method was used. However, the Keough et al. method applied to photographs reflected real-time decomposition more closely and thus appears more suitable to evaluate pig decomposition from 2D photographs. The findings indicate that the type of scoring method used has a significant impact on the ability to accurately evaluate the decomposition of exposed pig carcasses from photographs. It was further identified that photographic taphonomic analysis can reach high inter-observer reproducibility. These novel findings are of significant importance for the forensic sciences as they highlight the potential for high quality photograph coverage to provide useful complementary information for the forensic taphonomic investigation. New recommendations to develop robust transparent approaches adapted to photographs in forensic taphonomy are suggested based on these findings.