Vertebral artery dissection complicating occipital injection of heparin for treatment of thoracic outlet syndrome

A 38-year-old woman with a 2-year history of chronic neck pain radiating down her right arm underwent radiological and neurological evaluations, which revealed no anatomical cause for her pain. She sought alternative therapies including intramuscular heparin injections. Following a right occipital injection of heparin, cyanocobalamin, and lidocaine, she had a sudden cardiorespiratory arrest and was successfully resuscitated, but did not regain consciousness.Computed tomography of the head and neck and subsequent autopsy revealed a right vertebral artery dissection, but at autopsy, no significant subarachnoid hemorrhage was noted at the base of the brain. This is the first case report where heparin (a potent anticoagulant) used in an occipital injection was documented to cause a vertebral artery dissection. It is also the first reported case where radiographically and histologically documented vertebral artery dissection did not present with overwhelming subarachnoid hemorrhage at the base of the brain. The subtle gross anatomical findings in this case highlight the importance of evaluating the cervical spinal cord in any case of sudden cardiorespiratory arrest following even apparently minor neck injury.     

Legal liability and research ethics boards: the case of neuroimaging and incidental findings

Neuroimaging research covers a wide range of intriguing issues from revealing brain structures to investigating what happens in our brain when we lie. The field appears to be thriving, but skepticism and alertness to the various ethical, scientific, policy and philosophical challenges associated with it also appear to be on the rise. One particularly complex issue concerns what to do with incidental findings that emerge during the course of neuroimaging research. Research ethics boards (REBs) play a central role in research oversight. In this paper, we will consider some of the potential issues associated with REB liability in negligence in the context of incidental findings in neuroimaging research.     

Defining workplace bullying behaviour professional lay definitions of workplace bullying

As is commonly the case in new areas of research, workplace bullying researchers and practitioners have struggled to establish a single agreed-upon definition of this phenomenon. As a consequence, there are numerous definitions of workplace bullying currently in use around the world to investigate this serious workplace issue, to educate the workforce about this form of harassment and to assess claims involving allegations of workplace bullying. Additionally, little is known about how employees and people in general define workplace bullying behaviour, and whether current researcher, practitioner and legal definitions coincide with lay definitions of bullying. To compare researcher, practitioner and legal definitions of workplace bullying with lay definitions, the content of definitions composed by adults from diverse personal and professional backgrounds (N=1095) was analysed. Results confirmed that components commonly used by researchers and practitioners, including the occurrence of harmful and negative workplace behaviours, were frequently cited by participants as central defining components of bullying behaviour. In addition, lay definitions often included themes of fairness and respect. The emergence of these themes has important consequences for organisations responding to, and attempting to prevent the occurrence of workplace bullying behaviour in that organisations in which bullying is tolerated may violate both local laws as well as their ethical responsibility to provide employees with a safe, professional and respectful workplace.     

Behind the Blue Line: Investigating Police Officers’ Attitudes Toward Rape

The current study contributes to what is known about police officers’ attitudes toward rape. A survey was administered to 891 sworn police officers in two states in the southeastern United States. The surveys were designed to assess police officers’ acceptance of rape myths. It was hypothesized that police officers would be accepting of rape myths, which are inherently misogynistic. Attitudes toward rape were expected to vary according to educational attainment and experience with rape investigations, such that higher levels of education and more experience with rape investigations would lead to the rejection of rape myths. There was a significant difference in the acceptance of rape myths with varying levels of educational attainment and experience with rape investigations.

Palynology and mycology as biological evidence in a homicide case

Criminal cases are studied from several disciplines to link a suspect with a criminal act. In this case, a man was reported missing in a coastal area in Buenos Aires Province, Argentina. The victim's relatives pointed to a possible suspect, and the local police carried out the investigation. We contributed to this research by applying palynological and mycological techniques. Palynomorphs and fungal spores offer valuable trace evidence, as they can be easily transferred between objects and crime scenes due to their minute size and persist on them for a long time. The victim was found 25 days later, lying on sandy soil, which partially covered the body, 35 km from where the suspect was arrested. Comparative samples were collected from the crime scene and the suspect's home and belongings (clothes, footwear, and seized vehicle). The palynological associations obtained from the crime scene and the defendant's belongings were dominated by diatoms and acritarchs (Acantomorphitae), all elements of marine origin, and a high CFU number of Bipolaris cynodontis, which allowed the defendant's clothing to be related to the place of corpse discovery. Soil from the defendant's home had an entirely continental composition, and the fungal biota was characteristic of prairie areas which were different from those of the crime scene.     

Jail Calls: What Do Kids Have to Do with It?

For many domestic violence victims, witness tampering continues throughout an abuser’s detention while awaiting court appearance and sentencing, often via phone calls made from jail. A common question we are asked when leading an investigation and providing expert testimony is how abusers involve their children (directly or indirectly) during jail calls. In this commentary, we use three case examples to illustrate how abusers involve their children (directly or indirectly) to further manipulate and tamper with their victim. As the three case examples illustrate, domestic abusers tend to use similar strategies with children during the jail calls as they do with their primary victim (e.g., minimizing the abuse, calling up images of a broken family due to impending charges and sentencing), and tend to triangulate their children against the victim.     

Active in Not Being Active (AINBA): how East Asian powers accept R2P

This article explores and compares the positions of two major powers in East Asia—China and Japan—towards the ‘Responsibility to Protect’ (R2P) norm. R2P calls for collective international responsibility in the event that states are unwilling or unable to protect their people. Evaluating the mainstream argument in the literature that China and Japan have recently been welcoming the R2P norm, we ask the following questions: To what extent have China and Japan aligned themselves with R2P? How do international and national factors play out to influence their R2P stance? To summarize our findings up front: unlike what much of the current literature says, China and Japan's acceptance and practice of the R2P norm are largely pro forma. We argue that they both appear active in participating in the debates but only in order to remain inactive. In other words, they are active participants in the debates and discussions on R2P, but their aim is not to further its usage but to contain its effects. Their current stance on R2P is characterized by what we will call ‘Active in Not Being Active’ (AINBA). The article discusses the key sources and rationale for their AINBA policy with regard to R2P.