Suicide by drowning: a 20-year review

Drowning as a method of suicide is known to occur, but has primarily been described in environments with readily available access to water, such as coastal regions. In this study, we describe and analyze a series of suicidal drownings occurring in a noncoastal area of Texas. Between 1977 and 1996, 52 cases of suicidal drowning were investigated at the Southwestern Institute of Forensic Sciences in Dallas, Texas. Such deaths accounted for only 0.85% of all suicides and 4% of all drowning deaths. In contrast. suicidal drownings reportedly account for 2.8 to 8.9% of all suicides in regions with easy access to water. As with other studies of suicidal drowning, the victims are usually sober white males over the age of 40 years. Our results also confirm that certain individuals who commit suicide by drowning use weights to facilitate the process. A detailed analysis of the cases is provided. as is a synopsis of several questions that may aid in determining the manner of death in suicidal drowning cases.     

Death due to thrombotic thrombocytopenic purpura in pregnancy: case report with review of thrombotic microangiopathies of pregnancy.

Maternal death during pregnancy, although uncommon, may result from a broad range of conditions. In this paper, a case of thrombotic thrombocytopenic purpura diagnosed by postmortem examination is presented. Thrombotic thrombocytopenic purpura is one of a subset of diseases that result in the formation of microthrombi within the vasculature, either as a primary or secondary manifestation. Other conditions included in the differential diagnosis during pregnancy are hemolytic uremic syndrome, systemic lupus erythematosus, preeclampsia-eclampsia and the HELLP syndrome, acute fatty liver of pregnancy, antiphospholipid antibody syndrome, and disseminated intravascular coagulation. The histologic manifestations of these diseases can be similar and in most cases do not provide adequate information to accurately differentiate these diseases in the postmortem period. This paper addresses the need for clinical history (i.e., symptomatology, trimester of onset) and antemortem laboratory testing in addition to a thorough autopsy to accurately differentiate among the conditions named previously. In the absence of an adequate clinical history and antemortem laboratory testing, the more general diagnosis of "thrombotic microangiopathy of pregnancy" is acceptable.     

Familial filicide and filicide classification.

Filicide is the killing of a child by his or her parent. Despite the disturbing nature of these crimes, a study of filicide classification can provide insight into their causes. Furthermore, a study of filicide classification provides information essential to accurate death certification. We report a rare case of familial filicide in which twin sisters both attempted to kill their respective children. We then suggest a detailed classification of filicide subtypes that provides a framework of motives and precipitating factors leading to filicide. We identify 16 subtypes of filicide, each of which is sufficiently characteristic to warrant a separate category. We describe in some detail the characteristic features of these subtypes. A knowledge of filicide subtypes contributes to interpretation of difficult cases. Furthermore, to protect potential child homicide victims, it is necessary to know how and why they are killed. Epidemiologic studies using filicide subtypes as their basis could provide information leading to strategies for prevention.     

The construction of spatial regional identities: the case of the Baltic in a global context

Comparative interregionalism is often limited to the policy or panoramic dimension, reducing local differences and specificities, the “minute particulars” (Blake, William Blake’s Writings, 614, 620, 1978) of the lifeworld to their more abstract forms. This is particularly the case when the European Union (EU) and Association of Southeast Asian Nations (ASEAN) are compared: generalities remain abstractions, whereas the sharper the focus the more diffferentiated the mindscape becomes and the more the basis for the comparison is undermined. Yet, in a global knowledge networked economy (to get all the buzzwords in one phrase), comparisons are necessary if often invidious. While commentators are often reluctant to see the EU as a model for ASEAN, it is often seen as a complex of experiences to be shared. Yet what—in this domain—gets exported, transplanted and implanted elsewhere, how does this transference take place in such an internetted society, and to what end? Seen in an interregional, even global context, and including an examination of teaching Günter Grass’ Crabwalk (Im Krebsgang, 2002) in English translation to undergraduates of a contemporary European literature class at the National University of Singapore, the paper hopes to indicate some temporal and spatial contexts of transplantation and the means by which this is achieved.     

The Baltic Sea and South China Sea regions: incomparable models of regional integration?

This introduction explains the key concepts of integration and exemplifies how they can be applied to processes of regional integration in the Baltic Sea and South China Sea regions.     

Competency to stand trial: description and initial evaluation of a new computer-assisted assessment tool (CADCOMP).

The authors describe a Computer-Assisted Determination of Competency to Proceed (CADCOMP), a new instrument that collects data directly from the defendant through an interactive computer program and renders a report covering relevant historical, psychopathological, and legal information. The comprehensive report could be utilized by the clinician to focus the clinician's interview with the defendant on areas requiring further probing, thus reducing the time required to assess competency. Preliminary reliability and validity assessment studies are reported. The results support the predictive validity of CADCOMP used as a screening instrument and found the CADCOMP to be sufficiently reliable to be used for screening purposes.