Modification of hematoma findings in the breast region

Subcutaneous bruises caused by blunt injury are common findings in medicolegal case work. If the hematoma involves the anterior thoracic wall, bruises are mostly absent in the region of the nipples and the surrounding areola. A similar phenomenon has already been described for hypostatic skin hemorrhages. A possible explanation for both phenomena is the special tissue texture in the nipple–areola complex. Based on four cases from the forensic autopsy material and two cases from clinical forensic examinations, the macromorphological findings and the histological correlates are presented.     

Rebecca Roberts introduces this issue of cjm

Abstract

While the pages of Criminal Justice Matters frequently examine and assess criminal justice policies and often make recommendations on how to reform the system, this edition takes a more reflexive approach. Rather than focus on the nature of criminal justice reforms, this issue of cjm shines a spotlight on the reformers.     

Anaphylaxis After the Injection of Buprenorphine

Cause of death rulings in cases when the concentration of a drug or drugs is higher than observed following therapeutic use are generally straightforward “drug deaths.” However, when toxicology testing identifies drug concentrations consistent with therapeutic use or detects no drugs at all, then the cause of death determination is more complicated. Given the rapidity and protean manifestations of anaphylaxis, it should be considered in deaths where no other cause of death is apparent in a suspected drug death. This article reports two cases where an anaphylactic reaction was observed following either the actual or alleged use of therapeutic formulations of buprenorphine intravenously.     

Critical evaluation of planning frameworks for rural water and sanitation development projects

Poor initial planning processes have been implicated in the high failure rate of rural water and sanitation development projects. This article critically examines 17 existing planning frameworks for rural water supply and sanitation projects with respect to key attributes of good planning practice, in order to discover the extent to which these address the elements of planning that relate to sustainability. It identifies sustainability-related factors from the sector that have been recognised as such and incorporated into current frameworks, as well as factors that are not yet well covered, and makes recommendations to practitioners wishing to employ such frameworks.     

Musculoskeletal stress marker (MSM) differences in the modern American upper limb and pectoral girdle in relation to activity level and body mass index (BMI)

Obesity is a widespread condition affecting modern Americans. The prevalence of obesity has led to questions of how it can affect the skeleton, and if so can it be identified in unknown skeletal material. This study attempts to decipher the effects of activity level and body mass in modern Americans by employing musculoskeletal stress markers (MSM) to estimate osseous responses to workload and body weight. A total sample of 108 skeletons of known activity level and body mass index (BMI) was observed for MSM in the upper extremity (excluding hands). The entheses selected included arm muscles used during the sit-to-stand transition, which is common in most persons, regardless of activity level and BMI. Using the three categories: normal, active, and obese, logistic regression was calculated on MSM to ascertain which markers were the best indicators of these three categories. Numerous muscles of the upper limb were significant predictors of activity level and body mass, although they did not perform much better than chance. MSM may be used as predictors of activity level and/or BMI in forensic contexts; however, they should be used in conjunction with other indications of workload and/or BMI.