Guidelines for postmortem protocol for ocular investigation of sudden unexplained infant death and suspected physical child abuse

Postmortem examination is a cornerstone in identifying the cause of unexplained sudden death in children. Even in cases of suspected or known abuse, an autopsy may help characterize the nature of the abuse, which is particularly important in the forensic autopsy of children in the first 3 to 4 years of life when inflicted neurotrauma is most common. Forensic examinations are vital in cases that might otherwise be diagnosed as sudden infant death syndrome. The ocular autopsy in particular may demonstrate findings that were not appreciated on antemortem clinical examination. This protocol for postmortem examination of the eyes and orbits was developed to promote more consistent documentation of findings, improved clinical and forensic decision making, and more replicable and coherent research outcomes.     

"Just scanning around" with diagnostic medical ultrasound: should states regulate the non-diagnostic uses of this technology?

This article examines how the non-diagnostic uses of medical ultrasound may violate the prudent use of this technology and supports the proposal of state-based legislative efforts to protect consumers from abuse. The author identifies the potential health risks to consumers and reviews the existing federal and state regulations, ultimately recommending increased legislation and mandated control of this technology.     

The Argument from Transnational Effects I: Representing Outsiders through Freedom of Movement

This article and its sequel examine an argument that has become a shibboleth for the European pro‐attitude towards international and supranational legal arrangements. I call it the argument from transnational effects. The argument says that supranational or transnational forms of integration, in particular market integration, are desirable on account of democracy itself. National democracies find themselves thereby forced to confront and to internalise the externalities that they cause for one another. A fortiori, democracy becomes supposedly emancipated from the confines of the nation state. Since the argument favours normative limitations on national political processes it seems to lend strong support to the introduction of transnational constitutional discipline. In this article and its sequel it is claimed that the argument, correctly understood, cannot support the creation of transnational democracy. Rather, in a critically recalibrated form, the argument, paradoxically, provides strong backing for the existence of bounded political communities without, for that reason, succumbing to ontologically questionable beliefs about the essence of national communities. Hence, the argument is really as much about the limits set to transnational integration as it is about their legitimacy. This explains why it is of central relevance to constitutionalism in a global age. The opening sections of this article offer an interpretation of John Hart Ely's constitutional theory. Examining the latter helps to articulate adequately the democratic sensibility expressed in the argument. It is argued that Ely's theory exceeds the scope of a mere theory of judicial review. It presents, indeed, a theory of constitutional authority, which is highly relevant to an analysis of the argument from transnational effects. The article then distinguishes and discusses two different readings of the representation‐reinforcing task that Ely attributes to constitutional legality. According to one reading, representation is secondary and only ancillary to the realisation of equality. According to another reading, equal participation is prerequisite to the success of representative democracy whose aim is to discover common ground. It is concluded that the first reading is easier to accommodate in a transnational setting. It will be seen that Ely's theory—at any rate, the first reading of it—is basically concerned with the problem addressed by the argument from transnational effects. This article's discussion of the argument distinguishes two different types of situation. A third, more general type will be dealt with in a subsequent article. The first situation affects people who realise that they would be better off if they were to benefit from the laws of a different democracy. Hence, they would like to have these laws imported. It is argued that their interests do not find support in the argument from transnational effects. The second situation concerns someone who encounters obstacles when moving from one democracy to another. Such obstacles can emerge either as a result of discrimination against non‐nationals or from the sheer fact that laws between and among bounded societies are different. The antidote against the latter is to submit national legislation to a proportionality test. Even though reinforcing representation prima facie seems to support this conclusion, the article claims that virtual representation, correctly understood, actually restricts the sweep of constitutional control to cases of behavioural discrimination. Extending the scope of control would actually violate the respect that it is owed to national democratic autonomy pursuant to the principle of virtual representation. It is also shown that only by limiting its sweep the argument from transnational effects can be prevented from endorsing neoliberal political goals.     

The association between specific competence-related abilities and competence restoration treatment

Inpatient competence restoration treatment comes with enormous costs in terms of civil liberties, but also significant financial costs to the state/institution responsible for providing the treatment. The present investigation was designed to evaluate the utility of a commonly used competence assessment instrument, the MacArthur Competence Assessment Tool – Criminal Adjudication (MacCAT-CA), in identifying individuals who may require more tailored, lengthier, and/or more intensive treatment. The sample included 93 men and women who were administered the MacCAT-CA during an inpatient hospitalization for competence restoration treatment in the United States. All of the patients were restored to competence within the study period, ranging from 3 to 32 months of inpatient hospitalization. Results suggest that performance on the MacCAT-CA was associated with hospitalization length, with total scores as the greatest predictor of response to treatment. Sensitivity and specificity estimates are discussed in terms of their utility in identifying patients most at-risk for extended hospitalization, with the authors arguing that instruments like the MacCAT-CA can be used in a practical manner of identifying patients who might require greater or more intensive treatment.     

Illicit payments for illicit goods: noncontact drug distribution on Russian online drug marketplaces

The distribution or consumption of traditional drugs has become the subject of stringent penalties throughout most of the world and synthetic designer drugs have become the alternative. Novel psychoactive substances, also called ‘legal highs’, are highly varied in terms of chemical composition. These substances are advertised and distributed as an alternative to traditional drugs on the Internet, making identification of new substances and enforcement difficult. For this article, we downloaded and analysed 28 Russian-language online drug marketplaces which distribute traditional and novel psychoactive substances. All marketplaces used a noncontact drug dealing method where the seller and the buyer communicate through the Internet to arrange for payment and delivery of drugs without meeting face-to-face. Geographic information, price, amount, substance type and payment method data were extracted. Findings indicate such marketplaces are able to operate due to the ability of their clients to pay anonymously with the virtual currencies – Qiwi and Bitcoin.     

Head banging as a form of self-harm among inpatients within forensic mental health and intellectual disability services

Introduction: ‘Head banging’ is a common form of self-harm, linked to numerous negative outcomes including significant brain damage. However, little research has investigated head banging behaviour and its correlates in clinical populations. Method: Head banging episodes were identified from the incident records (n = 5417) of two inpatient forensic services (one intellectual disability and one mental health), using relevant search terms. Rates were compared between individual patients, by gender, diagnosis and level of security. Incident accounts were analysed qualitatively using thematic analysis. Results: Head banging incidents occurred approximately every 3 days in each service, with 229 incidents recorded in 1 year. Individual patient rates varied widely, ranging from 1 to 38 incidents within 1 year. Women, and patients in higher levels of therapeutic security, were significantly more likely to engage in head banging. Qualitative incident reports indicated that head banging was associated with mental distress, anger and psychotic experiences. Discussion: Head banging occurs frequently in forensic services, and has documented associations with traumatic brain injury in affected individuals, thus negatively impacting progress through the care pathway and treatment outcomes. Further research should investigate short- and long-term management strategies and treatment approaches, in order to minimise harm.     

Literatur

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