Health advocacy on the margins: human rights as a tool for HIV prevention among LGBTI communities in Botswana

ABSTRACT

Human rights discourse in health advocacy is largely correlated with experiences of vulnerability, marginalisation and discrimination, with the global story of HIV activism the most visible example. In a domestic context where culture, consensus and belonging are highly valued, both human rights and lesbian, gay, bisexual, transgender and intersex (LGBTI) people face critiques of being foreign, un-African, new, individualistic and threatening to tradition. Why, when and how do civil society actors draw on human rights to advocate for LGBTI health in relation to HIV in Botswana? I examine this paradox through a case study of the key civil society actor in this sector. I argue that while formal structures and belief shape why the group engages with human rights, when and how human rights are invoked is shaped by perceptions of threat, cultural context, and belonging.     

Incapacity of the Mind Secondary to Medication Misuse as a Not Criminally Responsible Defense

The manifestations of disorders of the mind may play a role in the occurrence of criminal behavior. In the majority of the cases, the presence of a psychiatric disorder is cited as the reason that an individual was not fully aware of his behavior. However, other conditions, such as seizure disorders or hypoglycemia, have also been linked to an inability to understand the nature and consequences of one's actions. On occasion, these situations can be explained by a state of automatism that may be described as insane or noninsane. In this article, we describe the case of a 77‐year‐old man, suffering from Parkinson's disease, where the issue of criminal responsibility associated with incapacity of the mind secondary to medication misuse was raised. We elaborate on the thinking behind this opinion and the implications according to Canadian law. Although the legal outcome of this case is specific to our jurisdiction, the clinical implication may be common to any patient suffering from a similar condition and may inform physicians, families, and lawyers.     

Can Cephalometrics Discriminate Between the Sexes in a Diverse Juvenile Sample?

A critical component of the biological profile is sex estimation. Methods commonly used for sex estimation in adults do not work well for juveniles. Population‐specific studies have used cephalometrics to estimate juvenile sex with 80–90% accuracy. Our study attempts to estimate sex in individuals less than 18 years of age using a sample of 1618 lateral cephalograms incorporating all three Angle Class occlusions as well as population diversity. For the sample as a whole, 10 skeletal cephalometrics were found to have significant differences between the sexes. Males and females classify correctly about 50% of the time. Dividing the sample by age groups and race/ethnicity improves results for older age groups and Native Americans, Hispanics, and Asian Americans. Our results indicate that cephalometrics are not useful in determining sex of unidentified juveniles when age and race are not known.     

Increased Lung Weights in Drug‐related Fatalities

This study is of autopsy data for potential validation as to whether increased weights of the lungs support toxic effects of drugs as the cause of death. This retrospective study compared data from 133 deaths resulting from the toxic effects of drugs with previously reported normal lung weights (Toxicol Mech Methods, 22, 2012, 159; Am J Forensic Med Pathol 33, 2012, 368). The lung weights and their standard errors were used in a two‐sample independent t‐test comparing the average drug‐related death weight to the average control weights. To account for multiple comparisons, a Bonferroni‐adjusted alpha level of 0.0125 was used. We are 98.75% confident that the mean right lung weight for female drug‐related deaths is between 227 and 377 g greater than the mean right lung weight for female non‐drug‐related deaths. We are 98.75% confident that the mean right lung weight for male drug‐related deaths is between 245 and 378 g greater than the mean right lung weight for male non‐drug‐related deaths.     

Detection of Acetone Processing of Castor Bean Mash for Forensic Investigation of Ricin Preparation Methods*

Abstract: Samples containing the toxic castor bean protein ricin have been recently seized in connection with biocriminal activity. Analytical methods that enable investigators to determine how the samples were prepared and to match seized samples to potential source materials are needed. One commonly described crude ricin preparation method is acetone extraction of crushed castor beans. Here, we describe the use of solid‐phase microextraction and headspace analysis to determine whether castor beans were processed by acetone extraction. We prepared acetone‐extracted castor bean mash, along with controls of unextracted mash and mash extracted with nonacetone organic solvents. Samples of acetone‐extracted mash and unextracted mash were stored in closed containers for up to 109 days at both room temperature and ?20°C, and in open containers at room temperature for up to 94 days. Acetone‐extracted bean mash could consistently be statistically distinguished from controls, even after storage in open containers for 94 days.     

Surgical Sutures as a Means of Identifying Human Remains*

Abstract: The Food and Drug Administration does not require surgical sutures to be tracked by manufacturer, physician, or patient; thereby, surgical sutures have been of little use to forensic practitioners who are tasked with establishing a positive identification with biological evidence. This study demonstrates the investigative process used to pinpoint suture manufacturers by presenting a case where surgical sutures were a distinctive characteristic that aided in the positive identification of skeletal remains. The suture’s manufacturer, construction material and structure, size, and medical use was determined by contacting a local surgical suture and orthopedic implant manufacturer and utilizing publicly available manufacturer websites, which provide catalogs and specific product details. This research was one of many lines of evidence used to establish the positive identification of a 47‐year‐old male.     

Lifeguards: a forgotten aspect of drowning prevention

Abstract:

An alarming number of drownings occur in lifeguarded swimming areas, where one might presume swimmers are protected from injury. One reason drownings occur in lifeguarded swimming areas is because lifeguard surveillance is a highly difficult task. Observational research suggests lifeguards are usually alert, but researchers also report egregious examples of inattention. We offer three strategies that have initial empirical support to reduce risk of drowning at lifeguarded swimming areas: (a) regular training to help lifeguards recognize they are vulnerable to drowning events and to raise their confidence; (b) regular practice via simulated emergency responses, and (c) addressing staff schedules so lifeguards can devote full attention to protecting swimmer safety while on duty. ‎     

Persistence of Polydimethylsiloxane Condom Lubricants

Polydimethylsiloxane (PDMS) is commonly used to lubricate condoms. The detection of PDMS on swabs from complainants can be used to support an allegation of sexual assault. Previous research has focused on establishing analytical techniques for detecting PDMS. This research examined the persistence of PDMS on the penis, in the vagina, in the mouth, and on skin. The longest PDMS detection times were 20 h on the penis, 35 h in the vagina, and 52 h on skin. PDMS was detected up to 4 h in the mouth if the participant did not eat or drink and up to 9 h if the participant slept. PDMS was not detected in the mouth after eating or drinking. The presence of biological fluids had no detrimental effect on the analysis. Aqueous extraction of swabs for DNA did not remove any significant amount of PDMS; hence, swab remains could be subsequently analyzed for PDMS.