The role of environmental factors in the causation of sudden death in infants: two cases of sudden unexpected death in two unrelated infants who were cared for by the same babysitter

We report two cases of sudden unexpected death in two unrelated African American female infants, 2 months and 4 months old. Both infants were attended to by the same babysitter in the same apartment and died 39 days apart in the same bed and in the same bedroom. The autopsy of the first infant revealed sudden unexplained death in an infant. Toxicologic analysis for carbon monoxide (CO) was not performed because it was not suspected. When the second infant died, investigation into the ambient air quality within the apartment revealed high levels of CO emanating from a poorly ventilated and defective hot water heater, which was located across a hallway from the bedroom where the two babies died. CO saturation levels in the postmortem blood samples of the two babies were elevated and were similar (13% and 14%). Nicotine and cotinine were not detected in the blood sample of the two infants. Cherry-red livor mortis was absent. Acute CO intoxication was determined to be the underlying cause of these two unexpected deaths. These two cases underscore the need to integrate ambient air analysis and postmortem CO analysis as routine components of the comprehensive death investigation of infants who die suddenly and unexpectedly.     

Qualitative Differences Among Rural and Urban Intimate Violence Victimization Experiences and Consequences: A Pilot Study

Relatively little is known about rural women's intimate violence experiences in comparison to urban women's experiences, partly because of the difficulty in accessing rural women. This pilot study used a protective order sample of 23 women (15 urban and 8 rural), which provides an access point that is relatively similar for comparisons across rural and urban areas. The number of participants is low and, therefore, results are preliminary. However, several significant findings emerged. Rural women reported significantly less social support, less education, less income, more physical abuse in the preceding year, more childhood physical and sexual abuse, and worse overall health and mental health, as well as encountering abuse earlier in the relationship. Both groups reported higher rates of illegal drug and cigarette use than those among the general population. The findings highlight some overall important themes in examining rural and urban intimate violence victims by suggesting that rural and urban intimate violence victims have different victimization experiences and service needs. Implications for further research and intervention are discussed.     

Predictors of Early Engagement in Home Visitation

Predictors of engagement in mothers receiving home visitation in the first year of service was examined. Early engagement was studied in three ways: (1) length of time active in the program during the first year of service (duration), (2) number of visits received (quantity), and (3) gaps in service between visits (consistency). Examined visits received in 515 first-time mothers in a Healthy Families America (HFA) program. Parameters of engagement were investigated, and predictors of engagement were identified using demographics and the Kempe Family Stress Inventory. Inclusive of the Assessment Visit, 31.8% of mothers disengaged prior to the first month of service. Remaining active in the program was associated with being Caucasian, and increased parenting risk (mental health/substance abuse history, low social support, increased stress). Most mothers had fewer home visits than prescribed. Gaps in prescribed service were common, with 89.4% of mothers experiencing gaps between visits of 1 month, and dropping to 16.4% having gaps of 2 months. In contrast to findings from clinic-based interventions, early engagement in home visitation is associated with lower levels of functioning and acute needs. These findings add to a growing body of literature suggesting that increased adversity promotes engagement in prevention programs in general, and home visitation programs in particular. To the extent that mothers who are actively engaged in home visitation are likely to have increased psychosocial needs, curricula may require modification and augmentation to address these needs and optimize program effectiveness.     

Amino acid alanine reactivity with the fingerprint reagent ninhydrin. A detailed ab initio computational study

Ninhydrin is one of the most widely used reagents for chemical development of fingerprints on porous surfaces. The detection is based on the reaction of ninhydrin with a monoacidic component of the fingerprint to form an intensively colored compound named Ruhemann's Purple. A computational study of the mechanisms and reaction energetics of the formation of Ruhemann's Purple from ninhydrin and alanine is presented. Such a study is significant from a forensic science point of view because of the strong interest in the forensic chemistry and law enforcement communities in developing alternatives to the current generation of ninhydrin like chemicals for the detection and development of latent fingerprints. Information about the mechanism of reaction between ninhydrin and amino acids can ultimately help to design compounds with stronger chromo-fluorogenic properties in aid of detecting fingerprints at crime scenes. The three most accepted mechanisms of formation have been considered using ab initio quantum mechanical calculations. At relatively high temperature ( approximately 100 degrees C) all three mechanisms are energetically feasible. However since it is recommended that forensic analyses be performed at room temperature, a revised mechanism is proposed for the formation of Ruhemann's Purple under this condition.