The link between recurrent maltreatment and offending behaviour

This article considers recurrent maltreatment and offending behaviour. The sample was 60 males and 19 females (11 to 18 years) resident within a secure institution in England and considered a risk to themselves and/or others. Overall, 20.8% had not experienced maltreatment, 6.5% had experienced a single incident, 11.7% were repeat victims (same perpetrator), 6.5% were revictimised (different perpetrators), and more than half (54.5%) had suffered both repeat and revictimisation. Of those who had committed a violent and/or sexual crime, 74% had experienced some form of revictimisation, compared to 33% of those who committed nonviolent offences. Those young people most likely to have committed violent and/or sexual crimes were those who had been victims of recurrent extrafamilial maltreatment (many of whom had also experienced recurrent intrafamilial maltreatment). Thus, in this sample, revictimisation was associated with serious crimes. However, these findings are preliminary, and prospective research with a larger sample is needed.     

Sudden unexpected death due to a previously undiagnosed plasma cell dyscrasia

The plasma cell dyscrasias are a diverse group of disorders characterized by the production of a clonal paraprotein. Sudden death is a recognized complication of the plasma cell dyscrasias, most commonly in individuals with cardiac involvement by amyloidosis. However, the current forensic literature has no reported cases in which sudden death resulted from complications of a plasma cell dyscrasia that was first diagnosed by postmortem histologic examination. We present the case of a woman whose sudden and unexpected death resulted from a seizure. Postmortem examination revealed no evidence of trauma or a grossly identifiable natural disease process that would have accounted for her death. However, microscopic and immunohistologic studies revealed a previously undiagnosed plasma cell dyscrasia, the clonality of which was determined by immunohistochemical studies for immunoglobulin light chains, that was not associated with amyloid deposition. This case elucidates a previously unrecognized cause of sudden unexpected death and illustrates the importance of microscopic studies in selected cases examined in medical examiner/coroner offices.     

Investigation of Postmortem Absorption and Redistribution After the Application of a Fentanyl Patch

Fentanyl deaths have increased with availability of transdermal patches. Interpretation of postmortem fentanyl levels may be complicated by postmortem redistribution and absorption of fentanyl from a patch. We applied an unused 100‐μg/h fentanyl patch onto the lower abdomen of a decedent with no premortem fentanyl exposure. Ocular fluid, blood, and urine were collected prior to placement, and the decedent was refrigerated for 23 h. Prior to the autopsy, urine, subcutaneous tissue under the patch, and samples from the same anatomic sites were obtained. We observed no fentanyl in any postpatch placement samples (LOD: 0.1 ng/mL for blood and vitreous fluid, 1.0 ng/mL urine, 2.0 ng/g for tissues). Although we observed no postmortem absorption of fentanyl, this was only a single case; therefore, we recommend that patches be removed after receipt of a cadaver before initiation of an autopsy, with the location of removed patch documented.     

Displacing Marginalized Bodies: How Human Rights Discourses Function in the Law and in Communities

In this article, we examine disability and eugenics discourses and the ways they function in spaces where vulnerable persons have been historically excluded by the state and blamed for their own “immiseration.” We ask how queer theories of repudiation, abjection, and vulnerability lend insight into the ways that people with intellectual disabilities are discursively located outside normative discourses of home, care, and quality of life, and whether these discourses shifted to serve this vulnerable population when historically the very places in question repudiated them, infringed on their human rights, and questioned their sexuality. To address these questions, we focus on the recent and impending closures of Virginia’s Training Centers, residential institutions for persons with intellectual disabilities now scheduled for staggered closures before 2020.