Drowning of a Friedreich's ataxia patient

We here report an unusual, apparently accidental death, in which weakness associated with a progressive neuromuscular disease, Friedreich's ataxia, apparently resulted in the drowning of the deceased. The possibility of neuromuscular disease as a rare cause of drownings should not be overlooked.     

Correlations on radioimmunoassay, fluorescence polarization immunoassay, and enzyme immunoassay of cannabis metabolites with gas chromatography/mass spectrometry analysis of 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine specimens.

Results obtained from three commercial immunoassay kits, Abuscreen, TDx, and EMIT, commonly used for the initial test of urine cannabinoids (and metabolites) were correlated with the 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (9-THC-COOH) concentration as determined by GC/MS. Correlation coefficients obtained based on 26 (out of 1359 total sample population) highly relevant samples, are 0.601 and 0.438 for Abuscreen and TDx. Correlation coefficients obtained from a parallel study on a different set of 47 (out of 5070 total sample population) highly relevant specimens are 0.658 and 0.575 for Abuscreen and Emit. The immunoassay concentration levels, that correspond to the commonly used 15 ng/ml GC/MS cutoff value for 9-THC-COOH, as calculated from the regression equations are 82 ng/ml and 75 ng/ml for TDx and EMIT and 120 ng/ml and 72 ng/ml for Abuscreen manufactured at two different time periods. The difference of these calculated corresponding concentrations provides quantitative evidence of the reagent specificity differences.     

Hazards of mattresses, beds and bedding in deaths of infants

Of 52 infants who had died suddenly and were referred to autopsy, nine had lain on adult water beds for the first time; five had died as a result of accidents; two had died on water beds; two were in beds with widely spaced slats; and one had died as a result of strangulation. Three deaths were due to overlying. Three other infants had been placed on sheepskin rugs for the first time and were found dead shortly thereafter. These infants ranged in age from 2 to 9 months, except for a severely mentally retarded nine-year-old with spastic paraplegia. We believe that a general warning should be issued concerning water beds and that soft bedding should not be used for infants. Infants should not be placed unattended or left to sleep on water beds; only beds recommended for infants should be used. Overlying of a young infant is most likely to occur on a water bed, or if the parent is obese or has consumed alcohol.     

Toxicology and Circumstances of Completed Suicide by Means Other than Overdose*

Abstract: To determine the prevalence and circumstances of psychoactive substances amongst nonoverdose completed suicide, 1436 consecutive cases autopsied at the NSW Department of Forensic Medicine over the period 1/1/1997–12/31/2006 were analyzed. Substances were detected in 67.2% of cases, and illicit drugs in 20.1%. Alcohol was present in 40.6% of cases. Males were more likely to be positive for alcohol, cannabis, and psychostimulants, and females for pharmaceuticals. Illicits were associated with younger age. Alcohol was most prominent amongst toxicity cases, as were opioids, psychostimulants amongst gunshot cases, and pharmaceuticals amongst drownings. Cases in which drug and alcohol histories were noted were more likely to have a substance detected. Alcohol was more common where a suicide note was left and where relationship problems were involved. Pharmaceuticals were more common where a previous attempt was noted. Licit and illicit substances are strongly associated with suicide, even when the method does not involve drug overdose.     

Group Identity and Alienation: Giving the We Its Due

The purpose of this paper is to argue for greater understanding and valuing of group affiliation and the formation of allegiances to groups during early adolescence. An overemphasis on themes of individual identity, self-reliance, and autonomy as the developmental trajectory of adolescence leads to a lack of attention to the positive, normative mechanisms that permit young adolescents to achieve a sense of belonging and connection. We propose developmental processes which underlie the capacity for reflection about groups, 4 basic components of group identity, and 6 propositions about new capacities that emerge as young adolescents struggle with the dialectic between group identity and alienation. The final section suggests opportunities that can emerge through a more appropriate emphasis on group identity as a valued, normative aspect of development during the early adolescent years.     

Constitutional Conversations

This is a review essay of Rajeeva Bhargava's Politics and Ethics of the Indian Constitution (5th ed., 2012), Sudhir Krishnaswamy's Democracy and Constitutionalism in India: A Study of the Basic Structure Doctrine (3rd ed., 2012), and Madhav Khosla's The Indian Constitution, Oxford India Short Introductions (2012).