Potential Use of Hydrocarbons for Aging Lucilia sericata Blowfly Larvae to Establish the Postmortem Interval

Previous studies on Diptera have shown the potential for the use of cuticular hydrocarbons' analysis in the determination of larval age and hence the postmortem interval (PMI) for an associated cadaver. In this work, hydrocarbon compounds, extracted daily until pupation from the cuticle of the blowfly Lucilia sericata (Diptera: Calliphoridae), have been analyzed using gas chromatography–mass spectrometry (GC–MS). The results show distinguishing features within the hydrocarbon profile over the period of the larvae life cycle, with significant chemical changes occurring from the younger larvae to the postfeeding larvae. Further interpretation of the chromatograms using principal component analysis revealed a strong correlation between the magnitudes of particular principal components and time. This outcome suggests that, under the conditions of this study, the cuticular hydrocarbons evolve in a systematic fashion with time, thus supporting the potential for GC–MS analysis as a tool for establishing PMI where such a species is present.     

Occult Adrenocortical Carcinoma and Unexpected Early Childhood Death

A four‐year‐old previously well boy collapsed unexpectedly and was taken immediately to hospital, where he developed seizures and cardiogenic shock with lethal, rapidly progressing multi‐organ failure. At autopsy, the height was >90th percentile and there were indications of early virilization. Internally, a friable tumor of the left adrenal gland was identified that had invaded the left renal vein and inferior vena cava. Histology revealed typical features of an adrenocortical carcinoma with aggregated trabeculae of cells containing abundant eosinophilic cytoplasm and large pleomorphic nuclei. There was strong positive cytoplasmic staining for inhibin; mitochondria were shown on electron microscopy to contain prominent electron‐dense granules. Death was due to massive pulmonary tumor embolism. Although adrenocortical carcinomas are very rare and are more commonly found in adults, the current case demonstrates that they may also occur in childhood and be responsible for unexpected death by the very unusual mechanism of tumor embolism.     

Evaluation of operation swordfish: a near-repeat target-hardening strategy

Objectives

This paper reports an evaluation of a police-led target-hardening crime prevention strategy inspired by research concerned with space–time patterns of burglary.

Methods

A total of 46 neighbourhoods in the West Midlands (UK) were randomly allocated to treatment and control conditions. Within treatment areas, resources were delivered to recent burglary victims and their close neighbours. Resources included inexpensive target-hardening measures as well as the delivery of dedicated police advice. The evaluation consisted of both a resident survey and a statistical outcome analysis.

Results

Results suggested that residents in treatment groups were slightly more satisfied with the police and more likely to have been contacted by the police concerning burglaries. Although they had more awareness of burglary, their fear of crime was not heightened. Statistical analysis suggested a very modest positive effect of intervention on crime and rates of re-victimisation. In particular, a survival analysis revealed that homes in low-crime treatment areas were less likely to be re-victimised than were those in similar control areas. Effects were more evident in low- than high-crime areas.

Conclusions

Results suggest that a low-intensity target-hardening intervention which adopted a near-repeat victimisation targeting strategy had a modest positive effect on residential burglary without increasing residents’ fear of crime.

     

From walls to membranes: fortress polis and the governance of urban public space in 21st century Britain

Drawing on the work of Paul Virilio, this paper addresses changes in the architectural and legal topography of the urban landscape through an examination of regulatory patterns, which increasingly intensify governance through, and as, ‘control’. Such regulation is ambivalent in that it cuts across many traditionally discrete regimes of power melding them into new forms with new effects; as a consequence it is no longer sufficient to think in terms of such distinctions as private/public, civil/criminal, and so on. This paper argues that a concern with patterns of enclosure and privatisation in our urban centres must now be placed within the context of changes in architectural practice and technology, which the authors term ‘open architecture’, and the embedding of governance through partnership, which give particular emphasis to the use of dematerialised and diffused modes of control. The paper utilises Virilio’s history and image of the fortress, which he tracks from a material form to a dematerialised form, to envisage these developments and to provide the foundation for an understanding of the importance of the development of practices of surveillance into, what the authors term, ‘total registration’ as a feature and function of governance through ‘control’.

Sudden infant death syndrome (SIDS)--standardised investigations and classification: recommendations

Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety of heritable and idiosyncratic endogenous factors interacting with exogenous factors. This has been elegantly summarised in the "three hit" or "triple risk" model. Contradictions and lack of consistencies in the literature have arisen from diverse autopsy approaches, variable applications of diagnostic criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions and protocols will ensure optimal investigation of individual cases and enable international comparisons of trends.     

Comparative Toxicology of Intentional and Accidental Heroin Overdose*

Abstract: The demographic and toxicological characteristics of deliberate (SUI, n = 50) and accidental (ACC, n = 927) fatal heroin overdose cases were examined. SUI cases were more likely to be female, had lower body mass indices, were more likely to be enrolled in treatment and less likely to have hepatic pathology. The median blood morphine concentration of SUI cases was significantly higher than that of ACC cases (0.70 vs. 0.40 mg/L, p < 0.001). Blood morphine concentrations of >1 mg/L were seen among 38.0% of SUI cases compared to 13.9% of ACC cases. Being a member of the SUI group remained a significant independent predictor of higher morphine concentrations after controlling for the effects of potential confounders (p < 0.001), other significant predictors being the absence of alcohol (p < 0.001), the presence of methadone (p < 0.05), and the presence of cocaine (p < 0.05). The current data are consistent with the view that suicide forms a small, but distinct, category of heroin overdose cases, rather than overdose being a parasuicidal phenomenon per se.     

The Ethical Health Lawyer: An Empirical Assessment of Moral Decision Making

Writing in 1999, legal ethics scholar Brad Wendel noted that "[v]ery little empirical work has been done on the moral decision making of lawyers." Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by the creation of a regular column "devoted to ethical issues arising in the practice of health law" in the Journal of Law, Medicine & Ethics , the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives.     

Using Administrative Data to Monitor Racial/Ethnic Disparities and Disproportionality Within Child Welfare Agencies: Process and Preliminary Outcomes

Child welfare administrative data are increasingly used to identify racial/ethnic disproportionality and disparities at various levels of aggregation. However, child welfare agencies typically face challenges in harnessing administrative data to examine racial/ethnic disproportionality and disparities at meaningful levels of analysis due to limited resources and/or tools for reporting. This article describes the process through which a multi-state workgroup designed and developed management reports to monitor racial/ethnic disparities and disproportionality using a web-based child welfare administrative data reporting system. The article provides an overview of the process, outcome, and challenges of the group’s work with the goal of offering a starting point for discussion to others who may be seeking to monitor racial/ethnic disparities and disproportionality, regardless of their reporting system.