A qualitative analysis of the use of community treatment orders in Saskatchewan

This study examined the opinions of patients who have been placed on a community treatment order (CTO), their relatives, mental health clinicians and representatives of community agencies about the use of CTOs in Saskatchewan. Patients were assessed using indepth interviews, while their relatives, mental health professionals and representatives of community agencies took part in facilitated focus groups. Patients had contradictory feelings about CTOs. Most experienced some degree of coercion while on the orders but many believed that CTOs provided necessary structure in their lives. Clinicians were more consistently positive but recognized the difficult choices in balancing the subject's right to self-determination with the benefits of a treatment order. Family members viewed CTOs as necessary to control a chaotic situation caused by the subject's limited insight.     

Domestic violence among immigrants from India: What we need to know — and what we should do

Little research has been reported on domestic violence among Indian immigrant families in the United States. While one national survey suggests that this is not a major problem, several smaller scale studies that focus specifically on South Asian immigrants suggest there is a substantial hidden problem warranting attention. In order to assist future research, this paper presents an integrated theoretical model to explain domestic violence in Indian immigrant communities. The model draws on feminist theory, family violence research, acculturation theory and victimological and crime opportunity theories. The model also provides a framework for thinking about possible intervention strategies. Those likely to provide more immediate benefits are discussed.     

Sudden unexpected death in a patient with splenic sequestration and sickle cell-beta+-thalassemia syndrome

Acute splenic sequestration crisis is a rare disorder that usually occurs in children, with sickle cell anemia, who are under the age of five years. A few cases have been described in adults with heterozygous sickle cell syndromes. Though this entity can be fatal there have been no reported cases associated with sudden death. We describe a case of sudden, unexpected death, associated with splenic sequestration, in a 29-year-old African-American man with undiagnosed sickle cell-beta-thalassemia syndrome.     

Techniques of Knowing in Administration: Co‐production,Models, and Conservation Law

Law frequently demands the production, sometimes effortful, of adequate knowledge for decision making. This article explores the challenging epistemic demands made by nature conservation law during planning law approval processes for major offshore wind farms. It explores this area through the prism of co‐production: not only are ‘science’ and ‘facts’ socially and legally constructed, but in addition, scientific and factual findings shape society, and law and governance. Models are used in planning law to assess whether bird deaths associated with a proposed wind farm will have an adverse effect on the integrity of a protected site. As much as providing an accurate factual representation of the impact of a wind farm on biodiversity, the models contribute to the very possibility of governing the impact of these novel infrastructure developments on biodiversity.     

Understanding the Structure of a Large Heroin Distribution Network: A Quantitative Analysis of Qualitative Data

An analysis is reported of 2,408 wiretap conversations gathered in the course of prosecuting a heroin dealing organization in New York City in the 1990s. The five-step analysis, which included a social network analysis of phone contacts, revealed a large, loosely structured group of 294 individuals, most of whom had very limited contacts with others in the group. The group’s active core comprised 38 individuals with extended contacts, little status differentiation and some task specialization. A smaller more tightly connected group of 22 individuals was somewhat independent of the remainder of the core and appeared to constitute a “communal business”. The existence was not confirmed of the large criminal conspiracy described by the prosecution that operated at all levels of trafficking and dealing, from wholesale distribution to street sales. Rather, it appeared that the 294 individuals comprised one segment of the heroin market in the city. However, the discrepancy could be due to the fact that the prosecution drew upon a wider set of information about the individuals concerned than provided by the wiretap data. The study supports recent analyses that see organized crimes, such as drug trafficking, as mostly the work of small groups of loosely linked entrepreneurs rather than large, highly structured criminal syndicates.

A classifier for the SNP-based inference of ancestry

Ancestral inference from DNA could serve as an important adjunct for both standard and future human identity testing procedures. However, current STR methods for the inference of ancestral affiliation have inherent statistical and technical limitations. In an effort to identify bi-allelic markers that can be used to infer ancestral affiliation from DNA, we screened 211 SNPs in the human pigmentation and xenobiotic metabolism genes. Allele frequencies of 56 SNPs (most from pigmentation genes) were dramatically different between groups of unrelated individuals of Asian, African, and European descent, and both observed and simulated log likelihood ratios revealed that the markers were of exceptional value for ancestral inference. Log likelihood ratios of the multilocus estimates of biological ancestry (EAE/EBA) ranged from 7 to 10, which are on par with the best of the STR batteries yet described. A linear classification method was developed for incorporating these SNPs into a classifier model that was 99, 98, and 100% accurate for identifying individuals of European, African, and Asian descent, respectively. The methods and markers we describe are therefore an important first step for the development of a practical multiplex test for the inference of ancestry in a forensics setting.     

Cardiac rupture in acute myocardial infarction: a reassessment

Cardiac rupture as a complication of acute myocardial infarction (AMI) has been described as occurring infrequently. Because of the recent dramatic decrease in autopsy rates, the authors believe that current studies do not accurately represent the frequency of this catastrophic complication. Autopsy protocols and archived histologic slides of patients with AMI were retrospectively reviewed to determine whether the frequency of cardiac rupture, as a complication of AMI, is altered when a non-hospital-based patient cohort after autopsy is evaluated. This review yielded 153 cases of 41 women and 112 men, whose postmortem examinations revealed gross and histologic evidence of AMI. Cardiac rupture was present in 30.7% of these cases. Of the 47 patients with rupture, 35 had no relevant medical history. The remaining 12 patients had various medical conditions. None of the patients in the rupture group had previously treated symptoms related to coronary artery conditions. Whereas women constituted 26.8% of the total AMI group, they had a cardiac rupture rate of 61%. By contrast, men with AMI had a cardiac rupture rate of 19.6%. All patients in the cardiac rupture group had heart weights over the predicted expected weight as a function of body weight. Age, gender, and heart weight were significant factors associated with cardiac rupture, whereas body mass index was not significantly related. When these factors were evaluated jointly, age was a significant explanatory factor for rupture among both men and women, whereas body mass index and heart weight were significant for men but not for women. When the rupture sites occurred on the left ventricular myocardium, the anterior wall was affected in 21 cases (45%), the posterior wall in 18 (38%), the lateral wall in 4 (9%), and the apex in 3 (6%). The right ventricular myocardium ruptured in 1 case (2%). Most of the patients had severe multivessel coronary artery disease. Histologic study of the specimens showed that the majority of ruptures occurred between 24 and 72 hours after myocardial infarction. This study showed a frequency of cardiac rupture of 30.7% in patients with AMI and sudden death according to medical examiner's records. These findings confirm and reinforce the importance of postmortem examination and autopsy as an adjunct to clinical medical practice.     

Heroin body packing: three fatal cases of intestinal perforation

Death from heroin body packing has been well described in the forensic literature. Most fatalities are due to drug leakage and consequent acute heroin toxicity. Recently, drug traffickers have become more sophisticated in their packaging, and the risk of rupture of drug packets is more remote. Though intestinal obstruction is a recognized risk of body packing, rarely has this resulted in death. We describe four cases of heroin body packing presenting to the Regional Medical Examiner Office in New Jersey. Death in three of these cases was due to intestinal obstruction, with resultant intestinal rupture and peritonitis. Toxicologic evaluation in these three cases was negative for opiates or other drugs of abuse. In one case, death was due to acute heroin toxicity, validated by toxicologic analysis. We briefly discuss the differing drug packaging found in these four cases and the ramifications of packaging as it relates to intestinal obstruction.