Comparing perceptions of long-acting reversible contraception among women during periods of incarceration and women attending a local clinic: An exploratory study.

OBJECTIVES: The objective of this study was to understand perceptions of long-acting reversible contraception (LARC) among incarcerated women. We compared survey responses specific to IUDs and implants between a convenience sample of incarcerated women to a sample of women attending a local ob/gyn clinic. STUDY DESIGN: We conducted a cross-sectional survey among two groups: (1) incarcerated women receiving medical care at the state correctional facility, and (2) women receiving care at an ob/gyn clinic in the same community. The anonymous survey included questions about demographic variables, current and past contraceptive use, and perception of IUDs and implants. RESULTS: Almost half of the total sample stated that they might consider an IUD or implant for contraception. Incarcerated women tended to be less likely to give an affirmative answer to current or future use of an IUD or implant (29% vs 39%, p = 0.19). Concerns about pain and side effects were similar between the groups, but more incarcerated women cited concerns about device removal (72% vs 57%, p = 0.02) and the level of training of the provider inserting the device (68% vs 53%, p = 0.02). Incarcerated women interested in using the IUD or implant were more comfortable with device placement in the community than in the correctional setting (42% to 30%, p < 0.001). CONCLUSIONS: Incarcerated women have concerns about LARC that may be specific to their experience of incarceration. Providers working with incarcerated women should consider these when counseling patients on contraceptive choices. Options for post-release follow-up care and device removal should be included in this discussion. IMPLICATIONS: Incarcerated women should receive comprehensive reproductive health care, including contraceptive services if desired. However, incarceration itself may introduce fundamental concerns regarding contraception and these concerns need to be better understood to balance the provision of services with the potential for reproductive coercion.

Revenge filicide: An international perspective through 62 cases.

Filicide is the purposeful killing of one or more children by a parent, step-parent, or other parental figure. Revenge filicide is a poorly understood, rare form of filicide in which a parent murders their child to cause emotional harm to the child's other parent. This descriptive study presents an international case series consisting of 62 revenge filicide cases from nine countries. Perpetrators were about equally likely to be male or female. Over half of the sample had an active mental disorder of any type, most often a personality disorder. A history of domestic violence was common. The mean victim age was 6 years. They were typically killed by asphyxiation, firearms, or knives, and preschool age children were targeted most frequently. In half of the cases, more than one child was murdered. Post-crime suicidal behavior was commonplace, and one-third of the sample died by suicide. Four revenge filicide subtypes were identified: rejection, custody/visitation dispute, infidelity/jealousy, and argument/conflict. These categories may prove useful in future research and for helping to identify children at high risk of becoming filicide victims. All surviving offenders were criminally convicted, and in only one case was a mental health defense successful in lessening culpability. Notable similarities and differences between the US and international cases are discussed.

Mosaic trisomy 20 and mitigation in capital crimes sentencing: A review and case report.

Trisomy 20 is a genetic abnormality in which individuals have an extra copy of chromosome 20. Complete trisomy 20 is rare and believed to be incompatible with life. A mosaic form of trisomy 20, in which only some cells or tissues contain the extra chromosome, is a relatively commonly encountered chromosomal abnormality found during prenatal testing, and c. 90% result in a normal phenotype. However, despite the absence of a consistent phenotype, certain findings have been reported across multiple cases of mosaic trisomy 20. These include an array of morphological findings, developmental delays, and learning disabilities. Beyond physical manifestations, a wide range of developmental and learning delays have also been reported. In this work, we provide an overview of the trisomy 20 literature and a case report of a young adult male with mosaic trisomy 20 who committed homicide. His developmental and life history, eventual diagnosis of mosaic trisomy 20, similarities and differences in his condition compared with prior research findings, and potentially new phenotypic findings associated with trisomy 20 that he manifested (childhood visual hallucinations, self-injury, polydactyly) are presented. Additionally, the potential role of this genetic diagnosis in his neuropsychiatric history and its successful application as a mitigating factor at his capital sentencing trial are described. We did not identify other similar cases during our search of major scientific and legal databases. As a backdrop, the use of genetics in criminal trials is on the rise, and courts are increasingly likely to accept behavioral genetics evidence; therefore, it is crucial that the legal system is well acquainted with the opportunities and limitations of these approaches.