Objectives: To report and associate acute cerebral infarctions in 2 young, previously healthy siblings with use of the street drug known as "spice" (a synthetic marijuana product, also known as "K2"), which they independently smoked before experiencing acute embolic-appearing ischemic strokes.Methods: We present history, physical examination, laboratory data, cerebrovascular imaging, echocardiogram, ECG, and hospital course of these patients.Results: We found that in both siblings spice was obtained from the same source. The drug was found to contain the schedule I synthetic cannabinoid JWH-018. Full stroke workup was unrevealing of a stroke etiology; urine drug screen was positive for marijuana.Conclusions: We found that our 2 patients who smoked the street drug spice had a temporal association with symptoms of acute cerebral infarction. This association may be confounded by contaminants in the product consumed (i.e., marijuana or an unidentified toxin) or by an unknown genetic mechanism. The imaging of both patients suggests an embolic etiology, which is consistent with reports of serious adverse cardiac events with spice use, including tachyarrhythmias and myocardial infarctions. Spice, a schedule I synthetic marijuana (also known as "K2"), is a recreational street drug with many known adverse effects, including seizures and myocardial infarction. However, to our knowledge, cerebral infarction associated with synthetic marijuana use has yet to be reported in the medical literature. Spice is frequently abused by young adults with increasing popularity because of its euphoric effects and the ease with which it is obtained, which creates the perception of "a legal high." The US Drug Enforcement Agency (DEA), law enforcement, hospitals, and poison control centers have noted gradually increasing use of spice in the United States since 2009. In 2011, 5 synthetic cannabinoids used in spice were categorized as schedule I substances under the Controlled Substances Act: JWH-018; JWH-073; 497; and cannabicyclohexanol. 1 At the time of our patients' presentations, spice was available for sale over-the-counter at convenience stores, smoke shops, gas stations, and over the Internet, and labeled as "herbal blends," "air fresheners," or "incense," often with the warning "not for human consumption."2 Common side effects of spice include tachycardia, vomiting, agitation, confusion, and hallucinations; more serious adverse reactions (seizures, myocardial infarction) have recently appeared in the medical literature. 2-4Furthermore, a number of spice-associated deaths have been reported in national news media. To our knowledge, the medical literature has not yet reported ischemic stroke associated with synthetic marijuana. We present 2 young siblings who experienced acute ischemic strokes soon after smoking synthetic marijuana.CASE REPORTS Patient A. A 26-year-old man was brought to the emergency department by emergency medical services approximately 50 minutes after he had the sudden onset of dysarthria, expressive ...

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This article examines the experiences of home education for Gypsy and Traveller groups in England, UK. We argue that home education is perceived in a particular historical 'moment' characterised in the media and more generally throughout society by 'risk'. Against this backdrop this article considers Gypsy and Traveller experiences of home education and their relationships with local education authorities. Drawing on case study data with ten Gypsy and Traveller families living on the South coast of England we argue that the marginal status of Gypsy and Traveller families exposes them to particular vulnerabilities associated with failure, incompetence and lack of concern regarding the education of their children. This is further heightened in present day 'risk society'. Drawing on the work of Ulrich Beck, we suggest home education is both a reaction to the risks associated with modernisation and also a perceived risk in itself when equated with issues of child protection and welfare. Despite maintaining community networks and longstanding traditions of home education, Gypsy and Traveller lifestyles are still perceived as being at risk within a 'moment' in which home education is under scrutiny.

This paper examines inclusionary processes and examples of 'good practice' in primary and secondary schools for Gypsy, Roma and Traveller pupils in one inner London Borough in the UK. It will explore the role of the Traveller Education Service (TES) and argue that the support provided by the TES to schools is essential for the development of 'good practice', but at the same time it stresses that the TES is not a substitute for the school's educational and welfare responsibilities. The paper will also argue that the commitment of the head teacher and senior management team to the inclusive ethos of the school is crucial in setting the tone of the school towards positive treatment of Gypsy, Roma and Traveller pupils. Where an inclusive ethos works successfully it is often the result of a wider social engagement between the school and community. The paper will draw on qualitative interview data with parents, head teachers, deputies, heads of year, teachers, and classroom assistants at the schools.

This paper examines understandings of community and safety for Gypsy, Roma and Traveller (GRT) groups in schools in a metropolitan borough. One school in particular was identified as being the 'Gypsy school' and was attended by the majority of GRT children in the borough. The school was recognised as a model of 'good practice' reflecting its holistic approach towards the GRT community but it was also successful for wider reasons. A picture of the intersection of different communities emerged from interview accounts in which a GRT community with strong local attachments, socially negotiated and maintained, figured very strongly. The GRT community was also identified as sharing racist attitudes towards other non-white immigrants. This article examines children's perspectives of their engagement with the education process and how the strong GRT community played an important part in their understandings of safety and belonging.