Cardiac pathology in 470 consecutive forensic autopsies

Cardiovascular disease continues to be the single most common generic cause of sudden and unexpected deaths. Atherosclerotic coronary heart disease and acute myocardial infarction are the most prevalent forms of fatal cardiac disease observed at autopsy. Other cardiac lesions are frequently listed as causes of death, but the prevalence of such lesions as incidental findings in the general population is unknown. In this study, 470 consecutive forensic autopsies were evaluated for minor and major anomalies. The most frequently observed major congenital finding was floppy mitral valve (5%). Tunneled coronary arteries, considered minor congenital findings, were seen in 29%. Atherosclerotic coronary heart disease was the most common major acquired finding, observed in 16% of cases. Of the 470 hearts, only 8% were considered normal.     

The Theory and Practice of “Nudging”: Changing Health Behaviors

Many of the most significant challenges in health care—such as smoking, overeating, and poor adherence to evidence‐based guidelines—will only be resolved if we can influence behavior. The traditional policy tools used when thinking about influencing behavior include legislation, regulation, and information provision. Recently, policy analysts have shown interest in policies that “nudge” people in particular directions, drawing on advances in understanding that behavior is strongly influenced in largely automatic ways by the context within which it is placed. This article considers the theoretical basis for why nudges might work and reviews the evidence in health behavior change. The evidence is structured according to the Mindspace framework for behavior change. The conclusion is that insights from behavioral economics offer powerful policy tools for influencing behavior in health care. This article provides public administration practitioners with an accessible summary of this literature, putting these insights into practical use.     

Realising the Right to Health for Young People in South Africa—Some Reflections

Abstract

The right to health is enshrined in the South African Constitution as well as a range of international and regional human rights treaties which South Africa accepts. Yet empirical data reveals some of the challenges faced by South African youth—childhood diseases, HIV/AIDS and such like. There are evidently challenges realising the right to health in practice. Nevertheless, South African courts have led the international field in recognising the justiciability of economic and social rights such as the right to health. Having reviewed the applicable laws and jurisprudence, the paper will conclude that a more holistic human rights-based approach offers perhaps the best way forward.     

Malta

European Journal of Political Research -     

Geographic Representation in Party‐Dominated Legislatures: A Quantitative Text Analysis of Parliamentary Questions in the German Bundestag

Political representation in European democracies is widely considered partisan and collectivist. This article, however, stresses that there is more to the representative process in European democracies than just its textbook version. It emphasizes the role of geographic representation as a complementary strategy in party‐dominated legislatures that is characterized by two distinct features. First, legislators employ distinct opportunities to participate in legislative contexts to signal attention to geographic constituents without disrupting party unity. Second, these activities are motivated by individual‐ and district‐level characteristics that supplement electoral‐system‐level sources of geographic representation. We empirically test and corroborate this argument for the German case on the basis of a content analysis of parliamentary questions in the 17th German Bundestag (2009–13). In this analysis, we show that higher levels of localness among legislators and higher levels of electoral volatility in districts result in increased geographic representation.     

The effect of digital technology on prisoner behavior and reoffending: a natural stepped-wedge design

Objectives

Although prisons aspire to rehabilitate offenders, they fail to prepare prisoners for release into our modern digitally sophisticated society. The objectives of the current study were to assess the impact of digital technology on the culture of prisons, and on prisoners’ ability to self-manage their behavior and reoffending.

Method

Using a natural stepped-wedge design, 13 prisons in the UK were examined that had installed self-service technology over a period of 7 years. A longitudinal multi-level model was used to analyze frequencies of disciplinary proceedings within and between the prisons before and after installation. Reoffending was examined in comparison with a control sample. Quantitative results were supported by a prisoner survey and usage data.

Results

Prison disciplinary offenses were significantly reduced over a two-year period, and reoffending in the first year after release was reduced by 5.36% compared to a 0.78% reduction in comparison prisons. The prisoner survey and usage data suggested that prisoners felt much more in control of their lives in prison and much more confident in coping with technology in the outside world.

Conclusions

The changes created by the introduction of digital technology offer the opportunity to make prisons more efficient for staff, and places of improved learning and rehabilitation for prisoners, contributing to a safer society. This study offers an important contribution to the field of corrections, providing the first quantitative assessment of the effect of prisoner self-service technology on prisoner behavior and reoffending.

     

Democracy,Power and Indigeneity

This article identifies a theoretical nexus between indigeneity and liberal democracy in three post‐colonial contexts. Like democracy, the politics of indigeneity asks questions and makes assumptions about where power ought to lie and how it ought to be shared in relation to political inclusion and national sovereignty. The interaction of indigeneity with democracy highlights the limitations of liberal theory as well as the opportunities it provides to meet indigenous claims and conceptions of justice. Exploring the ideological tensions and commonalities between democracy and indigeneity allows a contrast, in comparative context, of the proposition that in Fiji, for example, democracy is “a foreign flower” unsuited to the local environment with the argument that liberal representative democracy can, in fact, mediate power in favour of an inclusive national polity.