System Change through Collaboration…Eight Steps for Getting from There to Here

Family courts and child welfare agencies across the country are charged with protecting the safety of our children. That mission has become more challenging with increasing federal legislation and decreasing funding. In Buffalo, N.Y., the Family Court and the Department of Social Services have teamed up to respond to this challenge. With minimal additional staffing and resources, they have led a collaboration of agencies and service providers to change the way business is done in child welfare. By engaging each other in an interagency system change effort, the amount of time children spend in foster care has been reduced. The collaboration has been able to accomplish in a relatively short time what no agency had previously been able to accomplish on its own. The beneficiaries have been the children and families of Erie County.     

Driving less for better air: Impacts of a public information campaign

In the wake of the 1990 amendments to the Clean Air Act, localities across the United States initiated public information campaigns both to raise awareness of threats to air quality and to change behavior related to air pollution by recommending specific behavioral changes in the campaign messages. These campaigns are designed to reduce the health hazards associated with poor air quality and to avoid federal sanctions resulting from the failure to meet air quality standards. As in many other communities across the country, a coalition of government agencies and businesses initiated a public information campaign in the Atlanta metropolitan region to reduce certain targeted behaviors, mainly driving. A two‐stage model used to analyze data from a rolling sample survey shows that the centerpiece of the information campaign—air quality alerts—was effective in raising awareness and reducing driving in a segment of the population. When the overall information campaign was moderated by employers' participation in programs to improve air quality, drivers significantly reduced the number of miles they drove and the number of trips they took by car on days when air quality alerts were sounded. Public information campaigns can be successful in increasing awareness, but changing well‐established behaviors, such as driving, is likely to require institutional mediation to provide social contexts that support the behavioral change, as well. © 2003 by the Association for Public Policy Analysis and Management.     

Rapid death from thrombotic thrombocytopaenic purpura following caesarean section.

We report a case of rapid death from thrombotic thrombocytopaenic purpura (TTP) in a young pregnant lady who developed full blown symptoms soon after caesarean section. Extensive intramyocardial confluent haemorrhages and widespread microthrombi in heart, brain, adrenals and kidney were found at autopsy. Thrombotic thrombocytopaenic purpura is an uncommon condition, which carries a high fatality rate if untreated. Awareness of this syndrome together with its high risk of sudden death underlines the importance of rapid diagnosis and treatment.     

Determination of cocaine and benzoylecgonine in human amniotic fluid using high flow solid-phase extraction columns and HPLC.

A new solid-phase extraction procedure for the determination of cocaine and benzoylecgonine in amniotic fluid, using high flow co-polymeric sorbents is reported. The recoveries of cocaine and benzoylecgonine within the range 0.1-1 mg/l were 95.7% and 50.3%, respectively. The use of high-flow sorbents allowed the easy extraction of amniotic fluid regardless of sample viscosity or physical nature. The use of these solid-phase columns provided many advantages over the more commonly used solvent extraction, including an increase in extraction speed and efficiency, reduced operator time, reduced solvent use and disposal volumes and exceptional extract quality. Further, the determination of amniotic fluid obtained from pregnant cocaine users may provide important information about handling of cocaine by the fetus at various gestational ages. The procedure was successfully applied to amniotic fluid from suspected cocaine abusers.     

Polymerase chain reaction (PCR) amplification and human leukocyte antigen (HLA)-DQ alpha oligonucleotide typing on biological evidence samples: casework experience.

The polymerase chain reaction (PCR) method of specific gene amplification was used in casework to synthesize millions of copies of the polymorphic second exon of the human leukocyte antigen (HLA)-DQ alpha (or DQA1) locus from a variety of evidence samples. The HLA-DQ alpha allelic variants in the amplified deoxyribonucleic acid (DNA) were determined in a rapid non-radioactive test by hybridization to sequence-specific oligonucleotide probes in both the dot-blot and reverse dot-blot formats. This genetic typing system has been subjected to blind proficiency testing; the performance of this test in the analysis of experimentally mixed samples was also evaluated. As of August 1990, over 250 cases have been tested and more than 2000 individual evidence (bloodstains, semen stains, individual hairs, bone fragments, and tissue sections) and reference samples have been analyzed. The first 198 of these cases are summarized in this paper; in 65% of the cases with conclusive results a suspect was included, and in 35%, all suspects were excluded. Individual cases as well as some of the general issues relating to forensic science analysis and this genetic typing system are discussed. The high rate of exclusion reported here combined with the ability of PCR to type old evidence samples suggests the relevance of this genetic test for postconviction review; two cases in which the convicted suspect was excluded are discussed.     

Sulfide concentrations in postmortem mammalian tissues

Postmortem changes in sulfide concentrations in body tissues were examined in autopsied rats exposed to hydrogen sulfide concentrations of 550 to 650 ppm, and in nonexposed rats and humans. Analyses were made by gas chromatography, following an extractive alkylation. Sulfide concentrations in the blood, liver, and kidneys of rats increased in both the exposed and nonexposed groups, depending on the lapse of time after death. On the other hand, the lung, brain, and muscle showed little or no change in sulfide concentration with elapse of time after death. The data obtained from human tissues were almost the same as those for rats, except data for blood, in which no or little increase of sulfide was observed.     

Measuring carbon monoxide content in muscles

A method ist described to determine the CO-content in the tissue of muscles. The prepared tissue is pulverized in a swinging mill at the temperature of liquid nitrogen. Parts of the powder are weighed into headspace vessels. Carbon monoxide ist ejected by a formerly described method and measured gaschromatographically. The Fe-content is determined after an acid disintegration by AAS. Acute intoxications lead to higher CO-contents in heart than in periphere muscles. Chronic exposure to carbon monoxide does not produce these differences.     

Sudden death in angiodysplasia of the gastroesophageal junction.

A 22-year-old Korean soldier, who had received blows to the neck and epigastrium from an officer 10 h earlier, suddenly died after massive hematemesis. He had been in relatively good health except for episodes of blood-tinged vomiting approximately 5 and 7 months prior to this event. Postmortem examination revealed angiodysplasia involving the gastroesophageal junction, and the stomach was distended with blood. No abnormal findings were present around the whole viscera, and the duodenum was free of blood. The pathologic significance of upper gastrointestinal angiodysplasia as a potential source of bleeding and a chronologic correlation between the trauma and bleeding are discussed.