US–China Energy Relations and Energy Institution Building in the Asia–Pacific

Although China and the US are starting their fourth decade of energy cooperation, it is only recently that there has been a concerted US effort to create a framework for US–China bilateral energy relations. The past 30 years have witnessed many successful energy projects that have lacked follow through and institutionalization, often becoming ‘one-off’ exercises that duplicated previous projects. Recent initiatives intend to establish long-term linkages between US and Chinese energy bureaucracies, linking energy efficiency, energy security, and environmental issues. The US is nesting the bilateral relationship in global and Asia–Pacific multilateral energy and environmental regimes, and is also using bilateral agreements as mechanisms to promote domestic energy and environmental reform. This paper will examine US–China relations in the Asia–Pacific Partnership on Clean Development and Climate and the Five-Country Energy Ministerial.     

Spleen and portal lymphnode pathology in fatal drug addiction

Spleen and portal lymphnode sections from 86 drug addicts submitted for medico-legal autopsy at the Institute of Forensic Medicine in Copenhagen in the year 1979 were studied together with tissue sections from 24 "normal" persons. In 70% of the drug addicts the spleen weight was more than 200 g, and in 71% portal lymphnode hyperplasia was found. Birefringent foreign material was found in spleen tissue of drug addicts in 72% and in portal lymphnode tissue in 44%. Signs of antigen stimulation in both spleen and portal lymphnode tissue evaluated by the number of germinal centre and plasma cells were found in more than 80% of the drug addicts compared with about 20% of the "normal" persons. The results were related to anamnestic information of duration of drug abuse, to the spleen weight, to the occurrence of birefringent material and to the liver changes. Examination of lysozyme and immunoglobulin containing cells using the indirect preoxidase technique was performed in a total of 72 cases of spleen tissue, 59 cases of portal lymphnode tissue from drug addicts, 24 cases of spleen tissue and 18 of portal lymphnode tissue from "normal" persons. Lysozyme, IgM and IgG containing cells were found significantly more often among drug addicts than "normal" persons. The results indicate that the splenomegalia and the portal lymphnode hyperplasia often found in drug addicts are caused by continuous antigen stimulation due to repeated injections of various antigens.     

Reye's syndrome in a child on long-term salicylate medication

A case of Reye's syndrome in a four-year-old child on long-term salicylate medication for rheumatoid arthritis is reported. Severe fatty changes of the liver, lipid vacuolation in the renal proximal tubules, and severe brain oedema were the prominent postmortem findings. Symptoms of a trivial infection and vomiting just before death added to the resemblance of this case to Reye's syndrome.     

Liver pathology in fatal drug addiction

Liver sections from 273 drug addicts submitted to medicolegal autopsy at the Institute of Forensic Medicine in Copenhagen in the period 1975 – 1979 were studied. In 65% of the cases non-specific portal inflammation only was found. Birefringent foreign material — identified as the mineral talc (magnesium silicate) was observed in 38% of the cases; in these cases non-specific portal inflammation was always present. Changes compatible with acute or chronic persistent hepatitis or hepatitis sequelae were observed in 8% of the cases; cirrhosis in 3%. HBs-antigen was detected in 4%. In 22% fatty infiltration was present; in 4% as the only abnormal finding. Finally no pathological changes were found in 6%. The results were related to anamnestic information of kind and duration of drug abuse and to the cause of death. Furthermore a comparison was performed between the groups with and without birefringent material. The data suggest that the birefringent material may be of importance to the pathogenesis of the non-specific portal inflammation.     

Violent Life Events and Social Disadvantage: A Systematic Study of the Social Background of Various Kinds of Lethal Violence,Other Violent Crime,Suicide, and Suicide Attempts1

ABSTRACT

Open sanctions and changes in conceptions of rehabilitation are changing qualification requirements in the field of prison and probation services. In particular, the significance of social interaction between employees and offenders has emphasized. This study examines this issue from the viewpoints of social constructionism and discourse analysis. Research material was collected by interviewing 11 Finnish Criminal Sanction Agency employees who prepared and enforced supervised probationary freedom. According to the results, social interaction was structured from different points of view and linked to differently constructed identities in the interviewees’ speech. Professional interaction and a confidential employee–offender relationship were viewed as a means to create occupational safety and prevent security risks, and also to support offender’s rehabilitation. In addition, employees used a discourse of daily interaction and support which emphasized the significance of everyday encounters with the offender. Employees were able to overcome the tension between support and control by flexibly combining the discourse of supervision with the discourse of daily interaction and support, which enabled them to support the offender without being a rehabilitation professional. The study reveals the central role of social interaction, which creates challenges for education, and the development of an organizational culture in prison and probation services.     

Markets and Municipalities: A Study of the Behavior of the Danish Municipalities

The complex pattern ofMarket Orientation of the 275 Danishmunicipalities is analyzed. An MO-variableis constructed from a poll covering 12tasks, where municipalities are free toproduce the service or purchase it on themarket. Six potential explanations of theMO-pattern are operationalized. Four ofthose work: (1) MO is a modernization, (2)spreading by diffusion. (3) MO increases ifthe municipality is under economicpressure. (4) MO stays low if the fractionof the population that depends upon thepublic sector is large. Whilestakeholder/pressure group politics thusworks, explanations based onideology/partisanship fail. In theintegrated Copenhagen metropolitan areamost explanations fail.     

Increased risk of fatal intoxication and polypharmacy among psychiatric patients at death

Patients suffering from psychiatric disorders have an excess mortality and a shorter life span expectancy compared to the general population. Furthermore, they are treated with multiple drugs and are known to have an increased risk of drug abuse. In this study, we aimed at investigating the pharmaceutical drug and drug of abuse profiles of the deceased included in the Danish prospective autopsy‐based forensic study on psychiatric patients, SURVIVE. Using the postmortem systematic toxicological analysis results, we identified 129 different consumed compounds in our population (n = 443). Polypharmacy (≥5 compounds) was detected in 39.5% of the deceased. Deceased with a psychiatric diagnosis or who died from a fatal intoxication had significantly more compounds at the time of their death compared to having either no psychiatric diagnosis or another cause of death, respectively. Evidence of drug abuse was present, as 29.8% of our total population had consumed either methadone or illicit drugs of abuse, excluding tetrahydrocannabinol. Of those deceased with a psychiatric diagnosis, 33.6% had either consumed methadone or illicit drugs of abuse, a greater number than those without a psychiatric diagnosis. Fatal intoxication was the most frequent cause of death (40.6%) with methadone as the major intoxicant. Here, we found that those without a psychiatric diagnosis had fewer fatal pharmaceutical drug intoxications compared to the psychiatric diagnosis groups. Our findings add further context to understanding the excess mortality of psychiatric patents, since there is an increased occurrence of fatal intoxication, polypharmacy, and drug abuse in this population.     

Dieulafoy lesion of the esophagus causing massive upper gastrointestinal bleeding and death: a case report

Dieulafoy lesion is a rare cause of upper gastrointestinal bleeding. We present a case report of sudden and unexpected death in a previously healthy male where autopsy revealed a classic Dieulafoy lesion with a submucosal artery protruding through a small mucosal defect in the esophagus, thereby exposing it to stress and consequent rupture. Advances in endoscopic techniques have drastically reduced mortality from Dieulafoy lesion. Nevertheless, it is an important diagnosis to be kept in mind when autopsy reveals an upper gastrointestinal bleeding.