Interpreting results of ethanol analysis in postmortem specimens: a review of the literature

We searched the scientific literature for articles dealing with postmortem aspects of ethanol and problems associated with making a correct interpretation of the results. A person's blood-alcohol concentration (BAC) and state of inebriation at the time of death is not always easy to establish owing to various postmortem artifacts. The possibility of alcohol being produced in the body after death, e.g. via microbial contamination and fermentation is a recurring issue in routine casework. If ethanol remains unabsorbed in the stomach at the time of death, this raises the possibility of continued local diffusion into surrounding tissues and central blood after death. Skull trauma often renders a person unconscious for several hours before death, during which time the BAC continues to decrease owing to metabolism in the liver. Under these circumstances blood from an intracerebral or subdural clot is a useful specimen for determination of ethanol. Bodies recovered from water are particular problematic to deal with owing to possible dilution of body fluids, decomposition, and enhanced risk of microbial synthesis of ethanol. The relationship between blood and urine-ethanol concentrations has been extensively investigated in autopsy specimens and the urine/blood concentration ratio might give a clue about the stage of alcohol absorption and distribution at the time of death. Owing to extensive abdominal trauma in aviation disasters (e.g. rupture of the viscera), interpretation of BAC in autopsy specimens from the pilot and crew is highly contentious and great care is needed to reach valid conclusions. Vitreous humor is strongly recommended as a body fluid for determination of ethanol in postmortem toxicology to help establish whether the deceased had consumed ethanol before death. Less common autopsy specimens submitted for analysis include bile, bone marrow, brain, testicle, muscle tissue, liver, synovial and cerebrospinal fluids. Some investigators recommend measuring the water content of autopsy blood and if necessary correcting the concentration of ethanol to a mean value of 80% w/w, which corresponds to fresh whole blood. Alcoholics often die at home with zero or low BAC and nothing more remarkable at autopsy than a fatty liver. Increasing evidence suggests that such deaths might be caused by a pronounced ketoacidosis. Recent research has focused on developing various biochemical tests or markers of postmortem synthesis of ethanol. These include the urinary metabolites of serotonin and non-oxidative metabolites of ethanol, such as ethyl glucuronide, phosphatidylethanol and fatty acid ethyl esters. This literature review will hopefully be a good starting point for those who are contemplating a fresh investigation into some aspect of postmortem alcohol analysis and toxicology.     

尸检样本乙醇分析结果的解释策略

由于死后各种复杂的人为现象的存在,使得建立死后血液酒精含量(BAC)和死亡时醉酒状态之间的关系十分困难。在日常检案中必须考虑细菌污染、发酵是否引起死后乙醇再合成,死亡时胃中未被吸收的乙醇是否向周围组织以及血中扩散等问题。本文总结了关于死后乙醇分析及结果解释相关问题的研究文献,旨在为从事法医毒物学乙醇分析的同行在调查此类案件时提供良好的开端。     

Governing by Looking Back: Historical Analogies and Crisis Management

This article offers a conceptual framework that broadens and enhances our understanding of the role of 'history' in contemporary governance and the attempts by policy-makers to 'manage' critical issues. Building upon the literature on historical analogies in policy-making, we distinguish three dimensions that clarify how the past may emerge in and affect the current deliberations, choices and rhetoric of policy-makers. We apply this in a comparative examination of two cases of crisis management where historical analogies played an important part: the Swedish response to (alleged) submarine intrusions in 1982, and the European Union sanctions against Austria in 1999. We induce from the case comparison new concepts and hypotheses for understanding the role of historical analogies in public policy-making and crisis management.     

Economic Freedom and Growth: Decomposing the Effects

Most studies of the relation between economic freedom andgrowth of GDP have found a positive relation. One problem inthis area is the choice of economic freedom measure. A singlemeasure does not reflect the complex economic environment anda highly aggregated index makes it difficult to draw policyconclusions. In this paper we investigate what specific typesof economic freedom measures that are important for growth.The robustness of the results is carefully analysed since thepotential problem with multicollinearity is one of thenegative effects of decomposing an index. The results showthat economic freedom does matter for growth. This does notmean that increasing economic freedom, defined in generalterms, is good for economic growth since some of thecategories in the index are insignificant and some of thesignificant variables have negative effects.     

Global capital and local labour. Strategies and labour relations in the Hex River Textiles factory from the 1940s to the early 1990s

ABSTRACT

This article analyses labour relations and management strategies in the Hex River Textiles factory in Worcester, South Africa, from the 1940s to the early 1990s. The factory was established by a French textile manufacturer in 1946, who relocated an entire mill from Bradford in England, to exploit the low wage labour provided by primarily coloured women. The strategy also included investments in new technology. The workers who were drawn into capitalist production resisted exploitation despite government attempts to crush the trade unions. In the late 1980s, trade union activity was rekindled, not least because there was a core group of coloured workers, who carried on the tradition. The strategy in the 1980s was less militant than in the 1950s, but, arguably more successful.     

Democracy the Swedish Way? The Exclusion of ‘Immigrants’ in Swedish Politics

Official declarations state that Sweden is today a multicultural society. At the same time, ethnic hierarchies have become increasingly conspicuous in contemporary Sweden. Recently, a governmental inquiry on structural discrimination in Swedish society presented a report analysing the relationship between the multi-ethnic composition of the Swedish population and participation in Swedish politics. This article discusses some of the main findings of the report. On the basis of a number of case studies, it illustrates how inequalities in terms of participation and influence in Swedish politics are (re)produced. One of the main conclusions drawn in the article is that all citizens that participate in Swedish politics are faced with a series of routines, conventions and idea(l)s categorising citizens according to their perceived closeness to a Swedish 'normality'. Thus, democracy not only constitutes a formalised system of impartial procedures and conventions, routines and norms that regulate the political process in a way that guarantees freedom and equality to all participants. Rather, political participation also reflects exclusionary practices long well-documented in, for example, the housing and labour markets. In order to understand these practices, it is necessary to examine the historical interconnections between nationalism and democracy . By means of the recurrent characterisation of Swedish democracy as specifically Swedish, it becomes the job of Swedes to 'enlighten' the 'immigrants' to become 'Swedish democrats'. This specific conceptualisation of democracy is founded on the ideal of an archaic national community, which in contemporary multi-ethnic Sweden is not capable of including the whole population on equal terms.     

Less is more or the more the merrier? Analysing attitudes towards multiple-mandate holding among local officeholders

The practice of multiple-mandate holding is widespread across Europe. Critics argue that this practice contributes to a concentration of political power, a higher risk for conflicts of interest and damage to the public image of political actors. Advocates meanwhile claim that it provides clear benefits, such as local embeddedness of the national or regional political decision-making and a greater degree of professionalisation in politics. However, little is known about how political actors themselves look upon this practice. This especially in a context like Finland, where this practice is said to be embedded in the political culture and where another institutional level has recently been implemented, making it possible for political actors to simultaneously hold political mandates at the local-, regional- and national levels. This paper examines attitudes towards multiple-mandate holding among local political decision-makers using unique survey data gathered through a new online panel. The results suggest that councillors from a populist radical right party and those who perceive corruption and partial treatment as more common were the most negatively disposed towards this practice, while councillors from the traditionally strongest rural party were the most in favour.     

Evaluation of the role of abstinence in heroin overdose deaths using segmental hair analysis

In the body heroin is rapidly metabolized to 6-acetylmorphine and morphine. Victims of lethal heroin overdose often present with fairly low blood concentrations of morphine. Reduced tolerance due to abstinence has been proposed to account for this finding. The aim of the present study was to examine the role of abstinence in drug-related deaths by comparing recent and past exposure to opioids using segmental hair analysis with the postmortem blood morphine concentrations in deceased heroin users. The study included 60 deceased drug addicts in the Stockholm area, Sweden. In 32 cases, death was not related to heroin intake. In 18 of the 28 heroin fatalities, opioids were absent in the most recent hair segment, suggesting a reduced tolerance to opioids. However, the blood morphine levels were similar to those found in the 10 subjects that showed continuous opioid use. Hair and blood analysis disclosed an extensive use of additional drugs that directly or indirectly may influence the opioid system. The results suggest that abstinence is not a critical factor for heroin overdose death. Obviously tolerant subjects die after intake of similar doses. Other factors, particularly polydrug use, seem to be more causally important for these deaths.     

Exports and productivity of Russian firms: in search of causality

This paper uses a census of Russian manufacturing firms to study the relationship between exports and productivity at the firm level. The period studied, 1996–2002, implies that the results are affected by the Russian financial crisis of 1998. Exporters are shown to be more productive and larger than non-exporters, seemingly an effect of more productive firms self-selecting into the export market, rather than learning effects. But learning effects are significant among new entrants. Additionally, in examining the effect of the direction of exports on productivity, the finding is that the difference in the productivity level of firms exporting to the OECD and the CIS is insignificant.