The Effects of Gender Faultlines and Distribution of Rewards on Intragroup Power Struggles and Group Performance

Social Justice Research - Despite the relevance and importance of distribution of rewards for group performance, especially groups with active faultlines, existing literature exploring these...     

Death during transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery

Treatment for individuals suffering from migraines and pain due to an inflammation or impingement of a nerve range from noninvasive methods such as massage, physical therapy, and medications to invasive methods such as epidural steroid injections and surgery. Each method of treatment has an associated level of risk. While minor to moderate complications from such procedures do occur, deaths are very rare. We report the first cited case of a death associated with the pain management procedure called nerve root block, also referred to as a transforaminal epidural steroid injection. We present the medical history and autopsy findings of a 44-year-old white female who died of massive cerebral edema secondary to the dissection of the left vertebral artery and subsequent thrombosis due to the perforation of that artery by a 25-gauge spinal needle during a C-7 nerve root block.     

A review of nail gun suicides and an atypical case report

The nail gun was designed as a powerful industrial tool to drive nails into various hard surfaces with ease. Serious injuries associated with the tool are uncommon and deaths are rare. Unintentional injuries normally occur from misuse of the tool or from ricocheting nails. The intentional use of a nail gun to commit suicide is unusual. This paper will review successful and unsuccessful suicide attempts by use of a nail gun. We will present an atypical case of suicide committed with a nail gun by a 46-year-old depressed male investigated by the Allegheny County Coroner's Office in Allegheny County, Pennsylvania in April 2002. This case reports for the first time a unique pathological finding of a ring of bone traveling with the nail, which has not been seen in wounds of the head caused by other types of projectiles.     

Kawasaki disease: a review of pathologic features of stage IV disease and two cases of sudden death among asymptotic young adults

Kawasaki disease (KD) primarily affects infants and is rarely fatal in young adults. The sequelae of KD can result in death months to years after the exposure to the causative agent. Such deaths are defined as Stage IV KD, which is characterized by the formation of multiple aneurysms in the coronary arteries, calcification and recanalization of the obstructed portions of the coronary arteries, and myocardial infarction and ischemia. A 10-year retrospective review of sudden deaths in Allegheny County, Pennsylvania, identified two fatal cases of Stage IV KD involving young adults. These two young adults were healthy and completely asymptomatic; they had no identifiable risk factors for cardiovascular disease before the fatal event. One adult was involved in vigorous exercise, and the other was recumbent in bed at the time of death.     

Deaths among criminal suspects, law enforcement officers, civilians, and prison inmates: a coroner-based study

During the interaction between a criminal suspect and a law enforcement officer, the risk of death to the suspect, police, or civilians is increased. Unfortunately, very little information is available on the death risks arising from this interaction. This study provides an assessment of the risk of death to law enforcement officers, suspects, and bystanders by separating the interactions into the following 4 phases: (1) events prior to and during arrest; (2) police pursuits or chases; (3) transport of the suspects; and (4) during incarceration. A 5-year (1994-1998) retrospective coroner-based study of all deaths that occurred during these 4 phases was conducted in Allegheny County, Pennsylvania. A total of 77 cases were identified; 14 deaths (18.1%) occurred prior to or during arrest, 10 (12.9%) during police chases, 2 (2.6%) occurred while the actors were being transported, and 51 (66.2%) during incarceration. The majority of cases (98.7%) were males, blacks (63.6%), and single (50.6%). The respective risks of death by phase were prearrest/arrest, 6.5 per 100,000 arrests; transport, 0.93 deaths per 100,000 arrests; and incarceration, 268 deaths per 100,000 inmates. Study showed the following: (1) risk of death to offenders was greatest during police pursuits; (2) the risks during arrests are not insignificant and involved an officer being threatened with a weapon in one-third of the events; and (3) deaths among inmates were primarily due to natural causes.     

Screening and confirmation of drugs in urine: interference of hordenine with the immunoassays and thin layer chromatography methods.

Hordenine cross-reacted with various enzyme linked immunosorbent assay (ELISA) or radioimmunoassay (RIA) kits used for the screening of urine samples. Morphine-ELISA kit was most sensitive, whereas etorphine- and buprenorphine-ELISA kits were least sensitive to hordenine cross-reactivity. Hordenine also interfered with the thin layer chromatography of oxymorphone, hydromorphone and apomorphine. The major source of hordenine in humans is beer brewed from barley, whereas the major source of hordenine in horses is canary grass or barley. Therefore, the presence of hordenine in the urine of humans consuming beer or in the urine of horses consuming canary grass may give false positive values when the immunoassay and TLC methods are used for the screening of the urine sample. In order to distinguish hordenine from the opiate drugs, simple and sensitive gas chromatographic/mass spectrometric (GC/MS) and high performance liquid chromatographic (HPLC) methods have been developed in this study.     

Public Administration Reform in a Challenging Environment: A Review of the Establishment of the Health Economics and Financing Directorate (HEFD) within the Afghanistan Ministry of Public Health

The purpose of this article is to provide an example of recent public administration reform in Afghanistan. In 2003, the Afghan Ministry of Public Health (MoPH) established the Basic Package of Health Services (BPHS) and other health services. To date, service delivery has been conducted largely by NGOs, funded by the main international donors, and managed by the Grant and Contracts Management Unit (GCMU) of the MoPH. Despite these advancements, Afghanistan continues to face significant challenges in health service provision and policy. In 2009, the GCMU was restructured into the Health Economics and Financing Directorate (HEFD), which broadened the scope of the Unit to conduct important economic analyses. This article examines the MoPH's role in health financing as a developing institution engaged in applied health economics and policy analysis. This development will allow the MoPH to build evidence for policy-making and further establish its stewardship role in the health sector.     

Unsuspected hereditary hemochromatosis at forensic autopsy: its presentation, confirmation, and implications

Hereditary hemochromatosis (HH) is one of the most common genetic disorders and may present clinically in a variety of ways. The most common presentation is micronodular cirrhosis with possible associated diabetes. However, HH may also present with cardiac dysfunction and sudden death. The confirmation of unsuspected HH at autopsy is complicated by the growing number of genetic abnormalities, which are not detected by current commercial genetic testing for C282Y and H63D mutations. Consequently, quantitative liver iron studies on fresh or paraffin embedded liver is recommended in confirming HH. The importance of detection and confirmation of HH cannot be overemphasized given the need to screen surviving family members in preventing organ damage of asymptomatic individuals. We present a case of a 38-year-old white woman with micronodular cirrhosis secondary to unsuspected HH that was confirmed by a quantitative liver iron study. The possible presentation of cardiac sudden death from HH, confirmation issues and implications of a HH diagnosis for surviving family members are also discussed.