Repeat Coronary Artery Dissection in Pregnancy: A Case Report and Review of the Literature

Non‐atherosclerotic spontaneous coronary artery dissection (NA‐SCAD) is a rare cause of morbidity and mortality with a propensity for young, healthy, and often peripartum women. NA‐SCAD etiology is poorly understood, with possible hormonal and hereditary mechanisms. Current treatment strategies range from conservative management (often showing resolution on angiographic follow‐up) to invasive angiographic procedures. Rarely, NA‐SCAD has recurred in another coronary artery, ranging hours to years later. We report NA‐SCAD of the right coronary artery (RCA) in a 30‐year old, 3‐month postpartum female with an additional autopsy finding of remote myocardial infarction (MI) in the left anterior descending (LAD) coronary artery territory. The remote MI is consistent with prior NA‐SCAD of the LAD and, given the medical history, may have occurred in the peripartum period of the decedent first pregnancy 3 years earlier. As such, to the best of our knowledge, this may represent the first reported case of NA‐SCAD recurrence in a subsequent pregnancy.     

The Burglary Boost: A Note on Detecting Contagion Using the Knox Test

Objectives

A large body of literature in quantitative criminology finds that the spatio-temporal clustering of burglary is greater than one would expect from chance alone. This suggests that such crimes may exhibit a “boost” effect, wherein each burglary increases the risk to nearby locations for a short period. In this study, we demonstrate that standard tests for spatio-temporal dependence have difficulty distinguishing between clustering caused by contagion and that caused by changing relative risks. Therefore, any estimates of the boost effect drawn from these tests alone will be upwardly biased.

Methods

We construct an agent-based model to generate simulated burglary data, and explore whether the Knox test can reliably distinguish between contagion (one burglary increases the likelihood of another burglary nearby) and changes in risk (one area gets safer while another gets more dangerous). Incorporating insights from this exercise, we analyze a decade of data on burglary events from Washington, DC.

Results

We find that (1) absent contagion, exogenous changes in relative risk can be sufficient to produce statistically significant Knox ratios, (2) if risk is changing over time, estimated Knox ratios are sensitive to one’s choice of time window, and (3) Knox ratios estimated from Washington, DC burglary data are sensitive to one’s choice of time window, suggesting that long-run changes in relative risk are, in part, driving empirical estimates of burglary’s boost effect.

Conclusions

Researchers testing for contagion in empirical time series should take precautions to distinguish true contagion from exogenous changes in relative risks. Adjusting the time window of analysis is a useful robustness check, and future studies should be supplemented with new approaches like agent-based modeling or spatial econometric methods.

     

Motivation in humanitarian health workers: a self-determination theory perspective

This paper emerged from the authors' interest in why humanitarian health workers initially engage and remain in humanitarian work, often in the face of threats to safety and personal well-being. Semi-structured qualitative interviews assessed the consciously available reasons why individuals engaged in humanitarian health work. Interview data was unpacked through a thematic analysis. Using self-determination theory as a guiding framework, data suggested introjected and identified motivations are applicable to this occupational domain. Introjected motivation is implicated in initial reasons to engage the work, while identified motivation is implicated in reasons to continue. Theoretical and practical implications of these findings are discussed.

Motivation parmi les travailleurs humanitaires dans le domaine de la santé : un point de vue basé sur la théorie de l'autodétermination

Cet article a émané de l'intérêt de l'auteur concernant les raisons pour lesquelles les travailleurs humanitaires dans le domaine de la santé s'engagent initialement et continuent de travailler dans l'humanitaire, souvent malgré les menaces qui pèsent sur leur sécurité et sur leur bien-être personnel. Des entretiens qualitatifs semi-structurés ont permis d'évaluer les raisons consciemment disponibles qui expliquent que certaines personnes se soient engagées dans le travail humanitaire dans le domaine de la santé. Les données obtenues grâce aux entretiens ont été examinées au moyen d'une analyse thématique. En prenant la théorie d'autodétermination comme cadre d'orientation, les données ont suggéré que des motivations introjectées et identifiées sont applicables à ce domaine professionnel. La motivation introjectée intervient dans les raisons initiales de s'engager dans ce type de travail, tandis que la motivation identifiée intervient dans les raisons de continuer. Les implications théoriques et pratiques de ces conclusions font l'objet d'une discussion.

Motivação para Trabalhadores Humanitários da Área da Saúde: Uma Perspectiva da Teoria da Auto-Determinação

Este artigo surgiu do interesse dos autores em saber por que os trabalhadores humanitários da área da saúde engajam-se inicialmente e depois permanecem no trabalho humanitário, frequentemente enfrentando ameaças à segurança e bem-estar pessoal. Entrevistas qualitativas semiestruturadas avaliaram as razões dos indivíduos engajarem-se no trabalho humanitário na área da saúde, razões estas conscientemente apresentadas. Dados da entrevista foram processados através de uma análise temática. Utilizando a teoria da auto-determinação como estrutura de orientação, os dados sugeriram que as motivações introjetadas e identificadas são aplicáveis a este domínio ocupacional. A motivação introjetada está associada às razões iniciais de se engajar no trabalho, enquanto a motivação identificada está associada às razões de se permanecer no trabalho. As implicações teóricas e práticas destes resultados são discutidas.

La motivación en los trabajadores humanitarios de salud: una perspectiva de la teoría de la autodeterminación

Este ensayo surgió del interés de los autores en cómo los trabajadores humanitarios de salud inician su trabajo y permanecen en él a pesar de las frecuentes amenazas a su seguridad y bienestar personal. Las entrevistas cualitativas semiestructuradas realizadas revelaron las razones enunciadas conscientemente de porqué los individuos participan en el trabajo humanitario en salud. Se evaluaron las entrevistas a través de un análisis temático. Utilizando la teoría de la autodeterminación como marco, las entrevistas sugieren la existencia de motivaciones tanto introyectadas como identificadas en este ámbito de trabajo. La motivación introyectada se refiere a las razones para iniciar el trabajo y la motivación identificada a las razones para seguir en él. El ensayo examina las implicaciones teóricas y prácticas de estos resultados.     

The Value of Remorse: How Drivers’ Responses to Police Predict Fines for Speeding

After they stop drivers for exceeding the speed limit, police often have the discretion to alter the penalty. We investigated the degree to which extra-legal factors (apologies and other verbal responses), in addition to speed over the limit, predict ticket costs for speeding. Surveys of speeders were conducted in the U.S. and Canada. The data suggest that what people say to police matters. Participants who reported statements of remorse, e.g., “I’m sorry,” received lower fines for speeding. The relation of speeders’ responses to ticket costs is discussed from legal and psychological perspectives.     

Voluntary versus enforced tax compliance: empirical evidence for the “slippery slope” framework

The “slippery slope” framework is an alternative approach for research in tax compliance that suggests two key variables to obtain taxpayers’ compliance: trust and power. Furthermore, two forms of compliance are distinguished. It is hypothesized that voluntary compliance depends primarily on trust in authorities, whereas enforced compliance is a function of the power attributed to authorities. Using a large data set (N = 3,071) on taxpayers from Austria, the United Kingdom, and the Czech Republic, these hypotheses could be confirmed. Furthermore, whereas voluntary compliance seems to be positively related to age and education, enforced compliance is negatively related to education.     

The price of personalizing politics: Political distrust and economic performance in Latin America, 1996–2006

While research has provided evidence that culture and institutional performance shape individual level trust in political institutions, scholars have neglected to adequately estimate the effect of political institutions and macroeconomic conditions on trust. Using data from the World Value Surveys for eleven Latin American cases, we test if countries with “partyizing” electoral systems - those with rules that encourage voters to hold the party, not individuals, accountable for government performance - experience lower levels of distrust in political parties and the legislature in times of poor economic conditions than those countries with “personalizing” electoral rules. Our analysis shows that the macro political and economic context largely conditions the impact of culture and institutional performance on political trust.     

Potency Trends of Δ9‐THC and Other Cannabinoids in Confiscated Cannabis Preparations from 1993 to 2008*

Abstract: The University of Mississippi has a contract with the National Institute on Drug Abuse (NIDA) to carry out a variety of research activities dealing with cannabis, including the Potency Monitoring (PM) program, which provides analytical potency data on cannabis preparations confiscated in the United States. This report provides data on 46,211 samples seized and analyzed by gas chromatography‐flame ionization detection (GC‐FID) during 1993–2008. The data showed an upward trend in the mean Δ⁹‐tetrahydrocannabinol (Δ⁹‐THC) content of all confiscated cannabis preparations, which increased from 3.4% in 1993 to 8.8% in 2008. Hashish potencies did not increase consistently during this period; however, the mean yearly potency varied from 2.5–9.2% (1993–2003) to 12.0–29.3% (2004–2008). Hash oil potencies also varied considerably during this period (16.8 ± 16.3%). The increase in cannabis preparation potency is mainly due to the increase in the potency of nondomestic versus domestic samples.     

Biological sex variation in bone mineral density in the cranium and femur

Objectives

Sex and age trends in bone mineral density (BMD) play an important role in the estimation of age-at-death (AAD) of unidentified human remains. Current methodologies lack the ability to precisely estimate age in older individuals. In this study, BMD of the cranium and femur measured by DXA were examined to establish their applicability for age estimation in older adults. BMD as measured by DXA, is most commonly used clinically for prediction of osteoporotic fracture risk. We hypothesized that weight-bearing and non-weight-bearing bones, the femur and cranium, respectively, would provide valuable insights for aging.

Gorbachev's Economic Reform: A Soviet Economy Roundtable

The proceedings of a panel of American specialists devoted to the recent economic reform are summarized. The panelists noted that the most substantial changes to date have accompanied efforts to restructure the decisionmaking hierarchy—in particular, a recentralization of authority through the creation of biuros and state committees and legislation on individual economic activity. Changes in the systems of economic planning and incentives, on the other hand, have been minor, suggesting a continuing debate over the extent to which price reform and various economic incentives should be implemented. Journal of Economic Literature, Classification Numbers: 052, 113, 124.     

The Aftermath of the 19th Conference of the CPSU: A Soviet Economy Roundtable

The aftermath of the 19th Conference of the Communist Party, held in Moscow from June 28 to July 1, 1988, is analyzed by eight Western observers. The discussion covers impacts of the Conference on Soviet society and abroad, General Secretary Gorbachev's speech at the Central Committee Plenum on July 29, 1988, and reviews results of his policies since 1985. It proceeds to look at the current transitional period of Soviet reforms, including the formation of new enterprise forms and horizontal links in the economy. Finally, the discussants view prospects for political and economic development in the future. journal of Economic Literature, Classification Numbers: 052, 124, 113.