Pitfalls in the diagnosis of drug smuggler's abdomen

Narcotics "body packing" can be detected in abdominal X-rays by the ring shadow caused by air trapped in the packs. In a series of 82 cases admitted for abdominal X-ray in Helsinki, Finland, in 1982 through 1988, we encountered 9 (11.0%) true positives, 3 (3.6%) false positives, and 1 (1.2%) false negative. The false positives were due to the constipation often associated with the narcotics abuse. The false negative X-ray diagnosis was attributable to an inexperienced radiologist. False negatives may also be associated with packets containing marijuana, packs with few wrappings, aluminum-foil coated packs, and machine-packed narcotics. Searching for trapped air in radiographs, repeated X-raying by an experienced radiologist, use of computed tomography, or combined urinary drug screening may be applied to diminish false findings and to avoid unnecessary arrest for the purpose of fecal screening over several days.     

'Designing Better Health Care in the South': A Case Study of Unsuccessful Transformational Change in Public Sector Health Service Reform

This article presents a case study of a project known as 'Designing Better Health Care in the South' that attempted to transform four separately incorporated health services in southern Adelaide into a single regional health service. The project's efforts are examined using Kotter's (1996) model of the preconditions for transformational change in organisations and the areas in which it met or failed to meet these preconditions are analysed, using results from an evaluation that was commenced during the course of the attempted reform. The article provides valuable insights into an attempted major change by four public sector health organisations and the facilitators and barriers to such change. It also examines the way in which forces beyond the control of individual public sector agencies can significantly impact on attempts to implement organisational change in response to an identified need. This case study offers a rare glimpse into the micro detail of health care reform processes that are so widespread in contemporary health services but which are rarely systematically evaluated.     

经行政程序处理完的事情，当事人能否请求司法救济

请求司法救济是公民、法人运用法律武器保护自己合法权益的手段,但在司法实践中有些当事人不能正确运用法律武器保护自己的权利,且将行政程序处理完的事情请求司法救济。本文作者从几个方面分析了该案当事人的脱法行为,阐述了行政程序与法律程序在该案中适用范围及一事不再理原则在实践中的运用。     

From Cash to Accrual Budgeting and Accounting in the Public Sector: The Dutch Experience

Traditionally, governments used to deploy input‐based budgeting systems and cash‐based accounting systems. However, these systems do not provide the information that is necessary for a government to operate efficiently and effectively. Therefore, a growing number of countries have already shifted or are planning to shift from cash‐based to some form of accrual accounting in the public sector. Usually, the implementation of some accrual‐based system is linked to wider financial management reforms including performance management requiring information on cost. This paper focuses on the Dutch experience with the shift from cash‐based accounting and budgeting systems to an accrual‐based system.     

A Multi-mediation Model on the Relations of Bullying,Victimization, Identity,and Family with Adolescent Depressive Symptoms

This study investigated a multi-mediation model of the relationship between bullying behavior, peer victimization, personal identity, and family characteristics to adolescent depressive symptoms in 194 high school students, 12–18 years of age. In the first model, peer victimization mediated the relation between bullying behavior and depressive symptoms. In the second model, personal identity mediated the relation between peer victimization and depressive symptoms. In the final model, the two mediation models were combined. The relative influence of family characteristics on all variables in the two mediation models was studied using structural equation modeling. The results supported both mediation models and confirmed the influence of family characteristics on all variables in the mediation models. This study indicates that victimization by one’s peers has consequences for adolescents’ psychological health when their personal identity is affected. In addition, the study was able to model several processes in which family characteristics were related to adolescent depressive symptoms. Moreover, the final combined model (in which the two mediation models and the influence of family characteristics on all variables were confirmed) explained half of the variance in adolescent depressive symptoms.

The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies

Interpreting a myocardial inflammation as causal, contributory or as of no significance at all in the cause of death can be challenging, especially in cases where other pathologic and/or medico-legal findings are also present. To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases. We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death. Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations, the predominant inflammatory cell type, and the presence of inflammation-associated myocyte injury, fibrosis, edema and hemorrhage. Next, the cases were divided over three groups, based on the reported cause of death. Group 1 (n = 27) consisted of all individuals with an obvious unnatural cause of death. Group 2 (n = 29) included all individuals in which myocarditis was interpreted to be one out of more possible causes of death. Group 3 (n = 23) consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy, and no other cause of death was found. Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation (Group 1) or a potentially significant one (Groups 2 and 3). No other histological parameter showed significant differences between the groups. Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a (potentially) significant one.     

A retrospective study of drugged driving in Norway

The National Institute of Forensic Toxicology, Oslo, receives blood and urine samples from all Norwegian drivers apprehended on suspicion of driving under the influence of alcohol or drugs. In 1983 we received samples from 1446 drug-suspected drivers, out of which 445 underwent toxicological analysis. The drugs found most frequently were tetrahydrocannabinol (THC) (n = 199), diazepam (n = 166) and amphetamine (n = 102). A cautious interpretation of the data indicate that about 200 of the 445 subjects selected for toxicological analysis drove under severe influence of drugs. Because of the high percentage of submitted cases not analysed for drugs, this figure represents a minimum estimate. Compared with the results from 1978, we found a several-fold increase in detections of THC and amphetamine in 1983. The number of diazepam detections did not increase in a similar way, but we estimated that the diazepam detections would have increased 3-fold if we had analysed as frequent for this drug in 1983 as in 1978.     

EU issue voting and the 2014 European Parliament elections: a dynamic perspective

EU issue voting in European Parliament elections has been shown to be highly conditional upon levels of EU politicization. The present study analyzes this conditionality over time, hypothesizing that the effect of EU attitudes on EP vote preferences is catalyzed as EP elections draw closer. In contrast to extant cross-sectional post-election studies, we use a four-wave panel study covering the six months leading up to the Dutch EP elections of 2014, differentiating between party groups (pro, anti, mixed) and five EU attitude dimensions. We find that EU issue voting occurs for both anti- and pro-EU parties, but only increases for the latter. For mixed parties we find no effect of EU attitudes, yet their support base shifts in the anti-EU direction as the elections draw closer. The overarching image, however, is one of surprising stability: EU attitudes form a consistent part of EP voting motivations even outside EP election times.