Suicide by pipe bomb: a case report.

While lying down, a 23-year-old man detonated an improvised explosive device placed behind his head. The posterior neck and shoulders were singed, and much of the brain was avulsed. Death was due to laceration and partial avulsion of the cerebrum, midbrain, and brain stem. The injuries had a directional nature. Facts derived from the scene investigation and gross dissection, including nature, distribution, and extent of the wounds, in conjunction with preceding medical and social history, allowed for a reasonable reconstruction of the circumstances.     

Review article

The Burning Question, Michael Simmonds, Adam Smith Institute, 1989, pp. 43, £9.00.     

A diamond in the rough: digging up and polishing Harold D. Lasswell’s decision functions

Policy Sciences - As part of Harold D. Lasswell’s policy sciences, the decisions functions emerged to explore and understand comparative policy processes. The decision functions specified...     

Injuries of the Head from Backface Deformation of Ballistic Protective Helmets Under Ballistic Impact

Modern ballistic helmets defeat penetrating bullets by energy transfer from the projectile to the helmet, producing helmet deformation. This deformation may cause severe injuries without completely perforating the helmet, termed “behind armor blunt trauma” (BABT). As helmets become lighter, the likelihood of larger helmet backface deformation under ballistic impact increases. To characterize the potential for BABT, seven postmortem human head/neck specimens wearing a ballistic protective helmet were exposed to nonperforating impact, using a 9 mm, full metal jacket, 124 grain bullet with velocities of 400–460 m/s. An increasing trend of injury severity was observed, ranging from simple linear fractures to combinations of linear and depressed fractures. Overall, the ability to identify skull fractures resulting from BABT can be used in forensic investigations. Our results demonstrate a high risk of skull fracture due to BABT and necessitate the prevention of BABT as a design factor in future generations of protective gear.     

Medium‐Chain Acyl‐CoA Dehydrogenase Deficiency in Adulthood: A Potential Diagnosis in a Patient with Mental Status Changes Suspected of Drug Toxicity

Medium‐chain acyl‐CoA dehydrogenase (MCAD) deficiency is a rare but important component of the differential diagnosis for adults with a history of premortem mental status changes and the postmortem finding of hepatic steatosis. This case report describes a 30‐year‐old white man who, following a period of nausea and vomiting, was admitted to the hospital with sudden mental status deterioration followed rapidly by clinical deterioration and death. Treating physicians in this case suspected acute illicit drug toxicity with synthetic cathinones based on social history. Clinicians and medical examiners should be aware that the presentation, signs, and symptoms described may indicate an underlying inborn error of metabolism such as MCAD deficiency and take action accordingly.     

Community‐Based Organizations and Institutional Work in the Remote Rural West

The institutional landscape for public land management in the U.S. West underwent a seismic shift in the 1990s as the long‐dominant resource extraction paradigm was replaced by the ecosystem management paradigm. Here we analyze the efforts of community‐based organizations (CBOs), entities that emerged in some locations across the West to help their respective communities navigate the transition from resource extraction to environmental stewardship. Despite their formal status as civil society actors, in practice CBOs came to fill various institutional gaps by taking on roles traditionally assigned to both the state and the private sector. We use a case study approach to examine how the Hayfork, California–based Watershed Research and Training Center engages in institutional work within a setting that is at once both open and constrained, as the rural community within which it operates lacks strong state‐ or industry‐led development trajectories while remaining constrained by the legacies of past institutions.     

Comment on Kirk McClure's “Are low-income housing tax credit developments locating where there is a shortage of affordable units?”

Kirk McClure's article makes important contributions to our understanding of the way in which state allocating agencies are using the Low-Income Housing Tax Credit (LIHTC). However, one of the premises of his analysis – that allocating agencies should encourage the location housing developments in census tracts with a “surplus” of low-income renters – is mistaken. Census tracts are too small to be considered closed-system housing markets. Additionally, the LIHTC program does not exist in isolation, but instead as part of a combined national rental housing policy that includes both supply-side programs (LIHTC) and demand-side programs (housing vouchers). A final flaw in the notion that LIHTC units should be built in census tracts with a surplus of renter households in the 30% to 60% of AMI range compared with the units affordable to them is that increasing the amount of affordable housing in those tracts could have the effect of further concentrating households by income and race.