Fatal steamer accident; blunt force injuries and drowning in post-mortem MSCT and MRI

Steamer accidents, through contact with the bucket wheel, are very seldom today. No publication of such a kind of fatal accident could be found in literature. We present the case of a fatal steamer accident, in which the findings of a blunt traumatization of a person by the ship was completely documented by post-mortem combined multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) examinations. A rupture of the aorta was detected using both radiological methods without use of radiopaque material. Radiological examination revealed a comminuted fracture of the thorax vertebrae at the same level as the aortic rupture. Injuries of the soft tissues of the back, caused by the bucket wheel of the steamer, were also diagnosed. In addition to the signs of blunt force trauma the findings of drowning such as an over inflation of the lungs, fluid in the stomach and duodenum were revealed. Furthermore, algological analysis detected diatoms in the lung tissue and blood from the left heart. Therefore, the cause of death was considered being a combination of fatal hemorrhage, caused by the aortic rupture, and drowning. We conclude that virtual autopsy using combined post-mortem MSCT and MRI is a useful tool for documentation, visualisation and analysis of the findings of blunt force trauma and drowning with a large potential in forensic medicine.     

Measurement Properties of the Communities That Care<Superscript>®</Superscript> Youth Survey Across Demographic Groups

Prevention science has produced information about risk and protective factors that predict adolescent drug use and related problem behaviors. This paper investigates the Communities That Care Youth Survey that measures multiple risk and protective factors. Using a sample of 172,628 students who participated in surveys administered in seven states in 1998, analyses were conducted to test the factor structure of these risk and protective factors and to test the equivalence of the factor models across five racial/ethnic groups (African Americans, Asians or Pacific Islanders, Caucasians, Hispanic Americans, and Native Americans), four grade levels (6th, 8th, 10th, and 12th) and both gender groups. Results support the construct validity of the surveys risk and protective factor scales and indicate that the measures are equally reliable across males and females and five racial/ethnic groups. Implications of these findings for science-based prevention planning are discussed.     

The efficacy of electronic group meetings

Telephone conference calls could be used to extend participation in public decision-making. In order to clarify the involved problems and prospects we conducted 16 nine-member conference calls discussing and voting on a public issue. The discussions were recorded for analysis and a questionnaire was administered. The meetings worked well despite the isolation of the participants and the lack of visual contact. Access to the floor was easy, attention good, and participation was eager. The participants felt that the analysis of the topic had been effective. The chairman's guidance of the discussion was judged effective, and his actions legitimate. Additionally, the data suggest what we might call greater intellectual elbow room—less pressure to go along with the group opinion than in face-to-face meetings, and more ease in changing opinions and positions. The disagreements about the issue did not spill over into emotional hostility. The participants were quite pleased with the conduct and efficacy of the electronic meetings. These findings suggest that a mass participatory system, based upon such electronic meetings, can also be used to provide wider involvement in decision-making in our society.This study is part of a much larger project exploring the use of technology to extend political participation. The project is supported by the National Science Foundation, grant # GI-29940. Dr. Amitai Etzioni and Dr. Stephen Unger are Co-Principal Investigators for the MINERVA Project, which is being carried out at the Center for Policy Research in New York. The author is particularly indebted to Dr. Etzioni for many important contributions to the conception, design and analysis of the study reported in this paper. Dr. Unger also made significant contributions to the development of the study. Camille Gubello, Joshua Freeman and Nancy Gershon were of central importance in conducting the experiments, assembling the data and preparing this report.     

Comparative Sociology of Legal Professions: An Exploratory Essay

The author surveys and compares the legal professions of 15 nations, including both civil law and common law countries. The essay is organized around the ways that legal professionals control their markets—first by controlling "production of producers" or who and how many enter the profession (with formal education or apprenticeship requirements, examinations, access to entry-level positions). Legal professionals also control "production by producers"—both external competitors and lawyers themselves. This occurs, for example, through definition and defense of the professional monopoly, control of competition between licensed professionals, and creation of demand. The discussion takes place against the background of the legal profession's recent history—assessing changes in its composition (by race, age, gender), in lawyers' practice settings, in the categories of work they perform, and in the income and status associated with these categories and with the profession in general.     

Tramadol (Ultram) concentrations in death investigation and impaired driving cases and their significance

We reviewed a series of 66 deaths in Washington State between 1995-2000 in which tramadol (Ultram and Ultracet, Ortho-McNeil) was detected in the decedent's blood, in order to assess the role tramadol was determined to have played. Additionally, we reviewed a series of 83 impaired driving cases in which tramadol was detected in order to establish a non-lethal blood tramadol concentration reference range. In both populations, tramadol was consistently found together with other analgesic, muscle relaxant, and CNS depressant drugs. Death was rarely attributable to tramadol alone. However, tramadol may be a significant contributor to lethal intoxication when taken in excess with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased CNS depression. Although the incidence of tramadol detection has increased consistently over the last eight years, there is no evidence of a corresponding increase in the number of cases in which death was attributed solely to tramadol. Blood drug concentrations in many deaths exceeded the therapeutic serum range of 0.28-0.61 mg/L; however, the concentrations overlapped almost completely with the range identified in living subjects arrested for impaired driving. These findings suggest caution in the interpretation of blood tramadol concentrations outside of the recognized therapeutic range. It also suggests that the drug, even when used in moderate excess, is not a principle cause of death in suicidal or accidental deaths.