Supine Hypotensive Syndrome as the Probable Cause of Both Maternal and Fetal Death

Abstract: Supine hypotensive syndrome is characterized by severe supine hypotension in late pregnancy, whose clinical presentation ranges from minimal cardiovascular alterations to severe shock, resulting from inferior vena cava compression by gravid uterus. We report a case of a 41‐year‐old 39‐week‐pregnant woman found dead supine. Autopsy revealed the following: cyanosis of the limbs; congestion of the jugular and subclavian veins; abundant abdominal subcutaneous fatty tissue; uterus displacing intestine and diaphragm; collapsed inferior vena cava; both femoral veins dilated and filled with blood; edematous and congested lungs; and placenta 790 g, fetus 3475 g, amniotic fluid 800 cm³. The diagnosis of supine hypotensive syndrome as the probable cause of death is supported by the position of the body and autopsy findings. This syndrome can be considered as the first stage of the physio‐pathological mechanism that led to death in the case presented herein and should be considered by pathologists as a cause of sudden death.     

Two cases of acute propane/butane poisoning in prison

Hydrocarbon inhalation is seldom chosen as a means to commit suicide. This practice is exclusively a prerogative of the prison population; it is, however, only exceptionally found in this environment. The two cases of lethal inhalation of propane/butane gas observed by us over a very short time occurred in this context. Toxicologic analyses were performed by means of gas chromatography (head space) and revealed a propane/butane mixture in all specimens (heart blood, bile, and urine) except vitreous humor. Although fatal arrhythmia posthydrocarbon gas abuse is well known, the concentrations of the two hydrocarbons were sufficient to induce death by asphyxiation and were distributed (fairly) homogeneously in all biological fluids and organs examined, a parameter permitting one to assume that death occurred within a relatively short period of time. The absence of finding in vitreous humor and the trace amount in urine suggests that both men died very quickly.     

Handling manipulated evidence

Bayesian Networks have been advocated as useful tools to describe the relations of dependence/independence among random variables and relevant hypotheses in a crime case. Moreover, they have been applied to help the investigator structure the problem and evaluate the impact of the observed evidence, typically with respect to the hypothesis of guilt of a suspect. In this paper we describe a model to handle the possibility that one or more pieces of evidence have been manipulated in order to mislead the investigations. This method is based on causal inference models, although it is developed in a different, specific framework.     

Food security composite indices: implications for policy and practice

Food security is a major topic in academic and international debates. Numerous indicators have been proposed in order to establish which countries are in need of improved food security status, but the lack of consensus as to which indicator of food insecurity is the most appropriate has motivated scholars to propose composite indexes. Building composite indexes involves multiple choices. This Viewpoint warns how discretional choices of algorithms to compute composite indexes for food security may alter the findings. By commenting on the implications that different measurement choices may have in terms of global indexes, the Viewpoint raises provocative practical and political concerns.     

Beyond Copenhagen: The Political Economy of Securitising “Outside Influences” in Bali

Securitisation theory has contributed greatly to critical security studies. However, the Copenhagen School’s focus on discursive analysis fails to answer the “so what” question of why issues are securitised and for whose benefit. This article contends that more nuanced explanations can be provided by taking seriously the political economy context within which the process of securitisation is embedded. The article has two aims. First, it contributes to further refining securitisation theory by embedding Balzacq’s pragmatic act – which implies that securitising actors gain the assent of an audience based on a shared view of vulnerabilities – within a broad social conflict analysis. This latter can explain the socio-political struggles that create popular support for securitisation, and what social groups benefit from it. Second, it contributes to explanations of Bali’s contemporary political economy by operationalising the refined approach to explain how struggles over the spoils of tourism have created a receptive audience among a cross-class section of Balinese for the securitisation of “outside influences” – a euphemism for migrants, non-local investors and Western cultural influences. Securitisation has resulted in conservative elite groups marginalising progressive voices; “traditional” institutions being favoured in accessing state resources; and in a policing landscape in which migrants are harassed and exploited.     

The new great game in Central Asia post 2014: The US “New Silk Road” strategy and Sino-Russian rivalry

With the planned US and NATO withdrawal from Afghanistan in 2014 looming ever closer, and Central Asia's own future increasingly in doubt, major powers are all competing to enhance their influence in Central Asia. 2014 may mark a regional tipping point, but none can accurately predict how the regional balance might shift after the NATO withdrawal from Afghanistan. During 2009–2010, the signs of growing Russian dependence on China in terms of economy and energy were palpable, as were the signs of China successfully subordinating Russia to its Central Asian economic agenda. In 2011–2012, it was difficult to see Russia simply acquiescing in its subordination to China without reacting to that situation negatively. Since 2011, to avoid this dependence on China, Russia has vigorously pushed for its regional integration schemes. 2011 marked the launch of the US “New Silk Road” initiative. Great power regional integration schemes, however, undermine both regional and national development.     

How policy instruments are chosen: patterns of decision makers’ choices

Policy instruments are a fundamental component of public policies. Policy instruments are often a result of mediation within the policy design process, whenever decision makers reshape existing instruments without introducing any real innovation. This results in imitation, layering and ambiguity in tool choice selection, and raises the theoretical problem of the logic according to which decision makers choose certain specific policy instruments rather than others. Decision makers may have different reasons for choosing certain specific instruments, although these reasons should be connected to the two main purposes of decision-making, that is, the search for effectiveness and the construction of a shared sense, a common acceptance. Thus, the choice of instruments is a question of potentially conflicting drivers that decision makers have to cope with within a specific decisional situation, when asked to solve those problems that have arisen. This paper examines this question and offers an analytical framework based on the two main factors in terms of which the selection of instruments is channelled and assessed: legitimacy and instrumentality. The boundaries created by how decision makers perceive these two dimensions mean that only four selection patterns can be chosen by decision makers: hybridization, stratification, contamination or routinization.     

Quand la famille se déchire: analyse des sections divergentes cantonales lors des votations populaires 2003‐2011

The appearance of divergent cantonal sections during popular votes is a recurring phenomenon in Switzerland. However, despite the importance of its analysis to evaluate the internal cohesion of political parties, this has been neglected in the recent literature. We fill the gap by analyzing both quantitatively and qualitatively the divergent sections during popular votes in the last two legislatures (2003‐2007 and 2007‐2011). The quantitative analysis shows stability or even a slight decline of the phenomenon. The qualitative analysis (case studies) relativizes its impact on party cohesion: Its more important occurrences are confined to specific policy areas and caused by particular or specific causes.