Radiography of perforating centerfire rifle wounds of the trunk

All deaths resulting from perforating centerfire rifle wounds of the chest and abdomen, investigated by the Office of the Chief Medical Examiner for the Province of Alberta from 1988 to 1995. were reviewed retrospectively to determine whether the radiographic distribution of bullet fragments in such cases is a useful predictor of bullet trajectory. Study cases were limited to single gunshot wounds without surgical intervention or intermediate targets, and for which adequate radiography was available. Three pathologists individually viewed the radiographs on two separate occasions; wound locations were provided for the second viewing (Group 2). Differences in opinion regarding direction of fire were resolved by consensus review. A trauma radiologist independently made two sets of interpretations in the same way. Comparisons of these groups of interpretations were made with the actual bullet direction determined at autopsy. Of 21 cases included in the study, only three (14.3%) did not require consensus resolution in either group. Accuracy of pathologists' interpretation improved from 38.1% (8/21) to 76.2% (16/21) with provision of wound locations (p = 0.012). The radiologist achieved similar improvement, from 28.6% (6/21) to 47.6% (10/21). The rate of agreement between radiologist and pathologists increased from 42.9% (9/21) to 61.9% (13/21) between Groups 1 and 2. Both the pathologists and radiologist interpreted several cases the same way in both groups; of those cases interpreted differently, the second interpretation was occasionally incorrect after correct interpretation in Group 1. We conclude that bullet direction for perforating centerfire rifle wounds cannot be accurately determined from postmortem radiographs. When wound location is known, the ability to predict bullet direction improves but is still subject to error, including a lack of consistency between observers.     

Carisoprodol, meprobamate, and driving impairment

This paper considers the pharmacology of the centrally acting muscle relaxant carisoprodol, and its metabolite meprobamate, which is also administered as an anxiolytic in its own right. Literature implicating these drugs in impaired driving is also reviewed. A series of 104 incidents in which these drugs were detected in the blood of drivers involved in accidents or arrested for impaired driving was considered, with respect to the analytical toxicology results, patterns of drug use in these subjects, the driving behaviors exhibited, and the symptoms observed in the drivers. Symptomatology and driving impairment were consistent with other CNS depressants, most notably alcohol. Reported driving behaviors included erratic lane travel, weaving, driving slowly, swerving, stopping in traffic, and hitting parked cars and other stationary objects. Drivers on contact by the police displayed poor balance and coordination, horizontal gaze nystagmus, bloodshot eyes, unsteadiness, slurred speech, slow responses, tendency to doze off or fall asleep, difficulty standing, walking or exiting their vehicles, and disorientation. Many of these cases had alcohol or other centrally acting drugs present also, making difficult the attribution of the documented impairment specifically to carisoprodol and meprobamate. In 21 cases, however, no other drugs were detected, and similar symptoms were present. Impairment appeared to be possible at any concentration of these two drugs; however, the most severe driving impairment and most overt symptoms of intoxication were noted when the combined concentration exceeded 10 mg/L, a level still within the normal therapeutic range.     

On “Group size and the free-rider hypothesis: Another hypothesis.” by Jody W. Lipford: Comment

This paper develops a positive approach to grant design when the central government and a lobby of local governments are the main agents. It develops the hypothesis that the regressivity or progressivity of per capita grants regarding community size is,ceteris paribus, related to the structure of the lobbying activities of local governments and is independent of hypothetical economies or diseconomies of scale in the production of local public goods. An encompassing lobby organisation using a “one mayor one vote” system of representation supports the regressivity of per capita grants while under “proportional” representation the lobby will support a design of per capita grants which is progressive towards community size. An empirical analysis of lump-sum grants in Portugal supports the politico-economic hypothesis and rejects the hypothesis that economies of scale is the main explanatory cause for the observed regressivity of per capita grants.     

Undermining Western democracy promotion in Central Asia: China’s countervailing influences,powers and impact

This article examines whether and to what extent China’s involvement in Central Asian countries undermines the democracy promotion efforts of the European Union and the United States. Findings confirm that China does indeed challenge Western efforts, but in an indirect way. First, Chinese provision of substantial and unconditional financial assistance makes Western politically conditioned aid appear both ungenerous and an infringement of sovereignty. Second, the Shanghai Co-operation Organisation, inclusive of China’s leadership role, creates an institutional means through which the (semi-)authoritarianism of member states is legitimized and challenges Western emphasis on democracy and human rights. Finally, by the power of its own example, China demonstrates that democracy is not a prerequisite for prosperity, the rule of law and social well-being.     

DNA Analysis and Document Examination: The Impact of Each Technique on Respective Analyses

Threatening letters, counterfeit documents, and anonymous notes can commonly be encountered in criminal situations. Such handwritten documents may encourage DNA to transfer from the writer's hands and lower arms when these areas come into contact with the document. As any DNA transferred is likely to be at a low level, sensitive low copy number (LCN) DNA analysis can be employed for testing document exhibits. In this study, we determine locations on the document that are most commonly touched during writing and handling and compare DNA recovery from these sites. We describe the impact of DNA sampling on subsequent document examination techniques including the ESDA^® and likewise the effect of the ESDA^® and two other document examination techniques on subsequent DNA analysis. The findings from this study suggest that DNA results can be obtained through targeted sampling of document evidence, but that care is required when ordering these examination strategies.     

Ethics, Integrity, Compliance and Accountability in Contemporary UK Government–Business Relations – Till Death Do Us Part

This paper takes as its main themes the impact of public choice theory and the impact of Thatcherism and the rise of public management on the delivery of public services. These themes have created, according to a Chief Executive of a Regional Health Authority, the need 'to learn new disciplines of commercial relationships and competitive tendering and so on, and at the same time . . . remember the very important traditional public service values; and that is not an easy combination'. Whether the relationship with business has been a temporary affair, a marriage of convenience or a marriage until death do us part, business and business practices have had significant implications for the dominant morality now prevailing in the delivery of public services.     

Book reviews

How Nuclear Weapons Spread By F. Barnaby. Routledge, London, 1993, Hbk. £30.00.

Germany and the Approach of War in 1914 By V.R. Berghahn. Macmillan, London, second edition 1993 (first edition 1973), Hbk. £35.00, Pbk £10.99.

The Age of Migration’, International Population Movements in the Modern World By Stephan Castles and Mark Miller. Macmillan, Basingstoke, 1993, Hbk. £35.00, Pbk. £10.99.

Ideas and Foreign Policy, Beliefs, Institutions and Political Change Edited By Judith Goldstein and Robert O. Keohane. Cornell University Press, Ithaca, 1993, Hbk. S41.25, Pbk. S16.45.

European Monetary Union: Lessons from the Classical Gold Standard By Milivoje Panic. St. Martin's Press, New York, 1993.

In Defense of Naval Supremacy: Finance, Technology and British Naval Policy, 1889–1914 By Jon Tetsuro Sumida. Routledge, London, 1993, Pbk. £12.99.     

Closing the door

States no longer can afford to provide illegal immigrants with the health care and education federal law says they deserve.