The Role of Postmortem Cardiac Markers in the Diagnosis of Acute Myocardial Infarction*

Abstract: Sudden cardiac deaths because of acute myocardial infarction (MI) constitute a significant percentage of the caseload for death investigators, coroners, and forensic pathologists. Clinicians use cardiac markers, highly sensitive and specific for myocardial damage, to screen living patients for acute MI; however, to this point, the utility of these markers in the autopsy setting has not been fully established. The current study included 10 decedents, five who died of acute MI, and five subjects who died of noncardiac disease. Samples of pericardial fluid and blood from multiple sites were tested for creatine kinase, creatinine kinase MB, and troponin‐I. Three main conclusions were drawn: the levels of cardiac markers from all patients are significantly higher than the reference range for living patients, there are significant differences in cardiac marker levels between samples from different anatomic locations, and only three cardiac marker/anatomic site combinations were significantly different between the control and study groups.     

Defining sustainable development: environmental and investment perspectives and implications for administrative reform

The current catchphrase of “sustainable development” reflects two primary issues: increased concern with the environment and natural resource management, and heightened frustration with the meager staying power of many development investments once external support has ceased. Achieving and measuring sustainable benefits has been exceedingly difficult, however, and considerable confusion exists regarding the definitions and contexts in which the term is used. This paper outlines the similarities and differences between the environmental perspective and the development investment perspective, and discusses the lessons for administrative reform. The concept of development investment sustainability emphasizes that successful administrative reform must enhance the ability of the government to continually respond to change in the external environment. An important lesson from the environmentalists is that reforms must be approached in an integrative manner – all elements of the system must work together rather than in isolation for sustainable results.     

Directed Patrol for Preventing City Centre Street Violence in Sweden — A Hot Spot Policing Intervention

This study examines a hot spot policing intervention where private security guards patrolled a specific area in the city centre of a mid-sized Swedish town during summer weekend evenings and nights, aiming to reduce the number of reported street violence incidents. A follow-up of the intervention, using previous years as a control was conducted to measure changes in the number of street violence rates before and during the intervention. The results show non-significant decreases in the number of reported street violence incidents during the intervention. The results can be interpreted in at least two ways: that the intervention had no effects; or that the small, but non-significant decreases observed, are indeed small effects that can be strengthened by modifying the implementation of the intervention. An additional analysis shows that the changes in crime rates are larger at times when the guards adapted a stricter hot spot policing approach, which indicates that with a more structured implementation of the intervention it might be possible to see larger effects.     

Lessons from institution building in Kenya

Participant observation of institution building in a public sector organization in Kenya provides a basis for a critical discussion of key facets of the institution-building process. Problems identified include: flawed needs assessments; overambitious project designs; poor selection and briefing of consultants; and countervailing vested interests on the parts of external agents. Recommendations include narrowing the gap between development rhetoric and reality; more careful project formulation; greater emphasis on in-house training; more careful selection of project team leaders; and the provision of funding for post-project sustainability evaluations.     

Simulating terrorism and insurgency: video games in the war of ideas

This article analyses several video games created by Hezbollah and Afkar Media which simulate recent conflicts in Israel and Lebanon. These games are representative of an important new means of waging ideological warfare which is increasingly a part of the media strategies that states, violent non-state actors and media corporations employ in their efforts to persuade audiences. I argue that video games allow their developers to address players as though they were participants in ongoing conflicts, rather than passive observers, and that this style of presentation is extremely useful to efforts to create an attractive image of people who are frequently described as ‘terrorists’. Video games also enable their developers to carefully construct media narratives that appear to be realistic depictions of contemporary conflicts even when those narratives show signs of bias. Through these mechanisms, video games provide violent non-state actors and organizations sympathetic to them with a means of presenting their grievances and displaying their fighting prowess in ways that advance the organizations' strategic goals.