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.     

Invisible populations: LGBTQ people and federal health policy in Canada

This article reviews the state of federal health policy discourse toward the LGBTQ population in Canada. Despite the advent of greater attention to diversity and gender mainstreaming in federal public policy and the shift to legalized rights protections for LGBTQ people, symbolized by policies such as same‐sex marriage, LGBTQ health concerns continue to be marginalized in federal health policy. Based on a systematic review of federal policy documents and websites as well as a small number of interviews with federal policy‐makers, the research demonstrates the extent to which LGBTQ health concerns are rendered invisible in federal health policy. The article suggests several ways in which a commitment to gender‐based policy analysis could be expanded to take account of diverse health needs of LGBTQ Canadians.     

A Challenge for Police-Community Relations: Rethinking Stop and Search in England and Wales

This article presents research carried out as part of a government research programme looking at how police tactic of 'stop and search' in England and Wales. For many years, figures which have shown a higher rate of stop and search of minority ethnic groups, particularly black people, have provoked much controversy, and have been seen by many as a manifestation of police racism. This article reviews the way in which stop and search impacts on public confidence, with particular reference to those from minority ethnic groups. It goes on to explore its role within policing, including an examination of its effectiveness against crime and the evidence for racism in police practice. Following from this, it considers how stop and search can be used in a way that minimises negative impacts on the community and maximises its effectiveness against crime.     

The Human Rights Act 1998: research,freedom of speech and academic freedom

This article will consider rights to receive and express information and ideas from the perspective of the researcher, the researched, the researcher's institution and the wider community. It will also consider how the courts will resolve the inevitable conflicts between these rights. It does not address the right to education enshrined in Article 2 of the First Protocol² but rather the other Convention Articles, particularly Article 10, particularly relevant to the conduct of intellectual inquiry. It is intended to underline the potential reach of the Act for all public bodies which seek to be learning organisations, and the consequent need for such bodies to review their practices and procedures before the Act comes into force on 2 October 2000.     

'Talking to Fishers': A Response to Kesteven

Geoffrey Kesteven's 'Talking to Fishers' appeared in the March 1996 issue of AJPA 55(1). Here, Nick Rayns takes issue with Dr Kesteven's observations on the South East Fishery Workshop, held at Bateman's Bay in September 1994. Dr Kesteven's rejoinder follows this response.     

Volume Determination of Fresh and Dried Bloodstains by Means of Optical Coherence Tomography

The volume of bloodstains found on crime scenes may help forensic investigators reconstruct the location and kinematics of bloodletting events, as stain size, volume, and impact velocity are related. Optical coherence tomography was used as a method to determine the volume and volume ratio of dried and fresh bloodstains on both glass and irregular surfaces or deposited with an impact velocity. The volume of blood drops deposited on smooth glass surfaces was measured within a deviation of 2%. This deviation increased for droplets on irregular surfaces or deposited with an impact velocity. The volume ratio of dried and fresh bloodstains was equal to 19–28% depending on the individual donor and on the use of an anticoagulant. Optical coherence tomography is a good method to determine the volume of fresh and dried bloodstains in laboratory conditions and allows accurate determination of the dry/fresh ratio.     

Moving prison health promotion along: towards an integrative framework for action to develop health promotion and tackle the social determinants of health

The majority of prisoners are drawn from deprived circumstances with a range of health and social needs. The current focus within ‘prison health’ does not, and cannot, given its predominant medical model, adequately address the current health and well-being needs of offenders. Adopting a social model of health is more likely to address the wide range of health issues faced by offenders and thus lead to better rehabilitation outcomes. At the same time, broader action at governmental level is required to address the social determinants of health (poverty, unemployment and educational attainment) that marginalise populations and increase the likelihood of criminal activities. Within prison, there is more that can be done to promote prisoners’ health if a move away from a solely curative, medical model is facilitated, towards a preventive perspective designed to promote positive health. Here, we use the Ottawa Charter for health promotion to frame public health and health promotion within prisons and to set out a challenging agenda that would make health a priority for everyone, not just ‘health’ staff, within the prison setting. A series of outcomes under each of the five action areas of the Charter offers a plan of action, showing how each can improve health. We also go further than the Ottawa Charter, to comment on how the values of emancipatory health promotion need to permeate prison health discourse, along with the concept of salutogenesis.