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 Retrospective Study of the Investigation of Homicidal Childhood Asphyxial Deaths

As one of the leading causes of traumatic deaths in newborns, infants, and young children, there is no anatomic or microscopic feature that is pathognomonic for asphyxial deaths. Instead, pathologists rely on investigation information, including confessions and/or witness statements, and potential evidence at the scene. Twenty cases of homicidal newborn, infant, and young children asphyxial deaths were reviewed, which included death and police investigation reports and autopsy reports, as well as histology slides of lung sections. This series of homicidal asphyxial deaths highlight that, in a vast majority of such cases, the final cause and manner of death rulings are dependent on confession by the perpetrator. Furthermore, this series highlights the possible role of histology to help forensic pathologists better certify asphyxial deaths. Finally, this series emphasizes important investigation points and considerations at autopsy during the investigation of asphyxial deaths in newborns, infants, and young children.     

European national news

This article tracks developments at the national level in key European countries in the area of IT and communications and provides a concise alerting service of important national developments. It is co-ordinated by Herbert Smith Freehills LLP and contributed to by firms across Europe. This column provides a concise alerting service of important national developments in key European countries. Part of its purpose is to complement the Journal's feature articles and briefing notes by keeping readers abreast of what is currently happening ``on the ground'' at a national level in implementing EU level legislation and international conventions and treaties. Where an item of European National News is of particular significance, CLSR may also cover it in more detail in the current or a subsequent edition.     

Supply chain arrangements: The ABC to GDPR compliance—A spotlight on emerging market practice in supplier contracts in light of the GDPR

With ever increasingly complex and disaggregated sourcing supply chains and in the wake of the GDPR application deadline, this article shines a spotlight on early emerging market practice in supplier contracts.     

The Australian Greens: Party Organisation and Political Processes

The Greens challenge the Australian two‐party system by promoting an alternative political agenda and by facilitating democratic processes. Their recent successes in federal and state elections suggest that the party itself deserves closer scrutiny. This paper shows how the Greens are organisationally different from other parties currently active in Australian politics due to both their internal processes and their parliamentary practices. Recent theories of parties argue that party organisation has changed significantly for major parties, adopting an electoral‐professional or cartel model that centralises power and decision‐making in party representatives within parliaments. This paper shows how a smaller party uses identity formation processes to establish a distinctive organisational style. We examine the Greens' party organisation by analysing the interdependent relationships between the party membership, the state and national offices, and Green MPs. The paper is based on original research including in‐depth interviews undertaken with state and federal Greens members of parliaments.     

Laser microdissection separation of pure spermatozoa from epithelial cells for short tandem repeat analysis

Short tandem repeat (STR) analysis is a valuable tool in identifying the source of biological stains, particularly from the investigation of sexual assault crimes. Difficulties in analysis arise primarily in the interpretation of mixed genotypes when cell separation of the sexual assailant's sperm from the victim's cells is incomplete. The forensic community continues to seek improvements in cell separation methods from mixtures for DNA typing. The feasibility of applying laser microdissection (LMD) technology to precisely separate sexual assault cell mixtures by visual inspection coupled with laser dissection was assessed through three experiments. First, various histological stains were evaluated for use with LMD and DNA analysis. Second, different DNA isolation methods were evaluated on LMD-collected cells. Finally, STR analysis was performed on LMD-separated sperm cells from mixtures of semen and female buccal epithelial cells. The results indicated (a) hematoxylin/eosin staining performed best in its ability to differentiate sperm and epithelial cells while exhibiting the least negative effect on further downstream analysis; (b) both QIAamp and Lyse-N-Go methods were useful for recovery of DNA from LMD-collected sperm cells; and (c) LMD separation provided clear STR profiles of the male donor with the absence of any additional alleles from the female donor. This report describes an efficient, low-manipulation LMD method for the efficient separation of spermatozoa from two-donor sperm/epithelial cell mixtures.     

Investigating BCCI: A journalist's experience

This is a working journalist's account of his involvement in the BCCI affair. Investigative journalists, as nosey cynics who follow up leads, were able to accumulate information highlighting the fraud in the bank, whereas the several regulatory agencies involved operated independently and were reticent in using their powers of disclosure and compliance.     

The use of the determinate sentence—an historical perspective: A research note

During the past decade, the move toward determinate sentencing has been rapid, spurred by the fear of crime and a spiralling crime rate. In the 1920s the state of Ohio faced similar circumstances and altered its sentencing structure. This note examines this event and reveals that some unintended negative consequences can result from a shift in sentencing.     

Local government decision‐making—citizen participation and local accountability: some evidence from Kenya and Uganda

The current fashion for decentralisation is built on the assumption that it will result in decisions that reflect local needs and priorities. Yet representative democracy, through periodic elections, is a crude mechanism for establishing these needs and priorities. Most local government systems offer few other opportunities for citizens to participate, particularly for the poor, and few mechanisms of accountability. This article reviews the literature relating local level decision‐making, citizen participation and accountability. It then presents the findings of a study of decision‐making about the use of resources in a sample of municipal governments in Kenya and Uganda. Local governments in Kenya have traditionally offered minimal scope for citizen participation or accountability, but this is beginning to change, mainly as a result of performance conditions applied through the recently introduced Local Authorities Transfer Fund (LATF), together with an increasingly active civil society. In Uganda, which has undergone a radical decentralisation, there is much greater scope for citizen participation at the local level but there are still many of the same problems of local accountability as in Kenya. The article reviews some of the examples of, and reasons for, good (and bad) practice. It concludes that factors like committed local leadership, central monitoring of performance, articulate civil society organisations and the availability of information are critical. But even with these, there is no guarantee that decentralised decision‐making will be inclusive of the poor. Copyright © 2003 John Wiley & Sons, Ltd.