Postmortem Aortic Dissection: An Artifact of the Embalming Process

Aortic dissection (AD) is a serious condition that affects 3/100,000 individuals a year. Recently, a case report was published describing an embalmed patient with an aortic dissection. The purpose of this study was to examine the frequency of AD among 80 embalmed cadavers and confirm the AD with histopathologic evaluation. In seven cases of grossly identified AD, six were determined to be due to the embalming procedure and only one case of true antemortem AD was confirmed. These results suggest that aortic morphology can be altered by administration of the embalming fluid and that alterations can mimic AD, not only on gross inspection but also on postmortem imaging. Awareness of this embalming artifact may prevent misdiagnosis of an aortic dissection in an embalmed patient, a point particularly useful for autopsy pathology that may include postmortem examination of an embalmed patient.     

Seeking Sustainable Solutions: Using an Attractor Simulation Platform for Teaching Multistakeholder Negotiation in Complex Cases

We live and work in an increasingly complex and dynamic world. The demands of working in such environments require that negotiators understand situations of conflict and work with these situations in correspondingly complex and dynamic ways. Dynamical systems theory offers important insights and tools to enhance the understanding of difficult social conflicts, including the conceptualization of ongoing destructive conflicts as strong attractors: a particular form of self-organization of multiple elements comprising the mental and social systems associated with conflict. This article describes the pedagogical use of a computer simulation of conflict attractors (the attractor software) that allows participants to visualize and work interactively with the dynamics of conflict as they unfold over time. It further describes a negotiation workshop that employs the simulation to enhance participants' understanding of complex long-term dynamics in conflict and presents the findings of two outcome studiescomparing the effectiveness of a workshop that employed the simulation with one that employed a traditional integrative problem-solving method. While not definitive, these studies suggest that an understanding of the dynamical approach to conflict, supported by use of the attractor software, can promote the generation of more sustainable solutions for long-term conflicts.     

The prevalence of drugs and alcohol found in road traffic fatalities: A comparative study of victims

Researchers have studied the involvement of drugs and alcohol in fatal road traffic incidents, but with particular emphasis on the possible impairment of the driver. This paper describes a comparative study of drug and alcohol findings in various victim groups (drivers of cars, vans or lorries, car passengers, motorcyclists, motorcycle passengers, cyclists and pedestrians) between 2000 and 2006. Post-mortem blood and urine specimens submitted were analysed by immunoassay, GC–NPD, GC–FID, GC–MS and HPLC–DAD. The results of 1047 cases indicated 54% of all victims were positive for drugs and/or alcohol, with the highest percentage of positive findings occurring in pedestrians (63%). Males between the ages of 17–24 were most likely to be involved in a road traffic accident, whether being in control of a vehicle (driver) or involved indirectly (car passenger, pedestrian, motorcycle passenger). A wide range of drugs were detected (e.g. drugs of abuse, anti-convulsants, anti-histamines, anti-inflammatories, anti-psychotics, cardiac drugs and over-the-counter products), but alcohol and cannabinoids were the most frequent substances across the victim groups. When detected, alcohol was commonly above the legal driving limit in blood and urine (> 63% in those in control and > 60% not in control). Overall, the presence of drugs and/or alcohol was of similar frequency in those victims in control (55% of driver, 48% of motorcyclists, 33% of cyclists) and not in control of a vehicle (52% of car passengers, 63% of pedestrians). This degree of frequency strongly implicates the involvement of drugs and alcohol in road traffic incidents and infers an effect on driving ability and individual impairment.     

Trauma‐Informed Interventions in Parent–Child Contact Cases

Parent–child contact problems may arise in the context of high conflict separation/divorce dynamics between parents. In cases where there are parent–child contact problems and children resist or refuse contact with one of their parents, there may also be incidents of child maltreatment, intimate partner violence, or compromised parenting that can be experienced by a parent or child as traumatic. The circumstances around separation and/or post‐divorce often result in intense stress for families. In this paper we distinguish between the stressful circumstances that may arise as a result of high interparental conflict and pulls for alignment from a parent, and the real or perceived trauma as a factor which contributes to resistance or refusal of a child to have contact with a parent. Interventions to address both trauma responses and the resist‐refuse dynamics are differentiated and discussed. After screening and assessment, the intent is to treat trauma responses with short‐term, evidence‐based therapy, either before or concurrent with co‐parent and family intervention.     

A qualitative investigation into the U.S. Department of Agriculture 18‐item Household Food Security Survey Module: Variations in interpretation,understanding and report by gender

Food insecurity, or limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways, affects more than 10% of Americans. The U.S. Department of Agriculture's 18‐item Household Food Security Survey Module (HFSSM) is the most common measure used in the United States to assess food insecurity. This measure is to be completed by one adult who reports on the severity of disruptions in the quality and quantity of the household food supply. Recent work suggests that men and women might respond differently to some of the items in this measure. Therefore, the aim of the current study was to further explore how men and women interpret each of the items and specific concepts in this measure. Pairs (n = 25) of low‐income and food‐insecure mothers and fathers of children aged 2.5–10 years participated in one‐on‐one interviews to answer the HFSSM questions using the think‐aloud method. The data were analyzed using basic inductive qualitative methods, and the findings suggest that gender is related to interpretation of key concepts relevant to food insecurity including “household,” “balanced meal,” and “worry.” These findings have policy implications for the use of this measure as a national benchmark of food insecurity such as the potential need for an additional, complementary instrument to include several male reference questions with different terminology.