Detection of ketosis in vitreous at autopsy after embalming

Ketosis occurs in ketoacidosis or malnourishment. When either is suspected in relation to a death, it may be important to analyze for ketosis at autopsy. We encountered a case where starvation was suspected in a deceased nursing home resident, where the body had been embalmed prior to autopsy. Gas chromatography (GC) was unable to separate acetone from formaldehyde, a component of embalming fluid. The Acetest is a simple test that can detect acetone and acetoacetate in body fluids. We validated the Acetest with GC on vitreous. The Acetest and GC were consistent except at very low levels of acetone or acetoacetate. The sensitivity of the Acetest for acetoacetate in vitreous was 10 mg/dL, consistent with early starvation. Significant interference from embalming fluid did not occur. The Acetest was negative in the described case. The Acetest is a simple and useful test for the detection of ketosis in embalmed autopsies.     

The periphery-dominated centre

Abstract Irish political parties cannot be easily fitted into a conventional left-right framework. The Lipset-Rokkan centre-periphery concept is employed to explain this situation, and, in particular, to throw light on the persistent success of Fianna Fáil, the nationalist-populist party which has dominated the system since 1932. It is argued that Ireland affords an example of a polity in which the political concerns and style of the rural periphery came to 'invade' and dominate the urban centre for more than a generation. Evidence from a study of urban party activists indicates a persistence of rural political styles and ideological perspectives in a social context which has been for well over half a century.     

Radical Reform in New Zealand: Crisis, Windows of Opportunity, and Rational Actors

This article uses three perspectives to explain the radical economic and state sector reforms undertaken in New Zealand starting in 1984. We interpret the reforms using a rational-comprehensive perspective, a garbage can perspective and a modified garbage can perspective identified in the work of John Kingdon. With New Zealand as an illustrative case, we explore the conditions under which radical reform is possible, the factors governing the adoption of reforms, and the impact on the reform process of a country's historical and cultural traditions. Our analysis emphasizes the import of a package of ready-made solutions, strong advocates (particularly a well-placed policy entrepreneur) who attach the solutions to a problem, and the existence of a 'window of opportunity' for adoption of the reforms. We conclude with a discussion of the implications of adopting reforms that run counter to a nation's long-established traditions.     

Coping with Complex Leadership Roles: The Problematic Redefinition of Government-owned Enterprises

Inspired by New Public Management, many countries have changed their central public apparatus from an integrated to a more segregated structural model. A central element in this process is structural devolution and the establishment of new or reorganized state-owned companies with increased business autonomy and new formal control systems. This paper focuses on how this development, as exemplified by the case of Norway, is affecting the role of central executive political and administrative leaders. The study, based on elite interviews, shows that corporatization has made the role of central leaders more complex and ambiguous and undermined traditional political control. We interpret this development from a transformative perspective, underlining how structural devolution is filtered through the dynamic context of environmental pressure and internal structural and cultural factors; in addition, experiences from New Zealand are used to contrast the Norwegian case.     

Weight force during prone restraint and respiratory function

Prone maximal restraint position (PMRP, also known as hogtie or hobble) is often used by law enforcement and prehospital personnel on violent combative individuals in the field setting. Weight force is often applied to the restrained individual's back and torso during the restraint process. We sought to determine the effect of 25 and 50 lbs weight force on respiratory function in human subject volunteers placed in the PMRP. We performed a randomized, cross-over, controlled trial on 10 subjects placed in 4 positions for 5 minutes each: sitting, PRMP, PRMP with 25 lbs weight force (PMRP+25), and PRMP with 50 lbs weight force placed on the back (PMRP+50). We measure pulse oximetry, end-tidal CO2 levels, and forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). FVC and FEV1 were significantly lower in all restraint positions compared with sitting but not significantly different between restraint positions with and without weight force. Moreover, mean oxygen saturation levels were above 95% and mean end-tidal CO2 levels were below 45 mm Hg for all positions. We conclude that PMRP with and without 25 and 50 lbs of weight force resulted in a restrictive pulmonary function pattern but no evidence of hypoxia or hypoventilation.     

Suicidal asphyxiation by using pure helium gas: case report, review, and discussion of the influence of the internet

Suffocation by inhaled gases has been reported involving a variety of gases. We report a case of suicidal asphyxiation by forced replacement of oxygen with helium by using a complex homemade mask. In this case, a young woman researched suicide on the Internet and found an advocated method of suicide using helium. To our knowledge, there is only 1 previously reported case of suicidal asphyxia by using helium.     

The Role of EU Internal Policies in Implementing Greenhouse Gas Mitigation Options to Achieve Kyoto Targets

This paper reviews the role of internal European Union (EU) policies and measures in implementing the target for greenhouse gas mitigation in the Kyoto Protocol. It starts with a discussion of the EU Burden Sharing Agreement, which distributes the target between Member States. This leads to a review of the appropriate level of implementation of policies, i.e. at the EU level or Member State level. There is a role for the flexible mechanisms of the Protocol, particularly emission permit trading, in complementing Member State policies at the EU level. The implementation is to be done against the background of three major factors which may have an important bearing on the policies: the probable long-term requirement of substantial reductions in greenhouse gas emissions a changing structure of energy markets, following liberalisation of the gas and electricity markets EU enlargement to include economies in transition with the potential for further substantial reductions in emissions.The paper concludes with a discussion of ancillary benefits of the policies that may be substantial and a summary of the position as regards the "unfinished business" of the Protocol to be discussed at the Conference of the Parties in the Hague in November 2000.