Local Transportation Sales Taxes: California's Experiment in Transportation Finance

Over the last 25 years, voters in 20 California counties approved “local transportation sales taxes” to pay for transportation projects. A growing source of revenue, they generate roughly $2.5 billion per year. Four features explain their popularity: they require direct voter approval; funds are raised and spent within the counties that enact them, so voters experience benefits directly; most automatically expire; and they usually specify the improvements to be financed. These taxes are an important revenue source, but tend to favor capital investments over operations and maintenance. They have enhanced local governments' decision‐making authority, but may have made regional transportation planning in multicounty regions more difficult to achieve.     

Thrombotic thrombocytopenic purpura causing sudden, unexpected death--a series of eight patients

Eight patients were presented to the medical examiner after dying suddenly and unexpectedly from thrombotic thrombocytopenic purpura. Compared with patients who die after prolonged hospitalization and treatment, these patients showed fewer neurologic symptoms and correspondingly fewer or no microthrombi within the brain. Only four of eight subjects developed fever, which further contributed to misdiagnosis. The differences in clinical presentation between our cases and most published series is striking and may be explained by shorter duration and no treatment. Each case contained the characteristic histology of thrombotic thrombocytopenic purpura. Ischemic injury to the heart and conduction system was the most likely mechanism of sudden death. Included in this series is a patient with acquired immunodeficiency syndrome (AIDS) diagnosed at autopsy, a concurrence that is now appearing more frequently in the medical literature.     

The lay component in Scottish juvenile justice

A recently completed study of the Scottish juvenile justice system, employing a variety of methodological approaches, is used as a source of information on the behavior and attitudes of the lay volunteers who make up children's panels and are responsible for decisions concerning young people who are alleged to have committed an offense or are believed to be in need of care and protection. The reported data relate to the beliefs of panel members as to the causes of delinquency and the objectives of intervention and alternative disposals; the topics they raise for discussion in children's hearings and the factors which influence the decisions they make; and the manner in which they are perceived by the children and parents who have appeared before them.     

Quality of Maternal Parenting among Intimate-Partner Violence Victims Involved with the Child Welfare System

Children are overrepresented in households with intimate-partner violence (IPV), and many suffer the double burden of being the subject of maltreatment and bearing the consequences of abuse to their mothers. Despite this situation, little information exists concerning parenting by women who have been abused by an intimate partner. We examine the relationship between women’s experiences with IPV and the quality of maternal parenting using data from the National Survey of Child and Adolescent Well-Being. The sample consisted of 1,943 female caregivers of children younger than 10 years investigated for child maltreatment. Women who had experienced IPV in the past but were no longer victims of IPV had significantly better parenting scores than women who were currently experiencing IPV, when other risk factors were controlled. This study adds to the evidence that IPV does not necessarily impair maternal parenting. Women abused by an intimate partner deserve a thorough assessment of what services they need: parenting services should be offered as warranted on a case-by-case evaluation of the particular woman’s parenting skills.     

Jury on stage: a common law play

Legal processes have a theatrical component to them. They offer an audience (the spectators) and actors (the legal parties, lawyers, as well as the jury and judge) who perform a play on the stage of the courtroom. In this paper we focus on the role of the jury, which appears to be simultaneously audience and actor. As audience, it assures that the power of the judge is limited. As actor, the jury is able to play its role in such a way as to incorporate social attitudes into the verdict. Exploring this theatrical component may shed new light on the debate whether juries are a “good” way of finding legal settlements. Further, it could indicate how legal processes are perceived by the public. As our line of argument builds on Adam Smith’s moral and legal philosophy, the analysis may also contribute to the understanding of one of the building blocks of Smith’s philosophy, namely the impartial spectator.     

Pulmonary siderophages and unexpected infant death

It has been proposed that the presence of siderophages in the lungs of infants who die unexpectedly should be considered a marker of a previous hypoxic event, which may preclude a diagnosis of sudden infant death syndrome. The authors retrospectively reviewed all infant deaths (<1 year old) going to autopsy at the Denver Office of the Medical Examiner from January 1999 to January 2001. Lung sections were stained with Prussian blue, and siderophages were counted in 20 high-power fields per lobe sampled. Cell counts were performed by two independent pathologists who were blinded to history and cause of death, with good reproducibility. Iron stain results were then categorized by average number of siderophages per 20 high-power field (category 1 = <5, category 2 = 5-100, category 3A = 100-500, category 3B = >100 in a single lobe, category 4 = >500). The results were subsequently correlated to case history, autopsy findings, and cause/manner of death. Forty-three cases were reviewed. The causes of death included sudden infant death syndrome (16), asphyxia (5), undetermined (6), and other (16). Those deaths were categorized by the above criteria as follows: category 1. (32), category 2. (6), category 3. (4), and category 4. (1). All sudden infant death syndrome deaths were in category 1. Categories 1 and 2 also included deaths in which hypoxia might have been present before death because of such factors as pneumonia and congenital heart disease. Categories 3 and 4 included a known homicidal asphyxia in which repeated episodes of intentional smothering were documented, 2 probable asphyxias, 1 nonaccidental trauma, and 1 undetermined. All 5 cases had questionable circumstances surrounding the death of the infant. Pulmonary siderophages were described in only 1 of the 43 autopsy reports. It was concluded that pulmonary siderophages can be markedly increased in cases of repeated asphyxia. Siderophages may also be increased in cases where hypoxia may have been present for another reason, but not to the same degree. Siderophages are not increased in sudden infant death syndrome. Because iron-laden macrophages often are not recognized on routine examination with hematoxylin and eosin staining, iron stains may be helpful in the evaluation of infant deaths. If siderophages are present in increased amounts without an obvious explanation, further investigation is warranted.