Positional Asphyxia in Opioid-Related Deaths: Is It Being Overlooked?

The contribution of positional asphyxia in opioid-related deaths is currently unknown. Diagnostic criteria for positional asphyxia include finding the decedent in a position that does not allow for adequate respiration and an inability to extricate themselves from the position due to various conditions. Our primary objective was to assess whether positional asphyxia and the resulting airway compromise were a contributing factor to death due to the toxic effects of opioids. We evaluated 225 deaths where the death scene investigation contained adequate information to evaluate for positional asphyxia and performed a Pearson chi-square test to determine if the proportion of deaths found in an airway compromising position was higher when opioid(s) caused the death. The proportion of decedents found in a potential airway compromising position was greater when the death was related to opioid use (p < 0.0001). Further, narrowing the dataset to decedents who were definitely in an airway compromising position [Yes (24.49%) vs. No (11.02%)] showed a statistically significant association between positional asphyxia and deaths related to opioid use (p = 0.0021). Carefully documenting the position in which the decedent was initially found may be a significant factor in accurate reporting and in harm reduction efforts to decrease the opioid mortality rate.     

Rational benevolence in small committees

We consider a game in which three committee members must divide up a benefit among themselves. In response to the large literature on sequential procedures in this type of game, we propose an institution that is inspired by auction theory. The (sealed) bids of the players are proposals for a distribution of the benefit and are given simultaneously. If any of the bids is preferred to all others in a pairwise comparison (i.e., a Condorcet winner exists) then this proposal is implemented. If such a bid does not exist then an equal split of the benefit is assumed. An equilibrium of this game is for each player to suggest that one of the opponents should receive the lion’s share of the benefit, even though each player cares only about his own share. We call this phenomenon “rational benevolence”. Although the end that is desired by the players is purely egoistic, the means of achieving it may be perceived as benevolent. Several applications of the game are suggested.     

Locating Supreme Court Opinions in Doctrine Space

We develop a scaling model to estimate U.S. Supreme Court opinion locations and justice ideal points along a common spatial dimension using data derived from the citations between opinions. Citations from new opinions to precedent opinions usually apply and endorse the doctrine of the precedent opinion; however, sometimes they implicitly or explicitly dispute the precedent opinion. We collect original datasets classifying citations from search and seizure and freedom of religion opinions written between 1953 and 2006 into these different types and develop a model relating the similarity of the doctrine embodied in the citing and cited opinions to the relative probability of these different types of citations. The resulting spatial estimates of opinion location are used to evaluate theories of Supreme Court bargaining and opinion writing. We find empirical support for theoretical models that predict the majority opinion will fall at the ideal point of the median member of the majority coalition. Given the centrality of theories of judicial policymaking to various substantive problems in political science, the method of scaling opinions developed in this article can facilitate a range of future research.     

The role of committee systems in post-communist legislatures: a case study of the Lithuanian Seimas

European parliamentary committee systems play an important role in organising the work of legislatures so as to assure the parliamentary leadership of its agenda. At the same time, the strategic positioning of committees in the legislative process provides opportunities for chairs to potentially undo the will of the leadership. We consider the degree to which committees in the Lithuanian legislature serve the private interests of legislators or those of the parliamentary leadership. We argue that while committees most often assist the leadership in obtaining preferred legislative outcomes, chairs on occasion have been able to change proposals or even frustrate the parliamentary leadership of governing coalitions.     

Multiple deaths resulting from shipboard exposure to trichlorotrifluoroethane

During the course of dockside ship maintenance, a compartment was partially flooded with tricholotrifluoroethane gas. One sailor entered the compartment, collapsed, and was then rescued by two other men. All three victims then climbed a 11-m (36-ft) ladder and collapsed. They all experienced a rapid development of cardiac arrest. We report on the pathologic, toxicologic, and pathophysiologic aspects of the incident.