Study of the brainstem, particularly the arcuate nucleus, in sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD)

Complete examination of the brainstem involves transverse serial 5-microm sections made throughout the entire brainstem. The number of serial sections varies from 360 in sudden intrauterine unexplained death (SIUD) to 600 in term fetuses to over 1400 sections in sudden infant death syndrome (SIDS) victims. The procedure is not applicable in all histopathological laboratories, owing to the need for additional technical personnel. The simplified procedure allows a remarkable reduction of the number of sections. The brainstem is divided into 3 blocks. The first, cranial block, extends from the border between the medulla oblongata and pons up to the upper pole of the olivary nucleus. The second, intermediate block, corresponding to the submedian area of the inferior olivary nucleus, has as reference point the obex and extends 2 to 3 mm above and below the obex itself. The third, caudal block, includes the lower pole of the inferior olivary nucleus and the lower adjacent area of the medulla oblongata. Examinations of the brainstems from 106 SIDS victims, 30 controls, and 51 stillborns underlined a remarkable variability, particularly of the arcuate nucleus. The simplified examination of the brainstem makes it possible to evaluate the structures, examining 3 specific levels, defined by morphologic reference points.     

Have Cities Shifted to Outcome‐Oriented Performance Reporting?—A Content Analysis of City Budgets

“Outcome” orientation has been emphasized in performance measurement and reporting in recent years. Using budgetary documents of the largest cities in the United States, this paper analyzes more than 4,800 performance measures reported by 21 cities to show that clear progress toward outcome‐oriented performance measurement has been made. It also shows that the selection of performance measures differs among types of municipal services and is driven partly by professionalism in city management and the influence of professional organizations. The paper concludes by discussing the implications of the findings and potential future improvements of performance reporting.     

Is it time for a progress report on violence against women in Ghana?

Ghana, like many African countries, continues to grapple with domestic violence issues. Ghana's 1992 Constitution mandates provisions that should eradicate the scourge of violence against women and children. In this paper, two main questions are asked. First, will the 1992 Constitution ultimately lead to victories over discrimination and violence against Ghanaian women? Second, has progress been made in eradicating violence against women in Ghana to date? In that regard, have governmental and non-governmental organizations supported Ghanaian women to arrive at relative stability, empowerment and freedom from violence? Progress thus far is encouraging. Presently, there are several holistic or organic approaches being used to combat domestic violence in Ghana. however, an epidemiological examination of custom and a psychosocial approach towards domestic violence may facilitate permanent meaningful solutions.