Sudden death in angiodysplasia of the gastroesophageal junction.

A 22-year-old Korean soldier, who had received blows to the neck and epigastrium from an officer 10 h earlier, suddenly died after massive hematemesis. He had been in relatively good health except for episodes of blood-tinged vomiting approximately 5 and 7 months prior to this event. Postmortem examination revealed angiodysplasia involving the gastroesophageal junction, and the stomach was distended with blood. No abnormal findings were present around the whole viscera, and the duodenum was free of blood. The pathologic significance of upper gastrointestinal angiodysplasia as a potential source of bleeding and a chronologic correlation between the trauma and bleeding are discussed.     

The use of either the nose or outer ear as a means of determining the postmortem period of a human corpse.

Presented in this paper are the initial results involving the use of the nose or outer ear as temperature measurement sites to determine the postmortem period of the human corpse. Simple mathematical models for both sites are developed based on cooling curves of five corpses. Analysis of errors between actual and calculated postmortem intervals suggest that in its present form, the described methods would not be suitable for use in accurately determining the time since death of human corpses.     

Symbols, rationality, and justice: rationing health care.

Proposals to ration health care in the United States meet a number of objections, symbolic and literal. Nonetheless, an acceptance of the idea of rationing is a necessary first step toward universal health insurance. It must be understood that universal health care requires an acceptance of rationing, and that such an acceptance must precede enactment of a program, if it is to be economically sound and politically feasible. Commentators have argued that reform of the health care system should come before any effort to ration. On the contrary, rationing and reform cannot be separated. The former is the key to the latter, just as rationing is the key to universal health insurance.     

Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey     

The Influence of Advisers and Decision Strategies on Foreign Policy Choices: President Clinton's Decision to Use Force in Kosovo

In the following paper, I analyze the influence of advisers and domestic political factors on President Clinton's decision to use force against Slobodan Milosevic and the Serbs in Kosovo in March 1999. I present an analysis and examination of President Clinton's decision-making process, using press reports, personal speeches, etc. In other words, I attempt to trace the process by which Clinton came to the decision to use force in Yugoslavia. Specifically, using the poliheuristic theory, I argue that President Clinton's decision was influenced by noncompensatory domestic political calculations and the strong influence of his Secretary of State, Madeleine K. Albright. Examining how advisers interact with one another, their status in the advisory group, and the manner in which presidents solicit information from advisers will further our understanding of how, when, and under what conditions national security-level decision makers make decisions.     

ASSESSING NEIGHBORHOOD AND SOCIAL PSYCHOLOGICAL INFLUENCES ON CHILDHOOD VIOLENCE IN AN AFRICAN‐AMERICAN SAMPLE*

The present study examines the extent to which neighborhood and social psychological influences predict childhood violence among 867 African‐American youth. The results showed that neighborhood affluence was the only neighborhood‐level variable to exert a significant influence on childhood violence. Furthermore, childhood violence was significantly related to social psychological influences, such as adopting a street code, associating with violent peers, parental use of violence, and quality parenting. Overall, the findings suggested that simply living in a violent neighborhood does not produce violent children, but that family, peer, and individual characteristics play a large role in predicting violence in childhood.     

A Test of Generalizability of the Social Development Model Across Gender and Income Groups with Longitudinal Data from the Elementary School Developmental Period

The social development model (SDM) is a theory of behavior that has proven useful in explaining the etiology of delinquency, violence, and substance use among adolescents as well as early antisocial behavior among pre-adolescents. A further test of the model is its generalizability across population groups. A section of the SDM representing prosocial influences in the etiology of problem behavior was compared for boys and girls and for children from low- and non low-income families using three waves of child, parent and teacher survey data on a sample of 851 elementary school students. Multiple group structural equation modeling was used to assess differences across groups in both measurement of model constructs and hypothesized structural paths between constructs. The results indicate overall similarity in the reliability of measurement models and validity of structural models.