Cardiac pathology in 470 consecutive forensic autopsies

Cardiovascular disease continues to be the single most common generic cause of sudden and unexpected deaths. Atherosclerotic coronary heart disease and acute myocardial infarction are the most prevalent forms of fatal cardiac disease observed at autopsy. Other cardiac lesions are frequently listed as causes of death, but the prevalence of such lesions as incidental findings in the general population is unknown. In this study, 470 consecutive forensic autopsies were evaluated for minor and major anomalies. The most frequently observed major congenital finding was floppy mitral valve (5%). Tunneled coronary arteries, considered minor congenital findings, were seen in 29%. Atherosclerotic coronary heart disease was the most common major acquired finding, observed in 16% of cases. Of the 470 hearts, only 8% were considered normal.     

IMPROVING OBSERVATIONAL STUDIES OF POLICE

Despite advances in measurement and the sophistication of statistical technique, quantitative studies of police behavior seems to have reached the limits of their capacity to explain variance, develop and test theory, and inform policy choices. This paper suggests that further advances in observational studies of police behavior require that researchers account for the cognitive decision processes police use in exercising their discretion. A method for debriefing officers after encounters with the public is described. The results of a preliminary test of the method indicate that valuable in formation can be obtained with quite limited reactivity effects.     

Thymic hyperplasia. A clue to the diagnosis of hyperthyroidism

The association of simultaneous abnormalities of the thyroid and thymus is well documented, particularly in the case of Graves' disease. We present a case of a natural death following thyroid storm in which marked thymic hyperplasia was present. This finding can be helpful in determining the cause of death.     

Liberalism and capabilities: Theories of justice and the neutral state

Modern liberal theories share the idea that the state and its laws should remain neutral with respect to the varying conceptions of the good life held by individuals. This article discusses the way in which this notion of neutrality is defined and justified. Rawls's theory of justice is shown to be a prime example of such a theory. Questions are raised, however, if Rawls's theory has adequately formulated the conditions that would make it possible for each citizen to fulfill his own conception of the good. After arguing that Dworkin's solution to this problem is also problematic, it is argued that Sen's solution to the question of what conditions create neutrality shows the way ahead.     

A hybrid ampholyte focusing technique for esterase D subtyping of evidentiary material

An ultrathin-layer polyacrylamide gel isoelectric focusing technique that uses a composite of ampholytes from three commercial sources is described for subtyping esterase D. All common allelic products of esterase D were separated clearly. The technique described in this paper provides a higher conclusive call rate on known blood specimens (95.8%) and questioned bloodstains (69.7%) compared with continuous zone electrophoresis in agarose gels (89.9 and 37.6%, respectively).     

Public policy analysis in Washington and Ottawa

Policy analysis in the U.S. and Canada tends to follow the methods of systems analysis and takes into account variables relating to substantive matters as well as political and administrative constraints that governments face in pursuing different alternatives.Comparative analysis of the political effectiveness of the two governments in implementing the results of analysis indicates that Canada has built-in constitutional advantages. Comparative assessment of bureaucratic skills in policy analysis and policy implementation suggests that the American system is relatively weaker in terms of implementation, but relatively stronger in terms of policy analytical skills. This is followed by an assessment of the attempts made by the U.S. government to improve its policymaking structures through the setting up of the Domestic Council and the reorganized OMB, and the Canadian attempts to improve its policymaking capabilities through a reorganized Cabinet committee system and the strengthening of the Privy Council Office.The final section suggests that analysis of values and norms should be an integral part of policy analysis. The scope of policy analysis should be extended to include long-term economic and political analyses.     

Informed consent issues in the cardiac transplantation evaluation

As consultation-liaison psychiatrists to a cardiac transplantation team, we have observed various informed consent issues that are particularly associated with evaluation for cardiac transplantation. We discuss complicating factors that relate to each component of informed consent and present the defense mechanism of denial as a barrier to making the decision to accept or refuse transplantation. Changes in the evaluation protocol could preclude existing impediments to provision of information and patient autonomy; however, certain intrapsychic issues must be recognized as ongoing clinical realities to be addressed as the doctrine of informed consent continues to evolve.