Mountaineering fatalities on Mount Rainier, Washington, 1977-1997: autopsy and investigative findings.

Mountain climbing is a popular recreational activity with a growing number of participants and associated fatalities. To define the characteristics of these fatal incidents and the typical autopsy findings in the victims, we reviewed the autopsy and investigative findings of all fatalities that occurred on Mount Rainier from 1977 through 1997. A total of 50 deaths occurred in 29 separate incidents. Fifty-eight percent of accident victims died as the result of a fall; another 34% died as a result of an avalanche. The incidents leading to death occurred at an average altitude of 3652 m (11,977 feet); range, 2073 to 4389 m (6800-14,400 feet). The average age of the victims was 31.2 years (range, 17-55 years), and 47 of the 50 were men (94%). Bodies were not recovered in 13 cases (26%). Autopsies were performed in 30 of the remaining 37 cases. At autopsy, the cause of death was ascribed to multiple injuries in 12 cases (40%), isolated head and neck injuries in 7 cases (23%), and chest injuries in 1 case (3%). Asphyxia and hypothermia were the cause of death in 8 cases (27%) and 2 cases (7%), respectively. The frequency of specific injuries is presented by anatomic region. The unique autopsy and investigative features of mountaineering deaths are discussed.     

Radical Reform in New Zealand: Crisis,Windows of Opportunity,and Rational Actors

This article uses three perspectives to explain the radical economic and state sector reforms undertaken in New Zealand starting in 1984. We interpret the reforms using a rational‐comprehensive perspective, a garbage can perspective and a modified garbage can perspective identified in the work of John Kingdon. With New Zealand as an illustrative case, we explore the conditions under which radical reform is possible, the factors governing the adoption of reforms, and the impact on the reform process of a country's historical and cultural traditions. Our analysis emphasizes the import of a package of ready‐made solutions, strong advocates (particularly a well‐placed policy entrepreneur) who attach the solutions to a problem, and the existence of a ‘window of opportunity’ for adoption of the reforms. We conclude with a discussion of the implications of adopting reforms that run counter to a nation's long‐established traditions.     

Field Contamination of Skeletonized Human Remains with Exogenous DNA

The Armed Forces DNA Identification Laboratory reports the mitochondrial DNA (mtDNA) sequences of over 800 skeletal samples a year for the Joint POW/MIA Accounting Command–Central Identification Laboratory. These sequences are generated from degraded skeletal remains that are presumed to belong to U.S. service members missing from past military conflicts. In the laboratory, it is possible to control for contamination of remains; however, in the field, it can be difficult to prevent modern DNA from being transferred to skeletal elements and being carried forward through the analysis process. Four such cases are described here along with the controls in place in the laboratory to eliminate the possibility of the exogenous DNA being reported as authentic. In each case, the controls implemented by the laboratories prevented the false reporting of contaminant exogenous DNA from remains that were either faunal or human, but lacked endogenous DNA.     

Health Care Reform in China: An Analysis of Development Trends and Lack of Implementation

ABSTRACT

China's health care system, under the direction of the central government, has undergone continuous reform in recent decades. Many problems have been encountered, with successive measures attempting to deal with shortcomings and failings of previous reforms. To what extent can implementation failures account for the recurring problems, and what explains these failures? The analysis adopts the theoretical lens of structural-instrumental and cultural-institutional perspectives, respectively, and draws also on recent developments in implementation theory. The historical trajectory of health reform is described, with particular reference to why health policies formulated by the central government during different periods repeatedly failed to achieve their objectives. The empirical analysis finds that structural factors, such as departmentalism and regional separation resulting in complex, overlapping horizontal and vertical actor patterns, have been a primary reason for implementation failures and suggests that they will continue to dog future reform efforts.     

Application of low copy number STR typing to the identification of aged, degraded skeletal remains

Low copy number (LCN) STR typing was successfully applied to four interesting cases during developmental validation of the approach for degraded skeletal remains. Specific questions were addressed in each case, with the acquisition of STR data largely serving as additional confirmatory or investigatory information in any specific situation, and not necessarily providing the definitive evidence to establish identity. The cases involve missing U.S. service members from World War I, World War II, and the Vietnam War. The variety of these cases, in terms of the questions addressed, the age of the remains, and the type of reference material available for comparison, demonstrates the broad utility of LCN STR typing in the identification of degraded skeletal remains from missing persons.