Child malnutrition and mortality in China and Vietnam in a comparative perspective

Under the traditional socialist central planning system, economic growth in China and Vietnam was unstable and not very satisfactory. Yet, both countries achieved a remarkable progress in the area of human development. Later, under the market socialist model, China and Vietnam achieved very high rates of GDP growth, and malnutrition declined significantly. Yet, income distribution and the provision of key public services deteriorated in both countries. Progress in reducing child mortality in China was relatively slow, before improving in the early 2000s. Although Vietnam is much poorer than China, and has been growing less fast, its record in this area was markedly better. We show that this apparent paradox is due mainly to the fact that the negative side-effects of market-oriented reforms have reached a more advanced and alarming stage in China than in Vietnam. Our results also suggest that an additional factor is constituted by a relatively better status of women in Vietnam with respect to China. However, we also warn that signs are emerging in Vietnam too, indicating that it is entering a stage of development where the social problems now evident in China are starting to manifest themselves on a large and worrying scale. Our policy conclusions advocate in favour of re-establishing (in a new form, compatible with the maintenance of the economic dynamism of the market socialist system) some positive features of the pre-reform socialist model, among which universal public provision of basic public services is paramount.

Spontaneous umbilical cord hematoma: an unusual cause of fetal mortality: a report of 3 cases and review of the literature

Spontaneous hematoma of the umbilical cord represents a rare cause of fetal morbidity and mortality and the outcome is poor in half of the cases. There are many risk factors, such as infections, morphologic anomalies, alterations of the vessel walls, prolapses, twisting and traction of the cord, but in many cases the causes remain unknown. We present 3 cases of umbilical cord hematoma which took place at the end of the pregnancy and were followed by perinatal death of the fetus. In the 3 cases, which were autopsied including macroscopical and histopathologic examination of the placenta and the umbilical cord, a cordonal pathology was present; in all cases, there were alterations of the vascular wall, and in the third case inflammatory vasculopathy was found. In all 3 cases, the cause of death was attributed to acute anoxia due to the cordonal hematoma.     

Between hierarchy and heterarchy: Post-Arab uprisings’ civil–military relations and the Arab state

Every actor who commands coercive resources plays a relevant role in the complex processes of state restructuring following regime change. The role of armies in the 2010–2011 Arab uprisings has been widely explored, but limited attention has been devoted to how different agents with coercive power have been involved in the restructuring of political order. This contribution presents the theoretical framework within which the remaining empirical contributions are situated. The central insight is that better understanding of the emerging political orders requires moving away from binary notions of hierarchy and anarchy as ordering principles and look at how, within heterarchical political orders, coercive agents behave within fluid state–society relations.     

Multi-Rater Agreement Using the Adapted Fracture Healing Scale (AFHS) for the Assessment of Tubular Bones on Conventional Radiographs: Preliminary Study*

Better understanding of the timing of fracture healing may help in cases of interpersonal violence but also of personal identification. The intra- and inter-rater agreement for the adapted fracture healing scale (AFHS) assessing the post-traumatic time interval on radiographs were tested. This is a preliminary study, providing essential information on method reliability for upcoming studies using the AFHS. Five raters (two radiologists, a forensic pathologist, an orthopedist, and an anthropologist) were presented with a test in three parts consisting of 85 radiographs (from 30 adults) of fractures of tubular bones in different stages of healing purposefully selected from more than 1500 radiographs. The raters were firstly asked to assess 15 features describing fracture healing as present, absent, or not assessable. Thereafter, the raters were asked to choose from the AFHS a single-stage best representing the observed healing pattern. The intra- and inter-rater agreement were assessed using single-rating, absolute agreement, two-way mixed-effects intra-class correlation (ICC) coefficients. The intra-rater ICC of radiologist 1 ranged from 0.80 to 0.94. The radiologists’ inter-rater ICC ranged from 0.68 to 0.74, while it ranged from −0.01 to 0.90 for the other raters. The good to excellent ICC among the radiologists and forensic anthropologist provides good foundation for the use of the AFHS in forensic cases of trauma dating. The poor to good results for the other physicians indicate that using the AFHS requires training in skeletal anatomy and radiology.     

A signal failure: Sports grants,public servants,and traffic lights

The Auditor General's performance audit into the failings of the Community Sport Infrastructure Grant Program has led to a ministerial resignation and a parliamentary inquiry. The media melee prompted by the ‘sports rorts’ affair has focussed on political corruption of process, with a concentration on the role of ministerial advisers. This is only part of the story. This article argues that on this occasion the Australian Public Service (APS) did not acquit itself well, and that the affair was triggered by an administrative failure to advise on threshold legal and procedural issues: what is termed the ‘traffic light’ role of a professional public service. The article considers how such policy advice failings may have occurred, and whether APS performance in this instance is an indicator of declining institutional capacity.     

Democratic legitimacy in regional economic organizations: the European Union in comparative perspective

Regional organizations have been widely criticized for lacking democratic legitimacy, but these criticisms have been rather ad hoc, concerned with single case studies and reliant on unclear standards or metrics. Are all organizations similarly deficient? And how does the European Union (EU), the target par excellence of the criticisms, fare in comparative perspective? In this paper, we take a first step towards answering these questions by leveraging the rich debate on the EU to identify several institutional dimensions of democratic legitimacy and operationalizing them for comparative analysis. We then investigate the most important regional economic organizations (REOs) in the world. Our findings are three-fold: (i) there is systematic variation across REOs, with a group doing rather well, one mixed, and one poorly; (ii) procedural dimensions fare better than those related to representation or local self-determination; (iii) no organization exhibits or lacks legitimacy in all dimensions. These results qualify the perception that democratic legitimacy deficits are indiscriminately pervasive and indicate that the EU belongs to the most democratically legitimate group.     

Median Voter Preferences,Central Bank Independence and Conservatism

This paper studies how the independence and theconservatism of a central bank relate to the structureand stability of the median voter preferences. This isdone by means of a model of endogenous delegationwhere an opportunistic policy maker chooses themonetary regime (independence and conservatism) tomaximise the welfare of the median voter. The resultsshow that a high degree of inflation aversion ofmonetary policy is not necessarily associated with ahigh degree of central bank independence. A high andstable degree of inflation aversion of society (i.e.of the median voter) may lead to establish a dependentcentral bank which is highly inflation averse. This suggests that the negativecorrelation between inflation and central bankindependence indices detected by several empiricalstudies may reflect a link between inflation and somedeep features of social preferences.     

Denial of pregnancy and neonaticide: A historical overview and case report

While denial of pregnancy and neonaticide are rare, they are potentially associated and share some risk factors. Neonaticide has been proposed as the extreme outcome of a denial of pregnancy. However, the process leading to such a possible outcome is not yet fully understood. The primary goal of this essay is to examine the various definitions and ambiguities surrounding the denial of pregnancy. The case of a young woman with a history of two denied pregnancies with diverse characteristics and outcomes, the latest of which resulted in neonaticide, is then reported and examined. A forensic psychiatric evaluation was also performed to reconstruct the woman's mental state at the time of the crime. The forensic pathological analysis of the newborn, abandoned near the sea while still alive, is described. The victim's body showed signs of shaken baby syndrome. We contend that differing levels of awareness during a denial of pregnancy might not be predictive of the potential delivery outcome in terms of threat to the newborn's survival, according to the forensic pathological and psychopathological data of the current case. Early identification of women affected by denial of pregnancy who pose a danger of committing infanticide is hampered by both intrinsic traits (dissimulation, unawareness, low propensity to seek assistance) and environmental factors (isolation, low socioeconomic level, poor education.). A previous history of denial of pregnancy should activate health and support services to reduce the potential risks for the mother and the child.     

Can computed tomography replace or supplement autopsy?

Postmortem computed tomography (PMCT) has been integrated into the practice of many forensic pathologists. To evaluate the utility of PMCT in supplementing and/or supplanting medicolegal autopsy, we conducted a prospective double-blind comparison of abnormal findings reported by the autopsy pathologist with those reported by a radiologist reviewing the PMCT. We reviewed 890 cases: 167 with blunt force injury (BFI), 63 with pediatric trauma (under 5 years), 203 firearm injuries, and 457 drug poisoning deaths. Autopsy and radiology reports were coded using the Abbreviated Injury Scale and abnormal findings and cause of death (COD) were compared for congruence in consensus conferences with novel pathologists and radiologists. Overall sensitivity for recognizing abnormal findings was 71% for PMCT and 74.6% for autopsy. Sensitivities for PMCT/autopsy were 74%/73.1% for BFI, 61.5%/71.4% for pediatric trauma, 84.9%/83.7% for firearm injuries, and 56.5%/66.4% for drug poisoning deaths. COD assigned by reviewing PMCT/autopsy was correct in 88%/95.8% of BFI cases, 99%/99.5% of firearm fatalities, 82.5%/98.5% of pediatric trauma deaths, and 84%/100% of drug poisoning deaths of individuals younger than 50. Both autopsy and PMCT were imperfect in recognizing injuries. However, both methods identified the most important findings and are sufficient to establish COD in cases of BFI, pediatric trauma, firearm injuries and drug poisoning in individuals younger than 50. Ideally, all forensic pathologists would have access to a CT scanner and a consulting radiologist. This would allow a flexible approach that meets the diagnostic needs of each case and best serves decedents' families and other stakeholders.