Sudden epilepsy deaths and the forensic pathologist

Sudden unexpected deaths in epileptic persons are not rare events, most commonly encountered by the forensic pathologist rather than the clinician. Such deaths may represent 1-1.5% of all "natural" deaths certified by the medical examiner or coroner. The typical victim is a black male about 30 years of age who tends to abuse alcohol, with a history of generalized epilepsy for more than 1 year and likely for more than 10 years. There are a lack of obvious anatomic causes for the death at autopsy, but 60-70% of cases will have a lesion in the brain (most commonly old trauma) to explain the epilepsy. Most victims have no blood levels of anticonvulsant medications at the time of death. We have evolved a form for use by medical examiner/coroner's investigators at the scene to collect relevant information which will be of assistance to the pathologist in interpreting the case. Estimated prevalence of sudden epilepsy death, mechanisms, and other features of such cases are reviewed briefly.     

Employer strategies for modifying or terminating retiree benefits in the 1990s

Over the past decade, access to health care coverage has become a crucial national concern. At the same time, the rising cost of health care, the aging of the population, and new accounting requirements for retiree medical benefits have caused employers to reevaluate their commitment to providing unrestricted health care benefits to the retirees. This article discusses the key federal appellate court decisions concerning an employer's decision to modify or terminate retiree medical benefits. It then explores alternatives for meeting the statutory, legal, and accounting challenges faced by employers who now offer retiree health care coverage.     

Malice in Maasailand: The historical roots of current political struggles

Current struggles for power, land and resources in Kenyan Maasailandcan only be understood in a one hundred-year context, by returningto the forced moves and land losses of the 1900s and closelyexamining subsequent complaints about their alleged illegalityand long-term impacts. Drawing upon archival research and oraltestimony, this article explains why the Maasai community'ssense of loss and betrayal is so enduring. Maasai grievancesstem from a feeling that they have been betrayed by the British,from the political ambitions of particular Maasai leaders, andfrom historical divisions between different groups of Maasai.Entangled with all these reasons for grievance is the use ofhistory and myth in constructing nationalist and bounded identities.     

Degrees of Memory of Childhood Sexual Abuse Among Women Survivors in Therapy

Past and current memory for childhood sexual abuse reported by a clinical sample of 160 women survivors was assessed utilizing a structured clinical interview. Response alternatives for memory were ordered along a continuum. To minimize treatment effects, participants were interviewed as early in therapy as possible. Fairly complete recollection both in the past and currently was reported by 26.3% of the sample, 36.9% apparently lost and subsequently recovered sexual abuse memories, and 36.9% endorsed intermediate degrees of memory. Only 2.5% indicated a decrease in degree of recollection over time. Age at onset was the only abuse characteristic found to differentiate participants with fairly complete memory from the rest of the sample. Findings are interpreted as illustrating that conclusions about memory for abuse are highly dependent on the way inquiries are conceptualized and worded.     

The Liberalization of the Telecommunications Sector: A Rent-Seeking Perspective

This paper assesses market liberalization in the telecommunications industry from a rent-seeking perspective. Our focus is on United States regulation, with corollary international developments that are spurring competition. The analysis which is general in approach, assesses pervasive government controls which have long shaped the nature of competition in the telecommunication sectors. We find that government has been a means for retarding competition and innovation in the telecommunications sector through the actions of rent-seeking agents. Rapid technological change, however, increasingly is rendering traditional government regulation obsolete. This change is spurring welfare-enhancing competition, regulatory reform, and privatization in the telecommunications sector.     

Variability in Hormone Concentrations and Self-Reported Menstrual Histories in Young Adolescents: Menarche as an Integral Part of a Developmental Process

Menarche has been considered a marker for examining interindividual differences in biobehavioral development and for separating pubertal development into 2 stages. The purpose of this study was (1) to compare hormone concentrations in pre- and postmenarcheal girls to determine whether they fit a continuous or dichotomous model of pubertal development surrounding menarche; and (2) to address methodological issues of variability in self-reports of menstrual histories and reliability in reporting age at menarche. Girls (N = 52) ages 9 to 14 years were enrolled in a longitudinal study. Blood was drawn for hormone concentrations. Menstrual-cycle information was collected by questionnaire and oral report. Discrepancies in reporting of age at menarche ranged from 0 to 18 months and variability was noted in length of cycle. There was great overlap in hormones between pre- and postmenarcheal categories. Future studies might consider menarche as the culmination of underlying developmental processes rather than as a discrete event. Limitations of each measure of puberty should be considered by investigators conducting biobehavioral studies of adolescents.     

Author index of Volume 7

Authors Index

Author index of Volume 7