Ancillary studies in amniotic fluid embolism: a case report and review of the literature

The incidence of amniotic fluid embolism during pregnancy is approximately 1/50,000 and has a mortality rate in excess of 80%. The postmortem diagnosis of amniotic fluid embolism can be challenging for forensic investigators and pathologists. At autopsy, usually signs of disseminated intravascular coagulation suggest an amniotic fluid embolism. A definitive diagnosis of amniotic fluid embolism cannot be made until ancillary studies are performed on the decedent's tissues. We report a case of a 37-year-old G3P2 white female who was 36 weeks gestation when her membranes spontaneously ruptured. She suddenly became breathless, went into cardiogenic shock, and died. The autopsy revealed gross and microscopic findings of amniotic fluid embolism, which was confirmed with ancillary studies consisting of special stains, immunohistochemistry, and a serum tryptase level. The authors hope this case report, including gross and microscopic autopsy findings with procedural and ancillary studies, and review of the literature will help investigators and pathologists in the diagnosis of amniotic fluid embolism.     

Youth violence in everyday life

What we now know about violence in the United States is that it is a common occurrence and recurrence for youth. Self-report methods have greatly enhanced our understanding of interpersonal violence. Specifically, from the 1980s to the present the age group most vulnerable to violence is youth. In addition, and in any given year, one third will physically fight with peers, more than one third physically fight with dating partners, and a majority of those who fight with either peers or partners will repeat this at least one more time.     

Interviewing Children about Real and Fictitious Events: Revisiting the Narrative Elaboration Procedure

Elementary school children participated in a staged event. Two weeks later they were randomly assigned to three interview conditions: (a) a streamlined version of the Narrative Elaboration (NE) procedure involving training in the use of reminder cue cards, (b) exposure to reminder cue cards without training in their use (cue card control group), and (c) a standard interview including no NE training or exposure to reminder cue cards (standard-interview control group). Children in each interview condition were questioned about the staged event and a fictitious event to determine whether children trained in the streamlined NE procedure would provide more information about a staged event than would children in the two control groups and whether the NE interview would result in increased reporting of false information when questioned about a fictitious event. Results indicated that children questioned with the NE interview reported a greater amount of accurate, but not a greater amount of inaccurate, information during cue-card presentation for the staged event than did the cue-card control group. Analyses further indicated that the NE-interview group did not report significantly more false information about the fictitious event than did children in the two control groups. Large standard deviations for the NE-interview children's cue-card recall indicate that the streamlined NE procedure was useful for many children in reporting the staged event, but may have contributed to a small number of children providing false information for the fictitious event. Further research is being conducted to determine which children may be more likely to be helped and which children may be more likely to provide false information regarding a fictitious event.     

A Comparison of Acculturation Measures Among Hispanic/Latino Adolescents

Acculturation has been associated with numerous health and social outcomes among Hispanic/Latino adolescents. Various self-report scales have been used to measure acculturation, making comparisons of results across studies difficult. This study administered several commonly-used acculturation scales to 221 Hispanic/Latino 9th grade students in Los Angeles. Although all of these scales purport to measure acculturation, the correlations among the scales, and their correlations with language usage measures, were modest. As expected, higher scores on Hispanic/Latino orientation scales (or lower scores on U.S./White orientation scales) were associated with higher levels of ethnic identity formation. Results indicate that these acculturation scales may measure different aspects of the complex phenomenon of acculturation. For example, purely language-based measures shared only small amounts of variance with more comprehensive measures. Additional research is needed to create and validate acculturation measures for adolescents. Jennifer B. Unger, Ph.D. is an Associate Professor of Preventive Medicine at the University of Southern California Keck School of Medicine. She is the principal investigator of Project RED, which is examining parent-child acculturation patterns and substance use among Hispanic adolescents. Anamara Ritt-Olson, Ph.D. is a Research Associate in Preventive Medicine at the University of Southern California Keck School of Medicine. Karla Wagner, MA is a predoctoral student and research assistant in Preventive Medicine at the University of Southern California Keck School of Medicine. Daniel Soto, BA is the project manager on Project RED. Lourdes Baezconde-Garbanati, Ph.D. is an Associate Professor of Preventive Medicine at the University of Southern California Keck School of Medicine and a co-investigator on Project RED.     

An Approach to Measuring the Affordability of State Debt

Affordability is one important and widely accepted element of state and local debt policy. However, there is no well-established measure of affordability and no clear standard for making normative judgments about what amount of debt is affordable for a specific jurisdiction. This article suggests a six-step method for measuring affordability of state debt that provides a useful guideline for determining when a state may be entering a "danger zone" by having debt that exceeds norms of affordability.