Toxicological findings in a death involving dextromethorphan and terfenadine.

A case of fatal self-poisoning with dextromethorphan, an antitussive, and terfanadine, an antihistamine H1, is reported. Both drugs were quantified in several postmortem tissues and fluids using capillary gas chromatography coupled to mass spectrometry. Results are discussed in the light of the existing literature.     

Surveillance of human immunodeficiency virus (HIV) antibodies in medicolegal autopsies in Finland--monitoring early changes in HIV-seropositivity among risk groups and average population.

In order to cooperate with voluntary screening programs aimed at the surveillance of the HIV epidemic in Finland, we have studied medicolegal autopsies for HIV antibodies since 1986 using an enzyme immunoassay on postmortem sera. The investigation covered 47.4% and 39.2%, respectively, of all deaths under the age of 65 years in the metropolitan areas of Helsinki and Turku--two cities on the densely populated southern coast of Finland from which most HIV infections have thus far been detected. Nine HIV-positive cases (0.12%) were detected among the 7305 medicolegal autopsies tested in 1986 to 1990. This figure is higher than the prevalence of 0.01 to 0.03% in voluntary screening programs for the general population would suggest. Seven of our cases had previously tested positive, and two were previously unknown cases, indicating that people at high risk are clustered in the medicolegal autopsy series. Of the six cases in an early stage of infection, three committed suicide suggesting the importance of HIV-screening in suicide cases in tracing symptomless HIV carriers. Five of the cases were detected in 1990, a year when the number of new HIV infections had more than doubled compared to the previous two years. This suggests that testing of medicolegal autopsies as surrogate tests for the population gives useful information even in low-prevalence areas like Finland. Such testing has none of the ethical problems of many other back-up surveys, and may be particularly sensitive to early changes in epidemiology.     

Small business innovation,research, and development

Historically, small businesses have been the innovation engine of the United States, with significantly more than half of the new technologies and products coming from small enterprises. In 1992, there were more than 21 million small businesses with fewer than 500 employees each in the United States, including 4.5 million small corporations, 1.6 million partnerships, and 15.1 million sole proprietorships. Although most small businesses have considerably fewer than 100 employees, they employ more than half the private U.S. work force, contribute more than half of all sales in the country, and are responsible for over half of the private sector's products. From 1976 to 1990, small firms also generated 65% of the net new jobs. From 1988 to 1990, all of the net new jobs in the U.S. economy were created by small firms. Indeed, small business is really big business in the United States.     

Federal labor protetons and the privatization of public transit

Federal transportation officials assert that labor protections in the Urban Mass Transportation Act inhibit the propensity of local transit agencies to contract with private firms for services. The authors present results from a survey of a large sample of transit managers and econometric analysis to support their conclusion that labor protections do not appear to reduce the incidence of contracting. The labor protections, however, may be costly to transit management in other ways. The authors recommend actions, aside from repeal of labor protections, to increase contracting by local transit agencies.     

Global economic developments: A view from Switzerland

In a free market world economy now characterized by a strong trend towards integrated economic areas dominated by North America, Western Europe and the Pacific, effective cooperation is the key to sustained success. Mr. Lautenberg is a diplomat, whose career has been strongly oriented on bilateral and multilateral economic matters (Poland, FRG; GATT, EFTA, CSCE). Between 1970 and 1974, Mr. Lautenberg, who holds a degree in political sciences from the University of Lausanne, led various research programs at the General Staff of the Department of Defense.     

Are disturbed and normal adolescents equally competent to make decisions about mental health treatments?

This study uses a structured vignette procedure to assess competency to make treatment decisions in two groups of adolescents, one at risk for institutional placement and the other a matched community sample. Scores on Factual Understanding (the ability to recall facts), Inferential Understanding (the ability to make inferences about those facts), and Reasoning (the ability to weigh risks and benefits of various treatment options and to make choices based on that reasoning) were compared. Results showed that while at-risk adolescents and their community, counterparts did not differ in their factual and inferential understanding abilities, the at-risk adolescents did significantly less well than the community adolescents in reasoning. This difference could not be fully explained by differences in verbal IQ. Girls, no matter what their risk status, scored higher than boys on the Reasoning scale. Implications for legal policies concerning adolescents are discussed.     

The supplementary signs of strangulation asphyxia]

Analyzes the results of forensic medical examinations of the corpses after hanging. The findings were as follows: two strangulation grooves are seen on the corpse's neck after hanging, that are similar to the grooves seen after strangulation with a loop and subsequent hanging of a corpse; the presence of bruises on the neck, along with the strangulation grooves, is indicative of a strangulation made by the hands, whereas half-moon shaped bruises may be self-inflicted during hanging.     

Children in the environment: Forest day-care centers: Modern day care with historical antecedents

Some features of early child care are more prominent in Norway than in other countries, such as emphasis on the outdoor environment. Of general relevance and interest is the form of day care provided by forest day-care centers. Three ideas form the development of these centers placed in wild areas. First, throughout history, Norwegians have had a close attachment to nature and some parents want to provide their children with outdoor experiences at an early age. Second, urging children to play outdoors characterizes the image many parents have of a happy, healthy childhood. Third, provision of day care for children has always been restricted in western countries, forcing parents to invent types of service that can become part of an ecological system that promotes healthy development.The forest day-care centers developed recently represent a supplement to the wide typology of child care in the 21st century. The article outlines the connections between these ideas in general European and western history and Norwegian history and presents debate and decisions about a question dating from the last half of the 1980s. It concludes that the forest day-care centers are perhaps only a modern form of the original kindergarten concept, which started in Europe and America as gardens for children not gardens of children.