Dissecting intramural haematoma of the coronary artery with intimal tears.

A dissecting intramural haematoma of the coronary artery is an infrequent cause of sudden and unexpected death. Most cases are women and in a significant number of these women, the haematoma occurred at term to 80 days postpartum. Because the intimal rupture and communication with the lumen were not found in most of the cases, the site of rupture has been considered to be a vasa vasorum. The authors report on a case of one woman who was at a later postpartum period (106 days). The microscopic finding of the dissected coronary artery revealed two intimal tears in a section. The case showed that the dissecting intramural haematoma of the coronary artery is caused not only by the rupture of the vasa vasorum but also by the rupture of the intima.     

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.     

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.