Repeat Coronary Artery Dissection in Pregnancy: A Case Report and Review of the Literature

Non‐atherosclerotic spontaneous coronary artery dissection (NA‐SCAD) is a rare cause of morbidity and mortality with a propensity for young, healthy, and often peripartum women. NA‐SCAD etiology is poorly understood, with possible hormonal and hereditary mechanisms. Current treatment strategies range from conservative management (often showing resolution on angiographic follow‐up) to invasive angiographic procedures. Rarely, NA‐SCAD has recurred in another coronary artery, ranging hours to years later. We report NA‐SCAD of the right coronary artery (RCA) in a 30‐year old, 3‐month postpartum female with an additional autopsy finding of remote myocardial infarction (MI) in the left anterior descending (LAD) coronary artery territory. The remote MI is consistent with prior NA‐SCAD of the LAD and, given the medical history, may have occurred in the peripartum period of the decedent first pregnancy 3 years earlier. As such, to the best of our knowledge, this may represent the first reported case of NA‐SCAD recurrence in a subsequent pregnancy.     

The Burglary Boost: A Note on Detecting Contagion Using the Knox Test

Objectives

A large body of literature in quantitative criminology finds that the spatio-temporal clustering of burglary is greater than one would expect from chance alone. This suggests that such crimes may exhibit a “boost” effect, wherein each burglary increases the risk to nearby locations for a short period. In this study, we demonstrate that standard tests for spatio-temporal dependence have difficulty distinguishing between clustering caused by contagion and that caused by changing relative risks. Therefore, any estimates of the boost effect drawn from these tests alone will be upwardly biased.

Methods

We construct an agent-based model to generate simulated burglary data, and explore whether the Knox test can reliably distinguish between contagion (one burglary increases the likelihood of another burglary nearby) and changes in risk (one area gets safer while another gets more dangerous). Incorporating insights from this exercise, we analyze a decade of data on burglary events from Washington, DC.

Results

We find that (1) absent contagion, exogenous changes in relative risk can be sufficient to produce statistically significant Knox ratios, (2) if risk is changing over time, estimated Knox ratios are sensitive to one’s choice of time window, and (3) Knox ratios estimated from Washington, DC burglary data are sensitive to one’s choice of time window, suggesting that long-run changes in relative risk are, in part, driving empirical estimates of burglary’s boost effect.

Conclusions

Researchers testing for contagion in empirical time series should take precautions to distinguish true contagion from exogenous changes in relative risks. Adjusting the time window of analysis is a useful robustness check, and future studies should be supplemented with new approaches like agent-based modeling or spatial econometric methods.

     

Motivation in humanitarian health workers: a self-determination theory perspective

This paper emerged from the authors' interest in why humanitarian health workers initially engage and remain in humanitarian work, often in the face of threats to safety and personal well-being. Semi-structured qualitative interviews assessed the consciously available reasons why individuals engaged in humanitarian health work. Interview data was unpacked through a thematic analysis. Using self-determination theory as a guiding framework, data suggested introjected and identified motivations are applicable to this occupational domain. Introjected motivation is implicated in initial reasons to engage the work, while identified motivation is implicated in reasons to continue. Theoretical and practical implications of these findings are discussed.

Motivation parmi les travailleurs humanitaires dans le domaine de la santé : un point de vue basé sur la théorie de l'autodétermination

Cet article a émané de l'intérêt de l'auteur concernant les raisons pour lesquelles les travailleurs humanitaires dans le domaine de la santé s'engagent initialement et continuent de travailler dans l'humanitaire, souvent malgré les menaces qui pèsent sur leur sécurité et sur leur bien-être personnel. Des entretiens qualitatifs semi-structurés ont permis d'évaluer les raisons consciemment disponibles qui expliquent que certaines personnes se soient engagées dans le travail humanitaire dans le domaine de la santé. Les données obtenues grâce aux entretiens ont été examinées au moyen d'une analyse thématique. En prenant la théorie d'autodétermination comme cadre d'orientation, les données ont suggéré que des motivations introjectées et identifiées sont applicables à ce domaine professionnel. La motivation introjectée intervient dans les raisons initiales de s'engager dans ce type de travail, tandis que la motivation identifiée intervient dans les raisons de continuer. Les implications théoriques et pratiques de ces conclusions font l'objet d'une discussion.

Motivação para Trabalhadores Humanitários da Área da Saúde: Uma Perspectiva da Teoria da Auto-Determinação

Este artigo surgiu do interesse dos autores em saber por que os trabalhadores humanitários da área da saúde engajam-se inicialmente e depois permanecem no trabalho humanitário, frequentemente enfrentando ameaças à segurança e bem-estar pessoal. Entrevistas qualitativas semiestruturadas avaliaram as razões dos indivíduos engajarem-se no trabalho humanitário na área da saúde, razões estas conscientemente apresentadas. Dados da entrevista foram processados através de uma análise temática. Utilizando a teoria da auto-determinação como estrutura de orientação, os dados sugeriram que as motivações introjetadas e identificadas são aplicáveis a este domínio ocupacional. A motivação introjetada está associada às razões iniciais de se engajar no trabalho, enquanto a motivação identificada está associada às razões de se permanecer no trabalho. As implicações teóricas e práticas destes resultados são discutidas.

La motivación en los trabajadores humanitarios de salud: una perspectiva de la teoría de la autodeterminación

Este ensayo surgió del interés de los autores en cómo los trabajadores humanitarios de salud inician su trabajo y permanecen en él a pesar de las frecuentes amenazas a su seguridad y bienestar personal. Las entrevistas cualitativas semiestructuradas realizadas revelaron las razones enunciadas conscientemente de porqué los individuos participan en el trabajo humanitario en salud. Se evaluaron las entrevistas a través de un análisis temático. Utilizando la teoría de la autodeterminación como marco, las entrevistas sugieren la existencia de motivaciones tanto introyectadas como identificadas en este ámbito de trabajo. La motivación introyectada se refiere a las razones para iniciar el trabajo y la motivación identificada a las razones para seguir en él. El ensayo examina las implicaciones teóricas y prácticas de estos resultados.     

The Value of Remorse: How Drivers’ Responses to Police Predict Fines for Speeding

After they stop drivers for exceeding the speed limit, police often have the discretion to alter the penalty. We investigated the degree to which extra-legal factors (apologies and other verbal responses), in addition to speed over the limit, predict ticket costs for speeding. Surveys of speeders were conducted in the U.S. and Canada. The data suggest that what people say to police matters. Participants who reported statements of remorse, e.g., “I’m sorry,” received lower fines for speeding. The relation of speeders’ responses to ticket costs is discussed from legal and psychological perspectives.     

Treatment-Related Changes in Behavioral Outcomes of Psychopathy Facets in Adolescent Offenders

This study examines the association between the facets of psychopathy embedded in the Psychopathy Checklist: Youth Version (PCL:YV; Forth et al., Psychopathy Checklist: Youth Version, 2003), and changes in institutional behavior and post-treatment violent and general offending in a sample of juvenile delinquent males treated in the Mendota Juvenile Treatment Center (MJTC), an intensive treatment program. Affective, Interpersonal, Behavioral and Antisocial facet scale scores were calculated from items of the Psychopathy Checklist: Youth Version (PCL:YV; Forth et al., 2003). Data on daily institutional behavior were collected from treatment records. In order to analyze re-offense patterns, the number and type of new criminal charges were collected over a mean follow-up of 54 months (range = 24–79 months), after the youth was released from custody. The Interpersonal facet of the PCL:YV was significantly related to admission behavior problems, while other facet scores were not. Youth with elevated Interpersonal facet scores showed the greatest improvement in institutional behavior during treatment. Treatment was also associated with a significant decrease in general and violent offending for each facet. The Interpersonal facet of the PCL:YV was found to play a key role in institutional and community violence in this study. Treatment appeared to disrupt the link between institutional and community violence and psychopathy features in this population.     

The price of personalizing politics: Political distrust and economic performance in Latin America, 1996–2006

While research has provided evidence that culture and institutional performance shape individual level trust in political institutions, scholars have neglected to adequately estimate the effect of political institutions and macroeconomic conditions on trust. Using data from the World Value Surveys for eleven Latin American cases, we test if countries with “partyizing” electoral systems - those with rules that encourage voters to hold the party, not individuals, accountable for government performance - experience lower levels of distrust in political parties and the legislature in times of poor economic conditions than those countries with “personalizing” electoral rules. Our analysis shows that the macro political and economic context largely conditions the impact of culture and institutional performance on political trust.     

Potency Trends of Δ9‐THC and Other Cannabinoids in Confiscated Cannabis Preparations from 1993 to 2008*

Abstract: The University of Mississippi has a contract with the National Institute on Drug Abuse (NIDA) to carry out a variety of research activities dealing with cannabis, including the Potency Monitoring (PM) program, which provides analytical potency data on cannabis preparations confiscated in the United States. This report provides data on 46,211 samples seized and analyzed by gas chromatography‐flame ionization detection (GC‐FID) during 1993–2008. The data showed an upward trend in the mean Δ⁹‐tetrahydrocannabinol (Δ⁹‐THC) content of all confiscated cannabis preparations, which increased from 3.4% in 1993 to 8.8% in 2008. Hashish potencies did not increase consistently during this period; however, the mean yearly potency varied from 2.5–9.2% (1993–2003) to 12.0–29.3% (2004–2008). Hash oil potencies also varied considerably during this period (16.8 ± 16.3%). The increase in cannabis preparation potency is mainly due to the increase in the potency of nondomestic versus domestic samples.     

Five-year accuracy of assessments of high risk for sexual recidivism of adolescents

This study looked at 12 juveniles in Wisconsin who were recommended by experts for commitment under Chapter 980, known as the Sexually Violent Person Commitments Act, but who ultimately were not committed. The purpose was to determine the accuracy of these assessments and risk for sexual reoffending for juvenile sexual offenders. The results found a rate of 42% sexual recidivism among these individuals, with a 5-year at-risk period. This figure is in contrast to the low rates of sexual recidivism reported in the general juvenile sexual research. This provides evidence that the capability to assess the risk in juvenile sexual re-offending may at times be higher than previously estimated. Implications of these unusual results are discussed.     

Biological sex variation in bone mineral density in the cranium and femur

Objectives

Sex and age trends in bone mineral density (BMD) play an important role in the estimation of age-at-death (AAD) of unidentified human remains. Current methodologies lack the ability to precisely estimate age in older individuals. In this study, BMD of the cranium and femur measured by DXA were examined to establish their applicability for age estimation in older adults. BMD as measured by DXA, is most commonly used clinically for prediction of osteoporotic fracture risk. We hypothesized that weight-bearing and non-weight-bearing bones, the femur and cranium, respectively, would provide valuable insights for aging.

Why Nations Fail: The Origins of Power,Prosperity and Poverty

This study addresses compliance and business practices at the local level subsequent to the international adoption of the Kimberley Process Certification Scheme by states and the adoption of the voluntary System of Warranties by the diamond industry. This paper also explores the distance between norm creation, norm sustainability and norm expansion. Interests of various stakeholders led to the creation of international norms, and evidence supports widespread compliance at the state level. Data gathered at the local level of retailer suggests, however, that the regulatory system is not leading to the education of consumers that potentially transforms beliefs. Central to understanding the challenge of deepening and broadening new global norms is exploring the distance between compliance within the regulatory regime and the awareness or change of beliefs of stakeholders. Recommendations include steps to make the process of bringing diamonds to market transparent and available to public scrutiny.