Sudden death resulting from chicken bone perforation of the esophagus

Sudden death caused by foreign-body perforation of the esophagus is distinctly uncommon. We report the death of an elderly patient in a nursing home who exsanguinated after she swallowed a chicken bone that perforated her esophagus and right common carotid artery.     

Methadone concentrations in human hair of the head, axillary and pubic hair

The concentrations of methadone and its metabolites in the hair of the head, axillary and pubic hair obtained from patients receiving a daily maintenance doses, were determined. Comparison of the concentrations provides the highest values in the axillary hair, followed by pubic hair and the hair of the head.     

Stability of beta-HCG in old blood stains

Pregnancy was diagnosed from old blood stains by means of radioimmunoassay of beta-HCG. Up to 45 days, the age of the blood stains did not influence values, and extraction by ultrasound did not improve the results.     

Determination of ABO antigens in fingernails using the APAAP (immunoalkaline phosphatase) technique

Fingernail specimens with adherent nail-bed were taken from autopsy material with blood groups A, AB, B and O. Frozen 4-5-microns sections were submerged and floated carefully during each working step. Portions of fingernails were contaminated with blood and buccal cells, respectively. Furthermore, fingernail fragments of 8 volunteers were embedded in a biocomponent adhesive according to Grieve and Kotowski (Forensic Sci. Soc., 26 29-34) (1986) and cut by the usual microtome technique. APAAP staining is a proper method for demonstrating blood group antigens in fingernails from groove to margin. Frozen sections as well as smallest specimen embedded in a suitable adhesive are applicable for staining procedures. Using freshly prepared artificial stains, blood group constellations of red blood cells and/or buccal cells adherent on the surface of fingernails may be distinguished from the nail matrix.     

The "skin-skull-brain model": a new instrument for the study of gunshot effects

In order to create and study wound morphology, a "skin-skull-brain model" had to be designed which would make the laboratory reproduction of a real ballistic injury possible.To simulate the human skin, an artificial skin (a silicon cap) is used. This silicon scalp contains synthetic fibers (artificial leather) to simulate the collagen and fat of the scalp. The artificial skull is a layered polyurethane sphere (19 cm o.d.; and 5, 6, or 7 mm thick) constructed in a specially designed form with a Tabula externa, Tabula interna, and a porous Diploe sandwiched in between. The periostium of the artificial skull is made of latex. This elastic latex layer prevents the bone fragments from scattering after the model has been struck by gunfire. The brain itself is simulated with ordnance gelatin, 10% at 4 degrees C, a material well known in wound ballistics. Gunshots were fired at a distance of 10 m from the model.During the evaluation of the "skin-skull-brain model", it was possible to show that injuries inflicted to this model are fully comparable to the morphology of equivalent real gunshot injuries.Using the "skin-skull-brain model" has some significant advantages: the model is inexpensive, easy to construct, instantly available for use, and eliminates ethics conflicts. The main advantage of such a model is, in comparison with biological substances, the high reproducibility of inflicted traumas.     

A study of the morphology of gunshot entrance wounds, in connection with their dynamic creation, utilizing the "skin-skull-brain model"

The goal of this study was to document the dynamic effects created within, and the developing mechanisms of a gunshot entrance wound to the skin utilizing high-speed photography and the "skin-skull-brain model". The high-speed photography was taken with an Imacon 468/Hadland-Photonics camera. Full metal jacketed, 9 mm Luger projectiles were fired at the target model from a distance of 10 m. During the evaluation of the "skin-skull-brain model", it was possible to show that injuries inflicted to this model are fully comparable to the morphology of equivalent real gunshot entrance wounds. It has been possible to document and study the dynamic process of the "bullet-skin-interaction" in the gunshot entrance wound. The development of the morphologic terms of the entrance wound are discussed. In combination with high-speed photography, this "skin-skull-brain model" is a perfect tool for the documentation and the study of the dynamic development of gunshot entrance wounds in the skin.     

Patterns and issues in health care collective bargaining

Unionization of health care facilities has grown significantly over the last twenty years. More than 20 percent of American hospitals have one or more union contracts and an equal percentage of the industry's labor force is represented for collective bargaining purposes. Union membership is concentrated in the Northeast, Upper Midwest and Pacific Coast and is to be found particularly among large metropolitan hospitals. Although many different unions are actively organizing in the health care industry four labor organizations predominate: American Federation of State, County, Municipal Workers; Service Employees International Union; National Union of Hospital and Health Care Workers - District 1199; and the American Nurses Association.

One of the obstacles to union growth for many years was the absence of Federal legal regulation of labor relations. In 1974 Congress amended the so-called Taft Hartley Act to cover private nonprofit hospitals, the largest component of the industry. Since 1974 the application of Federal labor law has resolved old problems that arose from the lack of a basis to handle recognition disputes but at the same time created new issues. Among these issues are such legal questions as the legitimacy of the ANA to act as a labor organization, the proper bargaining classification for registered nurses, and the proper role in labor relations for hired consultants.

The growth of unions in health care raised concern that collective bargaining would impose onerous new burdens on an industry already hard pressed financially. Research indicates, however, that the impact on hospital costs have not been great -- perhaps on the order of an increase of 10 percent over what would be the case in the absence of unions. The greatest effects seem to be in the area of fringe benefits, working conditions, and the provision for grievance machinery.

Special problems have arisen in conjunction with the unionization of registered nurses. This particular category of health care workers occupies a strategic position in the hospital's work force. After a slow start nurse bargaining activity has come rapidly particularly as nonnursing unions such as 1199, SEIU, and the American Federation of Teachers have forced the ANA to respond to their efforts to make inroads among nurses.

Union growth in the industry seems to have stabilized for the time being without the prospect for much change in the remaining years of the decade. Incidence of conflict has been relatively low compared to other industries and this also shows little likelihood of change. While some visible signs of conflict over representation rights still remain collective bargaining is moving rapidly into an era of mutual accommodation.     

Connecting the dots: relevance of sustainable development principles in addressing environmental protection issues in Nigeria’s oil industry

Sustainable Development Principles are fundamental to addressing environmental protection issues in Nigeria’s oil industry. The paper examined sustainable development in its globally accepted meaning. Furthermore, this principle of environmental protection has in recent years evolved into international standards popularly called global best practices. The objective of the paper is to examine the sustainable development principle and its relevance in addressing the environmental challenges in Nigeria’s oil industry.