The relevance of the detection of troponins to the forensic diagnosis of cardiac contusion

The forensic diagnosis of cardiac contusion has hitherto been based mainly on anamnesis, concomitant thoracic injuries and the detection of macroscopic changes to the heart. Parallel histological and serological investigations of the heart-specific troponins have been conducted with varying results. This paper aims to show whether heart-specific troponins are suitable as a means of securing the diagnosis in proven cases of cardiac contusion and of determining which of the three heart-specific troponins cTnT, cTnI and cTnC are most significant in serology and histology for postmortem diagnosis.In the study, 25 cases of known cardiac contusion and 11 controls without vital myocardial trauma taken from autopsy material were prospectively investigated. Investigation of the venous serum revealed significant differences in the concentrations of the case and control groups for troponin T (mean value 5.5056 versus 0.4982; p = 0.014), for troponin C (mean value 263.9280 versus 68.5640; p = 0.001) and for troponin I (mean value 1404.0560 versus 36.1650; p = 0.003). In histology there are also significantly different depletions between the groups investigated (cTnT: p = 0.002; cTnC: p = 0.003; cTnI: p < 0.001) taking into account the autolysis time.     

Die Prämienverbilligung im Krankenversicherungsgesetz: Vollzugsföderalismus und sekundäre Harmonisierung

Subject of the report is the question about factors of influence on the development of a common policy between the cantons in implementing the subsidizing of contributions to health insurance of persons living in modest economic circumstances. It clearly appears that this so‐called secondary harmonization in the first place has been pushed by the concretization of the executive program by the federal administration. Secondly, the influence of various forms of horizontal cooperation is mentioned, which facilitated the exchange of information and reflection between the cantons and promoted the development of a common model for a solution. Thirdly, the paper refers to the role of the evaluation, in which a comparative analysis of the sociopolitical effectiveness of the cantonal implementation systems was made. This studies induced a number of cantons to make adaptations. In spite of all tendencies towards harmonization, however, the cantonal implementation systems still differ greatly also in this public policy. This fact is explained by fundamentally differing policy cores as well as by the varying extent to which information required for the implementation of subsidizing contributions is available in the cantons.     

Crimes against children in nineteenth-century France

Abuse of children is not entirely a modern phenomenon but the definition and classification of abusive practices has changed. Modern concepts of child abuse date only from the 1880s in France. Child abuse in twentieth-century terms of emotional and physical assault, neglect, abandonment, and sexual molestation was not considered a crime during most of the past century. Prior to the 1880s, only two acts, abortion and infanticide, constituted crimes against children. Child abandonment, rather than a crime, was the state supported, societally acceptable alternative to abortion and infanticide. After abandonment, malnourishment and neglect of these children, even to the point of death, likewise were not crimes. With changes in attitudes of the 1880s, parental neglect, assault, and starvation of children became defined as child abuse as did perceived immoral behavior of the parents such as habitual drunkenness and debauchery. Under these new definitions of abuse, state officials could deprive parents of their legal rights and make the children wards of the state for their own protection. The state becamein loco parentis. This essay explores the changing perceptions of child abuse, and the increasing state intervention for the care of abused children after the 1880s.