Extravasation of plasma proteins in brain trauma

The cellular distribution of extravasated plasma proteins in cortical contusions was studied with an immunoperoxidase method using polyclonal antibodies against human plasma albumin, alpha 1-acid glycoprotein, alpha 2-macroglobulin, alpha 1-antitrypsin, transferrin, hemopexin, haptoglobin, fibrinogen, fibronectin and immunoglobulin G. The material consisted of 24 human autopsy brains with a primary diagnosis of cerebral contusion due to blunt trauma. The time interval between injury and death ranged between minutes and 7 years. Immediately after the trauma, a complete breakdown of the blood-brain barrier (BBB) occurred with hemorrhage and extravasation of all types of plasma proteins. This was followed by spreading of edema fluid within the extracellular space in and around the wound. Uptake of extravasated protein by glial cells began on the 3rd day followed by proliferation of reactive astrocytes whose ample cytoplasm appeared to serve as a reservior for the extravasated plasma proteins. Within the reactive astrocytes, plasma proteins and S-100 protein had a similar and diffuse distribution in the immunostained sections. The plasma proteins once incorporated into the glial cells remained unchanged for several years with little sign of degradation. It is suggested that the extravasated plasma proteins subsequent to uptake and processing by the glial cells, may serve some important physiological function in wound healing.     

The electoral college and the rational vote

We have shown first, that if the electoral college was abolished the theoretically measured power of voters would increase and second, that in presidential elections the measure of voting power used does in fact have a highly significant impact on the decision as to whether or not to vote. Thus, the analysis predicts that the abolition of the electoral college would have a significant impact on voter participation. From a policy viewpoint, if we view participation in elections as desirable, this could be used as an argument in favor of direct election of the president. From a scientific viewpoint, we are able to make a strong and unambiguous prediction about the results of a (possible) future event from theoretical considerations. If the electoral college should be abolished, it will be possible to test our predictions. In addition, we have provided a further test of the rational behavior view of electoral participation and have shown that this model applies to presidential elections. Finally, we have shown that the theoretical measure of voting power does predict actual behavior.     

WORKING IN WHITEHALL: CHANGES IN PUBLIC ADMINISTRATION 1952–1982

There have been significant changes in public administration over the past thirty years, both internal to Whitehall and in its relationship to the outside world. The author offers a personal assessment based on his working experience. By taking a series of 'landmark reports published over that period he charts the extent to which they influenced, or reflected, changes in the character and style of public administration and in the general climate of public opinion within which the civil service works. He concludes that Whitehall today is better equipped than it used to be in its range of professional expertise and management techniques, but that it also faces a more sceptical and demanding audience. The next ten years may see the development of a style of public administration in which the traditional administrative skills are merged with the newer managerial concern for efficiency and effectiveness. But greater competence also requires improvements in the ways in which policy is formulated and its effects evaluated.     

Saleem Shah

This article describes the important ways in which Saleem Shah contributed to the improvement of delivery of forensic mental health services in state mental health systems throughout the nation. In addition, it describes his impact on the development of forensic mental health law, policy, and services internationally, especially in China and the former Soviet Union.