Death by sewer gas: case report of a double fatality and review of the literature

Hydrogen sulfide (H2S), the toxic gas associated with the smell of "rotten eggs," is an important cause of work-related sudden death. The gas is particularly insidious due to the unpredictability of its presence and concentration and its neurotoxicity at relatively low concentrations, causing olfactory nerve paralysis and loss of the warning odor. We report a double fatality involving 2 surveyors working near a man-hole, who fell into the sewer and died due to sudden exposure to hydrogen sulfide gas. Key historical, physical, and toxicologic findings are described. Additionally, we present a discussion of the clinical presentations and differential diagnosis, mechanism of injury, metabolism and toxicology, incidence, and scene and safety concerns in fatal hydrogen sulfide exposures.     

Reforming residency: modernizing resident education and training to promote quality and safety in healthcare

The goal of medical residency is to provide the best clinical education for future practice, while increasing quality and safety in current and future healthcare. This goal is not being met. Traditional residency programs often continue to utilize individually oriented, shame-and-blame approaches that do not recognize the systems nature of outcomes, care, and patient safety. Appropriate substantive methods, content, and training tools are also lacking, while residents continue to labor in a poor working environment. All these factors create a system that serves no one-not the resident, the patient, or the system in which both interact. Residency reforms are proposed to address these imperative concerns.     

Australia

European Journal of Political Research -     

Selfless androgyny: Gregory Rose as ‘virile woman’ in Olive Schreiner's the story of an African farm

While Lyndall, the feminist heroine of Olive Schreiner's The Story of an African Farm, articulates and enacts a critique of the position of women in male-dominated society, Gregory Rose's transformation from a vain and self-centred man into a nurturing female nurse is an important part of Schreiner's feminist vision. His womanhood both complements and critiques Lyndall's ‘virility,’ allowing Schreiner to present a fictional version of her theoretical ideal of selfless androgyny.     

Characteristics of married and unmarried adolescent mothers and their partners

In a middle-class, urban-clinic sample of 275, mostly Caucasian, adolescent mothers and their partners living in Utah, three groups were identified and their psychosocial characteristics were compared. Couples married at the time of conception (N=22) enjoyed more positive responses from prospective grandparents and earned more than couples not married at the time of conception. On the other hand, these initially married youths were much more likely to be high-school dropouts, which suggests limits in their lifetime earning capacities, and they were not more likely to identify one another as sources of emotional support. Couples who married between conception and delivery (N=110) reported that prospective grandparents responded less favorably to news of the pregnancy than did relatives of the initially married couples, but while their current salaries were lower, they were much more likely to be continuing with their education. Those who married after conception also had fewer antisocial and conduct disorders than young men and women who chose to continue in a dating relationship (N=29). Overall, the couples who married after conception appeared to face less severe problems than either the initially-married couples or the steady daters.This research was supported by grant number APR 000922-02-0 from the Office of Adolescent Pregnancy Programs to Drs. Elster and Lamb.where he and Dr. Lamb conduct research on pregnant teens, teenaged parents, and their children. Ms. Peters and Mr. Kahn are graduate students in School of Education at the University of Utah, while Ms. Tavare is a biostatistician at the University of Utah Medical Center.     

The electoral geography of immigrant groups in Britain

Recent interpretations of British politics have moved from the social and political homogeneity thesis to acknowledgment of Britain as a multinational and multiethnic state. An ‘ethnic marginals’ argument even contends that immigrant groups have played a crucial role in the outcome of recent general elections. This paper tests the electoral impact of different immigrant groups by matching the results of the 1981 Census by parliamentary constituency to the results of the 1983 general election. Immigrant groups collectively and individually are found to have almost no net effect on party voting patterns, but a substantial impact, largerly negative, on turnout. This evidence does not support the ethnic marginals argument. Although Britain is a multi-ethnic society, political cleavages not yet based on ethnic lines.     

Mixing God's Work and the Public Business: A Framework for the Analysis of Faith‐Based Service Delivery

Over the past thirty years, there has been a dramatic transformation in the way the American political process operates. There has been a growing public perception that traditional political institutions lack the capacity to meet existing challenges. This has led many observers to call for a rethinking of how government does its work. Numerous alternatives, including the use of faith‐based organizations, have been suggested. The current popular debate on the appropriate role of faith‐based organizations in public service delivery has shed little light on a number of important issues raised by engaging such actors in governance issues. The impact of using faith‐based institutions to design and implement public policy must be considered not only in terms of traditional evaluation standards, but also regarding potential long‐term impacts on the political process itself. This article outlines a theoretical framework for the evaluation of faith‐based organizations as “alternatives” to conventional governance structures. It identifies key practical and theoretical issues raised by such substitution, in both short and long range systemic terms.