The Importance of Microscopic Examination of the Lungs in Decedents with Sustained Central Intravascular Catheters: A Nine‐Case Series

Indwelling intravascular catheters provide convenient access to healthcare personnel and also recreational intravenous drug users who inject suspensions of oral medications. A nine‐case series of autopsies of clinically stable decedents with indwelling catheters and sudden death is herein presented. Pulmonary histologic findings were consistent with intravenous administration of oral medications in all cases. In eight, the mechanism of death was directly attributed to occlusive vascular embolization of foreign material, with or without contribution of acute drug toxicity. In one, the mechanism of death was solely attributed to acute drug toxicity. Acute, massive embolization of foreign material may explain sudden death by vascular obstruction, whereas chronic repeated injections lead to obliteration of the pulmonary vasculature, increased pulmonary vascular resistance, and cardiac failure. Therefore, a complete autopsy with histologic examination of the lungs and toxicology testing is recommended in patients with indwelling catheters to determine the cause and mechanism of death.     

Interventions with women offenders: a systematic review and meta-analysis of mental health gain

Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of evidence for the utility of some interventions, notably those addressing the consequences of earlier trauma, including interventions which also address comorbid substance misuse. This does not amount, to date, to a robust evidence base. Limitations of these studies are discussed and include small sample sizes, their restriction mainly to prison populations and that they were substantially undertaken in the US. Variations in outcome measures follow-up and the difficulties inherent in measuring change in this complex population are also detailed. However, the review delineates definite avenues for further work. To achieve this, those responsible for policy, practice and purchase of services should both be mindful of existing evidence and promote additional, high quality research into interventions which are designed around a coherent, theoretical approach.     

Legal ‘Elasticity’ and ‘Sidestepping’ in European Crisis Management of Financial Markets

This paper explores the roles played by law in crisis management of financial markets and some possible consequences. Three questions are raised ‐‐about the ‘elastic’ use of law, about ‘sidestepping’ existing legal order by invention of new structures and about redistributive consequences. These questions are appraised empirically in relation to three areas of financial market law: public support given to banking from 2008 onwards; English case law concerning derivatives contracts when confronted with Lehman‐style insolvencies; and the European Stability Mechanism, which during summer 2015 was being primed in relation to Greece. On the first two case studies, law, having been mightily stretched, did not break. Likewise, legal sidestepping, as epitomised by the European Stability Mechanism, may result in a less coherent legal structure; however such incoherence may be not be fatal to the ensemble. On all three fronts, redistributive questions remain controversial, but controversy in itself does not undermine legal structures. A particular form of theory, the Legal Theory of Finance, is discussed in light of the case studies. Such theory may have an unfulfilled longing to discern law‐like regularities (ironically chasing economics).     

Election Inversions under Proportional Representation

It has been shown by Peter Kurrild‐Klitgaard, using several empirical examples under the Danish electoral system, that proportional representation (PR) can produce ‘election inversions’ such that a coalition of parties collectively supported by a majority of voters fails to win a majority of parliamentary seats. However, Kurrild‐Klitgaard's examples result from imperfections in the Danish PR system introduced to serve goals other than proportionality. In this article, Kurrild‐Klitgaard's analysis is carried a step further by showing that election inversions can occur even under the purest type of PR – namely, one with (i) a single national constituency, (ii) no explicit seat threshold, and (iii) a highly proportional electoral formula. Inversions result from the unavoidable ‘whole number problem’. Recent election data from Israel and the Netherlands is examined and examples of inversions under their relatively pure PR systems are found. Inversions are also found after recalculating seat allocations without a threshold, and on the basis of the most proportional electoral formulas and when the analysis is restricted to seat‐winning parties. Kurrild‐Klitgaard's Danish data is then re‐examined in the same fashion, as is the most recent apportionment of seats in the United States House of Representatives, and more examples of inversions are found.     

Therapies of Resistance? Yuta,Help-seeking,and Identity in Okinawa

In contemporary Okinawa shamanism and psychiatry are both employed by Okinawans to bring relief from what are understood to be godly or psychiatric interventions in their lives. This paper examines some of the reasons that shamanism is still popular and well-patronized in a society that is part of one of the world's most developed nations. By situating the role of shamans within a historical context, it becomes clear that repression of these women has taken place at a number of junctures in Okinawan history, mainly because they were seen as “backward,” “primitive,” or “too” Okinawan. In other words, their primary identity as Okinawans led those in political power to attempt to remove them from being socially acceptable, forcing them underground as the state reinvented itself to suit broader political strategies. Notwithstanding almost four centuries of discrimination and attempted repression, shamans continue to prosper in contemporary society, using markers of Okinawan identity (in particular ancestor worship) to legitimate their roles as therapists and healers. Patients, too, hybridize both systems today in informed and idiosyncratic ways, moving comfortably between treatment regimes. Both shamans and psychiatrists are perceived as therapists in this article.     

The Correlates of Corruption in India: Analysis and Evidence from the States

Robert Bartley, Chan Heng Chee, Samuel P. Huntington and Shijuro Ogata, Democracy and Capitalism: Asian and American Perspectives (Singapore: Institute of South East Asian Studies, 1993), 81 pp.

Charles Hirschman, Charles F. Keyes and Karl Hutterer (eds.), with the assistance of G. Carter Bently, Southeast Asian Studies in the Balance: Reflections from America (Ann Arbor: The Association for Asian Studies, 1992), 146 pp.

S. Gordon Redding, The Spirit of Chinese Capitalism, (New York: Walter de Gruyter, 1993), 267 pp.

Zhongguo Quanli Jigou yu Lingdaoren (Power Structure and Leadership in the People's Republic of China) (Hong Kong: Ming Pao China Study Research Unit, 1993), 277 pp.

Robert Cottrell, The End of Hong Kong: The Secret Diplomacy of Imperial Retreat (London: John Murray, 1993), xi, 244 pp.

John Andrews, The Asian Challenge ‐ Looking Beyond 2000 (Hong Kong: Longman, 1992), 218 pp.