The Institution of a Standardized Investigation Protocol for Sudden Infant Death in the Eastern Metropole,Cape Town,South Africa,,

The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4). We instituted a standardized autopsy and infant DSI through a collaborative effort of local forensic pathology officers and clinical providers. The high standard of forensic investigation met international standards, identified preventable disease, and allowed for incorporation of research. We conclude that an effective infant autopsy and DSI protocol can be established in areas with both high sudden unexpected infant death, and elsewhere. (SUID)/SIDS risk and infrastructure challenges.     

Using feedback simulation to test educational finance policies

A system dynamics model of the dynamics of special education reimbursement policies, based upon work completed in Massachusetts, is presented. The model is used to analyze the causes of unstable growth in special education costs and to propose policy options for controlling such costs. Because of an elaborated ability to represent the behaviors of local school districts, the system dynamics technology was found to be ideally suited to this type of policy analysis. However, the existence of the elaborated feedback structure would make it extremely cumbersome to use the system dynamics model to project annual costs on a locality-by-locality basis, such projections being the principal strength of traditional education finance models. This trade-off between two modeling technologies suggests that analysts must carefully match their audience, purpose, and modeling technology to attain best analyses.     

Site, type, and local mechanism of tibial shaft fracture in drivers in frontal automobile crashes

The location, type, and local mechanism of tibial shaft fracture were determined for 66 drivers injured in frontal automobile crashes. The results from the analyses showed that the distal third is the most common fracture location (p<0.05) and that bending is responsible for the majority of these fractures regardless of the fracture site. These findings indicate that the current injury criterion for predicting the occurrence of tibial shaft fracture in crash tests with anthropometric test devices is appropriate in terms of accounting for the primary mechanism of fracture but that increased protective effectiveness could be achieved by redefining the criterion for the distal third shaft section instead of the currently specified mid-shaft section of the tibia.     

Advocating social marketing as ultimate weapon to fighting HIV/AIDS propagation,and related discrimination and stigmatisation

The spreading of HIV/AIDS in the African continent and related discrimination and stigmatisation towards people living with the virus have become a major issue to be addressed by communities, health organisations and governments in Africa. An effective way to successfully overcome these plagues necessitates the application of social marketing techniques and campaigns. However, when it comes to funding and supporting social marketing activities, African leaders deny the important role that the government could play in achieving the ‘HIV/AIDS free generation goal’ as well as making African societies a non‐discriminative and stigmatisation places for infected people. The present study intend to demonstrate through analysis of empirical data that social marketing is crucial in changing people's sexual behaviour and battling misconceptions that lead to discrimination and stigmatisation of infected people. In this light, African political authorities such as Congolese leaders need to understand the relevancy of this discipline in their HIV/AIDS policy.     

Economic knowledge and the scientization of policy advice

The growing role of economic expertise in contemporary policy-making has received increasing scholarly attention. Yet, so far, this discussion has only been tenuously linked to relevant debates in public policy and administration, such as the work on policy advisory systems. The article attempts to bridge this gap by examining the changing reliance on academic economic knowledge within policy advisory bodies. It does so by analysing appointments and citation patterns in Norwegian advisory commissions in economic policy over the last 45 years. The analysis shows a marked increase in the number of academic economists appointed to commissions and in citations to economic literature. Moreover, it reveals an orientation towards the most prestigious outlets of the international economics discipline. This development can be interpreted as a scientization of policy advice in the economic field, that is, a growing reliance on academic expertise for analysis and arguments about public policy.     

Private Schools and the Parents that Choose Them: Empirical Evidence from the Danish School Voucher System

Research on the effect of school choice on student performance has generally been based on small-scale experiments or comparisons of Catholic and public schools in the United States. Recent studies indicate, however, that the market competition stemming from school vouchers does not affect all private schools equally. This study makes use of individual-level register data on the performance of more than 30,000 students in Denmark, where private schools have been voucher-financed for more than 100 years, while public schools are governed and financed by the politico-administrative system. Using an instrumental variable model to exclude selection effects, the results show no significant average effect of private schooling on final examination scores. However, a multilevel model shows that private schools of high socio-economic status perform better than similar public schools, while private schools of low socio-economic status under-perform – even for individual students with high socio-economic status. This indicates that the institutional setting of a voucher system is not enough to raise educational performance in general, arguably because some parents choose schools on the basis of non-academic criteria.     

Does IPSAS Meet Heritage Assets’ User Needs?

Public organizations need to custody and protect heritage assets. This article questions the appropriateness and quality of the unique International Public Sector Accounting Standards (IPSASs) in delivering financial reports that meet the user needs in regard to heritage assets. By refining the earlier findings in Italian local governments with data from a completely different region being Flanders, the results highlight that the IPSASs are lacking an important area of expectations from a relevant user need perspective, being the local ruling politicians. Finally, current article improves previous publication by examining the different kinds of responses in the light of certain municipal characteristics.

List of abbreviations

IFRS: International Financial Reporting Standards IPSASs: International Public Sector Accounting Standards IPSASB: International Public Sector Accounting Standards Boards UNESCO: United Nations Educational, Scientific and Cultural Organization     

Toxicological and pathological findings in a series of buprenorphine related deaths. Possible risk factors for fatal outcome

Buprenorphine is considered to have little respiratory side effects at therapeutic doses and the partial agonistic properties should produce a "ceiling effect" for respiratory depression at higher doses. Still, there are several reports on buprenorphine related deaths. Most deaths involve drug users and the co-administration of other CNS depressant drugs as well as reduced tolerance have been suggested to be risk factors. The primary aims were to investigate if lack of tolerance and/or co-ingestion of other psychotropic drugs are significant risk factors in buprenorphine fatalities. From July 2005 to September 2009, all autopsy cases where buprenorphine or norbuprenorphine had been detected in femoral blood and where analysis of buprenorphine had been performed in urine were selected. Results from the postmortem examination and toxicology were compiled. Postmortem toxicology was performed using the routine methodology at the laboratory. In total, 97 subjects were included in the study. These were divided into four groups; Intoxication with buprenorphine (N=41), Possible intoxication with buprenorphine (N=24), Control cases where buprenorphine was not the cause of death (N=14), and Unclear (N=18). The metabolite to parent compound ratios in both blood and urine in the Intoxication group were significantly different from those in the Control and Unclear groups. An extensive poly-drug use was seen in all groups with several additional opioids in the Possible group (54%) and in the Unclear group (78%) and hypnotics or sedatives in more than 75% of the Intoxication, Possible, and Unclear cases. Illicit drugs were present in all groups but not to a great extent with amphetamine and tetrahydrocannabinol as the main findings. Interestingly, 4 cases in the Intoxication group presented with no other significant drugs in blood other than buprenorphine. We conclude that a lethal concentration of buprenorphine in blood cannot be defined. Instead the analysis of blood as well as urine can be an important tool to show that the drug was taken shortly before death and to rule out a continuous use of buprenorphine supporting the notion that abstinence is an important risk factor. The presence of alprazolam in more than 40% of the Intoxications and the presence of hypnotics and sedatives in 75% of the Intoxications suggests that these drugs interact with buprenorphine producing toxic effects that buprenorphine alone would not have produced. Still, in 10% of the Intoxications no other drugs were found indicating that under certain circumstances buprenorphine alone may produce respiratory depression resulting in death.     

Water always finds its way: Identifying new forms of money laundering

Money laundering regulations have become stricter over time and involve more and more actors. This means that the accountability of laundering regulation will become more important; theoretically, money laundering should have decreased with the implementation of new regulations. However, as this paper shows, it is difficult to estimate even the sign of the trend in the proceeds of crime and of laundering over time with particular reference to the drug trade. There seems to be a substitution from hard to softer drugs, and no substantial decline in the proceeds of crime and likewise no substantial decline in money laundering. Criminals seem to switch from the more controlled banking sector into still less controlled parts of financial markets, and from financial markets to other sectors. These new sectors include electronic payments, trade and real estate. The paper shows how one can empirically approach the latter two by using economic information of unusual prices and other characteristics in order to identify the amount of laundering in these sectors. Combining economic information with criminological data facilitates the development of a new tool for identifying money laundering in some important sectors.