Subaortic Pseudoaneurysm of the Left Ventricle Complicating Staphyloccal Endocarditis*

Abstract: Subaortic pseudoaneurysms are rare but can be a cause of sudden death in young individuals. This case report involves a 20‐year‐old Vietnamese male who died suddenly from rupture of a subaortic pseudoaneurysm with resultant hemopericardium with tamponade. He had a history of bicuspid aortic valve with recent but healed Staphylococcal endocarditis. A review of the literature reveals few similar cases and enlightens the association between aortic bicuspid valve, endocarditis, and subvalvular aortic aneurysm. The pathogenesis as well as recent studies that identified aneurysm predisposing genes in patients with bicuspid aortic valve will be discussed.     

Pacemaker/defibrillator evaluation at Los Angeles County Department of Coroner*

Pacemakers and implantable cardioverter-defibrillators (ICDs) are implanted medical devices for the treatment of cardiac arrhythmias. These devices are now commonly encountered in the postmortem situation. The Los Angeles County Department of the Coroner uses the services of a cardiac electrophysiology consultant to interrogate pacemakers and ICDs, producing a detailed picture of the cardiac events recorded by the device. We have used this method to evaluate 20 cases where the ICD or pacemaker provided significant information. We report four forensic cases to illustrate the different applications of pacemaker interrogation and its contribution in forensic investigation. This technique was used to establish identification of the decedent, to determine the cause and time of death, and to determine whether device malfunction could have played a role in the death. We conclude that detailed evaluation of the pacemaker or ICD in selected cases may provide essential information to the forensic pathologist.     

Inconsistencies in children's recall of witnessed events: The role of age,question format and perceived reason for question repetition

Purpose. Children's inconsistencies when answering repeated questions about past events are a source of concern in forensic, educational, and other contexts. Theoretical accounts of these inconsistencies have predominantly assumed that children shift because they infer adult dissatisfaction with their initial answer. This study aimed to test this account via examination of the effects of question format on shifting, as well as via direct questioning of children. Method. Four‐, five‐, and seven‐year‐olds (N = 226) were asked 17 recall questions about a recent classroom activity, with eight target questions repeated in one of four formats: no‐correct (mildly misleading questions to which the correct answer was ‘no’), yes‐correct (mildly misleading questions to which the correct answer was ‘yes’), specific open wh‐ questions, and forced‐choice questions. They were then asked about the adult's reasons for repetition. Accuracy, shifting, and interpretations of question repetition were examined. Results. Shifting from accuracy decreased with age, and was affected by question format in 4‐year‐olds only, who shifted more to no‐correct than to forced‐choice questions. Shifting towards accuracy was more common in forced‐choice questions than either no‐correct or open questions, but there were no significant age differences. First‐answer‐unsatisfactory interpretations of question repetition were rare, especially in the two younger groups. The oldest group offered a wider range of interpretations and also showed some evidence of an association between first‐answer‐unsatisfactory interpretations and shifting. Conclusions. Overall, our findings present a challenge to first‐answer‐unsatisfactory explanations of young children's shifting in recall settings, at least where overt pressure to shift is low. Forensic implications are considered.     

The sketch of Brazil’s grand strategy under the Workers’ Party (2003–2016): Domestic and international constraints

After passage of the 1988 Constitution of Brazil, successive democratic governments worked to build bridges between the nation’s foreign policy and its defence strategy, thus fostering a dialogue among administrations and constituencies under the aegis of the rule of law. It was under the Lula da Silva and Dilma Rousseff administrations that Brazil laid out a grand strategy, implementation of which was interrupted by the controversial impeachment proceedings of 2016. The argument unfolds from a consideration of Brazil’s development model and domestic politics as key structural variables in analysing the challenges faced in the conception and implementation of its grand strategy. The article is organised into two sections: (1) The sketch of a grand strategy: when Brazil’s foreign and defence policies converged; (2) An ambition frustrated? Or, the impact of Brazil’s development model and domestic politics on the conception and implementation of its grand strategy.     

In search of a leftist democratic imaginary: what can theories of populism tell us?

It might seem that Herbert Marcuse was right: leftist politics can no longer avoid the challenge of devising its own positive normative grounds. The neoliberal political rationality that is now hegemonic must be taken on by a new imaginary: radical, leftist and democratic. This article explores what major theories about new populism have to offer to a radical leftist attempt to reinvent itself. The regeneration of populist movements across the globe appears to offer signposts to guide a new radical politics. Yet I argue that populism is no ideologically empty mobilizing strategy able to be harnessed to all manner of political purposes. Embedded in its demagogic form are key presumptions about the character of democratic justification that collude with a neoliberal political project. Theories of new populism help us to shed light, instead, on the challenges that face the Left in its own self-reconstitution amidst liberal democratic crisis. Circumspection concerning the ideological load that is carried by a populist rendering of democratic politics needs to be united with an insight into how the rise of populism itself issues a warning about aspects of a social democratic past that cannot be reclaimed unchanged.     

The Frequency of Cranial Base Fractures in Lethal Head Trauma

The interpretation of cranial base injuries has never been investigated from a purely anthropological perspective. Very little exists in forensic literature in order to interpret the significance of cranial base fractures. We analyzed 296 cases of deaths due to skull–brain injuries. The frequency of vault fractures was 75.7% and that of base fractures was 91.9%. We observed the distribution of cases of death according to manner of death and manner of injury and number of fossae involved. These observations were analytically compared to different variables (age, sex, manner of injury, and mode of injury). The study presented the proportion of base fractures associated with vault fractures, and the frequency of absence of base fracture in subjects with no vault fractures. Interesting associations of base fractures to age and manner of death are shown.     

Field-portable detection of fentanyl and its analogs: A review

The need to detect fentanyl and its analogs in the field is an important capability to help prevent unintentional exposure or overdose on these substances, which may result in death. Many portable methods historically used in the field by first responders and other field users to detect and identify other chemical substances, such as hazardous materials, have been applied to the detection and identification of these synthetic opioids. This paper describes field portable spectroscopic methods used for the detection and identification of fentanyl and its analogs. The methods described are automated colorimetric tests including lateral flow assays; vibrational spectroscopy (mid-infrared and Raman); gas chromatography–mass spectrometry; ion mobility spectrometry, and high-pressure mass spectrometry. In each case the background and key details of these technologies are outlined, followed by a discussion of the application of the technology in the field. Attention is paid to the analysis of complex mixtures and limits of detection, including the required spectral databases and algorithms used to interrogate these types of samples. There is also an emphasis on providing actionable information to the (likely) non-scientist operators of these instruments in the field.     

Workforce Crisis in Residential Aged Care: Insights from Rural,Older Workers

In Australia, workforce shortages in residential aged care present a significant challenge for the aged care industry. The growing demand for workers in aged care, combined with the shrinking supply of younger workers entering the field, highlights a future workforce crisis. The current shortfalls are set to worsen with the retirement of a generation of women who have provided the backbone of the workforce. Although targeted retention of this group may alleviate this issue, few studies have explored the retirement decisions of this cohort. This paper reports on a qualitative study of this cohort of Victorian public sector residential aged care staff. Although current government rhetoric promotes intrinsic rewards (altruism, moral fulfilment) over extrinsic rewards (excessive workload, pay and conditions), a combination of these factors was associated with job satisfaction. It would seem timely to revisit some of these concerns to ensure an adequate and sufficiently skilled workforce.