Unexpected death due to infectious mononucleosis

A 14-year-old boy with infectious mononucleosis died unexpectedly in hospital. The most significant finding at autopsy was the presence of marked bilateral tonsillar enlargement with considerable narrowing of the upper airway. There were no other underlying organic diseases that could have caused or contributed to death. Narcotic analgesia had been administered less than 2 h before death and may have contributed to respiratory compromise. The blood morphine level was 0.08 mg/L. Toxicological evaluation of individuals with obstructive lesions of the upper airway may, therefore, be a useful adjunct to the autopsy assessment of such cases as it may reveal factors exacerbating mechanical blockage.     

Data registers in respiratory medicine: a pilot project evaluating compliance with privacy laws and the National Statement on Ethical Conduct in Research Involving Humans

This article reports on data from a small pilot survey evaluating the compliance of voluntary databases in respiratory medicine with privacy laws and the National Health and Medical Research Council's National Statement on Ethical Conduct in Research Involving Humans. The increasing complexity of privacy law, including the recent private sector amendments, creates many challenges for database administrators. The impact of privacy laws upon voluntary or non-statutory databases, and upon doctors reporting patient data to such databases, is far from straightforward. The article suggests way in which the law might be adapted in order to better facilitate the role of voluntary data registers in health research and public health surveillance, while still protecting the privacy of patient information. The article also briefly considers how database administrators might "future-proof" their existing data holdings to ensure compliance with legal and ethical standards.     

The Great Disconnect: Global Governance and Localised Conflict in the Cases of India and the EU

Academic scholarship displays a curious disconnect between two trends, connecting peace and governance issues. At the same time when conflicts tended to shift inwards (from inter-state to civil wars), global governance approaches seemed to decentre the management of peace and conflict outwards (from the nation state to international forums). This paper investigates this disjuncture by examining the European Union and India's governance strategies in different conflict contexts. It studies whether their strategies operate close to the global governance model and/or whether they are able to connect with and effectively support local peace initiatives in conflict-ridden areas.     

Lethal Laryngopyocele

A 44‐year‐old man collapsed after complaining of difficulty breathing. Layer dissection of the neck at autopsy revealed a large mixed internal and external laryngopyocele occluding the upper airway. It contained 30 mls of yellow‐gray pus. Mechanisms of death in laryngoceles involve obstruction of the opening into the larynx resulting in accumulation of mucus or air within the sac causing airway occlusion. Once infection supervenes, deaths in laryngopyocoeles result either from accumulated pus causing airway occlusion from a mass effect (as in the current case) or the discharge of pus into the airway causing death from aspiration. Sudden death in laryngopyoceles is a very rare event that requires careful dissection at autopsy to demonstrate the characteristics of the underlying lesion and the possible mechanism of death. Laryngopyocele should be considered in the differential diagnosis of natural conditions causing acute, potentially lethal, upper airway obstruction.     

Labouring in the Shadow of the British Political Tradition: The Dilemma of ‘One Nation’ Politics in an Age of Disunification

The British state is in flux and the Labour party is struggling to shape an effective response to the politics of disunification. This article reflects on the nature of Labour's governing project and its conception of modern statecraft which has evolved since the party became a serious contender for power in the aftermath of the First World War. We argue that Labour's initially pluralising instincts cultivated in opposition have been checked by the ongoing reality of a state‐centric mode of governing, in which the party continued to robustly defend the Westminster model operating within the parameters established by the British Political Tradition (BPT). Ed Miliband's conception of ‘One Nation’ Labour threatens to reinforce this historical pattern of reversion to the Westminster model, at precisely the moment when devolutionary forces are destabilising the existing political settlement. To break out of this impasse, Labour must look elsewhere in its ideological lexicon for inspiration, chiefly to the tradition of socialist pluralism and associationalism.     

Book notes

Jeffrey Mourssaieff Masson and Susan McCarthy: When Elephants Weep: The Emotional Lives of Animals. New York: Doubleday, 1995.

Val Plumwood: Feminism and the Mastery of Nature. London: Routledge, 1993.

Karen J. Warren, ed.: Ecological Feminism. London: Routledge, 1994.

John Brinckerhoff Jackson: A Sense of Place, A Sense of Time. New Haven: Yale University Press, 1994.

Wendy Harcourt, editor: Feminist Perspectives on Sustainable Development. New Jersey: Zed Books Limited and the Society for International Development, 1994.     

AGAINST ODDS: A THIRTY-YEAR STRUGGLE TO SAVE THE FORESTS OF SARAWAK

When Malaysia came to independence, considerable powers, particularly in the natural resources sector, were devolved on the rulers of the states of East Malaysia, Sabah and Sarawak. The subsequent deforestation, which benefitted the logging companies (and the politicians) was hard to reconcile with the interests of the indigenous peoples. Their plight was projected internationally by a Swiss activist, Bruno Manser, who lived with the Penan people for several years. But the resulting expressions of international concern over the rate of deforestation from, for example Al Gore and Prince Charles, have received short shrift from the government of Malaysia. Sarawak reputedly continues to have among the highest rates of forest destruction in the world.