Activated protein C resistance is uncommon in sudden death due to pulmonary embolism

Activated protein C resistance (APC-R) is the most common inherited defect of the coagulation system known to date, affecting 3-5% of Americans. It is an autosomal dominant disorder associated with an increased risk of venous thrombosis and is reportedly found in 21% of individuals with deep venous thrombosis. Medical examiners are in a unique position to make the diagnosis since a fatal pulmonary embolism may be the first manifestation of the disorder. This study examines the prevalence of APC-R in individuals who die suddenly of pulmonary embolism to help medical examiners decide if routine testing is indicated. We examined 66 cases of sudden death due to pulmonary embolism seen at the Bexar County Forensic Science Center in San Antonio, Texas, from 1993-1997. The median age was 46 years with a range of 14 to 93 years. Fifty-three percent were Caucasian, 24% were African-American, and 23% were Hispanic. Twenty-seven percent had no known risk factors for pulmonary embolism. Whole blood was tested for the factor V codon 506Q mutation responsible for APC-R using polymerase chain reaction. The prevalence of APC-R was 4.5%, which is similar to the prevalence of APC-R in the general American population. These data imply that individuals with APC-R are not in increased risk for sudden death due to pulmonary embolism, or, conversely, that most fatal pulmonary emboli seen in the medical examiner setting are not induced by APC-R. Routine postmortem testing for the factor V 506Q mutation does not appear indicated at this time, given the low prevalence and high cost of testing.     

A Load of Old Garbage: Applying Garbage–Can Theory to Contemporary Housing Policy

This article reviews the applicability of Kingdon's garbage–can model of agenda setting and alternative specification for understanding the complexities of policy–making in the housing policy context. Garbage–can theories reject conventional 'policy cycle' models which envisage policy development processes as rational and underpinned by the logic of problem solving. They posit a loose relationship between problems and the policy solutions offered by national governments. Using an Australian housing policy case study, this article demonstrates the usefulness of Kingdon's garbage–can theory. A modified framework is used to explain how the policy agenda has become narrowed to focus on safety–net assistance for the most disadvantaged, while housing problems have continued to worsen.     

The Effect of Family Structure and Family Functioning on Adolescents' Perceptions of Intimate Time Spent with Parents,Siblings, and Peers

In previous research, family structure variables have been operationalized as family size, birth order, sibling spacing, and sibling density. These structure variables have been linked to parental strictness, reasonableness, and supportiveness [J. S. Kidwell (1981), Number of Siblings, Sibling Spacing, and Birth Order: Their Effects on Perceived Parent–Adolescent Relationships, Journal of Marriage and the Family, Vol. 43, pp. 315–333]. Other research has drawn attention to the link between the amount of time adolescents spend with parents and peers and the influence of family relations variables—intensity, duration, and frequency of conflicts. [R. Montemayor (1982), The Relationship Between Parent–Adolescent Conflict and the Amount of Time Adolescents Spend Alone and with Parents and Peers, Child Development, Vol. 53, pp. 1512–1519]. More recent research has related family structure (family size, sibling spacing, and gender) effects to the amount of time adolescents spend with parents, a measure of relationship quality, and a set of measures of discipline [R. A. Richardson et al. (1986), Parent–Child Relationships in Early Adolescence: Effects of Family Structure, Journal of Marriage and the Family, Vol. 48, pp. 805–811]. To date, the questions asked by researchers have not simultaneously explored whether it is the family relations or the family structure variables that contribute most powerfully to the amount of time that female and male adolescents spend with family members and peers. In this research adolescents were asked to report the amount of time they spend with their mother, father, siblings, and peers, and to respond to a questionnaire that has three factors that define family functioning: Parenting Style (democratic decision making), Intimacy, and Conflict [P. Noller et al. (1992), Parent and Adolescent Perceptions of Family Functioning: A Comparison of Clinic and Nonclinic Family, Journal of Adolescence, Vol. 15, pp. 101–115]. The analyses revealed that complex and interpretable family structure and family functioning factors differentially influence whether males and females spend time with family members and peers.     

EXPORTING AMERICAN ECONOMIC DEVELOPMENT PRACTICE TO RUSSIA

The failure of US initiatives to build local/regional economic development capacity in Russia following the fall of Communism has been partly blamed on national factors, Russian culture, and American consultants. Much of the failure, however, probably resulted because American approaches to economic development—‐highly successful in other contexts—could not work during Russia's transition from a command economy to its current state. Such things as promoting entrepreneurship, developing public‐private partnerships, creating a market economy, accessing start‐up capital, attracting foreign investment, overcoming bureaucratic corruption and high taxation, working within the rule of law, and negating organized crime either should not have been done, or could not have been done, leaving many of our programs ineffective. We ask whether the Russian deviations from the U.S. model have any implications for the current situation facing state and local development policy in the U.S.     

Positive identification of the principal component of a white powder as scopolamine by quantitative one-dimensional and two-dimensional NMR techniques

An unidentified white powder collected as evidence in an intelligence investigation was characterized exclusively by nuclear magnetic resonance (NMR) analysis. A small fraction of the powder dissolved in D2O was subjected to a series of one- and two-dimensional techniques which were used to elucidate the molecular structure of the powder's major component and positively identify it as the scopolamine biotoxin. Quantitative one-dimensional experiments identified individual proton and carbon atom sites, and conventional 14N spectroscopy detected a single nitrogen atom site. Heteronuclear single quantum coherence data correlated all protons to their directly bonded carbon atom, and together with the quantitative spectra, were used to determine the number of protons directly bonded to each carbon atom. The presence of a methyl, carboxyl, and a benzyl group was also identified from these data. Correlation spectroscopy detected a three proton and a nine proton JH,H network, representing a CH2CH moiety and seven carbon atom ring, respectively. These five elements were assembled into an almost complete molecular structure by using long-range, J-coupled, 1H-13C pairs detected by heteronuclear multiple bond correlation (HMBC) spectroscopy and 1H-1H dipolar-coupled pairs found from nuclear Overhauser effect spectroscopy (NOESY) data. Additional oxygen atom sites were inferred from 1H-13C correlation intensities in the HMBC spectra along with 1H and 13C chemical shift values, or directly from NOESY correlations. Only a single oxygen atom site could not be inferred from NMR data, but its presence was inferred from comparisons to target analyte structures to complete the structure of the scopolamine molecule. To confirm these results, an ethanol/H2O solution of the powder was analyzed by direct infusion into an ion trap mass spectrometer. A prominent base signal was observed at m/z 304.1 amu, corresponding to the protonated molecular ion of scopolamine. Subsequently, the ion was selected and subjected to collision-induced dissociation, producing characteristic major MS/MS fragments at m/z 138.1 and 156.1. Comparisons of 1H and 13C chemical shift values and JH,H values measured from our NMR data were found to agree very favorably with previously reported values for scopolamine in D2O.