The pathological features and circumstances of death of lethal crush/traumatic asphyxia in adults--a 25-year study

A 25-year retrospective study of cases of crush/traumatic asphyxia autopsied at Forensic Science SA, Adelaide, Australia from 1980 to 2004 was undertaken. A total of 79 cases of crush asphyxia was found consisting of 63 males (80%) and 16 females (20%). The age range of the males was 19-86 years (mean=41.8 years) and of the females was 19-75 years (mean=38.6 years). In 18 cases the exact circumstances of death were unclear, leaving 61 cases in which details of the fatal episode were available. Major categories included vehicle crashes (N=37), industrial accidents (N=9), farm accidents (N=6) and entrapment beneath vehicles (N=5). Forty of the 79 victims (51%) had only very minor bruises and abrasions; 28 (35%) had evidence of chest compression with rib and sternal fractures and large areas of soft tissue bruising of the chest; 7 cases (9%) had other significant injuries or findings that had contributed to death. All of these victims had signs of crush asphyxia in the form of intense purple congestion and swelling of the face and neck, and/or petechial hemorrhages of the skin of the face and/or conjunctivae. The pattern of pathological findings of crush asphyxia was not influenced by the presence or absence of concomitant serious or lethal injuries. In 4 cases (5%) where the circumstances of the lethal episode were those of crush asphyxia there were no characteristic pathological findings. This study has shown that a high percentage of crush asphyxias may be caused by vehicle accidents. It has also demonstrated that on occasion fatal crush asphyxia may have to be a diagnosis of exclusion, made only when there are characteristic death scene findings, and no evidence of lethal natural diseases or injuries at autopsy, with negative toxicological screening.     

Mechanisms of unexpected and/or sudden death in Lafora disease

A 23-year-old male was found dead wedged between two chairs at his home address. His past history included a diagnosis of Lafora disease (a type of heritable progressive myoclonic epilepsy) at the age of 16 years. This had been characterised by the development of epilepsy and progressive motor impairment and mental deterioration. Diagnosis had been confirmed by demonstration of mutation in the EPM2A gene on chromosome 6q24. At autopsy, petechial haemorrhages were noted of the face and conjunctivae bilaterally. There were no other significant findings apart from gastric contents within the airways. Death was attributed to positional asphyxia complicated by aspiration of gastric contents. Although death in Lafora disease is usually predictable and often protracted, sudden and/or unexpected death may occur and involve status epilepticus, sudden unexpected epileptic death, choking, aspiration of gastric contents, and cardiac arrhythmias. In addition, the possibility exists of unnatural causes of death, such as accidents, provoked by epilepsy or physical inability of the victims to extricate themselves from dangerous situations, or homicides, provoked by difficulties in caring for individuals with significant and progressive disabilities.     

U.S.—Soviet relations: The global village and the free flow of information∗

For the past sixty‐seven years, the Council on Foreign Relations has dedicated itself to enlarging the public dialogue on matters affecting U.S. foreign policy and international affairs. This effort is to be commended. It stands as a testimony to your strong sense of civic responsibility, and it illustrates yet another way in which America's private and public sectors cooperate in matters of national concern.

Forty‐one years ago, Foreign Affairs published the landmark article—"Mr. X"— calling for a bold new approach to the challenges of the post‐war world. At that time, the international structure and order inherited from the nineteenth century had collapsed, and attempts to replace it were directed from two philosophically distinct and antagonistic power centers. This was the era of the Cold War.

America met those challenges with a sense of daring and determination. The Truman Doctrine, the Marshall Plan, NATO—these stand as testimonials to imaginative leadership and effort. The renewed vitality of Western Europe and Japan—protected by the shield of a strong and effective deterrence—are a measure of its success.

Today, America faces another historic challenge occasioned neither by war nor post‐war dislocations. Rather, it results from changes set in motion by a new and powerful dynamic which in recent years has exploded onto the world scene—the grand spectacle of the Information Revolution.     

Deblockierung durch Kooptation? Eine Fallstudie zur Aufnahme der Katholisch‐Konservativen in die schweizerische Landesregierung 1891

Kommt die Regierungsmehrheit in einer halbdirekten Demokratie gut organisierten Minderheiten nicht entgegen, riskiert sie, dass der Gesetzgebungsprozess mittels Volksrechten blockiert wird. Nach Neidhart (1970) ist die Aufnahme politischer Gegner in die Regierung eine mögliche Strategie zur Annäherung und Deblockierung. Die vorliegende Fallstudie untersucht, ob die Kooptation der schweizerischen katholisch‐konservativen Opposition in die vormalige Einparteienregierung des Freisinns 1891 die erwartete Wirkung gezeigt hat. Der behauptete Annäherungs‐ und Deblockierungsprozess zwischen 1874 und 1914 wird anhand quantitativer und qualitativer Daten zu 62 Volksabstimmungen und anhand von 100 Namensabstimmungen aus dem Nationalrat untersucht. Zusätzlich wird das damalige Schlüsseldossier der Eisenbahnverstaatlichung einer Analyse unterzogen. Die Ergebnisse zeigen, dass die Aufnahme der Opposition in die Regierung nur einen schwachen unmittelbaren Effekt auf die Annäherung und die Deblockierung hatte. Die beiden einst verfeindeten Lager haben sich bereits vor 1891 angenähert, sei es im Parlament oder an der Urne.     

Inhalant deaths in South Australia: a 20-year retrospective autopsy study

A 20-year retrospective study of inhalant deaths in South Australia, autopsied at Forensic Science SA, was undertaken from January 1983 to December 2002. Thirty-nine cases were identified from an autopsy pool of 18,880 cases, with a male to female ratio of 12:1. Sixty-four percent of the victims (N = 25) died during voluntary inhalation of volatile substances and 28% (N = 11) committed suicide utilizing a volatile substance or gas. The remaining 3 cases involved a workplace accident (N = 1) and 2 cases of autoerotic death where inhalants were being used to augment solitary sexual activity. The mean age of the 28 victims of accidental inhalant death of 21 years (range, 13-45 years) was considerably less than that of the 11 suicide victims of 31.5 years (range, 17-48 years). No homicides were found. Approximately one quarter of the victims were Aboriginal (N = 11), 10 of whom had died as a result of gasoline inhalation ("petrol sniffing"). Other common substances of abuse were aliphatic hydrocarbons such as butane. The study has shown that those most at risk for accidental or suicidal inhalant deaths were young males, with 92% of victims overall being male, and with 77% of victims being under 31 years of age. Gasoline inhalation remains a significant problem in Aboriginal communities in South Australia.     

Is right coronary artery hypoplasia and sudden death an underdiagnosed association?

Determining whether hypoplasia of a coronary artery has caused or contributed to death is often complicated by an absence of histologic evidence of myocardial ischemia in the area of the heart supplied by the affected artery and also by the lack of data for assessing coronary artery size at autopsy. A 45-year-old woman is reported who collapsed and died and who was found at autopsy to have a dominant, small-caliber, right coronary artery, with acute and chronic ischemic changes in the posterior interventricular septum supplied by the diminutive vessel. This case provides evidence that small-caliber coronary arteries may be associated with a lethal outcome. Given the difficulties that may occur in determining whether there is a causal link between small coronary artery caliber and death, it is possible that this may be an underdiagnosed cause of sudden cardiac death, rather than a coincidental finding of minimal significance.     

Contesting resources – rent seeking, conflict and the natural resource curse

A growing empirical literature links natural resource abundance and “pointiness” to impeded economic growth and civil strife. We develop rent seeking and conflict models that capture the most salient features of contests for resource rents, and show how both resource abundance and geographical clustering can be associated with intense contests and sub-optimal economic performance. However, we also show that these relationships are not necessarily monotonous – pointiness can trigger more intense contests but can also facilitate the coordination on peaceful outcomes. Finally we show that contesting resources through violent conflict may yield superior outcomes (from an economy-wide perspective) than contests through rent seeking.