Prevalence and blood concentrations of benzodiazepines and opioids in opioid-positive death investigations in Ontario,Canada, from 2017 to 2021

The aim of this study was to investigate the incidence of benzodiazepines in opioid-positive death investigations, including trends in frequency and combination of drugs, as well as demographic data and blood concentrations, where available. Additionally, naloxone concentrations in polysubstance compared to opioid-only cases were analyzed. This was a retrospective study that consisted of all post-mortem toxicology cases in Ontario, Canada, from January 01, 2017, to December 31, 2021, with an opioid finding in any analyzed autopsy specimen. There were 11,033 death investigations identified. The overall rate of benzodiazepine co-involvement was 54.5%. Males accounted for the majority of cases (71%), and the most affected age group was 30- to 39-year-olds. The most frequently detected opioid was fentanyl and the most frequently detected benzodiazepine was etizolam, which was also the most frequently observed opioid/benzodiazepine combination. Findings related to differences in concentrations of opioids when naloxone was also present were mostly non-significant, except for methadone. The rate of benzodiazepine detection with opioids grew faster than opioid detections overall, potentially due to the increasingly toxic drug supply. Detection of novel psychoactive drugs fluctuated more unpredictably than opioids and benzodiazepines associated with clinical use. These findings can help inform policy decisions by public health agencies in exploring harm reduction efforts, for example, education and drug-checking services.     

Medium‐Chain Acyl‐CoA Dehydrogenase Deficiency in Adulthood: A Potential Diagnosis in a Patient with Mental Status Changes Suspected of Drug Toxicity

Medium‐chain acyl‐CoA dehydrogenase (MCAD) deficiency is a rare but important component of the differential diagnosis for adults with a history of premortem mental status changes and the postmortem finding of hepatic steatosis. This case report describes a 30‐year‐old white man who, following a period of nausea and vomiting, was admitted to the hospital with sudden mental status deterioration followed rapidly by clinical deterioration and death. Treating physicians in this case suspected acute illicit drug toxicity with synthetic cathinones based on social history. Clinicians and medical examiners should be aware that the presentation, signs, and symptoms described may indicate an underlying inborn error of metabolism such as MCAD deficiency and take action accordingly.     

States of Environmental Justice: Redistributive Politics across the United States, 1993–2004

In the 20 years since a president committed federal government agencies to achieving environmental justice (EJ), states have been at the forefront of policy development. But states have varied in the nature and extent of their EJ efforts. We use Guttman Scaling to measure state EJ effort and test hypotheses regarding the relative importance of problem severity, politics, and administrative variables to variation in state policy development. Our analysis offers a novel characterization of state policy intensity and demonstrates its scalability. Income‐based problem severity, environmental group membership, and nonwhite populations were important predictors of state EJ policy intensity during our study period. The political geography of EJ policy also displayed a distinctive southern pattern and the EJ policy intensity model contrasted significantly with a model of environmental policy innovation. The findings suggest that state EJ politics are more indicative of redistributive policy than regulatory.     

Assembling noncitizenship through the work of conditionality

Abstract

We develop a framework for understanding noncitizenship that combines attention to systemic processes with interest in contingency and indeterminacy in the production and substantive practices associated with noncitizen legal status categories and trajectories. We argue that noncitizenship is a dynamic, multi-scalar assemblage that brings together disparate elements in patterned and changing ways. Individuals and institutions generate the formal and substantive systems that confer or deny noncitizens the formal and substantive right to be present in a country and/or to access entitlements. Noncitizens exercise agency in choosing to make claims (or choosing to not make claims) to substantive rights, and the individuals and institutions with which they interact may facilitate or hinder such claims-making. In this process, social actors are enacting conditionality; they are working to meet the conditions required to maintain presence and access. Discretion, migrant agency, unequal social interactions, and social learning unfold over time and can generate a range of experiences of noncitizenship and legal status trajectories. These do not necessarily conform to expected pathways and timelines, and may combine access to various resources and public goods in variable and contingent ways. We illustrate the framework with data from research conducted in Toronto.     

Governance Interventions in Conflict-Affected Countries

This paper reviews an emerging body of literature on governance interventions in countries with ongoing violent conflict, recovering from conflict or at risk of conflict. The review focusses on three broad intervention areas. The first includes interventions that support local governance and the improvement of local capacity for collective action. The second area comprises interventions that strengthen the accountability, legitimacy, and reach of state institutions, including the improvement of information and the provision of public goods. The third centres on interventions aimed at changing social norms that shape systems of governance. Ways forward for future research and policy are proposed.     

Sino‐French relations: Historical alliance vs. economic reality

Abstract

In an increasingly integrated international economy, nation-states are, of themselves, no longer the prime containers or coordinators of political–economic activity. The extra-territoriality of states and the blurring of the boundaries between states and firms, for example, have been captured in analytical concepts such as ‘triangular diplomacy’ the ‘web of global interdependencies’ and ‘cosmopolitan democracy’. Such trends have become visible in what have been termed mega-urban regions or zones of economic integration or of graduated sovereignty. Moreover, such zones are held to illustrate non-traditional or cooperative inter-state relations. This paper utilizes Stopford and Strange's (1991) Stopford, J. and Strange, S. 1991. Rival States, Rival Firms: Competition for World Market Shares, Cambridge: Cambridge University Press. [Crossref] , [Google Scholar] notion of ‘triangular diplomacy’ to interpret the development of one such zone – the Indonesia–Malaysia–Singapore growth triangle (IMS-GT). The paper argues that whilst embodying elements of cooperative inter-state relations the development of the IMS-GT also highlights the persistence of the ‘traditional’ concerns of inter-state relations. It also uses the notion of triangular diplomacy to draw attention to different models of social order sought by multinational enterprises (MNEs).     

Predicting Deliberative Conversation: The Impact of Discussion Networks,Media Use,and Political Cognitions

This study explores the meaning and origins of deliberative political conversation, characterized by an openness to political conflict, the absence of conversational dominance, clear and reasonable argument, and mutual comprehension. Adapting McLeod, Scheufele, and Moy's (1999) McLeod, J. M., Scheufele, D. A. and Moy, P. 1999. Community, communication, and participation: The role of mass media and interpersonal discussion in local political participation. Political Communication, 16: 315–336. [CSA][CROSSREF][Taylor & Francis Online], [Web of Science ®] , [Google Scholar] model of democratic engagement, we posit a series of relationships among discussion networks, media use, political cognition, and public participation. Using two divergent samples—one consisting of 149 adult literacy students and another comprising 130 public forum participants—we test the model's utility as a predictor of deliberative conversation. Structural equation modeling indicates that network characteristics had mixed effects. Print media use and interpersonal discussion tended to enhance deliberative conversation, and television news viewing hindered both the reasonableness of one's arguments and the comprehension of others' views. Taken together, these results suggest that the deliberative quality of public talk has a complex relationship with common predictors of other political communication behavior.     

Standardization of Histological Procedures for the Detection of Toxic Substances by Immunohistochemistry in Dipteran Larvae of Forensic Importance

Immunohistochemistry (IHC) technique is an alternative toxicological analysis to detect drugs in insects of forensic importance, but it requires thorough histological procedures. In this study, we tested different fixatives—phosphate‐buffered paraformaldehyde 4% (PP), Carnoy's fluid (CF), Kahle's solution (KS), ethanol in different concentrations, and ethanol associated to PP and CF, time of fixation and histological processes for dipteran larvae's tissue, aiming to develop a sample preparation protocol for IHC application. A suitable fixation was achieved using PP for 12 and 24 h, CF for 3 h, 70% ethanol for 19 days, and 70% ethanol/CF for 2 h/3 h. Postfixation using negative pressure, two immersions in xylene for 30 min each, and one in xylene plus paraffin for 45 min increased tissue preservation. An immunohistochemical test for cocaine detection was performed using monoclonal benzoylecgonine antibody from mouse, peroxidase‐conjugated anti‐mouse IgG and visualized by 3,3′‐diaminobenzidine method showed these histological procedures didn't compromise antigenicity.     

The Age Structure-Crime Rate Relationship: Solving a Long-Standing Puzzle

Objectives

Develop the concept of differential institutional engagement and test its ability to explain discrepant findings regarding the relationship between the age structure and homicide rates across ecological studies of crime. We hypothesize that differential degrees of institutional engagement—youths with ties to mainstream social institutions such as school, work or the military on one end of the spectrum and youths without such bonds on the other end—account for the direction of the relationship between homicide rates and age structure (high crime prone ages, such as 15–29).

Methods

Cross sectional, Ordinary Least Squares regression analyses using robust standard errors are conducted using large samples of cities characterized by varying degrees of youths’ differential institutional engagement for the years 1980, 1990 and 2000. The concept is operationalized with the percent of the population enrolled in college and the percent of 16–19 year olds who are simultaneously not enrolled in school, not in the labor market (not in the labor force or unemployed), and not in the military.

Results

Consistent and invariant results emerged. Positive effects of age structure on homicide rates are found in cities that have high percentages of disengaged youth and negative effects are found among cities characterized with high percentages of youth participating in mainstream social institutions.

Conclusions

This conceptualization of differential institutional engagement explains the discrepant findings in prior studies, and the findings demonstrate the influence of these contextual effects and the nature of the age structure-crime relationship.