Designer drugs in herbal aphrodisiacs

In the presented case three herbal aphrodisiacs (Libidfit, Satibo and Viamax) were investigated for the presence of regular pharmaceuticals against erectile dysfunction. However, high-performance liquid chromatography with diode array detection and mass spectrometry (HPLC-DAD-MS) and nuclear magnetic resonance (NMR) analyses revealed the presence of ingredients, having a molecular structure strongly resembling those of sildenafil (Viagra) and vardenafil (Levitra). The health risk posed by these analogous substances is high because they were found to be potent phosphodiesterase 5 (PDE5) inhibitors used in pharmacologically relevant quantities having no known safety profile. Based on structural and functional analogy these analogs represent a new class of designer drugs and should be taken off the market for being unapproved drug substances. In the Libidfit court case this was done successfully, setting a precedent.     

Forward to the past: Organized crime and Cuba’s history, present and future

Before the 1959 revolution, Cuba was virtually a Mafia fiefdom. However, as the future of Cuban leader Fidel Castro—and thus the entire revolutionary regime — becomes increasingly uncertain, there is growing reason to fear that history is about to repeat itself and Cuba will become a focus for organized criminality in the Caribbean, with an impact not just on the regional but global underworld. Cuba and its airspace and territorial waters have become important nodes on smuggling routes into the United States. While Havana may no longer be willing to turn a blind eye to the traffickers’ activities, it lacks the resources to interdict effectively or deter them. However, Cuba is also beginning to suffer from both domestic drug abuse and the first indications of organized criminality at home. This is very limited compared with the strength of Cuban-American organized crime in the United States, but does open up the prospect of these groups exploiting any weaknesses in Cuba to reestablish operations on the island. Although it is possible that the revolutionary regime might survive Castro, at the very least it will experience a turbulent transition, one in which power politics will divert attention from the problem of growing crime. Were the Cuban Communist Party to fall, either to a democratic revolution or a military coup, then either way this would probably generate increased domestic organized crime and open up the country even more rapidly to international criminal influences. Perhaps the final tragedy of the revolutionary regime, born out of a rejection of authoritarian rule and rampant organized crime, is that it will have proven to lay the foundations for an even more dynamic and voracious criminalization of Cuba. This article draws on an earlier, shorter piece: Mark Galeotti, “Organized crime gangs pose threat to Cuban development,” Jane's Intelligence Review, 18, 2 (2006).     

BritCrits: Subversion and submission,past, present and future

This article explores some of the intellectual influences which have shaped the development of Critical Legal Studies in Britain and the contexts in which these influences made themselves felt. It then considers which influences might or should steer Critical Legal Studies in the future. In terms of the past, specific attention is given to the influence of Marxism, Freud and Lacan, feminism, Foucault and Derrida, and recent genres of history-writing. As to the future, the question is asked whether Critical Legal Studies will engage constructively with recent developments in the life sciences and the philosophy of science, and, more generally, whether it will be able to surpass its established mooring in the philosophy of history. This revised version was published online in July 2006 with corrections to the Cover Date.     

Hospital utilization review: past experience, future directions

Utilization review (UR) programs seek to determine whether specific services are medically necessary and whether they are delivered at an appropriate level of intensity and cost. Although UR programs have been operating for more than 40 years, they have changed dramatically during the past two decades. Today, many health care providers, analysts, and policymakers view UR as a possible solution to hospital inpatient cost and quality problems. This paper addresses how UR has evolved, how UR is used today by different delivery mechanisms (i.e., Medicare, health maintenance organizations, preferred provider organizations, Blue Cross, and commercial insurers), the cost effects of various UR approaches, and how UR will be used in the future.     

Cost-effectiveness analysis in the courts: recent trends and future prospects

This article provides an initial look at how managed care organizations (MCOs) might incorporate cost-effectiveness analysis (CEA) into their decision-making process and how the courts might respond. Because so few medical liability cases directly involve CEA, we must look at other areas of the law to assess potential MCO liability for applying CEA. In general negligence cases, courts rely on a risk-benefit test to determine customary practice. Likewise, in product liability cases, courts use a risk-utility calculus to determine liability for product design defects. And in challenges to government regulation, courts examine how agencies use CEA to set regulatory policy. The results have been mixed. In product liability cases, CEA has led to some punitive damage awards against automobile manufacturers. But courts have integrated it in negligence cases without generating juror antipathy, and generally defer to agency expertise in how to incorporate CEA. The article discusses the implications of these cases for MCO use of CEA and outlines various options for setting the standard of care in the managed care era.     

Vitality and wound-age estimation in forensic pathology:review and future prospects

Determining the age of a wound is challenging in forensic pathology,but it can contribute to the reconstruction of crime scenes and lead to arrest of suspects.F...     

20 years of research into violence and trauma: past and future developments

This reflection on major developments in the past, present, and future of the wider field of violence and trauma is a personal (and probably biased) sampling of what the authors hold to be important. The authors reviewed advances for victims and perpetrators of violence separately. For victims, the authors note that empirical research has established the potential traumatic impact of violence as well as various predictors of what makes persons vulnerable to adverse psychological consequences. The authors also note that the definitions of violence and trauma have evolved to include such behavioral patterns as stalking. Finally, encouraging evidence regarding the efficacy of exposure-based treatments for victims of violence is reviewed, as well as discouraging evidence regarding the efficacy of single-session debriefing following trauma. For the perpetrators, the importance of individual assessment in planning interventions is underscored, and advances in explicit and implicit assessment techniques are discussed.     

The past and the future of violence against women

The most important thing we have learned about violence against women over the past 20 years is that violence is gendered and learned and can only be understood in the context of gender inequality. Most violence is male, and although some violence is done by females, it is far from equal and often done for very different reasons. Among other major findings is that children from violent households tend to grow up to be problematic, which means that a major method of curbing juvenile delinquency in 10 years is to stop violence against women today.     

Medicare revisited: a look through the past to the future

This paper examines the elderly's out-of-pocket health care expenditures by category of expense, before and after the inception of Medicare. It describes the shifting of out-of-pocket expenses from hospital care to nursing-home care, while physician services and drugs have remained prominent components of out-of-pocket expenditures. Recent corrosive trends in the protection against out-of-pocket liability are discussed and analyzed. The author contends that the raging debate over the Medicare program must include and recognize the concerns of the elderly consumer.     

Legislatures and their past: The History of Parliament project and the significance of history

Using interviews with Conservative MPs, three aspects of the Poll Tax not covered by the extant literature are examined. Conservative backbenchers are shown to be more supportive of the tax than in previous accounts. The nature and effect of both the legal and non‐legal protests against the Poll Tax are discussed. The effect of petitioning is found to be minor, but the amount and (especially) the nature of post which MPs received had more impact. Other than the quantity, five characteristics are identified which contributed to making this post more significant than other ‘issue’ post received by MPs. The extra‐parliamentary action is also shown to have had a surprisingly strong effect on Conservative MPs.