Thiodicarb and methomyl tissue distribution in a fatal multiple compounds poisoning

Abstract:  Thiodicarb is a nonsystemic carbamate insecticide whose acetylcholinesterase activity is related to its main methomyl degradation product. A 40-year-old woman was found dead in her car. Empty packages of medicines and an open bottle of Larvin^® containing thiodicarb were found near her body. No signs of violence nor traumatic injuries were noticed upon autopsy, and police investigations strongly suggested a suicide. Systematic toxicological analysis performed on postmortem specimens revealed the presence of various sedatives, hypnotics, and antipsychotic drugs in blood, urine, and gastric content. Some of the compounds identified were determined at blood concentrations well above the known therapeutic concentrations: zolpidem (2.87 mg/L), bromazepam (2.39 mg/L), nordazepam (4.21 mg/L), and levopremazine (0.64 mg/L). Specific analysis of thiodicarb and of its methomyl metabolite was then performed on all fluids and tissues collected during autopsy by liquid chromatography ion trap tandem mass spectrometry (LC-MS-MS). The anticholinesterase capacity of blood, urine, and gastric content collected at autopsy was 83%, 82%, and 32%, respectively (normal value: 0%). The presence of thiodicarb in the bottle found near the body corroborates the hypothesis of an intake of that compound. Although thiodicarb was only detected in gastric content (24.3 mg/L), its methomyl metabolite was quantified in most postmortem tissues and fluids: gastric content (19.9 mg/L), peripheral blood (0.7 mg/L), urine (8.5 mg/L), bile (2.7 mg/L), liver (0.7 mg/kg), kidney (1.7 mg/kg), lung (1.5 mg/kg), brain (9.3 mg/kg), and heart (3.6 mg/kg).     

Hair analysis to document a clinical case of TCDD over-exposure

Dioxins and related compounds (furans) are persistent environmental contaminants that cause adverse biological effects. Their influence on humans is still unclear, except for accidental high-dose exposure. Chronic exposure to these compounds seems to be involved in cancer, endocrine disruption and neurobehavioral effects. For several years, a large concern about the potential health risks of dioxins is emerging in Europe and United States. The case of a 50-year-old man victim of an acute over-exposure to tetrachloro dibenzo-p-dioxin (TCDD or Seveso dioxin) is reported here with particular focus on hair investigations. The developed method involved the decontamination of the hair strand using picograde level methylene chloride, the homogenization of hair segments with scissors and their extraction in presence of 13C12-marked dioxin congeners under reflux of toluene using a Soxhlet, 8h at 130 degrees C. After reduction of the toluene fraction to 1 ml and addition of purification marker (37Cl4-2,3,7,8-TCDD), dioxins purification was achieved using three successive columns: silica, alumina/sodium sulfate and carbon/Celite columns. Finally, the toluene eluent was evaporated and the extract injected in the analytical system. After chromatographic separation, detection was achieved in single ion monitoring mode using a high resolution mass spectrometer operating in electron impact ionization mode (40 eV, minimal resolution of 10,000). The analysis of the first hair segment (0-6 cm) revealed the presence of 2,3,7,8-TCDD at 65 fg/mg when the distal one remained negative (LOQ=0.3 fg/mg). All other congeners (n=16) were in the range of those determined in the general population (0.62 and 0.89 fg/mg in the two hair segments, respectively). The extremely low dioxin levels generally found in hair specimens (low fg/mg range) lead us to analyze them using the very sensitive and specific gas chromatography-high resolution mass spectrometry apparatus. From the best of our knowledge, this is the first case of over-exposure to Seveso dioxin through hair analysis reported in the literature.     

Advance directives in bipolar disorder, a cognitive behavioural conceptualization

Mental Health Advance Directives (MHADs) are potentially useful for bipolar patients due to the episodic characteristic of their disease. An interest for the development of a Cognitive Behavioural Therapy (CBT) approach in the creation process of MHADs arises because of a lack of efficiency of the non-collaborative processes, the potential impact of psychopathology and the awareness of the illness in MHADs' content, the link between the patient's directives interest and the case manager's interest, and the lower interest reported by the potentially high MHADs beneficiary. The CBT intervention in the MHADs creation process that is proposed in this article is based on: the self-determination model for adherence, the cognitive representation of illness model, and the concordance model. The principles of the intervention were adapted from Motivational interviewing's (MI), emphasising personal choice and responsibility, and focusing on the patient's concerns about the treatment through Socratic dialogue. During the course of 2004, 20 advance directives written by patients (17 with bipolar disorder, 3 with schizoaffective disorder) have been collected following the described intervention. Therefore, this intervention seems to be relevant for patients with bipolar disorder.     

From Rebellion to Extinction: Where have all the Tory Remainer MPs Gone?

This article examines the process of extinction of former remainer Conservative MPs who followed different paths in the run-up to the 2019 general election: either choosing to stay loyal and merge with the rest of the parliamentary party, or to express their discontent and leave the party. When they chose to rebel against the leadership, only a small minority dared to vindicate their position. The other rebels constantly played down their identity as remainers and justified their views in an apologetic way. More remarkably, they were treated differently by Boris Johnson, who eventually suspended the last remainers and called for a general election to renew the composition of the party. The consequences of this last move are crucial in order to understand the radical transformation of the Conservative Party into the actual (and only) ‘party of Brexit’.     

Somewhere Between Love and Justice: a Roman Catholic Church in Paris Responds to the European Migration Crisis

The European migration crisis has had a transformative impact on many transit and destination localities in Europe, and in doing so it has mobilised many faith-based communities. This paper analyses the social action of Saint Bernard de La Chapelle, a Roman Catholic parish in northern Paris, which hosts a semi-formal association called Solidarités Saint Bernard (SSB) involved in support and relief activities for indigent migrants in the local area. Based on ethnographic research conducted within the parish and the association, I analyse how the topic of migration has become a point of exchange between the parish community and local civil society, how religious and secular discourses and motivations co-exist within SSB, and how these influences shape SSB’s social action. Through this micro-scale approach, and drawing on Luc Boltanski’s theoretical framework of regimes of action, my aim is to identify conceptual elements to better understand the broad convergence between religion, social action, and migration, and to better understand the relation between charity and justice within faith-based social action in the domain of migration advocacy more specifically.     

Four worlds of morality politics: the impact of institutional venues and party cleavages

The most prominent theory accounting for variation of morality politics across Western Europe is the so-called Two Worlds framework. According to this approach, the presence or absence of a secular?religious cleavage in national party systems strongly affects the degree of conflict intensity and the framing of morality policy issues. This article shows that the explanatory power of the Two Worlds model could be enhanced significantly by introducing a second analytical dimension that captures the institutional venue (party politics vs. parliamentary politics), in which moral conflicts take place. This is useful because there are instances in which a religious cleavage is lacking, but moral conflicts are nonetheless highly intense and party-based (the traditionalist world), and there are cases in which the religious cleavage formally exists, but moral conflicts are nonetheless resolved in the parliamentary arena (the unsecular world).     

Combining Household Income and Asset Data to Identify Livelihood Strategies and Their Dynamics

Current approaches to identifying and describing rural livelihood strategies, and household movements between strategies over time, in developing countries are imprecise. Here we: (i) present a new statistical quantitative approach combining income and asset data to identify household activity choice variables, characterise livelihood strategy clusters, and analyse movements between strategies, and (ii) apply the approach using an environmentally-augmented three-wave household (n = 427) level panel dataset from Nepal. Combining income and asset data provides a better understanding of livelihood strategies and household movements between strategies over time than using only income or asset data. Most households changed livelihood strategy at least once over the two three-year periods. A common pathway out of poverty included an intermediate step during which households accumulate assets through farming, petty trading, and migratory work.     

Women’s Empowerment and Wellbeing: Evidence from Africa

We use household survey data from Senegal to model the effects of empowerment within the home on married women’s wellbeing. The estimated effects of empowerment are at least as large as more conventional development indicators, such as household income. The size of the empowerment effect is robust to alternative estimation techniques, including an Instrumental Variables estimator.     

The influence of sense of coherence,self-care and work satisfaction on secondary traumatic stress and burnout among child and youth residential care workers in Switzerland

The present study aimed to investigate the incidence of post-traumatic and secondary traumatic stress as well as burnout symptoms among child and youth welfare workers in residential care in Switzerland and to assess the predictive value of sense of coherence, self-care, and job satisfaction. A sample of 319 child welfare professionals in Swiss child and youth residential care was assessed using questionnaires that addressed sense of coherence, perceived collective efficacy, self-care, and work satisfaction, as well as symptoms of traumatic stress and burnout. Linear regression analyses were conducted to determine the influence of sense of coherence, self-care and job satisfaction on symptoms of burnout and traumatic stress. Enhancing sense of coherence, work-related self-care and work satisfaction could reduce stress symptoms and increase the well-being of child and youth welfare staff. The authors discuss how child and youth residential care institutions could improve these factors among their staff.     

Fit for purpose? A review of guides for gender-equitable value chain development

This article presents a review of seven guides for gender-equitable value chain development (VCD). The guides advocate persuasively the integration of gender into VCD programming and raise important issues for designing more inclusive interventions. However, gaps persist in their coverage of gender-based constraints in collective enterprises, the influence of norms on gender relations, and processes to transform inequitable relations through VCD. Guidance for field implementation and links to complementary value chain tools are also limited. The article identifies opportunities for conceptual and methodological innovation to address the varying roles, needs, and aspirations of women and men in VCD.