Fentanyl concentrations in 23 postmortem cases from the hennepin county medical examiner's office

The purpose of this study was to compare blood fentanyl concentrations in fentanyl-related deaths with fentanyl concentrations found incidentally at autopsy, as well as with fentanyl concentrations found in hospitalized patients receiving fentanyl. Between the years 1997 to 2005, 23 fentanyl-positive postmortem cases were identified. Nineteen of 23 (82.6%) cases were deemed to be drug overdoses. Fentanyl alone was responsible for 8 of the 19 (42.1%) overdose deaths. Mean and median fentanyl concentrations were 36 (SD 38) microg/L and 22 microg/L, respectively, range 5-120 microg/L. Seven of the cases were accidental, one undetermined. The remaining 11 of the 19 (57.9%) cases were mixed drug overdoses. Fentanyl concentrations in these cases were 31 (SD 46) microg/L, range 5-152 microg/L. All of the mixed drug overdoses were determined to be accidental. Four cases where fentanyl was considered an incidental postmortem finding were determined to be natural deaths. In hospitalized inpatients (n = 11) receiving fentanyl 2 of the patients receiving fentanyl for chronic pain for more than 3 months had concentrations of 8.5 microg/L and 9.9 microg/L. The other nine inpatient concentrations were less than 4 microg/L. In conclusion, blood fentanyl concentrations found in cases where fentanyl alone was determined to be the cause of death were similar to cases where fentanyl was part of a mixed drug overdose. There was also considerable overlap between fentanyl concentrations in fentanyl-related overdose deaths compared to hospitalized patients being treated for chronic pain. Fentanyl concentrations in postmortem cases must be interpreted in the context of the deceased's past medical history and autopsy findings.     

Explaining the Spread of Ethnosectarian Conflict: Syria's Civil War and the Resurgence of Kurdish Militancy in Turkey

Ethnic civil wars tend to spread to adjacent countries, yet the processes whereby diffusion takes place remain obscure. Quantitative studies point to a wide range of factors and dynamics that drive ethnosectarian conflicts across international borders with no consensus regarding the causal potency of these variables or the ways in which they interact with one another. Surveying the most influential theories that have been advanced so far clarifies the logic of disparate arguments and offers hypotheses that can be tested against particular cases. The civil war in Syria represents one notable instance in which fighting along ethnosectarian lines provoked a revival of political violence in a neighboring state, the Turkish Republic. Applying existing theories to this empirical case clarifies promising directions for future research.     

The effects of administrative linkages on implementation: Welfare policy in Israel

This article focuses on the interaction between local-national relations and the implementation of welfare policy in Israel. It studies the administrative linkages between different levels of governmental jurisdictions involved in the implementing of certain policies of the Ministry of Welfare. It seeks to understand their impact on the original goals and programs of the national government and on actual services provided at the municipal level. These linkages include the arrangements for provision, funding, employment, regulations, and inspection. Without denying the importance of other explanations, the article emphasizes the significance of administrative linkages for understanding welfare policy and practices. In effect, the present study evaluates the extent to which the administrative linkages enable the national government to implement its policies on the one hand, and local authorities to influence national policies and programs on the other.The findings and analysis of administrative linkages suggest four conclusions. First contrary to Government policy the welfare system involving the Ministry, local municipalities and their agencies, is very inegalitarian; services are neither uniform nor adjusted to need. Second, the administrative linkages maximize local output and undermine the ability of the Ministry to implement its policies. Third, it is questionable whether the Israeli government can use its present Welfare Ministry to cope with major aspects of the problem. Fourth, it appears that the operations of the Israeli Welfare Ministry system are more similar to the federal than unitary model.     

Scientific Realism as a Meta-Theory of International Politics

The recent increase in interest in scientific realist foundations for international relations theory, spearheaded by Wendt in various works, most fully articulated in his Social Theory of International Politics , and supported by a number of other authors, has brought to the fore a set of related issues in the philosophy of the social sciences. The advocacy of scientific realism in the international relations literature has largely taken the form of attacks on various nonscientific realist foundational theories. Consequently, the success of the arguments for scientific realism depends in large measure on the accuracy of the characterizations of the competing views. This paper argues that Wendt and others have misrepresented the challengers and have thus overstated the superiority of scientific realism. The paper further considers the aims and purposes of providing meta-theoretical foundations for IR theories, and argues that when the alternative accounts are properly described, the purposes are better satisfied by the latter and, in particular, by a version of Duhemian conventionalism.     

A methodology for assessing citizen perceptions of police

This study was initiated to determine perceptions that Wichita community residents hold toward their police. A scale, Citizen's Perception of the Police, was developed. Race and dogmatism were examined as variables influencing perceptions. Non-white residents evaluated police less favorably than did whites. No significant difference was found on level of dogmatism in evaluating the police. The methodology for developing the scale is described. Applications of these methods to other communities was suggested as well as the importance of assessing citizen perceptions of the police to obtain data which will optimize the setting of goals for police-community relations programming.