Predicting the Onset of Sexual and Drug Risk Behaviors in HIV-Negative Youths with HIV-Positive Mothers: The Role of Contextual,Self-Regulation,and Social-Interaction Factors

HIV-negative, inner-city adolescents with HIV-infected parents are considered to be at high risk for acquiring HIV themselves. Using a modified theory of health behavior, this study examined the effects of maternal HIV infection and psychosocial variables on the onset of sexual and drug risk behavior in 144 HIV-negative adolescents with and without HIV-positive mothers. Adolescents and their mothers were interviewed when the youths were 10–14 years old and again when they were 13–19 years old. By follow-up, 42% of youths reported the onset of vaginal sex (vs 5% at baseline). Marijuana and alcohol use increased from 6 and 38%, respectively, at baseline to 25 and 60% at follow-up. Among those reporting risk behaviors, 40--50% reported onset prior to 14 years. Youth and family psychosocial variables, but not maternal HIV status, were associated with risk behaviour outcomes. Claude A. Mellins research interests include mental health, psychosocial, and public effects of maternal and pediatric HIV; interventions for HIV-affected families; and adherence. Curtis Dolezal research interests include HIV-related sexual behavior in a variety of populations with a particular emphasis on methodology/measurement issues. Elizabeth Brackis-Cott research interests include impact of HIV/AIDS on the lives of children and families directly affected by the disease. Ouzama Nicholson research interests include international public health and pediatric HIV infection and operational issues in developing effective prevention of mother-to-child transmission of HIV infection and pediatric HIV care programs. Patricia Warne research interests include program development, structural interventions for HIV, and policy. Heino F. L. Meyer-Bahlburg research interests include psychosexual assessment, the development and determinants of sexual risk behavior, and the effects of HIV disease on sexual functioning.     

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.     

Labouring in the Shadow of the British Political Tradition: The Dilemma of ‘One Nation’ Politics in an Age of Disunification

The British state is in flux and the Labour party is struggling to shape an effective response to the politics of disunification. This article reflects on the nature of Labour's governing project and its conception of modern statecraft which has evolved since the party became a serious contender for power in the aftermath of the First World War. We argue that Labour's initially pluralising instincts cultivated in opposition have been checked by the ongoing reality of a state‐centric mode of governing, in which the party continued to robustly defend the Westminster model operating within the parameters established by the British Political Tradition (BPT). Ed Miliband's conception of ‘One Nation’ Labour threatens to reinforce this historical pattern of reversion to the Westminster model, at precisely the moment when devolutionary forces are destabilising the existing political settlement. To break out of this impasse, Labour must look elsewhere in its ideological lexicon for inspiration, chiefly to the tradition of socialist pluralism and associationalism.     

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.     

Ten years of infitah: class,rent, and policy stasis in Egypt

The Political Economy of Income Distribution in Egypt. Edited by Gouda Abdel‐Khalek and Robert Tignor. New York: Holmes & Meier, 1982. $55. ISBN 0 8419 0633 5.

Employment Opportunities and Equity in Egypt: A Labour Market Approach. By Bent Hansen and Samir Radwan. Geneva: International Labour Office, 1982. $25.65 and $19.95. ISBN 92 2 102995 6 and 102996 4.

Egypt: Politics and Society, 1945–1981. By Derek Hopwood. London: George Allen & Unwin, 1982. £12.50. ISBN 0 04 956011 5.

An Economic History of the Middle East and North Africa. By Charles Issawi. London: Methuen, 1982. £12.50. ISBN 0 416 34330 9.

Population and Development in Rural Egypt. By Allen C. Kelley, Atef M. Khalifa, and M. Nabil El‐Khorazaty. Durham, NC: Duke Press Policy Studies, 1982. $22.75. ISBN 0 8223 0475 9.     

The public service ethos and the role of the British civil service

The last Conservative administration invested much time and effort in reforming the structure and organisation of the Civil Service. Yet it left untouched the core principles which underpinned Whitehall, often referred to as the public service ethos. In this article, we argue that this ethos has been defended by both conservative and liberal opinion as something fundamentally good. Yet, in reality, the public service ethos is a power/knowledge system which legitimises the rule of a particular elite by presenting public service as a worthy occupation and, thereby, authorising a system of power which is relatively closed and secretive. This accounts for why it has been in the interests of both the last Conservative administration and the present Labour government to ensure the ethos remains intact.