Loperamide as a Potential Drug of Abuse and Misuse: Fatal Overdoses at the Medical University of South Carolina

Loperamide is an over‐the‐counter, μ‐opioid receptor agonist commonly used as an antidiarrheal agent. Loperamide was thought to have minimal abuse potential due to its low bioavailability and limited central nervous system activity; however, there have been increasing reports of loperamide misuse in supratherapeutic doses to achieve euphoria and/or avoid opioid withdrawal. A literature review suggests a rise in loperamide abuse was inevitable, with substantial increases in reported cases over the last decade. Five fatal cases of toxic medication use where loperamide was listed as a primary or contributory cause of death were identified at the Medical University of South Carolina. The characteristic autopsy demographics and findings are described, and the mechanisms of abuse and toxicity of loperamide are reviewed. Loperamide overdoses are a growing concern from both a forensic and clinical standpoint, and the frequency of reported cases will likely increase as awareness grows within the medical and toxicological communities.     

Patterns of Aggressive Behavior and Peer Victimization from Childhood to Early Adolescence: A Latent Class Analysis

The developmental period characterized by the transition from childhood and elementary school to early adolescence and middle school has been associated with increases in aggressive behavior and peer victimization. Few longitudinal studies, however, have examined the stability of aggression and victimization during this critical transition. This study uses latent class analysis (LCA) to examine patterns of aggressive behavior and victimization during the transition to middle school among urban, public school students (N = 458; Girls = 53%; Latino/a = 53%; M age at t1 = 10.2 years). Independent LCA models were conducted using self-reported data assessing subjects’ involvement in aggressive conduct and victimization during the spring semesters of grades four, five, and six. Elementary school students in the fourth grade initially belonged to one of four groups identified as aggressor, victim, aggressor-victim, and uninvolved latent classes. Contrary to prior research, membership in these classes changed significantly by the time students completed their first year of middle school with most youth participating in episodes of aggression and victimization during the transition. Six common paths that describe patterns of aggressive behavior and victimization from the last two years of elementary school to the first year of middle school were found. Findings are discussed in the context of social dominance theory and prior research that has found greater stability in aggression and victimization among early adolescents.     

Fracture patterns on the infant porcine skull following severe blunt impact

The objective of this study was to document patterns of fracture on infant porcine skulls aged 2-28 days (n = 57) because of a single, high energy blunt impact to the parietal bone with rigid (nondeformable) and compliant (deformable) interfaces. Fracture patterns were mapped using Geographic Information System software. For the same generated impact force, the rigid interface produced more fractures than the compliant interface for all ages. This study also showed that this increased level of impact energy versus an earlier study using a lower energy resulted in new sites of fracture initiation and also caused previously defined fractures that propagate into an adjacent bone. Several unique characteristics of bone and diastatic fracture were documented as a function of specimen age, impact energy, and interface. These data describe some baseline characteristics of skull fracture using an animal model that may help guide future studies from forensic case files.     

Funding,capabilities and the use of child soldiers

Recent years have seen increased scholarly attention given to the issue of child soldiering. Primarily dedicated to the decision-making calculus of rebel groups, this body of work has generally emphasised supply-side versus demand-side arguments. We contribute to this growing literature by explicitly investigating a previously untested aspect of the latter. Prior scholarship has made vague references to a potential association between economic endowments and child soldiering, including natural resource wealth, but scant empirical attention has been given. We argue that the specific type of endowment has important consequences for the decision to utilise child soldiers. We argue access to and exploitation of lootable natural resources (e.g. gemstones) to be especially likely to promote the use of child soldiers due to their ease of access, the low skills required to harness them and the heightened likelihood that groups will become more profit-oriented. A systematic cross-national investigation of rebel groups provides robust evidence that lootable resources such as diamonds and gemstones are strongly associated with the use of children, while non-lootable resources such as oil are not.     

Give them toys? Military allocations and regime stability in transitional democracies

In contrast to the conventional wisdom that democratization reduces coups, 46% of coups targeted democracies from 2000–2009, twice the rate seen in the prior half-century. Efforts to explain coups have arrived at wildly varied conclusions regarding the vulnerability of democracies. We argue that this is attributable to regime type acting as a conditional influence. We theorize that democratization incentivizes old elites to veto the process, and these vetoes are more likely to occur when the new regime cannot credibly commit to the military’s corporate interests. Using cross-national data for 172 states for the years 1952–2009, we find that though young democracies are more vulnerable to coups than either civilian authoritarian regimes or older democracies, this vulnerability is mitigated when military expenditures are near or above the sample mean. We also find that commonly argued determinants of coups appear to be driven by their influence in democracies, suggesting the need for scholars to revisit commonly held assumptions regarding autocratic survival.