Establishment of the measurement uncertainty of 11-nor-D9-tetrahydrocannabinol-9-carboxylic acid in hair

The quantitative analysis of 11-nor-D(9)-tetrahydrocannabinol-9-carboxylic acid (THCCOOH) in hair requires a sensitive method to detect a low-pg level. Before applying the method to real hair samples, the method was validated; in this study, we examined the uncertainty obtained from around the cut-off level of THCCOOH in hair. We calculated the measurement uncertainty (MU) of THCCOOH in hair as follows: specification of the measurand, identification of parameters using "cause and effect" diagrams, quantification of the uncertainty contributions using three factors, the uncertainty of weighing the hair sample, the uncertainty from calibrators and the calibration curve, and the uncertainty of the method precision. Finally, we calculated the degrees of freedom and the expanded uncertainty (EU). The concentration of THCCOOH in the hair sample with its EU was (0.60 ± 0.1) × 10(-4)ng/mg. The relative uncertainty percent for the measurand 0.60 × 10(-4)ng was 9.13%. In this study, we also selected different concentrations of THCCOOH in real hair samples and then calculated the EU, the relative standard uncertainty (RSU) of the concentration of THCCOOH in the test sample [u(r)(c0)], the relative uncertainty percent, and the effective degree of freedom (v(eff)). When the concentrations of THCCOOH approached the cut-off level, u(r)(c0) and the relative uncertainty percent increased but absolute EU and v(eff) decreased.     

Fatal neurotoxic response to neuroleptic medications: case report and review of the literature

Neuroleptic malignant syndrome (NMS) is a diagnosis of exclusion difficult to make due to a lack of pathognomonic features. Diagnosing NMS by postmortem examination becomes increasingly challenging when possible underlying brain pathology is obscured. The diagnosis is based on clinical history and laboratory findings. Autopsy and histologic findings, if any, usually are reflective of hyperthermia or complications (eg, aspiration pneumonia) of NMS. The authors describe a case of a 36-year-old Hispanic woman with a presumptive diagnosis of pseudoseizures, treated with various combinations of neuroleptic medications over a 6-week period prior to her sudden, unexpected, in-hospital death. Neuroleptic malignant syndrome is likely to have contributed to this patient's death. Confounding factors and medicolegal issues of a postmortem diagnosis of NMS are discussed.     

Asphyxial games in children and adolescents

Asphyxial games, as played by young adolescents, and going by various names, are not new phenomena. What seems to be different at present is an increase in lethality introduced by the increasing use of ligatures and "playing" the game alone. The authors present a properly certified but insufficiently appreciated case followed 2 years later by 2 closely spaced but unrelated deaths in young adolescent males that made known this practice in New Hampshire youth. Other cases presented to the author from other jurisdictions are reviewed in aggregate. Presented are characteristics of victims of this practice that may help distinguish these deaths from suicidal asphyxia. A relative paucity of literature regarding asphyxial games outside the realm of autoerotic asphyxia gives rise to certification difficulties given the high prevalence of youth suicide.     

The relationship between childhood sexual abuse and adult mental health among undergraduates: victim gender doesn't matter

A large body of research has documented the harmful effects of childhood sexual abuse (CSA) on adult mental health among females, but less work has examined this issue among males. This study examined whether gender moderated the relationship between CSA and adult mental health among a mixed-gender sample of 406 undergraduates. A Pearson chi-square test indicated that a significantly greater proportion of females (41.6%) than males (30.7%) reported a history of CSA. ANCOVAs tested whether gender, CSA status, and their interaction were related to adult mental health symptomatology as measured by Brief Symptom Inventory gender-normed t scores. Participants with a history of CSA reported significantly higher levels of global mental health problems, hostility, paranoid ideation, and psychoticism. The gender by CSA status interaction was not significant for any scale, indicating that the harmful effects of CSA on adult mental health did not vary by gender.     

E‐Participation,Transparency, and Trust in Local Government

This article examines the relationship between electronic participation (e‐participation) and trust in local government by focusing on five dimensions of the e‐participationprocess: (1) satisfaction with e‐participation applications, (2) satisfaction with government responsiveness to e‐participants, (3) e‐participants’ development through the participation, (4) perceived influence on decision making, and (5) assessment of government transparency. Using data from the 2009 E‐Participation Survey in Seoul Metropolitan Government, this article finds that e‐participants’ satisfaction with e‐participation applications is directly associated with their development and their assessment of government transparency. The findings reveal that e‐participants’ satisfaction with government responsiveness is positively associated with their perceptions of influencing government decision making. Furthermore, there is a positive association between e‐participants’ perception of influencing government decision making and their assessment of government transparency. Finally, the article finds that there is a positive association between e‐participants’ assessment of government transparency and their trust in the local government providing the e‐participation program.     

Rapid and simple GC-MS method for determination of psychotropic phenylalkylamine derivatives in nails using micro-pulverized extraction

A rapid and simple gas chromatography-mass spectrometry (GC-MS) method was developed and validated for the simultaneous detection and quantification of five psychotropic phenylalkylamines (amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine, and norketamine) in toenails. After external decontamination, nail clippings were mechanically pulverized with a bead mill and then incubated in methanol under ultrasonication at 50°C for 1 h. The resulting solutions were evaporated to dryness, derivatized, and analyzed by GC-MS. The intra- and inter-day precisions were within 10.7% and 13.9%, respectively. The intra- and inter-day accuracies were -4.2% to 5.0% and -2.4% to 8.4%, respectively. Limits of detection and quantification for each analyte were lower than 0.024 and 0.08 ng/mg, respectively. The recoveries were in the range of 80.6-87.5%. The results indicated that the proposed method is a simple, rapid, accurate, and precise for quantification of five phenylalkylamines in nails. The method was successfully applied to the simultaneous detection and quantification of phenylalkylamines in nail samples of possible drug abusers.     

Simultaneous determination of creatinine and uric acid in urine by liquid chromatography-tandem mass spectrometry with polarity switching electrospray ionization

A simple liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed and validated to simultaneously determine creatinine (Cr) and uric acid (UA) levels as a confirmatory method for adulteration or dilution of urine. Centrifuged urine samples (10μL) were diluted with 390μL of distilled water. 30μL of internal standard solution (Cr-d(3), 5μg/mL) and 10μL of acetonitrile were added to 20μL aliquots of diluted urine samples and filtered. The samples (1μL) were introduced into LC-MS/MS with no further pretreatment. Cr and UA were separated on a multi-mode ODS column (Scherzo SM-C18, 75mm×2.0mm I.D., 3μm) and quantified by LC-MS/MS with polarity-switching electrospray ionization. Cr requires the positive-ion mode, whereas the negative-ion mode is required for the analysis of UA. The linear ranges were 1.0-300mg/dL for Cr and 0.5-300mg/dL for UA, with good determination coefficients (R(2)≥0.9988). The intra-day and inter-day precision of the analytes was within 13.0% and 14.4%, respectively. The intra-day and inter-day accuracy was -8.8 to 3.7% and -0.3 to 6.6%, respectively. The lower limits of detection (LLODs) were 0.3mg/dL for Cr and 0.07mg/dL for UA. The applicability of the developed method was examined by analyzing urine samples from suspected drug abusers (n=46).     

Neoliberalism,Transnational Education Norms,and Education Spending in the Developing World, 1983–2004

Using the case of education, we consider how global cultural and economic forces affect national education spending policies. Our analysis includes both an historical analysis of the construction and transformation of ideas about education at the global level and a statistical assessment of the implementation of conflicting approaches to state education funding within countries. In the historical analysis, we show how the idea of free education, although institutionalized in international law, was subject to powerful challenges from international financial institutions, which advocated user fees for public services, including education. Ultimately, the principle of free education prevailed despite the financial clout behind the opposing view. Using data from poor‐ and middle‐income countries from 1983 to 2004, we also show that the presence of international nongovernmental organizations (INGOs) advocating child rights was linked to an increase in the levels of state funding for education. This suggests that embeddedness in global discourses, as evidenced by country‐specific linkages to INGOs, is critical in making governments more accountable for supporting institutionalized ideas concerning education.     

Nurses, midwives and the requirement for "appropriate" professional indemnity insurance

The Health Practitioner Regulation National Law Act 2009 (the National Law) imposes the obligation on nurses and midwives to have appropriate professional indemnity insurance coverage as a condition of applying for, or renewing, their registration to practise in Australia. The National Law also empowers the Nursing and Midwifery Board of Australia to develop a registration standard and guidelines in relation to professional indemnity insurance and to enforce compliance through the registration process. Though not previously a requirement for their registration, nurses and midwives must now understand the nature and extent of the professional indemnity insurance under which they practise and declare that they will not practise their profession unless they have appropriate professional indemnity insurance arrangements which cover the full scope of their practice. This column provides an overview of the obligations and responsibilities imposed on nurses and midwives under the National Law and the Nursing and Midwifery Board of Australia's registration standard and guidelines. It is imperative that nurses and midwives understand the National Law provisions and the standard and guidelines developed by the Board before making decisions about their professional indemnity insurance and self-declaring that they have "appropriate" professional indemnity arrangements in place.