Fatal Insulin Overdoses: Case Report and Update on Testing Methodology

Suicidal insulin overdoses are an under‐recognized and uncommon cause of death, often relying on scene and nonspecific autopsy findings. Here, we present a case report of a fatal exogenous insulin overdose in a patient with type 1 diabetes. In our case, there were no contributory autopsy findings; however, serum analog aspart insulin levels were c. 10× the predicted therapeutic upper limit (4000, reference 6.6–55 uU/mL), which correlated with scene findings. This was specifically determined by a newly developed immunocapture liquid chromatography–tandem mass spectrometry assay, able to discriminate between various synthetic insulin analogs. Total insulin levels by immunoassay were highly elevated on the Siemens Advia Centaur, but not the Roche platforms (4741 vs. 5.2 uU/mL, respectively), showing variable sensitivity of detection within the same analog depending on assay. We discuss the prevalence and features to look for at autopsy in these types of cases. Additionally, analytical options for testing insulin levels, including new methodologies, guidance on collection of samples, as well as an outline of available historical reference range data are discussed.     

Utilization and satisfaction of volunteer law enforcement officers in the office of the American sheriff: an exploratory nationwide study

Many government organizations utilize volunteers to enhance services, and volunteers have been used in law enforcement agencies for a variety of functions. However, volunteers in American policing are a largely under-studied part of the criminal justice system. This current paper examines the utilization of volunteer reserves, auxiliaries, and special deputies in the office of the American sheriff. The article also examines the perceived organizational characteristics of those agencies that treat volunteers the same as regular full-time sworn deputies by allowing them full power of arrest and the authority to carry a weapon on and off duty. The results generally show that volunteer deputies that are treated the same as their full-time counterparts in regard to authority and responsibility are generally more satisfied with their role within the organization and report greater satisfaction with the organization in terms of communication, leadership, and professionalism.     

Cases and Controversies: How Novitiates Are Trained to Be Masters of the Public Policy Universe

Public policy schools were established 30 years ago to provide analytic and management skills to aspiring policy professionals. A centerpiece of policy management training has been the action‐centered teaching case, modeled after the cases long used in business schools. Though other aspects of public management teaching and research have been vigorously debated, little attention has been paid to the content of teaching cases.Taking these texts as a central element in policy student socialization, the authors ask what implicit lessons they convey. A close reading of 10 best‐selling cases from the Kennedy School of Government finds the policy world to be the domain of high‐level, lone protagonists beset by hostile political forces; collaborative problem‐solving is rare, street‐level actors insignificant, and historical, social, and institutional contexts of minimal importance. The article discusses the implications of this construction and raises questions about its appropriateness for the training of future public servants. © 2001 by the Association for Public Policy Analysis and Management.     

Childhood,age of consent and moral regulation in Canada and the UK

This paper analyses the resurgent regulation of young people's sexuality in Canada and the UK and examines notions of childhood in relation to adulthood, referred to by the term ‘generation’, as they are portrayed in the political process. In both cases, the political manipulation of the identity of childhood in relation to adulthood that is both gendered and generational is an important enabling factor, although regulation takes place within a specific context for each. Moreover, this politics of generation reaches beyond the specific regulation of young people's sexuality through notions of hegemonic femininity and masculinity and the idealization of the heterosexual family in a far more pervasive regulation of society in general.     

Exploring Aggregate vs. Relative Public Trust in Administrative Agencies that Manage Spent Nuclear Fuel in the United States

Trust is a key component of democratic decision‐making and becomes even more salient in highly technical policy areas, where the public relies heavily on experts for decision making and on the information provided by federal agencies. Research to date has not examined whether the members of the public place different levels of trust in the various agencies that operate within the same policy subsystem, especially in a highly technical subsystem such as that of nuclear energy and waste management. This paper explores public trust in multiple agencies operating within the same subsystem, trust in each agency relative to aggregate trust across agencies that operate within the nuclear waste subsystem, and trust in alternative agencies that have been suggested as possible players in the decision‐making process. We find that trust accorded to different federal agencies within the nuclear waste subsystem varies. The variation in trust is systematically associated with multiple factors, including basic trust in government, perceptions about the risks and benefits of nuclear energy/waste management, party identification, and education. These findings have significant implications for research on public trust in specific government agencies, alternative policy entities, and for policy makers who want to design robust and successful policies and programs in highly technical policy domains.     

Conceptualizing China–Latin America relations in the twenty-first century: the boom,the bust,and the aftermath

Despite the emergence of a rich literature on the rise of China in Latin America (LAC) since 2000, we are still grappling with this phenomenon. In this article we seek to theorize this expanding South–South relationship from two vantage points. First, from the perspective of China, we argue that, by necessity, the PRC has had to internationalize its development strategy in order to compensate for its serious natural resource deficit, feed the world's largest domestic population, and fuel the soon-to-be largest economy in the world. LAC has been just one slice of China's ‘go out’ strategy. Our second perspective probes the effect of China's entry into the region. Through the lens of development economics, we identify three separate political economy scenarios that have been accentuated within those countries that have the strongest economic ties with China. We rely on measures of institutional performance and macro-economic trends to illustrate the variable effects of China on LAC.     

Risk and Outcomes: Are Adolescents Charged with Sex Offenses Different from Other Adolescent Offenders?

Juveniles who have committed sexual offenses are subject to specialized treatment and policies based on their assumed unique dangerousness, despite contradictory evidence. Limited information is available regarding risk factors and their relationships to outcomes in this population. The comparative frequency and predictive utility of empirically supported risk factors for general delinquency were examined using data from the Pathways to Desistance study. Adolescent males who committed sexual offenses (n = 127) were compared to adolescent males who committed non-sexual offenses (n = 1021). At the start of the study, the sample ranged in age from 14 to 18 (M = 16.00, SD = 1.12) and self-identified as primarily African American (44 %), Latino (29 %), or White (25 %). Outcomes were measured over 7 years and included general and sexual recidivism, involvement in school and work, and positive relationships with peers and adults. The results indicated a few small differences in the presence of risk factors and their relationship to outcomes, with many similarities. Juveniles who have committed sexual offenses had equivalent general recidivism but higher sexual recidivism, though this rate was low (7.87 %, or 10 of the 127 adolescents who had committed sexual offenses). New clinical and policy approaches may be needed given the similarities between groups.     

The Politics of Climate Change Adaptation in Development: Authority,Resource Control and State Intervention in Rural Zambia

In this article, we call for more attention to the national and local politics of climate change in developing countries, and contribute to this through a study of climate change adaptation interventions in Zambia. We show how such interventions form part of central state efforts to extend authority and control over natural resources, and how competing institutional actors such as local governments and chiefs seek to counter this. The article thereby shows how climate change adaptation is emerging as a new arena for deep-seated political and institutional struggles over issues such as authority, land control and devolution in development.     

Victim Offender Overlap: Dual Trajectory Examination of Victimization and Offending Among Young Felony Offenders Over Seven Years

The relationship between victimization and offending has been shown consistently across different samples, settings, and crime types. This study uses data from the Pathways to Desistance Study to examine dual trajectories of offending between the ages of 15 and 24 in a sample of male felony offenders. The dual trajectory models demonstrate substantial convergence in victimization and offending. And while there are sizable numbers of youth who continue to be victimized, but desist or decrease in their offending behaviors, very few youth continue to offend in the absence of continued victimization. This study also proposes and tests three criminological theories that have been employed as explanations for the victim-offender overlap—low self-control, lifestyles/routine activities, and street-code attitudes. The logistic regression results indicate that involvement in risky and/or unstructured, unsupervised activities is a key correlate of the victim-offender overlap. The strength of the relationship between routine activity variables and the victim-offender overlap supports the provision of structured, supervised activities for youth and young adults as a way of preventing future victimization and offending, particularly among youth who have high exposure to violence.