Pubertal Development, Choice of Friends, and Smoking Initiation among Adolescent Males

Prior research has indicated that pubertal development and peer associations are important determinants of adolescent smoking behavior. However, more remains to be learned about why these variables matter or how they may be related to one another in ways that lead to the initiation of smoking. Using contractual data from the National Longitudinal Study of Adolescent Health, we consider the relationship between early pubertal development and associations with close friends who smoke, and smoking initiation among male youths. The results of the study reveal a link between advanced pubertal development and the initiation of smoking among boys, but we discover that the effect is indirect, mediated by a greater propensity of sexually mature males to forge friendships with peers who smoke. We also find that this propensity is greatest among the youngest adolescents in the sample, suggesting that the age of the respondent conditions the effects of pubertal development on the formation of friendships with peers who smoke.(Ph.D., The University of Texas at Austin), is an Assistant Professor at Washington State University at Vancouver. Her areas of interest include juvenile delinquency and substance abuse.(Ph.D., Rutgers: The State University of New Jersey) is an Assistant Professor at Westfield State College. Her area of interest is adolescent identity development.(Ph.D., The University of Texas at Austin) is an Associate Professor at the University of Portland. His areas of interest include biosocial models of adolescent problem behavior.     

Oxycodone intoxication in an infant: accidental or intentional exposure?

A case is presented of a 10 month old male who went into cardiac arrest at a local store. The infant subsequently expired and was autopsied at the Office of the Chief Medical Examiner, State of Maryland. The only remarkable finding was the detection of oxycodone in the postmortem specimens; the blood and liver oxycodone concentrations were 0.6 mg/L and 1.6 mg/kg, respectively. Oxycodone was identified and quantitated by gas chromatography-nitrogen-phosphorus detection and confirmed by full scan electron ionization gas chromatography-mass spectrometry. The medical examiner ruled that the cause of death was oxycodone intoxication, and the manner of death was homicide. The key toxicologic question in this case was whether or not it was reasonable for the infant to be exposed to oxycodone exclusively through breast milk or through an alternate source. It was concluded that, at best, there were serious concerns about the likelihood of drug exposure through consumption of breast milk.     

Interest groups and state Medicaid drug programs

A simultaneous equations model is estimated to analyze the interaction between state Medicaid pharmaceutical drug reimbursement rates, drug recipients per capita, and expenditures per drug recipient. Interest groups are shown to have a strong positive impact on pharmacy reimbursement rates, which, in turn, have an impact on pharmacy participation rates and drug utilization and expenditure patterns. Finally, a strong inverse relationship exists between expenditures per recipient and program size. The results verify the existence of substantial variation in state Medicaid programs and point to potentially growing disparities as a result of current policies.     

Fatal diphenhydramine intoxication in infants

Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.