Emergence of fentanyl-related deaths in Travis County,Texas and surrounding areas: A retrospective review of postmortem fentanyl-related drug toxicities from 2020 to 2022

The opioid epidemic has affected the United States (US) for decades with fentanyl and its analogs accounting for a recent surge in morbidity and mortality. Currently, there is a relative lack of information characterizing fentanyl-related fatalities specifically in the Southern US. A retrospective study was conducted to examine all postmortem fentanyl-related drug toxicities in Travis County, Texas, encompassing Austin (one of the fastest-growing cities in the US), from 2020 to 2022. Fentanyl contributed to 2.6% and 12.2% of deaths submitted for toxicology between 2020 and 2022, respectively, representing a 375% increase in fentanyl-related deaths over this 3-year period (n = 517). Fentanyl-related fatalities primarily occurred in males in their mid-30s. Fentanyl and norfentanyl concentrations ranged from 0.58 to 320 ng/mL and 0.53 to 140 ng/mL with mean (median) concentrations of 17.2 ± 25.0 (11.0) and 5.6 ± 10.9 (2.9) ng/mL, respectively. Polydrug use was present in 88% of cases, with methamphetamine (or other amphetamines) (25%), benzodiazepines (21%), and cocaine (17%) representing the most frequently identified concurrent substances. Co-positivity rates of various drugs and drug classes widely varied over time. Scene investigations reported illicit powder(s) (n = 141) and/or illicit pill(s) (n = 154) in 48% (n = 247) of fentanyl-related deaths. Illicit oxycodone (44%, n = 67) and illicit “Xanax” (38%, n = 59) pills were frequently reported on scene; however, toxicology only identified oxycodone and alprazolam in 2 and 24 of these cases, respectively. The results of this study provide a better understanding of the fentanyl epidemic in this region creating an opportunity to promote increased awareness, shift focus to harm reduction, and aid in minimizing public health risks.     

Assessing effective participation in vulnerable juvenile defendants

Effective participation in trial is outlined under article 6 of the European Convention on Human Rights and refers to the ability to understand and engage in trial. Juvenile defendants are often referred to psychologists or psychiatrists by their solicitors to establish ‘effective participation’ capacity. In the USA, key components to participate effectively are defined and standardised assessments available. In the UK, no formal measures exist. A consecutive series of 20 adolescents aged 12–20 years, referred by their solicitors to our service, were assessed using a standardised battery and a semi-structured interview designed to assess effective participation. Fifty-five per cent had at least one neurodevelopmental disorder. Low IQ was common and 50% had age-equivalent language scores below 10 years. Rates of depression, anxiety and PTSD were high. Knowledge about trial was poor. These findings have implications for Criminal Justice System professionals and to ensure fair trials for young defendants.     

Removing the barriers; adolescent coping and attitudes towards mental health services in custodial settings – Can we improve services?

Young people in custodial care are known to have high levels of mental health and emotional problems, and recent policy and service developments have sought to improve their access to services. However, little is known about how they cope or about what would increase their uptake of services (when such services are available). This study aimed to develop, validate and use a standardised measure to examine the coping, help-seeking and attitudes of a larger cohort of young people in custody. There was a marked reluctance to seek help for any but the most serious of problems, but there were also indicators of what would make services more acceptable to this population, with implications for both commissioning and delivering services. In particular, greater involvement of parents and carers, offering a wider range of interventions and offering them more flexibly, and challenging stigma within the secure environment may increase uptake of services.     

Collaborative Governance in the Reform of Western Australia's Alcohol and Other Drug Sector

Collaborative governance involves processes and structures for policy development and decision making with particular relevance for health and social services. We examined collaborative governance in the reform of Western Australia's alcohol and other drug sector, applying Emerson et al.'s (2012) integrative framework. A documentary review and group interviews with government, sector, and consumer representatives were involved. Contextual factors included increased service funding, and the development of a partnership approach. Drivers for collaboration involved leadership and financial incentives for policy implementation. Key stakeholders across government and the sector reported a mutually supportive and constructive relationship and increased capacity, and they shared an agenda for change. The integrative framework was a useful structure for the explication of collaborative governance, although financial arrangements were not addressed.     

Barry Goldwater: insurgent conservatism as constitutive rhetoric

Conservatives are generally held to be biased towards the present state of affairs, but some conservatives see the present state of affairs as so great a threat, they advocate its overthrow. They are insurgent conservatives. Scholars portray a Republican Party in the 1950s and 1960s dominated by a north-east liberal establishment confronting an emerging opposition based on anti-communism, economic liberalism and limited government. Barry Goldwater, deploying ideas developed as a long-standing opponent of the New Deal, from his experiences as a businessman, and his philosophic commitment to individualism, engaged extensively with conservatives from the mid- to late 1950s, becoming the spokesman for the developing conservative movement. Goldwater articulated an alternative, radical interpretation of conservatism. Using constitutive rhetoric, an under-used tool in the study of conservatism, this paper explores the content and message of Goldwater’s insurgent conservatism. Rather than focussing on persuasion, constitutive rhetoric focuses on the relationship between the speaker and the audience in the forging of an identity. Goldwater’s audience was already persuaded; what was needed was a common conservative identity to inspire a political movement. Goldwater did not ‘call conservatism into being,’ but his rhetoric fuelled an insurgency and constituted conservatism in a new configuration.     

Brexit and the British Constitution: a Long View

The Brexit referendum of 2016 brought a new concept to British politics, namely the ‘people’s will’, one that is seemingly at odds with conventional notions of parliamentary sovereignty, even a threat to its very existence. This article argues that although the device of the referendum is relatively new, the kind of popular control over Parliament and the executive that it invokes has long been a part of British politics. Ranging over 200 years, examples are drawn from the recall and deselection of MPs, mass petitioning campaigns, the role of the Speaker, and the flourishing of independent parties.     

Pregnancy in prison,Mother and Baby Unit admission and impacts on perinatal depression and ‘quality of life’

Limited research exists on the impact of prison mother and baby unit (MBU) residence. Research in the UK suggests women in MBUs have lower prevalence of mental disorder. Higher rates of mother-child attachment for women in prison nurseries in the US have been reported. Eighty-five pregnant women were interviewed at baseline and 62 followed up in nine different prisons. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure perinatal depression; the World Health Organisation Quality of Life (WHOQOL – BREF), for quality of life; and the Mother-to-Infant Bonding Scale (MIBS) for mother-child bonding. EPDS scores were higher at baseline than follow-up. Women admitted to MBUs had lower EPDS scores at baseline and follow-up, and this reduction was greater than for women not admitted to MBUs. WHO-QOL scores were higher at follow-up than baseline on all domains, except the social domain for those not admitted to MBUs. Findings suggest women with perinatal depression are less likely to be admitted to MBUs, and MBU placement may contribute to a reduction in perinatal depression. Increased QOL-BREF scores at follow-up suggest improved quality of life for all participants. Reduced support post-separation may contribute to lower social domain scores for women not admitted to MBUs.     

Exploring conceptual legal knowledge building in law students’ reflective reports using theoretical constructs from the sociology of education: what,how and why?

The substantive content of the undergraduate law curriculum in the UK is currently under scrutiny as a result of forthcoming changes in the entry level requirements of the legal profession. As a result LLB curriculum designers are evaluating what knowledge should be included in the curriculum, how students should access this knowledge, and which pedagogic approaches to adopt. This study will analyse student submissions for an assessment item at York Law School called the reflective report to explore how students are building their conceptual legal knowledge, and what this means for curriculum designers. The data analysis will be informed by the theoretical constructs of three sociologists of education, Michael Young, Basil Bernstein, and Karl Maton, including their respective concepts of social realism, hierarchical and horizontal knowledge structures, and semantic gravity. It develops themes exploring how students can weaken the semantic gravity of knowledge to make meanings that reach beyond the learning context. It draws some conclusions about the implications of the research on future curriculum design and the importance of developing students’ engagement with powerful knowledge in the delivery of legal education in an academic environment.     

Do We See Victims’ Agency? Criminal Justice and Gender Violence in Spain

The Spanish criminal justice system has a specific Law for Gender Violence (1/2004). This article addresses what happens when a law with a feminist perspective is implemented in a predominantly patriarchal institution. The main aim of this paper is to approach women’s experiences in the Spanish criminal justice system, analysed as a technology of power producing women’s subjectivities, and focusing on their agency. We used a qualitative methodology with participant observation (24 sessions) and in-depth interviews with professionals working with gender violence (17) and women who reported gender violence by their heterosexual partner (11 individual and 1 group). We analysed data with the qualitative analysis software Atlas.ti. The results focus on subjective processes and agency among reporting violence, the expedited trial, protection and restraining orders, and probation.