Acute intoxication with guaifenesin, diphenhydramine, and chlorpheniramine.

Mixed drug reactions are frequently encountered in emergency department overdose cases and also in fatal intoxications. Assessment of the relative contribution of each drug in producing adverse effects is often compounded by lack of case history and the paucity of cases reported in the literature. This report describes a fatal intoxication with three common over-the-counter medications: guaifenesin, diphenhydramine, and chlorpheniramine. A 48-year-old woman was found dead in the attic bedroom of her residence. Specimens obtained at autopsy for toxicologic analysis included heart blood, urine, bile, gastric contents, vitreous humor, and cerebrospinal fluid. The over-the-counter drugs were identified and quantitated by acid/neutral or basic liquid-liquid extraction followed by gas chromatographic analysis with nitrogen phosphorus detection. Concentrations of guaifenesin, diphenhydramine, and chlorpheniramine detected in the heart blood were 27.4, 8.8, and 0.2 mg/L, respectively. The cause of death was determined to be acute intoxication by the combined effects of guaifenesin, diphenhydramine, and chlorpheniramine, and the manner of death was determined to be suicide. To our knowledge, the blood guaifenesin concentration in this case is the highest reported concentration to date associated with an acute intoxication.     

Comparing technological risks in large scale national projects

In policy debates concerning large scale R&D efforts, the achievements of the Manhattan and Apollo projects are frequently cited as evidence of Yankee ingenuity and the ability to overcome technical obstacles. In this article, the factors which contributed to the success and failure of large scale crash development projects are analyzed systematically. Successes are distinguished from failures according to two criteria. First, while the successes are marked by parallel development of technological components which began only after the basic scientific and technical obstacles had been overcome and the basic feasibility had been demonstrated, in the failures, parallel development began much earlier. In addition, the successful crash projects, such as the atomic bomb effort and the moon program, were designed to meet static technical goals and did not depend on overcoming countermeasures. The unsuccessful projects, such as the Safeguard ballistic missile defense (BMD) system, failed in the face of changes in Soviet military technology.Using these criteria to analyze the Reagan administration's space-based ballistic missile defense program (SPBMD), the author concludes that despite the claims made by supporters, this R&D effort is not similar to the Manhattan or Apollo projects. Rather, like the Nuclear Airplane and Skybolt missile, parallel developments have begun prior to proof of feasibility, and like the Safeguard BMD, the SPBMD must adapt to countermeasures.     

BETWEEN POSITIVISM AND POSTMODERNISM:

A growing body of scholarship has pointed to the problems of positivist assumptions that underlie policy analysis. Scholars have noted that neither the ends nor the methods by which judgments are derived are unambiguous or value-free. In the place of a positivist epistemology, some scholars have argued for a view of policy analysis as a rhetorical activity. In this view, the analyst becomes a participant in strategies of persuasion in-which the reasons for decisions are rhetorically constructed. Neither view, though, provides an adequate basis upon which the analyst is to form judgments that can claim public validity. In this essay, we draw on the work of Hannah Arendt whochallenges the distinction between “subjectivity” and “objectivity” upon which much of the contemporary debate hinges. Arendt argues for a notion of “impartiality” that arises from the imagining of other perspectives. In this way, the validity of judgments depends on a broadened perspective gained through a grasping of particulars. It is within this context that we can understand the importance of narratives in policy evaluation and judgment.     

Identity Development and Attachment to Parents in College Students

Previous research reveals the need to study adolescents' levels of exploration and commitment instead of overall identity categories for the purpose of identifying developmental trends in identity development. Similarly, attachment research points to the importance of considering separate measures of attachment to mother and attachment to father, as well as considering gender differences in attachment to parents. We tested the hypothesis regarding the relative levels of the identity-related constructs of commitment and exploration in relationship to adolescent males' and females' attachment to parents. The self-report data from 100 first-year college students suggests that females had significantly higher levels of exploration and commitment than the male subjects. Females' identity development was related to attachment relationships to parents, especially attachment to mother, while males' identity development was unrelated to attachment to either parent. These findings are discussed in terms of their implications for the development of university student services.