Influence of blood loss on the pharmacokinetics of citalopram

Extended blood loss results in several compensatory physiological mechanisms, including transfer of extravascular fluid into the blood circulation. If drugs are present in the body, this fluid exchange may imply that blood drug concentrations found in a trauma victim may differ from the concentrations present at the time of the trauma. To address this issue, an animal model was used to investigate the influence of blood loss on pre-existing levels of the antidepressant drug citalopram and its demethylated metabolites. Rats were administered citalopram either acutely (40 mg/kg, orally) or chronically (20 mg/kg daily, subcutaneously) for 6 days using osmotic pumps. In the experimental rats, blood loss was accomplished by withdrawing 0.8 mL blood at 10 min intervals during 70 min. In the control rats, blood was withdrawn at 0 and 70 min only. Blood, brain and lung drug concentrations were analyzed with an enantioselective HPLC method. In the chronically treated rats, the ratios between final and initial citalopram concentrations were 1.08 +/- 0.15 and 1.01 +/- 0.09 in the experimental rats and controls, respectively, indicating no major effect of blood loss. In contrast, acute oral administration resulted in increased ratios in the exsanguinated rats as compared to controls (1.84 +/- 0.50 versus 0.73 +/- 0.07; p = 0.0495). In conclusion, the observation of increased blood drug levels in the acute oral rats indicates that absorption of fluid from the gastrointestinal tract may be important in the intravascular refill. Further, in the interpretation of post-mortem blood levels of drugs, these physiological mechanisms should be taken into account.     

B: Reviews: general

MIDDLE EAST STUDIES IN DENMARK. Edited by LARS ERSLEV ANDERSEN. Odense, Odense University Press, 1994. 215pp. DKK 200.

APPROACHES TO THE HISTORY OF THE MIDDLE EAST: INTERVIEWS WITH LEADING MIDDLE EAST HISTORIANS. By NANCY ELIZABETH GALLAGHER. Reading, Garnet Publishing, 1994. viii, 197pp.

A HISTORY OF THE MODERN MIDDLE EAST. By WILLIAM L. CLEVELAND. Boulder and Oxford, Westview Press, 1994. 503pp. Tables, maps, photographs, glossary, select bibliography.

MUHAMMAD AND THE ORIGINS OF ISLAM. By F.E. PETERS. Albany, State University of New York Press, 1994. 334pp.

A READER ON CLASSICAL ISLAM. By F.E. PETERS. Princeton, NJ, Princeton University Press, 1994. 420pp.

BEFORE REVELATION: THE BOUNDARIES OF MUSLIM MORAL THOUGHT. By A. KEVIN REINHART. (SUNY Series in Middle Eastern Studies.) Albany, State University of New York Press, 1995. 255pp.

THE DIVINE GUIDE IN EARLY SH'ISM: THE SOURCES OF ESOTERICISM. By MOHAMMAD ALI AMIR‐MOEZZI. Translated by DAVID STREIGHT. Albany, SUNY Press, 1994. 279pp.

IMAGINAL WORLDS: IBN AL‐'ARABI AND THE PROBLEM OF RELIGIOUS DIVERSITY. By WILLIAM C. CHITTICK. Albany, SUNY Press, 1994. vii, 208pp. $18.95 (pb.).

RETHINKING ISLAM: COMMON QUESTION, UNCOMMON ANSWERS. By MOHAMMED ARKOUN. Translated and edited by ROBERT D. LEE. Oxford, Westview Press, 1994. 139pp.

A YOUNG MUSLIM'S GUIDE TO THE MODERN WORLD. By SEYYED HOSSEIN NASR. Cambridge, Islamic Texts Society, 1993. 270pp.

PIOUS PASSENGERS. THE HAJJ IN EARLIER TIMES. By M.N. PEARSON. London, Hurst, 1994. viii, 217 pp. Illustrated.

PILGRIMS AND SULTANS: THE HAJJ UNDER THE OTTOMANS. By SURAIYA FAROQHI. London, I.B. Tauris, 1994. xii, 244pp. 1 map.

DEMOCRACY WITHOUT DEMOCRATS? THE RENEWAL OF POLITICS IN THE MUSLIM WORLD. Edited by GHASSAN SALAMÉ. London and New York, I. B. Taurus, 1994. 340pp., figures and tables. £45.

THE PROPHET'S PULPIT: ISLAMIC PREACHING IN CONTEMPORARY EGYPT. By PATRICK D. GAFFNEY. University of California Press, 1994. 367pp. Map, bibliographic references and index.

THE WOMEN'S AWAKENING IN EGYPT: CULTURE, SOCIETY, AND THE PRESS. By BETH BARON. New Haven and London, Yale University Press, 1994. 259pp. £20.

THE UNIVERSITY OF ILLINOIS, URB ANA‐CHAMPAIGN

LE DESERT ET LA GLOIRE: LES MEMOIRES D'UN AGENT SYRIEN DE NAPOLEON. By FATHALLAH SAYIGH. Translated and edited by JOSEPH CHELHOD. Paris, Gallimard, 1991. 304pp.

AMERICAN CONSULS IN THE HOLY LAND: 1832–1914. By RUTH KARK. Jerusalem, Magnes Press & Hebrew University; Detroit, Wayne State University Press, 1994. 388pp. 28 plates.

PALESTINE IN TRANSFORMATION, 1856–1882: STUDIES IN SOCIAL, ECONOMIC AND POLITICAL DEVELOPMENT. By ALEXANDER SCHÖLCH. Translated by WILLIAM C. YOUNG and MICHAEL C. GERRITY. Washington, D.C., Institute for Palestine Studies, 1993. xii, 351pp. 8 maps, 44 tables. $29.95.

AN OCCASION FOR WAR: CIVIL CONFLICT IN LEBANON AND DAMASCUS IN 1860. By LEILA TARAZI FAWAZ. London, Centre for Lebanese Studies and I.B. Tauris, 1994. 302pp.

THE ROOTS OF SEPARATISM IN PALESTINE: BRITISH ECONOMIC POLICY 1920–1929. By BARBARA J. SMITH. London, I.B. Tauris, 1993. 258pp. £39.50.

SYRIA'S QUEST FOR INDEPENDENCE, 1939–1945. By SALMA MARDAM BEY. Reading, Ithaca Press, 1994. 288pp.

STAAT UND GESELLSCHAFT IN SYRIEN, 1970–1989. By VOLKER PERTHES. (Schriften des Deutschen Orient‐Institut.) Hamburg, Deutsches Orient‐Institut, 1990. 340pp. DM 39.‐

ÖFFENTLICHE UND PRIVATE LANDWIRTSCHAFT IN SYRIEN. EINE WIRTSCHAFTS‐ UND SOZIALGEOGRAPHISCHE UNTERSUCHUNG IM NORDWESTEN UND NORDOSTEN DES LANDES. By HANS HOPFINGER. (Erlanger Geographische Arbeiten, Sonderband 19.). Erlangen, Frankische Geographische Gesellschaft, 1991. 348pp, 24 illustrations, 77 tables, 13 photographs, 5 coloured maps.

LA GUERRE DU LIBAN: DE LA DISSENSION NATIONALE AU CONFLIT REGIONAL, 1975–1982. By SAMIR KASSIR. Paris, Karthala, 1994. 510pp.

A HISTORY OF THE DRUZES. By KAIS M. FIRRO. (Handbuch der Orientalistik, Ergänszungsband 9.) Leiden, Brill, 1992. 396pp. 9 maps.

VILLAGE, STEPPE AND STATE: THE SOCIAL ORIGINS OF MODERN JORDAN. Edited by EUGENE L. ROGAN and TARIQ TELL. London and New York, British Academic Press, 1994. xxviii, 226pp.

JORDAN'S INTER‐ARAB RELATIONS: THE POLITICAL ECONOMY OF ALLIANCE MAKING. By LAURIE A. BRAND. New York, Columbia University Press, 1995. x, 350pp.

THE PALESTINIANS IN ISRAEL: IS ISRAEL THE STATE OF ALL ITS CITIZENS AND ‘ABSENTEES'? Translated and edited by NUR MASALHA. Haifa, Galilee Center for Social Research, 1993. $12 (pb).

FASTING AND FEASTING IN MOROCCO: WOMEN'S PARTICIPATION IN RAMADAN. By MARJO BUITELAAR. (Mediterranea Series.) Oxford and Providence, Berg Publishers, 1993. 203pp. 9 photographs, 15 illustrations, glossary.

IMPERIAL IDENTITIES: STEREOTYPING, PREJUDICE AND RACE IN COLONIAL ALGERIA. By PATRICIA M. LORCIN. (Society and Culture in the Modern Middle East.) London, I.B. Tauris, 1995. x, 323pp. 1 map.

THE MAKING OF SAUDI ARABIA 1916–1936: FROM CHIEFTAINCY TO MONARCHICAL STATE. By JOSEPH KOSTINER. (Studies in Middle Eastern History.) New York and Oxford, Oxford University Press, 1993. xii, 260pp. Maps. £35.00

OIL, POWER AND PRINCIPLE: IRAN'S OIL NATIONALIZATION AND ITS AFTERMATH. By MOSTAFA ELM. New York, Syracuse University Press, 1994. xvii, 413pp. Map, tables (pb).

AN OTTOMAN STATESMAN IN WAR & PEACE: AHMED RESMI EFENDI, 1700–1783. By VIRGINIA H. AKSAN. (The Ottoman Empire & its Heritage, 3.) Leiden, Brill, 1995. xviii, 253pp. Illustration, maps, glossary of place names, terms and phrases, bibliography, index.

TURKEY: A MODERN HISTORY. By ERIK J. ZÜRCHER. London, I.B. Tauris, 1993. 381pp., maps, biographical notes.

THE SEED AND THE SOIL: GENDER AND COSMOLOGY IN TURKISH VILLAGE SOCIETY. By CAROL DELANEY. (Comparative Studies on Muslim Societies, 11.) Berkeley, University of California Press, 1991. xiii, 360pp. Illustrations. Photographs. Index.

INDIA AND THE MIDDLE EAST. By PRITHVI RAM MUDIAM. London, British Academic Press, 1994. ix, 232pp. £39.50.

ARAB WOMEN. Edited by JUDITH E. TUCKER. (Indiana Series in Arab and Islamic Studies.) Bloomington and Indianapolis, Indiana University Press, 1993. 256pp., index.

WOMEN, ISLAM AND THE STATE. By DENIZ KANDIYOTI. London, Macmillan, 1991. 271 pp., index.

VISITING ARAB COUNTRIES OF THE MIDDLE EAST: A PERSONAL GUIDE FOR WOMEN. By PENELOPE TURING. Glasgow, Centre for Management Training and Development in the Middle East, n.d. [1994]. 26pp.

MEDIEVAL AGRICULTURE AND ISLAMIC SCIENCE: THE ALMANAC OF A YEMENI SULTAN. By DANIEL MARTIN VARISCO. (Publications on the Near East, No. 6.) Seattle & London, University of Washington Press, 1994. xv, 349pp. 2 maps.

REORIENTATIONS: ARABIC AND PERSIAN POETRY. Edited by SUZANNE PINCKNEY STETKEVYCH. Bloomington and Indianapolis, Indiana University Press, 1994. x, 269pp. £25.

THE ARABIAN NIGHTS: A COMPANION. By ROBERT IRWIN. London: Allen Lane, The Penguin Press. 1994. 344pp. £20.

NAGIB MAHFOUZ: THE PURSUIT OF MEANING. By RASHEED EL‐ENANY. London and New York, Routledge, 1993. xv, 271pp. £12.99 (pb).

ARAB COMIC STRIPS: POLITICS OF AN EMERGING MASS CULTURE. By ALLEN DOUGLAS and FEDWA MALTI‐DOUGLAS. Bloomington & Indianapolis, Indiana University Press, 1994. xiii, 263pp.

ISLAMIC SCIENCE AND ENGINEERING. By DONALD R. HILL. (Islamic Surveys.) Edinburgh, Edinburgh University Press, 1994. 250pp. 78 illustrations. £16.95 (pb), £39.95 (hb).

CAUGHT IN TIME: GREAT PHOTOGRAPHIC ARCHIVES. KHIVA. BUKHARA. SAMARKAND. Series editor: VITALY NAUMKIN. Reading, Garnet Publishing, 1993. 127pp. (Khiva); 159pp. (Bukhara); 159pp. (Samarkand).

THE CORAL BUILDINGS OF SUAKIN: ISLAMIC ARCHITECTURE, PLANNING, DESIGN AND DOMESTIC ARRANGEMENTS IN A RED SEA PORT. By J.‐P. GREENLAW. London and New York, Kegan Paul International, 1995.132pp.     

Either or? Reconciling Findings on Mental Health and Extremism using a Dimensional Rather than Categorical Paradigm

The background for this paper is the debate over what role mental illness plays in radicalization to violent extremism. While one camp points to cases of abnormal functioning of perpetrators, another argues that normal psychological mechanisms are central. Through a review of these perspectives, it becomes clear that mental illness cannot be ruled out as an epi‐phenomenon, but is not a necessary condition either. The paper draws on work in psychiatric nosology on dimensional and categorical conceptions of illness and argues that the perspectives in this literature reflect a categorical approach to normal and abnormal functioning. Under a dimensional perspective, findings converge. The paper concludes by showing how this new dimensional approach to the role of mental illness in radicalization has implications for the design of risk assessment tools and leads to the recommendation for stronger inter‐agency cooperation between mental health professionals, social services, and police and intelligence services.     

Too risk averse to stay honest?: Business corruption,uncertainty and attitudes toward risk

The presence of business-corruption provokes firms to make choices between legal business approaches and illegal bribery. The outcome of a chosen strategy will usually be uncertain at the time the decision is made, and a firm’s decision will depend partly on its attitude towards risk. Drawing on empirical results about business corruption, this paper describes the risks, uncertainties and benefits attached to bribery, and specifies their impact on firms’ propensity to offer bribes. It then demonstrates how risk averse firms can be more inclined to offer bribes than risk neutral and risk attracted firms.     

School-Related Stress Experience as a Risk Factor for Bullying Behavior

Associations between bullying behavior and school-related stress experience, self-efficacy, social support, and decision control were explored in a study of 885 Norwegian adolescents aged 13–15 years. Information was based on self-reports. The psychosocial factors were represented by an average of scores on 3–12 single items, each with 5 possible response categories. Bullying behavior was defined as bullying other pupils sometimes or more often during the term. The prevalence of bullying behavior was 9.2%, but significantly higher among boys than girls. Odds ratios of bullying behavior according to psychosocial factors were calculated in a multiple logistic regression analysis. Increasing school alienation was associated with an increased risk of bullying, whereas increasing support from teachers and peers decreased the risk. Increasing self-efficacy was associated with a significant increase in risk only among 14-year-old pupils, but a similar tendency was seen for 15-year-old pupils. No significant association was seen with decision control.     

Contextualising Regional Innovation Systems in a Globalising Learning Economy: On Knowledge Bases and Institutional Frameworks

In order to advance the understanding of which types of regional innovation system represent effective innovation support for what kinds of industry in different regions analyses must be contextualized by reference to the actual knowledge base of various industries as well as to the regional and national institutional framework, which strongly shape the innovation processes of firms. Of special importance is the linkage between the larger institutional frameworks of the national innovation and business systems, and the character of regional innovation systems. In making the arguments about a general correspondence between the macro-institutional characteristics of the economy and the dominant form and character of its regional innovation systems a link is provided to the literature on ‘varieties of capitalism’ and national business systems.     

New Legal Moralism: Some Strengths and Challenges

The aim of this paper is to critically discuss the plausibility of legal moralism with an emphasis on some central and recent versions. First, this paper puts forward and defends the thesis that recently developed varieties of legal moralism promoted by Robert P. George, John Kekes and Michael Moore are more plausible than Lord Devlin’s traditional account. The main argument for this thesis is that in its more modern versions legal moralism is immune to some of the forceful challenges made to Devlin by Hart, Dworkin and Feinberg among others. Second, however, the paper challenges the new generation of legal moralists and suggests some areas for further development. Although Devlin’s position has been scrutinized thoroughly in the literature on the philosophy of law, there has, to my knowledge, been no comparable, systematic critique of these different proponents of legal moralism.     

Electoral institutional change and democratization: You can lead a horse to water,but you can't make it drink

Drawing on evidence from first and second elections in emerging democracies, this article addresses issues pertinent to understanding the interplay between institutional design and change on the one hand and on the other hand the course of the democratization process, its background and concomitants. Because the electoral system (understood broadly, that is, not only as seat allocation rules) is often seen as an institution conducive to the legitimation of emerging ‐ and therefore fragile ‐democracies, it is important to examine how the development of the electoral system has influenced the democratic transition outcome, in a number of cases. Cases considered include Kenya, Mongolia, Nepal and Tanzania, while comparisons with countries outside the third world such as Bosnia‐and‐Herzegovina and South Africa throw additional light on the argument. By seeking to avoid both the fallacy of electomlism and the fallacy of anti‐electoralism, the article argues that the electoral system is a crucial factor behind the unsatisfactory course of the democratization process in many countries. More emphasis should be put on sustaining the different prerequisites of democracy, while simultaneously more effort should be put into the preparation of elections, in order to progress beyond simple and inadequate electoral democracy. The technical refinement of the electoral process, while far from sufficient to guarantee democratic development, can be a step in that direction. Credible and transparent elections are conducive to internal legitimacy and the dynamic of the political‐electoral process will gradually bring along more contestation, more participation, and the enjoyment of more rights and liberties.