A fatality involving clomipramine

A fatality following ingestion of the tricyclic antidepressant clomipramine (Anafranil), alprazolam (Xanax), and ethyl alcohol is described. Clomipramine and N-desmethylclomipramine were quantitated by high performance liquid chromatography and alprazolam by gas liquid chromatography. Concentrations of clomipramine and N-desmethylclomipramine were: in blood--0.84 and 1.4 mg/L; in urine--0.56 and 0.62 mg/L. Alprazolam concentration in blood was 0.069 mg/L. Ethyl alcohol was measured by headspace gas chromatography and found to be 375, 385, and 435 mg/dL in blood, urine, and vitreous humor, respectively. These findings are compared to previous reports of clomipramine related fatalities and alprazolam toxicity combined with ethyl alcohol.     

Police psychology: The influence of Daubert and its progeny

In the current legal atmosphere, any practicing professionals, including police psychologists, may expect to have their decisions challenged in court. If such a challenge is not met, it may have a disastrous financial and reputational impact for both the psychologist (and other expert consultant) and the employer or contractor by whom the psychologist has been retained. The rules for expert witness qualification throughout the nation have been very strongly effected by the introduction of the Federal Rules of Evidence in 1975 and subsequent case law, particularly theDaubert, Joiner, andKumho Tire Supreme Court decisions. This article examines the history of the development of theDaubert Standard and proposes principles for potential expert witnesses in order to minimize the likelihood of aversive consequences, such as disqualification or malpractice accusations. Authors' Note: Cary Rostow, Ph.D., is president of Matrix, Inc., Baton Rouge, Louisiana, and is in private practice in Baton Rouge. He holds a Diplomate in Police and Criminal Psychology from the Society for Police and Criminal Psychology. Robert Davis, Ph.D., is executive vicepresident and director of science, research, and development, for Matrix, Inc., and has a private practice in Baton Rouge, Louisiana. He holds a Diplomate from the Society for Police and Criminal Psychology. Judith Levy, Ph.D., is currently a postdoctoral fellow at Matrix, Inc.     

A carpipramine related fatality

A fatality following ingestion of the tricyclic antidepressant carpipramine (Prazinil) and ethyl alcohol is described. Carpipramine was quantitated by high performance liquid chromatography. The concentration of carpipramine was 2.0 mg/L in blood and 0.44 mg/L in urine. Ethyl alcohol was measured by headspace gas chromatography and found to be 105 mg/dL in blood and 55 mg/dL in the urine. Quantitative analysis of stomach contents was positive for carpipramine by thin-layer chromatography. To our knowledge, this is the first reported fatality involving carpipramine.     

The MMPI-2 L scale as a tool in police selection

The MMPI has been used extensively in the selection of law enforcement personnel. Because police officer candidates have been preselected, however, individuals with obvious mental disturbance have been screened out of the candidate pool before evaluation. It is necessary to search for more subtle variables to serve as predictors of unsatisfactory future performance. The L scale is a subtle variable which can suggest potential for problematic behavior. The value of the L scale in the selection process is discussed. Authors' Note: William U. Weiss, Ph.D., is professor of psychology. The University of Evansville, 1800 Lincoln Av., Evansville, IN 47722. Robert Davis, Ph.D., is executive vice-president and director of science, research, and development, for Matrix, Inc., and Cary Rostow, Ph.D., is president of Matrix, Inc., Baton Rouge, LA. Sarah Kinsman was a psychology major at the University of Evansville at the time this research was conducted.     

Medicare reimbursement for hospice care: ethical and policy implications of cost-containment strategies

In several areas of health policy, current concern over rising costs has generated considerably political support for reforms that many in the business have advocated unsuccessfully on philosophical, ethical, or humanitarian grounds for years. Thus, for example, the spiraling cost of caring for the mentally ill and the developmentally disabled in an institutional setting has breathed new life into proposals to bring these groups out into the community where they can live more independently--and more cheaply. But this overlap of quality and frugality goals is only partial. Although alliances with cost-cutters can bring reform, health policy reformers are discovering that they may have to accept a lot of bathwater along with the baby. Medicare reimbursement for hospice care, authorized by Section 122 of PL 97-248, the Tax Equity and Fiscal Responsibility Act of 1982, provides one recent example of this dilemma. This article discusses the results of a survey--conducted by the Office of the Inspector General of the Department of Health and Human Services--to discover how many hospices would seek certification for reimbursement by Medicare, how many patients would be served, and the consequences of this legislation for cost, access, and quality of service.     

Tackling the Big Questions in Social Impact Bond Research through Comparative Approaches

Abstract

This special issue of theJournal of Comparative Policy Analysis brings together four cross-disciplinary articles representing the first concerted attempt to combine comparative approaches to extend theoretical and empirical understandings of Social Impact Bonds (SIBs). SIBs are investment-backed payment-by-results projects and have been subject to vigorous academic debate on their appropriateness and efficacy since the first SIB launched in 2010. This introduction to the special issue outlines the state of the academic literature on SIBs, identifying gaps and suggesting five big questions that do not yet have satisfactory answers: (1) What are the administrative or political problems to which SIBs respond? (2) Where and why do SIBs emerge in particular contexts? (3) What is the role of SIBs in the evidence-based policy movement? (4) Is delivering an intervention through a SIB more effective than other means and are associated costs justifiable? (5) Do SIBs catalyse wider organizational, system, or institutional changes? This introduction then summarizes the articles included in this special issue, discusses how they respond to these big questions, and suggests that further comparative research might best address remaining gaps in the literature.