Childhood Sexual Abuse and Intimate Partner Violence among Women in Methadone Treatment: A Direct or Mediated Relationship?

Women in substance use treatment report rates of childhood sexual abuse and intimate partner violence that far exceed those reported by women in the general population. Previous research with nonrandom samples of women in substance use treatment suggests that there is a statistically significant relationship between childhood sexual abuse and intimate partner violence; however, little is known about the mechanisms of risk between these two public health concerns among this population of women. To address this gap in knowledge and to inform intervention strategies, this study examined direct and mediated relationships between childhood sexual abuse and intimate partner violence risk among a random sample of 416 women in methadone treatment. In addition to high rates of childhood sexual abuse (57.9%), intimate partner violence (lifetime prevalence, 89.7%; 6-month prevalence, 78.4%), posttraumatic stress disorder (PTSD, 28.6%), and global psychological distress (19.5%), findings suggest that the relationship between childhood sexual abuse and intimate partner violence is mediated by mental health problems and that women experiencing PTSD or global psychological distress are 2.7 and 2.4 times more likely to experience intimate partner violence than women without such experiences, respectively. Although not a mediator in this relationship, financial independence reduced women's risk of partner violence by two-thirds. The paper includes discussion of social learning and stress and coping theories to explicate the findings and to inform intervention strategies. This study is based, in part, on the first author's dissertation. A previous version of this paper was presented at the Society for Social Work and Research Annual Conference held in January 2005 in New Orleans, Louisiana. The following grants provided funding for this study: R01DA11027 and 3T32MH014623-22S1.     

How Useful is Basal Renal Tubular Epithelial Cell Vacuolization as a Marker for Significant Hyperglycemia at Autopsy?

Basal vacuolization of renal tubular epithelial cells (so-called Armanni-Ebstein phenomenon) has been attributed to hyperglycemia causing accumulation of cytoplasmic glycogen. Review of 34 autopsy cases with significant hyperglycemia (vitreous glucose ≥ 15 mmol/L/270 mg/dL) was undertaken to determine whether there was any significant association between the degree of hyperglycemia and the severity of this morphological change (graded as 0, 1+, 2+, and 3+). No association was demonstrated. Review of the subgroup of 14 cases with terminal hyperglycemia without ketoacidosis was then undertaken to assess the effect of hyperglycemia in isolation on renal tubular epithelial cells. Vitreous glucose levels in these 14 cases ranged from 17 to 49.7 mmol/L (306-894.6 mg/dL) with a mean of 26.25 mmol/L (472.5 mg/dL) and β-hydroxybutyrate levels ranged from 0.02 to 2.55 mmol/L (0.36-45.9 mg/dL) with a mean 0.79 mmol/L (14.22 mg/dL). Not one of the latter cases displayed basal vacuolization. No relationship between basal vacuolization of renal tubular epithelial cells at autopsy and terminal hyperglycemia could, therefore, be demonstrated.     

Beyond Authoritarianism: The Conceptualization of Hybrid Regimes

This paper appraises the state of the field on hybrid regimes by depicting the tensions and blurred boundaries of democracy and authoritarianism “with adjectives.” An alternative conceptualization and ordering of regimes are subsequently introduced using a configurative approach. Rather than place regimes on a linear continuum from authoritarianism to democracy, it highlights the multi-dimensional arrangements possible for the construction of regime types. The configurative approach also provides an analytically useful way to measure and integrate hybrid regimes into our classificatory schemes. As a result, it helps alleviate the conceptual confusion in the literature and contributes to a discussion of hybrid regimes beyond the framework of authoritarianism. The paper concludes by presenting a list of all hybrid regimes in the world between 1990 and 2009 identified with this method.     

Methadone maintenance programs--a two-edged sword?

Retrospective review was undertaken of all autopsies in which methadone was detected at the Forensic Science Centre, South Australia, during a 3-year period from July 1996 to June 1999. Thirty-five cases were found in which methadone had either caused or contributed to death (age range = 14-54 years; average = 31 years; M:F = 3.4:1). Ten victims were participating in a methadone maintenance program, of whom four died within a week of enrollment. Eight victims (23%) not enrolled in a methadone maintenance program were found who had died after the use of "diverted" methadone (i.e., prescribed for someone else) (age range = 14-34 years; average = 25 years; M:F = 6:2). Deaths were directly attributable to methadone toxicity in seven of the eight cases, with additional drugs or alcohol being found in seven cases. Prevention of ongoing deaths caused by methadone diversion could be achieved by allowing only daily releases of methadone, with the addict having to consume the drug under close supervision.     

Resistance of degraded hair shafts to contaminant DNA

We have investigated the susceptibility of degraded human hair shaft samples to contamination by exogenous sources of DNA, including blood, saliva, skin cells, and purified DNA. The results indicate that on the whole hair shafts are either largely resistant to penetration by contaminant DNA, or extremely easy to successfully decontaminate. This pertains to samples that are both morphologically and biochemically degraded. We suggest that this resistance to the incorporation of contaminant DNA relates to the hydrophobic and impermeable nature of the keratin structures forming the hair shaft. Therefore, hair samples represent an important and underestimated source of DNA in both forensic and ancient DNA studies.     

The pathological features and circumstances of death of lethal crush/traumatic asphyxia in adults--a 25-year study

A 25-year retrospective study of cases of crush/traumatic asphyxia autopsied at Forensic Science SA, Adelaide, Australia from 1980 to 2004 was undertaken. A total of 79 cases of crush asphyxia was found consisting of 63 males (80%) and 16 females (20%). The age range of the males was 19-86 years (mean=41.8 years) and of the females was 19-75 years (mean=38.6 years). In 18 cases the exact circumstances of death were unclear, leaving 61 cases in which details of the fatal episode were available. Major categories included vehicle crashes (N=37), industrial accidents (N=9), farm accidents (N=6) and entrapment beneath vehicles (N=5). Forty of the 79 victims (51%) had only very minor bruises and abrasions; 28 (35%) had evidence of chest compression with rib and sternal fractures and large areas of soft tissue bruising of the chest; 7 cases (9%) had other significant injuries or findings that had contributed to death. All of these victims had signs of crush asphyxia in the form of intense purple congestion and swelling of the face and neck, and/or petechial hemorrhages of the skin of the face and/or conjunctivae. The pattern of pathological findings of crush asphyxia was not influenced by the presence or absence of concomitant serious or lethal injuries. In 4 cases (5%) where the circumstances of the lethal episode were those of crush asphyxia there were no characteristic pathological findings. This study has shown that a high percentage of crush asphyxias may be caused by vehicle accidents. It has also demonstrated that on occasion fatal crush asphyxia may have to be a diagnosis of exclusion, made only when there are characteristic death scene findings, and no evidence of lethal natural diseases or injuries at autopsy, with negative toxicological screening.     

Perceived positive aspects of intimate relationships among abused women in methadone maintenance treatment programs (MMTP)

This study examines the positive aspects of intimate relationships perceived by drug-involved women victims of intimate partner violence (IPV). The article examines the association of psychological distress, childhood abuse, and severity of IPV with the different positive aspects the women indicated. Most analyses were conducted on a subsample of 149 women in methadone maintenance treatment who intended to continue their relationship with their abusive partner. The women most frequently valued fulfillment of the role of an intimate partner such as "he takes care of me, loves me, makes me laugh" (29.7%). Fewer than one tenth of the women valued their partners' role as economic provider; however, these women reported more physical IPV. Women intending to continue the relationship (more than two thirds of the participants) reported less physical or sexual IPV and experienced less psychological distress. Policy and practice implications are discussed.     

The Evolving American Policy on Investment Protection: Evidence from Recent FTAs and the 2004 Model BIT

Twelve years after the inception of the North American FreeTrade Agreement (NAFTA), the US policy on the protection offoreign investment is evolving. This article compares the provisionson investment in the recent US free trade agreements (FTAs)and the 2004 model bilateral investment treaty (BIT) with NAFTA’s.While most of the provisions are similar, some differences canbe identified, both in substantive and procedural forms. Weexplain this evolution by a learning process of the US administrationfrom the NAFTA experience. We argue that the new features ofthe FTAs and of the revised model BIT result from the US interestin reaching a better balance between the protection of investmentand the protection of state sovereignty. This American concernstems from a reaction to the claims filed by foreign investorsunder NAFTA Chapter 11, at least some of which were perceivedas ‘frivolous’ by the US government. However, therecent US FTAs and model BIT do not reveal a thorough policyreorientation but rather adjustments to the policy at the basisof NAFTA’s investment chapter.