Validation of an ELISA-based screening assay for the detection of amphetamine, MDMA and MDA in blood and oral fluid

The use of amphetamine and 'ecstasy' (MDMA) has increased exponentially in many European countries since the late nineties, leading to a rapid growth in the number of clinical and forensic analyses. Therefore, a rapid screening procedure for these substances in biological specimens has become an important part of routine toxicological analysis in forensic laboratories. The objective of this study was to evaluate the Cozart amphetamine enzyme-linked immunosorbent assay (ELISA) for the screening of plasma samples and oral fluid samples (collected with the Intercept device). Authentic plasma samples from drivers (n=360) were screened, using an 1:5-fold dilution. True positive, true negative, false positive and false negative results were determined relative to the in-house routine GC-MS analysis. Samples consisted of 144 amphetamine-only positives, 141MDMA/MDA-only positives, and 74 negatives when using the limit of quantitation as the cut-off level for confirmation (10 ng/mL). Using these results, receiver operating characteristic (ROC) curves were generated and optimal cut-off values for the screening assay were calculated. Analysis showed that the ELISA is able to predict the presence of either amphetamine or *MDMA/MDA (*MDMA as its metabolite MDA) in plasma samples with 98.3% sensitivity and 100% specificity at a cut-off value of 66.5 ng/mL d-amphetamine equivalents. A similar analysis was conducted on 216 oral fluid specimens collected from a controlled double blind study. Subjects received placebo or a high (100 mg) or low (75 mg) dose of MDMA. Oral fluid samples were collected at 1.5 and 5.5h after administration. Combined results of the analysis of the high and low dose oral fluid samples indicated a screening cut-off of 51 ng/mL d-amphetamine equivalents with both a sensitivity and specificity of 98.6% (using a LC-MS/MS confirmation cut-off of 10 ng/mL). In conclusion, these data indicate that the Cozart AMP EIA plates constitute a fast and accurate screening technique for the identification of amphetamine and MDMA/MDA positive plasma samples and oral fluid specimens (collected with Intercept. It should be emphasized that method validation should be performed for each type of biological matrix.     

From Afro-Sweden with Defiance: The Clenched Fist as Coalitional Gesture?

Anti-racist activist Maria Teresa “Tess” Asplund, who is Afro-Swedish, became known around the world in 2016 when a photograph of her stepping out in front of three hundred marching neo-Nazis from the Nordic Resistance Movement went viral on social media. Tess raised her clenched fist in protest, as part of a counter-demonstration. The recognizability of her clenched fist as an act of protest struck a chord with anti-racist activists and movements around the world as the photograph of her lit up the Internet. In this article, we examine Asplund’s action as an expression of the current racial climate in Sweden, while at the same time tracing the viral and transnational circulation of her image across multiple-publics and mediaspheres to investigate how her solitary presence and her clenched fist function relationally and rhetorically.     

The loss of that which never was: Evaluating changes to the senior management of the Public Health Agency of Canada

In the fall of 2014, the Government of Canada formally split the role of the Chief Public Health Officer (CPHO) into two positions: the CPHO and the President of the Public Health Agency of Canada. Despite concerns raised by the public health community, these changes are consistent with the CPHO's authority. However, the nature of responsible government means that the CPHO cannot simultaneously serve as an independent advocate for policies and programs that might prevent disease and as a senior advisor to the government of the day.     

Les enjeux de l'évaluation de la performance : Dépasser les mythes

Since the 1990s, most Western countries have equipped themselves with frameworks and tools to measure health organizations and systems' performance. Paradoxically, several theoretical, methodological and usage issues remain unresolved. Conceptually, the notion of performance is vague and not well rooted in theory. From a methodological perspective, we are faced with numerous measures that don't always meet reliability, validity and usefulness criteria and don't help to grasp the complexity of the concept. Finally, the assessment results are not fully used to continuously improve performance. This article focuses on analyzing these issues by deconstructing the myths that slow down the development of better‐suited frameworks to meet decision‐makers' needs. It also proposes innovations based on the global and integrated assessment model of health systems.     

Accountability by Professionalism or Managerialism? Exploring Attitudes Among Swedish and Norwegian Local Government Leaders

Most developed countries continue to experience problems with malfeasance and corruption, making accountability a fundamental concern of the public government. Still, the mechanisms which ensure accountability are not given. This article explores two different and apparently conflicting principles of accountability in public organizations: “Professionalism” based on values and internalized incentive structures and “Managerialism” based on externalized incentives and hierarchy. The empirical analysis is based on a comparative survey among local government leaders in Sweden and Norway. The analysis shows that both professionalism and managerialism are regarded as important means for accountability and tend to be understood as complementary more than competing principles.     

The International Criminal Tribunal for the Former Yugoslavia: Judgements in 2005

The year of 2005 was a productive one for the InternationalCriminal Tribunal for the Former Yugoslavia (ICTY), which rendereda total of ten judgements. The present article, concentratingon the key facts of the case and on novel development in internationalcriminal and humanitarian law, reviews—in chronologicalorder—the judgements of the ICTY Trial Chambers and ofthe Appeals Chamber.