Discrimination Distress During Adolescence

Amidst changing patterns of accommodation and conflict among American ethnic groups, there remains a paucity of research on the nature and impact of racial and ethnic discrimination on development in multiethnic samples of youth. The Adolescent Discrimination Distress Index along with measures of caregiver racial bias preparation and self-esteem was administered to 177 adolescents drawn from 9th–12th graders self-identified as African American, Hispanic, East Asian, South Asian, and non-Hispanic white. Youth from all ethnic backgrounds reported distress associated with instances of perceived racial prejudice encountered in educational contexts. Instances of institutional discrimination in stores and by police were higher for older youth and particularly for African American and Hispanic teenagers. Encounters with peer discrimination were reported most frequently by Asian youth. Reports of racial bias preparation were associated with distress in response to institutional and educational discrimination and self-esteem scores were negatively correlated with distress caused by educational and peer discrimination. The importance of research on discrimination distress to understanding adolescent development in multiethnic ecologies is discussed here.     

Tramadol (Ultram) concentrations in death investigation and impaired driving cases and their significance

We reviewed a series of 66 deaths in Washington State between 1995-2000 in which tramadol (Ultram and Ultracet, Ortho-McNeil) was detected in the decedent's blood, in order to assess the role tramadol was determined to have played. Additionally, we reviewed a series of 83 impaired driving cases in which tramadol was detected in order to establish a non-lethal blood tramadol concentration reference range. In both populations, tramadol was consistently found together with other analgesic, muscle relaxant, and CNS depressant drugs. Death was rarely attributable to tramadol alone. However, tramadol may be a significant contributor to lethal intoxication when taken in excess with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased CNS depression. Although the incidence of tramadol detection has increased consistently over the last eight years, there is no evidence of a corresponding increase in the number of cases in which death was attributed solely to tramadol. Blood drug concentrations in many deaths exceeded the therapeutic serum range of 0.28-0.61 mg/L; however, the concentrations overlapped almost completely with the range identified in living subjects arrested for impaired driving. These findings suggest caution in the interpretation of blood tramadol concentrations outside of the recognized therapeutic range. It also suggests that the drug, even when used in moderate excess, is not a principle cause of death in suicidal or accidental deaths.