The insulin pump as murder weapon: a case report

Microprocessor-controlled insulin pumps designed for continuous delivery of short-acting insulin analogs into subcutaneous tissues offer several important potential benefits for diabetic patients. The delivery of other substances using these systems is technically feasible. We present a case of homicide involving lethal doses of etomidate and atracurium injected via the victim's insulin pump. This unique situation could be encountered by homicide investigators more frequently as the popularity of these systems continues to grow.     

Taking on the World: The International Activities of American State Legislatures

State legislatures in the United States engage in a substantialamount of international activity. In the 2001-2002 legislativesessions, some 886 bills and resolutions with significant internationalimplications were introduced. Approximately 306 of these wereadopted. This level of international activity has increasedsubstantially since 1991, and the substantive focus has changedover time. In addition, about half of all state legislaturesreceived at least one foreign delegation and sent at least onedelegation of members abroad in the last session. As in mostareas of state policy, there is considerable interstate variationin legislatures' international activities. Some states had virtuallyno international legislative activity, whereas others were veryactive. The principal factors explaining this variation werethe degree of state involvement in the international economy,as measured by the level of state exports, and party controlof the legislature.     

Factors Associated with Academic Achievement for Sexual and Gender Minority and Heterosexual Cisgender Students: Implications from a Nationally Representative Study

Research on sexual and gender minority student achievement indicates that such students report lowered achievement relative to other students. Increased victimization and less school belonging, amongst other factors, have been identified as contributing to these inequalities. However, supportive schooling structures and caregiver support may support their achievement. A nationally representative survey of secondary school students was used to identify specific factors that support achievement for sexual minority (n?=?485), gender minority (n?=?298), and heterosexual cisgender (where one’s sex assigned at birth “matches” a binary gender identity, i.e., a male assigned at birth identifies as a boy/man, n?=?7064) students in New Zealand. While reported victimization did not affect achievement for sexual and gender minority students, school belonging, and teacher expectations of success, emerged as significant factors. Differences emerged between sexual minority and gender minority achievement factors, suggesting a range of detailed policy implications and recommendations.

     

Designing Public Participation: Managing Problem Settings and Social Equity

Researchers suggest that inequity and disparities in public participation in the policy‐making process will go hand in hand unless public managers and community leaders are attentive to these concerns when they are designing participation opportunities. Previous research has considered how the design of participatory opportunities can address inequity, but it has provided few insights into what is behind design choices. This article provides a theoretical framework that links public managers' and community leaders' perspectives on their own political efficacy and sources of their efficacy, yielding four types of “designers.” The research hypothesizes that these types have different narratives of social equity in participation that affect their design choices. Data from more than 100 public managers and community leaders provide preliminary support for these relationships. Findings suggest that inequitable public participation will persist unless designers consider what is behind their choices, focusing first on understanding the problem setting, or their narrative of equity in public participation.     

THE PERFORMANCE OF NATIONAL HEALTH CARE SYSTEMS: A "GOOD NEWS, BAD NEWS" FINDING FOR REFORM POSSIBILITIES

This paper seeks to contribute to an understanding of how macro health systems work by comparing three possible sets of influences on national health care outcomes: 1) health care facilities and their presumed link to national affluence, 2) social characteristics which are assumed to promote healthy behavior, and 3) political variables in the form of welfare state development. Our findings bear both optimistic and pessimistic connotations. On the one hand, the somewhat limited importance of the first set of factors shows that good health in a country is not simply the function of high spending levels. However, the surprisingly strong role of “social development” in determining health care outcomes that emerges implies that much more than the direct provision of health care must be manipulated to ensure optimal health for a nation's population.