Postmortem urine immunoassay showing false-positive phencyclidine reactivity in a case of fatal tramadol overdose

This is a report of postmortem false-positive reactivity using an enzyme-multiplied urine phencyclidine (PCP) immunoassay (EMIT II+) due to a single-agent fatal tramadol overdose. An autopsy of a 42-year-old male who died alone at home revealed no identifiable lethal anatomic abnormalities, thus leading to toxicologic analysis. Femoral blood was obtained for drug testing by high-performance liquid chromatography (HPLC) and showed a tramadol level of 14.0 mg/L, 2 orders of magnitude greater than the therapeutic range (0.1 to 0.3 mg/L). Urine was also obtained and EMIT II+ immunoassay revealed positivity for PCP at 88 mAU/min. However, confirmatory testing by HPLC failed to identify PCP in either the urine or serum. To verify the suspicion that this was a false-positive PCP result, stock solutions of tramadol and its major metabolite (O-desmethyltramadol) at concentrations of 100 mg/L in 10% methanol/H2O were compared with a blank solution (10% methanol/H2O) for EMIT II+ PCP reactivity and demonstrated reactivities of 44 mAU/min and 27 mAU/min, respectively. While these individual results were below the cutoff reactivity for a positive EMIT II+ PCP result (ca. 85 mAU/min), they were much more reactive than the blank calibrator (set at 0 mAU/min). Therefore, we conclude that the immunoreactivity of tramadol and its metabolites in aggregate is responsible for the PCP immunoassay interference and false-positive result.     

Cultural and Spiritual Constructions of Mental Distress and Associated Coping Mechanisms of Tibetans in Exile: Implications for Western Interventions

The Tibet-TPO project in Dharamsala, North India aims to provideculturally sensitive psychosocial support to Tibetan refugees.In this study we have examined the cultural and spiritual constructionsof mental distress of Tibetan exiles from a secondary analysisof previously published data. Tibetans refugees' constructionsof mental distress were intimately linked to cultural, religiousand political factors. Family and religious support were regardedas key coping strategies, yet many new refugees lacked bothfamily support and detailed knowledge and understanding of TibetanBuddhism. Not all of those interviewed were positive about ‘westernapproaches’ to dealing with mental distress, but thoseusing the service seemed to do so in a pragmatic and integrativeway. We conclude that culturally sensitive psychosocial supportcan usefully ‘fill a gap’, especially for new refugeeswho lack both family support and access to, or understandingof, traditional religious coping mechanisms.     

Do Jurors “Know” What Isn’t So About Child Witnesses?

Are expert witnesses needed in child sexual abuse cases to educate jurors about children’s memory, suggestibility, and reactions to abuse, or do jurors already know what such experts could tell them? To cast light on this question, we surveyed jurors and jury-eligible college students and compared their beliefs with what is known via scientific research regarding children’s memory and ability to testify, reactions to interrogation, and reactions to sexual abuse. We also asked participants to infer results of four widely cited studies of children’s suggestibility. Participants’ beliefs were consistent with findings from research on some issues (e.g., that children can be led to claim that false events occurred) but diverged from the scientific consensus on other issues (e.g., whether children can remember painful events in infancy). Similarly, participants sometimes overestimated and sometimes underestimated the level of suggestibility observed in empirical studies. Individual differences in accuracy were related to participants’ gender, education and ethnicity, and there was considerable disagreement among participants on many questions. Implications of findings for the admissibility of expert testimony in child abuse cases are discussed.     

Facing rejection: new relationships, broken relationships, shame, and stalking

This study provides a preliminary examination of the relationship among shame-proneness, emotions, and persistent, unwanted courting or pursuit behaviour. A total of 222 undergraduates completed a questionnaire measuring responses to the termination of a relationship or the declining of a date. The Test of Self-Conscious Affect was used to measure shame. Although shame was unrelated to types of intrusive behaviour, individuals who engaged more repetitively in covert pursuit tended to ruminate more over their love interest than did those who rarely engaged in such behaviour. Rumination was positively correlated with shame. Self-harm behaviours and harm toward others were associated with feelings of sadness and depression, and those who engaged more often in harm toward others also reported feelings of anger and jealousy. Conclusions are made regarding the function of shame and other emotions in intrusive behaviour and their potential relevance to treatment of stalkers.     

Petitioning in early seventeenth-century Scotland, 1625–51

ABSTRACT

In contrast to recent work on England and other parts of Europe, research on petitioning in early modern Scotland is still in its early stages, notably in respect of its political significance in a comparative context. This article investigates supplicatory activity in Scotland during a crucial period in which the petition came under intense scrutiny. The 1630s saw a determined attempt by King Charles I’s Scottish government to clamp down on the use of supplications to express criticism of royal policy; assertive, but carefully controlled, petitioning was one part of a resistance strategy that resulted in the downfall of the king’s regime. When a new government came to power in 1638 headed by the Covenanters, petitioning activity came to be seen as a potential challenge to their authority. Petitioning does not appear to have invoked ‘opinion’ in 1640s Scotland as has been claimed for England; the printed petition remained a rarity in Scotland. Nevertheless constitutional reform, combined with the wartime conditions of the 1640s, generated more recourse to petitioning, and the government recognized opportunities to enhance its claims to legitimate rule. A preliminary investigation of everyday petitions to the government during the 1640s shows how the narratives constructed by supplicants often sought to endorse its values and ideals, but that this type of petitioning was also used by supplicants to critique the government’s policies and hold it to its own rhetoric.