Fatal intoxications in the Nordic countries. A forensic toxicological study with special reference to young drug addicts

Fatal intoxications in the 15-34 age group in the five Nordic countries during the years 1984 and 1985 (Sweden only in 1984) were investigated. The known drug addicts were studied separately. The highest incidence of intoxications, calculated per 10(5) population, was found in Finland (11.3), followed by Denmark (10.3), Sweden (8.5), Iceland (7.2) and Norway (6.6). The percentage of intoxications caused by drugs was 92 in Denmark, 71 in Norway, 66 in Sweden, 50 in Finland and 17 in Iceland. Ethanol intoxications were seen 5-7 and 2-3 times as frequently in Finland and in Iceland, respectively, than in the other three countries. Carbon monoxide intoxications accounted for two-thirds of all fatal intoxications in Iceland. Drug addicts accounted for 62% of all fatal intoxications in the Danish material. The corresponding figures were 33% in the Norwegian, 16% in the Swedish and 5% in the Finnish material. No deaths in drug addicts were found in Iceland. Most drug addicts in Denmark, Norway and Sweden died of hard drugs and most in Norway and Sweden, from heroin or morphine, whereas in Denmark other strong analgesics, such as methadone, dextropropoxyphene and ketobemidone, accounted for 40% of all hard-drug-related fatal intoxications. To a certain extent the results reflect differences in the legal autopsy routines in the various Nordic countries. However, the ascertainment of drug addicts is assumed to be near-complete in each country.     

Mandibular canine index--a clue for establishing sex identity

A preliminary study for establishing sex identity by Mandibular Canine Index is described. Seven hundred and sixty six individuals from a South Indian population of either sex, ranging in age from 15 to 21 years, with fully errupted, healthy and non-worn mandibular permanent canines were studied. The data collected was analysed statistically. Accurancy of sex determination identity was found to be 84.3% in the male and 87.5% in the female. The method is simple and inexpensive to conduct and therefore can be applied in Forensic Odontology, as a method for establishing sex identity.     

Constitutional,legal and political problems of local government in Nigeria

The new Nigerian local government system was clearly intended by its creators to be a representative and democractic system of devolution. The speed with which elected councils have been dissolved and replaced by caretaker committees and state appointees contrasts strangely with the constitutional provision that there should be a system of local government by democratically elected local councils. The constitutionality of dissolution has been confused with the constitutionality of further local government reform. Dissolution should be seen as an emergency measure to be used rarely in cases of proven maladministration by a local government. Further reform and reorganization of a state's system of local government should be regarded as a legitimate power of the state legislature. The role given by the Constitution to local government should not be interpreted as entrenching the system. Constitutional amendment is not required should further reform be necessary.     

The prospects for prepaid long-term care: the Arizona Medicaid experiment

Arizona is adding long-term care to its prepaid, capitated alternative to Medicaid. This article discusses the potential for this major cost-control experiment. Experience suggests that those able to quality for long-term care will fare better than the poor did in the previous system. However, limiting eligibility will be the primary means of controlling costs; significant price competition is not likely to develop. The bidding process will serve more to transfer risk to contract providers than to improve program efficiency. Potential cost savings will be more than offset by an increased identification of need.     

Regulatory policy and information deficiencies in the market for mental health services

This paper addresses issues related to the regulation of the delivery of mental health services. The focus is primarily on regulations that are aimed at dealing with the consequences of imperfect information in the marketplace. The paper reviews and assesses what is known about the impact of regulations on efficiency and equity. One conclusion is that we know a fair amount about impacts of regulation on prices for mental health service and very little about effects on quality of care. A research agenda is proposed based on the knowledge available in 1988.     

COMPETITIVE TENDERING IN THE NHS: AN ECONOMIC ANALYSIS' OF THE EARLY IMPLEMENTATION OF HC(83)18

Economic theory identifies circumstances where in-house production can be expected to be more efficient, in terms of the cost of production, than purchase from outside contractors. However, this efficiency advantage can also expect to be dissipated when in-house producers face no competition. The introduction of competitive tendering does not invalidate the case for in-house production; but significant cost savings can still be expected.
An in-depth analysis is made of six contracts put out to tender in the three hotel-type services. Markets for contracts were created, and open competition commonly brought about savings of one-third to two-thirds. Part of the cost saving was often achieved through a rationalization of services. Economic theory does not predict this result; but NHS management used the opportunities to introduce changes. Wage rates were usually cut and earnings fell by still more. Staff resignations and redundancies were common.     

Drug use and pretrial misconduct in New York city

Is recent drug use significantly associated with pretrial misconduct? Does consideration of recent drug use enhance risk classification among a sample of persons who have time free pending the disposition of their cases? Using data on arrestees in Manhattan, this paper examines these issues and some related questions. To measure recent drug use, urine samples were collected from persons shortly after their arrest and tested for four drugs: heroin, cocaine, PCP, and methadone. Two measures of pretrial misconduct are considered: whether a defendant fails to appear for a scheduled court date (FTA) and whether a defendant is rearrested prior to case disposition. Censored probit models are used to estimate the statistical association between drug test results and pretrial misconduct. Results show that drug test results are significantly associated with pretrial misconduct over and above the information typically available to judges at the time release decisions are made. Some implications of these findings for pretrial decision making are discussed.