Fatal diphenhydramine intoxication in infants

Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.     

Ego development in adolescence: Longitudinal studies

Adolescents from four schools (one inner-city, two suburban, and one private) were tested two or three times using the Washington University Sentence Completion Test of Ego Development. Testing intervals ranged from 1.5 to 6 years. About half (N=193) the original pool was retested at twelfth grade. Every sample showed a mean rise in ego level; for six of eight samples that rise was statistically significant. Every pair of testings showed a postive correlation between scores; 10 of 14 correlations were significantly different from zero. Thus both test-retest correlations (about 0.5) and change scores support the hypothesized sequence of ego development. Significant correlation between ego level and intelligence occurred in two schools (0.6 at elementary and junior high grades and 0.4 at twelfth grade), but correlation was about zero in the private school.These studies were supported by Grant MH-05115 and Research Scientist Award MH-00657, both from the National Institute of Mental Health, Public Health Service.Received her Ph.D. from Washington University. Main interest is adolescent development.Received her Ph.D. from the University of California, Berkeley. Main interest is theory and measurement of ego development.     

Career-marriage orientations in college youth: An analysis of perceived personal consequences and normative pressures

The present research was designed to examine factors associated with career and marriage orientations in male and female college students. The first phase of the research identified qualitatively different factors associated with variations in life structure. Respondents completed an open-ended questionnaire which elicited the perceived consequences and normative pressures concerning three life structure alternatives: (a) emphasizing career, (b) emphasizing marriage, and (c) placing equal emphasis on career and mariage. A set of 24 concerns was identified, and sex differences on several of these dimensions were noted. In general, the data were consistent with previous analyses of value structures in adults. The second phase of the research used a quantitative approach to examine the three life structure alternatives. Males and females did not differ in the relative emphasis they intended to give to career and marriage. However, sex differences in the perceived consequences of the life structure alternatives were noted.This research was conducted while the first author was a National Research Service Award (NIMH) trainee, Grant No. 1 T32 MH14593. A modified version of this paper was presented at the 87th Annual Convention of the American Psychological Association, New York, september 1979.Current research interest is psychosocial development during the adult years.Received Ph.D. from the University of Illinois, 1976. Current research interest is attitude theory and measurement.     

Tax Increment Debt Finance: An Analysis of the Mainstreaming of a Fringe Sector

Despite the persistent efforts of federal tax policymakers to place binding constraints on the economic development bond market in the United States, it has grown since the Tax Reform Act of 1986 and is a well established segment of the municipal securities market. This article provides an analysis of the development bond market by describing tax increment debt finance (TIF) in the United States and conducting an empirical analysis of California TIF debt. Our analysis indicates that tax increment debt finance (TIF) is no longer an obscure infrequently used financing tool, but for local governments in many states is a commonly used means of raising capital for multiple purposes. Our empirical analysis highlights the unique project-specific features of tax increment finance that bond issuers must understand and manage to enhance the credit quality and minimize the financing costs of tax increment debt.