The Prevalence of Paraphernalia Found at the Scene of Drug‐Related Deaths

Many illicit drugs involve the use of paraphernalia, and the presence of paraphernalia found at the scene of death may suggest that the death is drug‐related. Few sources of objective data are available regarding the prevalence of drug paraphernalia found at the scene of drug‐related deaths or the likelihood of a death with drug paraphernalia found at the scene to be drug‐related. This study reviews the deaths which were investigated by the Bexar County Medical Examiner's Office in an attempt to provide objective data. Over 4000 deaths with scene investigations were reviewed, and the presence of paraphernalia was found to be strongly associated with the death being drug‐related, heroin‐related, or cocaine‐related with the relative risk for each being 5.0, 15.4, and 6.6, respectively. This confirms that the presence of drug paraphernalia at the scene of death strongly suggests the death to be drug‐related and in particular heroin‐related.     

Consequences Matter More: In Defense of Instrumentalism on Private Versus Public Prisons

Alon Harel wants to show that punishment is a kind of symbolic expression that, as a matter of metaphysical necessity, can only be performed by governmental agents. Contrary to Harel, I argue private agents can in fact realize those features he argues only public agents can realize. I also argue that, even if he were right that only public guards and wardens can punish, it’s unclear why we would have an all-things-considered rather than merely a pro tanto/prima facie duty to punish. An instrumentalist can grant Harel that only state employees can punish, but still decide, on instrumental grounds, to reject public punishment in favor of private “schpunishment.”     

Parenting in Emerging Adulthood: An Examination of Parenting Clusters and Correlates

The changing nature of the transition to adulthood in western societies, such as the United States, may be extending the length of time parents are engaged in “parenting” activities. However, little is known about different approaches parents take in their interactions with their emerging-adult children. Hence, this study attempted to identify different clusters of parents based on the extent to which they exhibited both extremes of control (psychological control, punishment, verbal hostility, indulgence) and responsiveness (knowledge, warmth, induction, autonomy granting), and to examine how combinations of parenting were related to emerging adult children’s relational and individual outcomes (e.g. parent–child relationship quality, drinking, self-worth, depression). The data were collected from 403 emerging adults (M age = 19.89, SD = 1.78, range = 18–26, 62% female) and at least one of their parents (287 fathers and 317 mothers). Eighty-four percent of participants reported being European American, 6% Asian American, 4% African American, 3% Latino, and 4% reported being of other ethnicities. Data were analyzed using hierarchical cluster analysis, separately for mothers and fathers, and identified three similar clusters of parents which we labeled as uninvolved (low on all aspects of parenting), controlling-indulgent (high on both extremes of control and low on all aspects of responsiveness), and authoritative (high on responsiveness and low on control). A fourth cluster was identified for both mothers and fathers and was labeled as inconsistent for mothers (mothers were above the mean on both extremes of control and on responsiveness) and average for fathers (fathers were at the mean on all eight aspects of parenting). The discussion focuses on how each of these clusters effectively distinguished between child outcomes.     

Working with children as stakeholders in development: the challenges of organisational change

This article considers the challenges of promoting children's participation in development programming. It argues against the tendency to see the main obstacle to achieving this aim as technical. Instead it explores the institutional dimensions of change that may be required. The experience of a four-year process of training and organisational review within Save the Children Denmark provides the substance for reflection about the kinds of cultural and structural change that are implicated in enabling a development organisation to become capable of engaging young people as stakeholders in a meaningful and sustainable manner.     

Fatality involving complications of bupivacaine toxicity and hypersensitivity reaction

This case represents unusual findings of elevated bupivacaine and tryptase concentrations following local anesthetic, bupivacaine, administered as a scalene nerve block for elective rotator cuff repair surgery. Following bupivacaine injection, the patient exhibited almost immediate seizure activity, bradycardia, and cardiac arrest. Resuscitative efforts including cardiopulmonary bypass restored a cardiac rhythm. However, the clinical medical status of the patient progressively declined and he died 7 h following administration of the local anesthetic. Autopsy revealed several abnormalities of the heart including cardiomegaly, myocardial bridging, and lipomatous hypertrophy of the intraatrial septum, which may have contributed to bradycardia and arrhythmia. Postmortem toxicology results revealed elevated bupivacaine and tryptase concentrations. Elevated postmortem bupivacaine concentrations 7 h following administration and abrupt onset of seizures indicate unintentional intravascular injection instead of nerve and tissue infiltration. An elevated postmortem tryptase concentration points to the possibility of a hypersensitivity reaction to bupivacaine.     

Matching consequences to behavior: implications of failing to distinguish between noncompliance and nonresponsivity

Neither punitive nor therapeutic approaches alone are effective at addressing the dual public health and public safety concerns associated with managing criminal behavior perpetrated by people who have psychiatric and substance use disorders. The optimal solution may instead require the integration of both criminal justice supervision and treatment. Using problem-solving courts (PSCs) as a model, we focus on one dimension of this integrated approach, distinguishing between behavior that stems from willful noncompliance with supervision and behavior that results from nonresponsivity to treatment. First, we discuss the public health and public safety consequences of using singular approaches to address the criminal behavior of this population. We then present lessons learned from PSCs that distinguish between noncompliant and nonresponsive behaviors in making treatment and supervision decisions. Finally, we consider how the concepts of nonresponsivity and noncompliance may be extended, via policy, to probation and parole settings as well as mental health and substance abuse treatment services outside the criminal justice setting in order to enhance public health and safety.     

A supervisor like me: Race,representation, and the satisfaction and turnover decisions of public sector employees

Studies of race representation in public organizations illustrate the importance of bureaucrat race in determining client‐level outcomes. Building “upward” from this research, this study examines how supervisor race impacts outcomes for street‐level bureaucrats using data from a nationally representative sample of public schools. Employing multiple estimation methods, we find that, consistent with the predictions of representation theory, teachers report higher job satisfaction and turn over less often when supervised by an own‐race principal. We also find that race congruence impacts the tangible and intangible organizational benefits teachers receive, and, moreover, that race congruence impacts white and African American employees differently. Most troubling, we find evidence that black teachers earn substantially less in supplemental pay when they work for a white principal, even when compared to white teachers in the same school. © 2011 by the Association for Public Policy Analysis and Management.