Sudden unexpected death in epilepsy: neuropathologic findings

Sudden unexpected death in epilepsy refers to sudden death of an individual with a clinical history of epilepsy, in whom a postmortem examination fails to uncover a gross anatomic, toxicologic, or environmental cause of death. Evidence of terminal seizure activity may not be present. One to two percent of natural deaths certified by the medicolegal death investigator are attributed to epilepsy. Detailed microscopic examination of the brain has increasingly afforded the identification of structural changes representative of epileptogenic foci. The authors present 70 cases of death attributed to sudden unexpected death in epilepsy. These cases were classified as follows: individuals who lacked a gross brain lesion, those who had a brain lesion demonstrable at autopsy, and those who lacked neuropathologic evaluation because of decomposition or because only an external examination was done. All of the subjects had a clinical history of seizures. The authors confirm that various microscopic findings, including neuronal clusters, increased perivascular oligodendroglia, gliosis, cystic gliotic lesions, decreased myelin, cerebellar Bergmann's gliosis, and folial atrophy, are present in a higher percentage of the brains of sudden unexpected death in epilepsy subjects than in the brains of age- and sex-matched control subjects.     

Preferential Selection Independent of Race and Gender: Effects on Self-Evaluations and Newcomer Information-Seeking Behaviors

The current study investigated the effects of an experimentally imposed program of preferential selection on beneficiary self-evaluations and newcomer information-seeking behavior. One hundred-twenty undergraduates were randomly assigned to a classification condition (in which they were informed that they tended to think in either an analytical or abstract manner) and collaborated on a task in groups of three. A fourth participant was introduced into each of these 40 extant groups under either a condition of preferential selection or not. Preferentially selected newcomers were shown to have more positive self-evaluations than their nonpreferentially selected counterparts. The presence or absence of a similar (in terms of thinking style) incumbent moderated the effect of being preferentially selected on the use of specific information-seeking behaviors.     

Comparison of GC-MS and EIA results for the analysis of methadone in oral fluid

The purpose of these studies was to evaluate the performance characteristics of the Cozart Microplate Enzyme Immunoassay (EIA) for the determination of methadone in oral fluid from patients in a drug misuse treatment program. Oral fluid specimens were collected using the Cozart RapiScan Collection system from 198 donors who were receiving treatment for their addiction and were monitored for drug misuse. Oral fluid specimens were also collected from forty volunteer donors who were not drug users. The specimens were analyzed in the laboratory by EIA and then analysed for methadone and its main metabolite EDDP by gas chromatography-mass spectrometry (GC-MS). A total of 103 samples were confirmed positive for methadone. The Cozart Microplate EIA for d-Methadone in oral fluid using a cutoff of 30 ng/mL in diluted oral fluid had a sensitivity of 91.3% +/- 2.8% and a specificity of 100% +/- 1.0% vs. GC-MS.     

One hundred seventy two deaths involving the use of oxycodone in Palm Beach County

Oxycodone is a potent semi-synthetic narcotic prescribed for the management of pain. Previous investigators have reported that the abuse of oxycodone is most frequently seen in conjunction with the abuse of other drugs, although fatalities have been reported with oxycodone alone. We undertook a retrospective review of cases investigated by the Palm Beach County Medical Examiner's Office in which postmortem toxicologic studies indicated the presence of oxycodone. A total of 172 consecutive cases were studied, including 18 in which death was attributed to oxycodone toxicity, 117 to combined drug toxicity, 23 to trauma, 9 to natural causes and 5 to another drug or drugs. The postmortem blood concentrations of oxycodone overlapped among the groups. The mean blood oxycodone concentration among the cases of oxycodone toxicity was 0.69 mg/L, combined drug toxicity 0.72 mg/L and trauma 0.62 mg/L. Concentrations were lower in cases of deaths attributed to natural causes and to another drug or drugs (mean each 0.087 mg/L). Benzodiazepines, detected in 96 cases, were the most common co-intoxicants in the cases of combined drug toxicity, followed by cocaine, which was found in 41. The most frequently encountered benzodiazepine was alprazolam. This study confirms that deaths in which oxycodone is a factor are most commonly cases of combined drug toxicity. The high incidence of alprazolam as a co-intoxicant has not been previously recognized.     

Collective Security and a New World Order: Justifying Australia's Participation in the Persian Gulf Crisis, 1990-91

In response to Iraq's invasion of Kuwait on 2 August 1990, Australia's Labor government committed a naval task force to participate in the enforcement of sanctions, and subsequently, the Gulf War to expel Iraq from Kuwait. The Australian government justified its response to the Persian Gulf crisis in various ways, including the threat it posed to national and international security, and by employing representations of Australian identity and the radical Otherness of Saddam Hussein. The paper considers these aspects, then focuses on two ostensibly complementary justifications. Firstly, the rapid commitment was represented as a necessary act of collective security connected to revitalisation of the United Nations. Secondly, it was justified as contributing to the development of a post-Cold War new world order (NWO), framed within Australian regional security interests and shaped by the US alliance. The paper argues that the Australian discourse melds the justifications, despite collective security, based on UN leadership, sitting uneasily with a NWO premised on US leadership, without having to attend to the tensions between the two justifications.     

Designing a graduate entry route for police recruits: lessons from a rapid evidence assessment of other professions

ABSTRACT

Policing in the UK is currently undergoing changes to the training and attained qualifications of entry level police officers. The College of Policing is in the process of developing three entry routes into the profession, one of which is a graduate conversion course for those new recruits who hold, at a minimum, a Bachelor’s degree. The objective of this research was to gather evidence on existing conversion courses to inform the development of this route. A rapid evidence assessment was undertaken to a narrative synthesis of the literature on graduate conversion courses in other professions. Fifty-one studies were identified and coded. Four main themes emerged from the available evidence as being central. These themes – learning styles, translating theory into practice, teaching methods and assessment were cross cut by pedagogical sub-themes of collaborative learning, and reflective practice. Policy and practice implications for a policing conversion course are drawn out to guide development and delivery of police training and education in the 21^st century.