Overcoming the Barriers to Cooperation: Intergovernmental Service Agreements

Interlocal cooperation through service‐sharing agreements has a long history, but its use has increased in popularity during the last 20 years. The decisions of local government units to collaborate through intergovernmental service agreements are best understood as a two‐stage process. The first stage, in which communities decide whether to consider interlocal cooperation, involves the nature of the immediate problem faced plus specific demands for performance and efficiency gains that can result from service cooperation. In the second stage, communities confront a question of institutional supply, and hence must overcome inherent bargaining and collective action issues in order to forge interlocal agreements. Heckman probit estimates of such complex relationships using data drawn from a 2003 ICMA survey suggest strong support for this model. The authors conclude by discussing the role of network relationships among local actors for reducing transaction costs and facilitating intergovernmental collaboration.     

The psychiatric power of neo-liberal citizenship: the North Korean human rights crisis,North Korean settlers,and incompetent citizens

This essay discusses how North Korean settlers in South Korea are engaged in the rubric of neo-liberal citizenship to program the idea of an enterprise of free and autonomous selves. I call into question the psychiatric intervention in the North Korean population deprived of psychological capacities to be autonomous and responsible for their social life. My argument is that the psychiatric diagnosis of strange mental properties presents the criteria of successful assimilation as an antidote to the psychological oppression that North Korean settlers must have experienced, encouraging the South Korean public to tolerate the social deviance of these settlers.     

Intentional overdose of glargine insulin: Determination of the parent compound in postmortem blood by LC-HRMS

Insulin glargine is a long-acting insulin analog that is converted after enzymatic cleavage of the arginine pair of the β-chain into its main metabolite M1 (21^A-Gly-insulin), which is responsible for the hypoglycemic activity. In all the overdose cases described in the literature, only M1 concentrations have been reported, whereas insulin glargine was always absent or below the limit of quantitation. In this study, we present a case of suicide of a young nurse by injection of insulin glargine in which the parent molecule was found at a toxic concentration in blood. The determination and the discrimination of insulin glargine from human insulin and other synthetic analogs in the blood specimen were performed by liquid chromatography coupled to high-resolution mass spectrometry (Waters XEVO G2-XS QToF) and extraction after precipitation in the presence of bovine insulin (internal standard), with a mixture of acetonitrile/methanol +1% formic acid followed by purification on solid phase extraction cartridges C18. Glargine insulin tested highly positive in the blood with a concentration of 1.06 mg/L. Due to the difficulty in obtaining a M1 pure standard, the metabolite could not be dosed. This unique presence of the parent molecule, reported for the first time, can be explained by inter-individual variability in the rate of conversion to metabolite. Intravenous injection versus subcutaneous injection can also explain the presence of insulin glargine. Finally, the dose injected may have been so high that saturation of the proteolytic enzymes responsible for conversion to M1 should have occurred.     

Barriers to information sharing in state agencies: the case of the texas general land office

This paper explores barriers to information sharing and how they might be overcome. Through a case study of the Texas General Land Office, computer-based information sharing is explored in the organizational setting. In particular, the State Real Property Inventory information system is examined in terms of utilization of hardware, software, and local area networks. In addition, managerial and user attitudes towards computer use are explored. We find a number of technological and organizational factors that need to be addressed in order to improve computer- based information sharing. These technological and organizational barriers combine to create an inefficient environment for adoption and use. Finally, we suggest some improvements on how management and users can utilize information sharing technologies in more effective ways in the context of structural integration of information technology.     

Increased lung weight in fatal intoxications is not unique to opioid drugs

Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a single substance, we created models of combined lung weight and brain weight. The models used age and sex as predictors as well as nested varying effects for the specific intoxicant and category of intoxicant. Suicidal hanging with negative toxicology cases served as controls. The population majority was male among both intoxications (68%) and controls (83%). The most common single substance group was opioids. All tested substances were associated with heavier lungs than controls, with the largest effect in the opioid group. Our findings show that several substances are associated with increased lung weight and that among intoxication deaths there is no difference in expected brain weight between substances. Hence, heavy lungs, without a reasonable explanation, should prompt a broad toxicological screening.     

Suicide of an adolescent girl with sodium nitrite ordered on the internet

Nitrites are commonly used in the chemical, pharmaceutical, and food industries. Recently, they have been identified in cases of voluntary intoxication. We report the case of a 13-year-old girl who was found lifeless on her bed next to a glass containing a white powder and a bottle containing a white powder with a moistened appearance. External examination and autopsy revealed a nonspecific asphyxia syndrome, which was confirmed by the pathological analysis. Analysis of the samples revealed metoclopramide in the peripheral blood at a concentration of 0.402 mg/L (LC–HRMS). An analysis of the gastric contents was carried out after sodium nitrite was detected in the powders found near the body (Raman spectrometry). Nitrites were found in the gastric fluid at a concentration of 30.9 mg/L. Death occurred secondary to anoxia, following ingestion of nitrites; suicide kits are available on the web and nitrites are relatively easy to source and inexpensive. Nitrites are delivered in powder form to be dissolved in liquid, which may then be consumed with metoclopramide (or an alternative anti-emetic drug) to maximize absorption and reduce emesis. The toxic effect of nitrites lies in their oxidizing power, causing the transformation of hemoglobin into methemoglobin, which, when it accumulates, induces tissue anoxia resulting in death. There has been an alarming increase in the number of cases linked to suicide using nitrites or a nitrite suicide kit. The fact that nitrites are readily available online underscores the importance of establishing effective preventive measures such as limiting the access and use of this chemical.     

A retrospective analysis of cardiovascular deaths: A 5-year autopsy study of 1045 cases in Antalya,Turkey

This study aims to identify the macroscopic and microscopic changes that occur in the heart in different causes of cardiovascular death and sudden cardiac death in autopsy cases and evaluate the difficulties that a forensic practitioner may encounter during autopsies. All forensic autopsy cases in the Morgue Department of the Council of Forensic Medicine, Antalya Group Administration between January 1, 2015, and December 31, 2019, were examined, retrospectively. The cases were chosen according to inclusion and exclusion criteria, and their autopsy reports were examined in detail. It was determined that 1045 cases met the study criteria, 735 of which were also met the sudden cardiac death criteria. The top three common causes of death were ischemic heart disease (n = 719, 68.8%), left ventricular hypertrophy (n = 105, 10%), and aortic dissection (n = 58, 5.5%). The frequency of myocardial interstitial fibrosis was significantly higher in deaths due to left ventricular hypertrophy than in deaths due to ischemic heart disease and other causes (χ²(2) = 33.365, p < 0.001). Despite detailed autopsy and histopathological examinations, some heart diseases that cause sudden death may still not be detected.     

Coproduction of Government Services and the New Information Technology: Investigating the Distributional Biases

This article investigates how communications advances affect citizens’ ability to participate in coproduction of government services. The authors analyze service requests made to the City of Boston during a one‐year period from 2010 to 2011 and, using geospatial analysis and negative binomial regression, investigate possible disparities by race, education, and income in making service requests. The findings reveal little concern that 311 systems (nonemergency call centers) may benefit one racial group over another; however, there is some indication that Hispanics may use these systems less as requests move from call centers to the Internet and smartphones. Consistent with prior research, the findings show that poorer neighborhoods are less likely to take advantage of 311 service, with the notable exception of smartphone utilization. The implications for citizen participation in coproduction and bridging the digital divide are discussed.