Hair analysis of opiates in mothers and newborns for evaluating opiate exposure during pregnancy

The increasing interest in toxicological hair analysis as a marker of human exposure to xenobiotics such as illicit substances or therapeutic drugs, has been made feasible by the extension of mass spectrometry, a highly sensitive method of detection. A newborn exposed to drugs in utero can suffer from a varying degree of withdrawal syndrome, a few days after birth. If of opiate origin, the withdrawal syndrome can be treated with morphine, among other therapeutics, but it is not easy to diagnose because of atypical symptoms presented by neonates and especially when maternal drug addiction has not been revealed. To assess and measure toxicological factors linked with the appearance and the severity of this syndrome, maternal and neonatal matrices such as urine, meconium and hair were collected during a protocol approved by the ethical committee. Opiates in particular were measured with GC-MS and potential combined dependences (cannabis, cocaine, amphetamine, LSD and benzodiazepines) and/or substitutive therapeutics (methadone or buprenorphine) were also assessed in 17 mother/neonate couples. Gestational opiate exposure profiles were drawn up and linked with the observed withdrawal syndromes. A withdrawal syndrome seems to appear more frequently after foetal exposure to an association of opiates/substitutive molecules (8 out of 10 withdrawal syndromes observed in this study), although the impact of cocaine and benzodiazepines must also be taken into account. The results obtained in neonatal hair make it possible to affirm foetal drug exposure and are in accordance, for the majority, with the appearance of a neonatal withdrawal syndrome (NWS). Neonatal hair analysis could contribute to assess in utero exposure to opiates, particularly when results in urine and meconium are negative or when these matrices are not available.     

Review: The physiology of saliva and transfer of drugs into saliva

Although saliva or oral fluid "lacks the drama of blood, the sincerity of sweat and the emotional appeal of tears", quoting Mandel in 1990 [I.D. Mandel, The diagnostic uses of saliva, J. Oral Pathol. Med. 19 (1990) 119-125], it is now meeting the demand for inexpensive, non-invasive and easy-to-use diagnostic aids for oral and systemic diseases, drug monitoring and detection of illicit use of drugs of abuse, including alcohol. As the salivary secretion is a reflex response controlled by both parasympathetic and sympathetic secretomotor nerves, it can be influenced by several stimuli. Moreover, patients taking medication which influences either the central nervous system or the peripheral nervous system, or medication which mimic the latter as a side effect, will have an altered salivary composition and salivary volume. Patients suffering from certain systemic diseases may present the same salivary alterations. The circadian rhythm determines both the volume of saliva that will and can be secreted and the salivary electrolyte concentrations. Dietary influences and the patient's age also have an impact on composition and volume of saliva. The latter implies a wide variation in composition both inter- and intra-individually. Sampling must therefore be performed under standardized conditions. The greatest advantage, when compared to blood sample collection, is that saliva is readily accessible and collectible. Consequently, it can be used in clinically difficult situations, such as in children, handicapped and anxious patients, where blood sampling could be a difficult act to perform.     

The ICTR Ten Years On: Back to the Nuremberg Paradigm?

Since his appointment in 2003, the Prosecutor of the InternationalCriminal Tribunal for Rwanda (ICTR) remains silent on the issueof prosecuting officials of the victorious Rwandan PatrioticFront (RPF). There is certainly no lack of credible reportsabout massive violations of human rights and international humanitarianlaw by the RPF both in Rwanda and in neighbouring countries,in 1994 and thereafter. The Prosecutor and the UN Security Council,despite lip service to the contrary, seem less than eager toconfront the government in Kigali. It is therefore to be fearedthat prosecutorial practice at the ICTR will follow the Nurembergparadigm. This one-sided policy may, however, have far-reachingconsequences.     

Identity Statuses Based on 4 Rather Than 2 Identity Dimensions: Extending and Refining Marcia's Paradigm

Four identity dimensions (Commitment Making, Identification with Commitment, Exploration in Depth, and Exploration in Breadth) were used to derive identity statuses by means of cluster analysis in a sample of late adolescents. This strategy resulted in both a qualitative refinement and a quantitative extension of Marcia's (1966) model. Five clusters were retained. Four of those (the Achievement, Moratorium, Foreclosure, and Diffused Diffusion Cluster) bore a striking resemblance to Marcia's original identity statuses in terms of their definition and their associations with criterion variables. Adolescents in the fifth cluster, the Carefree Diffusion Cluster (low to moderate on both commitment dimensions and low on both exploration dimensions), scored as high as the 2 high Commitment Making clusters (i.e., the Achievement and Foreclosure Cluster) on several indicators of adjustment. Personality characteristics further differentiated these clusters in accordance with theory. The advantages of expanding the identity status paradigm, through additional distinctions that pertain to both commitment and exploration, are discussed and practical implications are outlined. Doctoral Researcher for the Special Research Fund (B.O.F.)—Flanders (Belgium). Current research focuses on adolescent identity formation and development. Assistant Professor of Developmental Psychology, Catholic University Leuven, Belgium. Received PhD in developmental psychology from the Catholic University Leuven, Belgium, 1988. Current research interests include adolescent identity, autonomy, and loneliness. Doctoral Researcher for the Fund of Scientific Research (F.W.O.)—Flanders (Belgium) at the Catholic University Leuven, Belgium. Research interests include parent–adolescent relationships, identity processes, and acculturation orientations of ethnic minority members. Postdoctoral Researcher for the Fund of Scientific Research (F.W.O.)—Flanders (Belgium). Received PhD in developmental psychology from the Catholic University Leuven, Belgium, 2001. Current research focuses on adolescent autonomy, parenting and mediators of parenting effects on individuation and identity. Doctoral Researcher for the Fund of Scientific Research (F.W.O.)—Flanders (Belgium) at the Catholic University Leuven, Belgium. Research interests include motivational processes, self-determination theory, parent–adolescent relationships, and identity processes.     

Spatial Effects and Ecological Inference

This paper examines the role of spatial effects in ecologicalinference. Both formally and through simulation experiments,we consider the problems associated with ecological inferenceand cross-level inference methods in the presence of increasingdegrees of spatial autocorrelation. Past assessments of spatialautocorrelation in aggregate data analysis focused on unidimensional,one-directional processes that are not representative of thefull complexities caused by spatial autocorrelation. Our analysisis more complete and representative of true forms of spatialautocorrelation and pays particular attention to the specificationof spatial autocorrelation in models with random coefficientvariation. Our assessment focuses on the effects of this specificationon the bias and precision of parameter estimates.     

Exploring the formal and informal roles of regulatory intermediaries in transnational multistakeholder regulation

Research on regulation and regulatory processes has traditionally focused on two prominent roles: rulemaking and rule‐taking. Recently, the mediating role of third party actors, regulatory intermediaries, has started to be explored – notably in a dedicated special issue of the ANNALS of the American Academy of Political and Social Science. The present special issue extends this line of research by elaborating the distinction between formal and informal modes of regulatory intermediation, in the specific context of transnational multistakeholder regulation. In this introduction, we identify two key dimensions of intermediation (in)formalism: officialization and formalization. This allows us to develop a typology of intermediation in multistakeholder regulatory processes: formal, interpretive, alternative, and emergent. Leveraging examples from the papers in this special issue, we discuss how these four types of intermediation coexist and evolve over time. Finally, we elaborate on the implications of our typology for regulatory processes and outcomes.     

Do Canadian university students in Political Science and Public Administration learn to perform critical appraisal?

The ability to critically appraise empirical studies of any type is a prerequisite to evidence‐informed policy making. We scanned the syllabi of all Canadian university undergraduate and graduate programs in public affairs, public administration, public policy and political science. Our findings suggest that evidence‐informed policy is not yet institutionalized in most public administration and political science training curricula. We conducted a systematic review of prospective experimental and quasi‐experimental studies examining the effect of university courses aimed at training social sciences students in critical appraisal, but did not find such a study.