Parent and Metabolite Opioid Drug Concentrations in Unintentional Deaths Involving Opioid and Benzodiazepine Combinations,,

Effects of benzodiazepines on postmortem opioid parent and parent/metabolite blood concentration ratios were determined for fentanyl‐, hydrocodone‐, methadone‐, or oxycodone‐related accidental deaths. These opioids are partially metabolized by the CYP3A4 enzyme system, which is also affected by diazepam and alprazolam. Opioid/metabolite combinations examined were as follows: fentanyl/norfentanyl, hydrocodone/dihydrocodeine, methadone/EDDP, and oxycodone/oxymorphone. Parent opioid concentrations were analyzed for 877 deaths. Parent/metabolite concentration ratios were analyzed for 349 deaths, excluding cases with co‐intoxicants present known to interfere with opioid elimination. Alprazolam in combination with diazepam significantly decreased median hydrocodone concentrations by 48% (p = 0.01) compared to hydrocodone alone. The methadone parent/metabolite concentration ratio was reduced by 35% in the presence of diazepam compared to methadone alone (p = 0.03). Benzodiazepines did not statistically significantly affect fentanyl or oxycodone concentrations. Possible factors affecting opioid concentrations and possible toxicity development, including any differential effects on specific opioids, should continue to be explored.     

Indignation or Resignation: The Implications of Transparency for Societal Accountability

International organizations, policy experts, and nongovernmental organizations promote greater governmental transparency as a crucial reform to enhance accountability and curb corruption. Transparency is predicted to deter corruption in part by expanding the possibilities for public or societal accountability, that is, for citizens and citizens associations to monitor, scrutinize, and act to hold public office holders to account. Although the societal accountability mechanism linking transparency and good government is often implied, it builds on a number of assumptions seldom examined empirically. This article unpacks the assumptions of principal‐agent theories of accountability and suggests that the logic of collective action can be used to understand why exposure of egregious and endemic corruption may instead demobilize the demos (i.e., resignation) rather than enhance accountability (i.e., indignation). We explore these theoretical contentions and examine how transparency affects three indicators of indignations versus resignation—institutional trust, political involvement, and political interest—given different levels of corruption. The empirical analyses confirm that an increase in transparency in highly corrupt countries tends to breed resignation rather than indignation.     

Negligence,Mens Rea,and What We Want the Element of Mens Rea to Provide

It is widely agreed that the top three Model Penal Code culpability levels suffice for criminal liability, but the fourth is controversial. And it isn̵     

Ethnicizing citizenship,questioning membership. Explaining the decreasing family migration rights of citizens in Europe

Citizenship does not equal belonging. In this paper, we investigate how the disjunction between the ‘imagined community’ and the formal citizenry impacts on citizens’ rights. In particular, we analyse decision-making on the family migration rights of citizens in France, Germany and the Netherlands. Our analysis shows that in these three countries, notwithstanding their different migration and citizenship regimes, the reduction of citizens’ family migration rights is based on the same discursive mechanism: the ‘membership’ of citizens of migrant origin who marry a partner from abroad is called into question. As they are excluded from membership of the imagined community, their entitlement to family migration rights is decreased. Ethnic conceptions of national community, intersecting with gender and class, play a crucial role in shaping the rights attached to citizenship in Europe today.     

Packaging Support for Low‐Income Families: Policy Variation across the United States

This paper addresses a gap in state‐level comparative social policy research by analyzing policies that support low‐income families with children. Variation in state policy “packages” is measured by considering three characteristics of 11 social programs. Individual measures of policy are found to be weakly and inconsistently inter‐correlated at the state level, but when cluster analysis is used to analyze multiple dimensions simultaneously, five clusters or regime types are identified that have distinctive policy approaches. These range from the most minimal provisions, to conservative approaches emphasizing private responsibility, to integrated approaches that combine generous direct assistance with employment support and policies that enforce family responsibility. A comparison of a subset of programs at two points in time (1994 and 1998) suggests that states made substantial changes in cash assistance and taxation policies after the 1996 federal welfare reforms. The magnitude and direction of these changes remained consistent with the state clusters identified in 1994. © 2001 by the Association for Public Policy Analysis and Management.     

On the front lines of welfare delivery: Are workers implementing policy reforms?

The impact of policy changes on the local delivery of services has been overlooked in several decades of largely unsuccessful efforts to “reform” welfare. This article uses one case of state-level welfare reform in the early 1990s to examine the implementation of policy changes in local welfare offices. Direct observation of transactions between welfare workers and clients suggests that policy reforms were not fully implemented by street-level bureaucrats. The instrumental transactions that continued to dominate interactions with clients were consistent with processing claims and rationing scarce resources, but they were poorly aligned with new policies aimed at changing the services and message delivered to welfare clients. The failure to fully implement reforms on the frontlines has implications for the achievement of policy objectives and for equity in service provision. Implementation issues will have even greater urgency as welfare is devolved from federal to state governments.     

Principal component analysis and analysis of variance on the effects of Entellan New on the Raman spectra of fibers

During the forensic examination of textile fibers, fibers are usually mounted on glass slides for visual inspection and identification under the microscope. One method that has the capability to accurately identify single textile fibers without subsequent demounting is Raman microspectroscopy. The effect of the mountant Entellan New on the Raman spectra of fibers was investigated to determine if it is suitable for fiber analysis. Raman spectra of synthetic fibers mounted in three different ways were collected and subjected to multivariate analysis. Principal component analysis score plots revealed that while spectra from different fiber classes formed distinct groups, fibers of the same class formed a single group regardless of the mounting method. The spectra of bare fibers and those mounted in Entellan New were found to be statistically indistinguishable by analysis of variance calculations. These results demonstrate that fibers mounted in Entellan New may be identified directly by Raman microspectroscopy without further sample preparation.     

Waiver of the psychotherapist-patient privilege: implications for child custody litigation

The psychotherapist-patient privilege, rooted in both common and statutory law, is predicated upon the public policy goal of protecting the reasonable expectation of privacy of individuals seeking psychotherapy. The privilege is not absolute, however. State and federal courts are far from uniform in determining how and when the privilege should be waived, in whole or in part, through implication, inadvertence or the affirmative action of the parties. In the family law context, the law that has evolved around the exercise of this privilege is even more complex as the needs of children add another wrinkle to the goal of balancing the imperative of confidentiality with the need for useful information that may be provided.