Association of Contextual Factors with Drug Use and Binge Drinking among White, Native American, and Mixed-Race Adolescents in the General Population

Large-scale surveys have shown elevated risk for many indicators of substance abuse among Native American and Mixed-Race adolescents compared to other minority groups in the United States. This study examined underlying contextual factors associated with substance abuse among a nationally representative sample of White, Native American, and Mixed-Race adolescents 12–17?years of age, using combined datasets from the National Survey on Drug Use and Health (NSDUH 2006–2009, N?=?46,675, 48.77?% female). Native American adolescents displayed the highest rate of past-month binge drinking and past-year illicit drug use (14.06 and 30.91?%, respectively). Results of a logistic regression that included seven predictors of social bonding, individual views of substance use, and delinquent peer affiliations showed that friendships with delinquent peers and negative views of substance use were associated significantly with both substance abuse outcomes among White and Mixed-Race adolescents and, to a lesser extent, Native American adolescents. The association of parental disapproval with binge drinking was stronger for White than for Native American adolescents. Greater attention to specific measures reflecting racial groups’ contextual and historical differences may be needed to delineate mechanisms that discourage substance abuse among at-risk minority adolescent populations.     

Beyond government? The appeal of public‐private partnerships

Abstract: For the most part, the considerable literature devoted to new public management and its subset, alternative service delivery, is enthusiastic about this dramatic shift in the role of government. The metaphor of governments steering and the private sector rowing is an appealing one that has captured the imagination of many public officials and private‐sector actors. Literature addressing this phenomenon tends to focus on defining the characteristics of various forms of government/private‐sector partnerships rather than on assessing the implications and results of actual examples. This paper attempts to complement the existing literature by examining six cases of public‐private partnerships, of both high and low profile ‐ the Confederation Bridge; the Charleswood Bridge; canarie ; rcmp /Disney; Highway 407; and Chrysler/University of Windsor. The higher profile (and more costly) ventures have placed heavy emphasis on confidentiality, which raises concerns about traditional public‐sector values such as accountability, democracy and neutrality. The conclusions of the article are mixed, but at the very least, they suggest the need for caution, vigilance and scepticism. Sommaire: Pour la plupart, c'est avec beaucoup d'enthousiasme que les nombreaux auteurs d'ouvrages sur la Nouvelle gestion publique et sur son sous‐élément, la Prestation de services de rechange, envisagent cette modification fondamentale du rôle des gouvernements. Le gouvernement au gouvernail et le secteur privé aux avirons, voilà une métaphore qui a fait de nombreux adeptes parmi les hauts fonctionnaires comme chez les intervenants du secteur privé. Plutôt que d'évaluer les répercussions et les résultats d'exemples réels, les ouvrages sur ce sujet ont tendance à focaliser sur la définition des caractéristiques de divers types de partenariats entre le gouvernement et le secteur privé. Dans cet article, nous visons à complémenter ces ouvrages en analysant six partenariats public‐privé entrepris par divers paliers de gouvernement au cours des années 1990. La gamme des cas choisis est assez hétéroclite, certains étant très connus, d'autres moins: les ponts Confédération et Charleswood, CANARIE, GRC/Disney, l'Autoroute 407 et Chrysler/Université de Windsor. Les projets plus connus (et plus coûteux) ont fortement souligné leur caractère confidentiel, ce qui a mis en cause les valeurs traditionnelles du secteur public, telles l'imputabilité, la démocratic et la neutralité. Selon les conclusions de l'article, qui sont variées, il conviendrait pour le moins de procéder avec prudence, vigilance et scepticisme.     

The implications for trustees of the possible EU Savings Directive reforms

The EU is considering making the Savings Directive more effective.One measure could be redefining trustees for the purpose ofthe Savings Directive and adopting the definition used in theThird Eu Money Laundering Directive.     

Political business cycles and macroeconomic credibility: a survey

There is clear evidence that government popularity and election performance is affected, in part, by economic performance, suggesting that governments may manipulate the economy to political advantage. Simple models incorporating adaptive expectations which allowed the government to exploit this relationship were developed in the 1970s, but fell out of fashion with the advent of new-classical economics. However, modern theories of the political business cycle, which are closely related to the macroeconomic policy game literature, assume rational expectations, and lead to forms of political business cycle, driven by the existence of uncertainty of one type or another. The international evidence suggests that some aspects of the theories apply, although definitive conclusions are – as we might expect – hard to come by.     

Fatal intoxication with 1,4-butanediol: Case report and comprehensive review of the literature

A fatal case of 1,4-butanediol (1,4-BD) oral ingestion is reported here, in which a 51-year-old man was found dead in his bed. According to the police report, the deceased was a known drug user. A glass bottle labeled (and later confirmed to be) “Butandiol 1,4” (1,4-BD) was found in the kitchen. Furthermore, the deceased's friend stated that he consumed 1,4-BD on a regular basis. The autopsy and histological examination of postmortem parenchymatous organ specimens did not revealed a clear cause of death. Chemical-toxicological investigations revealed gammahydroxybutyrat (GHB) in body fluids and tissues in the following quantities: femoral blood 390 mg/L, heart blood 420 mg/L, cerebrospinal fluid 420 mg/L, vitreous humor 640 mg/L, urine 1600 mg/L, and head hair 26.7 ng/mg. In addition, 1,4-BD was qualitatively detected in the head hair, urine, stomach contents, and the bottle. No other substances, including alcohol, were detected at pharmacologically relevant concentrations. 1,4-BD is known as precursor substance that is converted in vivo into GHB. In the synoptic assessment of toxicological findings, the police investigations and having excluded other causes of death, a lethal GHB-intoxication following ingestion of 1,4-BD, can be assumed in this case. Fatal intoxications with 1,4-BD have seldom been reported due to a very rapid conversion to GHB and, among other things, non-specific symptoms after ingestion. This case report aims to give an overview to the published of fatal 1,4-BD-intoxications and to discuss the problems associated with detection of 1,4-BD in (postmortem) specimens.     

The effects of the (fentanyl-fueled) drug overdose epidemic on medicolegal death investigation in the United States

The evolving opioid epidemic in the United States, fueled by illicit fentanyl, has greatly increased deaths from illicit drug use. These nonnatural deaths require formal death investigation. The National Association of Medical Examiners states in its Forensic Autopsy Performance Standards that autopsy remains a necessary component for proper investigation of suspected acute overdose deaths. If a death investigation office lacks adequate resources to investigate all deaths under its jurisdiction while meeting expected standards, then that office may be forced to consider altering its protocols for investigation by changing the types of deaths investigated or the extent of its investigations. Drug death investigations take longer to complete because novel illicit drugs and mixtures of drugs complicate toxicological analyses, prolonging a family's wait for completion of a death certificate and autopsy report. Public health agencies must also wait for results, but some agencies have developed mechanisms for rapid notification of preliminary results to allow timely deployment of public health resources. The increased deaths have strained the resources of medicolegal death investigation systems throughout the United States. Given the significant workforce shortage of forensic pathologists, newly trained forensic pathologists are too few to meet the demand. Nevertheless, forensic pathologists (and all pathologists) must make time to present their work and themselves to medical students and pathology trainees to encourage an understanding of the importance of quality medicolegal death investigation and autopsy pathology and to provide a model that can encourage interest in a career in forensic pathology.     

Development and validation of a LC–MS/MS method for analysis of vortioxetine in postmortem specimens. First data from an authentic case

Vortioxetine is an antidepressant recently licensed in USA and EU for the treatment of major depressive disorder. Neither fatal case due to overdose nor data about postmortem concentrations on blood or other specimens have been reported. The aims of this study were the development and validation of a method for vortioxetine analysis by Liquid Chromatography Tandem Mass Spectrometry (LC–MS/MS) in postmortem samples and its application in an authentic case. The method was validated and applied on blood, vitreous humor, bile, brain, liver, kidney, and gastric content. After protein precipitation, the supernatant was directly injected into LC–MS/MS. Analysis was carried out by Multiple Reaction Monitoring (MRM) mode. The authentic case concerned a 38 years-old woman, affected by depression, who was found hanged at home. The method determined an acceptable sensitivity, selectivity, linearity, precision, and accuracy for all matrices. No interference was shown for all matrices. The matrices do not significantly reduce the peak intensity of vortioxetine. No carryover was shown. Toxicological analysis of the authentic case showed vortioxetine in blood (234 ng/ml), vitreous humor (10.5 ng/ml), brain (490 ng/g), lung (479 ng/g), liver (3751 ng/g), kidney (798 ng/g), bile (2267 ng/ml) and gastric content (253 ng/ml). Our case suggests that even at blood concentrations of vortioxetine equal to 234 ng/ml, the subject was able to stage and carry out the hanging. Vortioxetine concentrations found in the other cadaveric samples (biological fluids, organs, and gastric content) may be helpful to evaluate further similar comparable cases.     

Death by compaction in a robotic dumpster

Robotic waste management automation systems are increasingly utilized around the globe as a user-friendly, ecological and hygienic alternative to waste disposal, simultaneously reducing the volume and frequency of waste collection. The present paper aims to report a case of death by compaction in an automated robotic waste management system and review relevant literature on compactor-related fatalities. The unusual fatal accident involved a 37-year-old male citizen who deliberately entered the robotic dumpster to retrieve his accidentally discarded medication. Upon entering the robotic chamber, the compaction system was automatically activated, although all safety measures were in full operation. This paper highlights the lack of standardized reporting on compactor-related mortality, which however is of importance both in terms of its social impact and public safety. These deaths occur rarely, in scattered areas of the globe, associated with various situations (e.g., occupational fatalities, homeless people, infanticide) and trash compactors of different types, technology, age, maintenance quality, warning signage and safety interlocks. In all previously reported fatalities, the technology involved was considerably older (as in conventional waste containers, garbage compaction trucks, chute-fed compactors in buildings, etc.). The case described in the present report is a rare event in both literature and international news coverage as it encompasses a fully automated technology intended for unsupervised, direct use by the public being located in public spaces where all citizens can interact with it. The aim of this report is to raise awareness and improve knowledge about safety parameters so that similar incidents can be avoided in the future.