Fatal diphenhydramine intoxication in infants

Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.     

Politics and Literature: Means and Ends in Koestler

The fruitfulness of imaginative literature as source material for the student of politics has been a subject for much debate over recent years, though the impact of literature on the teaching of politics remains limited. This paper addresses by means of an example (that of the relationship between means and ends) some of the fundamental problems involved in the relationship and some of the advantages which imaginative literature might bring to our understanding of political issue and concepts. Following introductory comments about the relationship between politics and literature in general we consider the treatment of means and ends in political theory, especially Machiavelli's claim that when the 'act accuses, the result excuses'. Finally and substantively we consider the treatment of the means/end theme in Arthur Koestler's Darkness at Noon and The Gladiators and conclude with some general comments about the relationship between the study of politics and imaginative literature.     

The lost 1990s? Personal reflections on a history of participatory technology development

This article traces a history of agricultural participatory research, largely from the author's personal experience. Participatory research in the 1970s was mostly led by disciplinary scientists, and characterised by innovative activities and open academic debate, with some recognition that policy and development practice was a political process. The 1980s saw a shift to learning from past experience, and a participatory mainstream developed, seeking methods for scaling up. Meanwhile, others sought to understand and influence policy and institutional change in their political and cultural contexts, and to keep open the academic debates. The author considers the 1990s as ‘lost years’, during which mainstream participatory practitioners became inward-looking development generalists, not so interested in learning from others outside their paradigm. The late 2000s provide a chance to re-recognise the political and cultural embeddedness of science and technology; re-introduce strong, widely based disciplines; and learn from past activities that resulted in positive development outcomes (planned or unplanned).     

Implicit theories of criminal responsibility

Three questions relevant to insanity decisions were examined: (a) What informational cues are weighed most heavily in the attribution of criminal responsibility? (b) How do verdict forms influence these attributions? And (c) How do individuals' beliefs about insanity and responsibility influence decision making? Undergraduate subjects (n=181) responded to vignettes portraying an act by a mentally disordered defendant. Psychiatric jargon was avoided, so that attributions were not a function of diagnostic terminology. It was found that, under the traditional scheme of not guilty by reason of insanity (NGRI) vs. guilty, level of mental disorder (schizophrenia vs. personality disorder) was the primary determinant of insanity decisions. Also, insanity judgments were more likely to be made for acts performed without planful intentionality. Under the alternative scheme of NGRI vs. guilty but mentally ill (GBMI) vs. guilty, mental disorder still controlled NGRI verdicts; a bizarre act increased the likelihood of a GBMI over a guilty verdict; and the GBMI verdict option reduced markedly the proportion of psychotic defendants found NGRI and the proportion of personality disordered defendants found guilty. There were no significant differences between diagnostic groups in the likelihood of being found GBMI. Most subjects preferred to utilize the GBMI option as a compromise verdict even in the face of very severe mental illness. Attitudinal data revealed considerable variation in agreement with the classic moral logic of the insanity defense and accounted for a significant amount of the variance in insanity decisions. The implications for both social policy and future research are discussed.     

这纠缠不清的网

＂哦,当我们第一次编谎话,我们织了怎样一张纠缠不清的网呀!＂这句话摘选自沃尔特·斯各特爵士1808年出版的史诗《玛米恩》。