Exposure to community violence and daily feeling states among urban African American youth

This longitudinal study examined the relationships between exposure to community violence and daily feeling states among 175 6th- through 8th-grade African American students. The relationships were tested both cross-sectionally and longitudinally over the 3-year span. Four daily feeling state subscales: contented, hostile, anxious, and dysphoric were developed from a factor analysis of the 30 Experience Sampling Method (ESM) feeling states. Cross-sectionally, regression analyses indicated that exposure to violence individually predicted most feeling states and more variability in most feeling states in 7th and 8th grades. When feeling states were entered into regressions together, fewer predicted violence exposure. Longitudinally, regression analyses revealed that more variability in dysphoric feelings in 6th grade predicted exposure to violence in 7th grade, while 6th-grade hostile and anxious feelings predicted 8th-grade exposure change. Longitudinal analyses did not indicate that exposure to community violence predicted later daily feeling states. Preventive and intervention implications are addressed.     

A survey of extraction techniques for drugs of abuse in urine

Sixty nine participants in the United Kingdom national external quality assessment scheme for drugs of abuse in urine reported details of their sample extraction technique by questionnaire. Laboratories were categorised by differences in technique and their analytical test results compared for samples containing D-amfetamine 0.4 (4) and 0.8 (3) mg/l, morphine 0.4 (4) and 0.8 (4)mg/l, and benzoylecgonine 0.15/0.2 (2) and 0.45/0.5 (4) mg/l. Values in parentheses are numbers of samples. For amfetamine, there was no significant difference in the frequency of true positive results between liquid-liquid or solid phase extraction and the Toxi-Lab A system at 0.8 mg/l. Toxi-Lab A gave significantly fewer positives when operating below its specified threshold at 0.4 mg/l. Paradoxically, laboratories using >5 ml urine volume performed less well. Acidification of the extract before volume reduction gave significantly more true positives. For extraction of morphine, solid phase systems significantly outperformed both liquid-liquid and the Toxi-Lab A system at both 0.8 and 0.4 mg/l. No significant differences between extraction techniques were demonstrated for analysis of benzoylecgonine.     

Suicide by intravenous injection of cocaine. A report of three cases

Death as a consequence of cocaine abuse is continuing to increase in all parts of the United States. Cocaine use may cause the development of psychosis, with subsequent expression of suicidal ideations, and potentially even successful suicide. Cocaine dependence may also cause depression in the individual who is unable to control his or her craving for the drug, and suicide may be perceived as the only solution to a desperate problem. Despite the dramatic escalation of cocaine abuse and the potential toxicity of this drug, there have been no reports within the United States of cocaine being used as the agent to accomplish a suicide. Herewith are reported three cases in which depression and desperation over cocaine dependence were the motivations for successful suicide, which was accomplished through the intravenous injection of cocaine to the point of death. True cocaine suicide is probably only identified through the presence of objective scene information that unequivocally proves suicidal intent, such as notes or letters which contain information to this effect. A careful search of the scene of death in cocaine fatalities is mandatory, and diligent application of routine scene investigation principles may reveal that suicide through the use of cocaine is more widespread than first appearances would suggest.     

The biohazard potential of cyanide poisoning during postmortem examination

A case of suicide by ingestion of cyanide salts provided an opportunity to determine whether personnel involved in postmortem examination of such cases are exposed to any significant degree of biohazard from cyanide remaining in body cavities or tissues of the decedent or both. It was found that potentially toxic concentrations of cyanide can develop in personnel so exposed. These findings have implications not only for the safety of pathologists and pathology assistants, but also for first responders (for example, police, firemen, emergency medical technicians [EMTs], paramedics, R.N.s) and emergency room personnel who may be involved in resuscitation efforts or removal of gastric contents or both in cyanide poisoning victims. Symptoms of cyanide toxicity and recommendations for reducing the potential for clinically significant cyanide exposure in medical settings are briefly reviewed.     

Ultrastructural and immunofluorescent detection of herpes simplex virus after embalming and burial

The practice of embalming preserves body tissues, and embalmed bodies may resist decay processes for many decades with relatively little change. As the chemicals used for embalming are poisonous to microorganisms, bacterial and viral cultures are futile after such funerary procedures are performed. However, embalming may act as a virtual tissue fixative, especially with arterial perfusion, and identification methods other than culture may be used to detect and identify pathogenic organisms. In the case presented here, a death from a fulminating, but unidentified, illness in a young girl was successfully diagnosed as herpes hepatitis by immunofluorescent and electron-microscopic studies of tissue obtained 3 weeks after she was embalmed and interred. Routine embalming and burial should not eliminate these diagnostic procedures from consideration in specific situations where potentially useful information may be realized.     

A shared leadership model for human services program management

This article discusses the evolution of the Minnesota Parents’ Fair Share (MNPFS) program and to identify factors that have enabled the development of innovative practice in the delivery of a government sponsored human service program. The development and success of the MNPFS program is the result of utilizing contemporary models of shared leadership and enterprise management with committed frontline leadership from a variety of human service organizations. The MNPFS program is delivered and managed by frontline staff and leadership is shared by three Minnesota counties (Anoka, Dakota, and Ramsey) by staff from the courts, child support enforcement, income maintenance, and employment and training programs. Program services are targeted to unemployed or underemployed noncustodial parents whose children are on public assistance. The program is based on the assumption that children benefit when both parents contribute significantly to their children's economic and emotional needs.     

The Impact of SWAps on Health Aid Displacement of Domestic Health Expenditure

Recent research suggests that an additional $1 of health aid would displace – or crowd out – nearly the same amount in a recipient government’s own health expenditure. Implementing a Sector Wide Approach (SWAp) may exacerbate crowding out because recipient governments should face fewer constraints when allocating health aid. This paper uses rigorous panel data methods to investigate this hypothesised effect of SWAps. We find that SWAps provide not an exacerbating but a potentially protective effect, reducing displacement of government health expenditure. This suggests some aid dollars are more fungible than others, and the mechanism for aid delivery makes a difference.     

Cocaine babies: the scourge of the '90s

Six cases of cocaine-related deaths of infants have covered the spectrum of potentially devastating effects. They include an intrauterine death of a 35-week-old fetus following acute maternal cocaine abuse; anoxic encephalopathy at birth with 3 months' vegetative survival from a similar episode; traumatic compression asphyxia in a 4-month-old; infectious cardiomyopathy with heart failure in a twin at age 21 months following maternal cocaine abuse at birth; malnutrition and dehydration in a 7-week-old during continuing cocaine abuse by the parents; and a teenage sibling's cocaine lacing of a baby milk bottle ingested by his 6-week-old brother. All the cases had positive toxicological screening for cocaine or metabolites or both in the mother at delivery or in the infant at birth, or both. There were no instances of sudden infant death syndrome (SIDS, or "crib death"). Pathologic and toxicologic, as well as birth, developmental, and social data are presented. An integrated medical, public health, law enforcement, and educational policy to prevent or at least ameliorate these tragic cases, now approaching epidemic proportions, has yet to be developed. A careful obstetrical history and examination of the mother, indication on the birth certificate of maternal drug abuse, and notification of health authorities (by birth certificate checking, among other ways) may send an early warning message to providers for intercession. Active ingestion/injection and passive inhalation by older children and teenagers require more intensive monitoring and aggressive interaction by pediatricians, social workers, school authorities, and employers.(ABSTRACT TRUNCATED AT 250 WORDS)