Concentrations of Opiates and Psychotropic Agents in Polydrug Overdoses: A Surprising Correlation Between Morphine and Antidepressants

Abstract: The relationship between postmortem concentrations of morphine and co‐detected psychoactive drugs in fatal overdoses is examined. Morphine and other drugs were detected in 161 medicolegal autopsy cases. Subsets of these morphine‐positive cases based on drug class were established, including opioids, antidepressants, ethanol, benzodiazepines, and “other.” Each subset was split into high or low concentration groups based on median drug concentrations. Morphine concentrations of the [high] and [low] groups were compared, with no significant difference in morphine concentration identified in the opioid, ethanol, or benzodiazepine subsets. The “other” drug class was too heterogeneous for statistical assessment. Morphine concentrations did show a significant direct relationship (p = 0.01) with antidepressants, namely increased concentrations of antidepressant drugs are associated with an increased concentration of morphine. This trend probably remains even after excluding cocaine‐positive cases. The unsuspected finding that postmortem concentrations of antidepressants positively correlate with morphine levels may be important in the treatment of depression in drug addicts.     

Sudden Death After Myocardial Infarction in a High‐School Athlete

Abstract: This is an unusual case of ischemic heart disease occurring in a young female athlete, aged 14 years, in whom almost the entire posterior wall of the left ventricle was affected. The patient collapsed and died suddenly after a vigorous physical activity while resting at home. The ischemic lesion was apparently owing to right orifice stenosis in association with a small hypoplastic right coronary artery.     

Sense-making and secondary victimization among unsolved homicide co-victims

Sense-making is a form of meaning-making that focuses on understanding loss which then contributes to identity reconstruction. This qualitative study examines how perceived communication with the criminal justice system can inhibit sense-making among unsolved homicide co-victims. One-time intensive interviews were conducted with 37 co-victims about their interactions with police and prosecutors. A grounded theory approach suggest that co-victims held negative views of the police and prosecutors because they perceived them as inhibiting their ability to adequately locate information needed to understand the crime and achieve justice. Results also suggest that race and ethnicity play a role in reducing sense-making because constructions of meaning were based on perceptions of discrimination. In the end, the intense desire for information, resolution, and justice led several co-victims to investigate their loved one's murder. Policies that law enforcement should adopt to promote better communication with co-victims and facilitate sense-making are examined.     

The Stress Response and Adolescents’ Adjustment: The Impact of Child Maltreatment

Experience with and management of stress has implications for adolescents' behavioral and socioemotional development. This study examined the relationship between adolescents' physiological response to an acute laboratory stressor (i.e., Trier Social Stress Test; TSST) and anger regulation and interpersonal competence in a sample of 175 low-income urban adolescents (51.8% girls). Findings suggested that heightened reactivity as indicated by cortisol, heart rate, and blood pressure was associated with increased interpersonal competence and anger regulation. However, these findings were context dependent such that, for youth high in self-reported child maltreatment, heightened reactivity was associated with decreased interpersonal competence and anger regulation. Results highlight the importance of considering how context may condition the effect of stress reactivity on functioning during adolescence.     

Reliability of Third Molar Development for Age Estimation in a Texas Hispanic Population: A Comparison Study*

Abstract: Evaluating third molars from 950 Hispanic individuals aged 12–22 years using Demirjian’s schematic for crown and root formation found that Hispanic third molar development was 8–18 months faster than American Caucasians as reported by Mincer, Harris and Berryman in 1993. This represents a statistically significant increase. Earlier development was more apparent in the later stages F through H. Hispanic males reach developmental stages faster than Hispanic females and maxillary third molars reach developmental stages faster than mandibular third molars in both sexes. The earliest age observed for stages B–H (e.g., Stage H first observed at age 13.92 years in females) and the oldest age observed for Stages B–G were developed to facilitate age prediction of unknown individuals. Prediction tables for minimum and maximum age for an observed stage (e.g., if a female maxillary third molar is stage F it means she is older than 13 years) for each sex‐jaw group were calculated.     

Effect on Eyewitness Accuracy When Witnesses Are Told versus Not Told That They Will Be Allowed a Second Viewing

Lindsay, Lea, and Fulford (J Appl Psychol 76:741–745, 1991) found that false identifications increased, correct rejections decreased, and correct identifications minimally increased when witnesses were allowed a second viewing of a sequential lineup. We conducted a similar study in which we allowed mock witnesses a second viewing of a sequential lineup. Results indicated that participants who were allowed a second viewing made mostly incorrect identifications. Participants correctly identified the perpetrator more often when they were not told in advance that they would have a second viewing than when they were told. Additionally, those participants who were told that they would be allowed a second viewing incorrectly rejected the lineup more often than those who were not told. The findings yielded conclusions similar to those of Lindsay et al. (J Appl Psychol 76:741–745, 1991) suggesting that witnesses should not be allowed to view the lineup a second time. The results also suggest that, if a repeated lineup is used, witnesses should not be informed of that in advance.     

Public Sector Governance Reform and the Motivation of Street-Level Bureaucrats in Developing Countries

This article draws on health sector reform in Honduras to examine the mechanisms through which governance reforms shape the behavior of street-level bureaucrats. It combines insights from behavioral public administration with original data from lab-in-the-field workshops conducted with more than 200 bureaucrats to assess the relationship between decentralization and motivation. Findings show strong evidence that motivation, measured as self-sacrifice, is higher among bureaucrats in decentralized municipalities compared with bureaucrats in comparable centrally administered municipalities. Increased motivation is most pronounced in decentralized systems led by nongovernmental organizations compared with those led by municipal governments or associations. Additionally, the evidence suggests that higher motivation is related to changes in the composition of staff rather than socialization or changes among existing staff. Overall, this research helps move beyond indiscriminate calls for decentralization by highlighting the interplay between reform design and bureaucratic behavior, as well as the limitations of governance reforms in motivating more experienced bureaucrats.