Demographic, pathologic, and toxicological profiles of 127 decedents testing positive for ephedrine alkaloids

The relative toxicity of ephedra-containing dietary supplements is disputed. In order to ascertain the magnitude of the problem, we reviewed all autopsies in our Medical Examiner's jurisdiction, from 1994 to 2001, where ephedrine or any its isomers (E+) were detected. Toxicology testing results were tabulated and anatomic findings in E+ cases were compared to those in a control group of drug-free trauma victims. Of 127 E+ cases identified, 33 were due to trauma. Decedents were mostly male (80.3%) and mostly Caucasian (59%). Blood ephedrine concentrations were <0.49 mg/l in 50% of the cases, range 0.07-11.73 mg/l in trauma victims, and 0.02-12.35 mg/l in non-trauma cases. Norephedrine (NE) was present in the blood of 22.8% (mean of 1.81 mg/l, S.D.=3.14 mg/l) and in the urine of 36.2% (mean of 15.6 mg/l, S.D.=21.50mg/l). Pseudoephedrine (PE) was present in the blood of 6.3% (8/127). More than 88% (113/127) of the decedents also tested positive for other drugs, the most common being cocaine (or its metabolites) and morphine. The most frequent pathologic diagnoses were hepatic steatosis (27/127) and nephrosclerosis (22/127). Left ventricular hypertrophy was common, and coronary artery disease (CAD) detected in nearly one third of the cases. The most common findings in E+ deaths are those generally associated with chronic stimulant abuse, and abuse of other drugs was common in those with CAD. There were no cases of heat stroke or rhabdomyolysis. In most cases, norephedrine was not detected, suggesting it plays no role in ephedrine toxicity.     

Decision Aiding,Not Dispute Resolution: Creating Insights through Structured Environmental Decisions

Public participation in environmental decisions has become commonplace. A favored model for public input is to use the tools of dispute resolution to seek consensus among members of a multi‐party stakeholder group. The authors believe that a focus on dispute resolution and consensus building can pose impediments to the creation of insights for decisionmakers and lead to the adoption of inferior policy choices. Instead, they advocate an alternative approach to stakeholder participation characterized as “decision aiding” through a structured process based on constructive, multi‐attribute techniques and value‐focused thinking. In this paper some of the major difficulties posed by a dispute‐resolution approach are articulated, the principles of a decision‐aiding process reviewed, and this alternative approach illustrated by describing a stakeholder consultation involving water‐use planning for a hydroelectric facility on the Alouette River in British Columbia, Canada. © 2001 by the Association for Public Policy Analysis and Management.     

DAMNED IF YOU DO AND DAMNED IF YOU DON'T

In contemporary Western societies women are often thought to have overcome inequality, become autonomous and resistant to social pressures, and in so doing gained the freedoms to make their own choices. However, this ‘post-feminist sensibility’ can arguably be seen as a double-bind as some types of ‘choices’ cannot always be recognised as freely chosen if they are taken as an indication of failing to resist social (appearance) pressures. We argue that one such example is the ‘choice’ to have cosmetic breast surgery, a practice that has received both criticism and celebration from different feminist angles. In this paper we analyse how women who have had breast augmentation are constructed by readers of an internet blog in which they are largely vilified and pathologised for not valuing their ‘natural’ (yet ‘deficient’) breasts. We demonstrate how the same discursive constructions that appear to value women's ‘natural’ bodies simultaneously (re)produce the conditions in which women may feel the need to have breast augmentation.     

The business case for sustainability in retrospect: A Scandinavian institutionalism perspective on the role of expert conferences in shaping the emerging “CSR and corporate sustainability space”

This paper is concerned with the rise and, in retrospect, successful “positioning” of corporate social responsibility (CSR) and corporate sustainability as a management idea. It answers to calls that more research is required into the “business case for sustainability,” especially the link between rhetoric and reality. We allow for a narrative-driven and dynamic perspective to frame the analysis of the discourse, rhetoric, and arguments in use during the emergence of “modern CSR” in Europe in the early 2000s. On the one hand, it shows that the European Union/Commission acted as an “enabler” of business case rhetoric. On the other hand, empirical evidence from two expert conferences series in Germany 2004–2008 leads to the conclusion that a wide coalition of interested parties continuously and progressively filled, shaped, and energized the early “CSR and corporate sustainability space” with presenting CSR as a rationale and progressive (management) idea.     

Cutting with the Grain: Human Rights,Conflict Transformation and the Urban Planning System—Lessons from Northern Ireland

This article examines how the urban planning system in Northern Ireland served to concentrate segregation and systemic inequalities during the course of the recent conflict. Using documents recently uncovered from the Northern Ireland Public Record Office (PRONI), this article will show how the security forces ‘cut with the grain’ of a planning system that had historically been predicated upon segregation and exclusion in order to better control and manage politically motivated violence leaving a divided city in which systemic inequalities have been built into the fabric of the urban environment. Drawing on developments within regulatory theory this article will outline a way forward for creating an integrated post-conflict planning agenda for Belfast that takes account of the limits of traditional forms of legalism and adds learning to the debate around the relationship between systemic inequalities and the process of conflict transformation.     

BOOK REVIEWS

Gary Paul Nabhan and Stephen Trimble: The Geography of Childhood: Why Children Need Wild Places. Boston, MA: Beacon Press, 1994.

Laura Westra and Peter S. Wenz, eds.: Faces of Environmental Racism: Confronting Issues of Global Justice. Lanham, Md.: Rowman &; Littlefield Publishers, Inc., 1995.

John Gray: Beyond the New Right: Markets, Government and the Common Environment. London: Routledge, 1993

Darrow Schecter: Radical Theories: Paths Beyond Marxism and Social Democracy. Manchester: Manchester University Press, 1994