Investigation of morphine and morphine glucuronide levels and cytochrome P450 isoenzyme 2D6 genotype in codeine-related deaths

Compared to morphine and morphine-6-glucuronide (M6G), codeine and its other major metabolites codeine-6-glucuronide and norcodeine have weak affinity to opioid μ-receptors. Analgesic effects of codeine are thus largely dependent on metabolic conversion to morphine by the polymorphic cytochrome P450 isoenzyme 2D6 (CYP2D6). How this relates to toxicity and post-mortem whole blood levels is not known. This paper presents a case series of codeine-related deaths where concentrations of morphine, M6G and morphine-3-glucuronide (M3G), as well as CYP2D6 genotype, are taken into account. Post-mortem toxicological specimens from a total of 1444 consecutive forensic autopsy cases in Central Norway were analyzed. Among these, 111 cases with detectable amounts of codeine in femoral blood were identified, of which 34 had femoral blood concentrations exceeding the TIAFT toxicity threshold of 0.3mg/L. Autopsy records of these 34 cases were retrieved and reviewed. In the 34 reviewed cases, there was a large variability in individual morphine to codeine concentration ratios (M/C ratios), and morphine levels could not be predicted from codeine concentrations, even when CYP2D6 genotype was known. 13 cases had codeine concentrations exceeding the TIAFT threshold for possibly lethal serum concentrations (1.6 mg/L). Among these, 8 individuals had morphine concentrations below the toxic threshold according to TIAFT (0.15 mg/L). In one case, morphine as well as M6G and M3G concentrations were below the limit of detection. A comprehensive investigation of codeine-related fatalities should, in addition to a detailed case history, include quantification of morphine and morphine metabolites. CYP2D6 genotyping may be of interest in cases with unexpectedly high or low M/C ratios.     

Planning Ahead? An Exploratory Study of South Korean Investigators’ Beliefs About Their Planning for Investigative Interviews of Suspects

Preparation and planning has been argued to be vitally important as to how effectively investigators undertake their interviews with suspects. Yet, it has also been found in previous research that investigators admit that they plan only occasionally, often attributing insufficient time as a reason for not undertaking the task. Employing a novel research paradigm that utilised theoretical foundations concerning planning, the present study explored empirically 95 South Korean financial crime investigators’ views, using a self-administered questionnaire. With the use of second-generation statistical modelling, an understanding was developed of the relative relationships between various concepts (which had themselves emerged from an established theoretical framework of planning that had been further extended to accommodate the context of the present study). The study found that perceived time pressures actually showed a very low association with interview planning. Rather, investigators’ self-belief as to their own capability alongside workplace culture was each found to have stronger associations with investigators’ intentions to plan for their interviews. As such, we argue that there should be more focus on improving occupational culture relating to interview planning, while developing training programs that identify, evaluate, and enhance investigators’ planning skills. Implications for practice are therefore discussed.     

The Appearance,Taste, and Concentrations of Zolpidem Dissolved in Still Water and Carbonated Beverages

Zolpidem is a sedative that could be used to drug victims, but its suitability to dissolve in drinks is unknown. In this small study, we added either crushed or whole tablets of zolpidem hemitartrate to carbonated beverages or still water to observe how this affected the taste and appearance. Also, concentrations were measured by ultra‐high performance liquid chromatography tandem mass spectrometry at different time intervals. Two crushed tablets (20 mg) in cider (250 mL) lead to a maximum concentration of 84 mg/L zolpidem base after 30 min, while the corresponding concentration after adding fifteen tablets (150 mg) was 467 mg/L. There was little change in taste, but froth and turbidity were observed when adding high doses to carbonated beverages. Carbonated beverages spiked with 20 mg of crushed zolpidem hemitartrate tablets reached concentrations that could cause impairment. Spiking with 150 mg could possibly be lethal if several mouthfuls were ingested.     

The social dynamics of revictimization and intimate partner violence: an embodied,gendered, institutional and life course perspective

This article offers a qualitative, institutional analysis of the dynamics of revictimization as the accumulation of disadvantages over time and across different institutional contexts, and its multiple gender dimensions. It draws on 37 qualitative interviews with victims of intimate partner violence, detailing the institutional causal pathways to victimization and revictimization over the life course, through the in-depth analysis of one case. Drawing on the vulnerability approach, developed by Martha Albertson Fineman, the analysis demonstrates how victimization and revictimization have been facilitated, tolerated, and even produced by particular institutional contexts, illustrating how the risk of revictimization is not a characteristic of the individual, nor is it destiny. The article contributes to a constructive social science, elucidating how victimization is contingent on social and institutional contexts, and how at several critical points, better institutions and better institutional responses to particular events might have prevented or interrupted the dynamics of accumulating victimization. Focusing on embodied, gendered subjects and the role of institutions in producing as well as remedying inequalities has far-reaching implications for research and prevention of violence. In contrast to a risk-factor approach targeting particular groups and individuals, a vulnerability analysis calls for a responsive state and universal institutional solutions.     

Zur Politisierung der Europäischen Union

The constitutional treaty of the EU failed. Why so? Does this failure indicate the end of European integration and the beginning of re-nationalization of European politics? This contribution argues that the failure of the constitutional treaty is due to a process of politicization of the EU. As a result, political processes beyond the nation state are judged increasingly not just on the basis of their effectiveness, but also in terms of the criteria for good political order, such as fairness and legitimacy. The respective governments of the EU member states, however, publicly still take an instrumental approach to the EU. This is doomed to failure and thus the future of the European project is open. Either politics adapts to the new evaluation criteria for European integration or a partial re-nationalization of European politics is indeed likely.     

Geographical heterogeneity of Y-chromosomal lineages in Norway

Y-chromosomal variation at five biallelic markers (Tat, YAP, 12f2, SRY(10831) and 92R7) and nine multiallelic short tandem repeat (STR) loci (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS385I/II and DYS388) in a Norwegian population sample are presented. The material consists of 1766 unrelated males of Norwegian origin. The geographical distribution of the population sample reflects fairly well the population distribution around the year 1942, which is the median birth year of the index persons. Seven hundred and twenty-one different Y-STR haplotypes but 726 different lineages (Y-STRs plus biallelic markers) were encountered. We observed six known (P*(xR1a), BR(xDE, J, N3, P), R1a, N3, DE, J), and one previously undescribed haplogroup (probably a subgroup within haplogroup P*(xR1a)). Four of the haplogroups (P*(xR1a), BR(xDE, J, N3, P), R1a and N3) represented about 98% of the population sample. The analysis of population pairwise differences indicates that the Norwegian Y-chromosome distribution most closely resembles those observed in Iceland, Germany, the Netherlands and Denmark. Within Norway, geographical substructuring was observed between regions and counties. The substructuring reflects to some extent the European Y-chromosome gradients, with higher frequency of P*(xR1a) in the south-west and of R1a in the east. Heterogeneity in major founder groups, geographical isolation, severe epidemics, historical trading links and population movements may have led to population stratification and have most probably contributed to the observed regional differences in distribution of haplotypes within two of the major haplogroups.     

Assessment of age at death by microscopy: unbiased quantification of secondary osteons in femoral cross sections

The microscopic method of age at death determination was introduced by Kerley in 1965 [E.R. Kerley, The microscopic determination of age in human bone, Am. J. Phys. Anthropol, 23 (1965) 149-163.]. However, even though the method has been revised several times, there remain some fundamental issues concerning the reliability of the methods. This is because several basic histological features seen in a cross section of a bone have to be quantified according to the method, but the definition, and hence quantification, of these features leaves room for subjectivity. In a previous study we found that some of these features (osteon fragments and Haversian canals) could not be identified reliably. Only secondary osteons could be identified with a low inter and intra observer error. Furthermore, since the histological features are quantified in only parts of an entire bone cross section, the selection of these parts or areas is a potential source of bias. Finally, unless an unbiased method is used for addressing features on the borders of the selected areas, this will also introduce error. These issues have not been addressed specifically in previous studies. In this study, we used the methods of stereology to choose the regions of interest, as well as for dealing with border phenomena, and we only counted secondary osteons. Our results show a statistically significant increase in the median number of osteons per area unit with increasing age at death. However, this was after exclusion of one outlier. This result is probably due to the limited sample size (N = 24). As such, this study is preliminary, but does warrant applying the described techniques to a larger sample.     

A comparative analysis of price,quantity, and mixed approaches for decentralized planning

Economic Change and Restructuring - No one approach is best along all of the four dimensions. The price approach maintains feasibility, where the other two do not necessarily. The quantity approach...