Comparison of GC-MS and EIA results for the analysis of methadone in oral fluid

The purpose of these studies was to evaluate the performance characteristics of the Cozart Microplate Enzyme Immunoassay (EIA) for the determination of methadone in oral fluid from patients in a drug misuse treatment program. Oral fluid specimens were collected using the Cozart RapiScan Collection system from 198 donors who were receiving treatment for their addiction and were monitored for drug misuse. Oral fluid specimens were also collected from forty volunteer donors who were not drug users. The specimens were analyzed in the laboratory by EIA and then analysed for methadone and its main metabolite EDDP by gas chromatography-mass spectrometry (GC-MS). A total of 103 samples were confirmed positive for methadone. The Cozart Microplate EIA for d-Methadone in oral fluid using a cutoff of 30 ng/mL in diluted oral fluid had a sensitivity of 91.3% +/- 2.8% and a specificity of 100% +/- 1.0% vs. GC-MS.     

Gasoline on hands: preliminary study on collection and persistence

The identification of an arsonist remains one of the most difficult challenges a fire investigation has to face. Seeking and detection of traces of gasoline could provide a valuable information to link a suspect with an arson scene where gasoline was used to set-up the fire. In this perspective, a first study was undertaken to evaluate a simple, fast and efficient method for collecting gasoline from hands, and to assess its persistence over time. Four collection means were tested: PVC, PE and Latex gloves, as well as humidified filter paper. A statistical assessment of the results indicates that Latex and PVC gloves worn for about 20 min, as well as paper filter rubbed on hands, allow an efficient collection of gasoline applied to hands. Due to ease of manipulation and to a reduced amount of volatile compounds detected from the matrix, PVC gloves were selected for the second set of experiments. The evaluation of the persistence of gasoline on hands was then carried out using two initial quantities (500 and 1000 microl). Collection was made with PVC gloves after 0, 30 min, 1, 2 and 4h, on different volunteers. The results show a common tendency of massive evaporation of gasoline during the first 30 min: a continued but non-linear decrease was observed along different time intervals. The results of this preliminary study are in agreement with other previous researches conducted on the detection of flammable liquid residues on clothes, shoes and skin.     

Bleedings, purges, and vomits: Dr. Benjamin Rush's republican medicine, the bilious remitting yellow-fever epidemic of 1793, and the non-origin of the law of informed consent

To the consternation of many physicians, the modern law of informed consent imposes certain constraints on their actions, not least that they respect patients' decisions to redefine at will the scope of care. The consequences of this transfer of power are often a nuisance and occasionally fatal, but always a reflection of democracy's leveling march: Physicians now take orders rather than give them. However frustrating the modern preference for process over result might be, we should ask ourselves-before condemning the law's evolution-about the consequences for patients' health of a more radically democratic practice of medicine. This paper proposes to examine this question as framed by the life of Dr. Benjamin Rush, who, in addition to signing the Declaration of Independence, crafted a medical practice uniquely suited to the young Republic's presumed moral character: Self-aware sufferers would promptly identify their own maladies and courageously treat themselves. In the end, his enterprise was flawed because his democratic instincts misled not only his scientific inquiries (disease is complex, not simple) but also his practice recommendations (patients are scared, not intrepid). Reflection on Rush's failed project should give pause to those who lament the passing of paternalistic medicine, for the law's requirements, however onerous they might be, tolerably accommodate both patients' need for physicians' expertise and our democratic belief that consent is the fundamental precondition of all rule.     

The New Punitive Regulation

There is now some evidence of a potential drift towards 'punitive' approaches to regulation in which greater emphasis is placed on criminal sanctions. This new enthusiasm for punishment can be seen in government policy, legislation and some regulators' public stances. There is evidence, however, that companies (even top ones) deal with punitive regulatory risks in a confused manner and that even when they do act rationally, this may not lead to compliance. One response to punitive approaches and their limitations is to move towards greater reliance on stimulating the self-regulatory capacities of corporations. Such stimulation, however, has to be carried out with an awareness of the dangers of self-regulation – notably that it may lead to controls that lack legitimacy, prove unfair and are exclusive and inefficient.     

Understanding a New Typology of Batterers: Implications for Treatment

This article reviews early theories of the phenomenology of battering as well as more recent empirical research on batterer personality and behavioral characteristics. These studies yielded inconsistent findings. Most recently, Chiffriller and Hennessy (Chiffriller, 2002; Chiffriller & Hennessy, in press) conducted an extensive study that attempted to expand and correct for the methodological limitations of previous research. Cluster analysis yielded five distinct profiles of men who batter women. Based on the behavioral and personality characteristics that defined each cluster, the following five labels were chosen: (a) pathological batterers, (b) sexually violent batterers, (c) generally violent batterers, and (d) psychologically violent batterers, and (e) family-only batterers. These five profiles, and the implications for understanding battering and developing appropriate interventions, are discussed.     

Motivational interviewing training in juvenile corrections: A comparison of outside experts and internal trainers

Purpose. This study was designed to compare expert consultant trainers and less experienced, in‐house trainers in providing basic training in motivational interviewing (MI) for juvenile corrections employees. Methods. Trainees (n= 1,552) attended a 3‐day workshop administered by either a member of the Motivational Interviewing Network of Trainers (MINT) or a corrections staff member who had been trained by a MINT trainer. Results. Pre‐ to post‐test MI knowledge and skill gains did not vary between MINT expert and internal trainers, and increased for both groups. MINT trainees were more motivated to learn MI and expected it to be more effective in their work compared with those trained by corrections staff. MINT trainers were perceived as more knowledgeable about the topic, whereas corrections staff trainers were rated as better at utilizing handouts and visual aids. The groups did not differ on other measures of trainee satisfaction. Conclusions. These data suggest that a train‐the‐trainers model, in which expert consultants provide initial trainings to develop a pool of staff to provide subsequent trainings, may be as effective as a model that relies exclusively on expert trainers.     

Why Vote with the Chief? Political Connections and Public Goods Provision in Zambia

Why are voters influenced by the views of local patrons when casting their ballots? The existing literature suggests that coercion and personal obligations underpin this form of clientelism, causing voters to support candidates for reasons tangential to political performance. However, voters who support candidates preferred by local patrons may be making sophisticated political inferences. In many developing countries, elected politicians need to work with local patrons to deliver resources to voters, giving voters good reason to consider their patron's opinions of candidates. This argument is tested using data from an original survey of traditional chiefs and an experiment involving voters in Zambia. Chiefs and politicians with stronger relationships collaborate more effectively to provide local public goods. Furthermore, voters are particularly likely to vote with their chief if they perceive the importance of chiefs and politicians working jointly for local development.