Fatal versus non-fatal heroin "overdose": blood morphine concentrations with fatal outcome in comparison to those of intoxicated drivers

The study was performed to distinguish fatal from non-fatal blood concentrations of morphine. For this purpose, blood levels of free morphine and total morphine (free morphine plus morphine conjugates) in 207 cases of heroin-related deaths were compared to those in 27 drivers surviving opiate intoxication. The majority of both survivors and non-survivors were found to show a concomitant use of depressants including alcohol or stimulants. Blood morphine levels in both groups varied widely, with a large area of overlap between survivors (free morphine: 0-128 ng/ml, total morphine: 10-2,110 ng/ml) and non-survivors (free morphine: 0-2,800 ng/ml, total morphine: 33-5,000 ng/ml). Five (18.5%) survivors and 87 (42.0%) non-survivors exhibit intoxication only by morphine. In these cases, too, both groups overlapped (survivors-free morphine: 28-93 ng/ml, total morphine: 230-1,451 ng/ml; non-survivors-free morphine: 0-2,800 ng/ml, total morphine: 119-4,660 ng/ml). Although the blood levels of free or total morphine do not allow a reliable prediction of survival versus non-survival, the ratio of free/total morphine may be a criterion to distinguish lethal versus survived intoxication. The mean of the ratio of free to total morphine for all lethal cases (N=207) was 0.293, for those that survived (N=27) 0.135, in cases of intoxication only by morphine 0.250 (N=87) and 0.080 (N=5), respectively. Applying a cut-off of 0.12 for free/total morphine and performing ROC analyses, fatal outcome can be predicted in 80% of the cases correctly, whereas 16% of the survivors were classified as dead. Nevertheless, in this study, all cases with a blood concentration of 200 ng/ml and more of free morphine displayed a fatal outcome.     

Organising for mutual advantage: municipal associations in Bulgaria

Networks of local government support organisations (LGSOs) are critical to successful intergovernmental relations and effective local governance in democratic societies. Bulgaria had no such network of municipal associations when it began the transition from communist rule in the early 1990s. Using US and other external technical assistance, Bulgaria over the next decade overcame the impediments to collective action and established what appears to be an effective and sustainable system to back up its cities and towns. Important factors in mobilising support included a long‐term focus on institutional development, non‐partisanship, flexibility in implementation and a pragmatic orientation that focused on learning by doing. Copyright © 2006 John Wiley & Sons, Ltd.     

Welfare Receipt and Private Charity

In the wake of welfare reform efforts, alliances between governments and charities, and public preoccupation with “social capital,” it is useful to understand how welfare payments interact with charitable giving. Using Consumer Expenditure Survey data from the first quarter of 1999, this article estimates the impacts on charitable giving by individuals from receipt of welfare payments, as well as income, wealth, and a number of demographic variables. The data analysis suggests that charity is negatively associated with welfare receipt, while wealth, income, and age have positive impacts on giving. These findings have significant implications for public policy and nonprofit management.     

Ideology and Political Alienation

A substantial literature over the years has focused on the relationship between political alienation and ideology. Much of this research contends that conservatives are more alienated than liberals because philosophically they believe that the best government is that which governs least. A close reading of the literature, however, reveals little consistency in the empirical findings. Survey data from Norway, Sweden, and the United States are used to provide a more extensive and consistent test of the hypothesis. Ideology is defined as both left/right self-identification and policy preference on economic and "new political" issues. The evidence reveals that in Scandinavia higher levels of alienation are found among conservatives, whereas in the US the left has been consistently more alienated, except on "new politics" issues. The discrepancy between the citizen's preferred ideological orientation and that which the public perceives the government to take, is used to explain the different findings for the three countries and the shifts in the relationship between ideology and alienation across time.     

Asbestos populism in David Foster Wallace’s Infinite Jest

ABSTRACT

This essay considers the changing relationship between asbestos and populism, as both terms travel across different semantic contexts. It argues that this dynamic relationship can help to outline a populist ecology, through which resource actors such as asbestos play a more significant role than either populist leaders or their people anticipate. Drawing on David Foster Wallace’s Infinite Jest as a site for examining the implications of this asbestos-inflected populist ecology, the essay suggests new ways of linking the recent populism of Donald Trump to an older, more articulate populism, exemplified by Pierre Trudeau.