Suspected clozapine poisoning in the UK/Eire, 1992-2003

OBJECTIVE: Toxicological analyses are often performed to investigate suspected poisoning, but the interpretation of results may not be straightforward. We studied suspected poisoning cases 1992-2003 where blood clozapine and N-desmethylclozapine (norclozapine) were measured in order to assess the relationship of these parameters to outcome. METHODS: Samples were referred from clinicians, pathologists/coroners, or via the Clozaril Patient Monitoring Service (CPMS, Novartis). Information was gathered from clinical, post-mortem, or coroners' reports. RESULTS: There were seven fatal [five male, two female; median (range) age 28 (24-41) year] and five non-fatal [four male, one female; median age 35 (26-41) year] clozapine overdoses. The median post-mortem blood clozapine and norclozapine concentrations were 8.2 (3.7-12) and 1.9 (1.4-2.4)mg/L, respectively [median clozapine:norclozapine ratio 4.4 (2.9-5.1)]. The median plasma clozapine and norclozapine concentrations (first or only sample) were 3.9 (1.7-7.0) and 0.40 (0.30-0.70)mg/L, respectively [median clozapine:norclozapine ratio 7.6 (5.3-18)] in the remainder. These overdoses were in patients who were poorly or non-adherent to clozapine, or who had taken tablets prescribed for someone else. In 54 further people who died whilst receiving clozapine [38 male, 16 female; median age 41 (22-70) year], the median post-mortem blood clozapine and norclozapine concentrations were 1.9 (0-7.7, n = 43) and 1.4 (0-6.0, n = 39)mg/L, respectively [median clozapine:norclozapine ratio 1.5 (0.4-7.6, n = 38)]. The median post-mortem increase in blood clozapine and norclozapine as compared to the most recent ante-mortem measurement was 489 (98-5,350)% and 371 (139-831)%, respectively [median sample time before death 14 (0-30, n = 21) days]. CONCLUSION: Clozapine poisoning cannot be diagnosed on the basis of blood clozapine and norclozapine concentrations alone. The analysis of ante-mortem blood specimens collected originally for white cell count monitoring and the blood clozapine:norclozapine ratio may provide additional interpretative information.     

Jocks, gender, binge drinking, and adolescent violence

Previous research has suggested a link between athletic involvement and elevated levels of adolescent violence outside the sport context. The present study expanded on this literature by positing differences in the sport-violence relationship across dimensions of athletic involvement (athletic participation vs. jock identity), type of violence (family vs. nonfamily), and gender as well as by examining the impact of binge drinking on the sport-violence relationship. Regression analyses using a sample of 608 Western New York adolescents indicated that (a) jock identity (but not athletic participation) was associated with more frequent violence, (b) jock identity predicted nonfamily violence (but not family violence), and (c) the link between jock identity and nonfamily violence was stronger for boys than for girls. Binge drinking predicted family violence among nonjocks only.     

Ownership of high-risk ("vicious") dogs as a marker for deviant behaviors: implications for risk assessment

This study examined the association between ownership of high-risk ("vicious") dogs and the presence of deviant behaviors in the owners as indicated by court convictions. We also explored whether two characteristics of dog ownership (abiding licensing laws and choice of breed) could be useful areas of inquiry when assessing risk status in settings where children are present. Our matched sample consisted of 355 owners of either licensed or cited dogs that represented high or low-risk breeds. Categories of criminal convictions examined were aggressive crimes, drugs, alcohol, domestic violence, crimes involving children, firearm convictions, and major and minor traffic citations. Owners of cited high-risk ("vicious") dogs had significantly more criminal convictions than owners of licensed low-risk dogs. Findings suggest that the ownership of a high-risk ("vicious") dog can be a significant marker for general deviance and should be an element considered when assessing risk for child endangerment.     

Issues surrounding a reduction in the use of internal autopsy in the coronial system

In 2003 it was estimated that 2,700 full internal coronial autopsies were performed in Queensland at a cost of approximately A$5.3 million. This large number of internal coronial autopsies (almost 95% of all matters referred to the coroner) is of concern not only due to the economic cost but also because of the public heath risks, availability of specialist staff and significant religious and cultural sensitivities surrounding internal autopsies. In 2005 the authors began research funded by the Australian Research Council (ARC) to determine if unnecessary internal autopsies are being performed in Queensland and to establish guidelines for when an internal autopsy is required. This article highlights areas of potential concern when the issue of autopsy is reviewed within the coronial system through an examination of international literature on the issue of autopsy diagnosis and error rates more generally, and through preliminary discussion of the data obtained. The article considers the role and purpose of the autopsy generally as well as within the coronial system specifically; compares diagnostic error rates in hospital autopsies with those in the coronial system; the current situation internationally with regard to internal autopsies; and finally the specific circumstances existing in Queensland.     

Toward a psychological ecology of affirmative action

Research-based knowledge of the effects of affirmative action has been little help to policy makers. That is the case because there has been no means through which to organize into a policy-relevant whole the findings that have come from a variety of disciplinary sources. A heuristic schematic of the psychological ecology of affirmative action is proposed as a step toward developing a conceptual framework that can reduce this problem. A psychological ecology of affirmative action consists of the mutual relations between policy interest groups and the procedures used to implement these policies. A critical point that the ecological framework leads to is that the nature of affirmative action procedures has a major influence on the material and subjective links between interest groups. Given that claim, the schematic is used to categorize, review, and critique the multidisciplinary research on affirmative action. From that overview, a set of general guidelines for the design of effective affirmative action programs is proposed. Finally, a call is made for a shift in the unit of policy analysis from a focus on group justice to relational justice.     

Pink‐Collar Representation and Budgetary Outcomes in US States

Legislatures worldwide are dominated by wealthy elites, who are often out of touch with the needs and problems of citizens. Research shows that the underrepresentation of the working class matters in terms of policy processes and outcomes. Yet the research on class has largely focused on blue‐collar representatives, who are primarily men. Working‐class women are more likely to hold pink‐collar jobs, or low‐status occupations dominated by women. We argue that pink‐collar legislators are uniquely positioned to legislate over education and social service policy. To test our argument, we combine a new coding of working‐class backgrounds that accounts for pink‐collar representation with state spending data on education and social services from US states over time. Modeling compositional budget data, we find that class and gender intersect to shape policy outcomes via state budget allocations, with women's pink‐collar representation associated with increased spending on both education and social services.     

The results of a randomized controlled trial of police body-worn video in Australia

Journal of Experimental Criminology - We report the results of a randomized controlled trial of police body-worn video (BWV) cameras in an Australian context, with a focus on how cameras influence...     

Does contact with the justice system deter or promote future delinquency? Results from a longitudinal study of British adolescent twins

What impact does formal punishment have on antisocial conduct—does it deter or promote it? The findings from a long line of research on the labeling tradition indicate formal punishments have the opposite-of-intended consequence of promoting future misbehavior. In another body of work, the results show support for deterrence-based hypotheses that punishment deters future misbehavior. So, which is it? We draw on a nationally representative sample of British adolescent twins from the Environmental Risk (E-Risk) Longitudinal Twin Study to perform a robust test of the deterrence versus labeling question. We leverage a powerful research design in which twins can serve as the counterfactual for their co-twin, thereby ruling out many sources of confounding that have likely impacted prior studies. The pattern of findings provides support for labeling theory, showing that contact with the justice system—through spending a night in jail/prison, being issued an anti-social behaviour order (ASBO), or having an official record—promotes delinquency. We conclude by discussing the impact these findings may have on criminologists’ and practitioners’ perspective on the role of the juvenile justice system in society.