Unusual fentanyl patch administration

Fentanyl is an extremely potent narcotic analgesic that is becoming more popular as a drug of abuse. Because of the unique way in which the drug is packaged and delivered, the potential for unusual methods of abuse exists. We report the first case of true fentanyl patch ingestion in the medical literature. Initially, though unusual, cases of fentanyl ingestion were thought to have been reported, but further investigation of the literature revealed that in other case reports the patches had been held in the mouth and chewed. Because no reports of swallowing the patch had been published, suicide was initially a strong consideration in this case; however, further investigation showed that the decedent and his brother enjoyed swallowing the patches for quick "highs." Cases such as these serve to remind medical examiners and law enforcement officials of the value of performing thorough death investigations by performing complete autopsies with toxicological testing and correlating with investigation information to form an opinion with regard to the cause and manner of death.     

An Indepth Actuarial Assessment for Wife Assault Recidivism: The <Emphasis Type="Italic">Domestic Violence Risk Appraisal Guide</Emphasis>

An actuarial tool, the Ontario Domestic Assault Risk Assessment (ODARA), predicts recidivism using only variables readily obtained by frontline police officers. Correctional settings permit more comprehensive assessments. In a subset of ODARA construction and cross-validation cases, 303 men with a police record for wife assault and a correctional system file, the VRAG, SARA, Danger Assessment, and DVSI also predicted recidivism, but the Hare Psychopathy Checklist (PCL-R) best improved prediction of recidivism, occurrence, frequency, severity, injury, and charges. In 346 new cases, ODARA and PCL-R independently predicted recidivism. An algorithm was derived for a combined instrument, the Domestic Violence Risk Appraisal Guide (DVRAG), and an experience table is presented (N=649). Results indicated the importance of antisociality in wife assault.     

Public health policy, legal uncertainty and the standard of care in rural and remote communities

This column examines the historical context in which the standard of health care offered to rural and remote communities has developed to become less than that afforded their metropolitan counterparts. In particular, it looks at the support offered to nurses working within these communities in terms of not only the lack of medical resources, including doctors, in these areas, but also the legal and professional restrictions placed on nurses that leave them feeling vulnerable to complaints of working outside their scope of practice. The column concludes with a discussion of the legal standard of care and ways in which nurses may adequately meet the health needs of their community while working within legal parameters.     

Emancipatory rural politics: confronting authoritarian populism

A new political moment is underway. Although there are significant differences in how this is constituted in different places, one manifestation of the new moment is the rise of distinct forms of authoritarian populism. In this opening paper of the JPS Forum series on ‘Authoritarian Populism and the Rural World’, we explore the relationship between these new forms of politics and rural areas around the world. We ask how rural transformations have contributed to deepening regressive national politics, and how rural areas shape and are shaped by these politics. We propose a global agenda for research, debate and action, which we call the Emancipatory Rural Politics Initiative (ERPI, www.iss.nl/erpi). This centres on understanding the contemporary conjuncture, working to confront authoritarian populism through the analysis of and support for alternatives.     

Longitudinal Examination of the Bullying-Sexual Violence Pathway across Early to Late Adolescence: Implicating Homophobic Name-Calling

The Bully-Sexual Violence Pathway theory has indicated that bullying perpetration predicts sexual violence perpetration among males and females over time in middle school, and that homophobic name-calling perpetration moderates that association among males. In this study, the Bully-Sexual Violence Pathway theory was tested across early to late adolescence. Participants included 3549 students from four Midwestern middle schools and six high schools. Surveys were administered across six time points from Spring 2008 to Spring 2013. At baseline, the sample was 32.2% White, 46.2% African American, 5.4% Hispanic, and 10.2% other. The sample was 50.2% female. The findings reveal that late middle school homophobic name-calling perpetration increased the odds of perpetrating sexual violence in high school among early middle school bullying male and female perpetrators, while homophobic name-calling victimization decreased the odds of high school sexual violence perpetration among females. The prevention of bullying and homophobic name-calling in middle school may prevent later sexual violence perpetration.     

Reciprocal Prospective Relationships Between Loneliness and Weight Status in Late Childhood and Early Adolescence

Adolescents who do not conform to weight ideals are vulnerable to disapproval and victimization from peers in school. But, missing from the literature is a prospective examination of weight status and feelings of loneliness that might come from those experiences. Using data from the Québec Longitudinal Study of Child Development, we filled that gap by examining the prospective associations between loneliness and weight status when the sample was aged 10–13 years. At ages 10, 12, and 13 years, 1042 youth (572 females; 92% from French speaking homes) reported on their loneliness and were weighed and measured. Family income sufficiency was included in our analyses given its relationship with weight status, but also its possible link with loneliness during early adolescence. The findings showed that (1) weight status and loneliness were not associated concurrently; (2) weight status predicted increases in loneliness from ages 12 to 13 years; and (3) loneliness predicted increases in weight from ages 12 to 13 years among female adolescents, but weight loss among male adolescents. The fact that loneliness was involved in weight gain for females suggests that interventions focused on reducing loneliness and increasing connection with peers during early adolescence could help in reducing obesity.     

Beyond ‘Revenge Porn’: The Continuum of Image-Based Sexual Abuse

In the last few years, many countries have introduced laws combating the phenomenon colloquially known as ‘revenge porn’. While new laws criminalising this practice represent a positive step forwards, the legislative response has been piecemeal and typically focuses only on the practices of vengeful ex-partners. Drawing on Liz Kelly’s (Surviving sexual violence. Polity Press, Cambridge, 1988) pioneering work, we suggest that ‘revenge porn’ should be understood as just one form of a range of gendered, sexualised forms of abuse which have common characteristics, forming what we are conceptualising as the ‘continuum of image-based sexual abuse’. Further, we argue that image-based sexual abuse is on a continuum with other forms of sexual violence. We suggest that this twin approach may enable a more comprehensive legislative and policy response that, in turn, will better reflect the harms to victim-survivors and lead to more appropriate and effective educative and preventative strategies.