Polydrug fatality involving metaxalone

A 29-year old female with a history of depression was found dead in a hotel room. The death scene investigation found empty pill bottles and an empty liter bottle of wine. Metaxalone, a centrally acting muscle relaxant, along with citalopram, ethanol, and chlorpheniramine were identified in the postmortem samples and quantitated by gas chromatography-mass spectrometry. The concentration of metaxalone in femoral vein blood was 39 mg/L. The heart blood concentration was 54 mg/L. Femoral vein blood concentrations of citalopram and chlorpheniramine were 0.77 mg/L and 0.04 mg/L, respectively. Ethanol levels were 0.13 g/dL in vitreous and 0.08 g/dL in heart blood. Other tissue samples were also analyzed. The authors consider the metaxalone concentrations toxic and potentially fatal. The citalopram concentrations were lower than those reported in fatal cases for this drug alone. Death was ascribed to polydrug abuse/overdose with metaxalone a major contributor. This represents the first reported case to our knowledge in which a metaxalone overdose significantly contributed to death.     

Public Opinion on Federalism in Canada, Mexico, and the United States in 2003

This research reports on public opinion surveys on intergovernmentaland federal issues conducted in Canada, Mexico, and the UnitedStates in March and April 2003. In all three countries, respondentsmost often see their federal government as being the least effective,least efficient, and least trustworthy. Respondents from Canadaappear least supportive of their federal government and mostsupportive of their local governments; those from Mexico appearmost supportive of their state governments; respondents fromthe United States appear more "balanced" in their support ofthe various orders of government. Also, far greater regionaldifferences in opinion exist in Canada than in Mexico or theUnited States. Support for more decentralized federalism isfound to be strong in all these federal countries. This researchalso updates long-term trend data for the United States. Comparedwith respondents from previous years, U.S. respondents in 2003showed a measurable uplick in support for the federal government,compared with state and local governments. This support seemsto be a carryover from the terrorist attacks of 11 September2001.     

Race, Caste, or Class? The Bunche–Myrdal Dispute Over An American Dilemma

Few observers doubt that Gunnar Myrdal and Ralph J. Bunche had sharp methodological disagreements and differing approaches to tactics for ending the Negro problem. Myrdal has been criticized as a statist liberal and utopian moralist by recent cultural historians defending progressive nationalism (multiculturalism), while Bunche has been characterized as a vulgar Marxist, and, with Myrdal, a denigrator of black culture. Inspection of An American Dilemma in contrast with Bunche's research memoranda suggests that Myrdal represented himself as a Burkean conservative, while Bunche's analyses transmit the radical puritan libertarian tradition, but without rejecting social democratic remedies en route to working-class control of industry. Their shared emphasis on class-based remedies to end poverty and powerlessness, however, renders them similarly unassimilable in a period where the progressive left has generally embraced racial or ethnic identity, not class power, as the source of individual emancipation, mental health, and economic betterment.     

Determination of drug levels in larvae of Protophormia terraenovae and Calliphora vicina (Diptera: Calliphoridae) reared on rabbit carcasses containing morphine

Two species of blow flies (Diptera: Calliphoridae) were reared on tissues from rabbits administered different dosages of morphine. These species, Protophormia terraenovae and Calliphora vicina are among the first wave of insects colonizing a dead body. Two series of 3 rabbits were given dosages of 10, 20, and 40 mg/h of morphine over a 3 h period via ear artery perfusion. A morphine blood level plateau was attained after 1 h of perfusion. Two other rabbits were used as controls. Samples of tissues collected from rabbits using a coelioscopic technique were determined to have morphine concentrations similar to those encountered in human overdoses and were correlated with dosages of morphine administered. All samples from control rabbits were negative for morphine. Larvae and puparia of both species were regularly collected from each rabbit for toxicological analysis. Concentrations of morphine in larvae reared on rabbit carcasses containing morphine were significantly lower than concentrations found in the tissues. There was a decrease in concentration in morphine observed in transition from feeding 3rd instar larva to puparium. A correlation between larval concentration and tissue concentration was found only in feeding 3rd instar larvae.     

Business Associate Agreements Inventory

This Business Associate Agreement Inventory is a checklist for use by covered entities who use or disclose individually identifiable health information with or to their Business Associates. The checklist is designed to assist the covered entities to review their contracts with each respective Business Associate and determine whether the contracts contain all of the provisions required by the Health Insurance Portability and Accountability Act regulations. The regulations addressed in the checklist include the Transactions and Code Sets Standards (effective October 16, 2000), the proposed Security Standards, and the final Privacy Regulations (published December 28, 2000).