Performance characteristics of the Cozart RapiScan Oral Fluid Drug Testing System for opiates in comparison to ELISA and GC/MS following controlled codeine administration

Oral fluid is an interesting alternative matrix for drug testing in many environments, including law enforcement, workplace drug testing, and drug treatment facilities. Performance characteristics of the FDA-cleared, qualitative, Cozart RapiScan Opiate Oral Fluid Drug Testing System (Opiate Cozart RapiScan System or Opiate CRS) were compared to the semi-quantitative Cozart Microplate EIA Opiate Oral Fluid Kit (Opiate ELISA) and to gas chromatography/mass spectrometry (GC/MS). The following oral fluid opiate cutoffs were evaluated: the GC/MS limit of quantification (LOQ) of 2.5 mg/l; 15 microg/l currently used for oral fluid testing in the United Kingdom (UK); 30 microg/l (Opiate CRS cutoff); and 40 microg/l, the proposed Substance Abuse and Mental Health Services Administration (SAMHSA) cutoff. Subjects provided informed consent to participate in this IRB-approved research and resided on the closed research ward throughout the study. Three oral codeine doses of 60 mg/70 kg were administered over a 7-day period. After a 3-week break, subjects received three doses of 120 mg/70 kg within 7 days. Oral fluid specimens (N = 1273) were analyzed for codeine (COD), norcodeine (NCOD), morphine (MOR) and normorphine (NMOR) by GC/MS with an LOQ of 2.5 microg/l for all analytes. MOR and NMOR were not detected in any sample; 26.5% of the specimens were positive for COD and 13.7% for NCOD. Opiate CRS uses a preset, qualitative cutoff of 10 microg/l; this is equivalent to 30 microg/l in undiluted oral fluid as the oral fluid collection process involves a 1:3 dilution with buffer. Sensitivity, specificity, and efficiency of Opiate CRS compared to Opiate ELISA were 98.6, 98.1, and 98.2% at a 30 microg/l cutoff and 99.0, 96.2, and 96.6% at a 40 microg/l cutoff. Compared to the much lower GC/MS LOQ of 2.5 microg/l, sensitivity, specificity and efficiency were 66.8, 99.3 and 90.7%. Increasing the GC/MS cutoff to the current UK level yielded performance characteristics of 81.5% (sensitivity), 99.3% (specificity), and 95.4% (efficiency). Using a GC/MS cutoff identical to the preset Opiate CRS cutoff yielded sensitivity, specificity, and efficiency of 88.5, 99.2, and 97.5%, respectively. At the proposed SAMSHA confirmation cutoff of 40 microg/l, sensitivity increased with little change in specificity and efficiency (91.3% sensitivity, 98.9% specificity, and 97.5% efficiency). Oral fluid is a suitable matrix for detecting drugs of abuse. Opiate CRS, with a 30 microg/l cutoff, is sufficiently sensitive, specific and efficient for oral fluid opiate analysis, performing similarly to Opiate ELISA at the same cutoff, and having performance characteristics >91% when compared to GC/MS at the proposed SAMHSA cutoff.     

Parents' perception of adolescent behavior problems

Fifty-seven parents, usually mothers, rated their adolescent sons and daughters on the Walker Checklist at the time of their initial clinic appointment. Parents perceived this group of adolescents as more disturbed than the elementary school age normative group on three of the scales, Immaturity, Acting Out, and Distractibility. The results support an increase in behavior problems at adolescence which is more marked for the younger females and younger males. Neither gender nor age, separately, determines the degree of behavioral disturbance, with one exception. The scores of both the younger and older male groups are significantly higher than the scores of their corresponding female groups on the school-related Distractibility scale.Received her Ph.D. from University of Washington 1959. Interests are adolescent development, personality, and evaluative research.Community Practice student in the Adolescent Clinic.     

Exploring the psychological and somatic impact of identity theft

Identity theft is a new and growing form of white-collar crime. This exploratory study examined the psychological and somatic impact of identity theft and coping methods utilized by victims. Thirty-seven victims of identity theft participated in regional victim focus groups. Participants completed a victim impact questionnaire designed by the authors and the Brief Symptom Inventory-18 (BSI-18). The majority of participants expressed an increase in maladaptive psychological and somatic symptoms post victimization. Results on the BSI indicated that identity theft victims with unresolved cases, in contrast to those with resolved cases, were more likely to have clinically elevated scores when compared with a normative sample. Relatively similar coping mechanisms were utilized across victims. The results from this study suggest that victims of identity theft do have increased psychological and physical distress, and for those whose cases remain unresolved, distress is maintained over time.     

Predictor Variables in Competency to Stand Trial Decisions

Clinicians possess significant discretion in competency to stand trial assessment. Therefore, it is paramount to explore the contribution of individual variables to ensure that the decision-making process is devoid of bias and solely relates to the legal criterion. To test for the possibility of bias in clinical decision-making, we examined the predictive efficiency of clinical, criminological, and sociodemographic variables in a sample of 468 criminal defendants referred for competency evaluations. Only clinical diagnostic variables and employment status were significant predictors. This finding supports the idea that examiner decisions of competency appear to be unbiased and relate primarily to a defendant's functional ability.     

Chimeric governance and the extension of resource regulation

The contemporary securitisation of underdevelopment is based on the myth of mutual vulnerability—the idea that underdevelopment and state failure pose diverse threats both to the developed world and the poor in the developing world. The mutual vulnerability thesis provides the rationale for an attempt to expand the range of both military and regulatory interventions inside the developing world. The promise of these interventions is of a synthesis between security for the developed world and solidarism with the poor. The reality is a form of chimeric governance which purports to protect the rich from a range of imagined threats and which masks an unwillingness to really address the problems of the poor.

One illusion has been shattered on 11 September: that we can have the good life of the West irrespective of the state of the rest of the world…. Once chaos and strife have got a grip on a region or a country trouble will soon be exported. Out of such regions and countries come humanitarian tragedies, centres for trafficking in weapons, drugs and people, havens for criminal organisations, and sanctuaries for terrorists…. The dragon's teeth are planted in the fertile soil of wrongs unrighted, of disputes left to fester for years, of failed states, of poverty and deprivation.1 ?1. Tony Blair, Prime Minister, speech at the Lord Mayor's Banquet 13 Nov. 2001. View all notes     

Neutral heroin impurities from tetrahydrobenzylisoquinoline alkaloids

Laudanosine, reticuline, codamine, and laudanine are members of the tetrahydrobenzylisoquinoline family of natural products. These alkaloids are present in the opium poppy, Papaver somniferum, and are subsequently found as impurities in clandestinely processed morphine. Morphine is then synthesized to heroin using hot acetic anhydride. During the course of this study, it was determined that these four tetrahydrobenzylisoquinolines undergo degradation to a series of 18 neutral impurities when subjected to hot acetic anhydride. Based on the degradation pathway, these new impurities were categorized into two sets of impurities called the C1-acetates compounds and the stilbene compounds. Synthesis, isolation, and structural elucidation information is provided for the tetrahydrobenzylisoquinoline alkaloids, and the new neutral impurities have been studied. Several hundred authentic heroin samples were analyzed using an established heroin signature program method. This methodology features the detection of trace neutral impurities present in heroin samples. It was determined that all 18 new impurities were detected in various quantities in four different types of heroin samples. Analytical results featuring these new impurities are reported for South American-, Southwest Asian-, Mexican-, and Southeast Asian-type heroin samples. These new impurities, coupled with other established forensic markers, enhance the ability to classify illicit heroin samples.     

Drug and alcohol use as determinants of New York City homicide trends from 1990 to 1998

In this population-level study, we analyzed how well changes in drug and alcohol use among homicide victims explained declining homicide rates in New York City between 1990 and 1998. Victim demographics, cause of death, and toxicology were obtained for all homicide (N = 12573) and accidental death victims (N = 6351) between 1990 and 1998 from the Office of the Chief Medical Examiner of New York (OCME). The proportion of homicide and accident decedents positive for cocaine fell between 1990 and 1998 (13% and 9% respectively); the proportion of homicide and accident decedents positive for opiates and/or alcohol did not change significantly. Changing patterns of drug and alcohol use by homicide victims were comparable to changing patterns of drug and alcohol use in accident victims, suggesting that changes in drug and alcohol use among homicide victims between 1990 and 1998 cannot solely explain the decline in NYC homicide rates.     

Sixth Graders’ Conflict Resolution in Role Plays with a Peer,Parent, and Teacher

This study used conflict resolution role play vignettes and self-report surveys of 450 New York City 6th graders to examine associations between adolescents’ conflict resolution efficacy and social skills. Vignettes covered 3 social contexts, conflict with a peer (disagreement over activities), with a parent (raise in allowance), and with a teacher (low grade on report). Effective and ineffective strategies for resolving these conflicts were coded from the videotaped interactions. Adolescents were more often effective in resolving conflict with peers than with parents (χ²(1) = 7.10, p < .01). Strong communication skills cut across interpersonal context as associated with effective resolution. Assertiveness and absence of aggression were associated with effective conflict resolution in vignettes with peers. Assertiveness was also associated with effective conflict resolution in vignettes with parents, however nervousness was unexpectedly found to facilitate conflict resolution in vignettes with parents. Only skills observed within a particular context were associated with effective resolution in that context; self-report skills and cross-context observed skills were not associated with efficacy. Implications for implementation and evaluation of social skills curricula and conflict resolution process are discussed.An earlier version of this paper was presented at the meetings of the Society for Research on Adolescence, New Orleans, LA, April 2002Received Ph.D. in Developmental Psychology from Teachers College, Columbia University in 2004. Research interests include adolescent social competence and youth development programs.Received Ph.D. in Developmental Psychology from Pennsylvania State University in 1991. Research interests include the psychosocial correlates of puberty, stress reactivity, and health compromising behaviors and adjustment.Received Ph.D. in Developmental Psychology from Teachers College, Columbia University in 2002. Research interests include social competence, prevention research, and women’s health.Received Ph.D. in Developmental Psychology from Teachers College, Columbia University in 2002. Research interests include social competence, prevention research, and women’s health.Received Ph.D. in 1975 from University of Pennsylvania in Human Learning and Development. Research focus centers around designing and evaluating interventions aimed at enhancing the wellbeing of children living in poverty and associated conditions. Conducts research on transitional periods during childhood and adolescence, focusing on school, family and biological transitions in childhood, adolescence, and adulthood. Specific interests are in the factors that contribute to positive and negative outcomes, and changes inwell-being over these years.Received Ph.D. in Developmental Psychology from Columbia University in 1977. Research interests include tobacco, alcohol, and drug abuse prevention, violence prevention, AIDS risk reduction among adolescents, health promotion and disease prevention, smoking cessation.     

Professionalization and unionization of police: A Delphi forecast on police values

The Delphi Forecasting technique was utilized to assess the general direction and magnitude of broad future trends in the occupationally-related values of police officers. Two panels of experts were established and utilized in the Delphi Process: one composed of veteran police officers and the other consisting of law enforcement educators, top echelon police administrators, attorneys, and social ethicists.Two major trends emerged in the course of the study: a movement toward professionalization and a movement toward unionization. These two movements were found to embody generally conflicting sets of occupationally-related values.The increasing emphasis of police chiefs and their administrators on managerial efficiency was identified as the critical factor influencing the future of these trends.