Diagnosis of sudden unexplained death in epilepsy by immunohistochemical staining for prolactin in cerebral vessels

Sudden unexplained death in epilepsy occurs when epilepsy patients die suddenly and unexpectedly in the absence of recent tonic-clonic seizure activity. There is currently no known reliable indicator of acutely lethal seizure activity. Clinical studies record a relationship between recent (within 10-40 minutes) seizure activity and elevated serum prolactin levels, and postictal elevation of prolactin within peripheral vessels has proved clinically useful in determining recent seizure activity. The authors hypothesized that elevated prolactin could be detected in cerebral vessels by immunohistochemical stains, serving as a marker for sudden unexplained death in epilepsy. They conducted a retrospective study of individuals who died in their jurisdiction during the 14 years from 1986 through 1999. The study contained one group of individuals who died of sudden unexplained death in epilepsy, a group with epilepsy who died of some other cause, and a control group whose members died rapidly of a gunshot wound of the torso. Sections of hippocampus and neocortex were obtained and stained with a polyclonal prolactin antibody. No significant difference in the level of immunostaining for prolactin in cerebral vessels was found between the experimental and control groups. A review of the protocols used indicates that revision of certain aspects may provide better immunostaining and more conclusive results.     

An empirical study of tissue banking in Australia: navigating regulatory and ethical challenges

Collections of tumour samples can be an invaluable resource for medical research. There are, however, numerous ethical and legal challenges associated with tumour banking. While there has been extensive discussion of these issues in the legal and ethical literature, there are few available empirical data in relation to the activities of tumour banks in Australia, their practices around ethically charged issues, and their success in implementing complex regulatory guidelines. The aim of this study was to gain more information about the activities of tumour banks in New South Wales, Australia, with a particular focus on their management of, and attitudes towards, ethical and regulatory issues. A survey of 27 tumour collection and research facilities was conducted using a 55-item questionnaire. There is significant heterogeneity of research methodologies as well as of methods for gaining consent and ensuring donor privacy, and there is general concern among the research community about ethical and regulatory issues related to tumour banking. Heterogeneity of practice and uncertainty about ethical and regulatory requirements is problematic in its potential to hinder research and its potential to generate the space for unethical practice, whether intentional or unintentional. There is a pressing need to address these issues so that tumour banks can be used in the most ethical and efficient way possible.     

Alprazolam-related deaths in Palm Beach County

Alprazolam is a commonly prescribed benzodiazepine. The abuse of benzodiazepines is most frequently seen in conjunction with the abuse of other drugs. Only rare fatalities have been attributed to alprazolam alone. We undertook a retrospective review of cases investigated by the Palm Beach County Medical Examiner's Office in which postmortem toxicologic studies indicated the presence of alprazolam, to further study the pattern of alprazolam abuse. Our review consisted of 178 cases, including 87 in which death was attributed to combined drug toxicity, 2 to alprazolam toxicity alone, 44 to trauma, 12 to natural causes, and 33 to another drug or drugs. Cocaine and methadone were the most common cointoxicants in the cases of combined drug toxicity, while heroin was less frequently detected. There was considerable overlap in the postmortem blood alprazolam concentrations among the groups. The overlapping ranges of concentrations of alprazolam detected indicate that it may be difficult to define a lethal alprazolam range, and that it may not be possible to determine the actual role of alprazolam as a causal factor in cases of combined drug toxicity. This study confirms that alprazolam alone is rarely a cause of death, and that alprazolam abuse usually occurs within a polydrug use pattern. The high incidence of cocaine as a cointoxicant has not been previously reported.     

Peer Victimization,Social Support,and Psychosocial Adjustment of Sexual Minority Adolescents

The present study examined the link between sexual orientation and adjustment in a community sample of 97 sexual minority (gay male, lesbian, bisexual, and questioning) high school students, taking into account their experiences of peer victimization and social support within peer and family contexts. Adolescents were identified in a large-scale survey study conducted at 5 high schools. They were matched to a comparison sample of their heterosexual peers. Sexual minority adolescents reported more externalizing behaviors and depression symptoms than heterosexual youth. Compared to their heterosexual peers, sexual minority youth reported more sexual harassment, more bullying, less closeness with their mothers, and less companionship with their best friends. There were no significant differences between gay male, lesbian, bisexual, and questioning adolescents. Overall, both victimization and social support mediated the link between sexual orientation and psychosocial symptoms. Among sexual minority youth, the link between social support and externalizing was mediated by experiences of peer victimization. These findings highlight the contextual risk and protective factors associated with non-heterosexual sexual orientation in accounting for the emotional and behavioral problems in this population. Ms. Williams completed her M.A. in Clinical-Developmental Psychology at York University in Toronto, Ontario. She is currently working on her Ph.D. Her research interests include adolescent sexual orientation, adolescent romantic relationships, and dating violence. Dr. Connolly is a Professor of Psychology at York University. She received her Ph.D. from Concordia University and is a Registered Psychologist in the Province of Ontario. Her current research examines adolescent romantic relationships and the peer context. Dr. Pepler is a Professor of Psychology at York University and Psychologist at the Hospital for Sick Children in Toronto. She received her Ph.D. from the University of Waterloo and is a Registered Psychologist in the Province of Ontario. Her current research examines aggression and victimization among adolescents with a concern to the processes related to these problems over the lifespan. Dr. Craig is a Professor of Psychology at Queen's University. She received her Ph.D. from York University and is a Registered Psychologist in the Province of Ontario. Her current research examines bullying, victimization, aggression, juvenile delinquency, peer relations, and the development of intervention programs.     

Perceptions of controllability and other stressor event characteristics as determinants of coping among young adolescents and young adults

Young adolescents (N=146, mean age=11.35, 54% female, 81% Anglo) and young adults (N=166, mean age=20.73, 68% female, 82% Anglo) completed questionnaires assessing appraisals of and efforts to cope with three common stressful events, conflicts with mother, a friend, and a failure. For each event, participants rated appraisals of event controllability, including control over event outcomes, event predictability, and perceptions of causal locus (self-culpable, other culpable, and unknown). Additional appraisals rated included event meaningfulness, duration, frequency of occurrence, and stakes/concerns (concerns about one's or another person's well-being). Employment of five coping strategies was rated for each event. Analyses revealed significant correlations among the appraisal and coping variables across the three events. Aggregate variables were computed and significant age differences emerged from analyses of variance. Results of hierarchical multiple regressions suggest that coping is multiply determined. Perceptions of control may be significant predictors for young adolescents, and concerns about other people may be predictive of young adults' responses.Obtained Ph.D. from The Pennsylvania State University in Individual and Family Studies. Major research interest is social and emotional development in children and adolescents.     

Government support of technical progress: Lessons from history

In the past, the U.S. government has been involved in various programs to support technical progress. The record of such programs in seven industries offers important guidelines. The economist's usual presumption that government support for such activities should be concentrated on those cases in which there is palpable market failure proves much too simple. Programs that stand the best chance of success are those in which the government itself is a dominant customer for the product concerned, those that do not require the government to determine what the commercial market wants, and those that do not directly threaten the relative position of competing firms in the industry. Some of the most successful programs have been positioned between basic research on the one hand and commercial application on the other.     

Women's power in heterosexual sex

The ‘male sexual drive’ discourse sees men as sexually insatiable and male sexuality as naturally an uncontrollable drive. Feminist analysis denies its ‘naturalness’ and its constitution as a ‘drive’, seeing it instead in terms of the power conferred on men in patriarchy. However, seeing the penis/male power as monolithic still ends up casting women as victims. Instead this paper looks at actual heterosexual relationships and examines ‘power’ as a more complex process of negotiation. Heterosexual women often fail to recognize that men need relationships; and that women have sources of power in relationships with them; and the paper argues that this occurs through gender-differentiated positions in discourses such as the ‘have/hold’ discourse as well as the ‘male sexual drive’ discourse.     

Spatial Effects and Ecological Inference

This paper examines the role of spatial effects in ecologicalinference. Both formally and through simulation experiments,we consider the problems associated with ecological inferenceand cross-level inference methods in the presence of increasingdegrees of spatial autocorrelation. Past assessments of spatialautocorrelation in aggregate data analysis focused on unidimensional,one-directional processes that are not representative of thefull complexities caused by spatial autocorrelation. Our analysisis more complete and representative of true forms of spatialautocorrelation and pays particular attention to the specificationof spatial autocorrelation in models with random coefficientvariation. Our assessment focuses on the effects of this specificationon the bias and precision of parameter estimates.