Tokin Up in the 5280: Insight Into How Denver Police Officers Make Sense of, and Define, Interpret, and React to the Legalization of Marijuana

Laws surrounding the possession, use, and distribution of marijuana have undergone many changes for over a century. Political pressures and social prejudices have most often been the cause of these changes, rather than scientific research or rational thinking. As a result, the law has sometimes lagged behind social practice as in the current case in much of the U.S., including Colorado. In such an environment, it often falls on a police officer\u27s definition, interpretation, and reaction to the laws to determine the extent to which certain laws and sanctions are enforced. Drawing on the work of Weick (1976), this dissertation utilizes the theoretical framework of sensemaking to examine two research questions. First, what sense are police officers in Colorado making of new legalization of marijuana laws? Second, how are officers defining, interpreting, and reacting to marijuana laws in Colorado? Semi-structured interviews were conducted with 22 Denver police officers. Findings suggest that the lack of bright line policies regarding marijuana enforcement play a role in officers making sense of the law in different ways. Officers\u27 definition and interpretation of marijuana law seems to be founded upon their experiences, as well as the experiences of their peers. Several unintentional consequences of marijuana legalization were identified by officers, and appear to play a substantial role in the sensemaking process. Theoretically, this research contends that the four key components of sensemaking (Weick 1976) (i.e., social process, ongoing process, reliant on extracted cues, and based off of plausibility rather than accuracy) are interwoven with the aspects of defining, interpreting, and reacting to laws. As such, a call exists for the elaboration or construction of a theory combining the intertwined elements of defining, interpreting, and reacting to organizational change with the interwoven elements of sensemaking. Findings suggest several policy implications. The call for Colorado and all states that are considering legalization for recreational purposes is to create bright line policies in an effort to reduce confusion among officers. The construction of such policies will reduce the grey area in which officers operate thereby ensuring that users are treated fairly across all jurisdictions and states

In Children With Nonalcoholic Fatty Liver Disease, Cysteamine Bitartrate Delayed Release Improves Liver Enzymes but Does Not Reduce Disease Activity Scores

Background & aimsNo treatment for nonalcoholic fatty liver disease (NAFLD) has been approved by regulatory agencies. We performed a randomized controlled trial to determine whether 52 weeks of cysteamine bitartrate delayed release (CBDR) reduces the severity of liver disease in children with NAFLD.MethodsWe performed a double-masked trial of 169 children with NAFLD activity scores of 4 or higher at 10 centers. From June 2012 to January 2014, the patients were assigned randomly to receive CBDR or placebo twice daily (300 mg for patients weighing ≤65 kg, 375 mg for patients weighing >65 to 80 kg, and 450 mg for patients weighing >80 kg) for 52 weeks. The primary outcome from the intention-to-treat analysis was improvement in liver histology over 52 weeks, defined as a decrease in the NAFLD activity score of 2 points or more without worsening fibrosis; patients without biopsy specimens from week 52 (17 in the CBDR group and 6 in the placebo group) were considered nonresponders. We calculated the relative risks (RR) of improvement using a stratified Cochran-Mantel-Haenszel analysis.ResultsThere was no significant difference between groups in the primary outcome (28% of children in the CBDR group vs 22% in the placebo group; RR, 1.3; 95% confidence interval [CI], 0.8-2.1; P = .34). However, children receiving CBDR had significant changes in prespecified secondary outcomes: reduced mean levels of alanine aminotransferase (reduction, 53 ± 88 U/L vs 8 ± 77 U/L in the placebo group; P = .02) and aspartate aminotransferase (reduction, 31 ± 52 vs 4 ± 36 U/L in the placebo group; P = .008), and a larger proportion had reduced lobular inflammation (36% in the CBDR group vs 21% in the placebo group; RR, 1.8; 95% CI, 1.1-2.9; P = .03). In a post hoc analysis of children weighing 65 kg or less, those taking CBDR had a 4-fold better chance of histologic improvement (observed in 50% of children in the CBDR group vs 13% in the placebo group; RR, 4.0; 95% CI, 1.3-12.3; P = .005).ConclusionsIn a randomized trial, we found that 1 year of CBDR did not reduce overall histologic markers of NAFLD compared with placebo in children. Children receiving CBDR, however, had significant reductions in serum aminotransferase levels and lobular inflammation. ClinicalTrials.gov no: NCT01529268