Marketization, Managers and Moral Strain: Chairmen, Directors and Public Service Ethos in the National Health Service

Survival of the public service ethos in Britain has been called into question following introduction of the 'new public management' and marketizing reforms in much of the public sector. This article examines how these developments have occurred in the NHS, using survey data to analyse NHS board members' substantive ethical values. Unexpectedly the results suggest that NHS board members with a predominantly NHS background appear less ethically conservative, more flexible and less risk–averse than those recruited from non–NHS backgrounds; and that as yet the NHS management 'culture' is not very homogenous in respect of 'business ethics'. The NHS reforms also appear to accentuate the tensions between transparent public accountability in NHS management and incentives not to publicize certain types of information. Recent codification of NHS 'business ethics' can be understood as an attempt to buttress the public service ethos against the increased moral strains of a quasi–market.     

Comparison of the elemental composition of office document paper: evidence in a homicide case

Fraudulent substitution of a page within a multiple page document such as a will or business contract, the counterfeit manufacture of paper banknotes, and linking ransom or extortion notes have all been the focus of criminal investigations at one time or another. In a recent homicide investigation, document examiners were requested to compare a threatening letter received by a business partner of the deceased with paper samples seized under warrant from a suspect's house. Through a quantitative elemental analysis of the concentrations of nine elements (Na, Mg, Al, Mn, Sr, Y, Ba, La, and Ce) within the questioned and specimen documents, determined by inductively coupled plasma-mass spectrometry (ICP-MS), it was concluded that (i) the paper of the threatening letter originated from a different source to that of the paper seized from the suspect's house and (ii) all six pages of paper seized from the suspect's house originated from the same source. This discrimination of paper is presented as both a statistical t-test analysis (99.9% confidence limit) as well as construction of an elemental fingerprint for individual replicates within the questioned and specimen sample populations. This is the first reported use of the comparison of the elemental composition of document paper, determined by ICP-MS, to assist in a criminal investigation.     

健康促进学校活动简介

健康促进学校起源于健康促进活动,是由世界卫生组织发起、许多国家积极响应的一场国际运动。健康促进学校是一所有着系统的政策、程序、活动和结构,旨在保护和促进学生、职员和更广泛学校社区成员健康与幸福的学校。     

Factors associated with breath test refusals in drunken driving arrests.

OBJECTIVE: Jurisdictions with per se breath alcohol legislation rely heavily on breath test evidence in prosecuting drunk driving cases. Depending on other legal considerations, where subjects refuse the breath test, prosecution may be more difficult. The objective was to identify factors significantly associated with the risk of test refusal. This knowledge would be relevant for improving the compliance rate. METHOD: A retrospective observational study evaluated drunken driving arrest records (n = 38,687) within Washington State during 2003 where breath tests were requested under implied consent legislation. The association was determined between the risk of test refusal and several categorical variables including: arresting agency, gender, race, age, accident involvement, repeat offense, pre-arrest breath test, driver's license and all possible two-way interactions. The association was quantified by odds ratios (OR) and 95% confidence intervals (CI) using a logistic regression model. RESULTS: The overall refusal rate was 19.7%. The single main effect variable associated with the greatest reduction in risk of refusal was the performance of a pre-arrest breath test (OR = 0.31, 95% CI 0.30-0.33). No single main effect variables showed significant association with an increased risk of refusal. Several two-way interactions, however, were significant. Other possible predictor variables, not included in the analysis, are also discussed. CONCLUSIONS: An arrested subject's decision to refuse the breath test is clearly a multivariate issue. Knowledge of these results should help in developing a jurisdictionally specific breath test compliance model by identifying the legal, demographic and procedural factors contributing most significantly to breath test refusal rates.     

The Accuracy of Handheld Pre‐Arrest Breath Test Instruments as a Predictor of the Evidential Breath Alcohol Test Results

Drunk driving is a serious threat to public safety. All available and appropriate tools for curbing this threat should be employed to their full extent. The handheld pre‐arrest breath test instrument (PBT) is one tool for identifying the alcohol‐impaired driver and enforcing drunk driving legislation. A set of data was evaluated (n = 1779) where the PBT instrument was employed in drunk driving arrests to develop a multivariate predictive model. When maintained and operated by trained personnel, the PBT provides a reasonable estimate of the evidential test result within the relevant forensic range (95% prediction interval:  ± 0.003 g/210 L). ROC analysis shows that a multivariate model for PBT prediction of the evidentiary alcohol concentration above versus below the legal limit of 0.08 g/210 L has excellent performance with an AUC of 0.96. These results would be of value in evidential hearings seeking to admit the PBT results in drunk driving trials.     

Fatal falls from a height: two case studies

Two case studies are presented involving fatal falls of adult females from a height. One involved a launch at low speed from a balcony, and one involved a launch at high speed from the top of a cliff. Crime scene evidence obtained on the balcony itself provided a strong indication of homicide, but subsequent investigation showed that the fall was accidental. No crime scene evidence was obtained for the cliff fall since the fall initially appeared to be just another suicide from a popular suicide spot. Subsequent investigations indicated homicide based on measurements of cliff height, horizontal distance to the impact, and available runup distance, plus measurements of possible run, jump, and throw speeds. It was found that a female weighing 61 kg (134 lb) can be thrown at speeds up to 4.85 m/s by a strong male, more than enough to account for the estimated launch speed (4.5 m/s). Given the available 4.0 m runup distance, it was found that women of better than average rather than elite athletic ability can dive at speeds of about 3.5 m/s or jump feet first at speeds of about 4.0 m/s, both being less than the estimated launch speed. The decedent had no athletic ability and landed head first after falling through a height of 29 m.