Criminal Justice System Involvement Among Homeless Adults

This study characterized the specific offenses for which homeless individuals are arrested and incarcerated. Data were gathered from 581 homeless adults across 6 Oklahoma City shelters. Participants were asked to self-report incarceration history, nights spent in jails and prisons, and the offenses for which they were arrested. Overall, 76% of the sample had ever been arrested. Fifty-seven percent of the sample had been to jail more than 3 times in their lifetime and 13% had ever intentionally been arrested. The most prevalent type of arrest was drug possession (35%), followed by driving under the influence (31%) and disorderly conduct or public drunkenness (28%). Violent arrests, such as assault, robbery, domestic violence, murder, and rape, were the least prevalent type of arrest. In summary, offenses were largely drug and status offenses. These offenses may be prevented through increased substance use treatment accessibility and availability of housing. Policies to increase employment and housing for homeless adults regardless of criminal history should be expanded to reduce the occurrence of justice involvement.     

Survey of forensic pathologists

A survey of board-certified forensic pathologists (from a list of board-certified forensic pathologists supplied by the American Board of Pathology) was conducted to determine their current practice situations. The purpose of the survey was to provide information useful to the public in general and to those organizations that represent forensic pathologists in particular to better understand and meet the needs of the forensic pathology community. A total of 773 surveys were mailed, and 18 were returned as undeliverable. There were 337 replies (45%). Responses were as follows: In terms of age, 7% were in their 30s; 32% were in their 40s; 29% were in their 50s; 19% were in their 60s; and 13% were 70 years of age or older. In terms of gender, 79% were male and 21% were female. For pathology practice status, 72% worked more than 30 hours per week; 11% between 5 and 30 hours per week; 5% less than 5 hours per week; and 12% no longer practice pathology. For percentage of pathology practice that is forensic pathology, 69% of respondents were more than 80%; 6% were 50%-80%; 5% were 25%-50%; 8% were 5%-25%; and 12% were less than 5%. In terms of forensic pathology practice setting, 54% were employed by medical examiner or coroner systems; 13% worked under contract to medical examiner or coroner systems; 27% worked in private practice or consultation; and 6% responded as "other."     

Historical systems and social systems

Studies in Comparative International Development -     

Efforts to improve patient safety in large,capitated medical groups: description and conceptual model

Medical care should be safer. Inpatient problems and solutions have received the most attention; this outpatient qualitative case study addresses a gap in knowledge. We describe safety improvements among large physician groups, model the key influences on their behavior, and identify beneficial public and private policies. All groups were trying to reduce medical injury, which was part of the sample design. The most commonly targeted problems are those that are similar across groups: shortcomings in diagnosis, abnormal tests follow-up, scope of practice and referral patterns, and continuity of care. Medical group innovators vary greatly, however, in implementation of improvements, that is, in the extent to which they implement process changes that identify events/problems, analyze and track incidents, decide how to change clinical and administrative practices, and monitor impacts of the changes. Our conceptual model identifies key determinants: (1) demand for safety comes from external factors: legal, market, and professional; (2) organizational responses depend on internal factors: group size, scope, and integration; leadership and governance; professional culture; information-system assets; and financial and intellectual capital. Further, safety is an aspect of quality (the same tools, decision making, interventions, and monitoring apply), and safety management benefits from prior efficiency management (similar skills and culture of innovation). Observed variation in even simple safeguards shows that existing safety incentives are too weak. Our model suggests that the biggest improvement would come from boosting the demand for quality and safety from both private and public larger group purchasers. Current policy relies too much on litigation and discipline, which have sometimes helped, but not solved, problems because they are inefficient, tend to drive needed information underground, and complicate needed cultural change. Patients' safety demand is also weak for want of information and market power. Big purchasers' demands, however, quickly influence the internal environment of medical groups, helping managers advance quality safety toward the top of groups' congested decision-making "queues."     

Glycogenated squamous epithelial cells as a marker of foreign body penetration in sexual assault

Nonconsensual insertion of a foreign object into the vagina, anus, or mouth in some judicial jurisdictions is synonymous with rape, and elsewhere may constitute some degree of sexual assault or battery. Few techniques, however, are available to assist the criminalist in determining whether an object has been criminally inserted. Glycogenated epithelial cells have been used as a marker for vaginal epithelium, and as such, may indicate vaginal insertion if recovered from an object. This hypothesis was tested by studying orally and vaginally inserted objects from 42 volunteers and 20 rectally inserted objects recovered from cadavers. Glycogen positivity was assayed from smears of object swabbings stained with the periodic acid-Schiff (PAS) technique. More than 75 glycogen positive cells were recovered from 39 of 42 vaginally inserted objects. Glycogenated cells were recovered from 8 of 20 rectally inserted objects (5 with more than 100 positive cells). Of 42 orally inserted objects, 32 also contained glycogen positive cells, but none with more than 28 positive cells. No glycogen positive cells were seen in skin exposed but not inserted objects. Large numbers of glycogen cells were seen in dried saliva drops. Amylase activity was not seen on 5 of 20 orally inserted shields, and thus the possibility of noninsertional saliva contamination could not be ruled out with shields yielding only small numbers of positive cells. Recovery of large numbers of glycogenated cells from foreign objects is strongly suggestive of either vaginal or anal insertion assuming amylase negativity. Glycogen positive cells are not seen secondary to glabrous skin exposure.     

Economic performance and U.S. Senate elections: Reply

Major criticisms made by Chressanthis and Shaffer (C-S) are addressed: the authors' failure to include noneconomic variables in the regression model, the inclusion of open elections in the sample, and the use of variables other than the state unemployment rate as economic performance measures. Errors in C-S's interpretations are noted. Additional regression results are reported using modifications of the authors' original model. These suggest that the change (notrelative change as in C-S) in state unemployment rate is superior, and that the authors' model yields a stronger effect of state economic performance on election outcomes than does the C-S model.John Beck contributed helpful comments.     

A method for estimating the GNP loss from a future oil embargo

This article develops a theoretical model to estimate the loss in GNP to the U.S. economy that would result from a future oil embargo. The model is based on an input-output matrix of the economy, but modifies the traditional input-output analysis in order to take account of conservation and substitution possibilities. Data generated from the 1973–74 embargo is used as a bench mark for this study in order to assure that the model produces reasonable estimates. Based upon estimates of future economic and energy growth, this study concludes that the United States will become increasingly vulnerable to economic damage as a result of a future embargo.This work was begun while the author was employed at the Center of Naval Analyses during the summer of 1974. Financial support for the continuation of this project was received from the Federal Energy Administration, and this paper is a condensed version of a report sent to the FEA. Views expressed in this paper are those of the author, and do not necessarily reflect the position of either of the above organizations.