Can APB 2000 Be Used to Discern Sincerity of Effort in Unimpaired Subjects from Maximal Performance in Subjects with Shoulder Pain?

The automated pegboard (APB 2000), which has been found to objectively quantify motor performance, was used to differentiate maximal motor performance among subjects with shoulder pain, healthy unimpaired subjects performing normally and also while feigning shoulder pain. Six participants with shoulder pain and 15 healthy unimpaired individuals participated. Individuals with shoulder pain were tested on the APB 2000 using their affected upper extremity. Unimpaired participants were instructed to perform normally on the test with randomly selected upper extremity and to feign shoulder pain with the other upper extremity. The two tests for the unimpaired participants were conducted 1 week apart. There were significant differences in mean performance time for normal, patient, and feigned performance, with 80, 111, and 149 sec for the three groups respectively (p < 0.0005). There was also considerable overlap in the three distributions of performance times. These preliminary findings suggest that the APB 2000 is able to distinguish performance time between these three groups. Whether it can be used to distinguish between maximal performance and submaximal performance in individuals suspected of submaximal performance requires further study.     

A survey of background levels of explosives and related compounds in the environment

In this paper, swabbings from various public areas in 28 different cities throughout the United States were collected. A wide variety of objects were tested, ranging from park benches and telephones to sign posts and mailboxes. Inorganic anions and cations common in low explosives were detected simultaneously using capillary zone electrophoresis. Organic high explosives including nitroaromatics, nitramines, and nitrate esters were detected using gas chromatography with a pulsed-discharge electron capture detector. Confirmation of selected results was performed by ion chromatography and negative ion chemical ionization GC/MS. In general the results provide two major conclusions: (i) with the exception of nitrate, most low explosive oxidizers are rare in the environment; (ii) no organic explosives or significant interferences to these explosives were detected.     

Do you get what you pay for? Type of counsel and its effect on criminal court outcomes

Although the Sixth Amendment of the constitution guarantees assistance of counsel to indigent criminal defendants, questions exist about the quality of this representation. Critics assert that ‘you get what you pay for’ and that public defenders are less effective than privately retained counsel regarding criminal justice outcomes. Some research, however, reveals that public defenders are as effective as privately retained counsel because of their working relationships with prosecutors and judges, the so-called courtroom workgroup. The current study tested the assertion that ‘you get what you pay for’ by examining the effect of type of counsel (public defenders versus private attorneys) on four different case processing outcomes for a large mid-western jurisdiction. Results generally show that type of counsel has no significant direct effect. Tests for interaction, however, suggest that for some defendants, type of counsel interacts with other key variables to influence certain outcomes.     

Improved access to care for the uninsured poor in large cities: do public hospitals make a difference?

This study compares the volume of uncompensated care provided to the uninsured poor in cities with public hospitals to that provided in cities without a public hospital in order to determine whether public hospitals increase access to care. Multiple regression analysis is used to control for selected variables that also influence utilization of hospital care. Cities with public hospitals were found to provide between 31 and 34 uncompensated adjusted admissions per 100 uninsured poor; in cities without a public hospital, 24 such admissions were provided. In the regression analysis the coefficients for dummy variables representing three types of public hospital governance structures were all positive and statistically significant. The coefficient measuring teaching commitment among a city's hospitals was also positive and statistically significant. This analysis suggests that local tax support for public hospitals does not merely offset philanthropic or other revenue sources for voluntary hospital uncompensated care but is also likely to increase the amount of uncompensated care offered. We also find that public hospital closures may reduce access to care for the uninsured poor in large cities.     

Canada: Court affirms that prisoner health information must be treated as private and personal

On 8 April 2003, the Federal Court of Canada - Trial Division ruled that Correctional Services Canada (CSC) does not have a duty to warn an inmate of the potential violence or health hazards posed by a cellmate in the absence of clear and foreseeable danger.     

Examining the use of the M-FAST with criminal defendants incompetent to stand trial

The Miller Forensic Assessment of Symptoms Test (M-FAST) was developed to provide evaluators with a brief, reliable, and valid screen for malingered mental illness. This study examined the initial validity of the M-FAST in a sample of 50 criminal defendants found incompetent to stand trial because of a mental illness. The M-FAST total score and items were compared with the Structured Interview of Reported Symptoms (SIRS) and the fake-bad indicators of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results indicated good evidence of construct and criterion validity, demonstrated by t tests, receiver operating characteristics analysis, and high correlations between the M-FAST, SIRS, and the fake-bad indices on the MMPI-2. Tentative cut scores for the M-FAST total score and scales were examined and demonstrated high utility with the sample of criminal defendants incompetent to stand trial.     

Assisted reproductive technologies: professional and legal restrictions in Australian clinics

The professional and legal regulation of assisted reproductive technologies (ART) in Australia is a vast maze of intersecting laws and guidelines which place restrictions on the provision of services such as infertility treatment, surrogacy, sex selection for social reasons, donor insemination, pre-implantation diagnosis and human embryo research. This study investigated the application of these restrictions on clinical practice in New South Wales, a relatively unregulated State, and Victoria, a relatively highly regulated State. The results of the survey indicate that the range of ART services in Victorian clinics was far more limited than in New South Wales clinics. The Victorian clinics uniformly restricted access of single and lesbian women and did not offer social sex selection procedures. The New South Wales clinics adopted different polices regarding these services. It was found that restrictive laws governing "social" issues have a significant impact on the availability of ART services and some respondents seemed unclear about the nature of restrictions and laws relevant to their work. It was also found that "reproductive tourism" is prevalent and restrictions were circumnavigated by patients with assistance from clinics. It was concluded that more evidence is required to evaluate regulation in this field of medicine.