Variation in the growth and incidence of medical malpractice claims

This study analyzes the incidence of medical malpractice claims since 1976, using data drawn from the 1982 core survey of the American Medical Association's Socioeconomic Monitoring System. The data show that, on average, physicians incurred twice as many claims per year in the years 1976 to 1981 as they did during their careers prior to that period. Using Tobit analysis, we find the annual frequency of claims to be greater among surgeons, obstetricians and gynecologists (OBGs), physicians in group practice, and physicians in states which apply the legal doctrine of informed consent. In addition, we find that the number of years since medical residency is positively related to physicians' claims incidence during the first 27 years of practice, and that OBGs and medical specialists who spend more time with their patients per office visit incur fewer claims.     

Neck injuries: I. Occipitoatlantal dislocation--a pathologic study of twelve traffic fatalities.

Twelve of 155 persons killed in traffic crashes had occipitoatlantal dislocations. Nine were vehicular occupants, 2 were cyclists, and one was a pedestrian. The dislocations involved various combinations of lacerations of the alar ligaments, the occipitoatlantal joint capsules, the dura mater, the tectorial membrane, the rectus capitis muscles, and the suboccipital muscles. In 2 instances, an occipital condyle failed instead of the corresponding alar ligament, producing condyle fractures. Atlas ring fractures occurred in 3 instances. Axial and subaxial cervical trauma were uncommon. Facial or mandibular fractures occurred in a majority of cases, vault skull fractures were uncommon, and basilar fractures were absent. Pontomedullary brainstem lacerations occurred in 9 of the 12, and 4 had midbrain lacerations. The majority of the victims succumbed to acute neurogenic shock as the sole or the major mechanism of death. The biomechanical basis for occipitoatlantal dislocation is discussed, and the author suggests that distraction, in concert with variable combinations of extension, rotation, and posterior translation is responsible for occipitoatlantal dislocations.     

Portrait of the North American runaway: A critical review

Runaway behavior has been viewed as a psychopathological problem by many. However, a review of the available research literature questions this perspective. An examination of the reported psychological profile of runaways suggests no clear relationship between personality and runaway behavior. Further, a multiplicity of factors can be noted which are potential causal agents for running away. These factors range from sociocultural values to school problems. Runaway research is shown to be methodologically limited by several factors, but the data are suggestive. Also, the authors conclude that future research on this growing social problem might utilize an “alternative values” or “deindivuation model” in generating testable hypotheses about runaway behavior.     

Remote spectroscopic identification of bloodstains

Blood detection and identification at crime scenes are crucial for harvesting forensic evidence. Unfortunately, most tests for the identification of blood are destructive and time consuming. We present a fast and nondestructive identification test for blood, using noncontact reflectance spectroscopy. We fitted reflectance spectra of 40 bloodstains and 35 nonbloodstains deposited on white cotton with spectroscopic features of the main compounds of blood. Each bloodstain was measured 30 times to account for aging effects. The outcome of the blood measurements was compared with the reflectance of blood-mimicking stains and various body fluids. We found that discrimination between blood and nonblood deposited on white cotton is possible with a specificity of 100% and a sensitivity of 98%. In conclusion, a goodness of fit between the sample's reflectance and the blood component fit may allow identification of blood at crime scenes by remote spectroscopy.     

Sex determination by PCR analysis of DNA extracted from incinerated, deciduous teeth.

Establishing the biological sex of human remains is a very important part of identifying victims of fire when severe soft tissue destruction has occurred. Deciduous (children's) teeth were exposed to a range of incineration temperatures 100-500 degrees C for 15 minutes. Polymerase Chain Reaction (PCR) amplification was used to identify specific human amelogenin regions. There was successful identification of human biological sex, from deciduous teeth exposed to incineration temperatures of 200 degrees C and below, using standard ethidium bromide gel staining. There was greater sensitivity using fragment analysis by laser induced fluorescence which achieved sex identification from some teeth heated to 400 degrees C.     

Volume Determination of Fresh and Dried Bloodstains by Means of Optical Coherence Tomography

The volume of bloodstains found on crime scenes may help forensic investigators reconstruct the location and kinematics of bloodletting events, as stain size, volume, and impact velocity are related. Optical coherence tomography was used as a method to determine the volume and volume ratio of dried and fresh bloodstains on both glass and irregular surfaces or deposited with an impact velocity. The volume of blood drops deposited on smooth glass surfaces was measured within a deviation of 2%. This deviation increased for droplets on irregular surfaces or deposited with an impact velocity. The volume ratio of dried and fresh bloodstains was equal to 19–28% depending on the individual donor and on the use of an anticoagulant. Optical coherence tomography is a good method to determine the volume of fresh and dried bloodstains in laboratory conditions and allows accurate determination of the dry/fresh ratio.     

Political Thuggery and Democratic Dividends in Nigeria

This study focuses on political thuggery and democratic dividends in Nigeria. Utilizing secondary and personal observation data the authors sought to address the following concerns: meaning of political thuggery and democratic dividend, manifestation and spate of political thuggery, and causes and effect of political thuggery and democratic performance since 1999 to date. The study reveals that poverty, unemployment, financial attractiveness of elective positions, the value system of wealth accumulation, and an ineffective security agency account for the incidence of political thuggery in Nigeria. Political thuggery hinders public accountability of elective officers and thus is a bane to good governance in Nigeria. Itg also increases the crime rate and the emergence of credible candidates in elections and thus is a threat to the achievement of democratic dividends and exercise of citizenship rights in Nigeria. On the basis of these findings, the study recommends that government should make elective offices less attractive financially and conceited government programs and policies should be aimed at alleviating unemployment and poverty and strengthening the capacity of security agencies. Government must consistently educate citizens and youth on the evil of political thuggery and violence.     

A Psychosocial Risk-Targeted Intervention to Reduce Work Disability: Development, Evolution, and Implementation Challenges

Research has been consistent in showing that certain psychosocial variables can increase the risk for prolonged work disability. Four psychosocial variables have emerged as robust predictors of disability across a wide range of debilitating health and mental health conditions. These include catastrophic thinking, symptom exacerbation fears, disability beliefs, and perceived injustice. The Progressive Goal Attainment Program (PGAP) is a psychosocial risk-targeted intervention that was developed to reduce psychosocial barriers to work resumption in individuals with debilitating health or mental health conditions. This paper describes the conception, developmental process, and the evolution of the PGAP. Research studies are summarized that have played a significant role in the developmental trajectory of the PGAP. Some of the legal and legislation-relevant challenges that were faced in the development and implementation the PGAP are discussed.