Investigation of elderly deaths in nursing homes by the medical examiner over a year

Despite death being one of the most common reasons for discharge from a nursing home, fewer than 1% of nursing home resident deaths are autopsied. To evaluate our role as medical examiner in nursing home deaths, we conducted a retrospective review of all decedents in Jefferson County, Alabama, for the year 2001. Death certificate data indicate that 995 deaths occurred in nursing homes in Jefferson County in 2001. Of those 995 deaths, 119 (12%) were reported to the Jefferson County Coroner/Medical Examiner Office. Jurisdiction was accepted in 5 cases in which the circumstances already made clear that the death was a nonnatural event. In the remaining 96% of nursing home deaths reported to the medical examiner, the statements of the reporting person were taken to be true concerning the expected nature of the death. An independent scene evaluation was provided by a police officer or paramedic in 82% of the cases reported to the medical examiner's office. Elderly individuals, as a group, are expected to die, but the death of a particular elder may or may not be expected. In our jurisdiction, only 12% of all nursing home deaths are reported to our office, and only 4% of reported deaths are actively investigated. Actively investigating each nursing home death would overwhelm the resources currently available to our office. We advocate the study and development of criteria to aid in determining whether the death of an individual elder is sudden and unexpected.     

Typologies of men who are maritally violent: scientific and clinical implications

Varying levels and types of husband violence may be conceptualized as typologies of maritally violent men. Across studies, batterer subtypes resembling those proposed by Holtzworth-Munroe and Stuart (1994) have been identified and generally found to differ in predicted ways. Longitudinal data from this study suggests that the subgroups continued to differ over three years. Over time, however, the placement of individual men into some subtypes was not stable. Whether to best conceptualize the heterogeneity among maritally violent men as differing subtypes or as variability along dimensions is considered. Clinical issues regarding the typology are discussed, including concern that the use of absolute cut-off points to identify subtypes is premature and consideration of using the typology to predict treatment outcome and to match interventions to subtypes. Regarding future research ideas, it is time to consider more immediate, situational and dyadic, processes leading to violence perpetration within each subtype.     

Better than Raw: A Guide to Measuring Organizational Performance with Adjusted Performance Measures

Like oysters on the half shell, some things are better when they're raw. In evaluating the performance of organizations and providing guidance for improving performance, however, raw performance measures, such as test scores or success rates, are often inferior to performance measures adjusted for client and environmental characteristics, or adjusted performance measures (APMs). Using examples from a variety of public services and data on public schools in Georgia, we compare the performance data generated by raw scores and by APMs. We conclude with guidance for constructing and using adjusted performance measures.     

Child protective intervention in the context of welfare reform: The effects of work and welfare on maltreatment reports

Recent changes in welfare policy have produced changes in parental work and welfare receipt. These factors are assessed in relation to investigated reports of child abuse and neglect using survey data on 1998 welfare recipients in nine Illinois counties, in conjunction with longitudinal administrative data on cash welfare benefits, employment, and child abuse and neglect reports. Trend analyses show that rates of child maltreatment reports among welfare recipients have risen since the passage of PRWORA in 1996. Findings from multivariate analyses indicate that parental employment has a protective effect on reports to child protection systems (CPS), that this effect is greatest when combined with welfare receipt, and that this effect becomes stronger over time. Those who receive welfare in the absence of employment face a significantly greater risk of CPS involvement, even compared with those who neither work nor receive welfare. © 2003 by the Association for Public Policy Analysis and Management     

Supportive Community Resources Are Associated with Lower Risk of Substance Use among Lesbian,Gay, Bisexual,and Questioning Adolescents in Minnesota

Journal of Youth and Adolescence - Research has indicated that lesbian, gay, bisexual, and queer/questioning (LGBQ) adolescents have disproportionately high rates of substance use compared to...     

Results of the 2018 Rapid DNA Maturity Assessment

Three commercially available integrated rapid DNA instruments were tested as a part of a rapid DNA maturity assessment in July of 2018. The assessment was conducted with sets of blinded single-source reference samples provided to participants for testing on the individual rapid platforms within their laboratories. The data were returned to the National Institute of Standards and Technology (NIST) for review and analysis. Both FBI-defined automated review (Rapid DNA Analysis) and manual review (Modified Rapid DNA Analysis) of the datasets were conducted to assess the success of genotyping the 20 Combined DNA Index System (CODIS) core STR loci and full profiles generated by the instruments. Genotype results from the multiple platforms, participating laboratories, and STR typing chemistries were combined into a single analysis. The Rapid DNA Analysis resulted in a success rate of 80% for full profiles (85% for the 20 CODIS core loci) with automated analysis. Modified Rapid DNA Analysis resulted in a success rate of 90% for both the CODIS 20 core loci and full profiles (all attempted loci per chemistry). An analysis of the peak height ratios demonstrated that 95% of all heterozygous alleles were above 59% heterozygote balance. For base-pair sizing precision, the precision was below the standard 0.5 bp deviation for both the ANDE 6C System and the RapidHIT 200.     

Caregiver Issues and Concerns Following TBI: A Review of the Literature and Future Directions

Psychological Injury and Law - Survival following traumatic brain injury (TBI) has increased following advances in medical care. However, TBI survivors often experience significant deficits in...     

Are women more likely to throw the rascals out? The mobilizing effect of social service spending on female voters

Public Choice - This study focuses on gender differences in voter reactions to a corruption scandal in one’s preferred party. We analyze, in a framework of ‘exit, voice and...