Does Mirror Imaging a Radiograph Affect Reliability of Age Assessment Using the Greulich and Pyle Atlas?*

Abstract: Age estimation is routinely undertaken by comparing radiographs of the individual in question to published reference samples of individuals of known age. This study examines the reliability of age estimation utilizing the Greulich and Pyle atlas in relation to both left‐ and right‐hand/wrist radiographs and explores whether reversing right‐hand/wrist radiographs, so that they are in the same anatomical orientation as those images used in the atlas affects reliability. A total of 403 left‐hand/wrist radiographs and 415 right‐hand/wrist radiographs were age assessed using the Greulich and Pyle atlas. Analysis showed that there is no significant loss in reliability when radiographs of the right hand (women R² = 0.887 and men R² = 0.907) are utilized instead of the left (women R² = 0.939 and men R² = 0.940) or when they are assessed as mirror images to those printed in the reference atlas (reversed female left hand R² = 0.929 and reversed male left hand R² = 0.931).     

Body recovery from hostile environments--a test of three kits

Disaster Victim Identification (DVI) procedures and protocols have largely been standardised through the creation of, and amendments to, the INTERPOL DVI Guide. Whilst robust in addressing the recovery of mass fatality victims resulting from natural disasters, accidents and acts of terrorism, the guide does not explore the problematic issue of recovery of fatalities during active conflicts or peacekeeping operations where the environment may be hostile and the time taken to perform the task may impact significantly on the risk of injury or additional fatalities. This study tested the viability of the current UK style body recovery kit for use in a hostile environment simulation and compared its performance to two new bespoke kits specifically designed by the first author for this purpose. The aim was to recover the maximum amount of available physical evidence to support possible future judicial review, maintain respectful dignity for the deceased and focus on the safety of those fulfilling this task who may be operating on the front line. The kits were tested by military personnel experienced in hostile environment deployment. The trials showed that the time taken to record and recover the deceased could be reduced from 40 min using the standard DVI kit to just over 2 min using a bespoke kit. It was also shown that evidential recovery was not adversely affected and it is suggested that personal safety could be significantly enhanced if the proposed methodology and kit were adopted.     

When risk‐based regulation aims low: A strategic framework

This article develops a strategic framework for regulators to employ when choosing intervention strategies for dealing with low risks and reviewing performance, building on the analysis by the same authors in the previous edition of this journal. The framework occupies the operational “middle ground” between risk analysis and formal enforcement action. At its core is a matrix, the Good Regulatory Intervention Design (GRID), which provides a framework to categorize sites or activities on the basis of two factors: the nature of the risk and the nature of the regulatee. Using GRID, regulators can select which intervention tools to use, and determine the overall level of regulatory intensity that should apply. GRID is accompanied by the Good Regulatory Assessment Framework (GRAF) for agencies to use in reviewing their performance and provides a step‐by‐step process for enabling “double loop learning.” The article also argues that the process of developing such a framework highlighted the extent to which “low risk” and “high risk” regulation are distinct. “Low risk” means “low priority.” Justifying why certain risks should not receive much regulatory attention requires a particular type of engagement, and has a bearing on the regulatory strategies that are adopted.     

The five capabilities of socially responsible companies

This paper develops and tests a model that integrates processes of public affairs management with stakeholder engagement and dialogue, business ethics and social reporting to explain social responsibility capabilities in organisations. The model, called Corporate Social Responsibility Management Capacity, describes social responsiveness as arising from a firm's social responsibility orientation and its public relations orientation. The paper shows how the model can be used by managers to measure, manage and improve their company's ability to be socially responsible. Copyright © 2004 Henry Stewart Publications     

Whatever happened to regionalization? The curious case of Nova Scotia

Abstract: The case of Nova Scotia well illustrates the complexities involved in implementing a strategy of regionalization in health care. In 1996, under the leadership of Liberal Premier John Savage, thirty‐six local hospital boards were amalgamated into four regional health boards. By 2001, however, Conservative Premier John Hamm had expanded the four regions into nine district health authorities. Both measures were justified by explicit references to cost containment and greater accountability, even though the first took numerous units and amalgamated them, while the second took the few units and multiplied them. How can this seeming contradiction be explained, and what does it say about the nature of regionalization as a policy tool for health care? The authors find that neither cost containment nor citizen engagement can explain the system of regionalization which currently informs the health care system in Nova Scotia. Rather, the present form of regionalization exists because it is useful politically in two ways: it maintains the centralization of power that existed previous to the formal decentralization of health care; and it restores the system of representation that existed prior to the implementation of regionalization. The authors conclude that, to understand how regionalization has been implemented in any given jurisdiction, one must pay close attention to the political context in which strategies of regionalization have been executed. Sommaire: Le cas de la Nouvelle‐Écosse illustre bien les complexités inhérentes à la mise en œuvre d'une stratégie de régionalisation dans les soins de santé. En 1996, sous le leadership du Premier ministre libéral John Savage, 36 conseils d'hôpitaux locaux ont fusionné pour former quatre conseils de sante régionaux. En 2001, cependant, le Premier ministre conservateur John Hamm a élargi les quatre régions pour les transformer en neuf conseils de santé de district. Ces deux mesures ont été justifiées par des références explicites à la compression des coûts et à une plus grande imputabilité, même si la première a consistéà prendre de nombreuses unités et à les fusionner, tandis que la seconde a consistéà prendre quelques rares unités et à les multiplier. Comment peut‐on expliquer cette apparente contradiction, et qu'est‐ce que cela nous dit sur la nature de la régionalisation en tant qu'outil de politique en matière de soins de santé? Les auteurs trouvent que ni la compression des coûts, ni la participation des citoyens ne peuvent expliquer le système de régionalisation qui caractérise actuellement le système de soins de santé en Nouvelle‐Écosse. Au contraire, la forme actuelle de régionalisation existe parce qu'elle est politiquement utile de deux manières: elle maintient la centralisation du pouvoir qui existait avant la décentralisation officielle des soins de santé; et elle restaure, jusqu'à un certain point, le système de représentation qui existait avant la mise en œuvre de la régionalisation. Les auteurs concluent que, pour comprendre la manière dont la régionalisation a été mise en œuvre, il faut prêter une grande attention au contexte politique dans lequel ces stratégies de régionalisation ont étéélaborées.     

Stubs Versus Swabs? A Comparison of Gunshot Residue Collection Techniques

Abstract: The collection efficiency of two widely used gunshot residue (GSR) collection techniques—carbon‐coated adhesive stubs and alcohol swabs—has been compared by counting the number of characteristic GSR particles collected from the firing hand of a shooter after firing one round. Samples were analyzed with both scanning electron microscopy and energy dispersive X‐rays by an experienced GSR analyst, and the number of particles on each sample containing Pb, Ba, and Sb counted. The adhesive stubs showed a greater collection efficiency as all 24 samples gave positive results for GSR particles whereas the swabs gave only positive results for half of the 24 samples. Results showed a statistically significant collection efficiency for the stub collection method and likely reasons for this are considered.     

Non-traumatic forensic neuropathology

The practicing Forensic Pathologist is likely to encounter case material in which either the cause of death or a major contribution to the cause of death is underlying damage to or disease of the central nervous system. While it is good practice in many instances to have a working relationship with a Department of Neuropathology, from which advice and practical help can be sought, there may be instances when the Forensic Pathologist needs to proceed on a basis of a working knowledge of Forensic Neuropathology up to and including how to examine the specimen and take tissue blocks for processing and subsequent histological examination. Some of the more common conditions of the central nervous system such as damage consequent to hypoxia-ischaemia, hypoglycemia and epilepsy, the encephalopathies associated with altered sodium concentration, deficiency due to Vitamin B(1) and various neurodegenerative diseases that manifest as dementia and include Alzheimer's disease, cortical Lewy body disease and the prion disorders, are outlined in this article.