Medical negligence in drug associated deaths

According to epidemiological studies adverse drug events are one of the most frequently encountered complications during medical treatment, a leading cause of hospitalisation and frequent cause of death. However, medical malpractice claims due to medication errors seem to be relatively rare. Based on a retrospective multicentre study on medical malpractice cases with lethal outcome (n = 4450), drug related cases (n = 575) were further evaluated. In 50% of cases a causal connection between drug therapy and death could be ruled out already after autopsy. In 232 cases a causal connection between drug therapy and death could be approved (drug allergies, relative overdose, wrong application, mix-up of drugs and sepsis after injection abscess). However, within the legal context only in 70 cases a medication error was approved which was in 42 cases causal for death, in 28 not. Administration of contraindicated drugs, incorrect application and relative overdose in renal insufficiency are the prevalent mistakes. Concerning the frequency of ADE in epidemiological studies medication errors are underreported in all data sources on medical malpractice; this seems to be due to the fact that even doctors and attending physicians rarely recognize an ADE; furthermore approving the connection between drug effect and death is extremely difficult for the expert witness.     

Comparison of the Plexor HY System, Quantifiler and Quantifiler Duo kits using the Roche LightCycler 480 System and the ABI 7900 real time PCR instrument

In this study, we used two real time PCR platforms (Roche LightCycler 480 System and the ABI 7900 real time PCR instrument) to compare three commercial kits for DNA quantification. Special emphasis was put on PCR efficiency, detection limit and detection range. Furthermore, we tested the influence of the calibrator DNA included in the different kits on the absolute values. 40 artificial stain samples as well as 40 reference saliva samples were tested and compared. Two main observations could be made: the kits had a strong influence on the amount of DNA determined (Quantifiler^® < Quantifiler Duo^® < Plexor^® kit) whereas the real time PCR platforms showed no significant influence on the outcome.     

Identification of biological samples in a case of contamination of a cytological slide preparation

Here we report a case where a discrete section of the cytological slide preparation of a female individual was obviously contaminated with pleura liquid of a female tumor patient. Analysis of the cancerous pleura liquid and the healthy cells of the slide preparation showed different DNA profiles, indicating that the material originated from two different female individuals. The DNA profile of the cell mixture revealed a heterogenous pattern whereby the alleles could be assigned to the healthy and the tumor patient. Loss of heterozygosity (LOH) was observed in four of eight short tandem repeat systems for the pleura liquid and the cell mixture. Despite the low amount of DNA on the slide preparation and the occurrence of LOH, it was possible to clarify the case and to support the assumption that a drop of cancerous pleura liquid contaminated the cytological slide.     

Constructing crime: Neighborhood characteristics and police recording behavior

It has long been acknowledged that police officers have substantial levels of discretion in their day-to-day activities. There is a well developed body of literature that considers how this discretion is exercised across a broad array of situations including the decision to arrest, use force, and grant citizen requests for official action. Using both social disorganization and conflict theories as conceptual models, the purpose of this study was to determine if neighborhood characteristics affect police reporting behavior across a wide cross-section of reported call types. The findings indicated that reporting behavior widely varies across crime types with a greater percentage of more serious crimes translated into official crime. Neighborhood characteristics did affect reporting practices, but surprisingly only for more serious forms of disorder where discretion was perceived to be less. The findings lent support for both social disorganization and conflict theories. Theoretical implications are discussed.     

Preparing individuals for leadership in Australasia,the United States,and the UK

ABSTRACT

Much is said about the importance of leadership in policing. In policing leadership is a key variable in organisational effectiveness, public confidence and employee well-being. We demand that our police leaders are ethical, decisive, skilled, and have the internal and external legitimacy needed to exert influence inside and outside the workplace. There are many advantages to such a pipeline approach to organisational leadership, and it presents organisations with an unparalleled opportunity to develop leaders and leadership talent over an extended period. There are questions, of course, about how much advantage our police organisations really take of this opportunity; how coherently leader development is planned and organised; and how effective our development models are. In this paper, we explore leader development in Australia, the United States and the United Kingdom. Drawing on data collected through semi-structured interviews with established senior police leaders in each country we explore development journeys, opportunities for learning inside and outside of policing, the impact of leader development on leadership-style and decision-making, and how well-prepared leaders feel for their roles having transited their organisational pipelines. Drawing on these data we present a model for leadership development that calls for individual and organisational work. By seeing leadership in terms of organisation capacity, rather than individual capacity, the model encourages a comprehensive and more cohesive approach through police education and other initiatives to developing our organisational leaders, and recognises too that preparing individuals is only part of the story.     

Driving under the influence of amphetamine-like drugs

Scientific opinions differ whether the use of stimulants causes deterioration in driving skills. In 1857 of 8709 cases of driving under the influence of drugs, amphetamine-like drugs (amphetamine, methamphetamine, and methylendioxyamphetamine) were present either alone or together with other licit or illicit drugs. In 338 cases, amphetamines were the only psychoactive substance group in plasma at mean, median, and highest concentrations of 0.18, 0.12, and 1.05 mg/L, respectively. A widespread opinion is that after the consumption of amphetamines, centrally stimulating effects with corresponding consequences on safe driving are expected. In contrast, many cases were observed that rather suggested an influence of centrally sedating substances when considering the psycho-physical conditions. Relations between concentration and effect could not be established. The apparent sedation is probably the consequence of sleep deprivation during an amphetamine binge and the after-effects of the drug.     

Studying traffic stop encounters

Racial profiling has received significant consideration in recent years as politicians, police, academics, the media, advocacy groups, and the general public attempt to understand and assess the extent to which this practice occurs in the nation. Despite considerable attention and the investment of substantial financial resources, the question of whether racial profiling exists has eluded a conclusive answer. As more efforts are made to study police traffic stop data, it is crucial that researchers have an understanding of the associated methodological issues. This article considers traffic stop studies from a methodological perspective, discussing the challenges associated with conducting meaningful research of police officer decision making patterns in traffic stop encounters. Using data from a Midwestern community, as well as the experiences of researchers across the country, the authors illustrate and discuss implications for data collection, variables, and data analysis.     

African American and White perceptions of police services: Within- and between-group variation

Existing research on attitudes toward the police identified demographic variables predicting citizen satisfaction with police services and performance. Common themes in this literature were the disparate rates of satisfaction reported by African American and Caucasian citizens. While it is generally understood that African American citizens express lower levels of satisfaction, the degree to which this reduced satisfaction is consistent among African Americans and the factors causing such variation are unclear. In addition, variation in levels of citizen satisfaction across diverse measures of police services has yet to be considered by race. This study used data from a medium-sized Midwestern community to contrast samples of White and African American citizens to better understand how demographic, experiential, and neighborhood contextual factors shape perceptions of global, traditional, and community police services. Results from this study indicate that there is significant variation in the importance of certain exogenous factors in predicting satisfaction with police services. The differences between perceptions and race are most prominent in the community policing services model.