The fraction of disability caused at work

Disability has high societal and personal costs. Various disparate federal and state programs attempt to address the economic and social needs of people with disabilities. Presumably workplace injuries and accidents are an important source of disability. Yet separate public policies and research literatures have evolved for these two social problems--disability and workplace injuries--despite their relatedness. This article seeks to document the overlap between these two phenomena in estimating the proportion of the disabled population whose disability was caused by workplace injury, accident, or illness using the Health and Retirement Study of 1992. The results point toward the need for initiatives to reduce disability that focus on work-related causes, which are a common pathway to disability, and that may result in substantial savings in federal programs.     

Diversity and heterogeneity in mitochondrial DNA of North American populations

Variation in the mitochondrial DNA (mtDNA) control region as detected by sequence-specific oligonucleotide (SSO) probes is described for 2282 individuals from African-American, European-American, and Hispanic subpopulations from five broadly defined regions of North America (Northeast, Southeast, Central, Northwest, Southwest). Population diversity estimates were uniformly high for all subpopulations and for each major ethnic group. Only the Pennsylvania Hispanic group was remarkable with respect to its mitochondrial DNA types, having both six low frequency population specific types (ranging from 1.2-8.6%) and three high frequency shared types (10-20% each). There was no statistically significant subpopulation heterogeneity present within any of the three major groups at either the subpopulation level or the regional level (p > 0.01). However, statistically significant heterogeneity was measured when comparing the three major groups to each other, with the variance component attributable to this large division accounting for 18.60% of the total variance (p < 0.001). Overall mtDNA is a satisfactory forensic typing locus within broadly defined African-American, European-American, and Hispanic groups from North America, based on the high diversity estimates and absence of heterogeneity, as characterized by SSO typing.     

Determination of drug levels in larvae of Protophormia terraenovae and Calliphora vicina (Diptera: Calliphoridae) reared on rabbit carcasses containing morphine

Two species of blow flies (Diptera: Calliphoridae) were reared on tissues from rabbits administered different dosages of morphine. These species, Protophormia terraenovae and Calliphora vicina are among the first wave of insects colonizing a dead body. Two series of 3 rabbits were given dosages of 10, 20, and 40 mg/h of morphine over a 3 h period via ear artery perfusion. A morphine blood level plateau was attained after 1 h of perfusion. Two other rabbits were used as controls. Samples of tissues collected from rabbits using a coelioscopic technique were determined to have morphine concentrations similar to those encountered in human overdoses and were correlated with dosages of morphine administered. All samples from control rabbits were negative for morphine. Larvae and puparia of both species were regularly collected from each rabbit for toxicological analysis. Concentrations of morphine in larvae reared on rabbit carcasses containing morphine were significantly lower than concentrations found in the tissues. There was a decrease in concentration in morphine observed in transition from feeding 3rd instar larva to puparium. A correlation between larval concentration and tissue concentration was found only in feeding 3rd instar larvae.     

Legal considerations of sleep deprivation among resident physicians

Medical training in the United States often takes the form of a grueling endurance test in which patients are often those most at risk. This Article discusses sleep deprivation among resident physicians in the United States with an eye towards resolving the problem through legal channels. It analyzes the effects of sleep deprivation on resident physicians, with subsequent discussion of the implications for patient care and medical training. Next, it makes comparisons to medical training in other developed nations, as well as regulations that exist in the airline and trucking industries, where public safety is a principal concern. Furthermore, this Article discusses proposals to mend the dilemmas created by sleep-deprived resident physicians through statutory and regulatory reform, deterrence by way of tort law, and unionization or collective bargaining.     

Doctors as fiduciaries--revisiting the past with an eye on the future

A substantial proportion of the body of literature dealing with the question of whether or not a doctor stands in a fiduciary relationship with a patient in Australia assumes or asserts that this should be the case, despite strong indications to the contrary in Australian case law. Three key bases for making such assertions, the internationalist, revisionist and remedialist approaches, are identified and critiqued. It is argued that each of these approaches to justifying the characterisation of the doctor-patient relationship as a fiduciary one is flawed and unlikely to meet with success in future litigation. Additionally, there are issues of economic and resource allocation conflict in doctor-patient relationships. The implications for these conflicts in the doctor-patient fiduciary debate are briefly considered. It is concluded that, contrary to the dominant assertion in the extant literature on the subject, in Australia at least, the scales tip against, rather than towards, the characterisation of the doctor-patient relationship as a fiduciary one.     

TBOR2 compliance plans: from rebuttable presumption to enforcement

This Article analyzes the implications and strategies of incorporating the Taxpayer Bill of Rights 2 ("TBOR2") into tax-exempt healthcare organizations' compliance plans. Beginning with a brief overview of TBOR2, the author examines the presumption of fair market value, how such organizations establish safe harbors, the current Internal Revenue Service (IRS or Service) position regarding enforcement of TBOR2, and the lurking potential for "whistleblowers" to start auditory procedures with an eye toward IRS bounties. Mr. Griffith concludes that the best advice for exempt organizations is to follow the rebuttable presumption procedure for all transactions involving potential disqualified persons, including staff and employed physicians, and seek to fit within the safe harbors for the less routine and larger of those transactions.