The new JCAHO patient safety standards and the disclosure of unanticipated outcomes. Joint Commission on Accreditation of Healthcare Organizations

This article looks at the newly-issued JCAHO standards and their increased focus on patient safety in performance standards for healthcare organizations. As part of these standards, hospitals are required to inform patients of outcomes of care, including unanticipated outcomes. This article examines this requirement and suggests varying interpretations of it. After looking at the current legal and ethical standards requiring disclosure of errors or negligent acts, the article suggests that hospitals are faced with many difficulties in implementing the standard. Specifically, the article argues that more details are necessary regarding what events must be reported and what hospitals are required to do when members of the medical staff refuse to inform patients of medical error.     

Surface sterilization of a maggot using bleach does not interfere with mitochondrial DNA analysis of crop contents

Mitochondrial DNA analysis of a maggot crop can identify the corpse a maggot has been feeding on. Analysis of the crop could be useful in a criminal investigation if maggots are found at a suspected crime scene in the absence of a body, or if there is a question of whether a maggot used in postmortem interval estimations moved onto the corpse from another food source. Such analysis can also resolve a chain of custody dispute if it has been suggested that larval samples have been switched. When recovering DNA from a maggot crop, the analyst must be careful to avoid external contamination. We investigated the effects of three simple wash methods developed to reduce external contamination. Maggots raised on pig liver and intentionally contaminated with cow blood were washed using water, 20% bleach, or a solution containing the enzyme DNase. Only washing the maggots in 20% bleach reduced the amount of vertebrate DNA amplified from the maggots' exteriors. No wash method affected the ability to recover DNA from the maggot crops.     

“Beggar thy Neighbor:” Testing for Free Riding in State-Level Endangered Species Expenditures

An important public policy question that remains unresolved iswhether devolution will enhance sensible policy making byexploiting informational asymmetries or, instead, trigger a``beggar thy neighbor'' response and stimulate free ridingamongst localities. We analyze this question within theframework of U.S. environmental policymaking by scrutinizing aunique panel data set on state-level endangered speciesexpenditure patterns. Our empirical estimates are consistentwith the notion that states free ride, which may lead to anexpenditure equilibrium that is not Pareto efficient.     

Pilot study examining factors asscociated with academic success for hispanic high school students

This study examines characteristics that distinguish succeeding and failing Hispanic students at an inner-city high school. While research on this topic has historically focused on dropouts, this study seeks to better understand successful high school students. Participants in the study were 48 Hispanic tenth-grade students at a large, predominantly minority and low-income high school. High-and low-risk groups were identified on the basis of ninth-grade attendance rates and course failures. When compared to their high-risk counterparts, low-risk students were found to be more satisfied with their school and to maintain a social group predominantly free of gang members. The findings are discussed in terms of how the distinguishing variables contribute to students' success.Obtained degree in clinical-community psychology from DePaul University. Research focuses on adolescent risk factors, particularly as they relate to academic success and high school completion.Earned degree in clinical-community psychology from the University of Rochester. Has published extensively on issues related to prevention and community psychology. Most recently work has focused on strategies to help high-risk school transfer children adjust to the academic demands of their new schools.     

STR analysis of artificially degraded DNA-results of a collaborative European exercise

Degradation of human DNA extracted from forensic stains is, in most cases, the result of a natural process due to the exposure of the stain samples to the environment. Experiences with degraded DNA from casework samples show that every sample may exhibit different properties in this respect, and that it is difficult to systematically assess the performance of routinely used typing systems for the analysis of degraded DNA samples. Using a batch of artificially degraded DNA with an average fragment size of approx. 200 bp a collaborative exercise was carried out among 38 forensic laboratories from 17 European countries. The results were assessed according to correct allele detection, peak height and balance as well as the occurrence of artefacts. A number of common problems were identified based on these results such as strong peak imbalance in heterozygous genotypes for the larger short tandem repeat (STR) fragments after increased PCR cycle numbers, artefact signals and allelic drop-out. Based on the observations, strategies are discussed to overcome these problems. The strategies include careful balancing of the amount of template DNA and the PCR cycle numbers, the reaction volume and the amount of Taq polymerase. Furthermore, a careful evaluation of the results of the fragment analysis and of automated allele calling is necessary to identify the correct alleles and avoid artefacts.     

Systematic differences in electropherogram peak heights reported by different versions of the GeneScan software

DNA profiling using STRs on the 310 and 3100 Genetic Analyzers routinely generates electropherograms that are analyzed with the GeneScan software available from the instrument's manufacturer, Applied Biosystems. Users have been able to choose from three different smoothing options that have been known to result in significant differences in the peak heights that are reported. Improvements in the underlying algorithm of the most recent version of the software also result in significant and somewhat predictable differences in peak height values. Laboratories that have performed validation studies using older versions of GeneScan should either reanalyze the data generated in those validation studies with the newest version of the software or otherwise take into consideration the systematically higher peak height values obtained as they begin following the recommendation of the manufacturer and use the new algorithm.     

A Linear Poisson Autoregressive Model: The Poisson AR(p) Model

Time series of event counts are common in political scienceand other social science applications. Presently, there arefew satisfactory methods for identifying the dynamics in suchdata and accounting for the dynamic processes in event countsregression. We address this issue by building on earlier workfor persistent event counts in the Poisson exponentially weightedmoving-average model (PEWMA) of Brandt et al. (American Journalof Political Science 44(4):823–843, 2000). We developan alternative model for stationary mean reverting data, thePoisson autoregressive model of order p, or PAR(p) model. Issuesof identification and model selection are also considered. Wethen evaluate the properties of this model and present bothMonte Carlo evidence and applications to illustrate.