Petechiae in hanging: a retrospective study of contributing variables

Petechiae, one of the classic signs of asphyxia, are thought to be more frequently observed in cases of hanging where part of the body is supporting the victim's weight, ie, cases of incomplete hanging. However, there is very little evidence-based medicine to support this claim. The present study is intended to evaluate the relationship between petechiae and the type of hanging (complete vs. incomplete). Furthermore, several other variables were analyzed to determine if they contribute significantly to the presence of petechiae. An 8.5-year retrospective study of 206 cases of death by hanging reviewed autopsy reports for the presence of petechiae. For each case, the following information was also compiled: gender and age, height and weight, body mass index, the type of hanging (complete or incomplete suspension), the type of ligature used (narrow or wide), and whether or not the victim had received cardiopulmonary resuscitation maneuvers. Statistical analysis revealed that the incidence was higher among incomplete hanging victims compared with cases of complete suspension and that the incidence of petechiae varied inversely with the height of the victims. The other factors were not shown to contribute significantly to the presence of petechiae.     

Pathogen detection using a liquid array technology

Abstract: Low concentrations of microbial pathogens in pure and mixed samples were detected using a bead‐based, liquid array technology. A 20‐bp sequence in the 23S rRNA gene, rrl, was amplified in four microorganisms: Bacillus cereus, Escherichia coli, Salmonella enterica and Staphylococcus aureus. PCR products were positively identified with the Luminex^® 100? system. The system could detect very low amounts of DNA and the instrument response was proportional to the input concentration. The lower limit of detection (LLD) was determined to be 0.5 ng for B. cereus and E. coli and 2 ng for S. enterica. The LLD for S. aureus was not determined as the instrument response was still above the threshold when quantities of DNA as low as 0.25 ng were used. The platform positively identified organisms present in mixed samples even when the minor component was overshadowed by a 10‐fold excess of the major component.     

Job Satisfaction and Gender in the APS: Who’d Want to be a Male?

This article uses the 2008 State of the Service survey data to compare the job satisfaction and attitudes toward work of men and women in the Australian Public Service (APS). It shows that up to and including Executive Level (EL) women are significantly more positive than men about their work and the organisation. At Senior Executive Service (SES) level men are more satisfied. The article also looks at the predictors of job satisfaction separately for men and women at each level, and finds that career progression, support for work‐life balance, agency leadership, role clarity and authority and good immediate management are significant contributors for most employees. It suggests that the APS use these findings to identify those areas which need to be developed in order to attract men, and increase the job satisfaction of existing male staff at Executive Level and below.     

Expanding dependent coverage for young adults: lessons from state initiatives

The Patient Protection and Affordable Care Act (ACA) requires that adults up to age twenty-six be permitted to enroll as dependents on their parents' health plans. This article examines the experiences of states that enacted dependent expansion laws. Drawing on public information from thirty-one enacting states and case studies of four diverse reform states, it derives lessons that are pertinent to the implementation of this ACA provision. Dependent coverage laws vary across the states, but most impose residency, marital status, and other restrictions. The federal Employee Retirement Income Security Act further limits the reach of state laws. Eligibility for expanded coverage under the ACA is much broader. Rules in some states requiring or allowing separate premiums for adult dependents may also discourage enrollment compared with rules in other states (and the ACA), where these costs must be factored into family premiums. Business opposition in some states led to more restrictive regulations, especially for how premiums are charged, which in turn raised greater implementation challenges. Case study states did not report substantial young adult dependent coverage take-up, but early enrollment experience under ACA appears to be more positive. Long-term questions remain about the implications of this policy for risk pooling and the distribution of premium costs.     

Perceptions of the health system and public trust in government in low- and middle-income countries: evidence from the World Health Surveys

In low- and middle-income countries, health care systems are an important means by which individuals interact with their government. As such, aspects of health systems in these countries may be associated with public trust in government. Greater trust in government may in turn improve governance and government effectiveness. We identify health system and non-health system factors hypothesized to be associated with trust in government and fit several multilevel regression models to cross-national data from 51,300 respondents in thirty-eight low- and middle-income countries participating in the World Health Surveys. We find that health system performance factors are associated with trust in government while controlling for a range of non-health system covariates. Taken together, higher technical quality of health services, more responsive service delivery, fair treatment, better health outcomes, and financial risk protection accounted for a 13 percentage point increase in the probability of having trust in government. Health system performance and good governance may be more inter-related than previously thought. This finding is particularly important for low-income and fragile states, where health systems and governments tend to be weakest. Future research efforts should focus on determining the causal mechanisms that underlie the observed associations between health system performance and trust in government.     

Child abuse and neglect:A National Summary Of State Statutes

Effective court improvements must be based on comprehensive, baseline analysis of state child abuse and neglect statutes. This information will provide policy makers with improved tracking and evaluation opportunities as significant statutory changes are contemplated in pending federal initiatives and state court improvement activities. This article provides excerpts of a comprehensive national study undertaken to determine the level of uniformity or variance in statutes since the initiation of federal legislation attempting to improve state practice in the handling of child abuse and neglect cases. The state-by-state information is designed to provide diverse jurisdictions with an opportunity for comparative statutory analysis. The complete, 50 state Matrix of State Statutes Pertaining to Child Abuse, Neglect and Dependency is scheduled for publication later this year.     

The history of women in science: A women's studies course

Women have always done scientific work but have rarely received the recognition they deserved. As a result most of us learn, from elementary school on through university, that science is and always has been the province of men. Women are seldom mentioned in history of science courses and their contributions are often attributed to male scientists. This paper describes a lower division course in the history of women in science, offered jointly through the Women's Studies Program and the Biology Department at Portland State University. It includes a discussion of the topics and issues covered in the course and the types of questions raised about women scientists. Examples are given to illustrate historic trends and some of our experiences in the classroom are described. A representative bibliography provides an introduction to various aspects of the subject.     

Laboratory evidence of unsuspected parental consanguinity among cases of disputed paternity

A search was conducted to find evidence of possible incestuous unions between the biologic parents of children involved in 2500 paternity cases. Suspicion was raised when either (1) a mother and her child possessed identical HLA phenotypes, or (2) the child appeared to be possibly homozygous for one maternal haplotype (i.e., one of the child's HLA haplotypes was a blank). These mother-child HLA-haplotype dualisms (MHDs) occurred in 5% of all cases. Frequency of exclusion of the accused men in cases demonstrating MHD, was compared with the remaining paternity cases.No significant difference was found in overall exclusion rates between MHD cases and controls when exclusion produced by HLA and red cell antigen systems were observed. However, there was a greater rate of exclusion in MHD cases when comparing exclusions produced by red cell antigen systems regardless of whether HLA tests excluded paternity (p < 0.025). MHD cases involving teenaged mothers differed from control cases in frequency of exclusion of paternity only on the basis of red cell antigen phenotyping (p < 0.005).The HLA system's usefulness in paternity testing is diminished when there is MHD; multiple, independently-inherited systems are relatively more useful in these circumstances.The search method detects only half of potential incest cases; proof of incest requires more extensive testing for homozygosity among other polymorphisms. Since calculations of likelihood of paternity are inappropriate in cases involving close consanguinity, detection and follow up studies are important.Data suggest that one-fifth of MHD cases may involve first degree consanguinity and that the incest rate among paternity cases may be as high as 2%.