A Policy for the Retention and Extended Examination of Organs at Autopsy*

Abstract: Recent organ retention scandals and law suits have created a focus on the practice of saving postmortem tissues for extended examination or research purposes. The New Mexico Office of the Medical Investigator (OMI) established a policy to notify families about organ retention and the subsequent disposition of the tissue. The OMI examined the success of this policy in regards to the retention of brains for extended examination by analyzing data abstracted from verbal consent forms from 2003 to 2006. During this time, 715 cases were identified as needing an extended examination of the brain. The percentages of brains saved in any given year, as a percent of the total number of autopsies performed that year, were: 2003 6.5%, 2004 10.4%, and 2005 11.8%. The disposition was cremation in 79% of cases, release with the body after a determined period of time in 14%, and cut fresh in 4%. In conclusion, the instigation of a policy on the verbal notification of the next of kin when organs are retained can be successfully implemented.     

Joined‐Up for What? Response to Carey and Harris on Adaptive Collaboration

Carey and Harris present the concept of adaptive management as a practice for supporting effective collaboration, suggesting that performance information be used to modify actions. They observe that end‐outcome performance information is less useful because of long delays between actions and effects, and recommend instead that the performance information should concern the collaborative process itself. The New Zealand government has followed a similar path to the Australian journey described by Carey and Harris. First, New Zealand tried using end outcomes to drive collaboration. Then, New Zealand tried using process measures, but found that the resulting collaboration lacked purpose and urgency. More recently, New Zealand has found great success in using intermediate‐outcome measures to drive adaptive collaboration: measures with intrinsic value, but short delay between action and effect. We echo Carey and Harris’ call for adaptive collaboration, but write to suggest that intermediate outcomes, rather than process measures, may drive more purposive management.     

Elevator-Related Deaths

Elevators are mechanical transportation devices used to move vertically between different levels of a building. When first developed, elevators lacked the safety features. When safety mechanisms were developed, elevators became a common feature of multistory buildings. Despite their well-regarded safety record, elevators are not without the potential for danger of injury or death. Persons at-risk for elevator-related death include maintenance and construction workers, other employees, and those who are prone to risky behavior. Deaths may be related to asphyxia, blunt force, avulsion injuries, and various forms of environmental trauma. In this review, we report on 48 elevator-related deaths that occurred in nine different medicolegal death investigation jurisdictions within the United States over an approximately 30-year period. The data represents a cross-section of the different types of elevator-related deaths that may be encountered. The review also presents an overview of preventive strategies for the purpose of avoiding future elevator-related fatalities.     

The economic effects of constitutions: replicating—and extending—Persson and Tabellini

Persson and Tabellini (The Economic Effects of Constitutions, The MIT Press, Cambridge, 2003) show that presidential regimes and majoritarian election systems have important economic effects. Here, the number of countries is expanded and more recent data is used. In replicating and extending their analyses, we find that the effect of presidential regimes vanishes almost entirely. With regard to electoral systems, the original results are largely confirmed: majoritarian (as opposed to proportional) electoral systems lead to lower government expenditure, lower levels of rent seeking but also lower output per worker. The institutional details, such as the proportion of candidates that are not elected on party lists and district size, are particularly important.     

Besprechungen

Ohne Zusammenfassung     

Incidence of auditory ossicle luxation and petrous bone fractures detected in post-mortem multislice computed tomography (MSCT)

As the auditory ossicles are difficult to display without harming them in conventional autopsies, lesions of these minute bones and the ossicular chain are regularly missed. In this study, the method of choice in clinical medicine for the examination of such lesions, namely multislice computed tomography, was applied to 100 corpses.The hereby obtained results regarding ossicle luxation and petrous bone fracture indicated that the lesions were not dependant on the amount, but rather on the type of energy inflicted to the head.     

Fake Claims of Fake News: Political Misinformation,Warnings, and the Tainted Truth Effect

Political Behavior - Fact-checking and warnings of misinformation are increasingly salient and prevalent components of modern news media and political communications. While many warnings about...     

Policy influences on community trail development

This study explores processes and policies that facilitate the development of community trails. With funding from Active Living Research and the research framework of the Physical Activity Policy Research Network (PAPRN), we conducted a multiple-site case study. A total of six trails in Hawaii, Massachusetts, Missouri, North Carolina, South Carolina, and Washington were chosen for study. The goals of this case study were to identify the policy influences on trail development, explore the roles of key players in trail development, and compare and contrast findings from the different trails. Trail development can be a long process. Some of the trails took over a decade to complete because of funding, opposition, and roadblocks in the form of design standard policies. Work in trail development requires a team of many players, and it is necessary to balance their varied motives to accomplish a shared overall goal. Foresight through the master planning process is also a vital component of successful trail development. Finally, community involvement is key. Communities contemplating trail development should explore the effects of policy on the trail projects reported here to proactively identify potential influence.