Accurately assessing elderly fall deaths using hospital discharge and vital statistics data

Historically, fatal injury monitoring and surveillance have relied on mortality data derived from death certificates (DC). However, problems associated with utilizing DC have been well documented. Recently, access to and utilization of hospital discharge data (HDD) have offered a new and important secondary source of data regarding in-hospital deaths. However, studies have shown that discrepancies between the HDD and the corresponding DC often exist. This discrepancy was especially evident when comparing HDD to the vital statistics data (VSD) for deaths by falls among those aged 65 and over in 19 states.This was a retrospective forensic review of elderly (age 65 and over) fall-associated fatalities (E880-E888) identified from HDD and VSD in Allegheny County, Pennsylvania, between 1997 and 1998. Seventy-seven cases were identified, with the original manner of death listed as natural (34), suicide (1), and accidental (42) on the DC. Following a forensic review of the cases, the manner of the death on the DC should have been changed from natural to accidental in 28% (n = 12) of the cases, representing an undercount in the VSD. Undercounts were due to a failure of clinicians to account for the significance of a fall event that contributed to subsequent pathology and death. In addition, in that 22% (n = 17) of the HDD fall-associated deaths, the fall did not contribute directly or sequentially to the underlying cause of death, thereby representing an overcount in the HDD.Based on these findings we recommend (1) elderly fall surveillance systems should only count HDD E-coded falls that demonstrate a serious traumatic injury which directly or subsequently results in death, (2) all in-hospital fall-associated deaths should be reported to and reviewed by coroner/Medical Examiner offices for determination of the cause and manner of death, and (3) physicians should be better educated in properly completing death certificates.     

Participatory action research in practice: a case study in addressing domestic violence in nine cultural communities

Participatory action research (PAR) is increasingly recognized as a viable approach to developing relationships with communities and working closely with them to address complex public health problems. In the case of domestic violence research, where ensuring the safety of women participants who are battered is paramount, participatory approaches to research that include advocates and women who are battered in research design, implementation, analysis, and dissemination are critical to successful and mutually beneficial projects. This article presents a case study of a PAR project that conducted formative qualitative research on domestic violence in nine ethnic and sexual minority communities. The article describes the specific ways in which a PAR approach was operationalized and discusses in detail how community participation shaped various stages of the research. Furthermore, specific actions that resulted from the research project are reported.     

Implications for Criminal Justice from the 2002 and 2006 Department of Defense Gender Relations and Sexual Harrasment Surveys

Sexual misconduct has emerged as a widespread problem throughout the criminal justice system as indicated by law enforcement officer sexual assault incidents in various cities and the findings of the recent National Prison Rape Elimination Act Research Commission. Through multivariate statistical analysis of data from two Department of Defense-wide surveys (2002 and 2006), this paper examines the indicators and cofounders of sexism, sexual harassment, and sexual assault with attention to change during the study period. Findings inform a suggested anticipatory model for prevention and intervention in military settings that, based on shared characteristics such as male dominance and authoritarian culture, provide an approximate reference context for criminal justice sexual misconduct best practices consideration.     

The religious conversion and race of a prisoner: Mock parole board members' decisions,perceptions, and emotions

Parole board members (PBMs) decide whether to release inmates on parole. Decisions may be affected by in‐group bias or stereotypes regarding religion and race. Two experiments investigated whether religious conversions/secular lifestyle changes and race affect mock PBMs' release decisions, emotions, and perceptions. Mock PBMs read a case file of an inmate who was eligible for parole and decided whether to grant parole. Study 1 manipulated whether the inmate had converted to Christianity or Islam, had a secular lifestyle change, or had no lifestyle change. Study 2 also varied race (African American or Caucasian). Race was not a significant factor, possibly because the manipulation was not strong enough to influence participants or because participants did not want to appear racist. Conversions to Islam and Christianity impacted the parole decision, and effects were mediated by believability of the conversion. Secular lifestyle changes affected release decisions and were mediated by perceptions of the inmate and beliefs about his likelihood of recidivism. Such inmates were the most likely to be released and were perceived most positively; their conversions were the most believable. Inmates who made no changes were perceived least positively, indicating that any lifestyle change is better than none. Importantly, no bias towards either religion (Islam, Christianity) was found. Furthermore, conversion type affected how scared PBMs were of the inmate, but this fear did not impact release decisions.     

Alternative Methods of Experience Rating Unemployment Insurance Employer Taxes

For most states the methodology used for assigning Unemployment Insurance tax rates to employers arose when the program was first established in 1935. More than 80 years later, with evolving employment relationships, state systems have become outmoded. This paper critiques current experience rating methods and presents new methodologies that are much easier to operate and that improve the incentives for employers to increase employment. The proposed methods would assess taxes based on employment or payroll variation such that growing firms would have lower taxes. A simulation analysis illustrates the impact of the new methods on employer groups.     

Vaseline on the Lens

正When my Chinese fiance and I decided to get married, there was no question about it: We would get our wedding portraits taken at one of the Chinese wedding studios that came with quaint names like "Paris," "Rome," "Golden Ladies," or "Mona Lisa. " "Are you going for the typical Chinese look? Vaseline on the lens, the works?" a British friend asked, in, shall we say, "amused" fashion.It was a Chinese tradition I would come to love; in the West, wedding photos are usually taken only during the ceremony and reception.