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.     

The New Water Legislation of Zimbabwe and South Africa – Comparison of Legal and Institutional Reform

Recently, several new pieces of water legislation have been promulgated in both Zimbabwe and the Republic of South Africa. The new acts are an attempt to correct injustices of a colonial past and to trigger development towards effective, equitable and efficient integrated water resources management influenced by the policy decisions in Agenda 21 and the need to respect economic and social human rights. This article aims at identifying and describing factors of prime importance in the process of legal and institutional reform. Major factors are earmarked and derived from the proceedings in Zimbabwe and are compared with the situation in South Africa. Thorough analysis by the author of proceedings, preambles, memoranda, legislation and addenda has induced roughly 5 major reform issues: The call for equitable water distribution based on a widely consented water resources management strategy; The need for effective and efficient integrated water resources management conducive to stakeholder participation through decentralisation processes; The redressing of legal shortcomings in former water legislation with the emphasis on the introduction of integrated approaches; The introduction of instruments of cost recovery for water resources management; The need to develop human resources capacity and institutional strength within the implementing agencies.For both Southern African states, these issues appear to be of comparable importance as major triggers for legal and institutional reform, although not always in the same sense.The resulting most important legal and institutional changes are presented, discussed and compared. Finally, prospects for and constraints on implementation of the new water legislation in these countries are compared.     

Delusional misidentification and aggression in Alzheimer's disease

Alzheimer's disease has been associated with serious behavioral disturbances including aggressive behaviors and agitation. Aggression in dementia of the Alzheimer's type may be associated with psychotic symptoms, particularly delusional misidentification phenomena. These phenomena are complex and varied in Alzheimer's disease and so far have been only rudimentarily described. In this paper, we explore the association of delusional misidentification and aggression in an individual suffering from Alzheimer's disease.