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.     

Evaluating the Short-Run Benefits of Six Department of Energy R&;D Projects

This paper evaluates the short-run benefits of research and development (R&D) projects funded by the Automotive Lightweighting Materials (ALM) Program of the Office of FreedomCAR and Vehicle Technologies of the U.S. Department of Energy (DOE). The six ALM projects evaluated—using qualitative and quantitative evaluation methods—yielded numerous benefits in the short-run. From the qualitative assessment, all met their technical goals, increased intellectual knowledge among the research teams, and led to increased collaboration among DOE, the auto industry, its suppliers, and national laboratories. Moreover, U.S. competitiveness appeared to have increased as a result of each R&D effort. One interesting finding, however, is that most of the participants indicated their firms would not have engaged in the research efforts without DOE funding. If they had engaged in the effort, it would have been with considerably less person time and financial commitment. With respect to quantitative measures, several graduate students were supported by the projects and numerous publications and presentations resulted, although these metrics varied across the ALM R&D projects.     

Forensic Analysis of mtDNA Haplotypes from Two Rural Communities in Haiti Reflects Their Population History

Abstract: Very little genetic data exist on Haitians, an estimated 1.2 million of whom, not including illegal immigrants, reside in the United States. The absence of genetic data on a population of this size reduces the discriminatory power of criminal and missing‐person DNA databases in the United States and Caribbean. We present a forensic population study that provides the first genetic data set for Haiti. This study uses hypervariable segment one (HVS‐1) mitochondrial DNA (mtDNA) nucleotide sequences from 291 subjects primarily from rural areas of northern and southern Haiti, where admixture would be minimal. Our results showed that the African maternal genetic component of Haitians had slightly higher West‐Central African admixture than African‐Americans and Dominicans, but considerably less than Afro‐Brazilians. These results lay the foundation for further forensic genetics studies in the Haitian population and serve as a model for forensic mtDNA identification of individuals in other isolated or rural communities.     

An inconclusive digital audio authenticity examination: a unique case

This case report sets forth an authenticity examination of 35 encrypted, proprietary-format digital audio files containing recorded telephone conversations between two codefendants in a criminal matter. The codefendant who recorded the conversations did so on a recording system he developed; additionally, he was both a forensic audio authenticity examiner, who had published and presented in the field, and was the head of a professional audio society's writing group for authenticity standards. The authors conducted the examination of the recordings following nine laboratory steps of the peer-reviewed and published 11-step digital audio authenticity protocol. Based considerably on the codefendant's direct involvement with the development of the encrypted audio format, his experience in the field of forensic audio authenticity analysis, and the ease with which the audio files could be accessed, converted, edited in the gap areas, and reconstructed in such a way that the processes were undetected, the authors concluded that the recordings could not be scientifically authenticated through accepted forensic practices.     

Personal identification of cold case remains through combined contribution from anthropological, mtDNA, and bomb-pulse dating analyses

In 1968, a child's cranium was recovered from the banks of a northern Canadian river and held in a trust until the "cold case" was reopened in 2005. The cranium underwent reanalysis at the Centre for Forensic Research, Simon Fraser University, using recently developed anthropological analysis, "bomb-pulse" radiocarbon analysis, and forensic DNA techniques. Craniometrics, skeletal ossification, and dental formation indicated an age-at-death of 4.4 ± 1 year. Radiocarbon analysis of enamel from two teeth indicated a year of birth between 1958 and 1962. Forensic DNA analysis indicated the child was a male, and the obtained mitochondrial profile matched a living maternal relative to the presumed missing child. These multidisciplinary analyses resulted in a legal identification 41 years after the discovery of the remains, highlighting the enormous potential of combining radiocarbon analysis with anthropological and mtDNA analyses in producing confident personal identifications for forensic cold cases dating to within the last 60 years.     

Who Is the Client and Who Controls Release of Records in a Forensic Evaluation? A Review of Ethics Codes and Practice Guidelines

Forensic psychologists often refuse to release evaluation records, especially to the evaluee. One justification for this practice is based on the ethical positions that the referral source “is the client” and “controls release of records” (also found in the Specialty Guidelines for Forensic Psychology). To determine whether these ethical positions are shared by the field of forensic mental health, official documents from forensic mental health organizations were used as a proxy for these views. Thirty-four supporting arguments for either position were identified from the literature; it was postulated that official documents would support both positions and utilize supporting arguments. Fifty-four official documents were discovered, and qualitative analysis was used to construct a 17-category model of official views. Neither position was supported by a majority of documents, and few of the supporting arguments were utilized by supportive documents. The positions are unsupported because official documents espouse a wide diversity of views, there are a number of logical flaws in supporting arguments, and even official APA documents hold conflicting views. Ethical arguments are advanced for contrary positions, and the referral-source-control of records release is contrary to law. A more ethical view is that the psychologist may have multiple, possibly conflicting responsibilities to multiple entities; the psychologist’s roles and responsibilities should be clarified with each entity using an informed consent process. Psychologists should release records at the behest of the evaluee, lest they be subject to licensing discipline, Health Insurance Portability and Accountability Act (HIPAA) complaints, and/or civil sanctions. Recommendations are offered for psychologists, future ethics codes and professional practice guidelines, and test security practices.