Suicidal incised wound of a fistula for hemodialysis access in an elderly woman: case report

A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. The incidence of suicide attempts in people undergoing hemodialysis is well known. Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. Various pattern differences between homicidal and suicidal stab wounds, characteristics of suicide in the elderly, and approaches to the investigation of such cases are briefly discussed.     

Output–Purchase Funding and Budgeting Systems in the Public Sector

Output–purchase funding systems are systems in which payments made to service delivery agencies by government are an explicit function of quantities of outputs delivered by those agencies. This article considers the feasibility of such systems for the funding of tax–financed public services. It focuses on the implications of key characteristics of public sector outputs and specifically upon the prevalence of heterogeneous outputs, the predominance of services (as opposed to physical goods), and the presence of many "contingent capacity services."     

Measurement as a means of accountability

Independent scrutiny can help empower bureaucracy's critics so that they might question “government as usual” tendencies, and therefore pressure governments to produce services as advertised. Our premise is that in order to honestly share access to decisions bureaucracies must share access to the information necessary to make those decisions. In particular, more pointed and sophisticated external scrutiny may embarrass management into fully applying the tools it now has available, but often fails to utilise. Data-based dialogues can make government more responsive and responsible in its use of available resources, that is, more productive and more accountable.     

Mega‐Disasters and Federalism

Measured in dollar terms, Hurricane Katrina was the worst natural disaster in American history. Mega‐disaster response recovery and mitigation put federalism to an especially difficult test because they require speed, efficiency, decisiveness, and effective coordination. This essay focuses on the response to and recovery from Katrina in order to probe the implications of mega‐disasters for federalism. It understands federalism as being composed of four dimensions: the three levels of government and the civic realm. It tests key defenses of federalism against civic and government performance during Katrina. It offers examples of successes and failures involving all four dimensions and provides specific recommendations for improving mega‐disaster mitigation, response, and recovery while maintaining an appropriate constitutional balance among the three levels of government and between the civilian government and the military.     

The Performance–Trust Link: Implications for Performance Measurement

Although the link between government performance and citizen trust in government seems intuitive, the relationship is not supported in some of the literature. This article argues that the difficulty of empirically demonstrating this link is rooted in the difficulty of defining and measuring government performance meaningfully. Performance measurement can improve citizen trust in government directly through citizen participation in the evaluation process or indirectly by improving citizens' perceptions of government performance. To achieve this potential, current performance-measurement practice must be improved: to measure what citizens really care about, to be more systematic and integrated across agencies, to include other governing entities, and to become an ongoing participatory process in which governments and citizens are both transformed.     

Orthodontic Treatment: Real Risk for Dental Age Estimation in Adults?

Dental age estimation becomes a challenge once the root formation is concluded. In living adults, one dental age indicator is the formation of secondary dentine, also associated with orthodontic treatment as well as root shortening. The aim of this study was to establish whether these secondary effects of orthodontic treatment could generate a statistically significant difference in dental age estimations when using Kvaal's method. The study sample included 34 pairs of pre‐ and postorthodontic panoramic radiographs, from different individuals with exactly the same age and sex distribution. Females 65%, median age 17.5 years, and males 35%, median age 22.5 years, were included. After data collection, dental age was estimated per tooth using formulae previously published. The risk of obtaining over‐estimation of age was calculated. (RR = 1.007). The changes caused by orthodontic treatment do not have any significant effect on age estimation when Kvaal et al.'s method is applied on panoramic radiographs.     

When Both Sides are Mistaken: Layperson and Legal Professionals’ Misconceptions of Canadian Suspects’ Legal Rights Upon Arrest

Canadian criminal suspects have notably limited access to legal counsel upon arrest compared to suspects in the U.S. Additionally, prior research has shown significant misunderstanding of police warnings informing suspects of their rights upon arrest. This paper presents three studies on Canadians’ comprehension of criminal suspects’ rights upon arrest, with a focus on the right to counsel. Study 1 (N=80) and Study 2 (N=377) examined Canadian layperson’s comprehension, knowledge, and perceptions of legal rights upon arrest. In turn, Study 3 (N=78) investigated Canadian legal professionals’ perceptions of laypersons’ knowledge of those rights. Results from these three studies indicated there is substantial confusion about the right to counsel for Canadian criminal suspects. These results also support previous research demonstrating problems with comprehension of Canadian police cautions. Taken together, the findings of the present research pose significant concern for an increased risk of false confessions from Canadian suspects who enter an interrogation with limited knowledge and understanding of their legal right to counsel.