Getting out what we put in: productivity of the English National Health Service

Many countries are incorporating direct measures of non-market outputs in the national accounts. For any particular output to be included there has to be data about it for two adjacent periods. This is problematic because the classification of non-market outputs is often subject to wholesale revision. We outline the challenges associated with classification changes and propose a solution. To illustrate we construct output and input indices and estimate productivity growth of the English National Health Service (NHS) for the period 2003-2004 to 2007-2008. Our index of output growth incorporates all care provided to NHS patients and captures improvements in survival rates, waiting times and disease management. We find that more patients are being treated and the quality of the care they receive has been improving. We implement our approach to dealing with changes as to how health services are defined and show what effect this has on estimates of output growth. Our index of input growth captures all labour, intermediate and capital inputs into health service production and we improve on how capital has been measured in the past. Inputs have increased over time but there has also been a slowdown since 2005-2006, primarily the result of a levelling off in staff recruitment and less reliance on the use of agency staff. Productivity is assessed by comparing output growth with growth in inputs, the net effect being constant productivity growth between 2003-2004 and 2007-2008.     

Filicide, attempted filicide, and psychotic disorders

The objective of the study was to describe and discuss the cases of two women who faced criminal charges, one for attempting to murder her three children and the other for killing her 1-year-old boy. After a forensic psychiatric assessment of their level of criminal responsibility, these patients were considered not guilty by reason of insanity and were committed to forensic mental hospitals. These two patients received a diagnosis of paranoid schizophrenia, according to the DSM-IV-TR criteria. In both cases, psychotic symptoms were present before the manifestation of violent behavior, in the form of persecutory delusions, auditory hallucinations, and pathological impulsivity. The investigation into cases of filicide may contribute powerfully to expand our understanding of motivational factors underlying this phenomenon and enhance the odds for effective prevention.     

State Government Targeting in Economic Development: The New York Experience

New York State has made extensive use of social, geographic,and sectoral targeting in economic development. It has targetedboth distressed industries, particularly manufacturing, andgrowth industries. When the initial assistance provided to manufacturingin the 1960s did not stem the decline of this sector, the stateresponded by providing larger subsidies. Even though manufacturingcontinued to decline, both absolutely and relatively, supportfor its preferred status has, nevertheless, remained strong,and few of the programs initially aimed at this sector haveseen any sign cant changes in their manufacturing focus. Effortsto target distressed areas and individuals, however, were notsustained over time. The state's two most significant effortsat geographic targeting were expanded statewide over relativelyshort periods of time.     

Remaking the Italian party system: How Lijphart got it wrong by saying it right

Italy is in the midst of a major party system transformation. The process has been gradual, caused by the decline of the former Communist Party and by the rise of the Northern League which has eroded the ‘stable instability’ of the Christian Democrats' one‐party dominance. Yet the direction of change remains uncertain. On electoral grounds, the recently introduced majoritarian electoral law should encourage the formation of competing coalitions. However, this change is taking place just at a time when the awakening of long‐established territorial cleavages is endangering national unity. A majoritanian government for a divided country might turn out to be the worst of the unintended consequences of institutional reform.     

DNA Preparation from Sexual Assault Cases by Selective Degradation of Contaminating DNA from the Victim

Abstract:  The standard method to purify sperm DNA from vaginal swabs taken from rape victims is to selectively digest the victim's epithelial cells to solubilize the victim's DNA, and then separate the soluble DNA from the intact sperm by centrifugation. A different approach to removing the soluble victim's DNA is to selectively degrade it using a nuclease, DNase I. DNase I reduces the amount of soluble DNA by over 1000-fold, while having virtually no effect on the sperm DNA remaining in the sperm head and inaccessible to the enzyme. Nuclease inactivation and sperm lysis then yield a soluble, pure male DNA fraction. An aliquot of soluble DNA is removed prior to nuclease addition to provide the victim's fraction. Vaginal swabs taken at defined time points following consensual sex and taken from rape victims were processed using the nuclease method or the standard method and the nuclease method gave superior short tandem repeat profiles.     

Development of a Simple and Low‐Cost Enzymatic Methodology for Quantitative Analysis of Carbamates in Meat Samples of Forensic Interest

Abstract: Foods contaminated with a granulated material similar to Temik (a commercial pesticide formulation containing the carbamate insecticide aldicarb) are often involved in accidental ingestion, suicides, and homicides in Brazil. We developed a simple technique to detect aldicarb. This technique is based on the inhibition of a stable preparation of the enzyme acetylcholinesterase, and it is specially adapted for forensic purposes. It comprises an initial extraction step with the solvent methylene chloride followed by a colorimetric acetylcholinesterase assay. We propose that results of testing contaminated forensic samples be expressed in aldicarb equivalents because, even though all other carbamates are also potent enzyme inhibitors, aldicarb is the contaminant most frequently found in forensic samples. This method is rapid (several samples can be run in a period of 2 h) and low cost. This method also proved to be precise and accurate, detecting concentrations as low as 40 μg/kg of aldicarb in meat samples.     

Unusual association of three rare alleles and a mismatch in a case of paternity testing

This study reports a paternity case analyzed by the AmpFlSTR Identifiler Kit (AB) in which father and daughter shared three rare alleles for D19S433, D18S51 and TH01 microsatellites. The case also showed an apparent exclusion, due to a mutation at the D3S 1358 microsatellite. Sequencing analysis was performed to assess the size of the rare alleles and to establish their structure, which revealed some molecular variations in regions flanking the motif repeats.     

DNA identification of sperm cells collected and sorted by flow cytometry

In cases of rape, obtaining enough biologic material for DNA identification of the attacker is often difficult because the methods for distinguishing and separating sperm cells from vaginal cells are not sufficiently efficacious. This article describes a new, innovative method for spermatic DNA extraction from the vaginal washing fluid by means of flow cytometry. The high specificity and sensitivity of the flow-cytometric sorting method provides enough sperm cells for DNA typing. The ease of execution of this method, involving vaginal washing with physiologic solution and flow-cytometric reading of the fresh sample, substantially increases its cost-benefit ratio.