The regulation of pharmacy ownership in Australia: the potential impact of changes to the health landscape

Australian community pharmacy ownership restrictions have been in place for many years. However, it is timely to review these structures in terms of the Commonwealth Government's proposed changes to the health care system and the need for flexibility to ensure access of vital medicines to the community. Careful consideration has to be given to the advantages and disadvantages of regulatory structures that limit ownership to pharmacists, compared to non-pharmacist ownership. Other ownership aspects that need to be evaluated include the number of pharmacies one pharmacist should be allowed to own or co-own and the extent of control required on the location of pharmacies.     

Incorporating index offence analysis into forensic clinical assessment

Purpose. Assessment is a core skill of clinical and forensic psychology practice and forms the basis of all ongoing engagements with offender/patients. In forensic settings, assessment involves the systematic gathering of reliable data on the characteristics of offenders and the offences which they have committed in order to develop understanding of the dynamics of offending and relevant intervention strategies. However, whilst the assessment process is aided by various protocols, no such instrument appears to exist for the assessment of an offender/patient's index offence. This paper presents a draft ‘index offence analysis guide’ designed by the present authors for this purpose and which has been piloted on prisoners and patients in secure settings. Argument. Evidence suggests that for various reasons, many clinicians do not routinely review crime scene data while working with offenders. However, this practice is arguably questionable, because how can decisions about admission, amenability to treatment, risk of reoffending, and discharge be made if there is limited awareness of what the offender/patient has done? The present authors argue that knowledge of the index offence is important to understanding the offender and suggest this can be obtained using a guide such as the one presented here. This is illustrated with an anonymous case. Conclusion. Index offence analysis should be a core task of any forensic clinician engaged in the assessment of offender/patients as it can provide a better understanding of crime scene actions and offence motivations. This can help guide treatment planning and improve risk assessments.     

Reliability and Validity of Prisoner Self-Reports Gathered Using the Life Event Calendar Method

Data collection using the life event calendar method is growing, but reliability is not well established. We examine test–retest reliability of monthly self-reports of criminal behavior collected using a life event calendar from a random sample of minimum and medium security prisoners. Tabular analysis indicates substantial agreement between self-reports of drug dealing, property, and violent crime during a baseline interview (test) and a follow-up (retest) approximately 3 weeks later. Hierarchical analysis reveals that criminal activity reported during the initial test is strongly associated with responses given in the retest, and that the relationship varies only by the lag in days between the initial interview and the retest. Analysis of validity reveals that self-reported incarceration history is strongly predictive of official incarceration history although we were unable to address whether subjects could correctly identify the months they were incarcerated. African Americans and older subjects provide more valid responses but in practical terms the differences in validity are not large.     

Carbon monoxide concentrations in the 2009 Victorian Bushfire disaster victims

Blood was available for the estimation of carboxyhemoglobin saturation (COHb) in 30 of the 173 persons who died in the Victorian bushfires in February 2009. The ages of these 30 deaths ranged from 3 to 80 years and there were 8 females. 13 cases (43%) were considered negative (less than 5% COHb), 12 (40%) were between 5 and 40% COHb, 2 (6.7%) between 40 and 50% and 3 (10%) were greater than 50% COHb. There were 6 persons either found within a building or a car and the COHb in these cases ranged up to 69% (mean 50%). There were 5 cases where the location was unable to be determined as either indoor or outdoor due to the extensive nature of the fire. The remaining 19 deceased persons were all located outside in the open and the concentration of COHb in these cases ranged up to 30% (mean 19%). Hydrogen cyanide was only detected in two deceased persons at concentrations of 0.5 and 2.7 mg/L, respectively. 13 deceased were found to have soot in the airways following necropsy but this did not correlate with the COHb levels.     

Analysis of 14C and 13C in teeth provides precise birth dating and clues to geographical origin

The identification of human bodies in situations when there are no clues as to the person's identity from circumstantial data, poses a difficult problem to the investigators. The determination of age and sex of the body can be crucial in order to limit the search to individuals that are a possible match. We analyzed the proportion of bomb pulse derived carbon-14 ((14)C) incorporated in the enamel of teeth from individuals from different geographical locations. The 'bomb pulse' refers to a significant increase in (14)C levels in the atmosphere caused by above ground test detonations of nuclear weapons during the cold war (1955-1963). By comparing (14)C levels in enamel with (14)C atmospheric levels systematically recorded over time, high precision birth dating of modern biological material is possible. Above ground nuclear bomb testing was largely restricted to a couple of locations in the northern hemisphere, producing differences in atmospheric (14)C levels at various geographical regions, particularly in the early phase. Therefore, we examined the precision of (14)C birth dating of enamel as a function of time of formation and geographical location. We also investigated the use of the stable isotope (13)C as an indicator of geographical origin of an individual. Dental enamel was isolated from 95 teeth extracted from 84 individuals to study the precision of the (14)C method along the bomb spike. For teeth formed before 1955 (N=17), all but one tooth showed negative Δ(14)C values. Analysis of enamel from teeth formed during the rising part of the bomb-spike (1955-1963, N=12) and after the peak (>1963, N=66) resulted in an average absolute date of birth estimation error of 1.9±1.4 and 1.3±1.0 years, respectively. Geographical location of an individual had no adverse effect on the precision of year of birth estimation using radiocarbon dating. In 46 teeth, measurement of (13)C was also performed. Scandinavian teeth showed a substantially greater depression in average δ(13)C (-14.8) than teeth from subjects raised in Japan (-13.5), Middle East and North Africa (-12.7) and South America (-10.9). In summary, isotopic analysis of carbon in enamel from a single tooth can give a good estimate of the year of birth of an individual and also provide information about the geographical origin of the individual. This strategy can assist police and forensic authorities when attempting to solve unidentified homicide cases and may facilitate the identification work associated with mass disasters.     

Comparison of glass fragments using particle-induced X-ray emission (PIXE) spectrometry

A procedure has been developed to analyze the trace element concentrations in glass fragments using particle-induced X-ray emission (PIXE) spectrometry. This method involves using accelerated protons to excite inner-shell electronic transitions of target atoms and recording the resultant X-rays to characterize the trace element concentrations. The protocol was able to identify those glass fragments that originated from different sources based on their elemental analyses. The protocol includes specific approaches to calculating uncertainties and handling measurements below the level of detection. The results indicate that this approach has increased sensitivity for several elements with higher atomic number compared with X-ray fluorescence methods. While not as sensitive as laser-ablation or inductively coupled plasma mass spectrometry methods of dissolved samples, it is entirely nondestructive and entails a much simpler sample preparation process that may be used to presort glass fragments for more comprehensive elemental analysis. As such, the technique described may have a niche role in forensic glass analysis.