HbA1c as a postmortem tool to identify glycemic control

Estimates suggest that more than 5A million U.S. citizens unknowingly have diabetes and are at increased risk of morbidity and mortality. We evaluated an immunoturbidimetric measurement of glycated hemoglobin (%HbA1c) as a postmortem tool to identify such individuals. Although postmortem samples undergo some degradation, the effects are not sufficient to invalidate the use of the test or method. Using two study populations whose medical history of diabetes was known, we found the mean %HbA1c of the non-diabetics (5.8+/-0.3) to be statistically different from that of the diabetics (12.4+/-2.8). For the population whose disease status was unknown, the %HbA1c ranged from 4.7 to 16.8. For six unknowns whose values exceeded 7.0%. the mean was 11.7%, which did not differ statistically from the diabetic mean (p = 0.6615). These studies suggest that postmortem blood samples can be used to characterize HbA1c values.     

A Comparison of Thresholding Methods for Forensic Reconstruction Studies Using Fluorescent Powder Proxies for Trace Materials

Image segmentation is a fundamental precursor to quantitative image analysis. At present, no standardised methodology exists for segmenting images of fluorescent proxies for trace evidence. Experiments evaluated (i) whether manual segmentation is reproducible within and between examiners (with three participants repeatedly tracing three images) (ii) whether manually defining a threshold level offers accurate and reproducible results (with 20 examiners segmenting 10 images), and (iii) whether a global thresholding algorithm might perform with similar accuracy, while offering improved reproducibility and efficiency (16 algorithms tested). Statistically significant differences were seen between examiners’ traced outputs. Manually thresholding produced good accuracy on average (within ±1% of the expected values), but poor reproducibility (with multiple outliers). Three algorithms (Yen, MaxEntropy, and RenyiEntropy) offered similar accuracy, with improved reproducibility and efficiency. Together, these findings suggest that appropriate algorithms could perform thresholding tasks as part of a robust workflow for reconstruction studies employing fluorescent proxies for trace evidence.     

Public Involvement in NHS Inquiries

Opportunities for engaging the public have changed over the fifty years since the inquiry into the Ely Hospital, Cardiff. NHS inquiries, and inquiries more widely, tend to be called where events have led to public concern and loss of public confidence. Involvement of the public could therefore be assumed to form a part of restoring that public confidence. This paper explores the mechanisms for public involvement in NHS inquiries over the past fifty years, assessing the roles played by the public. It uses the framework outlined by Geoffrey Howe to examine how members of the public have been involved in four NHS inquiries. Findings suggest that the roles and mechanisms have varied, but that understanding the extent of public involvement is a dimension to assessing each of the potential functions of an NHS inquiry.     

New Geographies of Disadvantage: Implications for Service Delivery

Shifts are apparent in the spatial distribution of disadvantage in Australia since the 1970s. Not only are new sites of disadvantage emerging (small rural towns, manufacturing centres, coastal welfare regions, some outer suburbs), but research suggests a possible spatial cleavage between best-accessed Melbourne and Sydney, and 'the rest' of the country. At the same time, examples of provision and delivery of services continue to occur locally andregionally that demonstrate lack of attention to the characteristics of the places in which those services are received. The paper calls for spatially conscious public policy in service delivery, and considers the possibilities of this occurring if governments form partnerships with other organisations to provide services for communities.     

Using subsidised seed to catalyse demand-driven bean seed systems in Malawi

Through an innovative public-private partnership, Demeter Agricultural Limited, along with the Malawi National Bean Programme and the International Center for Tropical Agriculture, supplied 2,559 tons of certified bean seed between 2009 and 2012 through the government's Targeted Farm Input Programme. Farmers were satisfied with the variety supplied, timeliness of the operation, pack size, and information provided. Growing numbers also accessed new improved varieties, from 264,661 households in 2009 to 344,200 in 2012. These emerging farmers’ demands and the subsequent DAL responses suggest a base for building sustainable delivery systems. However, decentralised seed-based systems will be needed for promoting varieties suited to micro-ecological niches.