Managing incidental findings in human subjects research: analysis and recommendations.

No consensus yet exists on how to handle incidental findings (IFs) in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are findings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed.     

Seasonal structure and dynamics of sarcosaprophagous fauna on pig carrion in a rural area of Cordoba (Argentina): their importance in forensic science

Four experiments, one in each season, were carried out during 2004 in a rural area of Córdoba, central Argentina. Two pigs (Sus scrofa L.), weighing approximately 8 kg each, were used in each of the four experiments. The animals were killed by a sharp blow to the head and immediately placed in an appropriate arthropod trap. One pig was placed in the shade and the other under direct sunlight. This research was conducted to determine the seasonal structure and dynamics of arthropods that constitute the sarcosaprophagous community in a given area of the central region of Argentina. The decomposition process was divided into five stages: fresh, bloated, decay, advanced decay and dry. The duration of each stage varied in different seasons, showing that the temperature and humidity are the most important variables that influence this process. A total of 51,500 adults and 36,909 immature were collected. More than 80% of the specimens collected belong to Insecta, and within this, Diptera were the most abundant order. The flies were mainly represented by adults and immature of the following species: Chrysomya albiceps (Wiedemann) (Calliphoridae), Musca domestica Linnaeus (Muscidae) and Fannia femoralis (Stein) (Fanniidae). Coleoptera were mainly represented by adults and immature of the species Creophilus maxillosus (Linnaeus) (Staphylinidae) and Dermestes maculatus (Geer) (Dermestidae). More than 50% of hymenopteran fauna collected belong to Formicidae. The trophic levels associated with the decomposition of the remains included five categories: necrophagous, parasites and predators of the necrophagous species, omnivores, opportunists and adventives. During faunal succession a strong dominance of the necrophagous species of the family Calliphoridae and Muscidae was observed, mainly during the early stages of decay process in all seasons.     

HealthConnect and privacy: a policy conundrum

A shared electronic health record is intrinsically privacy-invasive because it creates a comprehensive record for information-sharing. The author explains the significance of information privacy and why it is that health information warrants special protection. She also provides an overview of the existing regulatory framework and an evaluation of suggested options and proposals for addressing privacy-related issues. Her analysis of suggested consent models suggests that they ultimately involve a trade-off between privacy and the broader benefits promised by HealthConnect and that obtaining the right balance is essential if HealthConnect is to achieve optimal health outcomes.     

Disclosing health information breaches of confidence,privacy and the notion of the "treating team"

The authors utilise cases collected during a randomised population survey to illustrate some of the legal and policy issues concerning routine transfers of information between treating practitioners. Their analysis suggests that implied consent for many routine uses of health information should not be assumed. An important part of consent to health information disclosure is the patients' ability to tailor its scope and content. This requires that they should be provided with additional information. Introducing the measures advised into the clinical setting would bring health information-gathering practices closer to compliance with the collection principles contained in Australian information privacy legislation.     

Comparison of Different Analytical Methods for the Determination of Carbon Monoxide in Postmortem Blood

The determination of carbon monoxide (CO) and carboxyhemoglobin (COHb) is of utmost importance in forensic toxicology to determine the cause of death in cases of CO poisoning, fire, and explosions. To this end, reliable and updated analytical methods are required. In this paper, four different methods for the determination of carbon monoxide in postmortem blood samples were compared: (i) the spectrophotometric determination of COHb applying the method proposed by Rodkey and modified by Beutler–West, (ii) the spectrophotometric determination of CO using a micro-diffusion-based method, (iii) the determination of CO by gas chromatography coupled to a TCD detector, and (iv) the determination of COHb by blood gas analysis. Three postmortem blood samples were analyzed with all methods, and the results were comparable. The applied methodologies showed different features depending on the sensitivity, sample preparation, and volume. The HS-GC/TCD method in our hand was the most appropriate, on postmortem samples, and versatile to apply. Unfortunately, only a limited number of postmortem blood samples were available for this study due to the rarity of that kind of intoxication in our jurisdiction.