From ‘shallow’ to ‘deep’ policing:‘crash-for-cash’ insurance fraud investigation in England and Wales and the need for greater regulation

The policing of insurance fraud has traditionally been dealt with beyond the criminal justice system as a private matter between the claimant and the insurer with only a few iconic cases referred to the criminal justice system each year. The growth of insurance fraud, particularly ‘crash-for-cash’ fraud, and the disinterest of the police, has led to a change in the response of the insurance industry. This paper will argue that this response can be characterised as a shift from the traditional ‘shallow’ to a ‘deeper’ form of policing which sees greater focus upon criminal and quasi-criminal outcomes. This paper explores some of the private and innovative methods the industry has developed and illustrates what greater private criminal investigation might look like at a time when police privatisation has become a higher profile issue. The paper argues the shift to ‘deeper’ policing necessitates greater regulation of the private investigation of crime and outlines a number of proposals to address this gap which require further consideration and debate

From ‘shallow’ to ‘deep’ policing: ‘crash-for-cash’ insurance fraud investigation in England and Wales and the need for greater regulation

The policing of insurance fraud has traditionally been dealt with beyond the criminal justice system as a private matter between the claimant and the insurer with only a few iconic cases referred to the criminal justice system each year. The growth of insurance fraud, particularly ‘crash-for-cash’ fraud, and the disinterest of the police, has led to a change in the response of the insurance industry. This paper will argue that this response can be characterised as a shift from the traditional ‘shallow’ to a ‘deeper’ form of policing which sees greater focus upon criminal and quasi-criminal outcomes. This paper explores some of the private and innovative methods the industry has developed and illustrates what greater private criminal investigation might look like at a time when police privatisation has become a higher profile issue. The paper argues the shift to ‘deeper’ policing necessitates greater regulation of the private investigation of crime and outlines a number of proposals to address this gap which require further consideration and debate

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

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Garden and field seeds since 1905 : spring 1932 /

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ROR2 regulates the survival of murine osteosarcoma cells in lung capillaries

Aim: Lung metastasis is a leading cause of death in patients with osteosarcoma (OS). No effective therapy exists that improves the five-year overall survival rate of OS patients with metastasis. Therefore, finding novel therapeutic targets will help develop new treatment strategies for OS patients with lung metastasis.Methods: Based on analysis of gene expression profiles between sublines of the Dunn OS LM8 cell line with high (LM8-H) and low (LM8-L) metastatic ability, we have identified Wnt signal-related genes that play an important role in lung metastasis of OS. Function of the genes was investigated by establishing sublines of gene knockout and assessing their metastatic ability using a mouse lung metastasis model. The molecular mechanism underlying the function of the genes was further investigated by in vitro experiments.Results: We have identified that receptor tyrosine kinase-like orphan receptor 2 (ROR2), a receptor of the non-canonical Wnt signaling pathway, was involved in OS cell survival in lung capillaries during metastasis. LM8-H knocked out of Ror2 (H/Ror2-KO) significantly reduced lung metastasis by decreasing the viability in lung capillaries 48 h after intravenous injection. In vitro study revealed that ROR2 increased anoikis resistance through AKT activation. Reconstitution of ROR2 expression in H/Ror2-KO cells restored their metastatic ability and viability in lung capillaries.Conclusion: The results demonstrate a novel ROR2 function in OS lung metastasis and may inform new treatment strategies for OS patients

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