Databasing the disappeared and deceased: a review of the resources available in missing and unidentified persons cases

When an individual goes missing or an unidentified body is found, many resources are available to assist in resolving the case. These resources are operated and contributed to by a wide variety of entities including state, county, and local law enforcement agencies, coroners, medical examiners, forensic anthropologists and odontologists, military personnel, nonprofit organizations, volunteers, and concerned citizens among others. Currently, our nation does not have a single, fully operational, centralized database that is solely dedicated to finding missing persons and identifying the bodies of Jane and John Does. The existing resources for missing and unidentified persons cases are almost innumerable and the proliferation of these resources needlessly complicates missing and unidentified persons cases. The primary goal of the current research was to identify and analyze the many types of resources involved in missing and unidentified persons cases. This was accomplished through an extensive literature review on missing and unidentified persons and on the United States Department of Justice agencies and database that handle such cases. Two survey projects were also undertaken in addition to the literature review. The first survey gave forensic anthropologists an opportunity to voice their concerns over the handling of unidentified persons cases. The second survey was used to categorize and assess the multitude of web-based resources dedicated to both missing and unidentified persons cases. The missing and unidentified person issue is complex and cannot be fully understood without knowledge of the many factors that can act to prevent and complicate the resolution of cases. The current research has attempted to provide information on how each of these resources could be improved in order to approach better handling of missing and unidentified persons cases nationwide

Home Modification Outcomes in the Residences of Older People as a Result of Cougar Home Safety Assessment (Version 4.0) Recommendations

The purpose of this study was to determine if recommendations made as a result of the administration of the Cougar Home Safety Assessment Version 4.0 (CHSA 4.0) were effective in causing older residents to make environmental safety modifications in their homes. Initial data were collected during the administration of the CHSA 4.0 in the homes of 40 older people in four northeastern states. After completing the initial assessments, the researchers provided the participants with recommendations for improving the environmental safety of their homes. Approximately one month later, each home was reassessed with the CHSA 4.0. Overall, improvement in environmental safety was demonstrated in the homes with the greatest increases being in fire safety, emergency phone number placement, and bathroom safety. A t-test demonstrated a significant gain in compliance (t = 7.8, p < .001) by comparing the difference between the mean initial and reassessment home safety scores. A very large effect size (Cohen’s d = 1.7) was also found, indicating a high magnitude of difference between initial and reassessment safety ratings. The assessment proved to be beneficial in increasing the environmental safety of homes

Conducting a Supportive Oncology Clinical Trial During the COVID-19 Pandemic: Challenges and Strategies

The coronavirus disease 2019 (COVID-19) pandemic resulted in severe interruptions to clinical research worldwide. This global public health crisis required investigators and researchers to rapidly develop and implement new strategies and solutions to mitigate its negative impact on the progress of clinical trials. In this paper, we describe the challenges, strategies, and lessons learned regarding the continuation of a supportive oncology clinical trial during the pandemic. We hope to provide insight into the implementation of clinical trials during a public health emergency to be better prepared for future instances. Trial registration: ClinicalTrials.gov, a service of the US National Institute of Health (NCT03030859). Registered on 22 January 2017

An aphasia research agenda - a consensus statement from the collaboration of aphasia trialists.

Coordination of international aphasia research would minimise duplication of effort, support synergistic international activities across languages and multidisciplinary perspectives, and promote high-quality conduct and reporting of aphasia research, thereby increasing the relevance, transparency, and implementation of findings. The Collaboration of Aphasia Trialists (CATs) sought to develop an aphasia research agenda to direct future research activities, based on priorities shared by people with aphasia, family members, and healthcare professionals. Our established international research network spanning 33 countries contributed to this activity. Research literature reporting the priorities of stakeholders was reviewed and synthesised (phase 1). Representatives from Working Groups on Aphasia Assessment & Outcomes, Prognosis & Predictors of Recovery, Effectiveness of Interventions, and Societal Impact & Reintegration participated in a two-day research agenda setting meeting. The CATs expert panel refined research objectives and identified constituent components of research and methodological developments required to address these research components. The objectives and research components were grouped into overarching themes (phase 2). The resultant list was then circulated to more than 180 CATs members for review, revision, and approval. Consensus on the final aphasia research agenda and road-map was reached by CATs executive committee (phase 3). The expert panel identified five overarching research themes: (i) evidence-based interventions for people with aphasia, (ii) effective interventions to support those communicating with people with aphasia, (iii) cross-linguistic assessment and core outcomes for aphasia research, (iv) predictors of language recovery, and (v) clinical implementation of research findings. Within these broad themes, 30 research objectives and 91 individual aphasia research components were identified and sequentially ordered. This agenda builds on research priorities identified by people with aphasia and their families, and includes priorities of healthcare professionals and researchers, and will support the rehabilitation and recovery of people with aphasia. Our internationally relevant research agenda promotes rigour in methodology, considers international applicability, synergistic activities, and sharing of resources and expertise

Health behaviors among head and neck cancer survivors

Abstract Purpose To determine to what extent head and neck cancer (HNC) survivors participate in health behaviors (HBs) recommended by the National Cancer Center Network (NCCN®). Methods Participants identified through the tumor registries at the Abramson Cancer Center (ACC), University of Pennsylvania and affiliated sites. Eligibility: (a) diagnosis and treatment HNC; (b) aged 18 to 70 years; (c) ≥ 1-year post-diagnosis; (d) human papillomavirus (HPV) status confirmed; (e) ability to understand written English. Potential participants received an explanation of the study, informed consent, self-reported questionnaire, and self-addressed stamped envelope. Results 451 individuals eligible, 102 (23%) agreed to participate, HPV positive (74%). Current smoking rare (7%), historical use common (48%). Current alcohol use common (65%), average 2.1 drinks/day, 12 days/month. 22% binge drank with an average of 3.5 binge-drinking sessions per month. Nutritional behavior mean 7.1 (range 0–16), lower scores indicating better nutrition. Body mass index (BMI) 59% overweight/obese. Adequate aerobic exercise 59%, adequate strength and flexibility 64%. Leisure time activity, 18% sedentary, 19% moderately active, 64% active. All participants reported having a primary care physician, 92% seen in the previous 12 months. Conclusions Most HNC survivors participated in some HBs. Current smoking rarely reported, binge drinking and high BMI most common negative HBs. Opportunities remain to improve dietary and exercise behaviors. Implications for cancer survivors The NCCN® has outlined HBs that decrease likelihood of cancer survivors developing comorbidities that could impact overall survival. It is incumbent on healthcare providers to educate and encourage cancer survivors to participate in these HBs

Universal Lead Screening Requirement: A California Case Study.

OBJECTIVES:To estimate potential impacts of California Assembly Bill (AB) 1316: a requirement for universal screening and insurance coverage for child blood lead testing. METHODS:In April 2017 the California Health Benefits Review Program (Oakland, CA) analyzed AB 1316 for the California legislature, including a systematic review of lead screening effectiveness, commercial insurer surveys regarding screening coverage, and actuarial utilization and cost implication assessments. RESULTS:Universal screening requirements would increase child lead testing by 273%, raise affected populations' premiums by 0.0043%, and detect an additional 4777 exposed children 1 year after implementation. CONCLUSIONS:The evidence for a net societal benefit of universal screening approach is limited and is not supported by prominent medical professional groups. Public Health Implications. California expanded targeted screening to identify additional children at higher risk for lead poisoning on the basis of California-specific risk factors, while mitigating the potential harms of universal screening such as an increase in false positive tests and health care costs

Telemedicine-delivered treatment interventions for substance use disorders: a systematic review.

With increased negative impacts from opioid and other substance use disorders in the US, it is important for treatments to not only be effective, but also accessible to patients. Treatment delivery via telemedicine, specifically, the use of videoconferencing, which allows real time communication between a patient and a clinician at a distant site, has been shown to be an effective approach for increasing reach and access to treatments for mental health disorders and other chronic illnesses. This systematic review identified and summarized studies examining the effectiveness of telemedicine interventions to deliver treatment for patients with substance use disorders. Out of 841 manuscripts that met our search criteria, 13 studies met the inclusion criteria. Studies covered interventions for nicotine, alcohol and opioid use disorders. They varied widely in size, quality, and in the comparison groups examined. Studies examined both delivery of psychotherapy and medication treatments. Most studies suggested telemedicine interventions were associated with high patient satisfaction and are an effective alternative, especially when access to treatment is otherwise limited. However, there were substantial methodological limitations to the research conducted to date. Further studies are needed, including larger scale randomized studies that examine different models of telemedicine that can be integrated into existing healthcare delivery settings, to increase the use of effective treatments for patients with substance use disorders