A Biological and Procedural Review of Forensically Significant Dermestes Species (Coleoptera: Dermestidae)

The analyses of the insect species found on decomposing remains may provide useful information for the estimation of the minimum time elapsed since death and other parameters, such as causes and circumstances of death. The majority of research has focused on the early colonizing species, typically blowflies, while research concerning late colonizing insects is currently sparse. Dermestid beetles of the genus Dermestes L. (Coleoptera: Dermestidae) are one of the predominant insect species associated with decomposing remains during dry decay and skeletal stages of decomposition. In some dry environments, Dermestes species are likely to be the only necrophagous insects feeding on the decomposing remains. Furthermore, Dermestes species (immature and adults), their remains (cast skins and fecal material), and their artifacts (pupal chambers) are frequently found associated with ancient remains (e.g., mummies, fossils). Dermestes species have a worldwide distribution and are considered important in decomposition processes, forensic investigations, and economically as a known pest of stored products. Despite their recognized forensic importance, there is limited data documenting the ecology, biology, and the growth rates of the forensically relevant species. The aim of this review is to provide a comprehensive synopsis on the available literature concerning Dermestes species associated with forensic cases. In particular, aspects of colonization behavior, growth rates for forensic taxa and potential best practice guidelines for forensic casework encompassing late colonizing Dermestes species are discussed

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

Knight M, Acosta C, Brocklehurst P, Cheshire A, Fitzpatrick K, Hinton L, Jokinen M, Kemp B, Kurinczuk JJ, Lewis G, Lindquist A, Locock L, Nair M, Patel N, Quigley M, Ridge D, Rivero-Arias O, Sellers S, Shah A on behalf of the UKNeS coapplicant group. Background Studies of maternal mortality have been shown to result in important improvements to women’s health. It is now recognised that in countries such as the UK, where maternal deaths are rare, the study of near-miss severe maternal morbidity provides additional information to aid disease prevention, treatment and service provision. Objectives To (1) estimate the incidence of specific near-miss morbidities; (2) assess the contribution of existing risk factors to incidence; (3) describe different interventions and their impact on outcomes and costs; (4) identify any groups in which outcomes differ; (5) investigate factors associated with maternal death; (6) compare an external confidential enquiry or a local review approach for investigating quality of care for affected women; and (7) assess the longer-term impacts. Methods Mixed quantitative and qualitative methods including primary national observational studies, database analyses, surveys and case studies overseen by a user advisory group. Setting Maternity units in all four countries of the UK. Participants Women with near-miss maternal morbidities, their partners and comparison women without severe morbidity. Main outcome measures The incidence, risk factors, management and outcomes of uterine rupture, placenta accreta, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, severe sepsis, amniotic fluid embolism and pregnancy at advanced maternal age (≥ 48 years at completion of pregnancy); factors associated with progression from severe morbidity to death; associations between severe maternal morbidity and ethnicity and socioeconomic status; lessons for care identified by local and external review; economic evaluation of interventions for management of postpartum haemorrhage (PPH); women’s experiences of near-miss maternal morbidity; long-term outcomes; and models of maternity care commissioned through experience-led and standard approaches. Results Women and their partners reported long-term impacts of near-miss maternal morbidities on their physical and mental health. Older maternal age and caesarean delivery are associated with severe maternal morbidity in both current and future pregnancies. Antibiotic prescription for pregnant or postpartum women with suspected infection does not necessarily prevent progression to severe sepsis, which may be rapidly progressive. Delay in delivery, of up to 48 hours, may be safely undertaken in women with HELLP syndrome in whom there is no fetal compromise. Uterine compression sutures are a cost-effective second-line therapy for PPH. Medical comorbidities are associated with a fivefold increase in the odds of maternal death from direct pregnancy complications. External reviews identified more specific clinical messages for care than local reviews. Experience-led commissioning may be used as a way to commission maternity services. Limitations This programme used observational studies, some with limited sample size, and the possibility of uncontrolled confounding cannot be excluded. Conclusions Implementation of the findings of this research could prevent both future severe pregnancy complications as well as improving the outcome of pregnancy for women. One of the clearest findings relates to the population of women with other medical and mental health problems in pregnancy and their risk of severe morbidity. Further research into models of pre-pregnancy, pregnancy and postnatal care is clearly needed

Understanding diagnosis and management of dementia and guideline implementation in general practice: a qualitative study using the theoretical domains framework

Dementia is a growing problem, causing substantial burden for patients, their families, and society. General practitioners (GPs) play an important role in diagnosing and managing dementia; however, there are gaps between recommended and current practice. The aim of this study was to explore GPs' reported practice in diagnosing and managing dementia and to describe, in theoretical terms, the proposed explanations for practice that was and was not consistent with evidence-based guidelines

Matching linguistic training with individual indigenous community's needs

Australia is rapidly losing its Indigenous multicultural and multilingual identity. This vast continent has lost 90 per cent of its Indigenous languages and cultures, without adequate documentation, and risks losing the rest by 2050 if action is not taken. There are formal, accredited linguistics courses designed specifically for Indigenous Australians to document and maintain their traditional languages. This research assessed the relevance of linguistic training for Indigenous Australians in remote communities and whether it provides the necessary skills for Indigenous Australians to document and maintain their languages in their particular workplace or community. The study found that Indigenous Australians come from a diversity of areas across the vast continent of Australia, live a diversity of lifestyles, have a diversity of linguistic attitudes and have access to different and often limited resources and support to meet their goals of documenting their endangered languages. As a result, standardised formal training is generally unlikely to provide the necessary linguistic skills needed for their particular community or workplace. However, by matching linguistic training with individual language community's linguistic situation, targeted training could increase the documentation of Australia's Indigenous languages