Chemical Enhancement of Bloody Footwear Impressions from Buried Substrates

Footwear impressions are regarded as one of the most common forensic evidence types left at crime scenes. A review of research to date describes previous tests on the survival of footwear impressions in a range of contaminants on a myriad of surfaces. None, however, examined the effects of the burial environment on such impressions. Using human blood as a contaminant, footwear impressions were made on samples of white cotton, newspaper, and black plastic trash bags and were buried for specific time frames, from one to four weeks. The study examines the subsequent development of the surviving impressions postexcavation, using chemical enhancement techniques of ninhydrin, acid black 1, leucocrystal violet (LCV), and Bluestar. The majority of impressions recovered were from the substrates that were in the soil for the shortest period. Poor recovery rates and loss of impressions were observed on substrates buried for more than two weeks. LCV and Bluestar proved most effective for enhancing and retrieving impressions. Impressions were able to be examined by a trained forensic footwear investigator to identify class, individual, and wear characteristics of the impression itself. Potential survival of such identifying features is of paramount importance to an investigation

Selection on Moral Hazard in Health Insurance

In this paper we explore the possibility that individuals may select insurance coverage in part based on their anticipated behavioral response to the insurance contract. Such "selection on moral hazard" can have important implications for attempts to combat either selection or moral hazard. We explore these issues using individual-level panel data from a single fi?rm, which contain information about health insurance options, choices, and subsequent claims. To identify the behavioral response to health insurance coverage and the heterogeneity in it, we take advantage of a change in the health insurance options offered to some, but not all of the ?firm's employees. We begin with descriptive evidence that is suggestive of both heterogeneous moral hazard as well as selection on it, with individuals who select more coverage also appearing to exhibit greater behavioral response to that coverage. To formalize this analysis and explore its implications, we develop and estimate a model of plan choice and medical utilization. The results from the modeling exercise echo the descriptive evidence, and allow for further explorations of the interaction between selection and moral hazard. For example, one implication of our estimates is that abstracting from selection on moral hazard could lead one to substantially over-estimate the spending reduction associated with introducing a high deductible health insurance option.Insurance markets, Adverse selection, Moral hazard, Health insurance

Pilot Wellbeing & Work Related Stress (Wrs)

This paper presents the preliminary findings of an anonymous web-based survey addresing pilot work related stress (WRS) and wellbeing. The initial analysis indicates that pilots are under stress and experiencing wellbeing problems. Specific features of the job can result in wellbeing problems, spanning the three pillars of wellbeing. Critically, sources of WRS can increase a pilot’s risk in terms of developing a mental health (MH) issue. Further, sources of WRS can impact on performance and safety. Considerable barriers still remain in relation to reporting MH issues at work. Coping mechanisms addressing sleep/fatigue, diet, exercise and communication/reporting, enable some pilots to thrive in an environment that has negative impacts for others. The vast majority of pilots indicated that issues pertaining to WRS and wellbeing are not being adequately managed in terms of airline safety management systems/processes. Potentially, airline interventions might focus on enhancing existing safety management system processes/technology to address risks associated with WRS and wellbeing, training pilots, and introducing new wellbeing briefing/reporting systems. Further, new digital tools might be advanced to support pilot self management of WRS/wellbeing and risk identification, both inside and outside work

Deliberate clinical inertia: Using meta-cognition to improve decision-making

Deliberate clinical inertia is the art of doing nothing as a positive response. To be able to apply this concept, individual clinicians need to specifically focus on their clinical decision-making. The skill of solving problems and making optimal clinical decisions requires more attention in medical training and should play a more prominent part of the medical curriculum. This paper provides suggestions on how this may be achieved. Strategies to mitigate common biases are outlined, with an emphasis on reversing a 'more is better' culture towards more temperate, critical thinking. To incorporate such an approach in medical curricula and in clinical practice, institutional endorsement and support is required

The effect of promoting current local research activities on large monitors on the population’s interest in health related research – a randomized controlled trial

OBJECTIVE: The objectives of this study were threefold: to estimate people’s interest in health-related research, to understand to what extent people appreciate being actively informed about current local health-related research and to investigate whether their interest can be influenced by advertising local current health-related research using large TV monitors. DESIGN: Randomized controlled trial using a stepped wedge design. SETTING: The emergency department waiting room at two public hospitals in northern Queensland, Australia. PARTICIPANTS: Waiting patients and their accompanying friends and relatives in the emergency department waiting room not requiring immediate medical attention. INTERVENTIONS: A TV monitor advertising local current health-related research. MAIN OUTCOME MEASURES: Odds ratio for the effect of intervention on changing the interest in health-related research compared to a control group while adjusting for gender, age and socioeconomic standard

The effect of promoting current local research activities on large monitors on the population’s interest in health related research – a randomized controlled trial

OBJECTIVE: The objectives of this study were threefold: to estimate people’s interest in health-related research, to understand to what extent people appreciate being actively informed about current local health-related research and to investigate whether their interest can be influenced by advertising local current health-related research using large TV monitors. DESIGN: Randomized controlled trial using a stepped wedge design. SETTING: The emergency department waiting room at two public hospitals in northern Queensland, Australia. PARTICIPANTS: Waiting patients and their accompanying friends and relatives in the emergency department waiting room not requiring immediate medical attention. INTERVENTIONS: A TV monitor advertising local current health-related research. MAIN OUTCOME MEASURES: Odds ratio for the effect of intervention on changing the interest in health-related research compared to a control group while adjusting for gender, age and socioeconomic standard

Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland

Objective: The ITRACK study explored the process and predictors of transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Republic of Ireland. Method: Following ethical approval, clinicians in each of Ireland's four Health Service Executive (HSE) areas were contacted, informed about the study and invited to participate. Clinicians identified all cases who had reached the transition boundary (i.e. upper age limit for that CAMHS team ) between January and December 2010. Data were collected on clinical and socio-demographic details and factors that informed the decision to refer or not refer to AMHS and case notes were scrutinised to ascertain the extent of information exchanged between services during transition

An Incremental Adoption Pathway for Developing Precision Medicine Based Healthcare Infrastructure for Underserved Settings

Recent focus on Precision medicine (PM) has led to a flurry of research activities across the developed world. understaffed and underfunded health care systems in the US and elsewhere evolve to adapt PM to address pressing But how can healthcare needs? We offer guidance on a wide range of sources of healthcare data / knowledge sources as well as other infrastructure / tools that could inform PM initiatives, and may serve as low hanging fruit easily adapted on the incremental pathway towards a PM based healthcare system. Using these resources and tools, we propose an incremental adoption pathway to inform implementers working in underserved communities around the world on how they should position themselves to gradually embrace the concepts of PM with minimal interruption to existing care delivery