An investigation into the cause of the inner dark areas and outer lighter areas (ghosting) seen in dynamically-created two-dimensional bare footprints

Dynamic bare footprints differ from static bare footprints through the presence of additional, lighter markings around the rear of the heel print and apices of the toe print areas. These images can appropriately be described as inner dark and outer ghosting features. To date, the functional cause of both features has not been understood. To gain such an understanding could potentially allow the further development and use of these features in forensic identification. The aim of this project was to investigate the causes of the inner dark and outer ghosting features seen in dynamic bare footprints through an observational, practice-based action research approach within a gait laboratory. Volunteer male participants provided bare footprints on inkless paper taped to a Kistler force plate with video cameras situated either side. Ground reaction force data were collected as the footprints were formed and the event recorded using video cameras to allow these data to be correlated later. The findings suggest that the ghosting at the heel is the result of splaying of the fibro fatty pad, while that at the toes is the result of the distal ends of the toes coming into contact with the ground as the heel is lifted. Footprint, ground reaction force and video data comparisons showed that the inner dark area of the heel print corresponded with the main body of the heel contacting the ground. Outer ghosting corresponded with a backward splaying of the fat pad and the heel strike transient spike in vertical ground reaction force during increased loading. The inner dark area of the toes corresponded with a longer period of toe contact with the ground. Outer ghosting corresponded with the decreasing vertical ground reaction force and shorter contact time as the toes were leaving the ground towards the end of the contact phase of gait. Although the sample size was limited, these are new appreciations which could facilitate the use of the inner dark features in identification to provide additional points for comparison in cases involving dynamic bare footprints. Further work is now indicated to study these features in different populations and under varying conditions

Development and evaluation of a valid and reliable footprint measurement approach in forensic identification

Introduction: Bare footprints found at a crime scene can be used as forensic evidence to link a person to the incident using comparison methods. Identification relies upon methods of evaluation including measurement; however the science underpinning measurement in this field has not been fully explored. Method: A critical review of the literature revealed various measurement approaches and also demonstrated little or no measurement rigour in terms of reliability and validity. Therefore a novel pragmatic method for collecting and measuring two-dimensional bare foot impressions was developed by the researcher to provide the necessary tool for use in this field. Evaluation involved three static and three dynamic footprints collected from thirty female and thirty one male volunteers using an inkless paper system. The footprints were digitised and widths, lengths and angles constructed and automatically measured using freely vailable measurement software. Measurement rigour was pursued using modern validity and intra-/inter-rater reliability approaches followed by an evaluation of the tool by experts in the field. These explorations are presented within the thesis as separate investigations. Results: Statistically significant differences occurred between paired static and dynamic linear measurements (df 60) with t values ranging from 3.08 to 23.17, P < 0.01. The highest correlations with stature were shown to be the linear measurement from the heel to fifth toe print in the dynamic footprints (r = 0.858, P < 0.01). The reliability analysis found high intra-rater agreement using intraclass correlation coefficient (ICC) 0.99 with a 95% standard error of measurement 0.84 mm, 95% limits of agreement (LOA) -0.91 to 0.65. Conclusion: The research establishes a valid and reliable two-dimensional measurement approach, useful for footprint identification purposes and also as a baseline method for further research in this field

Estimating actual foot size from a static bare foot print in a White British Population

In forensic intelligence-gathering it would be useful to be able to estimate the size of a perpetrator's foot from a standing bare footprint found at the scene of crime. Currently, the advice is to add a fixed amount to the length of the footprint (typically 1.5 or 2.0 cm), but there is little evidence for this approach. This study used measured footprint and actual foot lengths from 146 participants from the white British student population of a University in the UK. Data were analysed using multiple regression with foot length as the dependent (outcome) variable and footprint length and sex as the independent variable/factor respectively. Sex was not a significant predictor. The regression equation for the best estimate of the foot length is 19.89 + 0.95 × print length ± 8 mm

An investigation to assess ankle mobility in healthy individuals from the application of multi-component compression bandages and compression hosiery

Background An investigation was undertaken to compare the effect of multi-component compression bandages and compression hosiery kits on individuals’ range of ankle motion whilst wearing typical and medical footwear, and barefoot. Methods A convenience sample of 30 healthy individuals recruited from the staff and student population at the University of Huddersfield, UK. Plantarflexion/dorsiflexion range of ankle motion (ROAM) was measured in participants over 6 steps in every combination of typical, medical and no footwear; and multi-component bandages, compression hosiery and no garments. Results Controlling for age, gender and garments, the use of typical footwear was associated with a mean increase in ROAM of 2.54° at best estimate compared with barefoot; the use of medical footwear was associated with a mean decrease in ROAM of 1.12° at best estimate compared with barefoot. Controlling for age, gender and footwear, the use of bandaging was associated with a mean decrease in ROAM of 2.51° at best estimate compared with no garments. Controlling for age, gender and footwear, the use of hosiery was not associated with a significant change in ROAM compared with no garments. Conclusions Bandages appear to restrict ROAM more than hosiery when used in conjunction with a variety of footwear types

Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

BACKGROUND: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety

The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning.

BACKGROUND: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training