Mock Case Research Articles

Mock jurors' perceptions and case decisions following a juvenile interrogation: Investigating the roles of interested adults and confession type.

Interested adults, such as parents and attorneys, may pose as safeguards against juveniles' vulnerabilities during custodial interrogations; yet, the trial-level ramifications of their presence are unknown. The current research examined mock jurors' perceptions and case decisions after they read about disputed juvenile confession evidence elicited in the presence of an interested adult. We hypothesized that when reading about a voluntary confession (vs. coerced or none), participants would be more likely to convict, find the defendant vulnerable, and view his interrogation less negatively. When an interested adult (parent or attorney) was present, we anticipated an increase in convictions, lower vulnerability perceptions, and less negative views of the interrogation, and especially so when the adult encouraged the juvenile to speak. Jury-eligible participants in Study 1 (N = 435) and Study 2 (N = 673) read a case about a 15-year-old male charged with murder and then completed a post case questionnaire. We manipulated confession type (coerced, voluntary, none) in both studies, interested adult's mere presence (parent, attorney, no adult) in Study 1, and adult advice (parent/attorney prompting the defendant to keep quiet or speak) in Study 2. Overall, findings demonstrated higher conviction rates when there was a voluntary confession (vs. coerced or none). Study 1 revealed that a parent's or attorney's presence inflated conviction rates, and Study 2 demonstrated that adults' advice did not affect convictions or perceptions. Interested adults' presence during juvenile interrogations seems to legitimize confession evidence instead of protecting juveniles at the trial level. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A mixed methods study for the evaluation of a digital health solution for cancer multidisciplinary team meetings using simulation-based research methods.

e14063 Background: Simulation-based research (SBR) methods involve setting up structured scenarios to replicate real-world situations, with the aim of eliciting real-world reactions and behaviours. SBR is useful for the evaluation of new healthcare solutions without compromising patient safety or navigating complex ethical review processes. However, there are few trials using SBR methods for the evaluation of digital health interventions (DHIs), the adoption of which has been hindered in the NHS due to a lack of evidence-base for their efficacy. SBR methods could be an appropriate tool for testing digital solutions. Methods: The Institute of Global Health Innovation (IGHI) developed a series of simulated lung cancer multidisciplinary team (MDT) meetings to test the NAVIFY Tumor Board solution by Roche Diagnostic Information Solutions, a digital solution for the preparation and conduct of cancer MDTs. To provide an environment for participants to evaluate the capabilities of the NAVIFY Tumor Board solution, 10 simulation sessions were organised in which groups of five to six clinicians were recruited to discuss up to 10 mock patient cases across two simulated MDTs, first using standard tools commonly used to conduct MDTs and then using the NAVIFY Tumor Board solution. The cases were developed by the study team at IGHI and consultants in respiratory medicine and oncology. 56 healthcare professionals (respiratory physicians, oncologists, radiologists, histopathologists, clinical nurse specialists and thoracic surgeons) were recruited. The sessions were video recorded and observations were noted by the study team, followed by a focus group in which participants provided feedback about their experience of the simulated MDTs. Results: Through this study we were able to generate evidence and multi-professional recommendations for Roche regarding the functionality, usability and applicability of the solution in the NHS, as well as beneficial features and those which could be improved. Participants reported that the simulations were realistic and a meaningful way of conducting evaluations of digital health solution without impacting clinical practice or patient safety. Conclusions: This study demonstrated the utility and validity of testing commercial tools in simulated settings to generate meaningful insights from endusers. SBR methods were shown to be an acceptable way for frontline practicing clinicians to participate in the testing and development of digital health tools in a standardised setting.

Dangerous or Desirable: Utilizing Augmented Content for Field Policing

ABSTRACT Location-based systems (LBS) can be of benefit to obtain information when and where it is needed. What is not captured with LBS are points of interest (dynamic hotspots) that are not fixed in one location, such as people. Furthermore, using 2D interface elements makes it difficult to communicate precise spatial information to users. The current study aims to assess the viability of dynamic hotspots and augmented content in a mobile hotspot policing application. Mock cases were constructed to mimic real field policing work. The system, comprised of a smartphone and smartwatch, gave static and dynamic hotspot information, which was enriched with the use of augmented elements viewed through the smartphone-camera. Interviews, observations and usability measures were used to gain insight for augmented reality (AR) design considerations in the domain of field-policing. The detection of dynamic hotspots was seen as desirable. While static and dynamic hotspot information was seen as valuable, AR information, as it was utilized in the current study, has too many drawbacks to be used in the field. Alternative modalities, insights into possible future iterations and technical limitations of AR for the emergency response domain are discussed.

Integrating the medical and cannabis systems: A mock case study.

Integrating the medical and cannabis systems: A mock case study.

The effects of body-worn camera footage and eyewitness race on jurors' perceptions of police use of force.

Police use of body-worn cameras (BWCs) is increasingly common in the USA. This article reports the results of one of the first experimental examinations of the effects of three BWC status conditions (absent, transcribed, viewed) and eyewitness race (Black, White) on mock jurors' case judgments, in a case in which a community member (defendant) was charged with resisting arrest but where the officer's use of force in conducting the arrest was controversial. Results provide evidence of significant main effects of both eyewitness race and BWC status. When the eyewitness supporting the defendant was White, mock jurors were less likely to vote the defendant guilty of resisting arrest, as well as more likely to consider the defendant credible and the officer culpable for the incident. In addition, when BWC footage of the arrest was viewed, compared with transcribed or absent, participants were less likely to vote the defendant guilty of resisting arrest, and also rated the officer's use of force less justifiable, and the officer more culpable and less credible. Follow-up analyses demonstrated that these relationships between BWC condition and case judgments were all mediated by moral outrage toward the officer.

How information about perpetrators' nature and nurture influences assessments of their character, mental states, and deserved punishment.

Evidence of perpetrators' biological or situational circumstances has been increasingly brought to bear in courtrooms. Yet, research findings are mixed as to whether this information influences folk evaluations of perpetrators' dispositions, and subsequently, evaluations of their deserved punishments. Previous research has not clearly dissociated the effects of information about perpetrators' genetic endowment versus their environmental circumstances. Additionally, most research has focused exclusively on violations involving extreme physical harm, often using mock capital sentences cases as examples. To address these gaps in the literature, we employed a "switched-at-birth" paradigm to investigate whether positive or negative information about perpetrators' genetic or environmental backgrounds influence evaluations of a perpetrator's mental states, character, and deserved punishment. Across three studies, we varied whether the transgression involved direct harm, an impure act that caused no harm, or a case of moral luck. The results indicate that negative genetic and environmental backgrounds influenced participants' evaluations of perpetrators' intentions, free will, and character, but did not influence participants' punishment decisions. Overall, these results replicate and extend existing findings suggesting that perpetrators' supposed extenuating circumstances may not mitigate the punishment that others assign to them.

Oral gram-positive bacterial DNA-based identification of saliva from highly degraded samples

Analyzing degraded evidence is an important challenge in forensic casework. Saliva remaining at a crime scene may deteriorate, due to various factors, making it difficult to identify. This study aims to clarify the efficacy of oral gram-positive and -negative bacterial DNA-based identification of saliva for analyzing highly degraded samples. Saliva samples were subjected to three different degradation treatments (heat denaturation: 40–80 °C in wet conditions; microbial decomposition: 1–5 days in humid soil; and ultraviolet (UV) irradiation: 0.01–1 J/cm2). We compared saliva markers’ detectability from the degraded samples—oral gram-positive bacterial DNA (Streptococcus salivarius and Streptococcus oralis), oral gram-negative bacterial DNA (Veillonella atypica and Prevotella maculosa) and salivary α-amylase. Oral bacterial DNA was detected using a melting curve analysis following real-time PCR. The efficacy of short tandem repeats (STR) and mitochondrial DNA (mtDNA) analyses were also compared. All oral bacterial DNA were detected with specific melting peaks from the heat-denatured samples, while neither catalytic nor immunochromatographic tests detected salivary α-amylase from the heat (80 °C) samples. The gram-positive bacterial DNA (S. salivarius and S. oralis) was detected from the microbial degradation (1–5 days) samples. In contrast, the gram-negative bacterial DNA (V. atypica and P. maculosa) and salivary α-amylase were not detected from samples treated for more than two days. UV exposure made bacterial DNA-based saliva identification difficult in a dose–dependent manner; however, UV irradiation did not influence protein-based saliva tests using salivary α-amylase as an indicator. As a result of STR and mtDNA typing, partial or null STR profiles were generated from the severely degraded (microbial (2–5 days) and UV (0.1–1 J/cm2) degradation) samples, but full mtDNA profiles were obtained from all degraded samples. The forensic applicability of bacterial DNA test evaluated, using mock case samples, indicates that the oral gram-positive bacterial DNA was more resistant to degradation than the other markers. We conclude that the oral gram-positive bacterial DNA-based examination could be useful for identifying saliva from severely environmentally-exposed forensic samples as well as mtDNA typing.

Targeted interventions to prevent transitioning from acute to chronic low back pain in high-risk patients: development and delivery of a pragmatic training course of psychologically informed physical therapy for the TARGET trial

BackgroundLow back pain (LBP) is a public health concern because it is highly prevalent and the leading cause of disability worldwide. Psychologically informed physical therapy (PIPT) is a secondary prevention approach that first aims to identify individuals at high risk for transitioning to chronicity and then provides tailored treatment to reduce that risk. Training models that are feasible to implement with acceptable training quality are needed to improve scalability for widespread implementation of PIPT. This manuscript describes the PIPT training program that was developed for training physical therapists providing PIPT in the TARGET trial.MethodsThe PIPT training program was developed, tested, and modified using an iterative process. Content development consisted of stakeholder engagement, beta testing, modification of training, and confirmation of final course objectives. Methods of delivery consisted of a website that included brief online educational modules followed by a live 8-h workshop that included video-based mock case scenarios and case-based role playing. Attitudes, beliefs, and confidence in implementing PIPT principles were assessed before and immediately after training to measure training quality and impact.ResultsEarly stakeholder engagement and beta testing indicated the need for increased emphasis on experiential learning opportunities and patient-centered communication training. Booster training varied extensively across TARGET sites with involvement of ‘clinician champions’ providing brief follow-up sessions identified as best practice. Favorable post-training changes in physical therapist attitudes and beliefs toward biopsychosocial treatment orientation and increased confidence in implementing PIPT principles were observed.ConclusionsPIPT training for provider participation in the TARGET trial was feasible to deliver. Course content was acceptable to physical therapists and resulted in improved beliefs and confidence in applying PIPT skills during clinical practice. Ongoing consultation and site-based continuing education were methods by which specific TARGET sites maintained or augmented PIPT skill training; however, implementing ongoing training was challenging in general. Due to the pragmatic nature of the TARGET trial, it was not possible to directly measure the effect of PIPT training on treatment fidelity, which was a limitation of our approach.Trial registrationClinicalTrials.gov, NCT02647658. Registered on 6 January 2016.

Utility of Spatial Point-Pattern Analysis Using Residential and Workplace Geospatial Information to Localize Potential Outbreak Sources.

Identifying the source of an outbreak facilitates its control. Spatial methods are not optimally used in outbreak investigation, due to a mix of the complexities involved (e.g., methods requiring additional parameter selection), imperfect performance, and lack of confidence in existing options. We simulated 30 mock outbreaks and compared 5 simple methods that do not require parameter selection but could select between mock cases’ residential and workplace addresses to localize the source. Each category of site had a unique spatial distribution; residential and workplace address were visually and statistically clustered around the residential neighborhood and city center sites respectively, suggesting that the value of workplace addresses is tied to the location where an outbreak might originate. A modification to centrographic statistics that we propose—the center of minimum geometric distance with address selection—was able to localize the mock outbreak source to within a 500 m radius in almost all instances when using workplace in combination with residential addresses. In the sensitivity analysis, when given sufficient workplace data, the method performed well in various scenarios with only 10 cases. It was also successful when applied to past outbreaks, except for a multisite outbreak from a common food supplier.

Validation of a Drug-Related Problem Classification System for the Intermediate and Long-Term Care Setting in Singapore.

Background: This study aims to evaluate the inter-rater reliability and perceived usability of a newly developed drug-related problem (DRP) classification system for use by pharmacists in the intermediate and long-term care (ILTC) setting in Singapore. Methods: This was a cross-sectional survey study involving the use of a self-administered questionnaire. All 55 pharmacists affiliated to the Pharmaceutical Society of Singapore (PSS) ILTC Pharmacists Workgroup who were above 21 years old and not authors of the classification system were invited to participate. The inter-rater reliability of participants’ classification of 46 mock DRP cases using the new DRP classification system was determined using Fleiss’s kappa (κ). Participants’ perceived usability of the classification system was evaluated using six items with five-point Likert scales (1—“strongly disagree”, 5—“strongly agree”). Results: Thirty-three pharmacists responded to the survey. Overall inter-rater reliability was found to be substantial (κ = 0.614; 95% CI: 0.611–0.617). All usability items received positive ratings (“strongly agree” or “agree”) from at least 69% of participants. Conclusion: The new DRP classification system has substantial external validity and appears to be suitable for use by pharmacists to document and report DRPs in the ILTC setting in Singapore and facilitate evaluation of the impact of pharmaceutical care in the ILTC setting.

NIST interlaboratory studies involving DNA mixtures (MIX13): A modern analysis

MIX13 was an interlaboratory exercise directed by NIST in 2013. The goal of the exercise was to evaluate the general state of interpretation methods in use at the time across the forensic community within the US and Canada and to measure the consistency in mixture interpretation. The findings were that there was a large variation in analysts’ interpretations between and within laboratories.Within this work, we sought to evaluate the same mock mixture cases analyzed in MIX13 but with a more current view of the state-of-the-science. Each of the five cases were analyzed using the Identifiler™ multiplex and interpreted with the combined probability of inclusion, CPI, and four different modern probabilistic genotyping systems. Cases 1–4 can be interpreted without difficulty by any of the four PG systems examined. Cases 1 and 4 could also be interpreted successfully with the CPI by assuming two donors.Cases 2 and 3 cannot be interpreted successfully with the CPI because of potential of allele dropout. Case 3 demonstrated the need to consider relevant background information before interpretation of the profile. This case does not show that there is some barrier to interpretation caused by relatedness beyond the increased allelic overlap that can occur. Had this profile been of better template it might have been interpreted using the CPI despite the (potential) relatedness of contributors.Case 5 suffers from over-engineering. It is unclear whether reference 5C, a non-donor, can be excluded by manual methods. Inclusion of reference 5C should be termed an adventitious match not a false inclusion. Beyond this statement this case does not contribute to the interlaboratory study of analyst/laboratory interpretation method performance, instead, it explores the limits of DNA analysis.Taken collectively the analysis of these five cases demonstrates the benefits of changing from CPI to a PG system.

An inquiry on a mock trial case as law-related education method

An inquiry on a mock trial case as law-related education method

NIST interlaboratory studies involving DNA mixtures (MIX05 and MIX13): Variation observed and lessons learned

Interlaboratory studies are a type of collaborative exercise in which many laboratories are presented with the same set of data to interpret, and the results they produce are examined to get a “big picture” view of the effectiveness and accuracy of analytical protocols used across participating laboratories. In 2005 and again in 2013, the Applied Genetics Group of the National Institute of Standards and Technology (NIST) conducted interlaboratory studies involving DNA mixture interpretation. In the 2005 NIST MIX05 study, 69 laboratories interpreted data in the form of electropherograms of two-person DNA mixtures representing four different mock sexual assault cases with different contributor ratios. In the 2013 NIST MIX13 study,108 laboratories interpreted electropherogram data for five different case scenarios involving two, three, or four contributors, with some of the contributors potentially related. This paper describes the design of these studies, the variations observed among laboratory results, and lessons learned.

Improving Pediatric Resident Communication During Family-Centered Rounds Using a Novel Simulation-Based Curriculum.

While family-centered rounds (FCR) have become increasingly important in pediatrics, there is often no training for residents on appropriate FCR practice. This curriculum was developed to address this identified gap in pediatric trainee education through a combination of didactic presentation, direct observation, and simulated FCR. Residents participated in a didactic presentation on key components of FCR and tenets of communication with families. A subset of residents participated in a simulated intervention in which they practiced an FCR encounter using a mock patient case and received immediate feedback from a multidisciplinary team. Following the simulation, residents completed follow-up surveys and focus group discussions to assess their experience and comfort. Resident trainees were observed and rated during FCR by trained parent advisors using a novel FCR checklist both before and after participation in the simulation. This curriculum was implemented with 10 pediatric interns (intervention group). These residents demonstrated statistically significant improvements in the areas of greeting family by name and soliciting rounding preferences, enhancing family comfort in participating in FCR, and increasing family engagement in FCR. Compared to controls, intervention group residents had higher ratings on the majority of performance items. Resident-reported self-efficacy in conducting FCR increased following the intervention, and the feedback portion of the intervention was highly valued. Simulation-based training is an effective model for teaching residents best practices in FCR with lasting impact on resident communication skills as seen in comparative analysis from before and after the intervention.

Human-associated microbial populations as evidence in forensic casework

In forensic investigations involving human biological traces, cell type identification is often required. Identifying the cell type from which a human STR profile has originated can assist in verifying scenarios. Several techniques have been developed for this purpose, most of which focus on molecular characteristics of human cells. Here we present a microarray method focusing on the microbial populations that are associated with human cell material. A microarray with 863 probes targeting (sets of) species, specific genera, groups of genera or families was designed for this study and evaluated with samples from different body sites: hand, foot, groin, penis, vagina, mouth and faeces. In total 175 samples from healthy individuals were analysed. Next to human faeces, 15 feline and 15 canine faeces samples were also included. Both clustering and classification analysis were used for data analysis. Faecal and oral samples could clearly be distinguished from vaginal and skin samples, and also canine and feline faeces could be differentiated from human faeces. Some penis samples showed high similarity to vaginal samples, others to skin samples. Discriminating between skin samples from different skin sites proved to be challenging. As a proof of principle, twenty-one mock case samples were analysed with the microarray method. All mock case samples were clustered or classified within the correct main cluster/group. Only two of the mock case samples were assigned to the wrong sub-cluster/class; with classification one additional sample was classified within the wrong sub-class. Overall, the microarray method is a valuable addition to already existing cell typing techniques. Combining the results of microbial population analysis with for instance mRNA typing can increase the evidential value of a trace, since both techniques focus on independent targets within a sample.

Justice Served? Perceptions of Plea Bargaining Involving a Sexual Assault in Child and Adult Females

Seventy-four community members (46 women, 28 men) read vignettes describing a plea bargain in a mock sexual assault case. We employed a within-participant design and manipulated rape victim age (6- vs. 26-year-old), type of plea bargain agreement (reduced prison sentence vs. only probation), and reason for plea bargain (save victim from reliving a traumatic experience vs. save time in court). Participants answered questions about the plea bargain agreement (e.g., was justice served). The results showed less support of plea bargaining when it (a) involved a child, (b) involved only probation, and (c) when the rationale for the plea bargain was to save time. Significant moderation revealed that plea deals involving probation in 6-year-old child cases were perceived most negatively. The results are discussed in terms of procedural justice theory in sexual assault cases, and how perceptions of the general public impact the use of plea bargaining as a legal tool.

Helping Trainees Develop Scholarship in Academic Medicine From Community Service.

Service in the community and academic medicine are often seen by trainees as unrelated. This may be one reason for the lack of faculty diversity and the declining interest in academic medicine among new trainees. We developed an educational workshop through the application of the Kern model to help medical students and residents understand the relationship between community service work and scholarship as it pertains to a career in academic medicine. Specifically, the workshop helped trainees (1) understand the terms service and scholarship, (2) understand the benefits of achieving community service scholarship, and (3) identify steps to achieve community service scholarship through mock cases and personal stories. The workshop was implemented at five conferences with a total of 139 trainees. Results of a paired-samples t test of learners' responses pre- and postworkshop showed statistically significant growth in their confidence to publish service-related work, as well as more positive agreement with the notion that community service work aligns with an academic medicine career. This effective module can help trainees understand how community service and academic medicine are aligned, and raise their confidence in building a foundation for an academic medicine career through conducting community service scholarship.

Ensuring Implementation Fidelity of a 10-Week Home Visiting Program in Two Randomized Clinical Trials.

Introduction Implementation fidelity is a challenge for the adoption of evidence-based programs within social service broadly and child welfare specifically. However, implementation fidelity is critical for maintaining the integrity of clinical trials and for ensuring successful delivery of services in public health settings. Methods Promoting First Relationships ® (PFR), a 10-week home visiting parenting intervention, was evaluated in two randomized clinical trials with populations of families in child welfare. Seven providers from community agencies participated in the trials and administered PFR. Fidelity data collected included observational measures of provider behavior, provider records, and input from clients to assess training uptake, adherence to content, quality of delivery, program dosage, and participant satisfaction. Results In mock cases to assess training uptake, providers demonstrated an increase in PFR verbalization strategies and a decrease non-PFR verbalizations from pre to post PFR training, and overall this was maintained a year later (Mann-Whitney U's = 0, p's < .01). Adherence to content in actual cases was high, with M = 97% of the program elements completed. Quality of delivery varied across providers, indicated by PFR consultation strategies (Wilks' Lambda F = 18.24, df = 15, p < .001) and global ratings (F = 13.35, df = 5, p < .001). Program dosage was high in both trials (71 and 86% receiving 10 sessions), and participant satisfaction was high (M = 3.9, SD = 0.2; 4 = greater satisfaction). Discussion This system of training and monitoring provides an example of procedures that can be used effectively to achieve implementation fidelity with evidence-based programs in social service practice.

Multi-centre audit of VMAT planning and pre-treatment verification

Background and purposeWe performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. Materials and methodsThe nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre’s equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. ResultsAll centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner’s methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. ConclusionsAll plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing.

Perception of and attitude toward ethical issues among Korean occupational physicians

BackgroundOccupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs.MethodsAn email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community ‘oem-doctors’ in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher’s exact test.ResultsResponses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought ‘consideration of worker’s health and safety’ (26.0%) and ‘neutrality’ (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations.ConclusionsThis study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.