Gunshot trauma in human long bones: towards practical diagnostic guidance for forensic anthropologists.

In contrast to cranial gunshot trauma, diagnosis and interpretation of gunshot trauma to long bones remains difficult and controversial. The aim of this study is to review the published literature on fracture patterns resulting from gunshot trauma in human long bones, and to use the described characteristics to provide practical guidance for the forensic anthropologist. In order to achieve this, medical and forensic publications on this topic were reviewed. Several types of fractures, such as linear, oblique, comminuted and butterfly fractures, have been observed in either the shaft or the ends of long bones. Indirect fractures that are not caused by bullets striking bone directly but by bullet-induced forces to the surrounding soft tissue have been found as well. Some of these fractures are related to a specific context or mechanism which might help in the forensic reconstruction of events. It is recommended that future research should focus on available medical data to provide more detailed descriptions on fracture patterns for forensic purposes. Experimentation with bone surrogates and computer modelling might also provide better and more realistic reconstructions of gunshot trauma in the future and provide valuable insights for its diagnosis and interpretation in forensic anthropology.

Tracing the policy implementation of commitments made by national governments and other entities at the Third Global Forum on Human Resources for Health.

We conducted a follow-up analysis of the implementation of the Human Resources for Health (HRH) commitments made by country governments and other actors at the Third Global Forum on HRH in 2013. Since then member states of the WHO endorsed Universal Health Coverage as the main policy objective whereby health systems strengthening, including reinforcement of the health workforce, can contribute to several Sustainable Development Goals. Now is the right time to trace the implementation of these commitments and to assess their contribution to broader global health objectives. The baseline data for this policy tracing study consist of the categorisation and analysis of the HRH commitments conducted in 2014. This analysis was complemented in application of the health policy triangle as its main analytical framework. An online survey and a guideline for semistructured interviews were developed to collect data. Information on the implementation of the commitments is available in 49 countries (86%). The need for multi-actor approaches for HRH policy development is universally recognised. A suitable political window and socioeconomic situation emerge as crucial factors for sustainable HRH development. However, complex crises in different parts of the world have diverted attention from investment in HRH development. The analysis indicates that investment in the health workforce and corresponding policy development relies on political leadership, coherent government strategies, institutional capacity and intersectoral governance mechanisms. The institutional capacity to shoulder such complex tasks varies widely across countries. For several countries, the commitment process provided an opportunity to invest in, develop and reform the health workforce. Nevertheless, the quality of HRH monitoring mechanisms requires more attention. In conclusion, HRH challenges, their different pathways and the intersectorality of the required responses are a concern for all the countries analysed. There is hence a need for national governments and stakeholders across the globe to share responsibilities and invest in this vital issue in a co-ordinated manner.