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Sample records for medicolegal practice questions

  1. Chronic traumatic encephalopathy (CTE) in a National Football League Player: Case report and emerging medicolegal practice questions.

    PubMed

    Omalu, Bennet I; Hamilton, Ronald L; Kamboh, M Ilyas; DeKosky, Steven T; Bailes, Julian

    2010-01-01

    We present a case of chronic traumatic encephalopathy (CTE) in a retired National Football League (NFL) Player with autopsy findings, apolipoprotein E genotype, and brain tissue evidence of chronic brain damage. This 44-year-old retired NFL player manifested a premortem history of cognitive and neuropsychiatric impairment, which included in part, chronic depression, suicide attempts, insomnia, paranoia, and impaired memory before he finally committed suicide. A full autopsy was performed with Polymerase Chain Reaction-based analyses of his blood to determine the apolipoprotein genotype. Histochemical and immunohistochemical analyses were performed on topographical gross sections of the brain. Autopsy confirmed a fatal gunshot wound of the head. The apolipoprotein E genotype was E3/E3 and the brain tissue revealed diffuse cerebral taupathy (Neurofibrillary Tangles and Neuritic Threads). This will be the third case of CTE in a national football player, which has been reported in the medical literature. Omalu et al., reported the first two cases in 2005 and 2006. This case series manifested similar premortem history of neuropsychiatric impairment with autopsy evidence of cerebral taupathy without any neuritic amyloidopathy. For a definitive diagnosis of CTE to be made, and for medicolegal purposes, a full autopsy must be performed with histochemical and immunohistochemical analyses of the brain to identify the presence of Neurofibrillary Tangles (NFTs) and Neuritic Threads (NTs). Further longitudinal prospective studies are required to confirm the common denominators and epidemiology of CTE in professional American football players, which have been identified by this case series.

  2. Preventing medico-legal issues in clinical practice.

    PubMed

    Raveesh, Bevinahalli N; Nayak, Ragavendra B; Kumbar, Shivakumar F

    2016-10-01

    The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient-doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom "you learn from your mistakes" is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit.

  3. Preventing medico-legal issues in clinical practice

    PubMed Central

    Raveesh, Bevinahalli N.; Nayak, Ragavendra B.; Kumbar, Shivakumar F.

    2016-01-01

    The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient–doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom “you learn from your mistakes” is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit. PMID:27891020

  4. Practice question.

    PubMed

    Linda, Nazarko

    2009-09-23

    Care homes in the UK are diverse. Some are small, stand alone homes while others are part of large groups. Some homes are in rural areas and some in towns. Staff working in care homes may be registered nurses or care assistants. Care home staff are more likely to work part time than staff working in the NHS. Keeping up to date with changes in practice is one of the challenges of working in a care home, especially a smaller home.

  5. Perceived practice change in Australian doctors as a result of medicolegal concerns.

    PubMed

    Nash, Louise M; Walton, Merrilyn M; Daly, Michele G; Kelly, Patrick J; Walter, Garry; van Ekert, Elizabeth H; Willcock, Simon M; Tennant, Christopher C

    2010-11-15

    To explore the perceived impact of medicolegal concerns on how Australian doctors practise medicine and to compare doctors who have experienced a medicolegal matter with those who have not. Cross-sectional survey (posted in September 2007, with reminder 4 weeks later) of Australian doctors from all major specialty groups, trainees and a sample of general practitioners who were insured with a medical insurance company. 2999 respondents of 8360 who were sent the survey. Perceived practice changes due to concerns about medicolegal issues, beliefs about medicolegal issues, and the influence of medicolegal issues on both career choices and how doctors relate to their patients. Respondents reported changes in practice behaviour due to medicolegal concerns, with 43% of doctors stating that they referred patients more than usual, 55% stating that they ordered tests more than usual, and 11% stating that they prescribed medications more than usual. Respondents also reported improved communication of risk (66%), increased disclosure of uncertainty (44%), developed better systems for tracking results (48%) and better methods for identifying non-attenders (39%) and for auditing clinical practice (35%). Concerns about medicolegal issues led to 33% considering giving up medicine, 32% considering reducing their working hours and 40% considering retiring early. These proportions were all significantly greater for doctors who had previously experienced a medicolegal matter compared with those who had not. This Australian study, like international studies, confirms that doctors' concerns about medicolegal issues impact on their practice in a variety of ways. There is a greater perceived impact on those doctors who have previously experienced a medicolegal matter.

  6. [Prevention of medico-legal conflicts in medical practice].

    PubMed

    Minossi, José Guilherme

    2009-02-01

    Generally, medico-legal conflicts which occur in surgical and medical practice are a source of worry for both the medical profession and the society as a whole, because on one hand, they could cause high emotional stress for doctors, and on the other hand, patients could be rejected. Once consolidated, defensive medicine increases treatment costs and the doctor-patient relationship could transform into a tragedy. There are many causes for this, including non-treatment factors, such as an unsupported and disorganized health system, lack of participation from society and the doctor in improving this system, the training machine which launches a large number of young unprepared doctors to practice in this noble profession, along with a lack of continuing training, as there are few public or private institutions providing preparation, or further medical training. The related treatment factors are generally, a deficient doctor-patient relationship, poor work condition, power abuse by the doctor, a lack of clear agreement, and poor medical record keeping. These conflicts cannot be solved by simple creating legislation, or by denying the existence of medical error, which occurs at higher frequency than the actual conflicts. It is very important to improve the doctor-patient relationship because an effective fraternal relationship reduces the chance of a judicial demand. The doctor still needs to fully understand his/her conduct obligations and mainly to avoid power abuse. Doctors must also professionally link themselves with politicians who fight for the individual's rights against the system. Society must also understand that health is not just an issue exclusive for doctors, and people must fight to improve living conditions. Society must seriously show its frustration with the increasing disparity between scientific possibilities and actual wellbeing. The training machine needs immediate profound changes to produce professionals with the highest qualifications equipped

  7. Test security in medicolegal cases: proposed guidelines for attorneys utilizing neuropsychology practice.

    PubMed

    Morel, Kenneth R

    2009-11-01

    In the context of forensic neuropsychological assessments, the professional interaction of law and psychology is viewed primarily as one where the retaining attorney or court dictates its needs to psychologists when resolving legal disputes. While this perspective is conceptually accurate, the positive and practical collaboration of law and psychology also relies on attorneys adhering to basic protections of sensitive psychological assessment procedures and tests. Objective testing is undermined when a practitioner of law engages in actions prior to, during, or following a neuropsychological examination in a manner that threatens the test security. An appreciation among practitioners of law and psychology regarding the necessity of test security is essential. This article reviews attorney actions that can affect test security, proposes a distinction by psychology between appropriate and problematic client preparation for a neuropsychological examination, integrates the available legal precedent regarding test security, and suggests productive measures to protect test security in medicolegal settings.

  8. To err is human: Quality management practices in surgical oral pathology, a safety net for medico-legal complications.

    PubMed

    Venkatraman, Narayan T; Bhadranna, Abhishek; Shenoy, Sadhana; Mohanty, Leeky

    2013-05-01

    Reading a slide and rendering a diagnosis is not only a science but also requires us to appreciate the constant artifact that is introduced in a controlled manner by tissue processing and obtaining a stained tissue section. There are a number of steps involved in getting the final stained tissue section and all these procedures if not performed properly have the potential to give rise to erroneous picture on the slide. Simple errors in judgments can lead to wrong diagnosis and unwarranted treatment. Such mistakes can put us at risk for Medico-Legal problems. The subject of Medico-Legal issues and practice of pathology has been neglected and amount of information available to the practicing professional in India is scarce. This paper focuses on standardized procedures for the various histopathology laboratory exercises. The paper highlights the importance of proper record maintenance with reporting protocols. A list of do's and don'ts for an Oral Pathologist is provided to help him/her in reducing the probable Medico-Legal issues. It does not in any way address the issue of individual competence and diagnostic abilities: That is an aspect for each individual to introspect upon and take remedial action.

  9. Ten Practical Questions about Branding

    ERIC Educational Resources Information Center

    Moore, Robert M.; Rattenbury, Jeanne

    2004-01-01

    "Marketing" and "branding" were once considered dirty words on campus but faculty, staff, and board members now appreciate the value of getting their message out and managing their reputation. The question is not so much whether to invest, but when, how, and most important, what's the return on investment? A roundtable of accomplished marketing…

  10. Ten Practical Questions about Branding

    ERIC Educational Resources Information Center

    Moore, Robert M.; Rattenbury, Jeanne

    2004-01-01

    "Marketing" and "branding" were once considered dirty words on campus but faculty, staff, and board members now appreciate the value of getting their message out and managing their reputation. The question is not so much whether to invest, but when, how, and most important, what's the return on investment? A roundtable of accomplished marketing…

  11. The assessment of grip strength after upper limb injuries in medico-legal practice.

    PubMed

    Belcher, Hjcr

    2017-03-01

    Four hundred adult claimants underwent medico-legal assessment following upper limb injuries. Dynamometry was performed on each using the Jamar five handle-position test. Injury causes loss of power and there is a significant relationship between the percentage loss of power and the measured whole limb impairment. This paper presents a new approach for the analysis of the tests. The normal physiological length-tension pattern of muscle is maintained in the majority of claimants albeit with modifications due to the specific effects of injury on hand function. This paper provides normative data for the analysis of dynamometry in this population and makes recommendations for parameters that suggest that a test is a true reflection of capacity and thus useable in court.

  12. Questioning Our Questions: Assessing Question Asking Practices to Evaluate a yPAR Program

    ERIC Educational Resources Information Center

    Grace, Sarah; Langhout, Regina Day

    2014-01-01

    The purpose of this research was to examine question asking practices in a youth participatory action research (yPAR) after school program housed at an elementary school. The research question was: In which ways did the adult question asking practices in a yPAR setting challenge and/or reproduce conventional models of power in educational…

  13. Questioning Our Questions: Assessing Question Asking Practices to Evaluate a yPAR Program

    ERIC Educational Resources Information Center

    Grace, Sarah; Langhout, Regina Day

    2014-01-01

    The purpose of this research was to examine question asking practices in a youth participatory action research (yPAR) after school program housed at an elementary school. The research question was: In which ways did the adult question asking practices in a yPAR setting challenge and/or reproduce conventional models of power in educational…

  14. Privacy Questions from Practicing School Nurses

    ERIC Educational Resources Information Center

    Bergren, Martha Dewey

    2004-01-01

    This Question and Answer (Q&A) article addresses practice issues related to school health records and school nursing documentation that were posed by school nurses in the field. Specifically, the questions addressed concern the following: education records, medication privacy issues, sharing of sensitive health information, privacy of…

  15. Questionable research practices among italian research psychologists.

    PubMed

    Agnoli, Franca; Wicherts, Jelte M; Veldkamp, Coosje L S; Albiero, Paolo; Cubelli, Roberto

    2017-01-01

    A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants' estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes.

  16. Questionable research practices among italian research psychologists

    PubMed Central

    Wicherts, Jelte M.; Veldkamp, Coosje L. S.; Albiero, Paolo; Cubelli, Roberto

    2017-01-01

    A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants’ estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes. PMID:28296929

  17. Questionable Hospital Chart Documentation Practices by Physicians

    PubMed Central

    Kostis, William J.; Wilson, Alan C.; Cosgrove, Nora M.; Hassett, Afton L.; Moreyra, Abel E.; Delnevo, Cristine D.; Kostis, John B.

    2008-01-01

    Background Physicians, influenced by various pressures, may document information in patient records that they did not personally observe. Objective To evaluate the hospital chart documentation practices of internists and internal medicine sub-specialists in the Northeastern United States. Design An anonymous mail survey questionnaire. Participants One thousand one hundred twenty-six randomly selected internists and internal medicine sub-specialists. Measurements Responses to questions describing their own hospital chart documentation practices, those they observed among their colleagues, and ratings of the importance of possible influences. Results Response rate was 43%. Fifty-nine percent (59%) of physicians reported personally engaging in one or more of six questionable documentation scenarios. Forty percent (40%, CI; 37%-43%) indicated that they recorded laboratory notes in patient records based on information that they did not personally obtain, while 6% (CI; 5%-8%) admitted to writing notes on patients not personally seen or examined. The corresponding percentages reported for their colleagues were 52% (CI; 49%-56%) and 22% (CI; 20%-25%), respectively. Increased rates of documentation lapses were significantly associated with working directly with residents and/or fellows (OR = 1.71, CI; 1.30–2.25), younger age (OR for 10 year age decrease = 1.35, CI; 1.19–1.53), white race (OR = 1.47, CI; 1.08–2.00), and graduation from US medical schools (OR = 1.75, CI; 1.31–2.34). Conclusion Most physicians report having engaged in questionable hospital chart documentation. This practice is more common among physicians who are younger, working with house staff, and graduates of US medical schools. PMID:18751759

  18. [On the question of a practice.].

    PubMed

    Sévigny, R

    1979-01-01

    The author, a psycho-sociologist and a professor in the department of sociology at l'Université de Montreal, looks back and reflects on his practice as an intervener in different types of groups. He returns to his first experiences with T-groups and to the analysis of them which he made at the beginning of his practice. Furthermore, this analysis touches on questions that remain very relevant. Thus the author explains why, for social reasons, he came to privilege work with "real groups" rather than that with spontaneous groups. On the basis of twenty years of experience and a view of many group approaches it can be asked whether the question of man in society as a change agent should not be posed to a greater extent within groups. 1) Dans Sociologie A Sociétés, vol. 9, no 2, d'octobre 1977, le lecteur trouvera un article de moi qui préserve une réflexion plus systématique mais sans référence immédiate à ma propre pratique. Oe numéro, entièrement consacré au thème "psychologie, sociologie, intervention" comprend également plusieurs textes qui ne sont pas étrangers à certains thèmes développés ici. On y trouvera aussi de nombreuses références bibliographiques.

  19. Evaluating medico-legal decisional competency criteria.

    PubMed

    Whiting, Demian

    2015-06-01

    In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria-where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the "Decisional Competency in Medico-Legal Contexts" section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility-it accords with the way decisional competency is understood in a number of everyday contexts-but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the "Primary and Secondary Requirements" section several requirements that decisional competence criteria ought to satisfy. Then, in the "Applying the Framework" section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements.

  20. Teaching Culture: Questioning Perspectives on Our Practices

    ERIC Educational Resources Information Center

    Met, Myriam

    2010-01-01

    Despite years of training, teaching experience, reading professional literature, attending conferences, and learning from expert colleagues, when it comes to the teaching of culture, the author wishes she knew more answers to many critical questions. Her questions are framed by the basic questions that all curricula seek to answer: WHAT is the…

  1. Risk management in clinical practice. Part 6b. Identifying and avoiding medico-legal risks in removable dentures.

    PubMed

    Stilwell, C

    2010-10-09

    The most likely cause of complaint with prosthodontics is a denture that in some way fails to be accepted. A denture that does not perform as the patient expects can give rise to great disappointment and anger. The problem is that acceptance of a denture is not just a technical issue. Success depends on the individual's ability to tolerate and adapt to the denture. It is therefore essential to make the right assessment for the patient from the outset. This includes discovering the patient's priorities and establishing realistic expectations. With the aim of assisting the dental profession in identifying and avoiding medico-legal risks in removable dentures, this article sets out a systematic, diagnostic and collaborative approach to complete and partial denture assessment and treatment.

  2. Questioning Techniques: A Study of Instructional Practice

    ERIC Educational Resources Information Center

    Hill, Joan Buchanan

    2012-01-01

    This study took place in an independent all girls' school which serves over six hundred students in grades pre-kindergarten through twelve. This study seeks to answer the question: To what extent do teachers use questions to encourage deeper thinking and fuller responses. Through a review of literature, observations, interviews and analysis,…

  3. To hold or not to hold: medicolegal death investigation practices during unexpected child death investigations and the experiences of next of kin.

    PubMed

    Rudd, Rebecca A; Marain, Lisa Capizzi; Crandall, Laura

    2014-06-01

    The purpose of this study was to identify the current practices within the medicolegal death investigation system, as well as the experience of bereaved parents due to sudden unexpected child death with regard to viewing, memorial keepsakes, and communication during the death investigation. Convenience samples of 197 professionals and 156 bereaved parents participated. Respondents were asked to participate in an online survey. Results show that the majority of professional respondents (96.5%) allow the next of kin (NOK) to view his/her child before transport to the morgue while holding the infant/child was somewhat less commonplace (68.9%). The majority of professional respondents (70.4%) would also permit memorial keepsakes to be made. Additional factors are explored that both hinder and promote these common family requests. Furthermore, professional practices and NOK experiences in regard to communicating preliminary and final cause of death information to the NOK were highly variable. This article provides a snapshot at the current death investigative practices in the United States, as well as how these practices are received by NOK along with their recommendations for change. These results may be used to further inform future guidelines to improve comprehensive and efficient death investigations that support the emotional needs of the newly bereaved.

  4. Beginning EFL Teachers' Beliefs about Quality Questions and Their Questioning Practices

    ERIC Educational Resources Information Center

    Pham, Ly Ngoc Khanh; Hamid, M. Obaidul

    2013-01-01

    Motivated by the scarcity of research that examines the impact of teacher beliefs on their actual practices in Vietnam, this study investigated the relationship between teachers' beliefs about quality questions and their questioning behaviours in terms of questioning purposes, content focus, students' cognitive level, wording and syntax. Thirteen…

  5. Beginning EFL Teachers' Beliefs about Quality Questions and Their Questioning Practices

    ERIC Educational Resources Information Center

    Pham, Ly Ngoc Khanh; Hamid, M. Obaidul

    2013-01-01

    Motivated by the scarcity of research that examines the impact of teacher beliefs on their actual practices in Vietnam, this study investigated the relationship between teachers' beliefs about quality questions and their questioning behaviours in terms of questioning purposes, content focus, students' cognitive level, wording and syntax. Thirteen…

  6. Opium alcaloids in toxicological medico-legal practice of Department of Forensic Medicine, Jagiellonian University Medical College

    PubMed

    Kłys, Małgorzata; Rojek, Sebastian; Maciów-Głab, Martyna; Kula, Karol

    2013-01-01

    Most likely, opium was the first narcotic substance discovered at the dawn of mankind. Contemporary drug abuse predominantly poses a social and clinical problem and encompasses among other aspects emergency procedures in cases of intoxication and treatment of addictions. On the other hand, this is also a problem of the judicial system, which implements the rule of apt punishment in criminal cases (rapes, robberies, drivers, production and trade in narcotic substances) and of the necessity of monitoring drug-associates deaths. In all drug-associated cases, investigative capabilities have increased with the introduction of extremely sensitive and specific analytical methods (GC-MS, LC/MS, HPLC/DAD) allowing for detection and identification of multi-component mixtures of xenobiotics found at low concentration levels in complex biological matrices. The history of the Krakow Department of Forensic Medicine dates back to the year 1877, since archival materials have been kept since that time. Isolated deaths resulting from morphine poisoning, mostly involving individuals employed in the health care sector, constituted the subject of medico-legal expert opinions starting at the beginning of the 20th century, but only the eighties did bring the need for multidirectional toxicological examinations of opiates and their metabolites in diversified biological and non-biological materials. The present report, in addition to the historical background of opiate addiction, discusses selected problems derived from published by Department reports on opiates, including cases of fatal intoxication, hair analysis of drug addicts in its various aspects, interactions in cases of poisoning and others.

  7. The medicolegal importance of enhancing timeliness of documentation when using an anesthesia information system and the response to automated feedback in an academic practice.

    PubMed

    Vigoda, Michael M; Lubarsky, David A

    2006-07-01

    Documentation should ideally occur in real time immediately after completion of a service. Although electronic records often do not print the time that documentation notes were entered on the medical record, automated anesthesia record keeping systems store an audit trail that time stamps events entered by all anesthesia providers. As more lawyers become aware of this fact and requisition audit trails, prospective charting of necessary documentation may undermine the integrity of an anesthesia care team accused of malpractice, with potentially significant medicolegal consequences. We changed existing documentation practices of a large academic practice via a three-step process. Educational sessions increased the percentage of cases with correct timing of emergence documentation from 25% to 60% over a 2-mo period. Automated email performance feedback further increased correct note timing to 70%. When combined with personal contact by a member of the billing office and email copy notification of the chair, the percentage increased to >99.5%. The behavioral change was seen in all individuals, as 95% of attendings had < or = 2 records/mo with untimely documentation at the end of the study period. Once the habits were ingrained, further input was rarely necessary over the next 9 mo. This suggests physician behavioral change related to work process flow, unlike that related to patient care, is easily sustained.

  8. Planning Questions and Persevering in the Practices

    ERIC Educational Resources Information Center

    Gurl, Theresa J.; Fox, Ryan; Dabovic, Nikolina; Leavitt, Arielle Eager

    2016-01-01

    The implementation of the Common Core's Standards for Mathematical Practice can pose a challenge to all teachers of mathematics but especially to preservice teachers. These standards require teaching in a way that often differs from what preservice teachers have experienced as learners. Standard 1--"Make sense of problems and persevere in…

  9. The Heteronormative Classroom: Questioning and Liberating Practices

    ERIC Educational Resources Information Center

    Garcia, Ana Maria; Slesaransky-Poe, Graciela

    2010-01-01

    This article is a critical examination of the ideologies and practices that educators bring to bear on their classrooms in order to create inclusive, safe, and welcoming environments for all children, but particularly for children with gender variant behaviors and interests. Using a feminist perspective, this article offers a new conceptual lens…

  10. Planning Questions and Persevering in the Practices

    ERIC Educational Resources Information Center

    Gurl, Theresa J.; Fox, Ryan; Dabovic, Nikolina; Leavitt, Arielle Eager

    2016-01-01

    The implementation of the Common Core's Standards for Mathematical Practice can pose a challenge to all teachers of mathematics but especially to preservice teachers. These standards require teaching in a way that often differs from what preservice teachers have experienced as learners. Standard 1--"Make sense of problems and persevere in…

  11. QTIPs: Questionable theoretical and interpretive practices in social psychology.

    PubMed

    Brandt, Mark J; Proulx, Travis

    2015-01-01

    One possible consequence of ideological homogeneity is the misinterpretation of data collected with otherwise solid methods. To help identify these issues outside of politically relevant research, we name and give broad descriptions to three questionable interpretive practices described by Duarte et al. and introduce three additional questionable theoretical practices that also reduce the theoretical power and paradigmatic scope of psychology.

  12. Polyp Resection - Controversial Practices and Unanswered Questions.

    PubMed

    von Renteln, Daniel; Pohl, Heiko

    2017-03-09

    Detection and complete removal of precancerous neoplastic polyps are central to effective colorectal cancer screening. The prevalence of neoplastic polyps in the screening population in the United States is likely >50%. However, most persons with neoplastic polyps are never destined to develop cancer, and do not benefit for finding and removing polyps, and may only be harmed by the procedure. Further 70-80% of polyps are diminutive (≤5 mm) and such polyps almost never contain cancer. Given the questionable benefit, the high-cost and the potential risk changing our approach to the management of diminutive polyps is currently debated. Deemphasizing diminutive polyps and shifting our efforts to detection and complete removal of larger and higher-risk polyps deserves discussion and study. This article explores three controversies, and emerging concepts related to endoscopic polyp resection. First, we discuss challenges of optical resect-and-discard strategy and possible alternatives. Second, we review recent studies that support the use of cold snare resection for ≥5 mm polyps. Thirdly, we examine current evidence for prophylactic clipping after resection of large polyps.

  13. On the placement of practice questions during study.

    PubMed

    Weinstein, Yana; Nunes, Ludmila D; Karpicke, Jeffrey D

    2016-03-01

    Retrieval practice improves retention of information on later tests. A question remains: When should retrieval occur during learning-interspersed throughout study or at the end of each study period? In a lab experiment, an online experiment, and a classroom study, we aimed to determine the ideal placement (interspersed vs. at-the-end) of retrieval practice questions. In the lab experiment, 64 subjects viewed slides about APA style and answered short-answer practice questions about the content or restudied the slides (restudy condition). The practice questions either appeared 1 every 1-2 slides (interspersed condition), or all at the end of the presentation (at-the-end condition). One week later, subjects returned and answered the same questions on a final test. In the online experiment, 175 subjects completed the same procedure. In the classroom study, 62 undergraduate students took quizzes as part of class lectures. Short-answer practice questions appeared either throughout the lectures (interspersed condition) or at the end of the lectures (at-the-end condition). Nineteen days after the last quiz, students were given a surprise final test. Results from the 3 experiments converge in demonstrating an advantage for interspersing practice questions on the initial tests, but an absence of this advantage on the final test.

  14. New Questions for Vocational Psychology: Premises, Paradigms, and Practices

    ERIC Educational Resources Information Center

    Savickas, Mark L.

    2011-01-01

    The innovative responses of vocational psychology and career counseling to the important questions raised by people living in information societies will continue the disciplines' tradition of helping individuals link their lives to the economic context. The questions pertaining to perspectives, paradigms, and practices arise mainly from the…

  15. New Questions for Vocational Psychology: Premises, Paradigms, and Practices

    ERIC Educational Resources Information Center

    Savickas, Mark L.

    2011-01-01

    The innovative responses of vocational psychology and career counseling to the important questions raised by people living in information societies will continue the disciplines' tradition of helping individuals link their lives to the economic context. The questions pertaining to perspectives, paradigms, and practices arise mainly from the…

  16. Bloom's Taxonomy and Journalism Conjoin To Improve Students' Questioning Practices.

    ERIC Educational Resources Information Center

    Blank-Libra, Janet

    This paper investigates the need for the infusion of critical thinking instruction into the teaching of the journalistic practice of questioning. Given research done in the area of questioning, it seems probable that critical thinking instruction could enable students to employ self-directed thinking skills that would allow them to ask better…

  17. What are the clinical questions of practicing veterinarians?

    PubMed

    Ebell, Mark H; Budsberg, Steven; Cervero, Ronald; Shinholser, Joanna; Call, Marlene

    2013-01-01

    Clinical questions are central to learning among veterinarians and drive informal learning during clinical practice. We set out to classify the clinical questions of practicing veterinarians using a taxonomy previously validated in human medicine. This prospective observational study used a convenience sample of 12 veterinarians in private, small-animal practices. We used three methods to gather clinical questions from the veterinarians: direct observation (asking veterinarians after each encounter), self-report via e-mail, and self-report via data-collection pocket cards. We then classified these questions using a validated taxonomy of question types, as well as by clinical category. A total of 157 clinical questions were collected; 99 were about dogs, 33 were about cats, and 25 were about multiple species or did not specify a species. Nearly half of the questions were rated as high priority, and only 11.5% as low priority. Over half of the questions (53%) were about treatment and 20% were about diagnosis. The two most common question types were "Is drug X indicated in situation Y or for condition Y?" and "How should I treat finding/condition Y (given situation Z)?" Overall, 5 of 57 question-type categories accounted for over half of the questions. The most common clinical categories were pharmacology, endocrine, musculoskeletal, and general surgery. This is the first study to systematically identify and classify the clinical questions of veterinarians. A better understanding of these questions can be used to inform the development of continuing-education (CE) activities that are directly responsive to the information needs of participants.

  18. 11 critical questions to ask when buying a physician practice.

    PubMed

    Jessee, William F

    2012-07-01

    Answering probing questions in advance of a practice purchase can help hospital and health system leaders make informed decisions. The questions are intended to stimulate careful consideration before entering into a practice acquisition; no single piece of information or answer should be considered definitive in the final decision-making process. Success depends on having a clear game plan and spending time ensuring that all players-board, management, physician leaders, and the physicians who will be employees--understand and support the plan.

  19. The role of professional journalism in protecting against questionable practice.

    PubMed

    O'Keefe, John P

    2003-01-01

    The editor in chief of the Journal of the Canadian Dental Association explains that professional journalism alone cannot be expected to protect against questionable practice but it plays a vital role in the network of resources that define standards of excellent and ethical care. According to some, the explosion of biomedical information has created a crisis as emerging science overwhelms practitioners' capacity to intelligently evaluate it and incorporate it into practice. Research in medicine shows that journals play only a part in decisions regarding practice patterns. Some initiatives taken by the Canadian Dental Association to publish professional literature relevant to practitioners' needs to remain current in order to prevent questionable dental practice are described.

  20. A Questioned Practice: Twenty Reflections on Art, Doubt, and Error

    ERIC Educational Resources Information Center

    Baldacchino, John

    2013-01-01

    In this article, author John Baldacchino presents twenty reflections on art, doubt, and error. In the first five reflections, he produces a discussion of a number of unmediated narratives that tend to aggregate and span across the plural horizon of arts practice. In terms of the arts "as well as" education, these questions are approached…

  1. Student questions in urban middle school science communities of practice

    NASA Astrophysics Data System (ADS)

    Groome, Meghan

    This dissertation examines student questions within three Communities of Practice (CoP), all urban middle school science environments. The study analyzed student questions from a sociocultural perspective and used ethnographic research techniques to detail how the CoP's shaped questions in the classroom. In the first study, two case study girls attempted to navigate questioning events that required them to negotiation participation. Their access to participation was blocked by participation frameworks that elevated some students as "gatekeepers" while suppressing the participation of others. The next two studies detail the introduction of written questioning opportunities, one into a public middle school classroom and the other into an informal classroom. In both studies, students responded to the interventions differently, most notable the adoption of the opportunity by female students who do not participate orally. Dissertation-wide findings indicate all students were able to ask questions, but varied in level of cognitive complexity, and the diagnostic interventions were able to identify students who were not known to be "target students", students who asked a high number of questions and were considered "interested in science". Some students' roles were as "gatekeepers" to participation of their peers. Two out of three teachers in the studies reported major shifts in their teaching practice due to the focus on questions and the methods used here have been found to be effective in producing educational research as well as supporting high-need classrooms in prior research. In conclusion, these studies indicate that social factors, including participation frameworks, gender dynamics, and the availability of alternative participation methods, play an important role in how students ask science-related questions. It is recommended that researchers continue to examine social factors that reduce student questions and modify their teaching strategies to facilitate

  2. Questions

    ERIC Educational Resources Information Center

    Kuntz, Haley

    2007-01-01

    A canoe trip guide for young people gets used to the never-ending flow of questions. Kids are constantly inquiring about how many kilometres have been traveled that day, how many kilometres to go that day, what is for dinner, and when the next set of moving water is coming up. With kids, the questions are endless. Questions often are used as a…

  3. [Regulatory aspects and medicolegal considerations regarding clinical drug trials].

    PubMed

    Cammarano, Andrea; De Dominicis, Enrico; Marella, Gian Luca; Maurici, Massimo; Arcudi, Giovanni

    2016-01-01

    This article aims to explore the regulatory and medicolegal aspects of experimental drug trials. Firstly, the authors provide definitions of drug according to WHO, the European Community and our official Pharmacopoeia, and that of experimental studies. They then explain the distinction between pure or basic research and drug trials and explain the various phases of the latter. Besides providing definitions, and exploring doctrinal, theoretical but also practical aspects of drug trials, the authors also discuss and analyze legislative aspects, with particular reference to the Italian legislative framework, and medicolegal issues, including informed consent, effects on humans, and professional responsibility.

  4. [Care and restraint, when the law questions nursing practice].

    PubMed

    Scotti, Jean-Charles

    With the reforms of 2011 and 2013 relating to psychiatric hospitalisation, raises the question of the suitability of modern psychiatric practice with regard to a person's recognised principles and basic rights. Achieving a balance is difficult and the Constitutional Council has joined the debate, bringing to an end any idea of compromise between safety and freedom. A decision which was made as a result of a clarification of certain regulations which have proved controversial from the point of view of individual liberties. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Do clinical incidents, complaints and medicolegal claims overlap?

    PubMed

    Goldsmith, Paul; Moon, Jackie; Anderson, Paul; Kirkup, Steve; Williams, Susan; Gray, Margaret

    2015-01-01

    Error reporting by healthcare staff, patient-derived complaints and patient-derived medico-legal claims are three separate processes present in most healthcare systems. It is generally assumed that all relate to the same cases. Given the high costs associated with these processes and strong desire to maximise quality and standards, the purpose of this paper is to see whether it was indeed the case that most complaints and claims related to medical errors and the relative resource allocation to each group. Electronic databases for clinical error recording, patient complaints and medico-legal claims in a large NHS healthcare provider organisation were reviewed and case overlap analysed. Most complaints and medico-legal claims do not associate with a prior clinical error. Disproportionate resource is required for a small number of complaints and the medico-legal claims process. Most complaints and claims are not upheld. The authors have only looked at data from one healthcare provider and for one period. It would be useful to analyse other healthcare organisations over a longer time period. The authors were unable to access data on secondary staffing costs, which would have been informative. As the medico-legal process can go on for many years, the authors do not know the ultimate outcomes for all cases. The authors also do not know how many medico-legal cases were settled out of court pragmatically to minimise costs. Practical implications - Staff error reporting systems and patient advisory services seem to be efficient and working well. However, the broader complaints and claims process is costing considerable time and money, yet may not be useful in driving up standards. System changes to maximise helpful complaints and claims, from a quality and standards perspective, and minimise unhelpful ones are recommended. This study provides important data on the lack of overlap between errors, complaints and claims cases.

  6. Maxillofacial Surgeon as Fact Witness for Medico-Legal Cases: Indian Scenario.

    PubMed

    Kedarnath, N S; Shruthi, R

    2015-12-01

    An Oral and Maxillofacial surgeon at any time during the practice will encounter medicolegal cases (MLC). There are lacunae in the knowledge and understanding of the correct method of dealing with such cases. Many of the practitioners are apprehensive and anxious as they have to interact with individuals and systems outside the normal realm of practice. In today's arena, it is of utmost importance to be aware of legal system and law of the land. An OMF surgeon needs to have thorough understanding in recording and maintenance of the details of all MLCs and presenting the same in the court. Professional guidelines for expert witness are often not well recognised as those relating to the clinical practice. Surgeon has an obligation to conduct him/herself to highest ethical standards. This article provides insight into the details of registration of MLC, examination and recording of injuries, collecting medico-legal evidences and writing a medico legal report. Also discusses the court proceedings and possible questions that may be faced by the surgeon in the court.

  7. Update on Medical Practices that should be questioned in 2015

    PubMed Central

    Morgan, Daniel J.; Dhruva, Sanket S.; Wright, Scott M.; Korenstein, Deborah

    2016-01-01

    Importance Overuse of medical care, consisting primarily of overdiagnosis and overtreatment, is a common clinical problem. Objective To identify and highlight articles published in 2014 that are most likely to impact overuse, organized into the categories of overdiagnosis, overtreatment, and methods to avoid overuse. These manuscripts were reviewed and interpreted for their importance to clinical medicine. Evidence Review A structured review of English-language articles on PubMed published in 2014 and review of tables of contents of relevant journals to identify potential articles that related to medical overuse in adults. Findings We reviewed 910 articles, of which 440 addressed overuse. Of these, 104 were deemed most relevant based on the presentation of original data, quality of methodology, magnitude of clinical impact, and the number of patients potentially affected. The 10 most influential articles were selected by author consensus using the same criteria. Findings included lack of benefit for screening pelvic examinations (positive predictive value <5%), carotid artery and thyroid ultrasounds. Harms of cancer screening included unnecessary surgery and complications. Head CT scans were an overused diagnostic test (4% with clinically significant findings) and overtreatment included acetaminophen for low back pain, prolonged opioid use after surgery (3% of patients on >90 days), perioperative aspirin, medications to increase HDL, and stenting for renal artery stenosis. Conclusions and Relevance Many common medical practices should be reconsidered. It is hoped that our review promotes reflection on these 10 articles and lead to questioning other non-evidence based practices. PMID:26551354

  8. [Mandatory or voluntary vaccinations? Juridical and medico-legal aspects].

    PubMed

    Molendini, L O; Zanetti, A; Buzzi, F

    2003-01-01

    The Italian juridical and legislative aspects of vaccination based on a compulsory system are presented considering the medico-legal questions. The prospective of a voluntary system, as anticipated by many normatives and other official documents, is examined. The experience of some local health authorities on cases of in observance of the vaccinal obligation are detailed Finally professional risks for vaccinal operators are examined and the need of specific guidelines for parents' consent to compulsory vaccination during infancy is prospected.

  9. Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

    ERIC Educational Resources Information Center

    Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

    2012-01-01

    The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

  10. Preventing and Addressing Challenging Behavior: Common Questions and Practical Strategies

    ERIC Educational Resources Information Center

    Hemmeter, Mary Louise; Ostrosky, Michaelene M.; Corso, Robert M.

    2012-01-01

    The purpose of this article is to offer preschool teachers strategies for preventing challenging behavior and supporting the development of social skills and emotional competencies. This article is framed in a question and answer format using questions from teachers who the authors have worked with in the past. These questions and strategies are…

  11. Hermeneutics of clinical practice: the question of textuality.

    PubMed

    Svenaeus, F

    2000-01-01

    In this article I scrutinize the question whether clinical medicine, in order to be considered a hermeneutical enterprise, must be thought of as a reading of different "texts." Three different proposals for a definition of the concept of text in medicine, suggested by other hermeneuticians, are discussed. All three proposals are shown to be unsatisfying in various ways. Instead of attempting to find a fourth definition of the concept of text suitable to a hermeneutics of medicine, I then try to show that the assumption that one needs to operate with the concept of text in order to develop a hermeneutics of medicine is false. Clinical interpretation can be shown to essentially consist in a dialogical hermeneutics, the pattern of which can be found in the philosophy of Hans-Georg Gadamer. This kind of hermeneutics is not a methodology of text reading, but an ontological, phenomenological hermeneutics in which understanding is a necessary feature of the being-together of human beings in the world. This being-together in and through language takes on a peculiar form in the clinical encounter, since the medical meeting is typically characterized by an asymmetrical enstrangement and has a specific goal--health for the patient--absent in other forms of hermeneutics. Central issues of Gadamer's philosophy, e.g. "fusion of horizons," are shown to fit the structure of clinical practice.

  12. [Relevant factors in medico-legal prognosis of whiplash injury].

    PubMed

    Pujol, Amadeo; Puig, Luisa; Mansilla, Joaquina; Idiaquez, Itziar

    2003-07-12

    Whiplash injury (WI) is commonly evaluated in medico-legal practice. With the aim of knowing the determining factors of WI's medico-legal prognosis, a prospective and observational study was carried out. One hundred and twenty consecutive patients who were clinically observed and evaluated in the Medico-Legal Clinic of Barcelona were studied. Socio-demographic, clinical, radiographic and evolutive factors were analyzed. We included 120 patients with a mean age of 35.6 (14) years (range, 4-74), with a homogeneous male/female distribution. An earlier cervical pathology was detected in 10% of patients; none of them had previous psychiatric pathology. 95% corresponded to road-traffic accident cases and there were 5 aggression cases. Over 50% of cases involved a rear-end collision. All patients had neck pain, almost 25% had headache and 13% had paresthesia. According to the Whiplash Association Disorders clinical classification, distribution in grades (G) was: G I 51%, G II 32% and G III 17%. Patients reported recovery within a mean time of 71.6 (46) days (range, 4-244), with 51,2 (45) no working days (range, 0-180 days). The 52% of the patients rest with complains. According to the recovery time, the following medico-legal prognostic factors were identified: age (p < 0.001), being female (p = 0.001), clinical grade (p < 0.001) and abnormal cervical MRI exploration (p < 0.001). Patients with previous cervical pathology reported more complaints (p = 0.001). In our study, WI affected young people of both sex mainly during rear-end collision. Worst medico-legal prognostic factors were age, being females, severity of initial clinical symptoms, previous cervical pathology and abnormal cervical MRI/CT.

  13. Avoiding medicolegal complications.

    PubMed

    Cotton, Peter B; Saxton, James W; Finkelstein, Maggie M

    2007-01-01

    Endoscopy can cause complications, even in the best of hands. Lawsuits are rare but more likely to be pursued when there is poor communication with patients and family before or after an event occurs. The likelihood of a suit (and of its success) can be minimized by practicing within accepted standards; by careful objective documentation of the education and consent process, and of the events themselves; and by a systematized approach to event management.

  14. Cosmetic surgery: medicolegal considerations

    PubMed Central

    Piras, Mauro; Delbon, Paola; Conti, Adelaide; Capasso, Emanuele; Niola, Massimo; Bin, Paola

    2016-01-01

    Abstract Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB) was also analyzed. Conclusion: The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery. PMID:28352816

  15. Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal.

    PubMed

    Domingues, Ana Patrícia Rodrigues; Belo, Adriana; Moura, Paulo; Vieira, Duarte Nuno

    2015-05-01

    It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

  16. Epistemological Questions about Research and Practice in ALM.

    ERIC Educational Resources Information Center

    Wedege, Tine

    The new research and practice area of "adults and mathematics" is situated within the didactics of mathematics as it is structured and delimited by the concrete forms of practice and knowledge currently regarded as mathematics teaching, learning, and knowing. "Adults Learning Mathematics" (ALM) is a community of practice and research within the…

  17. Dissociative identity disorder: Medicolegal challenges.

    PubMed

    Farrell, Helen M

    2011-01-01

    Persons with dissociative identity disorder (DID) often present in the criminal justice system rather than the mental health system and perplex experts in both professions. DID is a controversial diagnosis with important medicolegal implications. Defendants have claimed that they committed serious crimes, including rape or murder, while they were in a dissociated state. Asserting that their alter personality committed the bad act, defendants have pleaded not guilty by reason of insanity (NGRI). In such instances, forensic experts are asked to assess the defendant for DID and provide testimony in court. Debate continues over whether DID truly exists, whether expert testimony should be allowed into evidence, and whether it should exculpate defendants for their criminal acts. This article reviews historical and theoretical perspectives on DID, presents cases that illustrate the legal implications and controversies of raising an insanity defense based on multiple personalities, and examines the role of forensic experts asked to comment on DID with the goal of assisting clinicians in the medicolegal assessment of DID in relation to crimes.

  18. An audit of medicolegal conferencing.

    PubMed

    Pringle, R G

    2003-09-01

    In the English civil justice system, experts involved in a case are now commonly required to confer before the hearing and identify the areas of agreement and disagreement. A prospective study of 50 consecutive medicolegal conferences of experts was undertaken, with a view to defining their benefits, weaknesses and the optimum conference format. A record was kept of the dates of first instruction, court deadlines, and date, time and duration of conferences, together with related calls and correspondence. The manner of preparation of the statement was noted, the level of agreement/disagreement, any compromise, any later modifications of the draft, and the author's fees. Subsequently the instructing solicitors were asked to comment on the suitability of the joint statement and its contribution to settlement. Medicolegal conferencing is time-consuming and expensive. It may be of limited value where there is little or no difference of opinion, either between experts in a single field or between experts in different fields. The instructing solicitors must ensure that the participants receive, in advance of the conference, copies of all relevant documents including medical reports and medical records. An agenda is helpful in ensuring that matters of importance are not overlooked. Conferences are more effective when held in person than when conducted by telephone. The joint statement is best dictated in the presence of all participants during or after the conference. To ensure the most efficient and economical use of consultant time a formal combined audit of conferencing should be undertaken by the medical and legal professions.

  19. Writing-Based Teaching: Essential Practices and Enduring Questions

    ERIC Educational Resources Information Center

    Vilardi, Teresa, Ed.; Chang, Mary, Ed.

    2009-01-01

    Written by the team at Bard College's Institute for Writing and Thinking, this book is designed to provide practical guidance regarding the challenges and potential of writing-based teaching, and suggestions for how to adapt the practices to particular classroom situations. The contributors share candid, first-hand accounts of what it is like to…

  20. Perceptions of Teaching Practices Regarding Questioning and Discussion Techniques

    ERIC Educational Resources Information Center

    Robitaille, Yvette Jeannine Powell

    2013-01-01

    Questioning and discussion techniques are effective instructional methods that develop critical thinking and problem solving skills. Despite these positive associations, there is inconsistent implementation of these techniques across disciplines and grade levels, often resulting in a negative effect on student achievement. This collective case…

  1. Observe-reflect-act: The cycle of reflective practice on questioning in STEM education

    NASA Astrophysics Data System (ADS)

    Ginley, Erica

    Countless studies have been conducted on questioning techniques in education. However, little research has been focused on the use of reflective practice in relation to teachers' questioning techniques in STEM: Science, Technology, Engineering and Math education. Within this action research study of my own teaching, six lessons were taught, observed, and reflected upon. The main focus was on whether and how reflective practice influences questioning. Through the analysis of video footage, conversation transcriptions, reflective journal entries, pre-service teacher survey, and student work, the importance of different questioning techniques became apparent. They demonstrated that reflective practice has an impact on improving questioning skills and, thus, better engaging students in the learning process.

  2. [The victim as object of the medico-legal intervention].

    PubMed

    Magalhães, Teresa

    2005-01-01

    We present a reflection about the victim as the object of the medico-legal intervention, that opens perspectives not only to the evidence research (as a techno-scientific contribute to support Justice in what concerns bio-psycho-social questions), but also to the support of victims which, in a last analysis, is no more than another aspect of this the social contribution of this science to ensure the best interest of the victim. This reflection aims to contribute to a better knowledge of the victim in his/her various perspectives. Accordingly, during the exposition, we refer some contributes of Victimology towards the understanding of the victims' behaviour's. Afterwards, we focus on the problems related to the aetiologies (with a particular reference to trauma), levels and consequences (physical, psychological and socio-economical) of victimization, as well as the methodologies of victims approach, medico-legal evaluation and reparation. Considering victims as being not only those who suffer directly the consequences of the victimizing phenomena, but also those that suffer from it indirectly and even secondarily, we shall approach the topic regarding both perspectives. We highlight the importance of understanding the victim as a person, not just understanding him/her confined to the organic aspect (as it used to be until recently in certain fields of medico-legal intervention, and as it still happens due to some legal obligations, for instance in the Labour Law), but considering the person in a global way (body, capacities, life situations and subjectivity). In conclusion, we highlight the importance of this topic to the medico-legal mission, while taking part in various multidisciplinary interventions and being involved in strategies and measures which purpose is to prevent violence, promote safety, avoid secondary victimization and revictimization as well as guarantee the victims' protection and reintegration, in a work attitude that should happen, even more and

  3. Indoor air quality medicolegal issues.

    PubMed

    Ross, C S; Lockey, J E

    1994-08-01

    The regulatory and legal communities have begun only recently to address the medicolegal issues surrounding indoor air quality. No single governmental agency is responsible for indoor air quality issues. The focus of the federal government's indoor air quality programs is on the gathering and dissemination of information rather than on the regulation of indoor air pollution. State and local regulatory controls vary but may include antismoking ordinances, building codes, and contractor certification programs. Numerous lawsuits involving various parties and legal theories have been filed on the basis of illness allegedly related to indoor air quality. Further regulatory and legal review of indoor air problems will likely occur in the near future, particularly as a result of the characterization of environmental tobacco smoke as a class A carcinogen.

  4. Measuring the prevalence of questionable research practices with incentives for truth telling.

    PubMed

    John, Leslie K; Loewenstein, George; Prelec, Drazen

    2012-05-01

    Cases of clear scientific misconduct have received significant media attention recently, but less flagrantly questionable research practices may be more prevalent and, ultimately, more damaging to the academic enterprise. Using an anonymous elicitation format supplemented by incentives for honest reporting, we surveyed over 2,000 psychologists about their involvement in questionable research practices. The impact of truth-telling incentives on self-admissions of questionable research practices was positive, and this impact was greater for practices that respondents judged to be less defensible. Combining three different estimation methods, we found that the percentage of respondents who have engaged in questionable practices was surprisingly high. This finding suggests that some questionable practices may constitute the prevailing research norm.

  5. Questions about Certainty and Uncertainty in Clinical Practice

    ERIC Educational Resources Information Center

    Nelson, Nickola Wolf

    2011-01-01

    Purpose: This article offers a critical response to Kamhi's (2011) essay regarding the need to balance certainty and uncertainty in evidence-based practice (EBP). Method: Points of concordance and discordance (counterpoints) between Kamhi's essay and the author's frames of reference were considered. Results: In agreement with Kamhi, a major role…

  6. Questions about Certainty and Uncertainty in Clinical Practice

    ERIC Educational Resources Information Center

    Nelson, Nickola Wolf

    2011-01-01

    Purpose: This article offers a critical response to Kamhi's (2011) essay regarding the need to balance certainty and uncertainty in evidence-based practice (EBP). Method: Points of concordance and discordance (counterpoints) between Kamhi's essay and the author's frames of reference were considered. Results: In agreement with Kamhi, a major role…

  7. Questioning Research with Children: Discrepancy between Theory and Practice?

    ERIC Educational Resources Information Center

    Uprichard, Emma

    2010-01-01

    This paper argues that current child and childhood research is problematical in as much as there is a discrepancy between theory and research practice. Although in theory, children are conceptualised as active agents in the social world, the type of research that children are typically involved in implies that children are competent, knowledgeable…

  8. Dimensions of Questioning: A Qualitative Study of Current Classroom Practice in Malaysia

    ERIC Educational Resources Information Center

    Hussin, Habsah

    2006-01-01

    This study investigated questioning as practiced in Malaysian secondary school classrooms, to determine teachers' rationale for adopting certain techniques of questioning, and to use the findings to inform teacher education. Questioning is a central aspect of any classroom interaction as it serves so many functions but it is still an…

  9. Developing the Practice of Teacher Questioning through a K-2 Elementary Mathematics Field Experience

    ERIC Educational Resources Information Center

    Schwartz, Catherine

    2015-01-01

    This article presents findings from research on a field experience designed to help elementary preservice teachers learn the practice of teacher questioning during formal and informal interviews to analyze student mathematical thinking in K-2 classrooms. The practice of teacher questioning is framed as choosing a mathematical goal, analyzing…

  10. The questioned p value: clinical, practical and statistical significance.

    PubMed

    Jiménez-Paneque, Rosa

    2016-09-09

    The use of p-value and statistical significance have been questioned since the early 80s in the last century until today. Much has been discussed about it in the field of statistics and its applications, especially in Epidemiology and Public Health. As a matter of fact, the p-value and its equivalent, statistical significance, are difficult concepts to grasp for the many health professionals some way involved in research applied to their work areas. However, its meaning should be clear in intuitive terms although it is based on theoretical concepts of the field of Statistics. This paper attempts to present the p-value as a concept that applies to everyday life and therefore intuitively simple but whose proper use cannot be separated from theoretical and methodological elements of inherent complexity. The reasons behind the criticism received by the p-value and its isolated use are intuitively explained, mainly the need to demarcate statistical significance from clinical significance and some of the recommended remedies for these problems are approached as well. It finally refers to the current trend to vindicate the p-value appealing to the convenience of its use in certain situations and the recent statement of the American Statistical Association in this regard.

  11. Republished: Respiratory microbiota: addressing clinical questions, informing clinical practice

    PubMed Central

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-01-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:26304986

  12. Juggling law, ethics, and intuition: practical answers to awkward questions

    PubMed Central

    Sommerville, A

    2003-01-01

    The eclectic problem solving methodology used by the British Medical Association (BMA) is described in this paper. It has grown from the daily need to respond to doctors' practical queries and incorporates reference to law, traditional professional codes, and established BMA policies—all of which must be regularly assessed against the benchmark of contemporary societal expectations. The two Jehovah's Witness scenarios are analysed, using this methodology and in both cases the four principles solution is found to concur with that of the BMA's approach. The author's overall conclusion is that although the BMA resorts to a lengthier list of thins to consider, the solutions that emerge are often likely to coincide with the four principles approach. PMID:14519837

  13. A compilation of Good Laboratory Practice questions and (where to get the) answers.

    PubMed

    Mayer, D E; Purdue, T W

    1995-12-01

    Since the inception of the Food and Drug Administration's Good Laboratory Practice Regulations and Environmental Protection Agency's Good Laboratory Practice Standards, many "questions and answer" documents have been produced. Our purpose in this presentation is to pull together some of these reference documents and provide a cross-reference index to sort through the many topics and questions. The combined reference resource and index provide the quality assurance professional a useful Good Laboratory Practice information tool.

  14. The shifting sands of medico-legal intra-partum Ctg (I-P Ctg) monitoring.

    PubMed

    Buttigieg, George G

    2016-03-01

    Intra-partum (IP) surveillance of the unborn child by cardiotacography (CTG) monitoring is the commonest obstetric procedure in the developed world.(1) It is also the most medico-legally contested obstetric procedure in labour. In 2011, 'birth asphyxia' comprised 50% of the UK National Health Service (NHS) litigation costs,(2) and in the 2000-2010 decade, the same NHS paid out £3.1 billion for maternity medico-legal claims (the highest of any speciality), mostly involving cerebral palsy and CTG misinterpretation.(3) This article looks at a number of characteristics of IP CTG monitoring which argue for its questionable solidity of base in court proceedings.

  15. Contemporary medico-legal dental radiology.

    PubMed

    Wright, Brad

    2012-03-01

    The advent of extraoral radiology in general dental practice has become more widespread since 2000, particularly with digital systems. With this comes a range of medico-legal risks for dentists not adverted to previously. These risks include a higher than expected radiation dose for some surveys, and the risk of a 'loss of a chance' for a patient whereby the images may disclose pathology not diagnosed by general dental practitioners using OPG and CBVT radiology. Practitioners need to apply relevant legal principles in deciding which surveys to order and record, and also need to explain to patients the dosages of the radiation that they will likely receive. Practitioners also need to assess whether the resultant survey ought to be interpreted by a radiologist to diagnose any wider pathology with which a general practitioner may not be familiar. Extra caution needs to be used in ordering high dose radiology in paediatric patients. Dentists should not assume patients fully understand the nature of CBVT and MCT, and its risks and benefits. Consideration ought to be given to the volume of CBVT ordered dependent on factors such as patient age, symptoms, history and procedural intent. © 2012 Australian Dental Association.

  16. The Relationship between Teaching and Learning Conceptions, Preferred Teaching Approaches and Questioning Practices

    ERIC Educational Resources Information Center

    Pedrosa-de-Jesus, Maria Helena; da Silva Lopes, Betina

    2011-01-01

    This paper focuses on the relationship between preferential teaching approach (PTA) and the concept of teachers' questioning practices (TQP), as part of a large-scale three-year project aimed at developing the scholarship of teaching and learning at one Portuguese university. In order to contribute to understandings of how teachers' questioning is…

  17. Visitor Perspectives on the Nature and Practice of Science: Challenging Beliefs through "A Question of Truth."

    ERIC Educational Resources Information Center

    Pedretti, Erminia; Macdonald, Ronald D.; Gitari, Wanja; McLaughlin, Hooley

    2001-01-01

    Describes the "A Question of Truth" exhibit at the Ontario Science Centre which examines several questions about the nature of science itself, how ideas are formed, and how cultural and political conditions affect the practice of science. Observation data indicate that science center visitors are interested in considering science and the…

  18. Enhancing Cognitive Presence in Online Case Discussions with Questions Based on the Practical Inquiry Model

    ERIC Educational Resources Information Center

    Sadaf, Ayesha; Olesova, Larisa

    2017-01-01

    The researchers in this study examined the influence of questions designed with the Practical Inquiry Model (PIM), compared with the regular (playground) questions, on students' levels of cognitive presence in online discussions. Students' discussion postings were collected and categorized according to the four levels of cognitive presence:…

  19. The Relationship between Teaching and Learning Conceptions, Preferred Teaching Approaches and Questioning Practices

    ERIC Educational Resources Information Center

    Pedrosa-de-Jesus, Maria Helena; da Silva Lopes, Betina

    2011-01-01

    This paper focuses on the relationship between preferential teaching approach (PTA) and the concept of teachers' questioning practices (TQP), as part of a large-scale three-year project aimed at developing the scholarship of teaching and learning at one Portuguese university. In order to contribute to understandings of how teachers' questioning is…

  20. Practice question.

    PubMed

    Garrett, Dawne; Garrett, Rose

    2012-10-26

    The term 'personalisation' has become increasingly common in the context of a movement that recognises the importance of people's individuality and their right to exercise choice in their daily lives. In the fields of health and social care, personalisation focuses on placing the individual at the centre of their care and an understanding that they know best what their needs are and how to meet them ( Carr 2008 ). Personalisation can be as significant as a direct payment or individual budget, or as small as supporting a resident in a care home to decide for themselves when they should go to bed.

  1. Practice question.

    PubMed

    Jackson, Jill

    2010-09-23

    Everyone comes into contact with health and social care services at some point in their lives, usually when they are at their most vulnerable. Anyone who has had experience of health and social care services will have vivid memories of the care that they received, whether good or bad. It is often the small things that result in patients perceiving that care is poor or good. For example, staff being too rushed to say hello to patients or greeting them with a welcoming smile.

  2. Autopsy utilization in medicolegal defense of anesthesiologists.

    PubMed

    Lee, Lorri A; Stephens, Linda S; Fligner, Corinne L; Posner, Karen L; Cheney, Frederick W; Caplan, Robert A; Domino, Karen B

    2011-10-01

    The rate of autopsy in hospital deaths has declined from more than 50% to 2.4% over the past 50 yr. To understand the role of autopsies in anesthesia malpractice claims, we examined 980 closed claims for deaths that occurred in 1990 or later in the American Society of Anesthesiologists Closed Claims Project Database. Deaths with autopsy were compared with deaths without autopsy. Deaths with autopsy were evaluated to answer the following four questions: Did autopsy findings establish a cause of death? Did autopsy provide new information? Did autopsy identify a significant nonanesthetic contribution to death? Did autopsy help or hurt the defense of the anesthesiologist? Reliability was assessed by κ scores. Differences between groups were compared with chi-square analysis and Kolmogorov-Smirnov test with P < 0.05 for statistical significance. Autopsies were performed in 551 (56%) of 980 claims for death. Evaluable autopsy information was available in 288 (52%) of 551 claims with autopsy. Patients in these 288 claims were younger and healthier than those in claims for death without autopsy (P < 0.01). Autopsy provided pathologic diagnoses and an unequivocal cause of death in 21% of these 288 claims (κ= 0.71). An unexpected pathologic diagnosis was found in 50% of claims with evaluable autopsy information (κ = 0.59). Autopsy identified a significant nonanesthetic contribution in 61% (κ = 0.64) of these 288 claims. Autopsy helped in the defense of the anesthesiologist in 55% of claims and harmed the defense in 27% (κ = 0.58) of claims with evaluable autopsy information. Autopsy findings were more often helpful than harmful in the medicolegal defense of anesthesiologists. Autopsy identified a significant nonanesthetic contribution to death in two thirds of claims with evaluable autopsy information.

  3. Best practice strategies for effective use of questions as a teaching tool.

    PubMed

    Tofade, Toyin; Elsner, Jamie; Haines, Stuart T

    2013-09-12

    Questions have long been used as a teaching tool by teachers and preceptors to assess students' knowledge, promote comprehension, and stimulate critical thinking. Well-crafted questions lead to new insights, generate discussion, and promote the comprehensive exploration of subject matter. Poorly constructed questions can stifle learning by creating confusion, intimidating students, and limiting creative thinking. Teachers most often ask lower-order, convergent questions that rely on students' factual recall of prior knowledge rather than asking higher-order, divergent questions that promote deep thinking, requiring students to analyze and evaluate concepts. This review summarizes the taxonomy of questions, provides strategies for formulating effective questions, and explores practical considerations to enhance student engagement and promote critical thinking. These concepts can be applied in the classroom and in experiential learning environments.

  4. [Medico-legal assessment of systemic sclerosis].

    PubMed

    Graninger, M

    2007-10-01

    Diagnosis and management of the rare disease systemic sclerosis (scleroderma) is a challenge for the physician, not least due to the possible multitude of organ systems involved. The medico-legal assessment is important for the patient claiming insurance benefits or applying for early retirement due to scleroderma. Both the specialist for sclerosis and the impartial medico-legal assessor have to cooperate and understand the respective partner's requirements and terminology. Evaluations of individual organ impairments, handicaps and disabilities have to be taken into account when assessing the degree of impairment of occupational activity.

  5. Practice-Generated Questions: A Method of Formulating True Learning Needs of Family Physicians

    PubMed Central

    Jennett, Penny A.; Lockyer, Jocelyn M.; Parboosingh, I. John P.; Maes, William R.

    1989-01-01

    The importance of identifying true learning needs prior to planning and conducting educational programs is well documented. In this study a collection of 579 clinical questions forwarded by 87 family physicians in southern Alberta was reviewed and analysed to determine if the questions would cluster and, therefore, be useful as sources for planning continuing medical education (CME) conferences and newsletters. The nature of submitted questions was also examined to determine if particular groups of physicians, as identified by socio-demographic characteristics, significanly differed by type of questions submitted. The study findings indicate that the questions generated by the clinical practices of family practitioners did cluster into meaningful categories, and did vary significantly by identified physician groups. Questions relating to the genito-urinary system; adverse drug effects, interactions and contraindications; and nervous system and sense organs were most frequently submitted. The nature of questions generated differed significantly by gender, size of practice setting, and year and place of medical graduation. When highly relevant and specific clinical questions, as contrasted with broadly expressed needs, serve as sources of identified learning needs for CME planners, the daily clinical problems faced by practitioners are better addressed. The learning needs identified by this approach provide an optimum framework for planned CME to influence physician behaviour or practice patterns. PMID:21248985

  6. Asking Well-Built Questions for Evidence-Based Practice in Augmentative and Alternative Communication

    ERIC Educational Resources Information Center

    Schlosser, Ralf W.; Koul, Rajinder; Costello, John

    2007-01-01

    Evidence-based practice (EBP) is increasingly being advocated as the preferred approach to practice in augmentative and alternative communication (AAC). The EBP process involves multiple steps. The asking of a well-built question is the first step in the quest for answers. At the same time it is also often the first stumbling block for…

  7. Asking Well-Built Questions for Evidence-Based Practice in Augmentative and Alternative Communication

    ERIC Educational Resources Information Center

    Schlosser, Ralf W.; Koul, Rajinder; Costello, John

    2007-01-01

    Evidence-based practice (EBP) is increasingly being advocated as the preferred approach to practice in augmentative and alternative communication (AAC). The EBP process involves multiple steps. The asking of a well-built question is the first step in the quest for answers. At the same time it is also often the first stumbling block for…

  8. Application of DNA fingerprinting in medicolegal practice.

    PubMed

    Raina, Anupuma; Dogra, T D

    2002-12-01

    Fingerprinting is thought to establish the identify of an individual in forensic cases. The technique is extensively used for forensic purposes. Deoxyribonucleic acid (DNA) is the vehicle of generational transference of heritable unit. While arching markers for genetic disease professor Alec Jeffreys discovered that certain regions of DNA showed variations in the number of tandem repeats known as variable number of tandem repeats (VNTRs). Thus DNA fingerprint was named by observing the number of repeated sequences which differ from individual to individual. The structure of DNA is quite flexible, within the nucleus of each cell resides an identical copy of the individual's genetic material, DNA. The coding regions of the genomic DNA are known as genes. The DNA fingerprinting in forensic science has generated considerable excitement in the criminal justice community. DNA fingerprinting can be applied to identify an individual in criminal and civil cases. Polymerase chain reaction has revolutionised molecular biology it has an ability to amplify (usually fewer than 3000 bp) a particular sequence of DNA into million of copies in a very short period. Consequently only a very tiny amount of an organism's DNA needs to be available originally. This property of polymerase chain reaction has enabled to analyse many forensic samples particularly which are degraded. Microsatellite DNA or commonly as short tandem repeats are scattered throughout the human genome and occur on an average of every 10,000 nucleotides. Microsatellite markers are considered to be the most powerful genetic markers. Collection, preservation and handling are the integral part of DNA fingerprinting analysis. There are various methods to isolate DNA from different biological materials but presently most of the laboratories prefer using FTA paper. The age of humans can be estimated by using DNA based on telomere shortening.

  9. Ask the right question: a critical step for practicing evidence-based laboratory medicine.

    PubMed

    Price, Christopher P; Christenson, Robert H

    2013-07-01

    The purpose of laboratory medicine is to facilitate better decision making in clinical practice and healthcare delivery. Decision making implies an unresolved issue, problem or unmet need. The most important criterion for any investigation to be of value in clinical practice is that it addresses an unmet need. The different ways in which laboratory investigations are utilized in patient care can be represented in the form of questions. It is important that these questions are articulated to highlight the variables that will impact on the effectiveness of the investigation in the scenario being considered. These variables include the characteristics of the patient (or population) and clinical setting, the nature of the decision and action taken on receipt of the test result and the expected outcome. Asking a question is the first step of the evidence-based laboratory medicine (EBLM) cycle, the other steps being acquiring the evidence, critically appraising the evidence, applying the evidence and auditing use of the evidence. Getting the question right determines the quality of the whole process, thus, defines the quality in practice of laboratory medicine. Whilst the main focus of the EBLM cycle is to provide a strong evidence base for use in clinical practice, it is clear that the five steps are equally applicable in commissioning, delivery and audit (performance management) of services. Asking the right question is crucial to improving the quality of evidence, and practice, in laboratory medicine, and should be used in routine laboratory medicine practice and management throughout healthcare.

  10. Pharmacogenetics in medico-legal context.

    PubMed

    Sajantila, A; Palo, J U; Ojanperä, I; Davis, C; Budowle, B

    2010-12-15

    Medico-legal autopsy is the primary method in determining the cause and manner of death when the death is suspected to be unnatural. In some of these autopsies, the death remains ambiguous, even after a complete autopsy including histological investigation and toxicological screenings. In cases where there are no morphological abnormalities, medico-legal genetics may offer additional means to provide knowledge of possible genetic mutations, which may have initiated the process or predisposed the individual to stress risk conditions leading to death. One class of ambiguous deaths consists of drug-related deaths where the interpretation of the toxicological results are not clear. In such situations post mortem genotyping and the analysis of metabolite rations may provide an insight to the findings. A few cases demonstrating the potential strength of pharmacogenetics in medico-legal context has been published. However, there is a paramount need for serious scientific studies before the field of post mortem pharmacogenetics can be utilized in routine medico-legal analyses casework and brought routinely into courtroom.

  11. [Cancer screening: medico-legal aspects].

    PubMed

    Buzzi, F

    2003-01-01

    The cancer screening programmes need a particular considerations for their medico-legal implications: above all in order to the information toward the persons recruited, those must be aware about their diagnostic limits and about the ineluctable recurrence of false positive and false negative results.

  12. When range of motion is not enough: towards an evidence-based approach to medico-legal reporting in whiplash injury.

    PubMed

    Worsfold, Christian

    2014-07-01

    Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.

  13. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    PubMed

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  14. Study Behavior and Performance: Effect of Practice and Test Question Similarity.

    DTIC Science & Technology

    1979-07-01

    Inserted question s Te~t developmen t 20. ABSTRACT (Cones... on ‘cc. ~ .SU. SI onc. ..V ond IU..,H& by bS..b ~~~b.r) The st udy was conducted to test...that of a real-world classroom situation. Purpose The purpose of this research and development was to evaluate the effect of practice questions in a...The same prescription applies to classroom instruction where the teacher provides practice by oral quizzing or in workbooks, and to other situations in

  15. Documentation of torture victims, assessment of the start procedure for medico-legal documentation.

    PubMed

    Mandel, Lene; Worm, Lise

    2007-01-01

    A Pilot Study was performed at the Rehabilitation and Research Centre for Torture Victims (RCT) in Copenhagen in order to explore the possibilities for adding a medico-legal documentation component to the rehabilitation of torture victims already taking place. It describes the process and results on implementing medico-legal documentation in a rehabilitative setting. A modified version of the Guidelines in the Istanbul Protocol was developed on the basis of the review of literature and current practices described in "Documentation of torture victims, implementation of medico-legal protocols". The modified guidelines were tested on five clients. The aim was twofold: 1) To assess the client's attitude towards the idea of adding a documentation component to the rehabilitation process and: 2) To assess the practical circumstances of implementing the Istanbul Protocol in the everyday life of a rehabilitation centre. Results show that all five clients were positive towards the project and found comfort in being able to contribute to the fight against impunity. Also, the Pilot Study demonstrated that a large part of the medico-legal documentation was already obtained in the rehabilitation process. It was however not accessible due to lack of systematization and a data registering system. There are thus important synergies in collecting data for rehabilitation and documentation but a joint database system is necessary to realize these synergies.

  16. "Gym Class with Ed Fizz": Exploring Questionable Pedagogical Practices with Preservice Physical Education Teachers

    ERIC Educational Resources Information Center

    Robinson, Daniel B.; Gleddie, Doug

    2011-01-01

    Enabling preservice physical education teachers to critically consider questionable and taken-for-granted practices is an important component of a physical education teacher education (PETE) program. In an effort to offer a teaching and learning context in which to introduce such critical consciousness, the authors have included a staged physical…

  17. Deferred Acceptance Algorithms: History, Theory, Practice, and Open Questions. NBER Working Paper No. 13225

    ERIC Educational Resources Information Center

    Roth, Alvin E.

    2007-01-01

    The deferred acceptance algorithm proposed by Gale and Shapley (1962) has had a profound influence on market design, both directly, by being adapted into practical matching mechanisms, and, indirectly, by raising new theoretical questions. Deferred acceptance algorithms are at the basis of a number of labor market clearinghouses around the world,…

  18. Assessment of Anatomical Knowledge by Practical Examinations: The Effect of Question Design on Student Performance

    ERIC Educational Resources Information Center

    Sagoo, Mandeep Gill; Smith, Claire France; Gosden, Edward

    2016-01-01

    The objective structural practical examination (OSPE) is a timed examination that assesses topographical and/or applied knowledge of anatomy with the use of cadaveric resources and medical images. This study investigated whether elements of question design (provision of clinical context, type of visual resources used, gender context, and…

  19. Medicolegal response to violence against women in India.

    PubMed

    Prasad, S

    1999-05-01

    This article examines women's experiences in India with health and legal interventions that address domestic violence, dowry-related violence, and rape. By examining the experiences of survivors of abuse with the medicolegal system in New Delhi, it considers the extent to which women are able to access their legal rights within the special protection system constructed specifically for them. The use of primary data highlights the impact of state procedures on women, and it demonstrates how procedures designed to enhance women's access to the law actually inhibit it. Using semistructured interviews with female survivors of abuse, police officers, case workers, nongovernmental organization leaders, lawyers, physicians, and government officials in a 4-year period, this article examines women's access to state services designed to address violence against women, and raises questions about state tolerance of domestic and sexual violence.

  20. Medicolegal aspects of doping in football

    PubMed Central

    Graf‐Baumann, T

    2006-01-01

    This article describes the historical background of the medicolegal aspects of doping in sports and especially in football. The definitions of legal terms are explained and the procedure of individual case management as part of FIFA's approach to doping is presented. Finally, three medicolegal problems awaiting urgent solution are outlined: firstly, the difficulties in decision making arising from the decrease of the T/E ratio from 6 to 4; secondly, the therapeutic application of α‐reductase inhibitors for male pattern baldness in the face of the classification of finasteride as a forbidden masking agent; and lastly, the increasing use of recreational drugs and its social and legal implications in positive cases. PMID:16799105

  1. Medicolegal Implications of Common Rhinologic Medications.

    PubMed

    Poetker, David M; Smith, Timothy L

    2015-10-01

    As otolaryngologists, we prescribe many medications to our patients. The objective of this article is to review the potential side effects and medicolegal risks of the common medications used to treat chronic rhinosinusitis. The authors evaluate some of the common side effects as well as the published literature on the lawsuits associated with those medications. Finally, the authors review the informed consent discussion and opportunities to improve patient care and decrease the risk of litigation. Published by Elsevier Inc.

  2. Responses to non-emergency questions in rural medicine: their usefulness to practice decisions.

    PubMed

    Jennett, P A; Kishinevsky, M; Parboosingh, I T; Lockyer, J M; Maes, W R

    1991-05-01

    This study reports the nature of non-emergency, day-to-day practice-related questions which arose in rural practice and were phoned in to a medical information system (MIS). The usefulness of these questions, and their responses, to clinical decision-making is outlined. Sixty-seven practitioners from 10 rural communities enrolled in the project. In response to each inquiry two or three articles were sent to the practitioner and to a consultant for validation. At the conclusion of the study the questions posed, and their responses, were examined. Forty-six per cent of the questions received were categorized as diagnostic; 30% as management; and 24% as therapeutic. Questions were classified using the ICD.9.CM. Those most frequently posed were in the nervous system/sense organs (13%), injury/poisoning (9%), and genito-urinary (9%) categories. Interviews with doctors and consultants were conducted to assess the usefulness of the service. Study findings suggest that an MIS can provide helpful information for improving daily aspects of clinical care, doctor-patient communication, administrative decision-making, and physician education. Practitioners, consultants, and medical librarians reported benefits from this service.

  3. Asking well-built questions for evidence-based practice in augmentative and alternative communication.

    PubMed

    Schlosser, Ralf W; Koul, Rajinder; Costello, John

    2007-01-01

    Evidence-based practice (EBP) is increasingly being advocated as the preferred approach to practice in augmentative and alternative communication (AAC). The EBP process involves multiple steps. The asking of a well-built question is the first step in the quest for answers. At the same time it is also often the first stumbling block for practitioners. To facilitate the asking of well-built questions it may be helpful to follow a template. The most frequently used template is PICO, which stands for patient, intervention, comparison, and outcome [Richardson, W., Wilson, M., Nishikawa, J., & Hayward, R. (1995). The well-built clinical question: A key to evidence-based decisions. ACP Journal Club, 123, A12-A13]. In this article, we examine the suitability of the PICO template for AAC in terms of the representativeness of the components, and the appropriateness of its subcomponents, and their terminology. Based on this analysis, we propose the PESICO template, which stands for person, environments, stakeholders, intervention, comparison, and outcome. This template is then illustrated with examples representing a range of decision-making areas in AAC. Finally, directions for future research are provided. The reader will be able to: (1) appreciate the importance of asking well-built questions, (2) name the shortcomings of the PICO template, and (3) describe the components of the proposed PESICO template for asking well-built questions.

  4. The effect of different levels of constructive teaching practices on teacher question asking behaviors

    NASA Astrophysics Data System (ADS)

    Erdogan, Ibrahim

    The purposes of the study were: (1) to examine the effectiveness of the Iowa Chautauqua Professional Development Program (ICPDP) in moving elementary science teachers toward the use of more constructive teaching practices and (2) to investigate the effectiveness of different levels of teaching practices, especially in terms of a sample of teachers achieving "expert" state at the end of program compared with some attaining only with "competent" level. The variables considered were their perceptions of their own classroom practices, stated philosophy of teaching and learning, and their actual classroom practices and question asking behaviors observed via videotape recording. Structured questionnaires, focus group interviews, teacher reflections, and examination of lesson modules were used to collect data from thirty-three K-5 in-service teachers who were involved in a one-year ICPDP. Qualitative and quantitative analyses of data revealed that: (1) Teacher perceptions regarding their teaching and learning, and their actual teaching practices in classroom in terms of constructivist approaches were significantly changed after participation in the ICPDP. (2) Teacher perceptions of their classroom practices and stated philosophies of teaching and learning have a great affect on their actual practices that can be observed. (3) Teacher stated philosophies of teaching and learning significantly influence the quantity and quality of their use of questions in their classrooms. (4) The "expert" teachers accept students' alternative answers and deliberately ask high cognitive level questions that enable students to think critically and to guide them based on what the students are thinking. Alternatively, the "competent" teachers do not follow student responses and used questions which do not help students to understand their current level of understanding nor encourage students to reflect on their own thinking. (5) The role of "expert" teacher is more geared toward challenging

  5. [About medical accidents and their medicolegal implications. Information and consent].

    PubMed

    El Banna, S; Beauthier, F; Beauthier, J P

    2013-01-01

    Medical practice today is not simple because of various factors impinging on the doctor-patient relationship. The concept of consent arises from the ethical principle of patient autonomy and basic human rights. It is also the rule of law (Civil Code article 16-3) that guarantees the patient's right and freedom to decide what should or should not happen to his/her body and to gather information before undergoing a test/procedure/surgery. No one else has the right to coerce the patient to act in a particular way. The authors after a reflexion about medical accidents and their medicolegal implications, discuss the means to display in order to provide to the patients the adequate information about their disease and proposed treatment, therefore protecting the medical practitioner from the consequences of insufficient or ill information.

  6. Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.

    PubMed

    Vassalini, Marzia; Verzeletti, Andrea; De Ferrari, Francesco

    2016-06-22

    Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation.

  7. Connecting Theory to Practice: Using Guided Questions to Standardize Clinical Postconference.

    PubMed

    Harvey, Giuliana

    2015-11-01

    Assisting nursing students with the integration of theoretical knowledge in the practice setting can be a challenge for clinical instructors. Clinical instructors using planned questions to guide discussion among students during postconference is one method that can be used to achieve this goal. Open-ended guided questions that deliberately address and synthesize classroom knowledge during postconference discussions are advantageous to both students and clinical instructors. The purpose of this article is to describe the process of standardizing the weekly postconference by deliberately integrating questions within a second-year nursing clinical course at a Canadian university. In this course, the guided questions provided clinical instructors who facilitated the postconferences with an opportunity to enhance their own level of comprehension and currency in various subject areas, as well as evaluate students' critical thinking and knowledge gaps. Understanding the nursing curriculum and providing clinical instructors with the appropriate skills to facilitate postconference discussions were paramount to the success of these standardized postconferences. Copyright 2015, SLACK Incorporated.

  8. Talking with women about personal health resources in general practice. Key questions about salutogenesis.

    PubMed

    Malterud, K; Hollnagel, H

    1998-06-01

    We want to share experiences from an approach for clinical communication and research, intended to identify and mobilize personal health resources in female patients, and promote strategies for resource oriented talk in general practice. We used an action research design with qualitative evaluation to summarize the process where we developed a key question about self-assessed health resources in women, based on The Health Resource/Risk Balance Model, including salutogenesis, patient-centredness and gender perspectives. From consultations with 49 female patients in our own practices, we have drawn a narrative description of the development process, a summary of issues that facilitated resource talk, and our final version of the key question. We suggest that resource talk is based on 1) an explicit shift of language from disease to health, but nevertheless recognizing the fact that illness occurs, 2) options for answers given by the female patient and not by the doctor, 3) signification of the woman's assessment of her own situation (in contrast to the doctor's assessment), and 4) taking for granted that women's personal health resources exist as numerous strategies which are utilized, and may be identified. We have learnt that communicative action can provide tools for shifting the attention of doctor and patients from risks and diseases to resources and strengths. This is an example of one way to change your practice through systematic reflection in dialogue with a colleague.

  9. A primer on selected aspects of evidence-based practice relating to questions of treatment. Part 1: asking questions, finding evidence, and determining validity.

    PubMed

    Cleland, Joshua A; Noteboom, J Timothy; Whitman, Julie M; Allison, Stephen C

    2008-08-01

    The process of evidence-based practice (EBP) guides clinicians in the integration of individual clinical expertise, patient values and expectations, and the best available evidence. Becoming proficient with this process takes time and consistent practice, but should ultimately lead to improved patient outcomes. The EBP process entails 5 steps: (1) formulating an appropriate question, (2) performing an efficient literature search, (3) critically appraising the best available evidence, (4) applying the best evidence to clinical practice, and (5) assessing outcomes of care. This first commentary in a 2-part series will review principles relating to steps 1, 2, and 3 of this 5-step model. The purpose of this commentary is to provide a perspective to assist clinicians in formulating foreground questions, searching for the best available evidence, and determining validity of results in studies of interventions for orthopaedic and sports physical therapy.

  10. Barriers to the effective use of medico-legal findings in sexual assault cases worldwide.

    PubMed

    Mont, Janice Du; White, Deborah

    2013-09-01

    Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.

  11. Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology.

    PubMed

    Kunde, Lauren; McMeniman, Erin; Parker, Malcolm

    2013-08-01

    Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

  12. The prevalence of questionable occlusal caries lesions: findings from The Dental Practice-Based Research Network

    PubMed Central

    Makhija, Sonia K; Gilbert, Gregg H.; Funkhouser, Ellen; Bader, James D; Gordan, Valeria V.; Rindal, D. Brad; Bauer, Michael; Pihlstrom, Daniel J.; Qvist, Vibeke

    2012-01-01

    Objectives Questionable occlusal caries (QOC) can be defined as clinically-suspected caries with no cavitation or radiographic evidence of occlusal caries. To our knowledge, its prevalence has not been quantified; this was the objective of this study. Methods A total of 82 dentist and hygienist practitioner-investigators from “The Dental Practice-Based Research Network” (DPBRN) participated. When patients presented with at least one unrestored occlusal surface, their number of unrestored occlusal surfaces and QOC were quantified. Information also was recorded about patient characteristics on consented patients who had QOC. Data analysis adjusted for patient clustering within practices. Results Overall, 6,910 patients had at least one unrestored occlusal surface, with a total of 50,445 unrestored surfaces. Thirty-four percent of all patients and 11% of unrestored surfaces among all patients had QOC. Patient- and surface-level QOC prevalence varied significantly by region (p<0.001; p<0.03). The highest percent for patient-and surface-level prevalence was in Florida/Georgia (42%; 16%). Conclusions To our knowledge, this is the first study to quantify the prevalence of QOC in routine clinical practice. These results document a high prevalence overall, with wide variation in prevalence among DPBRN’s five main regions. Clinical Implications QOC lesions are common in routine practice and warrant further investigation regarding how best to manage them. PMID:23204090

  13. [Medicolegal aspects of doping in sports].

    PubMed

    Pruvost, J; Depiesse, F

    2004-08-01

    To investigate the medico-legal aspects of national and international procedures for monitoring prescription drug use by competing athletes. We studied the French law No. 99-223 of March 23, 1999, relating to the protection of the health of athletes? We also studied annual statistics from the Ministry of Sports concerning anti-doping controls, substances detected by the National Doping Control Laboratory and penalties applied since 2000, as well as the World Anti-Doping Code, which came into effect on January 1, 2004, and should be universally applied by 2006. Athletes registered with a federation or unregistered athletes taking part in competitions approved by sporting federations can use prescription drugs but must follow strict rules. Athletes under investigation for drug use must declare all drugs or products recently taken. The use of prescription drugs not on the list of the prohibited substances is allowed, but evidence of the use of such drugs is the responsibility of the prescriber. A medical practitioner in France who considers it essential to prescribe prohibited drugs or drugs under certain restrictions must systematically inform the athlete about the regulations by providing various certificates and forms. For international athletes, a form authorizing therapeutic use must be submitted to the validation committee of the applicable international federation. Disciplinary, ordinal and penal sanctions are also described. Prescription drug use by an athlete is never a light matter and always engages the responsibility of the doctor. Anti-doping controls and sanctions encourage physicians to comply scrupulously with the medico-legal rules set forth by the public health code and the world anti-doping code.

  14. The answer is questions: accelerated-nursing students report practice questions are fundamental to first-time NCLEX-RN success.

    PubMed

    Blozen, Barbara B

    2014-01-01

    There are a number of anecdotal reports on demographic characteristics and academic success of accelerated-nursing students; yet few empirical studies have examined accelerated-nursing students NCLEX-RN success. Applying Knowles' adult learning theory as a guiding framework, the purpose of this qualitative study was to explore, from the accelerated-nursing students' perspective, the factors reported as contributing to their success on the NCLEX-RN. The research questions aimed to elicit participants' descriptions of their experiences and factors contributing to their success via individual interviews. The most significant finding the participants identified as the factor that contributed to their success was the practicing of NCLEX-RN questions. The findings of this study have several implications for educational policy and practice for universities and schools of nursing as the information gained from this study applies to recruitment and retention as well as curriculum and educational strategies in an accelerated-nursing program.

  15. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'.

    PubMed

    Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F

    2012-03-14

    A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  16. Cardiac implantable electronic device infections: facts, current practice, and the unanswered questions.

    PubMed

    Tarakji, Khaldoun G; Wilkoff, Bruce L

    2014-09-01

    Over the last 2 decades, there has been a surge in newly implanted cardiac implantable electronic devices (CIEDs). This is largely due to the increasing indications for these devices and their role in improving both survival and quality of life among certain groups of patients with heart disease. However, the net benefit of these devices is affected by adverse events and complications. CIED infection is one of these complications that increase morbidity and mortality. Patients with CIED infection can present with pocket infection or endovascular infection. Management usually involves CIED removal and antibiotic therapy. Despite its importance, many questions remain unanswered. Longitudinal studies and randomized clinical trials are needed to better define risk factors for CIED infections and outcomes and to help assess best practices to prevent this complication.

  17. Comparative and integrative analysis of RNA structural profiling data: current practices and emerging questions.

    PubMed

    Choudhary, Krishna; Deng, Fei; Aviran, Sharon

    2017-03-01

    Structure profiling experiments provide single-nucleotide information on RNA structure. Recent advances in chemistry combined with application of high-throughput sequencing have enabled structure profiling at transcriptome scale and in living cells, creating unprecedented opportunities for RNA biology. Propelled by these experimental advances, massive data with ever-increasing diversity and complexity have been generated, which give rise to new challenges in interpreting and analyzing these data. We review current practices in analysis of structure profiling data with emphasis on comparative and integrative analysis as well as highlight emerging questions. Comparative analysis has revealed structural patterns across transcriptomes and has become an integral component of recent profiling studies. Additionally, profiling data can be integrated into traditional structure prediction algorithms to improve prediction accuracy. To keep pace with experimental developments, methods to facilitate, enhance and refine such analyses are needed. Parallel advances in analysis methodology will complement profiling technologies and help them reach their full potential.

  18. The effect of question wording in questionnaire surveys on placebo use in clinical practice.

    PubMed

    Babel, Przemyslaw

    2012-12-01

    To identify factors that contribute to the high variability of the rates of use of placebo interventions reported in questionnaire surveys, the author investigated the effect of the explicit use of the word "placebo" in questionnaire surveys on placebo use in clinical practice on the results obtained. 190 primary care physicians in Poland were divided randomly into two groups. The groups received a questionnaire in which either the word placebo or the term "nonspecific methods of treatment" was used. The respondents who were asked explicitly about the use of placebo interventions declared that they never used placebo interventions significantly more often than participants asked about the use of nonspecific treatment methods. Moreover, the former reported significantly rarer use of placebo interventions than the latter. The study demonstrates that differences in the wording of questions in questionnaire surveys on placebo use can create statistically significant differences in results.

  19. PrimeAnswers: A practical interface for answering primary care questions.

    PubMed

    Ketchell, Debra S; St Anna, Leilani; Kauff, David; Gaster, Barak; Timberlake, Diane

    2005-01-01

    This paper describes an institutional approach taken to build a primary care reference portal. The objective for the site is to make access to and use of clinical reference faster and easier and to facilitate the use of evidence-based answers in daily practice. Reference objects were selected and metadata applied to a core set of sources. Metadata were used to search, sort, and filter results and to define deep-linked queries and structure the interface. User feedback resulted in an expansion in the scope of reference objects to meet the broad spectrum of information needs, including patient handouts and interactive risk management tools. RESULTS of a user satisfaction survey suggest that a simple interface to customized content makes it faster and easier for primary care clinicians to find information during the clinic day and to improve care to their patients. The PrimeAnswers portal is a first step in creating a fast search of a customized set of reference objects to match a clinician's patient care questions in the clinic. The next step is developing methods to solve the problem of matching a clinician's question to a specific answer through precise retrieval from reference sources; however, lack of internal structure and Web service standards in most clinical reference sources is an unresolved problem.

  20. [Medicolegal considerations about rape as a reason to decriminalize abortion].

    PubMed

    González-Wilhelm, Leonardo; Moreno, Leonardo; Carnevali, Raúl

    2016-06-01

    The Chilean senate is discussing a proposal to decriminalize abortion in 3 causals. One of these is when the pregnancy occurs as a result of a rape. To be legally able to perform the abortion in this circumstance, a health care team must confirm the occurrence of the facts constituting the offence. Regardless of the patient’s will, the accusation will be reported to the justice. In our view, in its current status the proposed rule does not consider certain medicolegal and procedural topics. Those flaws may determine in certain scenarios critical problems, such as: a) a wrongful conviction as a consequence of a false allegation of rape; (b) some pregnant due to a rape will not have access to the abortion procedure; (c) some accusations of rape will not be accredited nor criminally sanctioned. Employing a fictional case, we illustrate how those scenarios can actually be seen in practice. We also emphasize the difficulties and limitations that the health care team will encounter if the project is approved under the current conditions. Finally, we encourage the professional societies implicated in the theme to contribute in the legislatorial debate. Therefore, we give a set of proposals aimed to improve the bill before it may be enacted as a law.

  1. How to Buy a Medical Home? Policy Options and Practical Questions

    PubMed Central

    Berenson, Robert A.

    2010-01-01

    In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for “new” PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations. PMID:20467911

  2. The medicolegal and forensic aspects of fires.

    PubMed

    Eckert, W G

    1981-12-01

    Fires, their consequences and their investigations, continue to provide forensic scientists, especially those involved in medicolegal investigation (the medical examiner or forensic pathologist), with constant work and variations in problems. The recent history of mass disasters involving high-rise buildings, transport accidents, and arson-related accidents in nightclubs and prisons has emphasized the necessity for corrective and preventive means to ensure safety to the occupants of any of these areas. Problems presented by fires include the determination of the cause of the fire, the identification of the victims, and the cause and manner of their deaths. The motivation of the fire setter and the settlement by the insurance company or legal means are also aspects to be considered. The imperceptible effects of the fires include many other aspects, among which loss of loved ones and family providers and loss of industrial revenue and job potential are all felt. The most frightening development of all, however, is the insidious surfacing of arson as a possible factor in many major fires. The most recent tragedies involving the Stouffer Inn fire and the Hilton International Hotel fire were both related to arsonous acts. The scope of this article is to review the subject as it affects the forensic medical practitioner directly or indirectly so that his or her investigation may be brought to completion in conjunction with other authorities involved in the case.

  3. Perinatal testicular torsion and medicolegal considerations.

    PubMed

    Massoni, F; Troili, G M; Pelosi, M; Ricci, S

    2014-06-01

    Perinatal testicular torsion (PTT) is a very complex condition because of rarity of presentation and diagnostic and therapeutic difficulties. In presence of perinatal testicular torsion, the involvement of contralateral testis can be present also in absence of other indications which suggest the bilateral involvement; therefore, occurrences supported by literature do not exclude the use of surgery to avoid the risk of omitted or delayed diagnosis. The data on possible recovery of these testicles are not satisfactory, and treatment consists of an observational approach ("wait-and-see") or an interventional approach. The hypothesis of randomized clinical trials seems impracticable because of rarity of disease. The authors present a case of PTT, analyzing injuries due to clinical and surgical management of these patients, according to medicolegal profile. The delayed diagnosis and the choice of an incorrect therapeutic approach can compromise the position of healthcare professionals, defective in terms of skill, prudence and diligence. Endocrine insufficiency is an unfortunate event. The analysis of literature seems to support, because of high risk, a surgical approach aimed not only at resolution of unilateral pathology or prevention of a relapse, but also at prevention of contralateral testicular torsion.

  4. Medicolegal aspects of PMA-related deaths.

    PubMed

    Rojek, Sebastian; Bolechała, Filip; Kula, Karol; Maciów-Głąb, Martyna; Kłys, Małgorzata

    2016-07-01

    Unlike amphetamine, amphetamine-like substances accessible on the drug market are less expensive and more easily available; they also produce hallucinogenic effects expected by the users. Such properties render them more attractive as compared to amphetamine. On the other hand, the knowledge of the toxicity of these compounds is very limited, what in consequence generates problems that create ever-expanding research areas, including analytical, clinical and medicolegal issues, thus leading to development of systemic databases. An example here is paramethoxyamphetamine (PMA), which appeared on the drug market in recent years as a result of creative inventiveness of producers of psychoactive substances, who aimed at PMA replacing the popular ecstasy (MDMA) as a less expensive and more available product. It is more potent than MDMA, but has a slower onset of action, which encourages users to take more. The problem is illustrated in the present paper by three fatal cases involving PMA, which were comprehensively investigated taking into consideration case histories, pathological and toxicological findings obtained with the use of LC-MS-MS method. In blood samples taken from all the three victims, very high concentrations of PMA were found (in the range of 10-27mg/L) and thus the cause of deaths was determined as overdoses of PMA with the underlying mechanism of acute cardiorespiratory failure.

  5. [Maternal death of obstetrical origin. Medicolegal aspects].

    PubMed

    Chevrant-Breton, O; Lebervet, J Y; Vialard, J

    1985-01-01

    The authors have become interested in maternal mortality. This study has been carried out solely to look at the medico-legal aspect. Increasingly good health is seen as a right and the doctor the dispenser of this service. The rights of the mother (and of the infant) become of increasing importance. The improvement in obstetrical techniques, which are much better known to the public, have made families far more confident of the results of delivery. This is now seen as something without any danger. But delivering a baby still has lots of risks. Because of this, if an accident happens the obstetrician more than any other doctor perhaps can find himself in the courts. To avoid this he has to know very well the causes of maternal mortality in order to avoid them as far as possible. Furthermore, he must not undertake stupid emergency measures often initiated as measures of desperation caused by his emotional involvement for a patient who is approaching death. Finally, the expert should look for all the causes of death so that he does no wrongly blame the doctor for a maternal death.

  6. ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: questions and answers.

    PubMed

    Montes de Oca, María; López Varela, María Victorina; Acuña, Agustín; Schiavi, Eduardo; Rey, María Alejandra; Jardim, José; Casas, Alejandro; Tokumoto, Antonio; Torres Duque, Carlos A; Ramírez-Venegas, Alejandra; García, Gabriel; Stirbulov, Roberto; Camelier, Aquiles; Bergna, Miguel; Cohen, Mark; Guzmán, Santiago; Sánchez, Efraín

    2015-08-01

    ALAT-2014 COPD Clinical Practice Guidelines used clinical questions in PICO format to compile evidence related to risk factors, COPD screening, disease prognosis, treatment and exacerbations. Evidence reveals the existence of risk factors for COPD other than tobacco, as well as gender differences in disease presentation. It shows the benefit of screening in an at-risk population, and the predictive value use of multidimensional prognostic indexes. In stable COPD, similar benefits in dyspnea, pulmonary function and quality of life are achieved with LAMA or LABA long-acting bronchodilators, whereas LAMA is more effective in preventing exacerbations. Dual bronchodilator therapy has more benefits than monotherapy. LAMA and combination LABA/IC are similarly effective, but there is an increased risk of pneumonia with LABA/IC. Data on the efficacy and safety of triple therapy are scarce. Evidence supports influenza vaccination in all patients and anti-pneumococcal vaccination in patients <65years of age and/or with severe airflow limitation. Antibiotic prophylaxis may decrease exacerbation frequency in patients at risk. The use of systemic corticosteroids and antibiotics are justified in exacerbations requiring hospitalization and in some patients managed in an outpatient setting.

  7. [Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

    PubMed

    Chiaravalli, M; Guzzetti, Laura; Tavani, M

    2007-01-01

    The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

  8. Patient question set proliferation: scope and informatics challenges of patient question set management in a large multispecialty practice with case examples pertaining to tobacco use, menopause, and Urology and Orthopedics specialties.

    PubMed

    Vande Loo, Sarah J; North, Frederick

    2016-04-12

    Health care institutions have patient question sets that can expand over time. For a multispecialty group, each specialty might have multiple question sets. As a result, question set governance can be challenging. Knowledge of the counts, variability and repetition of questions in a multispecialty practice can help institutions understand the challenges of question set proliferation. We analyzed patient-facing question sets that were subject to institutional governance and those that were not. We examined question variability and number of repetitious questions for a simulated episode of care. In addition to examining general patient question sets, we used specific examples of tobacco questions, questions from two specialty areas, and questions to menopausal women. In our analysis, there were approximately 269 institutionally governed patient question sets with a mean of 74 questions per set accounting for an estimated 20,000 governed questions. Sampling from selected specialties revealed that 50 % of patient question sets were not institutionally governed. We found over 650 tobacco-related questions in use, many with only slight variations. A simulated use case for a menopausal woman revealed potentially over 200 repeated questions. A group practice with multiple specialties can have a large volume of patient questions that are not centrally developed, stored or governed. This results in a lack of standardization and coordination. Patients may be given multiple repeated questions throughout the course of their care, and providers lack standardized question sets to help construct valid patient phenotypes. Even with the implementation of a single electronic health record, medical practices may still have a health information management gap in the ability to create, store and share patient-generated health information that is meaningful to both patients and physicians.

  9. Current medico-legal death investigation system in China.

    PubMed

    Chang, Lin; Zhang, Baosheng; Yan, Ping; Fowler, David; Li, Ling

    2011-07-01

    Medico-legal death investigation in China has a long history that can be traced back to the Chhin era in the third century BC. We conducted a national study on the current medico-legal death investigation system in China. Our study showed that, at present, medico-legal death investigations in China are conducted by c. 12,000 forensic medical experts mainly within five relatively independent agencies: the police organizations, the prosecutors' offices, the departments/divisions of forensic medicine/science in medical colleges and universities, the Institute of Forensic Science in the Ministry of Justice, and the government or private forensic societies. Owing to China's large population and area, the medico-legal death investigation is largely based on the administrative divisions. There is a wide variation in the scope, extent, and quality of investigations among the agencies and at the different levels of county/district, municipal, and provincial governments. This article gives a general overview of medicolegal death investigation in modern China.

  10. Why do residents fail to answer their clinical questions? A qualitative study of barriers to practicing evidence-based medicine.

    PubMed

    Green, Michael L; Ruff, Tanya R

    2005-02-01

    Physicians fail to pursue answers to most of their clinical questions, despite exhortations to practice evidence-based medicine (EBM). While studies have revealed several barriers practicing physicians experience in answering clinical questions, residents may encounter unique obstacles. The authors conducted a qualitative study to explore residents' experience in trying to answer their clinical questions. In 2003, the authors studied a convenience sample of 34 residents, representing 54% of the residents in a university-based internal medicine program. A professional facilitator convened and audiotaped three focus groups with the residents, following a discussion guide. The key question elicited the barriers residents encountered in attempting to answer their clinical questions. A thematic analysis of the transcripts was performed, using the constant comparison method of analysis. Two investigators met after independently analyzing each of the transcripts to compare coding structures, review theme exemplars, and reach consensus for differences. Eight main themes emerged that characterize the EBM barriers, including access to medical information, skills in searching information resources, clinical question tracking, time, clinical question priority, personal initiative, team dynamics, and institutional culture. The analysis suggested a conceptual model in which residents may encounter different barriers in every step of the EBM process. Furthermore, attitudinal or cultural barriers may lead a resident to abandon the pursuit of a question before some of the technical barriers would be encountered. Residents face several EBM barriers, some of which are unique to their status as trainees. While increased informatics training and reliable, rapid, and point-of-care access to electronic information resources remain necessary, they are not sufficient to help residents practice EBM. Educators must also attend to their attitudes toward learning and to the influence of

  11. Medico-legal education: a pilot curriculum to fill the identified knowledge gap.

    PubMed

    Evans, Adele; Refrow-Rutala, Donna

    2010-12-01

    We sought to determine if a medico-legal educational curriculum designed to increase physicians' familiarity with the legal system in a nonthreatening environment-a didactic and interactive educational seminar-would positively influence learners' knowledge base and self-awareness. Because neither the Accreditation Council for Graduate Medical Education nor its Residency Review Committees specifically addresses medico-legal liability education, we designed a 2-day intensive medico-legal educational curriculum and piloted it in 2007 and 2008 at a large academic tertiary-referral medical center. Postcurriculum evaluations and precurriculum and postcurriculum testing were used to identify areas of common and/or persisting knowledge deficit. A total of 50 graduating residents, fellows, and community practitioners participated in the course. Common areas of knowledge deficit were "privilege," "discovery," statutes of limitations, and basic legal procedure. Discordance in physician interpretation of patient perspective and misunderstanding among physicians of the impact of the legal suit were evident. Concentrated legal education at selected times during medical training may support physicians' motivations to improve the assurance of quality and continuity of care. We continue to revise the curriculum to address issues of lecturer style, lecture content, and overall attitudinal values related to clinical practice, legal education, long-term impact on practice patterns, job satisfaction and its effect on attention to quality and continuity-of-care issues, and health care provider attitudes about the provider's role within the legal system and the community. We plan to conduct follow-up of participants to assess retention and subsequent use of this knowledge.

  12. Medico-Legal Education: A Pilot Curriculum to Fill the Identified Knowledge Gap

    PubMed Central

    Evans, Adele; Refrow-Rutala, Donna

    2010-01-01

    Purpose We sought to determine if a medico-legal educational curriculum designed to increase physicians' familiarity with the legal system in a nonthreatening environment—a didactic and interactive educational seminar—would positively influence learners' knowledge base and self-awareness. Methods Because neither the Accreditation Council for Graduate Medical Education nor its Residency Review Committees specifically addresses medico-legal liability education, we designed a 2-day intensive medico-legal educational curriculum and piloted it in 2007 and 2008 at a large academic tertiary-referral medical center. Postcurriculum evaluations and precurriculum and postcurriculum testing were used to identify areas of common and/or persisting knowledge deficit. Results A total of 50 graduating residents, fellows, and community practitioners participated in the course. Common areas of knowledge deficit were “privilege,” “discovery,” statutes of limitations, and basic legal procedure. Discordance in physician interpretation of patient perspective and misunderstanding among physicians of the impact of the legal suit were evident. Conclusions Concentrated legal education at selected times during medical training may support physicians' motivations to improve the assurance of quality and continuity of care. We continue to revise the curriculum to address issues of lecturer style, lecture content, and overall attitudinal values related to clinical practice, legal education, long-term impact on practice patterns, job satisfaction and its effect on attention to quality and continuity-of-care issues, and health care provider attitudes about the provider's role within the legal system and the community. We plan to conduct follow-up of participants to assess retention and subsequent use of this knowledge. PMID:22132284

  13. Questioning in Tongan Science Classrooms: A Pilot Study to Identify Current Practice, Barriers and Facilitators

    ERIC Educational Resources Information Center

    Bay, Jacquie L.; Fohoko, Fehi; La'Akulu, Mumui; Leota, Ofa; Pulotu, Lesieli; Tu'Ipuloto, Sina; Tutoe, Salesi; Tovo, Oliveti; Vekoso, Ana; Pouvalu, Emeli H.

    2016-01-01

    Questioning is central to the development of scientific and health literacies. In exploring this concept, Tongan science teachers hypothesized that their ability to use and encourage questioning presented challenges in the context of Tongan social and cultural norms. This study set out to develop a peer-to-peer protocol to enable teachers to…

  14. Changes in Reference Question Complexity Following the Implementation of a Proactive Chat System: Implications for Practice

    ERIC Educational Resources Information Center

    Maloney, Krisellen; Kemp, Jan H.

    2015-01-01

    There has been longstanding debate about whether the level of complexity of questions received at reference desks and via online chat services requires a librarian's expertise. Continued decreases in the number and complexity of reference questions have all but ended the debate; many academic libraries no longer staff service points with…

  15. Changes in Reference Question Complexity Following the Implementation of a Proactive Chat System: Implications for Practice

    ERIC Educational Resources Information Center

    Maloney, Krisellen; Kemp, Jan H.

    2015-01-01

    There has been longstanding debate about whether the level of complexity of questions received at reference desks and via online chat services requires a librarian's expertise. Continued decreases in the number and complexity of reference questions have all but ended the debate; many academic libraries no longer staff service points with…

  16. Effect of question design on dietary information solicited during veterinarian-client interactions in companion animal practice in Ontario, Canada.

    PubMed

    MacMartin, Clare; Wheat, Hannah C; Coe, Jason B; Adams, Cindy L

    2015-06-01

    To establish the types of initial questions used by veterinarians in companion animal practice to solicit nutritional history information from owners of dogs and cats, the dietary information elicited, and the relationship between initial question-answer sequences and later nutrition-related questions. Cross-sectional qualitative conversation analytic study. 98 appointments featuring 15 veterinarians drawn from an observational study of 284 videotaped veterinarian-client-patient visits involving 17 veterinarians in companion animal practices in eastern Ontario, Canada. Veterinarian and client talk related to patient nutrition was identified and transcribed; conversation analysis was then used to examine the orderly design and details of talk within and across turns. Nutrition-related discussions occurred in 172 visits, 98 of which contained veterinarian-initiated question-answer sequences about patient nutritional history (99 sequences in total, with 2 sequences in 1 visit). The predominant question format used by veterinarians was a what-prefaced question asking about the current content of the patient's diet (75/99). Overall, 63 appointments involved a single what-prefaced question in the first turn of nutrition talk by the veterinarian (64 sequences in total). Dietary information in client responses was typically restricted to the brand name, the subtype (eg, kitten), or the brand name and subtype of a single food item. When additional diet questions were subsequently posed, they typically sought only clarification about the food item previously mentioned by the client. Results suggested that question design can influence the accuracy and completeness of a nutritional history. These findings can potentially provide important evidence-based guidance for communication training in nutritional assessment techniques.

  17. Journals publishing bio-medicolegal research in Europe.

    PubMed

    Boscolo-Berto, Rafael; Viel, Guido; Cecchi, Rossana; Terranova, Claudio; Vogliardi, Susanna; Bajanowski, Thomas; Ferrara, Santo Davide

    2012-01-01

    Fragmentation of bio-medicolegal knowledge has led to a proliferation of ultra-specialised sub-disciplines and branches, often published in 'field-oriented' scientific journals.The aim of this work is to provide an in-depth analytical picture of bio-medicolegal sources of publication, within and outside the traditional conception of legal medicine. An extensive search of bio-medicolegal articles published in the last five and a half years was performed on the MEDLINE database according to MeSH terms combined with free-text protocols. We performed a systematic analysis of targeted journals after merging, selecting and categorising all retrieved records, taking into account data from the 2009 JCR Science Edition (released on June 2010); 1,037 different journals were identified, of which only 48 (4.6%) focus specifically on bio-medicolegal matters, and of which only seven (14.6%) have an impact factor (IF). Despite this apparent dispersion, 47% of articles were published in bio-medicolegal journals (BML), of which 70.2% were in journals with IF (BML-IF). Articles published in BML-IF journals (33% of total papers) reach almost 50%, mainly in "Forensic Science International", "International Journal of Legal Medicine" and "Journal of Forensic Sciences". Instead, publications in not specifically bio-medicolegal journals (Not BML-IF) are greatly scattered and even fragmented in about 650 journals.The sub-disciplines that appear most frequently in Not BML-IF rather than BML-IF journals are Forensic Psychiatry (48.2% vs. 5.1%), Criminology (37.1% vs. 8.3%), Malpractice (50.7% vs. 4.0%), Medical Law and Ethics (46.4% vs. 6.9%) and Clinical Forensic Medicine (39.5% vs. 21.3%). The proposed bibliometric analysis revealed the preference of Forensic Pathology, Criminalistics (Biological), Forensic Genetics, Forensic Anthropology and Forensic Entomology for journals traditionally considered pertinent to the medico-legal discipline, with a considerable dispersion involving

  18. Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations.

    PubMed

    Leung, Lawrence

    2013-01-01

    With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach.

  19. Medical students' vs. family physicians' assessment of practical and logical values of pathophysiology multiple-choice questions.

    PubMed

    Secic, Damir; Husremovic, Dzenana; Kapur, Eldan; Jatic, Zaim; Hadziahmetovic, Nina; Vojnikovic, Benjamin; Fajkic, Almir; Meholjic, Amir; Bradic, Lejla; Hadzic, Amila

    2017-03-01

    Testing strategies can either have a very positive or negative effect on the learning process. The aim of this study was to examine the degree of consistency in evaluating the practicality and logic of questions from a medical school pathophysiology test, between students and family medicine doctors. The study engaged 77 family medicine doctors and 51 students. Ten questions were taken from cardiac pathophysiology and 10 questions from pulmonary pathophysiology, and each question was assessed on the criteria of practicality and logic. A nonparametric Mann-Whitney test was used to test the difference between evaluators. On the criteria of logic, only four out of 20 items were evaluated differently by students in comparison to doctors, two items each from the fields of cardiology and pulmonology. On the criteria of practicality, for six of the 20 items there were statistically significant differences between the students and doctors, with three items each from cardiology and pulmonology. Based on these indicative results, students should be involved in the qualitative assessment of exam questions, which should be performed regularly under a strictly regulated process.

  20. Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

    PubMed Central

    Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

    2009-01-01

    .036), ano-genital injuries alone (AOR 7.00, 95% CI 1.44–33.9, p = 0.017), or both nongenital and ano-genital injuries (AOR 12.34, 95% CI 2.87–53.0, p = 0.001). DNA was not associated with case outcome. Conclusions This is the first study, to our knowledge, to show an association between documentation of ano-genital injuries, trials commencing, and convictions in rape cases in a developing country. Its findings are of particular importance because they show the value of good basic medical practices in documentation of injuries, rather than more expensive DNA evidence, in assisting courts in rape cases. Health care providers need training to provide high quality health care responses after rape, but we have shown that the core elements of the medico-legal response require very little technology. As such they should be replicable in low- and middle-income country settings. Our findings raise important questions about the value of evidence that requires the use of forensic laboratories at a population level in countries like South Africa that have substantial inefficiencies in their police services. Please see later in the article for the Editors' Summary PMID:19823567

  1. Medical Students' vs. Family Physicians' Assessment of Practical and Logical Values of Pathophysiology Multiple-Choice Questions

    ERIC Educational Resources Information Center

    Secic, Damir; Husremovic, Dzenana; Kapur, Eldan; Jatic, Zaim; Hadziahmetovic, Nina; Vojnikovic, Benjamin; Fajkic, Almir; Meholjic, Amir; Bradic, Lejla; Hadzic, Amila

    2017-01-01

    Testing strategies can either have a very positive or negative effect on the learning process. The aim of this study was to examine the degree of consistency in evaluating the practicality and logic of questions from a medical school pathophysiology test, between students and family medicine doctors. The study engaged 77 family medicine doctors…

  2. Medical Students' vs. Family Physicians' Assessment of Practical and Logical Values of Pathophysiology Multiple-Choice Questions

    ERIC Educational Resources Information Center

    Secic, Damir; Husremovic, Dzenana; Kapur, Eldan; Jatic, Zaim; Hadziahmetovic, Nina; Vojnikovic, Benjamin; Fajkic, Almir; Meholjic, Amir; Bradic, Lejla; Hadzic, Amila

    2017-01-01

    Testing strategies can either have a very positive or negative effect on the learning process. The aim of this study was to examine the degree of consistency in evaluating the practicality and logic of questions from a medical school pathophysiology test, between students and family medicine doctors. The study engaged 77 family medicine doctors…

  3. Producing and Using Video Data in the Early Years: Ethical Questions and Practical Consequences in Research with Young Children

    ERIC Educational Resources Information Center

    Robson, Sue

    2011-01-01

    This article considers ethical questions and practical challenges arising from the production of video data with young children, and suggests that such considerations are reciprocal and that video data should be seen as constructed collaboratively by all participants. Video data can be a valuable means of eliciting children's perspectives, but it…

  4. Predicting self-reported research misconduct and questionable research practices in university students using an augmented Theory of Planned Behavior

    PubMed Central

    Rajah-Kanagasabai, Camilla J.; Roberts, Lynne D.

    2015-01-01

    This study examined the utility of the Theory of Planned Behavior model, augmented by descriptive norms and justifications, for predicting self-reported research misconduct and questionable research practices in university students. A convenience sample of 205 research active Western Australian university students (47 male, 158 female, ages 18–53 years, M = 22, SD = 4.78) completed an online survey. There was a low level of engagement in research misconduct, with approximately one in seven students reporting data fabrication and one in eight data falsification. Path analysis and model testing in LISREL supported a parsimonious two step mediation model, providing good fit to the data. After controlling for social desirability, the effect of attitudes, subjective norms, descriptive norms and perceived behavioral control on student engagement in research misconduct and questionable research practices was mediated by justifications and then intention. This revised augmented model accounted for a substantial 40.8% of the variance in student engagement in research misconduct and questionable research practices, demonstrating its predictive utility. The model can be used to target interventions aimed at reducing student engagement in research misconduct and questionable research practices. PMID:25983709

  5. Predicting self-reported research misconduct and questionable research practices in university students using an augmented Theory of Planned Behavior.

    PubMed

    Rajah-Kanagasabai, Camilla J; Roberts, Lynne D

    2015-01-01

    This study examined the utility of the Theory of Planned Behavior model, augmented by descriptive norms and justifications, for predicting self-reported research misconduct and questionable research practices in university students. A convenience sample of 205 research active Western Australian university students (47 male, 158 female, ages 18-53 years, M = 22, SD = 4.78) completed an online survey. There was a low level of engagement in research misconduct, with approximately one in seven students reporting data fabrication and one in eight data falsification. Path analysis and model testing in LISREL supported a parsimonious two step mediation model, providing good fit to the data. After controlling for social desirability, the effect of attitudes, subjective norms, descriptive norms and perceived behavioral control on student engagement in research misconduct and questionable research practices was mediated by justifications and then intention. This revised augmented model accounted for a substantial 40.8% of the variance in student engagement in research misconduct and questionable research practices, demonstrating its predictive utility. The model can be used to target interventions aimed at reducing student engagement in research misconduct and questionable research practices.

  6. Testing for Questionable Research Practices in a Meta-Analysis: An Example from Experimental Parapsychology

    PubMed Central

    Bierman, Dick J.; Spottiswoode, James P.; Bijl, Aron

    2016-01-01

    We describe a method of quantifying the effect of Questionable Research Practices (QRPs) on the results of meta-analyses. As an example we simulated a meta-analysis of a controversial telepathy protocol to assess the extent to which these experimental results could be explained by QRPs. Our simulations used the same numbers of studies and trials as the original meta-analysis and the frequencies with which various QRPs were applied in the simulated experiments were based on surveys of experimental psychologists. Results of both the meta-analysis and simulations were characterized by 4 metrics, two describing the trial and mean experiment hit rates (HR) of around 31%, where 25% is expected by chance, one the correlation between sample-size and hit-rate, and one the complete P-value distribution of the database. A genetic algorithm optimized the parameters describing the QRPs, and the fitness of the simulated meta-analysis was defined as the sum of the squares of Z-scores for the 4 metrics. Assuming no anomalous effect a good fit to the empirical meta-analysis was found only by using QRPs with unrealistic parameter-values. Restricting the parameter space to ranges observed in studies of QRP occurrence, under the untested assumption that parapsychologists use comparable QRPs, the fit to the published Ganzfeld meta-analysis with no anomalous effect was poor. We allowed for a real anomalous effect, be it unidentified QRPs or a paranormal effect, where the HR ranged from 25% (chance) to 31%. With an anomalous HR of 27% the fitness became F = 1.8 (p = 0.47 where F = 0 is a perfect fit). We conclude that the very significant probability cited by the Ganzfeld meta-analysis is likely inflated by QRPs, though results are still significant (p = 0.003) with QRPs. Our study demonstrates that quantitative simulations of QRPs can assess their impact. Since meta-analyses in general might be polluted by QRPs, this method has wide applicability outside the domain of experimental

  7. Testing for Questionable Research Practices in a Meta-Analysis: An Example from Experimental Parapsychology.

    PubMed

    Bierman, Dick J; Spottiswoode, James P; Bijl, Aron

    2016-01-01

    We describe a method of quantifying the effect of Questionable Research Practices (QRPs) on the results of meta-analyses. As an example we simulated a meta-analysis of a controversial telepathy protocol to assess the extent to which these experimental results could be explained by QRPs. Our simulations used the same numbers of studies and trials as the original meta-analysis and the frequencies with which various QRPs were applied in the simulated experiments were based on surveys of experimental psychologists. Results of both the meta-analysis and simulations were characterized by 4 metrics, two describing the trial and mean experiment hit rates (HR) of around 31%, where 25% is expected by chance, one the correlation between sample-size and hit-rate, and one the complete P-value distribution of the database. A genetic algorithm optimized the parameters describing the QRPs, and the fitness of the simulated meta-analysis was defined as the sum of the squares of Z-scores for the 4 metrics. Assuming no anomalous effect a good fit to the empirical meta-analysis was found only by using QRPs with unrealistic parameter-values. Restricting the parameter space to ranges observed in studies of QRP occurrence, under the untested assumption that parapsychologists use comparable QRPs, the fit to the published Ganzfeld meta-analysis with no anomalous effect was poor. We allowed for a real anomalous effect, be it unidentified QRPs or a paranormal effect, where the HR ranged from 25% (chance) to 31%. With an anomalous HR of 27% the fitness became F = 1.8 (p = 0.47 where F = 0 is a perfect fit). We conclude that the very significant probability cited by the Ganzfeld meta-analysis is likely inflated by QRPs, though results are still significant (p = 0.003) with QRPs. Our study demonstrates that quantitative simulations of QRPs can assess their impact. Since meta-analyses in general might be polluted by QRPs, this method has wide applicability outside the domain of experimental

  8. Group Billing for University Residence Hall Damages: A Common but Questionable Practice.

    ERIC Educational Resources Information Center

    Richmond, Douglas R.

    1989-01-01

    University residence hall administrators employ a variety of strategies, including group billing, to combat vandalism. Reviews theoretical and practical bases for group billing; examines potential challenges to the practice; and offers recommendations for residence administrators and university counsel. (MLF)

  9. The use of human samples obtained during medicolegal autopsies in research: An introduction to current conditions and initiatives in Japan.

    PubMed

    Tsujimura-Ito, Takako; Inoue, Yusuke; Muto, Kaori; Yoshida, Ken-Ichi

    2017-04-01

    Background Leftover samples obtained during autopsies are extremely important basic materials for forensic research. However, there are no established practices for research-related use of obtained samples. Objective This study discusses good practice for the secondary use of samples collected during medicolegal autopsies. Methods A questionnaire was posted to all 76 departments of forensic medicine performing medicolegal autopsies in Japan, and 48 responses were received (response rate: 63.2%). As a secondary analysis, we surveyed information provided on department websites. Results Ethical reviews conducted when samples were to be used for research varied greatly among departments, with 21 (43.8%) departments reporting 'fundamentally, all cases are subject to review', eight (16.7%) reporting 'only some are subject to review' and 17 (39.6%) reporting 'none are subject to review'. Information made available on websites indicated that 11 departments had a statement of some type to bereaved families about the potential research use of human samples obtained during autopsies. Nine of these included a notice stating that bereaved families may revoke their consent for use. Several departments used an opt-out system. Conclusion There is no common practice in the field of legal medicine on the ethical use for medical research of leftover samples from medicolegal autopsies. The trust of not only bereaved families but also society in general is required for the scientific validity and social benefits of medical studies using leftover samples from medicolegal autopsies through the use of opt-out consenting and offline and online dissemination and public-relations activities.

  10. Power and practices: questions concerning the legislation of health professions in Brazil.

    PubMed

    Velloso, Isabela S C; Ceci, Christine

    2015-07-01

    Developments in professional practice can be related to ongoing changes in relations of power among professionals, which often lead to changes in the boundaries of practices. The differing contexts of practices also influence these changing relations among health professionals. Legislation governing professional practice also differs from country to country. In Brazil, over the past 12 years, in a climate of deep disagreement, a new law to regulate medical practice has been discussed. It was sanctioned, or made into law, but with some notable changes, in July 2013. Of interest to us in this paper are the ways the proposed legislation, by setting out the boundaries and scope of medical practice, 'interfered' in the practices of other health professions, undermining many 'independent' practices that have developed over time. However, even taking into account the multiple routes through which practices are established and developed, the role of legislation that seems able to contradict and deny the historical realities of multiple, intersecting practices should be critically interrogated. In this paper, we use the theoretical resources of poststructuralist thinking to explore gaps, ambiguities, and power relations implicit in the discourses that constituted this law. We argue that although the new law can be understood as a social and political device that will interfere in the organization of other health professions' practices, such legislation is only part of what constitutes change in a consolidated professional practice. And while it is important to understand the effects of such legislation, healthcare practices are also realized or 'made real' through ongoing relations of knowledge and power, including, as we will see in this case, activities of resistance. The problem, then, is to understand the practical arrangements, including legislation, traditions and routines, values and knowledge that come to shape the practices of nursing in a particular context.

  11. Question Mapping

    ERIC Educational Resources Information Center

    Martin, Josh

    2012-01-01

    After accepting the principal position at Farmersville (TX) Junior High, the author decided to increase instructional rigor through question mapping because of the success he saw using this instructional practice at his prior campus. Teachers are the number one influence on student achievement (Marzano, 2003), so question mapping provides a…

  12. Question Mapping

    ERIC Educational Resources Information Center

    Martin, Josh

    2012-01-01

    After accepting the principal position at Farmersville (TX) Junior High, the author decided to increase instructional rigor through question mapping because of the success he saw using this instructional practice at his prior campus. Teachers are the number one influence on student achievement (Marzano, 2003), so question mapping provides a…

  13. Questioning the Character and Significance of Convergence between Social Network and Professional Practices in Teacher Education

    ERIC Educational Resources Information Center

    Turvey, Keith

    2012-01-01

    This paper captures and characterises the interplay between a group of student teachers' narratives of social network practice and their emergent professional practice with technologies. Teachers on an Initial Teacher Education programme in the UK spent a semester studying a module that synthesised university-based lectures with a professional…

  14. Questioning the Character and Significance of Convergence between Social Network and Professional Practices in Teacher Education

    ERIC Educational Resources Information Center

    Turvey, Keith

    2012-01-01

    This paper captures and characterises the interplay between a group of student teachers' narratives of social network practice and their emergent professional practice with technologies. Teachers on an Initial Teacher Education programme in the UK spent a semester studying a module that synthesised university-based lectures with a professional…

  15. Complexity Theory, School Leadership and Management: Questions for Theory and Practice

    ERIC Educational Resources Information Center

    Morrison, Keith

    2010-01-01

    Complexity theory (CT) has had a meteoric rise in management literature and the social sciences. Its fledgling importation into school leadership and management raises several questions and concerns. This article takes one view of CT and argues that, though its key elements have much to offer school leadership and management, caution has to be…

  16. The Theory Question in Research Capacity Building in Education: Towards an Agenda for Research and Practice

    ERIC Educational Resources Information Center

    Biesta, Gert; Allan, Julie; Edwards, Richard

    2011-01-01

    The question of capacity building in education has predominantly been approached with regard to the methods and methodologies of educational research. Far less attention has been given to capacity building in relation to theory. In many ways the latter is as pressing an issue as the former, given that good research depends on a combination of high…

  17. Complexity Theory, School Leadership and Management: Questions for Theory and Practice

    ERIC Educational Resources Information Center

    Morrison, Keith

    2010-01-01

    Complexity theory (CT) has had a meteoric rise in management literature and the social sciences. Its fledgling importation into school leadership and management raises several questions and concerns. This article takes one view of CT and argues that, though its key elements have much to offer school leadership and management, caution has to be…

  18. Questions About Cervical and Breast Cancer Screening Knowledge, Practice, and Outcomes: A Review of Demographic and Health Surveys.

    PubMed

    Viens, Laura; Perin, Doug; Senkomago, Virginia; Neri, Antonio; Saraiya, Mona

    2017-05-01

    United Nation's Sustainable Development Goals and the World Health Organization's Global Monitoring Framework support a strong global commitment to reducing the high burden of cervical and breast cancers among low- and middle-income countries. Strategies include vaccination, screening, and early diagnosis. Population-based surveys, such as those conducted by the Demographic and Health Surveys (DHS) Program, can collect the information needed to guide cancer control efforts in a standardized comparable manner. We identified and evaluated the breadth of breast and cervical cancer screening information that was collected by the DHS from 1984 through 2015. Then, we determined if these surveys currently provide the specific and measurable data about both the quantity and quality of cancer screening needed to guide national efforts to reduce the overall effects of cervical and breast cancers. We searched the DHS website to identify surveys conducted between the start of the DHS Program in 1984 and November 2015 that included questions about breast and cervical cancer screening. The relevant questions were extracted from the questionnaire, translated into English, and grouped by themes. Of the 90 countries where DHS surveys have been implemented, cervical cancer screening questions were included in 22 countries (24.4%) and breast cancer screening questions in 18 countries (20.0%). The common themes identified were disease knowledge, screening knowledge, screening practice, and screening outcomes. Most countries with survey questionnaires available for review addressed at least one aspect of screening practice (88.9% of cervical and 87.5% of breast), although few countries queried knowledge and outcomes. Questions that assess varied aspects of breast and cervical cancer screening have been incorporated into relatively few DHS surveys. The themes identified could guide the design of a standard set of questions for use in future population-based surveys and enable evaluation

  19. Distribution of Practice in Motor Skill Acquisition: A Few Questions and Comments.

    ERIC Educational Resources Information Center

    Ammons, R. B.

    1988-01-01

    A review and commentary on the previous article discusses the effects of stabilized retinal images on performance and the perceptual organization of a patterned skill. Future research on distribution-of-practice is considered. (JD)

  20. [Practical approach to management of gynecomastia: six questions to be answered by the paediatrician regarding a patient with gynecomastia].

    PubMed

    2011-08-01

    Pubertal gynecomastia is a common concern in the consultation of the adolescent. Usually, it is accompanied by an emotional component that can lead to changes in everyday attitudes of youth. The responsability of the pediatrician is to rule out other etiologies, to avoid unnecessary additional studies, to limit active therapeutic attitudes, and to reaffirm the variation of normality. We briefly describe six eminently practical questions to be answered by the physician.

  1. A practical discussion to avoid common pitfalls when constructing multiple choice questions items

    PubMed Central

    Al-Faris, Eiad A.; Alorainy, Ibrahim A.; Abdel-Hameed, Ahmad A.; Al-Rukban, Mohammed O.

    2010-01-01

    This paper is an attempt to produce a guide for improving the quality of Multiple Choice Questions (MCQs) used in undergraduate and postgraduate assessment. Multiple Choice Questions type is the most frequently used type of assessment worldwide. Well constructed, context rich MCQs have a high reliability per hour of testing. Avoidance of technical items flaws is essential to improve the validity evidence of MCQs. Technical item flaws are essentially of two types (i) related to testwiseness, (ii) related to irrelevant difficulty. A list of such flaws is presented together with discussion of each flaw and examples to facilitate learning of this paper and to make it learner friendly. This paper was designed to be interactive with self-assessment exercises followed by the key answer with explanations. PMID:21359033

  2. The RCP's 'Three Key Questions' for asthma: review of practical use.

    PubMed

    Steven, K; Neville, R G; Hoskins, G; Sullivan, F M; Drummond, N; Alder, E M

    2002-06-01

    Assessment tools are a vital component of chronic disease management. The Royal College of Physicians has developed a patient-focused outcome measure for the treatment of asthma, the 'Three Key Questions'. However, in a study investigating the goals of people with asthma, several issues related to the tool emerged. Forty-seven adults of a range of ages and asthma severity but with no significant co-morbidity were interviewed. It emerged that the outcome measure may be subject to recall bias. Also, symptom reports may be conflated if daytime symptoms also occur with activity. 'Interference with activity' is a subjective term the interpretation of which varies considerably. Changes in the level of activity undertaken may be reported rather than changes in symptom severity. The 'Three Key Questions' are not fully patient-centred because they assess the presence of symptoms rather than their importance to the individual. The use of the 'Three Key Questions' as an outcome measure may not allow valid comparisons to be made between settings.

  3. Alcohol in a series of medico-legally autopsied deaths in northern Norway 1973-1992.

    PubMed

    Nordrum, I; Eide, T J; JŁrgensen, L

    2000-05-15

    It is well established that use of alcohol increases the risk of fatal injuries. The presence of blood alcohol in autopsied deaths is regularly encountered in medico-legal practices. The aim of this study was to investigate the prevalence and concentration of alcohol in 1539 medico-legal autopsies in two counties in northern Norway in the period 1973-1992, and the reporting of acute alcohol influence among these deaths to the official cause-of-death statistics. Blood alcohol concentration (BAC) >/=0.5 per thousand (50 mg/100 ml) was found in 47.6% (n=456) of violent deaths tested, and in 93% (n=426) of these the BAC was >/=1.0 per thousand. In 17.4% (n=55) of tested natural deaths the BAC was >/=0.5 per thousand. Acute alcohol-influenced violent deaths were under-reported to the cause-of-death statistics. Deaths by motor vehicle traffic accidents did not differ from other violent deaths in this respect. The under-reporting among violent deaths was 41% in cases with BAC >/=0. 5 per thousand and 37% where the BAC was >/=1.0 per thousand during the whole period. It is concluded that post-mortem BAC >/=0.5 per thousand, should be regarded as a possible contributory cause in all violent deaths, and reported accordingly.

  4. [Medico-legal opinions in penal cases provided by clinicians and forensic medicine specialists--comparative analysis].

    PubMed

    Chowaniec, Czesław; Chowaniec, Małgorzata; Nowak, Agnieszka

    2005-01-01

    From the practice of the Forensic Medicine Department, Medical University of Silesia, Katowice it appears that in criminal cases the level of medico-legal opinions provided by experts appointed by the district court or 'ad hoc' is very low. The analysis of the chosen files shoved a divergence of opinions given to the adopted motions as well as numerous offences to regulations in the nature of a consultative error. In the paper the authors have made an attempt to appraise causes of the above mentioned problems such as: 1. the lack of medico-legal knowledge and experience in court experts. 2. excessive ease of registration to the panel of court experts and the lack of processes which verify the qualifications of experts. 3. the lack of judicial control over expert's opinions and common acceptance of their work. 4. ignorance of the obligatory penal law. 5. ignorance of the basic rules for giving medico-legal opinions (legal consequences, casual nexus). 6. excessive but groundless self-confidence in experts. 7. the lack of a correct way of thinking and conclusion making. The aim of the paper was to pay close attention to the absolute need of verification of court experts' qualifications and work.

  5. Molecular biology in marine science: Scientific questions, technological approaches, and practical implications

    SciTech Connect

    1994-12-31

    The ocean plays an important role in regulating the earth`s climate, sustains a large portion of the earth`s biodiversity, is a tremendous reservoir of commercially important substances, and is used for a variety of often conflicting purposes. In recent decades marine scientists have discovered much about the ocean and its organisms, yet many important fundamental questions remain unanswered. Human populations have increased, particularly in coastal regions. As a result, the marine environment in these areas is increasingly disrupted by human activities, including pollution and the depletion of some ecologically and commercially important species. There is a sense of urgency about reducing human impacts on the ocean and a need to understand how altered ecosystems and the loss of marine species and biodiversity could affect society. During the past two decades, the development of sophisticated technologies and instruments for biomedical research has resulted in significant advances in the biological sciences. While some of these technologies have been readily incorporated into the study of marine organisms as models for understanding basic biology, the value of molecular techniques for addressing problems in marine biology and biological oceanography has only recently begun to be appreciated. This report defines critical scientific questions in marine biology and biological oceanography, describes the molecular technologies that could be used to answer these questions, and discusses some of the implications and economic opportunities that might result from this research which could potentially improve the international competitive position of the United States in the rapidly growing area of marine biotechnology. The committee recommends that the federal government provide the infrastructure necessary to use the techniques of molecular biology in the marine sciences.

  6. The Impact of the Assessment of Practice Teaching on Beginning Teaching: Learning To Ask Different Questions.

    ERIC Educational Resources Information Center

    Orland-Barak, Lily

    2002-01-01

    Examined the impact of student teaching assessment on teaching and the synchrony between assessment and performance in passing from practice teaching to teaching, noting the perspectives of five outstanding student teachers. Data from portfolios, evaluation forms, feedback sessions, interviews, and written stories highlighted how students teachers…

  7. A System for Individualizing Instruction. Practical Answers to U-SAIL Implementation Questions. Monograph No. 4.

    ERIC Educational Resources Information Center

    Utah System Approach to Individualized Learning Project.

    The U-SAIL system is a practical approach to individualization of instruction in which a problem-solving process is employed to install a program in logical sequential phases. U-SAIL is a nationally validated, successfully replicated, cost-feasible system for individualization of instruction which can be implemented in a variety of settings with…

  8. Training Design Conception and Reflexive Practice: How to Answer Teachers' Questions?

    ERIC Educational Resources Information Center

    Clottu, Régine

    2017-01-01

    This research studies the practices related to the conception of training "on demand" in the field of continuous training of teachers. Training "on demand" adapts itself to the problems of professionals. The analysis of the demand faces the complexity of the different contexts as well as the diversity of professionals'…

  9. The Impact of Game Sense Pedagogy on Australian Rugby Coaches' Practice: A Question of Pedagogy

    ERIC Educational Resources Information Center

    Light, Richard Lawrence; Robert, John Evans

    2010-01-01

    Background: Recent developments in games and sport teaching such as that of Teaching Games for Understanding, Play Practice and Game Sense suggest that they can make a significant contribution toward the development of tactical understanding, ability to read the game, decision-making and a general "sense of the game", yet empirical…

  10. Questioning a Discourse of Information Literacy Practice in Web-Based Tutorials

    ERIC Educational Resources Information Center

    Schreiber, Trine

    2013-01-01

    Introduction: A number of Scandinavian Web-based tutorials on information seeking mediate a kind of discourse of information literacy practice by combining the two themes, written academic assignment and information seeking. The aim of the paper is first to examine students' experience of the pragmatic value of two of these Web-based tutorials,…

  11. Creating a Living Educational Theory from Questions of the Kind, "How Do I Improve My Practice?"

    ERIC Educational Resources Information Center

    Whitehead, Jack

    1989-01-01

    Explains how educators can create a living educational theory and improve their practice by reflecting on the improvement process. Reflection must focus on areas like acknowledging one's existence as a living contradiction, showing values in action, and determining which power relations influence the academic legitimacy of a living educational…

  12. Evaluating the Effectiveness of Combining the Use of Corrective Feedback and High-Level Practice Questions

    ERIC Educational Resources Information Center

    Fenesi, Barbara; Sana, Faria; Kim, Joseph A.

    2014-01-01

    A growing trend in teaching practices is to combine instructional techniques to optimize learning. If two instructional techniques can independently facilitate comprehension, it may be reasonable to assume that their combination would contribute to even greater learning. Here we examine the effects of using corrective feedback (present or absent)…

  13. Sociomaterial Texts, Spaces and Devices: Questioning "Digital Dualism" in Library and Study Practices

    ERIC Educational Resources Information Center

    Gourlay, Lesley; Lanclos, Donna M.; Oliver, Martin

    2015-01-01

    Work on students' study practices posits the digital and material as separate domains, with the "digital" assumed to be disembodied, decontextualised and free-floating, and spaces in the material campus positioned as prototypically "traditional" and analogue. Libraries in particular are often characterised as symbolic of…

  14. Sociomaterial Texts, Spaces and Devices: Questioning "Digital Dualism" in Library and Study Practices

    ERIC Educational Resources Information Center

    Gourlay, Lesley; Lanclos, Donna M.; Oliver, Martin

    2015-01-01

    Work on students' study practices posits the digital and material as separate domains, with the "digital" assumed to be disembodied, decontextualised and free-floating, and spaces in the material campus positioned as prototypically "traditional" and analogue. Libraries in particular are often characterised as symbolic of…

  15. Molecular biology in marine science: Scientific questions, technological approaches, and practical implications

    SciTech Connect

    Not Available

    1994-12-31

    The ocean plays an important role in regulating the earth`s climate, sustains a large portion of the earth`s biodiversity, is a tremendous reservoir of commercially important substances, and is used for a variety of often conflicting purposes. In recent decades marine scientists have discovered much about the ocean and its organisms, yet many important fundamental questions remain unanswered. Human populations have increased, particularly in coastal regions. As a result, the marine environment in these areas is increasingly disrupted by human activities, including pollution and the depletion of some ecologically and commercially important species. There is a sense of urgency about reducing human impacts on the ocean and a need to understand how altered ecosystems and the loss of marine species and biodiversity could affect society. This report describes molecular techniques that could be invaluable in addressing process-oriented problems in the ocean sciences that have perplexed oceanographers for decades, such as understanding the basis for biogeochemical processes, recruitment processes, upper-ocean dynamics, biological impacts of global warming, and ecological impacts of human activities. The coupling of highly sophisticated methods, such as satellite remote sensing, which permits synoptic monitoring of chemical, physical, and biological parameters over large areas, with the power of modern molecular tools for ground truthing at small scales could allow scientists to address questions about marine organisms and the ocean in which they live that could not be answered previously.

  16. Playing with Data--Or How to Discourage Questionable Research Practices and Stimulate Researchers to Do Things Right.

    PubMed

    Sijtsma, Klaas

    2016-03-01

    Recent fraud cases in psychological and medical research have emphasized the need to pay attention to Questionable Research Practices (QRPs). Deliberate or not, QRPs usually have a deteriorating effect on the quality and the credibility of research results. QRPs must be revealed but prevention of QRPs is more important than detection. I suggest two policy measures that I expect to be effective in improving the quality of psychological research. First, the research data and the research materials should be made publicly available so as to allow verification. Second, researchers should more readily consider consulting a methodologist or a statistician. These two measures are simple but run against common practice to keep data to oneself and overestimate one's methodological and statistical skills, thus allowing secrecy and errors to enter research practice.

  17. The assessment of critical thinking skills in anatomy and physiology students who practice writing higher order multiple choice questions

    NASA Astrophysics Data System (ADS)

    Shaw, Jason

    Critical thinking is a complex abstraction that defies homogeneous interpretation. This means that no operational definition is universal and no critical thinking measurement tool is all encompassing. Instructors will likely find evidence based strategies to facilitate thinking skills only as numerous research efforts from multiple disciplines accumulate. This study focuses on a question writing exercise designed to help anatomy and physiology students. Students were asked to design multiple choice questions that combined course concepts in new and novel ways. Instructions and examples were provided on how to construct these questions and student attempts were sorted into levels one through three of Bloom's Cognitive Taxonomy (Bloom et al. 1956). Students submitted their question designs weekly and received individual feedback as to how they might improve. Eight course examinations were created to contain questions that modeled the Bloom's Cognitive Taxonomy levels that students were attempting. Students were assessed on their course examination performance as well as performance on a discipline independent critical thinking test called the California Critical Thinking Skills Test (CCTST). The performance of students in this study was compared to students from two previous years that took the same course but did not have the question writing activity. Results suggest that students do not improve their ability to answer critical thinking multiple choices questions when they practice the task of creating such problems. The effect of class level on critical thinking is examined and it appears that the longer a student has attended college the better the performance on both discipline specific and discipline independent critical thinking questions. The data were also used to analyze students who improved their course examination grades in the second semester of this course. There is a pattern to suggest that students who improve their performance on course examinations

  18. An evidence-based approach to clinical questions in the practice of equine neurology.

    PubMed

    Van Biervliet, Jérôme

    2007-08-01

    The practice of equine neurology has special challenges posed by the size of the animal being examined. Many diagnostic procedures routinely used in small animal practice are unsafe when applied to the equine patient or unavailable to the equine practitioner. Therefore, astute observation is the mainstay of making a neuroanatomic diagnosis, and detailed evidence on the deficits present may be difficult to obtain. Because clinical observation can sometimes be ambiguous and somewhat subjective, it is even more important to approach equine neurology from an evidence-based point of view. Here, such an approach is outlined for the diagnosis of cervical vertebral compressive myelopathy (CVCM), one of the most common noninfectious causes of equine neurologic disease. This article is an attempt to summarize all aspects of making a diagnosis of CVCM on the basis of signalment, clinical examination, ancillary diagnostic tests, and pathologic examination. Each of these considerations has inherent limitations regarding diagnostic accuracy, which are discussed.

  19. Contemplation on marking scheme for Type X multiple choice questions, and an illustration of a practically applicable scheme

    PubMed Central

    Siddiqui, Nazeem Ishrat; Bhavsar, Vinayak H.; Bhavsar, Arnav V.; Bose, Sukhwant

    2016-01-01

    Ever since its inception 100 years back, multiple choice items have been widely used as a method of assessment. It has certain inherent limitations such as inability to test higher cognitive skills, element of guesswork while answering, and issues related with marking schemes. Various marking schemes have been proposed in the past but they are not balanced, skewed, and complex, which are based on mathematical calculations which are typically not within the grasp of medical personnel. Type X questions has many advantages being easy to construct, can test multiple concepts/application/facets of a topic, cognitive skill of various level of hierarchy can be tested, and unlike Type K items, they are free from complicated coding. In spite of these advantages, they are not in common use due to complicated marking schemes. This is the reason we explored the aspects of methods of evaluation of multiple correct options multiple choice questions and came up with the simple, practically applicable, nonstringent but logical scoring system for the same. The rationale of the illustrated marking scheme is that it takes into consideration the distracter recognition ability of the examinee rather than relying on the ability only to select the correct response. Thus, examinee's true knowledge is tested, and he is rewarded accordingly for selecting a correct answer and omitting a distracter. The scheme also penalizes for not recognizing a distracter thus controlling guessing behavior. It is emphasized that if the illustrated scoring scheme is adopted, then Type X questions would come in common practice. PMID:27127312

  20. Contemplation on marking scheme for Type X multiple choice questions, and an illustration of a practically applicable scheme.

    PubMed

    Siddiqui, Nazeem Ishrat; Bhavsar, Vinayak H; Bhavsar, Arnav V; Bose, Sukhwant

    2016-01-01

    Ever since its inception 100 years back, multiple choice items have been widely used as a method of assessment. It has certain inherent limitations such as inability to test higher cognitive skills, element of guesswork while answering, and issues related with marking schemes. Various marking schemes have been proposed in the past but they are not balanced, skewed, and complex, which are based on mathematical calculations which are typically not within the grasp of medical personnel. Type X questions has many advantages being easy to construct, can test multiple concepts/application/facets of a topic, cognitive skill of various level of hierarchy can be tested, and unlike Type K items, they are free from complicated coding. In spite of these advantages, they are not in common use due to complicated marking schemes. This is the reason we explored the aspects of methods of evaluation of multiple correct options multiple choice questions and came up with the simple, practically applicable, nonstringent but logical scoring system for the same. The rationale of the illustrated marking scheme is that it takes into consideration the distracter recognition ability of the examinee rather than relying on the ability only to select the correct response. Thus, examinee's true knowledge is tested, and he is rewarded accordingly for selecting a correct answer and omitting a distracter. The scheme also penalizes for not recognizing a distracter thus controlling guessing behavior. It is emphasized that if the illustrated scoring scheme is adopted, then Type X questions would come in common practice.

  1. Molecular biology in marine science: Scientific questions, technological approaches, and practical implications

    SciTech Connect

    1994-12-31

    This report describes molecular techniques that could be invaluable in addressing process-oriented problems in the ocean sciences that have perplexed oceanographers for decades, such as understanding the basis for biogeochemical processes, recruitment processes, upper-ocean dynamics, biological impacts of global warming, and ecological impacts of human activities. The coupling of highly sophisticated methods, such as satellite remote sensing, which permits synoptic monitoring of chemical, physical, and biological parameters over large areas, with the power of modern molecular tools for ``ground truthing`` at small scales could allow scientists to address questions about marine organisms and the ocean in which they live that could not be answered previously. Clearly, the marine sciences are on the threshold of an exciting new frontier of scientific discovery and economic opportunity.

  2. Medicolegal investigation of political killings in El Salvador.

    PubMed

    Thomsen, J L; Gruschow, J; Stover, E

    1989-06-17

    An axiom of Thomas Hobbes states that "people are never more helpless than when the force meant to protect their rights turns against them." Hobbes' axiom holds true today, with Amnesty International reporting that hundreds of thousands have been murdered by their governments. This article examines the medicolegal aspects of an investigation into the deaths of two Salvadoran peasants who were reportedly tortured and executed by soldiers in February 1988. One of the authors, Thomsen, participated in the investigation as a court-ordered expert, and as a representative of the American Association for the Advancement of Science and of a Salvadoran legal aid organization. His necropsy findings are reported with observations and comments. The article concludes with suggestions for initiatives that might be undertaken by individual physicians and institutions to improve the quality and impartiality of medicolegal investigations into political killings.

  3. Applications of social network media in medicolegal death investigation.

    PubMed

    Hookano, Ryan; Knight, Laura D; Brunelli, Ronald A; Stoppacher, Robert

    2013-11-01

    With the increased popularity of online social networking services (SNS) such as Facebook, LinkedIn, Twitter, and Google+, we propose that a wealth of new resources is available for medicolegal death investigation. Recognizing this potential, we identified cases in which social media had been useful in the past in our office and asked our investigative staff to consider using social media in current cases. These cases provided illustrative examples for this primer regarding how information from SNS was used in death investigations in our office. Information gleaned from online social media aided in establishing preliminary identification of a decedent, locating next-of-kin, investigating the circumstances of death as relevant to the manner of death, corroborating eyewitness accounts, and providing information relevant to time of death. Potential pitfalls were identified, such as shared accounts or online impostors. SNS proved useful to the medicolegal death investigator and medical examiner, so long as their limitations were recognized.

  4. Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations

    PubMed Central

    Leung, Lawrence

    2013-01-01

    With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach. PMID:26317093

  5. Imaging of body packing: errors and medico-legal issues.

    PubMed

    Reginelli, Alfonso; Russo, Anna; Urraro, Fabrizio; Maresca, Duilia; Martiniello, Ciro; D'Andrea, Alfredo; Brunese, Luca; Pinto, Antonio

    2015-10-01

    Body packing is the ingestion or insertion in the human body of packed illicit substances. Over the last 20 years, drug smuggling has increased global and new means of transport of narcotics have emerged. Among these, the most frequent one is the gastrointestinal tract: from mouth to anus, vagina, and ears. Cocaine is one of the most traded drugs, followed by heroin. Condoms, latex gloves, and balloons are typically used as drug packets for retention in the body. There are different radiologic modalities to detect illicit drugs in body packing: Plain radiography, computed tomography (CT), ultrasound, and magnetic resonance. Current protocols recommend the use of radiography to confirm packet retention and, in case of doubt, the use of abdominal CT scan with reduced mAs. In case of packet rupture, catastrophic effects can occur. Management of patients carrying packets of drugs is a recurrent medico-legal problem. To improve diagnostic accuracy and prevent hazardous complications, radiologists and emergency physicians should be familiar with radiologic features of body packing. The radiologist plays both a social and a medico-legal role in their assessment, and it should not be limited only to the identification of the packages but must also provide accurate information about their number and their exact location. In this review, we focus on diagnostic errors and medico-legal issues related to the radiological assessment of body packers.

  6. [Nursing and the environmental question: proposal of a theoretical model for the professional practice].

    PubMed

    Ribeiro, M C; Bertolozzi, M R

    1999-01-01

    Considering the side effects of environmental changes over the population's health, a theoretical model is proposed in this study in order to incorporate ecologic matters into the nursing practices. The reference for this work is the eco-socialist-marxist theory. The model is based on the analysis of the capitalist economic process, its production technologies and consumption. It is known that this economic model generates ecoinequalities and anthropogenic impacts that rebound on the health-disease profile of the population. The nursing action, permeated by ecological awareness, can prevent and also combat ecoinequalities and destructive human actions on the environment.

  7. Ask Questions to Encourage Questions Asked

    ERIC Educational Resources Information Center

    belcastro, sarah-marie

    2017-01-01

    We delineate some types of structured practice (modeling, requests, feedback, and space-making) that help students learn to pose appropriate questions and to initiate exploration of those questions. Developing skills requires practice, so we suggest ways to embed structured practice into existing class sessions. Including structured practice is…

  8. Ask Questions to Encourage Questions Asked

    ERIC Educational Resources Information Center

    belcastro, sarah-marie

    2017-01-01

    We delineate some types of structured practice (modeling, requests, feedback, and space-making) that help students learn to pose appropriate questions and to initiate exploration of those questions. Developing skills requires practice, so we suggest ways to embed structured practice into existing class sessions. Including structured practice is…

  9. When does the 'learning curve' of innovative interventions become questionable practice?

    PubMed

    Healey, P; Samanta, J

    2008-09-01

    Demand for less invasive surgical intervention has increased in recent years resulting in surgeons occasionally being pressurised into adopting new techniques before evidence of safety and efficacy has been established. Unlike pharmaceutical research, most innovative surgical procedures enter surgical practice without regulatory oversight. This anomaly was recently highlighted in the 'Bristol Report' resulting in a recommendation that unproven therapies or surgical techniques be subjected to ethical overview or independent oversight. When a novel technique is introduced, the surgeon will find himself/herself gaining proficiency and experience on suitable patients. Hence the surgeon embarks on a 'learning curve'. A learning curve can be defined as a graphic representation showing the relationship between experience with a procedure and outcome. Studies demonstrate that learning curves generally 'flatten out' as experience increases, resulting in fewer complications and less of a need to convert to the standard procedure. In addition to lack of regulatory oversight, it is this learning curve that gives rise to many ethical and legal dilemmas. This paper considers the ethical issues relating to a surgeon's candour and clinical equipoise, the legal standard of care in a negligence action and the ethical and legal implications regarding risk disclosure during informed consent. The paper concludes by considering a more patient centred approach where new and innovative therapies are being considered in order to ensure good medical practice and avoid litigation for allegations of negligence or breach of human rights.

  10. Best practices to identify gay, lesbian, bisexual, or questioning youth in primary care.

    PubMed

    Chaplic, Kyle C; Allen, Patricia Jackson

    2013-01-01

    Compared to heterosexual youth, gay, lesbian, bisexual, and questioning (GLBQ) adolescents engage disproportionately in a variety of health risk behaviors and are at risk for numerous negative health outcomes. Adolescents reporting same-sex sexual attraction, romantic relationships, and sexual experience are also at increased risk, regardless of self-identified sexual orientation. While adolescents feel it is important to discuss sexuality with primary care providers, they are unlikely to initiate discussion about sexuality or to openly disclose GLBQ sexual orientation to their providers. Primary care providers should identify GLBQ youth to increase delivery of targeted preventive health services to this at-risk population. However, providers do not routinely address sexual orientation in their clinical encounters with adolescents, and the majority of GLBQ youth are not identified in the primary care setting. To better serve the needs of this population, providers should initiate open, sensitive, nonjudgmental, and confidential discussion of sexuality with all adolescents. Providers should inquire about sexual orientation, sexual attraction, romantic relationships, and sexual partners.

  11. Rural healthcare providers question the practicality of motivational interviewing and report varied physical activity counseling experience.

    PubMed

    Miller, Stephania T; Beech, Bettina M

    2009-08-01

    To evaluate rural healthcare providers (HCP) physical activity (PA) counseling experiences and perceptions of motivational interviewing (MI), a behavioral counseling style, prior to MI training. Four moderator-led focus groups were conducted among rural HCPs providing care to rural African American women with Type 2 diabetes. Questions about experiences with PA counseling in this patient population were asked. Following a DVD demonstration of a MI patient/provider consultation, MI impressions were solicited. Focus groups data were transcribed verbatim. Content-based analysis was conducted using qualitative data analysis software, Atlas.ti., and thematic coding by two analysts. Thirty-three HCPs (64% nurses) participated. Fifty-five percent reported little or no PA counseling comfort due to either the lack of knowledge of PA recommendations or individual challenges in being physically active. MI was viewed as a potentially effective communication approach (positive impression theme). However, HCPs voiced concern about the limited input of the provider during the MI consultation (disadvantage theme) and the feasibility of implementing MI in healthcare settings (disadvantage theme). Future studies should evaluate whether integrating, into MI training, information about previous PA counseling experiences and impressions of MI from rural HCPs truly increases the effectiveness of MI training and subsequent PA interventions.

  12. Questioning the Questions

    ERIC Educational Resources Information Center

    Tienken, Christopher H.; Goldberg, Stephanie; DiRocco, Dominic

    2010-01-01

    Historical accounts of questioning used in the education process trace back to Socrates. One of the best examples of his use of questioning is found in Plato's "The Republic." Socrates used a series of strategic questions to help his student Glaucon come to understand the concept of justice. Socrates purposefully posed a series of…

  13. Questioning the Questions

    ERIC Educational Resources Information Center

    Tienken, Christopher H.; Goldberg, Stephanie; DiRocco, Dominic

    2010-01-01

    Historical accounts of questioning used in the education process trace back to Socrates. One of the best examples of his use of questioning is found in Plato's "The Republic." Socrates used a series of strategic questions to help his student Glaucon come to understand the concept of justice. Socrates purposefully posed a series of…

  14. Questioning the Questions

    ERIC Educational Resources Information Center

    Tienken, Christopher H.; Goldberg, Stephanie; DiRocco, Dominic

    2009-01-01

    Well-known historical accounts of questioning used in the education process trace back to Socrates. One of the best examples of his use of questioning is found in Plato's classic work "The Republic" (2003). Today, teachers still use questions as one way to help students develop productive thinking skills and to understand concepts and topics.…

  15. The importance of medico-legal evaluation in a case with intraabdominal gossypiboma.

    PubMed

    Uluçay, Tarik; Dizdar, Mustafa Gökhan; SunayYavuz, Mehmet; Aşirdizer, Mahmut

    2010-05-20

    Data concerning the incidence of gossypiboma tend to fluctuate and is difficult to estimate because of a low reporting rate lest medico-legal implication. Gossypiboma is frequently located in the abdominal and pelvic cavities after gynecologic and upper abdominal surgical operations but can also follow thoracic, orthopedic, and urological and neurosurgical procedures. In medical literature, there are few articles about the medico-legal evaluation of gossypiboma although it is typically subjected to a medico-legal process. In this article, we reported a 22-year-old female case with intraabdominal gossypiboma following a cesarean procedure and discussed the importance of medico-legal evaluation of gossypiboma.

  16. Modular projects and 'mean questions': best practices for advising an International Genetically Engineered Machines team.

    PubMed

    Tsui, Jennifer; Meyer, Anne S

    2016-07-01

    In the yearly Internationally Genetically Engineered Machines (iGEM) competition, teams of Bachelor's and Master's students design and build an engineered biological system using DNA technologies. Advising an iGEM team poses unique challenges due to the inherent difficulties of mounting and completing a new biological project from scratch over the course of a single academic year; the challenges in obtaining financial and structural resources for a project that will likely not be fully realized; and conflicts between educational and competition-based goals. This article shares tips and best practices for iGEM team advisors, from two team advisors with very different experiences with the iGEM competition. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. A primer on selected aspects of evidence-based practice to questions of treatment. Part 2: interpreting results, application to clinical practice, and self-evaluation.

    PubMed

    Noteboom, J Timothy; Allison, Stephen C; Cleland, Joshua A; Whitman, Julie M

    2008-08-01

    The process of evidence-based practice (EBP) guides clinicians in the integration of individual clinical expertise, patient values and expectations, and the best available evidence. Becoming proficient with this process takes time and consistent practice, but should ultimately lead to improved patient outcomes. The EBP process entails 5 steps: (1) formulating an appropriate question, (2) performing an efficient literature search, (3) critically appraising the best available evidence, (4) applying the best evidence to clinical practice, and (5) assessing outcomes of care. This second commentary in a 2-part series will review principles relating to steps 3 through 5 of this 5-step model. The purpose of this commentary is to provide a perspective to assist clinicians in interpreting results, applying the evidence to patient care, and evaluating proficiency with EBP skills in studies of interventions for orthopaedic and sports physical therapy.

  18. Four Questions

    ERIC Educational Resources Information Center

    Hark-Weber, Amara G., Ed.

    2013-01-01

    Teaching artists often find themselves working in schools and communities that are new to them, whether these are situations close to home or farther afield. This issue of Four Questions highlights teaching artists who travel extensively as part of their teaching and artistic practices and bring their expertise, energy, and creativity to…

  19. Four Questions

    ERIC Educational Resources Information Center

    Hark-Weber, Amara G., Ed.

    2013-01-01

    Teaching artists often find themselves working in schools and communities that are new to them, whether these are situations close to home or farther afield. This issue of Four Questions highlights teaching artists who travel extensively as part of their teaching and artistic practices and bring their expertise, energy, and creativity to…

  20. [In-house questioning on patient satisfaction in a maximum resource clinic--report from practice].

    PubMed

    Schröder, C; Riedel, S; Schmutzer, G; Brähler, E; Schwarz, R

    2004-10-01

    Since 1999, the statutory obligation of all German hospitals to establish an internal quality management system has resulted in an increase of patient surveys on inpatient care. Information on the subjective satisfaction of the patients is of particular interest because improvements may be realised. In the present paper, the objectives, the methodology and the choice of a tested survey instrument, the interpretation of the results and the practical problems in implementing a survey on patient satisfaction at the Leipzig University Hospital (a public institution comprising 1,464 beds in 2001) will be reported. This is intended to facilitate comparable projects in the future and to enable hospitals with fewer resources to organize and use such surveys. Altogether, 1,718 questionnaires (Hamburg questionnaires on patient stay in hospital, HFK) from 43 wards could be evaluated. The high satisfaction determined (mean values of the scores for 10 test parameters are between 1.72 and 2.02 on a 5-point scale) corresponds to the general tendency of patients to make socially desirable responses. Covert dissatisfaction was therefore analysed comparing the relative frequencies of complete and limited satisfaction at item level. Sociodemographic patient characteristics such as age and stay in hospital were of no substantial relevance. One important aim of the Leipzig survey project was to give detailed feedback within brief time periods. The project focussed on a differentiated and early monitoring of responses. If requested, an oral presentation of the results was made to each structural unit. This presentation included the spontaneous responses of the patient, which enhanced the acceptance of the investigation by the medical staff.

  1. Medicolegal aspects of child abuse and neglect.

    PubMed

    Krugman, Richard D; Bross, Donald C

    2002-04-01

    Neurosurgeons that see children and care for those with traumatic injury are highly likely to see cases of child abuse and neglect. That fact makes it inevitable that they will encounter the legal system. It is hoped that this article has demystified the legal process and systems that one encounters in day-to-day practice. Avoiding the diagnosis of abuse because of lack of knowledge or phobia of the legal system is hazardous to the health and well-being of children.

  2. Medicolegal aspects of esophageal cancer surgery.

    PubMed

    De Giorgio, Fabio

    2005-01-01

    Forensic implications of esophageal cancer surgery are varied and complex depending on the field of specialization involved i.e. civil law, criminal law, insurance or social security and for the distinct probative requirements related to each field. The aim of this article is to reconstruct the logical procedure of a forensic doctor who actually examines a practical case to establish the profiles of professional responsibility in particular in civil or criminal law.

  3. Cone beam computed tomography (CBCT) as a tool for the analysis of nonhuman skeletal remains in a medico-legal setting.

    PubMed

    Lucena, Joaquin; Mora, Esther; Rodriguez, Lucia; Muñoz, Mariela; Cantin, Mario G; Fonseca, Gabriel M

    2016-09-01

    To confirm the nature and forensic significance of questioned skeletal material submitted a medico-legal setting is a relatively common procedure, although not without difficulties when the remains are fragmented or burned. Different methodologies have been described for this purpose, many of them invasive, time and money consuming or dependent on the availability of the analytical instrument. We present a case in which skeletal material with unusual conditions of preservation and curious discovery was sent to a medico-legal setting to determine its human/nonhuman origin. A combined strategy of imagenological procedures (macroscopic, radiographic and cone beam computed tomography - CBCT-technology) was performed as non-invasive and rapid methods to assess the nonhuman nature of the material, specifically of pig (Sus scrofa) origin. This hypothesis was later confirmed by DNA analysis. CBCT data sets provide accurate three-dimensional reconstructions, which demonstrate its reliable use as a forensic tool.

  4. The medico-legal aspects of prescribing vitamin D

    PubMed Central

    Davies, John S; Poole, Chris D; Feldschreiber, Peter

    2014-01-01

    Vitamin D is a particularly important sterol hormone and its effects beyond bone are increasingly recognized. Over the last decade clinical interest has grown in vitamin D, with increased recognition of deficiency and hence increased prescribing of vitamin D products. However, the increased prescription of vitamin D has generally been met with unlicensed vitamin D products which potentially expose the patient to clinical risk. This review discusses the issues relating to the clinical use of unlicensed vitamin D products, safety concerns that may arise from this, as well as discussing the medico-legal responsibilities of the prescriber and dispenser. PMID:25047693

  5. Medicolegal aspects of necrotizing fasciitis of the neck.

    PubMed

    Sperry, K; McFeeley, P J

    1987-01-01

    Necrotizing fasciitis of the neck (NFN) is a relatively rare, fulminating infectious process of the cervicofacial tissues which may cause sudden and unexpected death. Although often the result of a dental infection, injuries of the soft tissues of the neck may also initiate rampant cellulitis, and recognition of the underlying etiology of such cases is necessary to determine properly the manner of death. Five cases of NFN are presented with a review of the causative factors and usual bacteriology, and specific factors of medicolegal interest are addressed.

  6. [Sexual hallucinations and dreams under anesthesia and sedation : medicolegal aspects].

    PubMed

    Schneemilch, C; Schiltz, K; Meinshausen, E; Hachenberg, T

    2012-03-01

    Dreams and hallucinations under sedation or anesthesia have been well known phenomena since the introduction of anesthesia. Sexual hallucinations may lead to allegations of sexual molestation or assault by medical doctors or professional nursing staff. Hallucinations under the influence of sedative or hypnotic drugs may be very vivid and as misinterpreted as being real and it is therefore often difficult to disprove the resulting false allegations. In this report the terms drug-induced dreams and hallucinations are defined and the probable mechanism described. By a historical review and case reports the medicolegal consequences are demonstrated and procedures recommended to avoid allegations of sexual assault.

  7. [Medicolegal aspects of driving ability and discussion of study methods].

    PubMed

    Berghaus, G

    2008-06-01

    Medicolegal aspects of driving ability primarily concern patients themselves, because they are responsible when driving in traffic while under drug treatment. Pain patients taking analgesic medication prescribed by a doctor do not commit an offence, insofar as they are able to drive. A doctor's main duty consists of informing the patient about the way a given disease or drug intake affects driving ability. Patients have the duty to inform themselves about the drug they are taking and to assess their driving ability each time before they drive a car.

  8. Oh how I try to use evidence in my social work practice: efforts, successes, frustrations, and questions.

    PubMed

    Williams, Nathaniel J; Sherr, Michael E

    2013-01-01

    Convinced by the literature that they could do better for their clients, in this article the authors describe their efforts to transform a categorically-funded program model at one agency from relying on authority and good intentions to evidence-based practice (EBP). Using a case study approach the authors describe a six-year research effort in which they experienced a modicum of success, including completion of a few projects, followed by paralyzing frustrations that warrant sharing with other social work professionals. Reflecting on their experiences, they posit a few questions about EBP for practitioners and leaders in the profession to contemplate. The authors then offer five pathways for moving the profession closer to making EBP a reality in social work.

  9. The forensic radiographer: a new member in the medicolegal team.

    PubMed

    Schneider, Benjamin; Chevallier, Christine; Dominguez, Alejandro; Bruguier, Christine; Elandoy, Cristèle; Mangin, Patrice; Grabherr, Silke

    2012-03-01

    Multidetector computed tomography is becoming more widespread in forensic medicine. In most services, autopsy assistants perform the radiological examination. We introduced professional radiographers into the legal medicine service and hypothesized they would also be able to take over duties currently reserved for other specialists. The aims of this study were to evaluate if radiographers could be trained as "forensic radiographers" by (1) integrating graduated medical radiographers into the legal medicine service, (2) investigating the advantages of this collaboration, and (3) defining the duties of the forensic radiographers.The study was performed prospectively on a group of 8 recruited radiographers who underwent a testing period with special training. They learned the basics of medicolegal case treatment, the autonomous execution of postmortem computed tomography angiography, and postprocessing of data. Seven of 8 radiographers finished the training and were integrated into our service. Although all radiographers were able to fulfill the duties demanded after the training period, some radiographers could not enter or complete the program because they were unable to work with dead bodies.Our study presents the advantages of integrating radiographers into the medicolegal team and proposes how to train the forensic radiographers. In addition, the duties and responsibilities of these new specialists are defined.

  10. A Question of Questions.

    ERIC Educational Resources Information Center

    Fenwick, John; McMillan, Rod

    In a conventional teaching situation, a lecturer may use a wide range of questioning techniques aimed at helping students to become active learners. In distance learning, students are often isolated and have limited opportunities for interaction in a social learning environment. Hence, learning strategies in distance learning need to be structured…

  11. [Professional autonomy in the choice and management of therapy. Medicolegal aspects].

    PubMed

    Bolino, G; Alfano, C

    2002-02-01

    Any discussion of the delicate subject of a doctor's autonomy in the choice and management of therapy entails addressing the intimate question of professional and ethical conduct. The professional freedom to choose which therapy to use continues to be the most quintessential expression of the medical professional and, in respect of the primary purpose of safeguarding health, must be aligned with: the choices of the informed patient or his/her legal representatives, existing guidelines and the equitable allocation of resources. On these grounds, the author sets out brief considerations regarding a number of issues frequently raised in the everyday work of the pediatrician and neonatologist: from the doctor's autonomy to adopt a diagnostic-therapeutic approach, with special reference to the prescription of drugs and the subtle differences compared to pharmacological trials, to the promotion and protection of breastfeeding, with explicit reference to the Ministry of Health's recent Circular no. 16 of 24.10.2000 ("Promotion and protection of breastfeeding") which, following a cursory reading of the text, appears to highlight restrictions to the pediatrician's decision-making autonomy. Special emphasis is also given to the medicolegal problems of caring for high-risk neonates. The clinical practice of neonatology often places the doctor in "critical" decision-making situations, with far from negligible ethical and moral implications, not to mention juridical and forensic ones. The author sets out a number of decision-making parameters for use as guidelines: the statistical criterion, the legal criterion and the clinical criterion, the only one capable of adjusting to scientific progress and to the specific technical and professional resources of the medical centre where the doctor is required to intervene in order to preserve even the simple "possibility" of autonomous life for the fetus. From this point of view, the so-called chronological vitality and scientifically

  12. Mathematics Teachers' Use of Questions: Is There a Change of Practice after the Curriculum Change?

    ERIC Educational Resources Information Center

    Delice, Ali; Aydin, Emin; Cevik, K. Seda

    2013-01-01

    The aim of this study is to investigate the questions that are used by teachers. In broader sense the intention is to focus on questions as part of teachers' formal as well as informal assessments. We will mainly concentrate on how students are assessed and how the questions in the assessments are formed and marked. The research is mainly…

  13. Mathematics Teachers' Use of Questions: Is There a Change of Practice after the Curriculum Change?

    ERIC Educational Resources Information Center

    Delice, Ali; Aydin, Emin; Cevik, K. Seda

    2013-01-01

    The aim of this study is to investigate the questions that are used by teachers. In broader sense the intention is to focus on questions as part of teachers' formal as well as informal assessments. We will mainly concentrate on how students are assessed and how the questions in the assessments are formed and marked. The research is mainly…

  14. Improving the recording of clinical medicolegal findings in South Africa.

    PubMed

    Jina, Ruxana; Kotzé, Johanna Marianne

    2016-08-02

    The accurate recording of findings in clinical medicolegal cases is important, yet the current J88 form used for this purpose in South Africa has been reported to have many flaws. In addition, there are reports of poor completion of the form, which could in part be due to its poor design and clarity. To describe the process that was undertaken to revise the current J88 form. A repetitive consultative process was used to revise the current J88 form and to obtain inputs from relevant government institutions. A brief outline of the changes that have been made to the current J88 form and the reasons why these changes were proposed by national experts is provided. The revised J88 form will provide clearer guidance to healthcare providers on the completion of necessary information in an expedited fashion. It is hoped that the form will soon be approved by the necessary government institutions.

  15. Adjudication of fibromyalgia syndrome: Challenges in the medicolegal arena

    PubMed Central

    Fitzcharles, Mary-Ann; Ste-Marie, Peter A; Mailis, Angela; Shir, Yoram

    2014-01-01

    The medicolegal challenges surrounding fibromyalgia (FM) arise from the subjectivity of symptoms, causal attribution and reported symptoms sufficiently severe to cause disablement. In the present article, the authors have endeavoured to provide clarification of some current issues by referencing the current literature, including the 2012 Canadian Fibromyalgia Guidelines. While FM is accepted as a valid condition, its diagnosis is vulnerable to misuse due to the subjectivity of symptoms. Without a defining cause, a physical or psychological event may be alleged to trigger FM, but adjudication of causation must be prudent. Although some individuals may experience severe symptoms, the prevalent societal concept of disablement due to FM must be tempered with the knowledge that working contributes to psychosocial wellbeing. Evidence provided in the present report may assist the courts in reaching decisions concerning FM. PMID:25479148

  16. [Medicolegal aspects of a survived suicide attempt by hanging].

    PubMed

    Nadjem, Hadi; Pollak, Stefan

    2013-01-01

    Report on the clinical and medicolegal findings in a survived suicide attempt by hanging. A 39-year-old woman was found unconscious in a crouching position on the balcony of her flat. The hanging device was an electric cable running around her neck in a single loop and attached to the balcony wall. After removing the noose, resuscitation measures were started immediately. For 5 hours, the victim was at first in a comatose and then in a somnolent state. The period of amnesia covered also the preparations for the suicidal act. The forensic examination performed on the same day showed a reddish, streak-like hanging mark, pronounced signs of blood congestion with dense petechial haemorrhages in the facial skin, confluent haemorrhages in the conjunctivae as well as bleeding from the left external auditory canal. BAC was 2.2 per mil. On the basis of the findings and the clinical course, criminalistic and pathophysiological aspects of near-hanging are discussed.

  17. The response of relatives to medicolegal investigations and forensic autopsy.

    PubMed

    Plattner, Thomas; Scheurer, Eva; Zollinger, Ulrich

    2002-12-01

    Relatives of deceased persons, on whose body a forensic autopsy had been performed at the Institute of Forensic Science, Bern, Switzerland, were interrogated by a questionnaire. The aim was to investigate the attitude of relatives toward medicolegal investigation procedures in general and toward forensic autopsy in particular. A great majority of the relatives showed a positive or indifferent attitude toward a forensic autopsy. They showed a great interest in autopsy results and wished to be informed. It was concluded that information given before the autopsy is important for better understanding and can, if properly given, improve the relatives' acceptance and collaboration regarding forensic investigations. By contrast, a lack of information before the autopsy and about the autopsy results can cause further suffering on behalf of the bereaved. A forensic autopsy can be of great benefit for relatives and can help them to cope with a tragic loss.

  18. The pathology and medicolegal aspects of sexual activity.

    PubMed

    Eckert, W G; Katchis, S; Donovan, W

    1991-03-01

    The pathology of injury and its complications related to sexual activities has changed remarkably when compared with that of the past, which usually involved assaults or murders of female victims of varying ages, with moderate to serve beatings that may have accidentally resulted in the victim's death. Serial murderers, serial rapists, and molesters of both boys and girls have become much more prevalent in the last two decades in the United States. Unorthodox sexual behavior, such as "fisting," has increased in frequency, as has sexual violence related to cults, such as satanism. All of these present many challenges to medicolegal investigators. This report describes general and specific pathological sexual activities and injuries, some characteristics and methods of the perpetrators, and some specific cases as examples.

  19. [Two complex suicidal poisonings with drugs and their medicolegal aspects].

    PubMed

    Kłys, M; Skupień, E; Bujak-Gizycka, B; Latacz, B

    2001-01-01

    The main subject of the study was a toxicological investigation of biological specimens coming from two cases of intoxication with mixture of drugs. Two young people decided to commit suicide by the use of mixture of drugs mainly analgesic in approximately equal doses. For one person the dose of drugs administered turned out to be fatal while second person survived with the symptoms of acute intoxication. The analysis carried out with the use of liquid chromatographic method with mass detection (HPLC/MS) confirmed the presence of mixture of drugs in blood of living person and in postmortem specimens of the victim in significant concentrations. The toxicological findings have delivered information for discussion in medico-legal and ethical aspects.

  20. [Remarks about the position of the medico-legal expert in imperative regulations in the Penal and Civil Codes].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Chowaniec, Małgorzata; Kobek, Mariusz

    2005-01-01

    In the monograph 'Medico-legal opinions--essays on theory', prof. K. Jaegermann wrote that 'the use of an expert requires theoretical or fairly clear knowledge about the mutual relationship between judge and expert'. In his opinion knowledge of this kind plays a significant role in estimating the usefulness of so-called expert evidence. Practical knowledge about the relationship between the judge and expert is necessary but not a decisive condition not only for a lawyer to be a judge but also for a physician to be a medico-legal expert. An expert can be not only a person appointed by the court but must also possess proper knowledge in a particular field, namely, the required professional and specialist qualifications and must also considered to be impartial. On the basis of the analysis of law in force and imperative regulations in Penal and Civil Codes, the authors have presented remarks relating to the expert's status as well as the lack of judicial control over the activity of experts appointed by court. Verification of professional qualifications in court experts and a reduction of those appointed 'ad hoc' are suggested. In the authors opinion co-operation between lawyers and experts should be improved. It is also essential to introduce statutory legal protection of court experts as well as to undertake activities leading to equaling the status of Polish court experts to that of other European countries.

  1. Practical question-and-answer guide on VDTS (video display terminals) for BEES (base bioenvironmental engineer). Final report

    SciTech Connect

    Olson, B.M.

    1985-01-01

    The USAF OEHL conducted an extensive literature review of Video Display Terminals (VDTs) and the health problems commonly associated with them. The report is presented in a question-and-answer format in an attempt to paraphrase the most commonly asked questions about VDTs that are forwarded to USAF OEHL/RZN. The questions and answers have been divided into several topic areas: Ionizing Radiation; Nonionizing Radiation; Optical Radiation; Ultrasound; Static Electricity; Health Complaints/Ergonomics; Pregnancy.

  2. A clinical analysis of 500 medico-legal claims evaluating the causes and assessing the potential benefit of alternative dispute resolution.

    PubMed

    B-Lynch, C; Coker, A; Dua, J A

    1996-12-01

    1. To evaluate the common causes of medico-legal dispute in obstetrics and gynaecology. 2. To assess the potential benefit of early alternative dispute resolution. A prospective analysis of over 500 cases submitted from over 100 solicitors between 1984 and 1994 for medical expert opinion on potential medico-legal claims. Five hundred consecutive cases that met the inclusion criteria: 488 from the United Kingdom and 12 from abroad (Hong Kong, Republic of Ireland). The main principles underlining medico-legal disputes and causes of such claims. Analysis of 500 claims show 46% were misguided allegations, 19% incompetent care, 12% error of judgement, 9% lack of expertise, 7% failure of communication, 6% poor supervision and 1% inadequate staffing. Of the misguided allegations 119/225 cases (59%) were obstetric and 111/275 (40%) cases were gynaecological. The most common cause of obstetric dispute was "cerebral palsy' (22%), while the commonest cause of gynaecological dispute was failed sterilisation (19%). Settled claims were under-reported by solicitors. Because of the high percentage (46%) of misguided allegations, an alternative course of dispute resolution must be a realistic way forward. This course of action, combined with improved communication, could result in a major reduction in the costs of potential medical litigation. Early alternative dispute resolution should be considered in an attempt to reduce the escalating quantum of damages and costs. We recommend recruiting independent, experienced and unbiased consultants in active practice within the appropriate specialty to review such cases at the level of hospital complaints management as an in house review procedure, particularly for small and moderate-sized claims, as a means whereby doctors can retain control of medico-legal disputes, in contrast to control by the legal profession.

  3. [Selected medico-legal problems in cases of poisoning with substances of abuse].

    PubMed

    Kłys, M; Klementowicz, W; Trela, F

    1997-01-01

    In toxicological examinations of substances of abuse with respect to medico-legal purposes many problems have been discussed. A selection of biological material and proper analytical methods in confrontation with interpretation of results in reference to the subject in question seems to be a central toxicological issue. Blood and urine samples are usually used in cases of human. The problem is more complicated if it concerns dead subjects on the account of postmortem processes in a body. From this point of view, in fatal cases of poisonings experience proves, besides blood and urine also other body fluids such as: cerebrospinal fluid, vitreous humor, perilymph and bile turned out to be usefull for examinations of various xenobiotics. The analytical methods (FPIA, HPLC, GC-MS) have been used for qualitative and quantitative evaluation in wide range of xenobiotic concentration in biological matrix. Interpretation of the results including such problems as toxic interaction, metabolism, data base has been discussed in the study on the basis of intoxication cases with substances of abuse.

  4. The Use of Questions within In-the-Moment Coaching in Initial Mathematics Teacher Education: Enhancing Participation, Reflection, and Co-Construction in Rehearsals of Practice

    ERIC Educational Resources Information Center

    Averill, Robin; Drake, Michael; Anderson, Dayle; Anthony, Glenda

    2016-01-01

    Managing mathematical discussion is known to be challenging for novice teachers. Coaching within student teacher rehearsals of teaching has been shown to develop mathematics teaching practice, but can be time consuming. To examine how coaching using questions could assist novice teachers to promote mathematical thinking and discussions within…

  5. The Use of Questions within In-the-Moment Coaching in Initial Mathematics Teacher Education: Enhancing Participation, Reflection, and Co-Construction in Rehearsals of Practice

    ERIC Educational Resources Information Center

    Averill, Robin; Drake, Michael; Anderson, Dayle; Anthony, Glenda

    2016-01-01

    Managing mathematical discussion is known to be challenging for novice teachers. Coaching within student teacher rehearsals of teaching has been shown to develop mathematics teaching practice, but can be time consuming. To examine how coaching using questions could assist novice teachers to promote mathematical thinking and discussions within…

  6. Do Workshops in Evidence-Based Practice Equip Participants to Identify and Answer Questions Requiring Consideration of Clinical Research? A Diagnostic Skill Assessment

    ERIC Educational Resources Information Center

    Wyer, Peter C,; Naqvi, Zoon; Dayan, Peter S.; Celentano, James J.; Eskin, Barnet; Graham, Mark J.

    2009-01-01

    Evidence-based practice (EBP) requires practitioners to identify and formulate questions in response to patient encounters, and to seek, select, and appraise applicable clinical research. A standardized workshop format serves as the model for training of medical educators in these skills. We developed an evaluation exercise to assess the ability…

  7. Do Workshops in Evidence-Based Practice Equip Participants to Identify and Answer Questions Requiring Consideration of Clinical Research? A Diagnostic Skill Assessment

    ERIC Educational Resources Information Center

    Wyer, Peter C,; Naqvi, Zoon; Dayan, Peter S.; Celentano, James J.; Eskin, Barnet; Graham, Mark J.

    2009-01-01

    Evidence-based practice (EBP) requires practitioners to identify and formulate questions in response to patient encounters, and to seek, select, and appraise applicable clinical research. A standardized workshop format serves as the model for training of medical educators in these skills. We developed an evaluation exercise to assess the ability…

  8. Necessity of including medico-legal autopsy data in epidemiological surveys of individuals with major trauma.

    PubMed

    Bagher, A; Wingren, C J; Ottosson, A; Andersson, L; Wangefjord, S; Acosta, S

    2015-08-01

    It is rare that epidemiological surveys of patients with major trauma include both those admitted to the emergency department and those sent for medico-legal autopsy. The main aim of the present population-based study of major trauma was to examine the importance of medico-legal autopsy data. A new injury severity score (NISS)>15 or lethal outcome was used as criteria for major trauma and to identify patients at the emergency, anaesthesiology and forensic departments and/or being within the jurisdiction of the Malmö police authority and subjected to a medico-legal autopsy between 2011 and 2013. According to Swedish legislation all trauma related deaths should be reported to the police who refer these cases for medico-legal autopsy. Among the 174 individuals included, 92 (53%) died and 81 (47%) underwent medico-legal autopsy. One hundred twenty-six patients were primarily admitted to hospital and 48 died before admission to hospital and were sent directly for medico-legal autopsy. Forty-four in-hospital deaths occurred, of whom 33 (75%) were sent to medico-legal autopsy. In those sent directly to the department of forensic medicine the proportion of accidents was lower (p<0.001), self-inflicted injuries higher (p<0.001) and gunshot wounds higher (p=0.002) in comparison with those sent to hospital. The most prevalent drugs detected by forensic toxicology screening in the 81 fatalities were ethanol (20%), sedatives (16%), anti-depressives (15%) and illicit narcotics (9%). Forty-four cases (54%) were positive for at least one drug, and twenty-eight cases (35%) were positive for two or more drugs. Factors associated with a lower rate of medico-legal autopsies among trauma-related deaths at hospital were high age (p<0.001), lower NISS (p<0.001), a longer duration between trauma and death (p<0.001), falls (p=0.030) and trauma-related infections (p<0.001). This population based study covering clinical and forensic data shows that more than half of the individuals

  9. [Medicolegal and compensation scientific approach to automobile accident].

    PubMed

    Yamanouchi, Haruo

    2002-09-01

    Multiple injuries are frequently observed over the whole body of traffic victims in medico-legal autopsy cases. The assessment of a traffic casualty must include not only the victim but also the vehicle and the circumstances of the accident. Only consideration of all available data permits a better assessment of the mechanism of the crash and causation of injuries. J. M. Thevenet drove the first car carried from France to Japan on February 6, 1898. On October 28th, 1905, the first death by a road traffic accident occurred in Osaka. We performed a retrospective analysis of 279 traffic fatalities examined by medico-legal autopsy in Niigata that occurred over a twenty-two-year period from 1980 to 2001. All persons who had an ICD-10 code were grouped by 153 pedestrians, 43 pedal cyclists, 20 motorcycle riders, 45 car occupants, 11 occupants of pick-up trucks or vans, 4 occupants of heavy transport vehicles and 3 others. The average of ISS (injury scale score) is 40.7 in pedestrians, 26.7 in pedal cyclists, 32.4 in motorcycle riders, 25.1 in car occupants, 16.5 in occupants of pick-up trucks or vans, 24.0 in heavy transport vehicles and 69.0 in others. Rib fractures were observed in 170 cases (60.9%) and the frequency of other injuries was shown in Table 2. Criminal Punishment for drivers involved in 261 traffic accidents amounted to 35 sentences of imprisonment (13.4%), 46 suspension of execution of sentence (17.6%) and 60 sentence of fine (23.0%). Forty prone pedestrians run over by cars showed high ethanol levels in their blood. It was necessary to identify the driver of a vehicle in twelve car accidents and simulation with a computer is very useful. The average of ISS was 34.0 in ten drivers and 22.0 in fourteen fellow passengers. Four sudden natural deaths of drivers at the wheel, eight cases of death immediately after and from one day to five months after road traffic accidents, nine suicides and one intentional accident are excluded from traffic death. Both a

  10. Practicing patient-centered care: the questions clinically excellent physicians use to get to know their patients as individuals.

    PubMed

    Hanyok, Laura A; Hellmann, David B; Rand, Cynthia; Ziegelstein, Roy C

    2012-01-01

    Patient-centered care, which is dependent on knowing each patient as an individual, has been identified as a critical aspect of healthcare. The most effective and efficient methods to get to know patients as individuals have not been defined. Our aim was to identify questions and phrases that can be used by physicians to get to know their patients. We surveyed 15 physicians who have been formally recognized for their clinical excellence to determine what questions or phrases they use when interviewing patients to get to know them as individuals. A total of 28 questions or phrases were received from 13 physicians and were qualitatively analyzed and grouped into six major themes: (i) appreciation of the patient's concerns; (ii) personal relationships; (iii) hobbies and pleasurable activities; (iv) open-ended questions to learn about the patient; (v) work; and (vi) the patient's perspective on the patient-physician relationship. This work identifies questions and phrases used by clinically excellent physicians to get to know their patients as people. Future work should focus on obtaining the perspectives of patients, and on examining whether using the identified questions and phrases results in an improved patient experience as demonstrated by improved satisfaction ratings, ratings on the quality of physician-patient interaction, or patient outcomes.

  11. The Clinical and Medicolegal Analysis of Electrical Shocked Rats: Based on the Serological and Histological Methods

    PubMed Central

    Wang, Qiaofeng; Zhao, Ze; Xie, Yanan; Ding, Suzhen

    2016-01-01

    This research was aimed at discovering the serological and histological changes in cardiac and hepatic tissue after electric shock. The CK-MB, ALT, and AMS indexes were tested with serological methods. Moreover, the Bcl-2, Bax, and Hsp-60 expression levels were carefully measured. An electrical injury model was established by giving rats electric shocks at 110 V with alternating electric current. Blood samples from the rats were analyzed for the biochemical indexes. The degrees of pathological changes in the heart and liver were evaluated using IHC staining for Bcl-2, Bax, and Hsp-60. The levels of CK-MB in the electrical injury group rapidly peaked at 0.5 hours after the electric shock. Additionally, the levels of Bcl-2, Bax, and Hsp-60 in the cardiac and hepatic tissues changed regularly after the electrical injury and exhibited apparent differences from the levels in the control group. CK-MB, ALT, and AMS were altered regularly after electric shock, and these results provide significant information for clinical and medicolegal practice. This research has shed light on the assessment of electrical injury without obvious electrical burns. Furthermore, the findings obtained for Bcl-2/Bax and Hsp-60 can also facilitate pathological diagnosis and the identification of antemortem and postmortem electrical injury. PMID:27648446

  12. [The possibility of medico-legal opinionating on medical error in cases of waived postmortem examination].

    PubMed

    Kunz, Jerzy

    2008-01-01

    For several years now, with the introduction of the health care sector reform we have been observing a considerable drop in the number of postmortem examinations performed in patients who died in hospitals. The decrease amounts to as much as 50 to 70%. This is undoubtedly a consequence of financial restrictions imposed on the management of these inpatient facilities. On the other hand, Departments of Forensic Medicine established to evaluate the so-called medical errors are swamped with an increasing avalanche of complaints concerning the appropriateness of therapeutic management. This leads to a growing number of orders from penal prosecution and jurisdiction agencies with requests for assessment whether a medical error has been committed in a particular case. The result of a postmortem examination is practically the only basis for a factual evaluation of a given case. When no autopsy has been performed, the experts are virtually helpless, and in the majority of such instances, they are forced to refuse passing an expert opinion. The report presents basic principles of medico-legal opinionating in criminal cases (including proceedings pertaining to medical errors), the rules governing the medical error assessment, as well as problems encountered in evaluating the appropriate course of treatment when a post mortem examination has been waived.

  13. Making Questions Flow

    ERIC Educational Resources Information Center

    Rothstein, Dan; Santana, Luz; Minigan, Andrew P.

    2015-01-01

    Getting students to ask questions can feel like pulling teeth. How can teachers transform that feeling and create classrooms that come alive with questions? The authors, developers of the question formulation technique, suggest two simple changes: First, teachers need to give students both a structure and the opportunity to practice generating…

  14. Making Questions Flow

    ERIC Educational Resources Information Center

    Rothstein, Dan; Santana, Luz; Minigan, Andrew P.

    2015-01-01

    Getting students to ask questions can feel like pulling teeth. How can teachers transform that feeling and create classrooms that come alive with questions? The authors, developers of the question formulation technique, suggest two simple changes: First, teachers need to give students both a structure and the opportunity to practice generating…

  15. [Depression --the most pragmatic diagnosis in medico-legal opinionating].

    PubMed

    Kowalski, Piotr; Skupień, Elzbieta

    2007-01-01

    As it follows from the expertise practice of the authors, broadly understood "depression syndrome" is the most common diagnosis occurring in sick-leave certificates provided for legal procedures to the court. This problem is encountered in penal, civil and insurance cases. At the same time, in a significant percentage of cases, the patient's self-presentation does not correspond with the provided diagnosis. A particular legal situation of a person stigmatized with such a diagnosis clearly indicates its pragmatic character. Hence, several questions emerge: (1) Why does such a particular diagnosis prevail? (2) Is there another disease entity in psychiatry, which has such a broadly reactive background? On the basis of a particular case the authors formulate the problem of the appropriately understood interest of the patient. Does the current protection against broadly understood legal consequences cause the patient to fixate on the defense mechanisms and -- in consequence -- degradation of his functioning?

  16. Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.

    PubMed

    French, Keisha L; Daniels, Eldra W; Ahn, Uri M; Ahn, Nicholas U

    2013-01-01

    Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases.

  17. Medicolegal considerations in the diagnosis of breast cancer.

    PubMed

    Strunk, Albert L; Kenyon, Sharon

    2002-03-01

    From the standpoint of the obstetrician, gynecologist, failure to diagnose breast cancer is a significant medicolegal issue in terms of the number of claims initiated and the indemnity awards paid to successful plaintiffs. The incidence of breast cancer may continue to increase. Without quality care and good risk management on the part or health care providers, claims for failure to diagnose cancer in a timely manner will also increase. The challenge for the health care provider is to formulate a plan that promotes early detection and treatment while allowing for independent clinical judgment. Ideally, the plan should be written and followed for every patient in whom complaints of a breast mass have been documented. It is incumbent upon the physician and office staff to create an atmosphere in which patient complaints are not minimized, the limitations of mammography are recognized. follow-up procedures are in place and strictly followed, and a definitive diagnosis within 4 to 6 weeks of the initial presentation is the ultimate goal. Following these suggestions will improve the quality of health care for the patient and significantly decrease the likelihood of litigation alleging a failure to diagnose breast cancer. In the event breast cancer is diagnosed and a lawsuit is brought for failure to diagnose in a timely fashion, the best defense a physician can have is to be able to demonstrate that the patient's complaints were taken seriously, a consistent treatment plan was followed and documented, and the patient received appropriate care.

  18. Five questiouns dentists should ask about their money. Question 4: how do the communities (family, practice, profession, culture, neighborhood, etc.) in which I live affect my financial decisions?

    PubMed

    Jones, Troy E

    2006-11-01

    Communities, and the personal value you place on them, affect all your spending, both business and personal. Once you begin questioning and analyzing how they affect your financial decisions, you will begin making more complete choices - the better-informed, the greater chance of success. Society has attached many financial expectations to dentists - both good and bad. By participating in this part of the Five Questions process, you will be able to separate the business of dentistry from the practice of dentistry and your persona beliefs from the beliefs of your communities'.

  19. Research into Practice: Suggestions to Help Sustain Teacher Turn-Taking Talk and Socratic Questions with Low-Income Preschoolers

    ERIC Educational Resources Information Center

    Honig, Alice Sterling; Martin, Patricia M.

    2009-01-01

    Research using an intensive single-session training to increase use of Socratic (open-ended) questions and to lengthen turn-taking talk with low-income preschoolers showed that immediate posttraining gains were not sustained in classrooms 3 months later. Suggestions are given for trainers and for teachers that can boost teacher ability to…

  20. A Case Study of the Pedagogical Tensions in Teacher's Questioning Practices When Implementing Reform-Based Mathematics Curriculum in China

    ERIC Educational Resources Information Center

    Dong, Lianchun; Seah, Wee Tiong; Clarke, David

    2015-01-01

    This study examines a teacher's questioning strategies in mathematics classrooms in China when implementing reform-based mathematics curriculum. It explores teacher's strategies to deal with the tensions involved in the creation of opportunities for students to express and communicate mathematics ideas while ensuring the productivity of…

  1. Developing great research questions.

    PubMed

    Lipowski, Earlene E

    2008-09-01

    The process for developing a good research question is described. Three steps comprise the formulation of a great research question: (1) ask interesting questions, (2) select the best question for research, and (3) transform the research question into a testable hypothesis. Research is designed to generate information that cannot be gained from any other source. A research question is a narrow, challenging question addressing an issue, problem, or controversy that is answered with a conclusion based on the analysis and interpretation of evidence. A variety of strategies can be applied to stimulate creative thinking and generate new insights into old problems. A good research question challenges researchers to see matters from a new perspective and to learn something new. Practice research questions are evaluated by the probability of achieving their goal, along with the potential impact and feasibility of the project. The proposed research must meet important professional and societal goals, fit with the mission of the organization, garner administrative support, and be accomplished with available resources in a reasonable time frame. The research question should be refined to generate one or more hypotheses that specify the nature of the relationships to be observed and measured. Properly formulated questions yield findings to inform decisions that enhance practice, transfer to other settings, and make efficient use of resources. Developing a good research question is the most important part of the research process. The question should be narrow and address an important issue that fits within the mission of the organization.

  2. The medico-legal scene in Dubai: 2002-2007.

    PubMed

    Benomran, Fawzi A

    2009-08-01

    Various characteristics of the medico-legal scene in Dubai are described, along with an overview of all cases examined over a period of 6 years. During the period of study, a total of 17,683 cases were examined in the Department of Forensic Medicine of Dubai Police General Headquarters. This constituted a yearly average of (2947.16). The average annual increment was 11.13%, the percentage of increase between 2002 and 2007 being 68.96%. Of these 10,165 (57.48%) were clinical cases of injuries, 5404 (30.56%) postmortem examinations, 1525 (8.62%) clinical cases of sexual crimes, 409 (2.3%) age estimations, 58 (0.32%) medical responsibility, 20 (0.11%) criminal abortion, 61 (0.34%) civil actions and 38 (0.21%) miscellaneous cases. Of postmortem examinations, 4846 (89.7%) of them were males and 558 (10.3%) females. The age ranged from (0-90) years, with a mean age of 40.5 years. The peak incidence was in the age group (20-50) years, where the extremes of age were least represented (Fig. 1). Only in 361 cases (6.68% of the grand total) the deceased was a local citizen. Autopsies amounted to 394 cases, which constituted 7.29% of the total deaths examined. The four manners of death in descending order of frequency were natural 3003 (55.57%), accidental 1727 (32%), suicidal 498 (9.2%), homicidal 164 (3%). The manner was undetermined in 12 (0.22%) of the cases over the 6 year period.

  3. Medicolegal Aspects of Iatrogenic Dysphonia and Recurrent Laryngeal Nerve Injury.

    PubMed

    Ta, Jennifer H; Liu, Yuan F; Krishna, Priya

    2016-01-01

    To examine aspects of litigation involving iatrogenic dysphonia and injury to the recurrent laryngeal nerve in the adult population. Legal database review. Medicolegal judicial system. Jury verdicts and settlement reports listing voice impairment or recurrent laryngeal nerve dysfunction as a primary injury in adult patients were identified in the Westlaw Database. Reports were examined for plaintiff demographics, defendant specialty, procedure performed, rates of settlements and verdicts, monetary awards, primary plaintiff symptoms, and common allegations. A total of 123 jury verdict and settlement reports were identified. General surgeons (24%), otolaryngologists (20%), and anesthesiologists (18%) were involved in the majority of cases. The procedure causing the alleged injury was primarily thyroidectomy (34%), followed by intubation (18%) and spinal instrumentation (10%). The majority of cases (70%) were decided in favor of the defendant. Where monetary awards were recorded, settlements and jury verdicts in favor of the plaintiff ranged between $4250 and $3,000,000, with a mean of $788,713. In addition to voice disturbances, complaints of dyspnea and dysphagia were commonly listed alleged injuries. The only factors associated with plaintiff verdicts were general surgery specialty (odds ratio, 6.3; 95% confidence interval, 1.7-23.2) and claims of loss of consortium (odds ratio, 8.5; 95% confidence interval, 1.2-60.7). Dysphonia is a common complication in a number of procedures across multiple specialties. Although the majority of cases are decided in favor or the defendant, payments awarded can be considerable. Awareness of factors involved in these medical malpractice cases can help limit physician liability. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  4. Epistaxis: the factors involved in determining medicolegal liability.

    PubMed

    Khan, Mohemmed N; Blake, Danielle M; Vazquez, Alejandro; Setzen, Michael; Baredes, Soly; Eloy, Jean Anderson

    2014-01-01

    The purpose of this study was to examine litigation involving epistaxis and analyze factors that determine liability. Jury verdicts and settlements regarding cases involving epistaxis were gathered utilizing the Westlaw database. Factors involved in litigation gathered included demographics, defendant specialty, procedure, alleged cause of malpractice, outcome, monetary award, and other variables. A total of 26 cases were analyzed. The majority of cases (57.7%) were decided in favor of the plaintiff or settled out of court. Total awards amounted to $24,501,252. Average awards for cases decided in favor of the plaintiff were $2,260,893 and ranged from $499,845 to $9,022,643. Settlements averaged $1,084,375 and ranged from $300,000 to $3,800,000. Common causes of malpractice encountered included delay in diagnosis, complications from medical procedures, and failure to recognize complications in a timely manner. Contrary to previous reports analyzing malpractice for varying medical procedures and complications, litigation in epistaxis is more commonly resolved in favor of the plaintiff or resolved through out-of-court settlements. Substantial financial awards and therapeutic complications from blindness to death make epistaxis a candidate for litigation. Of importance from a medicolegal stand is the fact that 30.8% (8) of the patients involved in epistaxis litigation died, either from complications of therapy or from experiencing epistaxis as a complication of another procedure/pathology. Using necessary diagnostic imaging, ensuring proper management techniques, and recognizing complications in a timely manner can serve to limit legal liability and enhance patient safety. © 2013 ARS-AAOA, LLC.

  5. The perils of dental vacation: possible anaesthetic and medicolegal consequences.

    PubMed

    Feltracco, Paolo; Gaudio, Rosa Maria; Barbieri, Stefania; Tiano, Letizia; Iacobone, Maurizio; Viel, Giovanni; Tonetti, Tommaso; Galligioni, Helmut; Bortolato, Andrea; Ori, Carlo; Avato, Francesco Maria

    2013-01-01

    The aim of this paper is to emphasize anaesthesiologists' difficulty in detecting poor dentition in cases of poorly applied prostheses and/or advanced periodontal disease, and to establish whether it is possible, and in which conditions, to calculate compensation in cases of dental damage postlaryngoscopy and/or intubation. The main complex problem here lies in trying to reconstruct exactly what the dental situation was before the teeth were damaged. For this reason the important preoperative factors (dental prostheses, crown fractures, parodontal disease, etc.) must be clearly shown before surgery on a dental chart. Two cases of interest, both to anaesthesiologists practising intubation and medicolegal physicians who have to deal with potential claims, are briefly reported. The first patient was a 55-year-old diabetic patient, who underwent emergency surgery for acute abdominal pathology. He had gone outside Italy for dental treatment three years previously and now presented with very poor pre-existing dentition, carefully noted on an anaesthetic chart. He now demanded compensation for dental damage due to intubation in Italy; the resulting dental treatment was very expensive because substantial remedial work was required. The second patient had received treatment outside Italy, work which involved cosmetic coating of the teeth. After surgery in Italy, she demanded compensation because one tooth, which had been coated and appeared to be healthy, was broken after emergency intubation. In both cases, the patients demanded very high compensation. Dental tourism alone accounts for more than 250,000 patients each year who combine a holiday with dental treatment in Eastern Europe. However, if prosthetic devices or conservative treatments are not applied correctly, it should be noted that durability may be poorer than expected, but iatrogenic damage may also be caused.

  6. Relatives' attitudes towards medico-legal investigation and forensic autopsy: a study from South Delhi.

    PubMed

    Behera, C; Rautji, R; Dogra, T D

    2008-04-01

    Relatives of deceased persons on whose bodies a medico-legal autopsy had been performed at the All India Institute of Medical Sciences, New Delhi, India were personally asked to complete a questionnaire. The aim of study was to determine surviving family members' attitudes towards medico-legal investigation and forensic autopsy. The majority of the relatives showed a positive attitude towards forensic autopsy but were not aware of the detailed procedure of the autopsy. They wanted sufficient information to be provided before the autopsy. They showed a great interest in autopsy results i.e. the cause of death. It was concluded that sufficient relevant explanations given before the autopsy improves the relatives' acceptance and helps alleviate the suffering of the bereaved. The experience and opinions of relatives may help an autopsy surgeon in more effective management of medico-legal cases.

  7. Bio-medicolegal scientific research in Europe. A country-based analysis.

    PubMed

    Viel, Guido; Boscolo-Berto, Rafael; Cecchi, Rossana; Bajanowski, Thomas; Vieira, Nuno Duarte; Ferrara, Santo Davide

    2011-09-01

    The European mosaic of socio-cultural, economic and legal realities is reflected in forensic and legal medicine, in which a great variety of operational modes of forensic medical services, organisational systems, structures, functional competences and scientific research strategies can be observed. The present work analyses the European bio-medicolegal scientific output of the last 5.5 years (exact time window, January 1, 2005-June 1, 2010), categorising papers by nationality of the corresponding author and forensic sub-discipline in question, in order to identify the peculiarities of national sub-specialised competences and to build up international research projects. This country-based bibliometric analysis, based on the number of articles and the impact factor produced by each European country, also considering its economic profile (gross domestic product and per capita gross domestic product), highlights the prevailing productive role of Western and Southern Europe (Germany, Great Britain, Italy, Switzerland, Spain and France). Categorising scientific output by forensic sub-discipline and branch, significant in terms of impact factor are contributions from Germany (coming first in Pathology, Toxicology, Genetics, Anthropology and Biological Criminalistics), Great Britain (first in Clinical Forensic Medicine, Malpractice and Invalidity-Social Insurance), Switzerland (first in Criminology), Italy (second in Toxicology, Anthropology and Invalidity-Social Insurance), The Netherlands (third in Clinical Forensic Medicine and Medical Law and Ethics), Spain (third in Genetics, Criminalistics and Invalidity-Social Insurance) and France (third in Toxicology and Malpractice). Interestingly, several countries with low gross domestic product, such as Poland, Turkey and other Eastern European nations, show notable scientific production in specific sub-disciplines such as Pathology, Toxicology and Forensic Genetics, suggesting that fruitful international cooperation could be

  8. Critiquing Questions

    ERIC Educational Resources Information Center

    Zimmerman, Lynn W.

    2015-01-01

    Question formation is a basic part of teaching and learning English. However, teachers often focus on the ability to form the question properly and not as much on the quality of the information the question is seeking. Whether teaching English language learners or students who want to be English teachers, teachers need to carefully consider the…

  9. Visualizing sexual assault: an exploration of the use of optical technologies in the medico-legal context.

    PubMed

    White, Deborah; Du Mont, Janice

    2009-01-01

    This article is an exploration of the visualization of sexual assault in the context of adult women. In investigating the production of visual evidence, we outline the evolution of the specialized knowledge of medico-legal experts and describe the optical technologies involved in medical forensic examinations. We theorize that the principles and practices characterizing medicine, science and the law are mirrored in the medico-legal response to sexual assault. More specifically, we suggest that the demand for visual proof underpins the positivist approach taken in the pursuit of legal truth and that the generation of such evidence is based on producing discrete and decontextualized empirical facts through what are perceived to be objective technologies. Drawing on interview and focus group data with 14 sexual assault nurse examiners (SANEs) in Ontario, Canada, we examine perceptions and experiences of the role of the visual in sexual assault. Certain of their comments appear to lend support to our theoretical assumptions, indicating a sense of the institutional overemphasis placed on physical damage to sexually assaulted women's bodies and the drive towards the increased technologization of visual evidence documentation. They also noted that physical injuries are frequently absent and that those observed through more refined tools of microvisualization such as colposcopes may be explained away as having resulted from either vigorous consensual sex or a "trivial" sexual assault. Concerns were expressed regarding the possibly problematic ways in which either the lack or particular nature of visual evidence may play out in the legal context. The process of documenting external and internal injuries created for some an uncomfortable sense of fragmenting and objectifying the bodies of those women they must simultaneously care for. We point to the need for further research to enhance our understanding of this issue.

  10. Separating "Inquiry Questions" and "Techniques" to Help Learners Move between the How and the Why of Biology Practical Work

    ERIC Educational Resources Information Center

    Philip, Judith M. D.; Taber, Keith S.

    2016-01-01

    School science practical activities have been criticised for exposing learners to a series of phenomena disconnected from the conceptual frameworks needed to understand them. Such activities are successful in the "domain of observables" but not the "domain of ideas". Few resources exist for classroom teachers wishing to improve…

  11. Some Misconceptions in Meiosis Shown by Students Responding to an Advanced Level Practical Examination Question in Biology.

    ERIC Educational Resources Information Center

    Brown, C. R.

    1990-01-01

    Discussed are problems revealed in student responses to a practical task which formed part of an advanced level examination. The frequencies with which some misconceptions about cell reproduction and genetics occurred are presented. The nature of these misconceptions is analyzed and their implications discussed. (CW)

  12. Some Misconceptions in Meiosis Shown by Students Responding to an Advanced Level Practical Examination Question in Biology.

    ERIC Educational Resources Information Center

    Brown, C. R.

    1990-01-01

    Discussed are problems revealed in student responses to a practical task which formed part of an advanced level examination. The frequencies with which some misconceptions about cell reproduction and genetics occurred are presented. The nature of these misconceptions is analyzed and their implications discussed. (CW)

  13. Separating "Inquiry Questions" and "Techniques" to Help Learners Move between the How and the Why of Biology Practical Work

    ERIC Educational Resources Information Center

    Philip, Judith M. D.; Taber, Keith S.

    2016-01-01

    School science practical activities have been criticised for exposing learners to a series of phenomena disconnected from the conceptual frameworks needed to understand them. Such activities are successful in the "domain of observables" but not the "domain of ideas". Few resources exist for classroom teachers wishing to improve…

  14. The medico-legal investigation of abandoned fetuses and newborns--a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa.

    PubMed

    du Toit-Prinsloo, L; Pickles, C; Smith, Z; Jordaan, J; Saayman, G

    2016-03-01

    There is a dearth of literature on the extent of fetal or newborn abandonment or "dumping" and the medico-legal investigation procedures these cases require. This is despite the fact that these occurrences are a worldwide phenomenon and by definition involve criminal law concerns such as illegal abortion, concealment of birth, murder, or neonaticide, depending on the country concerned. This article contributes to current literature in both respects and provides a retrospective case audit for the period 2004-2008 pertaining to all abandoned newborns and fetuses admitted to the Pretoria Medico-Legal Laboratory (PMLL) in South Africa. Demographic details, scope, and nature of the medico-legal investigation as well as formulation of cause of death were recorded. A total of 289 cases were identified for inclusion in this study, 57% of which were considered to have been non-viable fetuses, while 45 of the viable fetuses were deemed to have been stillborn. These instances involve the crimes of concealment of birth and at times illegal abortion, yet prosecution of these cases are relatively unheard of. Signs of live birth were identified in 38 of the cases in the study. Of these infants, 9 were deemed to have died from injuries they have sustained, and in a further 9 cases, no anatomical cause of death could be identified. Homicidal cases should be brought in cases where death ensued as a result of abandonment; however, it is not known how many cases were prosecuted. A comparatively large number of cases were found to have been admitted to the Pretoria Medico-Legal Laboratory. This is alarming because South African abortion laws are liberal and services are free at point of access in the public health care sector. A substantial percentage of cases of abandoned infants were found to have shown signs of life after birth implying a homicidal manner of death or death by abandonment, but it seems these cases are merely shelved.

  15. [Sudden death secondary to acute aortic syndromes in the North of Portugal: medico-legal study].

    PubMed

    Moreira, Pedro Costa; Santos, Agostinho

    2013-01-01

    An evaluation is presented on the clinical, pathological and sociodemographic characteristics of a sample of sudden death victims secondary to an Acute Aortic Syndrome (AAS) in the north of Portugal, submitted to medico-legal autopsy, during the period between January 2008 and December 2012. Autopsy reports were analyzed in which, through necropsy and histological examination, the confirmed cause of death was an Acute Aortic Syndrome. From the studied cases, 70.3% of the victims were male. The median age was 65,19 ± 14,35 years (minimum of 27 years and maximum of 88 years). Death occurred mainly at home (40,5%) and during the normal activities of daily living (43,1%). There was an history of prodromes in 64,9% of the cases, mainly syncope and pain or respiratory symptoms. In 62,2% of the cases no pain history was reported. In the internal examination three presentation forms were identified: cardiac tamponade (51,4%); hemotorax (16,2%) and intra-abdominal bleeding (32,4%). The occurence of an Acute Aortic Syndrome was related to an aneurysmatic formation in 81% of the cases. Atherosclerotic plaques were identified in 51,4% of the cases and left ventricular hypertrophy was identified in 54,1%. None of the victims had a family history of aortic pathology and 54,1% of them presented a history of arterial hypertension. Necropsy data analysis of sudden death victims allows a better understanding of the AAS presentation, thus complementing the existent clinical studies. This work reveals how forensic medicine can be a privileged medium for articulation with clinical practice.

  16. Demographic variables, clinical aspects, and medicolegal implications in a population of patients with adjustment disorder

    PubMed Central

    Anastasia, Annalisa; Colletti, Chiara; Cuoco, Valentina; Quartini, Adele; Urso, Stefania; Rinaldi, Raffaella; Bersani, Giuseppe

    2016-01-01

    Introduction Although adjustment disorder (AD) is considered as residual diagnosis and receives little attention in research, it plays an important role in clinical practice and also assumes an increasingly important role in the field of legal medicine, where the majority of diagnostic frameworks (eg, mobbing) often refer to AD. Our study aimed to look for specific stressor differences among demographic and clinical variables in a naturalistic setting of patients with AD. Methods A restrospective statistical analysis of the data of patients diagnosed with AD from November 2009 to September 2012, identified via manual search from the archive of the outpatient setting at the University Unit of Psychiatry “A. Fiorini” Hospital, Terracina (Latina, Italy), was performed. Results The sample consisted of 93 patients (46 males and 47 females), aged between 26 and 85, with medium–high educational level who were mainly employed. In most cases (54.80%), a diagnosis of AD with mixed anxiety and depressed mood was made. In all, 72% of the sample reported a negative family history for psychiatric disorders. In 22.60%, a previous history of psychopathology, especially mood disorders (76.19%), was reported. The main stressors linked to the development of AD were represented by working problems (32.30%), family problems (23.70%), and/or somatic disease (22.60%) with significant differences with respect to age and sex. Half of the patients were subjected to a single first examination; 24.47% requested a copy of medical records. Conclusion Confirming previous data from previous reports, our results suggest that AD may have a distinct profile in demographic and clinical terms. Increased scientific attention is hoped, particularly focused on addressing a better definition of diagnostic criteria, whose correctness and accuracy are critical, especially in situations with medicolegal implications. PMID:27099504

  17. Clinical Neuropathology practice guide 5-2015: MGMT methylation pyrosequencing in glioblastoma: unresolved issues and open questions.

    PubMed

    Bienkowski, Michal; Berghoff, Anna S; Marosi, Christine; Wöhrer, Adelheid; Heinzl, Harald; Hainfellner, Johannes A; Preusser, Matthias

    2015-01-01

    O6-methylguanine-methyltransferase (MGMT) promoter methylation status has prognostic and, in the subpopulation of elderly patients, predictive value in newly diagnosed glioblastoma. Therefore, knowledge of the MGMT promoter methylation status is important for clinical decision-making. So far, MGMT testing has been limited by the lack of a robust test with sufficiently high analytical performance. Recently, one of several available pyrosequencing protocols has been shown to be an accurate and robust method for MGMT testing in an intra- and interlaboratory ring trial. However, some uncertainties remain with regard to methodological issues, cut-off definitions, and optimal use in the clinical setting. In this article, we highlight and discuss several of these open questions. The main unresolved issues are the definition of the most relevant CpG sites to analyze for clinical purposes and the determination of a cut-off value for dichotomization of quantitative MGMT pyrosequencing results into "MGMT methylated" and "MGMT unmethylated" patient subgroups as a basis for further treatment decisions.

  18. Death and AIDS: A Review of the Medico-Legal Literature.

    ERIC Educational Resources Information Center

    Huber, Jeffrey T.

    1993-01-01

    Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

  19. Death and AIDS: A Review of the Medico-Legal Literature.

    ERIC Educational Resources Information Center

    Huber, Jeffrey T.

    1993-01-01

    Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

  20. Curiosity Questions

    ERIC Educational Resources Information Center

    Nelsen, Jane; DeLorenzo, Chip

    2010-01-01

    Have you ever found yourself lecturing a child, with the best of intentions, in an attempt to help him or her learn a lesson or process a situation in a manner that you feel will be productive? Curiosity questions, which the authors also call What and How questions, help children process an experience, event, or natural consequence so that they…

  1. Curiosity Questions

    ERIC Educational Resources Information Center

    Nelsen, Jane; DeLorenzo, Chip

    2010-01-01

    Have you ever found yourself lecturing a child, with the best of intentions, in an attempt to help him or her learn a lesson or process a situation in a manner that you feel will be productive? Curiosity questions, which the authors also call What and How questions, help children process an experience, event, or natural consequence so that they…

  2. Essential Questions

    ERIC Educational Resources Information Center

    Wilhelm, Jeffrey D.

    2012-01-01

    The secret to teaching may be as simple as asking students good questions--and then giving them the opportunity to find the answers. The author shares how he uses essential questions that set the class off on an inquiry. Rather than consuming information that he distributes and then repeating it on a test, students carry out their own…

  3. Questions for Surveys

    PubMed Central

    Schaeffer, Nora Cate; Dykema, Jennifer

    2011-01-01

    We begin with a look back at the field to identify themes of recent research that we expect to continue to occupy researchers in the future. As part of this overview, we characterize the themes and topics examined in research about measurement and survey questions published in Public Opinion Quarterly in the past decade. We then characterize the field more broadly by highlighting topics that we expect to continue or to grow in importance, including the relationship between survey questions and the total survey error perspective, cognitive versus interactional approaches, interviewing practices, mode and technology, visual aspects of question design, and culture. Considering avenues for future research, we advocate for a decision-oriented framework for thinking about survey questions and their characteristics. The approach we propose distinguishes among various aspects of question characteristics, including question topic, question type and response dimension, conceptualization and operationalization of the target object, question structure, question form, response categories, question implementation, and question wording. Thinking about question characteristics more systematically would allow study designs to take into account relationships among these characteristics and identify gaps in current knowledge. PMID:24970951

  4. Approaches to Cell Biology Teaching: Questions about Questions

    ERIC Educational Resources Information Center

    Allen, Deborah; Tanner, Kimberly

    2002-01-01

    There are many questions to be asked about the pedagogical practice of questioning. Questions provide insight into what students at any age or grade level already know about a topic, which provides a beginning point for teaching. Questions reveal misconceptions and misunderstandings that must be addressed for teachers to move student thinking…

  5. Approaches to Cell Biology Teaching: Questions about Questions

    ERIC Educational Resources Information Center

    Allen, Deborah; Tanner, Kimberly

    2002-01-01

    There are many questions to be asked about the pedagogical practice of questioning. Questions provide insight into what students at any age or grade level already know about a topic, which provides a beginning point for teaching. Questions reveal misconceptions and misunderstandings that must be addressed for teachers to move student thinking…

  6. Contemplative Pedagogy: Frequently Asked Questions

    ERIC Educational Resources Information Center

    Coburn, Tom; Grace, Fran; Klein, Anne Carolyn; Komjathy, Louis; Roth, Harold; Simmer-Brown, Judith

    2011-01-01

    Contemplative Pedagogy is a new and sometimes controversial pedagogical practice. Faculty often have basic questions about how to implement the pedagogy in their classrooms, in addition to questions that challenge the educational value and appropriateness of the practice. Assembled here are the most frequently asked questions about Contemplative…

  7. Multidisciplinary cancer care in Australia: a national audit highlights gaps in care and medico-legal risk for clinicians.

    PubMed

    Wilcoxon, Heidi; Luxford, Karen; Saunders, Christobel; Peterson, Janice; Zorbas, Helen

    2011-03-01

    Multidisciplinary care (MDC) is accepted as best practice in cancer treatment planning and care. Despite recognition of the importance of a team approach, limited data are available about the extent to which MDC has been implemented in Australia. The aim of the audit was to investigate the implementation of MDC for five main cancer types across Australia in line with best practice. A sample of 155 hospitals was surveyed to investigate the status of MDC for cancer treatment planning in Australia across five cancer types (breast, gynecological, lung, prostate and colorectal). The survey investigated team structure, meetings, patient consent, documentation of team recommendations and communication with the patient. Two-thirds of hospitals surveyed did not have a multidisciplinary team. Of those with such a team; in one-third patients were not informed their case would be discussed by the team, in half patient consent was not sought for all cases discussed by the team, in one-quarter the team's recommended treatment plan was not noted in the patient record. Less than 1% of teams reported routine attendance by the tumour-specific minimum core team. MDC is not being implemented in line with best practice or applied consistently across Australia. This audit has highlighted gaps in care delivery, despite national recommendations about MDC. Areas being neglected can affect the quality of care provided and may put clinicians at medico-legal risk. Recommendations to improve uptake and effectiveness of MDC are provided. © 2011 Blackwell Publishing Asia Pty Ltd.

  8. An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico-legal Mortuary During 2010-2011.

    PubMed

    Keyes, Craig A; Hill, Lawrence; Gordon, Guinevere M

    2016-03-01

    Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico-legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics.

  9. Four Questions

    ERIC Educational Resources Information Center

    Hark-Weber, Amara G., Ed.

    2013-01-01

    In this issue, editor Amara G. Hark-Weber speaks with two practicing artists who teach in very different programs and settings at college level. The first works with individuals who want to make a career out of their craft. Terry Gess is a potter in Western North Carolina who maintains his own practice and studio while also teaching at Haywood…

  10. Four Questions

    ERIC Educational Resources Information Center

    Hark-Weber, Amara G., Ed.

    2013-01-01

    In this issue, editor Amara G. Hark-Weber speaks with two practicing artists who teach in very different programs and settings at college level. The first works with individuals who want to make a career out of their craft. Terry Gess is a potter in Western North Carolina who maintains his own practice and studio while also teaching at Haywood…

  11. Questor's Question

    ERIC Educational Resources Information Center

    Erickson, Mary; Dock, Michelle Nichols; Eldridge, Laurie

    2009-01-01

    Questor is a curious little bird whose four broad questions are helpful to anyone interested in making art or understanding the art of others. He was designed as a character in an online video for children, "Building on a River: Questor's Tale." The video is narrated by Questor, who relates the 2000 year history of architecture along the Salt…

  12. Questioning Styles

    ERIC Educational Resources Information Center

    Martin, Nikki

    2003-01-01

    In this article, the author discusses a project involving the observation of 12 teachers in different schools, teaching pupils at Key Stage 3 of differing ages and abilities, noting both questioning techniques used and pupils' responses. The teachers involved were volunteers, chosen to give a range of experience, styles, and school, and included a…

  13. Questor's Question

    ERIC Educational Resources Information Center

    Erickson, Mary; Dock, Michelle Nichols; Eldridge, Laurie

    2009-01-01

    Questor is a curious little bird whose four broad questions are helpful to anyone interested in making art or understanding the art of others. He was designed as a character in an online video for children, "Building on a River: Questor's Tale." The video is narrated by Questor, who relates the 2000 year history of architecture along the Salt…

  14. Questionable Exercises.

    ERIC Educational Resources Information Center

    Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

    1999-01-01

    This publication presents general guidelines for exercise prescription that have an anatomical basis but also consider the exerciser's ability to do the exercise correctly. It reviews various common questionable exercises, explaining how some exercises, especially those designed for flexibility and muscle fitness, can cause harm. Safer…

  15. "The" Question.

    ERIC Educational Resources Information Center

    Lowe, Pardee, Jr.

    1984-01-01

    Examines the suggestions found in Michael Canale's paper, "Considerations in the Testing of Reading and Listening Proficiency," in the light of a possible U.S. Government's Interagency Language Roundtable receptive skills proficiency test which must supply the answer to the question of how well an individual can understand a particular…

  16. Critical Questions.

    ERIC Educational Resources Information Center

    Worthy, Jo; Hoffman, James V.

    1998-01-01

    Offers responses from four readers of this journal, all reading and/or classroom teachers, to a question posed by another teacher: whether children who have had limited literacy experiences should start reading in whole-language readers and/or trade books or whether they should start in controlled-vocabulary preprimers. (SR)

  17. The Gentle Art of Questioning: Writing Great Clicker Questions

    NASA Astrophysics Data System (ADS)

    Chasteen, Stephanie

    2012-02-01

    How does a teacher use questioning effectively? This workshop will focus on writing those questions that engage students, spark their curiosity, help recap material, give you insight into their thinking, or help them learn critical ideas in physics. We will focus on ``peer instruction'' -- a research-tested method of requiring students to discuss challenging questions with one another. We will investigate the surprising power of multiple-choice questions to achieve critical thinking skills. Finally, we will look at writing questions that align with our goals for students, discuss the elements of effective questions, and practice writing questions and work on improving them.

  18. Screening, assessment, and treatment of osteoporosis for the nurse practitioner: key questions and answers for clinical practice--a Canadian perspective.

    PubMed

    Rice, Peggy; Mehan, Upender; Hamilton, Celeste; Kim, Sandra

    2014-07-01

    Using a case-based approach, we review key clinical questions relevant to nurse practitioners (NPs) regarding the screening, assessment, and treatment of patients at risk for osteoporosis and fractures in a Canadian general practice setting. A case presentation with relevant questions and answers to guide management of a patient. Osteoporosis is a common condition in both the aging male and female populations. Screening, diagnosis, and treatment of osteoporosis is lagging behind relative to other chronic disease states. NPs have a unique opportunity to help reduce this care gap by playing an integral role in the identification, risk stratification, and treatment of patients at risk for osteoporosis and fractures. This case highlights the important role an NP can have in screening a patient previously not diagnosed or managed for osteoporosis. Performing a focused history and physical exam of the patient to determine appropriate screening tests and fracture risk will help in guiding treatment decisions. ©2014 Amgen Inc. Journal of the American Association of Nurse Practitioners published by John Wiley & Sons, Inc. on behalf of American Association of Nurse Practitioners.

  19. Why "What Data Are Necessary for This Project?" and Other Basic Questions are Important to Address in Public Health Informatics Practice and Research.

    PubMed

    Dixon, Brian E; Grannis, Shaun J

    2011-01-01

    Despite the likelihood of poor quality data flowing from clinical information systems to public health information systems, current policies and practices are pushing for the adoption and use of even greater numbers of electronic data feeds. However, using poor data can lead to poor decision-making outcomes in public health. Therefore public health informatics professionals need to assess, and periodically re-evaluate, the quality of electronic data and their sources. Unfortunately there is currently a paucity of tools and strategies in use across public health agencies. Our Center of Excellence in Public Health Informatics is working to develop and disseminate tools and strategies for supporting on-going assessment of data quality and solutions for overcoming data quality challenges. In this article, we outline the need for better data quality assessment and our approach to the development of new tools and strategies. In other words, public health informatics professionals need to ask questions about the electronic data received by public health agencies, and we hope to create tools and strategies to help informaticians ask questions that will lead to improved population health outcomes.

  20. Why “What Data Are Necessary for This Project?” and Other Basic Questions are Important to Address in Public Health Informatics Practice and Research

    PubMed Central

    Dixon, Brian E.; Grannis, Shaun J.

    2011-01-01

    Despite the likelihood of poor quality data flowing from clinical information systems to public health information systems, current policies and practices are pushing for the adoption and use of even greater numbers of electronic data feeds. However, using poor data can lead to poor decision-making outcomes in public health. Therefore public health informatics professionals need to assess, and periodically re-evaluate, the quality of electronic data and their sources. Unfortunately there is currently a paucity of tools and strategies in use across public health agencies. Our Center of Excellence in Public Health Informatics is working to develop and disseminate tools and strategies for supporting on-going assessment of data quality and solutions for overcoming data quality challenges. In this article, we outline the need for better data quality assessment and our approach to the development of new tools and strategies. In other words, public health informatics professionals need to ask questions about the electronic data received by public health agencies, and we hope to create tools and strategies to help informaticians ask questions that will lead to improved population health outcomes. PMID:23569618

  1. [MEDICOLEGAL ASSESSMENT OF THE AGGRESSOR TO PREVENT ADVERSE OUTCOMES IN WOMEN VIOLENCE].

    PubMed

    Castellano Arroyo, María

    2014-01-01

    Violence against women is a health care problem because it is very prevalent and its consequences are serious. The number of deaths due to this problem keep being alarming. Measures to prevent this could be:--Make victims and their families know that complaint is very important.--After complaint, protect the victim and solve her situation quickly. A medicolegal assessment is needed, with a medical-psychological-and psychiatric exploration of the aggressor, to detect alcohol or substances abuse, and to know his personality profile. Risk features are emotional instability, suspicion, pride, sense of abandonment, sense of injustice about the complaint, anxiety, emotional stress or depression. These features mean risk of lethal or very serious damage. Anxiety and depression can also means homicide followed by suicide of the aggressor. An adequate and early medico-legal assessment of the possible aggressor can prevent these adverse outcomes.

  2. Medico-legal investigations of the Airbus, A320 crash upon Mount Ste-Odile, France.

    PubMed

    Ludes, B; Tracqui, A; Pfitzinger, H; Kintz, P; Levy, F; Disteldorf, M; Hutt, J M; Kaess, B; Haag, R; Memheld, B

    1994-09-01

    The authors present the medico-legal investigations and identification after the aircrash of the Airbus A320 upon the Mount Sainte-Odile (France). The identification team comprising investigators from the gendarmerie, forensic pathologists, odontologists, and scientists of the Institute from Legal Medecine rapidly retrieved and identified 85 of the 87 victims, with 17 being identified through DNA typing, three through fingerprints and the remaining through dental records and specific physical or X-ray findings. Full autopsies were performed on all fatalities to determine patterns of injury and cause of death. Results lead us to point out the importance of a multidisciplinary team of forensic practitioners especially trained for managing medico-legal investigation in mass disaster and the ability of DNA technology to solve complex identification problems.

  3. Educational level and pseudohypacusis in medico-legal compensation claims: a retrospective study.

    PubMed

    Mahdavi, Mohammad-Ebrahim; Mokari, Nooshin; Amiri, Zohreh

    2011-01-01

    Pseudohypacusis or the intentional feigning of hearing loss is a challenging situation in the medicolegal evaluation of hearing levels. Few studies have been performed on predisposing factors that make compensation claims susceptible to malingering. The goal of this study was to investigate the relationship between educational level and frequency of pseudohypacusis in a group of medico-legal clients. Retrospectively, we studied the files of subjects (n=421) referred to the audiology clinic of a government hospital during a 12 month period. Educational levels of the individuals with and without pseudohypacusis were compared by the Chi-square test. The results show that individuals with pseudohypacusis have lower educational levels than cooperative clients. The relative frequency of individuals with pseudohypacusis among illiterates (43.5%) was clearly higher than individuals with higher educational levels (17.5%). The education level of a person filing a compensation claim may alert an examiner in detecting pseudohypacusis.

  4. Sudden unexpected death in epilepsy: some approaches for its prevention and medico-legal consideration.

    PubMed

    Verma, Archana; Kumar, Alok

    2015-09-01

    Worldwide, mortality associated with epilepsy is a matter of grave concern. The mortality rate in epileptic population is two to three times more than that of the general population. Sudden unexplained death in epilepsy, better known as sudden unexpected death in epilepsy (SUDEP), is a mysterious and rare condition, in which typically young or middle-aged people with epilepsy die without a clearly defined cause. At times, this may raise a strong suspicion of foul play and raise several medico-legal issues. There may be several different underlying mechanisms but most research has focused on seizure-related cerebral and respiratory depression, cardiac arrhythmia and autonomic dysfunction. In recent years, some significant risk factors have been recognized and strategies have been suggested that could be useful in prevention of SUDEP. Present communication provides some of the updates on new advances in prevention of SUDEP as well as highlights related medico-legal issues.

  5. The clinical management of diabetic foot in the elderly and medico-legal implications.

    PubMed

    Terranova, Claudio; Bruttocao, Andrea

    2013-10-01

    Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

  6. Functional and symptomatic assessment of medico-legal claims after upper limb injuries.

    PubMed

    Belcher, Hjcr

    2016-10-04

    A consecutive group of 250 patients underwent medico-legal assessment at a mean of 24 (±13) months following upper limb injuries. Each had completed questionnaires to assess function (Quick-DASH) and cold intolerance (CIQ36) before clinical assessment following which their whole limb impairment percentage was calculated. The mean(±SD) whole limb impairment, QDASH and CIQ36 scores were 9(±14)%, 43(±24) and 17(±10), respectively. There was a significant correlation between whole limb impairment and QDASH, although some patients reported surprisingly high disability levels despite minimal or no objective functional impairment. Whilst useful qualitative information can be obtained from questionnaires, the correlation between subjective and objective scores is weak albeit statistically significant. Individual patients can show marked discrepancies between objective and subjective functional scores. The results of questionnaires in individual medico-legal patients should be treated with caution.

  7. The First Survey of Forensically Important Entomofauna Collected from Medicolegal Autopsies in South Korea

    PubMed Central

    Shin, Sang Eon; Lee, Hyun Ju; Park, Ji Hye; Ko, Kwang Soo; Kim, Yu-Hoon; Kim, Kyung Ryoul; Park, Seong Hwan

    2015-01-01

    Forensic entomology applies insect evidence to legal problems such as the estimation of minimum postmortem interval (mPMI). For this purpose, knowledge of the insect fauna that are attracted to human cadavers in each geographic region is a prerequisite. Despite many studies investigating the insect fauna attracted to meat, there has been no survey of the entomofauna on human cadavers in the East Asian temperate climate zone, particularly in Korea. Therefore, this study reports the entomofauna collected from medicolegal autopsies in northeastern Seoul and its suburbs. Insect samples were collected from 35 medicolegal autopsies in 2010, 2011, and 2013. Molecular and morphological methods were utilized for taxonomic identification. Among 1398 individual samples belonging to 3 orders, 13 families, 18 genera, and 32 species, the dominant family and species were Calliphoridae and Lucilia sericata, respectively. Despite its limited scale, this study provides a snapshot of the general entomofauna that are attracted to human cadavers in this region. PMID:26185759

  8. A medico-legal evaluation of the use of assisted reproductive technologies in Turkey.

    PubMed

    Pelin, S S

    1997-01-01

    In Turkey, as possibly in the case of several or even many other countries, infertility is generally regarded as a negative phenomenon in women. Assisted Reproductive Technologies (ARTs), which provide certain childless couples with the possibility of having a baby, are being applied more and more frequently in this country, apparently as has been the case in the world at large. From a medicolegal point of view, the related applications in Turkey can only be realized in the case of married couples. Other forms of application in this area, on the other hand, such as sperm banks or surrogate motherhood, are not allowed legally. A text which was called "Guidelines Regarding the Centers of In Vitro Fertilization and Embryo Transfer" was prepared in 1987 by the Ministry of Health. The aim of these Guidelines is to find solutions to the medico-legal problems created by the application of ARTs in this country.

  9. [Anxiety and anxiety disorders--differential diagnosis, etiology and medico-legal assessment].

    PubMed

    Licha, Christina; Stevens, Andreas

    2012-06-01

    Psychiatric disorders including anxiety disorders, are becoming more and more important in medico-legal assessment. Anxiety disorders are frequent in the general population. However, they may not be reliably diagnosed even by psychiatric experts because the disorders' symptoms may fail to manifest themselves during the examination. Functional impairments related to anxiety disorders are similarly problematic to assess. Finally, given the existence of effective therapies, it is hard to explain why patients with anxiety disorders have to be assessed at all. This report discusses the various and quite heterogeneous concepts associated with the word "anxiety". Anxiety disorder as a disease is differentiated from anxiety as a physiological emotion. Evidence concerning the etiology of anxiety disorders is compiled and strategies for medico-legal assessment, including the efficacy of therapies, are presented.

  10. The demographic characteristics of medicolegal death among welfare recipients in Tokyo Metropolis (2008-2013).

    PubMed

    Suzuki, Hideto; Tanifuji, Takanobu; Abe, Nobuyuki; Fukunaga, Tatsushige

    2017-04-01

    Background The number of welfare recipients has steadily increased in Japan during recent years, although the number of homeless persons has decreased. Despite there being many reports regarding medicolegal death among homeless persons, medicolegal death among welfare recipients has not been fully investigated. Methods We identified 10,293 individuals who received welfare aid during their lifetime among the 81,867 cases that were examined by the Tokyo Medical Examiner's Office (2008-2013). We retrospectively compared the proportions of medicolegal death to total population, age, sex, family status, clinical history, and manners/causes of death among non-indigent persons (controls), homeless persons, and welfare recipients. Results A higher proportion of medicolegal death to total population was observed among the welfare recipients, compared with the controls. The welfare recipients (65.5 years) were younger than the controls (68.9 years), and the proportions of male sex and living alone were higher among the welfare recipients. Hypertension and circulatory disease were the leading clinical conditions among the welfare recipients. Death due to disease was the leading manner of death, and circulatory disease was the leading cause of death among the welfare recipients. The proportion of individuals with a long period between death and discovery (which made determining the cause of death difficult) was also higher among the welfare recipients. Conclusion Welfare recipients have a greater risk of sudden death compared with non-indigent persons. Preventive strategies should target middle-aged to elderly men who live alone, and should address their risks of circulatory diseases and solitary death.

  11. Medico-legal perspectives on sudden cardiac death in young athletes.

    PubMed

    Oliva, Antonio; Grassi, Vincenzo M; Campuzano, Oscar; Brion, Maria; Arena, Vincenzo; Partemi, Sara; Coll, Monica; Pascali, Vincenzo L; Brugada, Josep; Carracedo, Angel; Brugada, Ramon

    2017-03-01

    Sudden cardiac death (SCD) in a young athlete represents a dramatic event, and an increasing number of medico-legal cases have addressed this topic. In addition to representing an ethical and medico-legal responsibility, prevention of SCD is directly correlated with accurate eligibility/disqualification decisions, with an inappropriate pronouncement in either direction potentially leading to legal controversy. This review summarizes the common causes of SCD in young athletes, divided into structural (hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary artery anomalies, etc.), electrical (Brugada, congenital LQT, Wolf-Parkinson-White syndrome, etc.), and acquired cardiac abnormalities (myocarditis, etc.). In addition, the roles of hereditary cardiac anomalies in SCD in athletes and the effects of a positive result on them and their families are discussed. The medico-legal relevance of pre-participation screening is analyzed, and recommendations from the American Heart Association and European Society of Cardiology are compared. Finally, the main issues concerning the differentiation between physiologic cardiac adaptation in athletes and pathologic findings and, thereby, definition of the so-called gray zone, which is based on exact knowledge of the mechanism of cardiac remodeling including structural or functional adaptions, will be addressed.

  12. Iatrogenic splenic injury: review of the literature and medico-legal issues

    PubMed Central

    Feola, Alessandro; Niola, Massimo; Conti, Adelaide; Delbon, Paola; Graziano, Vincenzo; Pietra, Bruno Della

    2016-01-01

    Abstract Introduction: Iatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed to a technical error of the operator rather than being an unpredictable and unpreventable complication. It is important for the medico-legal expert to have great knowledge on iatrogenic splenic injuries because it is important to evaluate every step of the first procedure performed, how a splenic injury is produced, and whether the correct treatment for the splenic injury was administered in a judgment. PMID:28352813

  13. The Questions of Liberal Education

    ERIC Educational Resources Information Center

    Arcilla, Rene V.

    2007-01-01

    There is a certain kind of liberal educator who bases his or her practice on a particular attitude toward the "Big Questions." The questions of fundamental literacy in K-12 education, or of expertise in vocational and professional education, may be just as important, but they are seen as quite different in kind. Indeed, the questions of liberal…

  14. The Hermeneutics of Educational Questioning

    ERIC Educational Resources Information Center

    Bingham, Charles

    2005-01-01

    This article looks at the practice of educational questioning using the philosophical hermeneutics of Hans-Georg Gadamer. It first looks at questions and statements from a hermeneutic perspective, demonstrating some of the differences and similarities between the two. It then details Gadamer's notion of the "true question", asking whether it is…

  15. The Hermeneutics of Educational Questioning

    ERIC Educational Resources Information Center

    Bingham, Charles

    2005-01-01

    This article looks at the practice of educational questioning using the philosophical hermeneutics of Hans-Georg Gadamer. It first looks at questions and statements from a hermeneutic perspective, demonstrating some of the differences and similarities between the two. It then details Gadamer's notion of the "true question", asking whether it is…

  16. How Do Question Writers Compose External Examination Questions? Question Writing as a Socio-Cognitive Process

    ERIC Educational Resources Information Center

    Johnson, Martin; Constantinou, Filio; Crisp, Victoria

    2017-01-01

    The focus of this research is on the practice of education examination question writing. Educational examinations are tests that are taken by candidates in schools or colleges but that are externally developed, administered and marked by an assessment organisation. Whilst the practice of writing external examination questions is ubiquitous,…

  17. The Knowledge, Awareness, and Practices of Portuguese General Practitioners Regarding Multimorbidity and its Management: Qualitative Perspectives from Open-Ended Questions.

    PubMed

    Prazeres, Filipe; Santiago, Luiz

    2016-11-08

    Multimorbidity's high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs) regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal. Open-ended questions were analysed via inductive thematic content analysis. GPs pointed out several difficulties and challenges while managing multimorbidity. Extrinsic factors were associated with the healthcare system logistics' management (consultation time, organization of care teams, clinical information) and society (media pressure, social/family support). Intrinsic factors related to the GP, patient, and physician-patient relationship were also stated. The most significant conclusion to emerge from this study is that although GPs perceived difficulties and challenges towards multimorbidity, they also have the tools to deal with them: the fundamental characteristics of family medicine. Also, the complex care required by multimorbid patients needs adequate consultation time, multidisciplinary teamwork, and more education/training.

  18. Medicolegal death of homeless persons in Tokyo Metropolis over 12 years (1999-2010).

    PubMed

    Suzuki, Hideto; Hikiji, Wakako; Tanifuji, Takanobu; Abe, Nobuyuki; Fukunaga, Tatsushige

    2013-05-01

    Recently, the number of homeless persons in Japan has steadily decreased. However, it is not certain whether unexpected death of the homeless have actually decreased in proportion to decrease in total number of cases. The documentation of medicolegal deaths among homeless persons handled in the Tokyo Medical Examiner's Office during 1999-2010 were reviewed, and we compared the number and manner/cause of death between cases occurring before 2004 and those occurring after 2004. In addition, we compared manner/cause of death between homeless and non-homeless persons. The number of medicolegal deaths of homeless persons remained almost the same during the study period in spite of a marked decrease in the total number of homeless persons after 2004. Age distribution shifted to older after 2004, and a higher proportion of the deceased had longer postmortem periods after 2004. Comparison between the manners/causes of death of the cases occurring before 2004 and those occurring after 2004 showed little difference. Disease constituted about 70% of all cases, and causes of death from disease were more various than those of non-homeless persons. Certain specific patterns included a higher proportion of death from circulatory disease in elderly homeless persons and a higher proportion of death from alcohol-related digestive disease and tuberculosis among younger homeless persons. Regarding accidental death, hypothermia was a leading cause of death irrespective of age group. Aging and isolation among homeless persons might contribute to an unchanged number of medicolegal death of them. In addition to measures to address frequent causes of death in each age group, better intervention for isolated homeless persons might be a key factor to prevent unexpected deaths of homeless persons in the future. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Bio-medicolegal guidelines and protocols: survey and future perspectives in Europe.

    PubMed

    Ferrara, Santo Davide; Bajanowski, Thomas; Cecchi, Rossana; Snenghi, Rossella; Case, Colette; Viel, Guido

    2010-07-01

    The preservation of uniqueness and the enhancement of the value of evidence in legal medicine is based on the implementation and development of a "quality management system," which includes a continuous education of specialists, the introduction and application of guidelines and protocols, as well as mechanisms of internal quality control. This ongoing process shows differences with regard to various fields of knowledge such as forensic genetics, toxicology, forensic pathology or forensic psychiatry, especially if different European countries are compared. To get an overview on the development of legal medicine in different European countries, a questionnaire was developed and sent to representatives of 42 European countries to verify the existence of bio-medicolegal guidelines and protocols. A National Society of Legal Medicine is established in 27 out of 32 countries (84%) which could be included in the final analyses. In 25 countries (78%), a specialisation is necessary as a prerequisite of inclusion in a national register, and 30 of the countries (94%) have guidelines in at least one field of legal medicine. The most common guidelines concern forensic pathology (in the fields of professional qualification and sudden death), forensic toxicology (driving under the influence of drugs and substance testing) and forensic genetics (paternity testing and personal identification). The findings of this study show that comparison is possible and can be a basis for further consensus in the European medicolegal community. The process of harmonisation of the medicolegal autopsy rules in Europe initiated in 1990 was a first step on this way. Further consensus is necessary and might be gained by developing European guidelines for each field within the subdisciplines, based on a standard European Guideline Format.

  20. Using existing information from medico-legal death investigations to improve care of older people in residential aged care services.

    PubMed

    Ibrahim, Joseph Elias; Bugeja, Lyndal; Ranson, David

    2013-12-01

    The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or responsibility A significant proportion of deaths are preventable, specifically those occurring prematurely from natural causes or due to injury and trauma. By addressing these preventable deaths, significant public health cost savings and better health outcomes for our growing ageing population can be achieved. Despite substantive monitoring of the provision of aged care, no single entity is explicitly responsible for systematically analysing medico-legal death information. The data and skills for using information from medico-legal death investigations currently exist. Dispelling the myths removes one impediment to investing in this area of public health.

  1. E-suicide note: A newer trend and its medico-legal implications in India.

    PubMed

    Behera, C; Karthik, Krishna; Dogra, Td; Lalwani, S; Millo, T; Singh, Sr

    2014-06-01

    Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on people's day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as "E-suicide note" and discuss its medico-legal implications in India with examples from their observations.

  2. Suicide pact by drowning with bound wrists: a case of medico-legal importance.

    PubMed

    Behera, C; Karthik, Krishna; Singh, Hansraj; Deepak, Prakash; Jhamad, Akhilesh R; Bhardwaj, D N

    2014-03-01

    Suicide pacts are uncommon and mainly committed by male-female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted "brother of convenience" were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

  3. Tuberculous abdominal aortic aneurysm with alimentary tract hemorrhage: a case report with medico-legal implications.

    PubMed

    Xie, Dan; Xie, Kai; Li, Pei; Peng, Yu-Long; Yang, Xiang; Yang, Li-Ying; Cai, Ji-Feng

    2014-04-01

    An autopsy case of sudden death induced by alimentary tract hemorrhage was presented, which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic aneurysm (TAAA). The initial diagnosis was made of the syndrome of coronary heart disease and hypertensive disease. The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sudden rupture of the mass after posture changing was ascertained as the cause of death. The diagnosis of TAAA was determined by the autopsy findings. Analysis for the medical dispute of TAAA was described, and the difficulty of the diagnosis and medico-legal implications were also discussed.

  4. Trivial trauma, heart disease and medico-legal interpretation of death.

    PubMed

    Kohli, Anil; Mishra, Kiran

    2008-01-01

    Forensic experts are often required to give an opinion on the cause of death and its medico-legal interpretation in cases where an individual dies after receiving non-fatal injuries and at autopsy is discovered to have had a natural disease that alone could have caused death. The significance of this varies in different countries depending on the local laws relating to death in cases of trivial trauma associated with natural disease. This paper discusses this issue from an Indian perspective with the help of an illustrative case report and highlights the importance of the forensic pathologist in such cases.

  5. [Medico-legal risks of human voluntary sterilization].

    PubMed

    Le Quinquis, P; Chevrant-Breton, O

    1986-01-01

    brought the action in civil rather than criminal court, and the question of the legal status of the operation was not raised even though the operation was not performed to remedy any pathological condition. The Court of Cassation was careful to specify that the surgeon had an obligation to use appropriate techniques according to state of the art procedures to obtain sterilization. The surgeon's error was not failure of the operation but failure to warn the patient of the possibility of pregnancy.

  6. Medico-legal claims against English radiologists: 1995–2006

    PubMed Central

    Halpin, S F S

    2009-01-01

    A list of claims against radiologists from 1995–2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under £8.5 million has so far been paid in damages, with a further £5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of £464 000 (£673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was £300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future. PMID:19470570

  7. Medico-legal claims against English radiologists: 1995-2006.

    PubMed

    Halpin, S F S

    2009-12-01

    A list of claims against radiologists from 1995-2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under pound8.5 million has so far been paid in damages, with a further pound5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of pound464 000 ( pound673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was pound300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future.

  8. Medicolegal investigation in New York City. History and activities 1918-1978.

    PubMed

    Eckert, W G

    1983-03-01

    Medicolegal investigation in America can truly be said to have begun in an organized manner in 1918. The Massachusetts medical examiner system, which began in 1877, never developed with the central control and the completeness that characterizes the New York Office of the Chief Medical Examiner, nor did it influence the spread of this form of medicolegal investigation. An overview of the period before the establishment of the New York Office in 1918 and early experiences in coroner's investigation in New York is presented. The roots of the development of the office are discussed, as were the early days of the office under Dr. Charles Norris, whose influence on the spread of knowledge and of providing an important service to the community in general is detailed. The contributions of Alexander Gettler, the father of forensic toxicology in America, are also discussed. The contributions of Gonzales, Vance, Helpern, Umberger, and Wiener are also included. Special problems of New York City are described, including narcotic deaths, gas refrigerator deaths, malaria in addicts, plastic bag hazards, sudden infant deaths, operative deaths, as well as many famous cases involving murder, disasters, and unusual deaths over a period of 60 years. Milestones in the Office of the Chief Medical Examiner of New York City are listed, as are chronological details of major cases and problems. Several comparative figures of the workload and frequency of various types of death are also included. A relationship of deaths to different life-styles is noted.

  9. [Behavioral disorders in Parkinson's disease. Genetic, pharmacological and medico-legal aspects].

    PubMed

    Sobrido, M J; Dias-Silva, J J; Quintáns, B

    2009-01-23

    Patients with Parkinson's disease (PD) may present neuropsychiatric and conduct disorders at different stages of the development of the disease that make treatment even more difficult. The neurologist must be on the lookout for the possible appearance of alterations affecting impulse control, even from the early stages of the disease, so as to be able to prevent them or to plan a suitable adjustment of treatment. Some of the most common impulsivity disorders include hypersexuality, compulsive gambling and other addictive behaviours which, if left undetected and untreated, can end up having a destructive effect on the patient's socio-familial surroundings. Psychotic disorders (hallucinations, delusions) are often associated to advanced phases of PD and to the effect of dopamine therapy, and they are associated to a higher morbidity and mortality rate. Factors of a genetic or pharmacogenetic nature or a gene-environment interaction may account for the different individual susceptibility to disorders in the neuropsychiatric realm among patients with PD. It is wise to bear in mind the possible medico-legal implications that may stem from behavioral disorders, both for the patient and his or her family and for the physician, because situations could arise that trigger conflicts between confidentiality and preventing third parties from being harmed, as well as harm that can be attributed to the side effects of medicines. The specialist must be familiar with, foresee and propose suitable treatment for behavioral and neuropsychiatric disorders in PD with potential medico-legal implications.

  10. [Medico-legal features of early discharge in acute myocardial infarction and chest pain].

    PubMed

    Montisci, M; Ruscazio, M; Snenghi, R; Nalin, S; Montisci, R; Iliceto, S; Ferrara, S D

    2001-06-01

    The authors' aim is to outline some of the main medico-legal problems in cardiology, especially those regarding the premature hospital discharge of patients with undefined chest pain and/or with acute myocardial infarction. After a brief overview on the etiology and clinical definition of chest pain and myocardial infarction, premature hospital discharge is defined and the incidental medico-legal risks that physicians operating in such situations are exposed to are pointed out. Next, the profiles regarding both the positive and negative views of professional medical responsibility are described. In the negative frame, the authors outline the most frequent civil and penal aspects of the unpremeditated responsibility. Then the physician's error, in both qualitative (generic or specific guilt) and quantitative (degree) terms, is considered; particularly, negligence, imprudence and inexperience, as qualitatively accepted meanings of generic guilt, are dealt with by adopting illustrative cases settled in the light of the right legal interpretation. The phases of the diagnostic or prognostic error are evaluated, and clinical protocols, as a reference parameter for the identification of error, are considered. Lastly, the problem of causality, essential condition for the judgment about the professional responsibility, and the problem of the patient's consent, including an evaluation of the legal capability or incapability about the declaration of consent, are examined closely.

  11. Witnesses of the body: medico-legal cases in seventeenth-century Rome.

    PubMed

    De Renzi, Silvia

    2002-06-01

    Studying early modern medico-legal testimonies can enrich our understanding of witnessing, the focus of much research in the history of science. Expert testimonies were well established in the Roman Cannon law, but the sphere of competence of expert witnesses - one of the grounds on which seventeenth-century physicians claimed social and intellectual authority- troubled contemporary jurists. By reconstructing these debates in Counter Reformation Rome, and by placing in them the testimonies given by Poalo Zacchia, one of the founding fathers of legal medicine, this article discusses the epistemological and social issues surrounding the definition of expertise about the body in court. It shows how a high-ranking expert witness would define his competence versus the legal authority on the one hand, lower-status expert witnesses on the other. But it also explores the interactions between specific legal constraints, for example about eye witnessing, and the ways in which different kinds of witnesses would use the body as a source of evidence for testimony. While engaging with medico-legal issues including the ambiguous signs of childbirth and the (in)visibility of pain, the article examines their meanings within Counter Reformation social controversies, including control over sexuality, imposition of discipline and the social status of physicians. Copyright 2002 Elsevier Science Ltd. All rights reserved.

  12. [Medico-legal opinionating in cases of insobriety in medical personnel].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Drozd, Radosław

    2009-01-01

    The authors analyzed the medico-legal opinions in cases of insobriety in medical personnel. The studies were based on the results of 157 medico-legal evaluations in criminal cases performed in the years 2005-2007. Expert appraisals included: correctness of medical management, degree of exposure to direct danger of death or grave detriment to health associated with alcohol intoxication of a physician, regardless of his activities being correct in their merits, as well as influence of insobriety on personnel behavior. Penal responsibility is implemented in case of exposing the patient to direct danger to life or severe detriment to health. The necessary analysis should include activities that have been or should have been performed by a physician with respect to his patients, their health status (degree of danged to life or health) and the effect of the physician's alcohol intoxication on his abilities to perceive and assess the reality, make decisions and perform his duties. The Polish law in force lacking the equivalent of Article 147 found in the Polish penal code of 1969 causes problems in penalization of insobriety in medical personnel.

  13. Questions raised by artificial prolongation of life of the aged patient.

    PubMed

    Rougé, D; Telmon, N; Albar ede, J L; Arbus, L

    1994-01-01

    The existence of treatments which now make it possible to prolong life beyond the point when it would previously have ended, gives rise to particular questions in the context of the care of aged patients: the distinction between curative and palliative treatment, the evaluation of incurability, the right to refuse treatment, competence to make such a decision and the use of the limited objective and pure objective tests in the event of incompetence. The natural role of the physician as protector adds a further ethical dimension to what is also a medicolegal question.

  14. A case of stillbirth: the importance of placental investigation in medico-legal practice.

    PubMed

    Marchetti, Daniela; Belviso, Maura; Fulcheri, Ezio

    2009-03-01

    The authors present a case of stillbirth in which histologic examination of the placenta provides the opportunity to make a definitive diagnosis of a death due to fetal thrombotic vasculopathy (FTV). Establishing the etiology in cases of stillbirth may avoid medical malpractice litigation. The better knowledge of the cause of stillbirths also helped obstetricians to recognize factors that could have prejudiced future pregnancies.

  15. Readiness for legally literate medical practice? Student perceptions of their undergraduate medico-legal education.

    PubMed

    Preston-Shoot, Michael; McKimm, Judy; Kong, Wing May; Smith, Sue

    2011-10-01

    Medical councils increasingly require graduates to understand law and to practise medicine mindful of the legal rules. In the UK a revised curriculum for medical law and ethics has been published. However, coverage of law in medical education remains variable and doubts exist about how far students acquire legal knowledge and skills in its implementation. This survey of students in two UK medical schools measured their law learning and their confidence in using this knowledge. Concept maps and a self-audit questionnaire were used to capture students' understanding and perceptions of this knowledge domain and self-assessments of their legal knowledge and skills. A large sample was achieved across first, second and final year students. Students agree that a sound understanding of law is essential to being a good doctor. Their perceptions of law are generally positive but the interface between the legal rules and codes of medical ethics creates difficulty. In some areas students offer relatively confident self-assessments of their legal knowledge and skills for practising law. However, levels of confidence in other areas of their law learning raise doubts about the degree to which they can advocate for and protect their patients. Conclusions are drawn about the effectiveness of students' law learning and recommendations made for further research.

  16. Toward automated consumer question answering: automatically separating consumer questions from professional questions in the healthcare domain.

    PubMed

    Liu, Feifan; Antieau, Lamont D; Yu, Hong

    2011-12-01

    Both healthcare professionals and healthcare consumers have information needs that can be met through the use of computers, specifically via medical question answering systems. However, the information needs of both groups are different in terms of literacy levels and technical expertise, and an effective question answering system must be able to account for these differences if it is to formulate the most relevant responses for users from each group. In this paper, we propose that a first step toward answering the queries of different users is automatically classifying questions according to whether they were asked by healthcare professionals or consumers. We obtained two sets of consumer questions (~10,000 questions in total) from Yahoo answers. The professional questions consist of two question collections: 4654 point-of-care questions (denoted as PointCare) obtained from interviews of a group of family doctors following patient visits and 5378 questions from physician practices through professional online services (denoted as OnlinePractice). With more than 20,000 questions combined, we developed supervised machine-learning models for automatic classification between consumer questions and professional questions. To evaluate the robustness of our models, we tested the model that was trained on the Consumer-PointCare dataset on the Consumer-OnlinePractice dataset. We evaluated both linguistic features and statistical features and examined how the characteristics in two different types of professional questions (PointCare vs. OnlinePractice) may affect the classification performance. We explored information gain for feature reduction and the back-off linguistic category features. The 10-fold cross-validation results showed the best F1-measure of 0.936 and 0.946 on Consumer-PointCare and Consumer-OnlinePractice respectively, and the best F1-measure of 0.891 when testing the Consumer-PointCare model on the Consumer-OnlinePractice dataset. Healthcare consumer

  17. Toward Automated Consumer Question Answering: Automatically Separating Consumer Questions from Professional Questions in the Healthcare Domain

    PubMed Central

    Liu, Feifan; Antieau, Lamont D.; Yu, Hong

    2011-01-01

    Objective Both healthcare professionals and healthcare consumers have information needs that can be met through the use of computers, specifically via medical question answering systems. However, the information needs of both groups are different in terms of literacy levels and technical expertise, and an effective question answering system must be able to account for these differences if it is to formulate the most relevant responses for users from each group. In this paper, we propose that a first step toward answering the queries of different users is automatically classifying questions according to whether they were asked by healthcare professionals or consumers. Design We obtained two sets of consumer questions (~10,000 questions in total) from Yahoo answers. The professional questions consist of two question collections: 4654 point-of-care questions (denoted as PointCare) obtained from interviews of a group of family doctors following patient visits and 5378 questions from physician practices through professional online services (denoted as OnlinePractice). With more than 20,000 questions combined, we developed supervised machine-learning models for automatic classification between consumer questions and professional questions. To evaluate the robustness of our models, we tested the model that was trained on the Consumer-PointCare dataset on the Consumer-OnlinePractice dataset. We evaluated both linguistic features and statistical features and examined how the characteristics in two different types of professional questions (PointCare vs. OnlinePractice) may affect the classification performance. We explored information gain for feature reduction and the back-off linguistic category features. Results 10-fold cross-validation results showed the best F1-measure of 0.936 and 0.946 on Consumer-PointCare and Consumer-OnlinePractice respectively, and the best F1-measure of 0.891 when testing the Consumer-PointCare model on the Consumer-OnlinePractice dataset

  18. Trends in domestic animal medico-legal pathology cases submitted to a veterinary diagnostic laboratory 1998-2010.

    PubMed

    McEwen, Beverly J

    2012-09-01

    Pathologists at veterinary diagnostic laboratories receive medico-legal cases from a variety of animal species for postmortem examination. A search of computerized records of the Animal Health Laboratory, University of Guelph, Guelph, Ontario, Canada from 1998 to 2010 identified 1706 medicolegal cases. These were categorized according to the history as criminal investigations, anesthetic-related deaths, insurance, litigation, malpractice cases, and regulatory cases. Statistically significant linear trends in the proportion of medicolegal cases for all animals and criminal cases for companion animals were identified over the 12 year period. Companion animals had significantly greater odds of being a medicolegal case in all categories except for insurance and regulatory cases, compared to noncompanion animals. Based on pathology reports for the 271 criminal cases, 43.1% were consistent with neglect, 29.2% were compatible with non-accidental injury, 4.80% were poisonings, 10.7% were deemed to be due to natural disease, and 11.43% were inconclusive. © 2012 American Academy of Forensic Sciences.

  19. Exorcising excision: medico-legal issues arising from male and female genital surgery in Australia.

    PubMed

    Mason, C

    2001-08-01

    Genital surgery is one of the most controversial and contested practices, yet it is frequently described and referred to with little or no attention to cultural and social context. This article examines the practice, performed on both men and women, and the extent to which it clashes with issues of consent and capacity, as well as multicultural concepts of toleration for minority group practices. It then questions why female genital surgery, unlike male genital surgery, is legally prohibited in Australia. It argues that such legal gender bias stems from a liberal conception of "tolerance" and the limits of consent in Australia, placing female genital surgery in an "unacceptable" category and male genital surgery in an "acceptable" category.

  20. [Medicolegal responsibility].

    PubMed

    Cardona, Jacqueline; Cordier, Anne-Laure; Malicier, Daniel

    2005-05-15

    It was from 1835 onwards that jurisprudence considered that the doctor was responsible for his acts and that he must answer to what he does. Yet it took the Mercier act of 20/5/1936 that specified that between the doctor and his client exists a true contract comprising, for the doctor, an undertaking if not obviously to cure the patient, then at least to not give non-specific care but conscientious and attentive care and, except in exceptional circumstances, to conform to the body of evidence of science. This contract is based on a relationship of confidence, and even an involuntary violation of this contractual obligation is sanctioned. A victim of a medical accident has recourse to several types of legal processes, be it a request for civil or administrative indemnity reparations (depending on the whether the damages were incurred in the private sector or in a hospital), or a criminal pursuit if the first objective is to punish the doctor. Two important laws have brought innovations with regards to medical accidents. The law of the 10th of July 2000 has allowed a de-penalisation, whereas the law of 4/3/2002 has allowed more equitable compensation of the therapeutic risk, thus preserving free choice for the victim to seek medical help in the private or the public sector.

  1. Questioning Questions: Elementary Teachers' Adaptations of Investigation Questions Across the Inquiry Continuum

    NASA Astrophysics Data System (ADS)

    Biggers, Mandy

    2017-01-01

    Questioning is a central practice in science classrooms. However, not every question translates into a "good" science investigation. Questions that drive science investigations can be provided by many sources including the teacher, the curriculum, or the student. The variations in the source of investigation questions were explored in this study. A dataset of 120 elementary science classroom videos and associated lesson plans from 40 elementary teachers (K-5) across 21 elementary school campuses were scored on an instrument measuring the amount of teacher-direction or student-direction of the lessons' investigation questions. Results indicated that the investigation questions were overwhelmingly teacher directed in nature, with no opportunities for students to develop their own questions for investigation. This study has implications for researchers and practitioners alike, calling attention to the teacher-directed nature of investigation questions in existing science curriculum materials, and the need for teacher training in instructional strategies to adapt their existing curriculum materials across the continuum of teacher-directed and student-directed investigation questions. Teachers need strategies for adapting the teacher-directed questions provided in their existing curriculum materials in order to allow students the opportunity to engage in this essential scientific practice.

  2. [Nursing] Test Pool Questions. Area II.

    ERIC Educational Resources Information Center

    Watkins, Nettie; Patton, Bob

    This manual consists of area 2 test pool questions which are designed to assist instructors in selecting appropriate questions to help prepare practical nursing students for the Oklahoma state board exam. Multiple choice questions are utilized to facilitate testing of nursing 2 curriculum objectives. Each test contains questions covering each…

  3. [Nursing] Test Pool Questions. Area I.

    ERIC Educational Resources Information Center

    Watkins, Nettie; Patton, Bob

    This manual consists of area 1 test pool questions which are designed to assist instructors in selecting appropriate questions to help prepare practical nursing students for the Oklahoma state board exam. Multiple choice questions are utilized to facilitate testing of nursing 1 curriculum objectives. Each test contains questions covering each…

  4. [Nursing] Test Pool Questions. Area II.

    ERIC Educational Resources Information Center

    Watkins, Nettie; Patton, Bob

    This manual consists of area 2 test pool questions which are designed to assist instructors in selecting appropriate questions to help prepare practical nursing students for the Oklahoma state board exam. Multiple choice questions are utilized to facilitate testing of nursing 2 curriculum objectives. Each test contains questions covering each…

  5. Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form

    PubMed Central

    2012-01-01

    Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose. PMID:22583548

  6. Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form.

    PubMed

    Alharbi, Ziyad; Piatkowski, Andrzej; Dembinski, Rolf; Reckort, Sven; Grieb, Gerrit; Kauczok, Jens; Pallua, Norbert

    2012-05-14

    Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose.

  7. [Medico-legal autopsy--selected legal issues: the autopsy protocol].

    PubMed

    Gaszczyk-Ozarowski, Zbigniew; Chowaniec, Czesław

    2010-01-01

    The majority of experts in the field of forensic medicine maintain that the minutes of the medicolegal autopsy should be taken by the forensic pathologist. The authors argue that it is the public prosecutor who is obliged to draw up the minutes, whereas the forensic pathologist issues the expert opinion. To support their stance, the authors make frequent references to several provisions of the Criminal Procedure Code of 1997. The authors also imply that due to organizational reasons and the ratio legis of the aforementioned code, the forensic pathologist should not be assigned the role of the minutes-taker, despite the lack of a specific exclusion rule governing such a case. Possible consequences caused by the lack of the properly drawn up minutes are briefly discussed as well.

  8. Occupational fatalities in the construction sector: A medico-legal viewpoint.

    PubMed

    Das, Siddhartha

    2015-06-01

    Occupational fatalities are those that occur during the course of a person's occupation. They can occur in any industry or sector. Studies have shown that the construction sector is more dangerous for workers than the industrial sector, and there are more deaths both in the developed and developing countries. The construction sector has seen a boom in countries like India over the past few years and with it an increase in the number of occupational fatalities. Three different types of occupational fatalities pertaining to construction sector are presented here to increase awareness of the different types of occupational fatalities that may occur. The circumstances leading to them are discussed from a medico-legal viewpoint. Specific acts of negligence have been highlighted and suggestions offered with a view to decreasing fatalities.

  9. Danger points, complications and medico-legal aspects in endoscopic sinus surgery.

    PubMed

    Hosemann, W; Draf, C

    2013-12-13

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5-1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.

  10. Medico-legal autopsy of abandoned foetuses and newborns in India.

    PubMed

    Behera, C; Sikary, Asit Kumar; Krishna, Karthik; Garg, Aayushi; Chopra, Saurav; Gupta, S K

    2016-06-01

    Foeticide and the abandonment of newborns are important, albeit frequently neglected, issues. Concealment of childbirth is often seen in the setting of unwanted pregnancy which has been recognised as one of the most important factors in both cases. This study highlights the medico-legal autopsy findings of 238 abandoned foetuses and newborns over a period of 17 years (1996-2012) from the region of South Delhi, India. There was no sex predilection. The majority of the cases were full term. Nearly 35% of the foetuses were still born, about 29% were live born and the remainder were non-viable. Among the live born, death by homicide was more common than a natural death and most were left by the roadside. The abandoning and killing of newborns needs urgent attention, and strict measures are needed to save thousands of innocent lives.

  11. Fetal Alcohol Syndrome in Sudden Unexpected Death in Infancy: A Case Report in Medicolegal Autopsy.

    PubMed

    Tangsermkijsakul, Aphinan

    2016-03-01

    Fetal alcohol spectrum disorder is a range of birth defects associated with prenatal alcohol exposure. Fetal alcohol syndrome (FAS) is the most serious form of fetal alcohol spectrum disorder. Infants with FAS are prone to death because of various physical abnormalities. Consequently, infants with FAS may be presented in the medicolegal investigation as a form of sudden unexpected death in infancy. The author reported a 6-month-old male infant who was found dead at home. The history of maternal ethanol consumption during pregnancy was obtained. The infant was diagnosed with FAS at the autopsy because he was presented with postnatal growth retardation, multiple facial abnormalities, and abnormal brain structures, which met the criteria of FAS. The cause of death was severe aspiration pneumonia. The purposes of this case report are to show an uncommon manifestation of sudden unexpected death in infancy case for the forensic pathologists and to emphasize on the national healthcare problem.

  12. Responsible use of cone beam computed tomography: minimising medico-legal risks.

    PubMed

    Noffke, C E E; Farman, A G; Van der Linde, A; Nel, S

    2013-07-01

    This communication highlights some of the ethical and possible legal responsibilities which pertain to the taking, reading, reporting, and communication of findings from cone-beam computed tomography (CBCT) scans. The importance of knowledge of head and neck anatomy and pathology to reduce the likelihood of incorrect interpretation is emphasised. Failure to detect critical findings in any diagnostic image can potentially result in medico-legal consequences. CBCT is no exception to this rule. Dental schools are advised to include CBCT imaging as a diagnostic tool in their under- and postgraduate curricula thereby equipping graduates to use 3D imaging in general and CBCT in particular. Existing dental practitioners are advised to seek continuing education on 3D imaging as part of their required lifelong learning.

  13. [Medicolegal opinions assessing the ability to undergo imprisonment vs. capacity of the Prison Health Service facilities].

    PubMed

    Jurek, Tomasz; Bujak, Marek; Szostak, Maciej; Swiatek, Barbara

    2008-01-01

    Estimating the subject's ability to undergo imprisonment has become a medicolegal opinionating problem. Polish penal law indicates the presence of negative prerequisites, such as a "serious disease" and "important health-associated reasons". In these cases, the conditions of imprisonment pose a direct danger of death or detriment to health. Interruption of imprisonment or remission of the penalty of imprisonment must constitute the only possibility of avoiding such dangers. In his opinion, the expert should define the health-associated needs of the condemned and the possibilities of meeting such needs in the situation of imprisonment, also taking into consideration the capacity of the prison health service facility and its cooperation with regular health care institutions.

  14. Danger points, complications and medico-legal aspects in endoscopic sinus surgery

    PubMed Central

    Hosemann, W.; Draf, C.

    2013-01-01

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education. PMID:24403974

  15. Medicolegal considerations in the initiation and termination of resuscitation in Canada.

    PubMed Central

    Gilmour, J M; Rosenberg, P J

    1989-01-01

    Medicolegal issues in cardiopulmonary resuscitation (CPR) and emergency cardiac care were considered in the United States by the National Conference on Cardiopulmonary Resuscitation in 1985. This paper discusses these issues in the Canadian context. Although there is little legislation or case precedent in Canada to guide providers of CPR in decision-making, there appears to be little risk of liability or prosecution for competently rendered care. Providers should be cautious in withholding or withdrawing resuscitative measures from incompetent patients when brain death has not occurred and cardiovascular unresponsiveness has not been demonstrated. However, resuscitation may be withheld when a competent patient refuses it or if there is another medically and legally valid reason to do so. PMID:2644006

  16. Experience with a medicolegal decision-making system for occupational hearing loss-related tinnitus.

    PubMed

    Dejonckere, Philippe H; Coryn, Christiane; Lebacq, Jean

    2009-01-01

    Owing to an increasing number of requests for compensation, a medicolegal decision-making system for tinnitus related to noise-induced hearing loss (NIHL) has been elaborated at the Federal Belgian Institute of Occupational Diseases. Experience with 113 patients, all of them claiming compensation for NIHL and tinnitus, is now available. The patients underwent an exhaustive audiological investigation, and their professional career and noise exposure were carefully and objectively documented. We reviewed the group of 35 "accepted" cases (i.e., with chronic tinnitus recognized as related to NIHL and financially compensated as an occupational disease) and analyzed the medicolegal arguments for acceptance or rejection. In these patients, tinnitus was mostly bilateral, was perceived on average at a frequency of 4 KHz and with a supraliminal intensity of 7.2 dB, and lasted on average for 7.3 years. To gain better insight into the relationship between cochlear damage and chronic tinnitus, we compared our group to a control group of 35 patients with similar hearing thresholds at 3 and 4 KHz but free of tinnitus. The main difference is a significantly steeper slope of the audiometric curve between 2 and 3 KHz in the tinnitus group. Furthermore, a notch in the distortion product-gram is noticed in 60% of the ears affected by tinnitus versus 9% of the ears in the control group. This abrupt discontinuity in the activity along the tonotopic axis of the auditory system-the main characteristic of NIHL-could be a factor eliciting tinnitus, as a correspondence between the audiometric notch and tinnitus frequency appears to exist.

  17. Variations in the papillary muscles of normal tricuspid valve and their clinical relevance in medicolegal autopsies.

    PubMed

    Aktas, Ekin O; Govsa, Figen; Kocak, Aytac; Boydak, Bahar; Yavuz, Ismail C

    2004-09-01

    In our study, tricuspid valves in cases of sudden death secondary to congenital differences of the tricuspid valve with significant papillary muscle anatomy were investigated. No studies of papillary muscle anatomy of the tricuspid valve have been found in medicolegal autopsies in literature. The purpose of our study is to investigate the relationship of papillary muscle in tricuspid valve in cases of sudden deaths, especially those resulting from cardiac disease, with the muscle structure, as well as the number of the muscle leading congenital changes. The study was carried out in the Department of Anatomy, Faculty of Medicine, Ege, University, Izmir, Turkey and comprised of 400 human hearts obtained between 2000 and 2002 from 400 autopsy cases during a medicolegal autopsy with permission from the Council of Forensic Medicine, Izmir. Quantitative and morphological aspects of the papillary muscles of the right ventricle were evaluated. The criteria such as number, incidence, length and shape of the anterior, (APM) septal (SPM) and posterior papillary muscles (PPM) have been observed. Although the papillary muscle presented great variability in numbers, with a minimum of 2 and a maximum of 9 papillary muscles in the right ventricle, there were usually 3 papillary muscles in the right ventricle; APM, PPM and SPM. The one headed APM was found to be more often in cardiac deaths. However, observing more frequent conical and flat topped configurations in all PPM was striking. The absence or lower ratio, or both of attachment bridges of SPM and APM/PPM in deaths of cardiac origin is also significant. We have found that the presence of this attachment is higher in deaths of noncardiac origin. This anatomical study may explain the increased in incidence wide variations of papillary muscle tricuspid valve in deaths of cardiac origin. The verdict in legal affairs may change with this. The knowledge regarding wide variations and minor anatomical abnormalities of papillary

  18. Recognizing Question Entailment for Medical Question Answering

    PubMed Central

    Abacha, Asma Ben; Dina, Demner-Fushman

    2016-01-01

    With the increasing heterogeneity and specialization of medical texts, automated question answering is becoming more and more challenging. In this context, answering a given medical question by retrieving similar questions that are already answered by human experts seems to be a promising solution. In this paper, we propose a new approach for the detection of similar questions based on Recognizing Question Entailment (RQE). In particular, we consider Frequently Asked Question (FAQs) as a valuable and widespread source of information. Our final goal is to automatically provide an existing answer if FAQ similar to a consumer health question exists. We evaluate our approach using consumer health questions received by the National Library of Medicine and FAQs collected from NIH websites. Our first results are promising and suggest the feasibility of our approach as a valuable complement to classic question answering approaches. PMID:28269825

  19. Recognizing Question Entailment for Medical Question Answering.

    PubMed

    Abacha, Asma Ben; Dina, Demner-Fushman

    2016-01-01

    With the increasing heterogeneity and specialization of medical texts, automated question answering is becoming more and more challenging. In this context, answering a given medical question by retrieving similar questions that are already answered by human experts seems to be a promising solution. In this paper, we propose a new approach for the detection of similar questions based on Recognizing Question Entailment (RQE). In particular, we consider Frequently Asked Question (FAQs) as a valuable and widespread source of information. Our final goal is to automatically provide an existing answer if FAQ similar to a consumer health question exists. We evaluate our approach using consumer health questions received by the National Library of Medicine and FAQs collected from NIH websites. Our first results are promising and suggest the feasibility of our approach as a valuable complement to classic question answering approaches.

  20. David Murray Morton: father figure of surgery at St Vincent's Hospital, bush lawyer and thwarted reformer of the medico-legal system.

    PubMed

    Vellar, Ivo D

    2002-08-01

    When the first Golden Age of surgery at St Vincent's Hospital Melbourne (a period covering the first 25 years of the twentieth century) is discussed, the names that spring to mind are usually those of Sir Thomas Dunhill, Sir Hugh Devine, Sir Douglas Shields and Julian Smith. A name which is often overlooked, and by now almost forgotten, is that of David Murray Morton. Murray -Morton's career both as a medical student, general practitioner, anaesthetist and surgeon coincided with a revolution in the practice of medicine. He witnessed the progression from Listerian antisepsis to asepsis in surgical practice, the improvements in anaesthesia, the introduction of antibiotics and, before he died in 1959, the beginnings of organ transplants and open heart surgery. Morton was fond of saying that he grew up with the hospital. From the time of his first appointment as an anaesthetist in l896 to the time of his retirement from St Vincent's as senior surgeon in 1931, Morton, admired by all as a highly competent surgeon and a man of incorruptible probity, can rightly be described as the father figure of surgery during the formative years of St Vincent's Hospital. His innate sense of justice and fair play formed the basis of his distinguished tenure of the Presidency of the Medical Defence Association of Victoria, where his constructive attempts at reform of the medico-legal system were only thwarted by the predictable opposition of the legal profession and politicians.

  1. Lethal envenomation: medicolegal aspects of snakebites and religious snake handlers in Kentucky: a report of three cases with comment on medical, legal, and public policy ramifications.

    PubMed

    Hunsaker, Donna M; Hunsaker, John C; Clayton, Tara; Spiller, Henry A

    2005-11-01

    Ritualistic serpent qua snake handling, which rests upon inveterate religious conviction arising out of literal interpretation of selected passages of the New Testament, is a rare ceremony practiced by a distinct minority of Christians predominantly in rural Appalachian regions of the United States commonly referred to as the Bible belt. The fervent, frenzied pursuit by anointed "sign-followers" of intimate contact with a variety of poisonous snakes, however, puts the handler together with sect members or bystanders at risk for lethal envenomation, particularly when prompt medical attention is held by the congregation of faith to contravene God's will. The authors report three separate cases of death due to envenomation by snakebite during a church service and the handler's faith-based refusal to seek treatment. Postmortem examination of each yielded similar physical findings attributable to various toxic sequelae of the complex venoms. A review of the injurious constituents of these chemical toxins also includes a discussion of complex pathophysiological mechanisms causing death. In addition, the authors review the history of representative legislative and judicial responses to the sensationally mortal phenomenon, all of which ineluctably grapple with fundamental Constitutional issues devolving from such controversial religious practices. We underscore the view that a thoroughly documented medicolegal investigation and autopsy are indispensable to both inform matters of public health and thereby contribute to the formulation of sound public policy.

  2. [EbM from the bottom up: are questions asking for evidence in daily clinical practice answerable?---a report from a pilot test to assist general practitioners with using evidence-based medicine].

    PubMed

    Blank, Wolfgang; Weingart, Olaf

    2009-01-01

    Many physicians agree on the advantages of using Evidence-based Medicine (EbM) in daily practice, but they do not make use of this method very often. One reason for this lack of EbM implementation is that it is difficult to access clinically relevant and appropriate information in daily practice. The division "Principles and Practices of EbM" in the German Network for Evidence-based Medicine (DNEbM) initiated a pilot project to improve their information management. During two weeks in February 2007 physicians in a local setting in the southeast part of Germany were offered an EbM expert service. They were asked to formulate open-ended questions arising from daily practice. Seventeen experts answered these questions within a three day period. In addition, all participants regularly received an edited version of these topics, and finally a questionnaire was sent out to evaluate physician satisfaction. Five family doctors and two hospital departments formulated 28 questions in two weeks. There was a wide range of answers, from evidence summaries (including full texts of the trials or relevant guidelines) up to expert opinion together with a discussion of different action strategies in the case of uncertain evidence. The participating physicians' satisfaction with this offer of low-barrier access to the best available evidence and the answers provided by the experts was high. Apart from the suggested solutions to the respective problems the project initiated a critical self-analysis of their individual clinical practice among the participating physicians. All of them saw the need for continuing this project. Further investigations are needed in order to optimise both the process of EbM implementation on a long-term basis and the health care quality by providing EbM expert services.

  3. Question Analysis for Biomedical Question Answering

    PubMed Central

    Sable, Carl; Lee, Minsuk; Zhu, Hai Ran; Yu, Hong

    2005-01-01

    We are developing a biomedical question answering system. This paper describes our system’s architecture and our question analysis component. Specifically, we have explored the use of various supervised machine learning approaches to filter out unanswerable questions based on physicians’ annotations. PMID:16779389

  4. Questions, Questioning Techniques, and Effective Teaching.

    ERIC Educational Resources Information Center

    Wilen, William W., Ed.

    This book focuses on questioning techniques and strategies teachers may employ to make the difference between active and passive learning in the classroom. There are nine chapters: (1) Why Questions? (Ambrose A. Clegg, Jr.); (2) Review of Research on Questioning Techniques (Meredith D. Gall and Tom Rhody); (3) The Multidisciplinary World of…

  5. [Problem of exposure to direct danger of death or grave detriment to health of a child breast-fed by an alcohol-abusing mother in medico-legal opinions].

    PubMed

    Swiderski, Paweł; Zaba, Czesław; Tezyk, Artur; Wachowiak, Roman

    2011-01-01

    In the last few years, the authors have noted an increasing amount of cases submitted for analysis in the Chair and Department of Forensic Medicine, Poznan University of Medical Sciences, and addressing alcohol abuse by breast-feeding mothers. A question about the exposure to direct danger of death or grave detriment to health of a child by a breast-feeding mother under the influence of alcohol is posed by prosecution or the court, and the expectation is obtaining answers from forensic experts as to whether the situation fulfills the meaning of article 160 of the penal code, which would result in the mother bearing criminal liability. Difficulties that have arisen during the analysis of such cases have prompted the authors to analyze the problem of alcohol abuse by breast-feeding mothers in terms of medico-legal opinions.

  6. Exploring the Theory-Practice Gap in Initial Teacher Education: Moving beyond Questions of Relevance to Issues of Power and Authority

    ERIC Educational Resources Information Center

    McGarr, Oliver; O'Grady, Emmanuel; Guilfoyle, Liam

    2017-01-01

    The "theory-practice divide" in teacher education can be viewed not simply as an acceptance of a body of knowledge but instead an acceptance of the teacher educator's authority to determine what is relevant educational theory. This research aimed to explore student teachers' views of "educational theory" and how it was…

  7. Review of medicolegal cases for cauda equina syndrome: what factors lead to an adverse outcome for the provider?

    PubMed

    Daniels, Eldra W; Gordon, Zachary; French, Keisha; Ahn, Uri M; Ahn, Nicholas U

    2012-03-07

    Cauda equina syndrome is 1 of a few true surgical emergencies involving the lumbar spine. Although treatment within 48 hours has been found to correlate with improved outcomes, recovery of bowel and bladder control does not always occur, and loss of these functions can be distressing to patients. An understanding of factors affecting the legal outcome can aid the clinician in determining risk management for medicolegal cases of cauda equina syndrome. This study is a retrospective analysis of medicolegal cases involving cauda equina syndrome. The LexisNexis Academic legal search database was used to obtain medicolegal cases of cauda equina syndrome to determine risk factors for adverse decisions for the provider. Outcomes data on trial verdicts were collected, as were associated penalties. Case data were also compiled on age, sex, initial presentation site, initial diagnosis, whether a rectal examination was performed, time to consultation with a specialist, time to completion of advanced imaging study, time to surgery, and neurosurgical vs orthopedic consultation. Based on our study of court cases involving cauda equina syndrome, a positive association was found between time to surgery >48 hours and an adverse decision (P<.05). The actual degree of functional loss did not appear to affect the verdicts. Because 26.7% of the cases involved an initial presentation that included loss of bowel or bladder control, this study emphasizes the importance of cautioning all patients with spinal complaints of the potential risk for cauda equina syndrome.

  8. Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation

    PubMed Central

    Polistena, Andrea; Sanguinetti, Alessandro; Buccelli, Claudio; Conzo, Giovanni; Conti, Adelaide; Niola, Massimo; Avenia, Nicola

    2016-01-01

    Abstract Aim of the present paper is the review of the principal complications associated to endocrine neck surgery considering how expertise, full adoption of guidelines, appropriate technology and proper informed consent may limit the medicolegal claims at the light of the incoming new regulation of the medical professional legal responsibility. A literature search, using the Medline/PubMed database for full-length papers, was used. Postoperative recurrent laryngeal nerve (RLN) palsy and hypoparathy-roidism remain the principal causes of surgical malpractice claims . In the procedure of neck lymphadenctomy intra-operative haemorrhage, thoracic duct injury, injuries to loco-regional nerves can be observed and can be source of claims. After many years of increased medicolegal litigations, the Italian government is proposing a drastic change in the regulations of supposed medical malpractice in order to guarantee the patient’s right to a safe treatment and in the meantime to defend clinicians from often unmotivated and prejudicial legal cases. Surgical errors and complications in neck surgery are a relevant clinical issue. Only the combination of surgical and clinical expertise, application of guidelines, appropriate technology and a routinely use of specific informed consent can contain potential medicolegal implications. PMID:28352812

  9. The competency question.

    PubMed

    Ruthemeyer, M

    2000-01-01

    JCAHO mandates "processes that are designed to ensure that the competency of all staff members is assessed, maintained, demonstrated, and improved on an ongoing basis." However, it is difficult to collect aggregate data regarding staff competency patterns and trends. How many facilities have the time or energy to collect aggregate data, let alone statistically analyze it for patterns and trends? Not many in today's environment. I saw the need to create a test to evaluate staff competency at my facility, but soon realized I would have no way of knowing if the results were good or bad. The only way to judge the results would be to have a standardized test that was used by multiple facilities. As president of the Houston X-ray Quality Society, I brought the topic up at a meeting in 1995, and a committee was set up to work on the test. The result is two competency tests--one for staff radiographers and one for mammographers--which are currently used by 35 to 40 facilities, with approximately 1,000 technologists taking the test each year. The tests include practical questions that reflect the knowledge required to perform daily exams. Each test has five sections that assess different areas of competency. The scoring system allows technologists to fail one or more individual sections but still pass the test overall. Twenty to 30 percent of the questions are new each year. That gives us the ability to look for improvement on previous year's questions, and at the same time, avoid producing a static and ineffective test. There are 60 questions on the staff radiographer test and 65 questions on the mammographer test, which also includes clinical images. Facilities must sign an agreement that states that they cannot use the test as a disciplinary tool in the employee's evaluation, or in any other way against the technologist. As a profession, radiology administration not only has regulatory requirements to evaluate competency, but also a moral duty to insure that patients

  10. [Application of hair analysis of selected psychoactive substances for medico-legal purposes. Part I. Segmental hair analysis in cases of fatal opioids and amphetamines poisoning].

    PubMed

    Rojek, Sebastian; Kłys, Małgorzata; Konopka, Tomasz

    2009-01-01

    The present experimental investigations were inspired by the necessity of standardizing the procedures and analytical methods employed in hair analysis aiming at a retrospective evaluation of ingestion of various xenobiotics. Thus, in keeping with the principal premises, the main objective of the study was development of unique, novel chemico-toxicological procedures for analyzing hair content of psychoactive substances in two basic groups of substances of abuse: opioids (morphine, 6-monoacetylmorphine, codeine) and amphetamines (amphetamine, methamphetamine, MDA, MDMA, MDEA) by HPLC-APCI-MS-MS, followed by verification of the thus worked out procedures in medico-legal practice through opinionating in selected group of patients deceased due to fatal psychoactive substance poisoning (cause of death determination). Determinations of opioids and amphetamines in the hair biological matrix were performed using high performance liquid chromatography - atmospheric pressure chemical ionization - tandem mass spectrometry (HPLC-APCI-MS-MS). In the group of fatal poisonings by ,,Polish heroine", hair segmental analysis confirmed the abuse profile of the opiate or mixed (opiate-amphetamine) type, which to some measure is characteristic of Polish drug addiction, indicating the presence of these xenobiotics in the investigating hair samples in the premortem period.

  11. Unproven (questionable) cancer therapies.

    PubMed Central

    Brigden, M L

    1995-01-01

    More than half of all cancer patients use some form of alternative treatment during the course of their illness. Alternative therapies are often started early in patients' illness, and their use is frequently not acknowledged to health care professionals. Some alternative therapies are harmful, and their promoters may be fraudulent. Persons who try alternative cancer therapies may not be poorly educated but may ultimately abandon conventional treatment. Recent attention has focused on aspects of questionable therapies that make these treatments attractive to patients and that may be perceived as being deficient in the practice of conventional health care professionals. Physicians with patients with cancer should always make sure that unproven therapies are discussed early in the therapeutic relationship. They should also attempt to be aware of alternative therapies that are in vogue in their particular geographic area. PMID:8533410

  12. Better Questions and Answers Equal Success.

    ERIC Educational Resources Information Center

    Swicegood, Philip R.; Parsons, James L.

    1989-01-01

    Students with learning disabilities and behavior problems need instruction designed to increase active thinking and questioning skills. Described methods for teaching these skills include T. Raphael's question-answer relationships, A. Hahn's questioning strategy, reciprocal teaching, and the "ReQuest" procedure. Practice activities for…

  13. Emergency Nursing Review Questions: July 2017.

    PubMed

    Shaw, Tracy

    2017-07-01

    The review questions that are featured in each of issue of JEN are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice, pediatric and adult. These questions offer emergency nurses an opportunity to test their knowledge about their practice. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  14. Emergency Nursing Review Questions: November 2016.

    PubMed

    Shaw, Tracy

    2016-11-01

    The review questions that are featured in each of issue of JEN are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice, pediatric and adult. These questions offer emergency nurses an opportunity to test their knowledge about their practice. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  15. Posing Einstein's Question: Questioning Einstein's Pose.

    ERIC Educational Resources Information Center

    Topper, David; Vincent, Dwight E.

    2000-01-01

    Discusses the events surrounding a famous picture of Albert Einstein in which he poses near a blackboard containing a tensor form of his 10 field equations for pure gravity with a question mark after it. Speculates as to the content of Einstein's lecture and the questions he might have had about the equation. (Contains over 30 references.) (WRM)

  16. Posing Einstein's Question: Questioning Einstein's Pose.

    ERIC Educational Resources Information Center

    Topper, David; Vincent, Dwight E.

    2000-01-01

    Discusses the events surrounding a famous picture of Albert Einstein in which he poses near a blackboard containing a tensor form of his 10 field equations for pure gravity with a question mark after it. Speculates as to the content of Einstein's lecture and the questions he might have had about the equation. (Contains over 30 references.) (WRM)

  17. Medicolegal cases involving periviable births from a major United States legal database.

    PubMed

    Muniraman, Hemananda; Cascione, Miranda; Ramanathan, Rangasamy; Nguyen, Jimmy

    2017-06-08

    The management of expectant mothers and infants born at the threshold of viability is challenging. We describe medicolegal cases from a major United States legal database involving periviable births in an effort to identify areas for improvement. We conducted a retrospective review of all United States state and federal cases in the Westlaw database from 1980 through 2016 involving peripartum and immediate post-delivery management of infants born between 22 0/7 and 25 6/7 weeks' gestation. Our search criteria returned 736 results, and 15 cases met full inclusion criteria. Eight cases involved conflicts on resuscitation contrary to parental directives. Eleven cases comprised alleged miscommunication between families and providers. Of these, seven cases alleged inadequate prenatal counseling of infant's chances of survival and neurological outcome, whilst four cases alleged miscommunication of infant's condition post-delivery. Miscommunication between providers and families during prenatal counseling and after birth was a major component of malpractice cases regarding infants born at the threshold of viability. The infant's immediate post-delivery condition and long term prognosis were of primary interest to parents, and improving effective communication may aid toward more genuinely informed resuscitation directives.

  18. A medicolegal study of domestic violence in south region of Jordan.

    PubMed

    Al-Hawari, Hasan; El-Banna, Asmaa

    2017-01-01

    Domestic violence is a forced pattern of behavior that happened in domestic settings to gain or maintain power and control over an individual. The aim of this work is to study the magnitude of domestic violence in south region of Jordan. The retrospective study was retrieved from the medico-legal reports of domestic violence cases referred to the Directorate of Forensic Medicine in south region of Jordan during six years period starting from 1st of January 2010 till the end of December 2015. The total number of cases was 128. The majority was females (77.3%), high prevalence (41.4%) was found in adult age group (18 years and above) in both genders. The prevalence was higher in rural areas (75%). Sexual abuse was the commonest method of domestic violence in both genders (41.4%). Nearly a quarter of cases (23.4%) leaving home as an outcome. Spring months represented the highest percentage of domestic violence occurrence (28.1%). Family and financial problems were reported in 71.1% of cases. Domestic violence rate in South Jordan is much lower than in other areas but still considered a problem and should be given high priority with regard to prevention, investigation and treatment.

  19. Student perceptions of medico-legal autopsy demonstrations in a student-centred curriculum.

    PubMed

    McNamee, Lakshini S; O'Brien, Frances Y; Botha, Julia H

    2009-01-01

    Teaching autopsies in undergraduate medicine, although traditionally considered valuable by both educators and students, have been marginalised in modern curricula. This study explored medical students' experiences of the medico-legal autopsy demonstrations which formed part of their training in forensic medicine. In this phenomenological study, qualitative data obtained by interviewing 10 Year 4 medical students from various socio-cultural backgrounds were interpretively examined. One-to-one, semi-structured interviews were tape-recorded and transcribed. The data were thematically organised and then analysed using a theoretical framework of three dimensions of learning, namely, cognitive, emotional and societal. Students still perceive autopsies as essential even in the context of self-directed learning. They identified a better understanding of anatomy and traumatology as the main cognitive benefits. At an emotional level students felt they had developed a degree of clinical detachment and would be better equipped to deal with issues surrounding death. Although socialisation influenced students' feelings about the autopsy, it did not detract from their appreciation of the educational value of the experience. The results support previous findings from both students, prior to curriculum reform, and medical educators who were canvassed for their opinions in relation to a modern curriculum. Besides the obvious cognitive advantages, educators should be mindful of the hidden curriculum that emanates from autopsies because it impacts on the development of professionalism and ethical behaviours of future medical practitioners.

  20. Forensic Odontology: A Boon to Community in Medico-legal Affairs.

    PubMed

    Chidambaram, R

    2016-01-01

    Forensic odontology is a sub-discipline of dental science which involves the relationship between dentistry and the law. The specialty of forensic odontology is applied in radiographic investigation, human bite marks analysis, anthropologic examination and during mass disasters. Besides the fact that radiographs require pretentious laboratory, it is still claimed to be a facile, rapid, non-invasive method of age identification in the deceased. The budding DNA technology has conquered the traditional procedures and currently being contemplated as chief investigating tool in revealing the hidden mysteries of victims and suspects, especially in hopeless circumstances. Forensic odontology has played a chief role in solving cold cases and proved to be strong evidence in the court of law. Systematic collection of dental records and preservation of the same would marshal the legal officials in identification of the deceased. To serve the forensic operation and legal authorities, dental professionals need to be familiar with the basics of forensic odontology, which would create a consciousness to preserve the dental data. The aim of this paper is to emphasize the vital applications of forensic odontology in medico-legal issues. Conjointly the recent advancements applied in forensic human identification have been updated.

  1. Fatal Clostridium perfringens septicemia suggested by postmortem computed tomography: A medico-legal autopsy case report.

    PubMed

    Yamaguchi, Rutsuko; Makino, Yohsuke; Chiba, Fumiko; Motomura, Ayumi; Inokuchi, Go; Yajima, Daisuke; Iwase, Hirotatro

    2015-08-01

    We report a fatal case of suspected Clostridium (Cl.) perfringens septicemia in a previously healthy woman in her eighties. At first, she presented at the hospital complaining of upper abdominal discomfort and vomiting, and was discharged the next day after ruling out any fatal conditions. However, her condition deteriorated approximately 10h after discharge and she died shortly after. The postmortem computed tomography (PMCT) performed 29h postmortem revealed an excessive systemic gas accumulation compared with the postmortem external appearance and time elapsed since her death, which suggested the presence of a gas-forming infection. Histopathological examination showed diffuse proliferation of Gram-positive bacilli in almost all the organ tissues, especially in blood vessels. Along with these findings, hyperthermia 3h postmortem, and severe anemia and thrombocytopenia without an obvious site of hemorrhage suggested hemolysis due to Cl. perfringens septicemia. These findings suggested the diagnosis before performing the conventional autopsy. To the best of our knowledge, this is the first case report to describe PMCT findings of gas-forming infection and septicemia in contrast with the external appearance and histopathological findings in a medico-legal autopsy setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Post-traumatic stress disorder and memory: prescient medicolegal testimony at the International War Crimes Tribunal?

    PubMed

    Sparr, Landy F; Bremner, J Douglas

    2005-01-01

    The nature of remembrance of traumatic events has been particularly controversial during the past decade as vigorous new research has reshaped thinking about trauma and memory. Memory alterations in traumatized individuals have been investigated within both theoretical and biological frameworks. There are different types of memory, and empirical studies have associated post-traumatic stress disorder (PTSD) with a simultaneous weakening and a strengthening of memory. Memory deficiencies in PTSD have been found to be related to problems in new learning (explicit memory), but other specific deficiencies are unvalidated. Recently, accuracy of memory has received particular scrutiny because considerable importance is attached to victims' recollections. In 1998, at the International War Crimes Tribunal in The Hague, The Netherlands, a Bosnian-Croatian soldier was tried for aiding and abetting the rape of a Muslim woman. The defendant's lawyers suggested that the woman's memory was inaccurate, having been adversely affected by her traumatic experiences, and that the defendant whom she identified was not present during her interrogation and abuse. The prosecution disagreed and argued that memories of traumatic experiences in individuals with PTSD are characteristically hyperaccessible. Expert witnesses on both sides were brought in to provide medicolegal testimony about the scientific parameters of stress and its long-term effects on brain regions associated with memory. With the expert witness discussion as background, this article reviews the most recent research about the nature of memory in the aftermath of trauma and the politics of psychological trauma and the law.

  3. Quality of Life and Medico-Legal Implications Following Iatrogenic Bile Duct Injuries.

    PubMed

    Hariharan, Deepak; Psaltis, Emmanouil; Scholefield, John H; Lobo, Dileep N

    2017-01-01

    In this review we aimed to evaluate quality of life after bile duct injury and the consequent medico-legal implications. A comprehensive English language literature search was performed on MEDLINE, Embase, Science Citation Index and Google™ Scholar databases for articles published between January 2000 and April 2016. The last date of search was 11 April 2016. Key search words included bile duct injury, iatrogenic, cholecystectomy, prevention, risks, outcomes, quality of life, litigation and were used in combination with the Boolean operators AND, OR and NOT. Long-term survival after bile duct injury is significantly impaired (all-cause long-term mortality approximately 21 %) along with the quality of life (especially psychological/mental state remains affected). Bile duct injury is associated with high rates of litigation. Monetary compensation varied from £2500 to £216,000 in the UK, €9826-€55,301 in the Netherlands and $628,138-$2,891,421 in the USA. Bile duct injuries have profound implications for patients, medical personnel and healthcare providers as they cause significant morbidity and mortality, high rates of litigation and raised healthcare expenditure.

  4. The role of fillers in aesthetic medicine: medico-legal aspects.

    PubMed

    Marinelli, E; Montanari Vergallo, G; Reale, G; di Luca, A; Catarinozzi, I; Napoletano, S; Zaami, S

    2016-11-01

    In recent years there has been an exponential increase of fillers use in aesthetic medicine. The popularity of this anti-wrinkle product is based on their capacity to offer significant improvement in the aesthetic field, particularly to skin rejuvenating processes with non-invasive and less expensive techniques, if compared to the surgical methods (i.e. surgical lifting). The great number of fillers on the market is composed of a large heterogenic number of biomaterials. The aim of this review was to provide an overview and a classification of the filling materials that are most commonly used. A synthesis of the literature concerning fillers and related side effects was also reported. The law decree no. 23 of 1998, converted in the law no. 94 of 1998 and the principal judgments of the Italian Court of Cassation have been examined with the medico-legal issues related to fillers use in medicine. With respect to their degradation, filler materials may be classified as temporary (degradable), semi-permanent and permanent (not degradable). The temporary fillers such as hyaluronic acid and collagen are completely degraded by the surrounding tissue in a few months. The permanent fillers, such as the ones derived from silicon oil and minerals are not biodegradable and may cause serious and irreversible side effects. Their use requires a physician with a high level of specialization to perform the treatment, a deep knowledge of face anatomy and a great degree of experience.

  5. Characteristics of victims of violence admitted to a specialized medico-legal unit in Switzerland.

    PubMed

    Hofner, Marie-Claude; Burquier, Raphaelle; Huissoud, Thérèse; Romain, Nathalie; Graz, Bertrand; Mangin, Patrice

    2009-07-01

    To improve care and services to victims of interpersonal violence, a medico-legal consultation unit was set up at the Lausanne University Hospital, Switzerland in 2006. Adult victims of violence are referred to the consultation by the emergency department. Patients are received by forensic nurses for support, forensic examination and community orientation. A descriptive study of medical reports filled for the 2006 population was conducted in 2007 with the aim to explore characteristics of this specific population and to better orient prevention. Among the 422 patients in 2006, 57% were men and 43% women, with a median age of 31 years old. Violent episodes took place in a public place for 90% of male victims and at home for 70% of female victims. The perpetrators were mostly unknown to male victims (62% of all men victims) and mostly known (usually the partner or a former partner) to female victims (90% of all women victims). For 80% of the women and 47% of the men, the violent event which brought them to the consultation, was not the first one. Because 90% of all patients under study were victimized by men., not only is it necessary to target prevention program to match the potential victims, prevention messages must also focus on potential offenders, especially on young men.

  6. [Medico-legal opinionating in cases of medical errors in declaration of death].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Drozd, Radosław

    2007-01-01

    Declaration of death is a diagnosis and it has legal consequences. While declaring death, there is a possibility of committing a medical error. The majority of irregularities in declaring an individual dead occur in emergency situations. When a physician declares death, he is released from the professional obligation of saving the individual's life. The studies were based on the results of medico-legal evaluations in criminal cases in medical errors. In case death is erroneously declared, we may face a situation of squandering the chance of saving the life of a human being. Exposure to loss of life or to severe detriment to health are possible charges here, along with failure to offer medical assistance, although a deliberate character of the offence according to article 162 of the Polish penal code renders such a legal qualification dubious in case of medical errors. In both cases verification is needed whether an interest protected by law was still in existence, i.e. whether the individual was still alive when the physician incorrectly declared him dead.

  7. Eight Questions for Better Lessons

    ERIC Educational Resources Information Center

    Kriegel, Otis

    2016-01-01

    In this article, veteran educator Otis Kriegel provides eight questions that teachers can ask themselves as they create or tweak lesson plans. With practical, straightforward advice, Kriegel suggests that teachers be mindful of who their audience is, how much students already know, and what materials they'll need. He also urges teachers to…

  8. Four Questions to Ask Yourself

    ERIC Educational Resources Information Center

    Abilock, Debbie, Ed.

    2007-01-01

    One's commitment to intellectual freedom is manifested not just in the creation of a strong and clear selection policy or the celebration of Banned Books Week but by his or her willingness to examine his or her practices openly with others. In this article, the author proposes four questions to explore in one's teaching and in professional…

  9. Eight Questions for Better Lessons

    ERIC Educational Resources Information Center

    Kriegel, Otis

    2016-01-01

    In this article, veteran educator Otis Kriegel provides eight questions that teachers can ask themselves as they create or tweak lesson plans. With practical, straightforward advice, Kriegel suggests that teachers be mindful of who their audience is, how much students already know, and what materials they'll need. He also urges teachers to…

  10. Revisiting Routine Questions

    ERIC Educational Resources Information Center

    Hughes, Rebecca; Monaghan, John; Shingadia, Eisha; Vaughan, Stephen

    2006-01-01

    What is a routine question? The focus of this paper is routine questions and time (in years) since a hitherto routine question was last attempted by the solver. The data comes from undergraduate students' work on solving two calculus questions. The data was selected for reporting purposes because it is well documented and because it threw up…

  11. Questions of Chemistry.

    ERIC Educational Resources Information Center

    Pedrosa de Jesus, Helena; Teixeira-Dias, Jose J. C.; Watts, Mike

    2003-01-01

    Documents the use of student-generated questions as diagnostic of their willingness to engage in classroom interactions. Explores four ways of gathering students' written questions and their relative effectiveness. Examines students' capacity to design and present 'quality questions' and the extent to which these questions are indicative of…

  12. Who Asks the Questions?

    ERIC Educational Resources Information Center

    Hervey, Sheena

    2006-01-01

    From a very young age, children actively strive to make sense of their world through constant questioning. The ability to ask questions comes naturally for young children, but such natural inclination does not continue because it teachers who ask most of the questions. Sheena Hervey suggests that teaching students how to pose questions is a…

  13. Questions of Chemistry.

    ERIC Educational Resources Information Center

    Pedrosa de Jesus, Helena; Teixeira-Dias, Jose J. C.; Watts, Mike

    2003-01-01

    Documents the use of student-generated questions as diagnostic of their willingness to engage in classroom interactions. Explores four ways of gathering students' written questions and their relative effectiveness. Examines students' capacity to design and present 'quality questions' and the extent to which these questions are indicative of…

  14. Question analysis for Indonesian comparative question

    NASA Astrophysics Data System (ADS)

    Saelan, A.; Purwarianti, A.; Widyantoro, D. H.

    2017-01-01

    Information seeking is one of human needs today. Comparing things using search engine surely take more times than search only one thing. In this paper, we analyzed comparative questions for comparative question answering system. Comparative question is a question that comparing two or more entities. We grouped comparative questions into 5 types: selection between mentioned entities, selection between unmentioned entities, selection between any entity, comparison, and yes or no question. Then we extracted 4 types of information from comparative questions: entity, aspect, comparison, and constraint. We built classifiers for classification task and information extraction task. Features used for classification task are bag of words, whether for information extraction, we used lexical, 2 previous and following words lexical, and previous label as features. We tried 2 scenarios: classification first and extraction first. For classification first, we used classification result as a feature for extraction. Otherwise, for extraction first, we used extraction result as features for classification. We found that the result would be better if we do extraction first before classification. For the extraction task, classification using SMO gave the best result (88.78%), while for classification, it is better to use naïve bayes (82.35%).

  15. Measuring victimization inside prisons: questioning the questions.

    PubMed

    Wolff, Nancy; Jing Shi; Bachman, Ronet

    2008-10-01

    Violence and victimization inside the prison setting are accepted as facts, although the facts about their prevalence remain uncertain. Variation in the methods used to estimate rates of sexual and physical victimization contribute to the wide range in estimates appearing in the prison literature. This article focuses on the questions used in the prison victimization literature to elicit information on victimization from inmates, compared to questions used in the general victimization literature. The questions used in the National Violence Against Women and Men Surveys are used to estimate sexual and physical victimization rates for an entire prison system. Rates of victimization were found to vary significantly by specificity of the question, definition of perpetrator, and clustering of behaviors. Facts about victimization inside prison will become more certain when the methodology becomes more standardized and consistent with definitions of victimization.

  16. Medical Malpractice in Bariatric Surgery: a Review of 140 Medicolegal Claims.

    PubMed

    Choudhry, Asad J; Haddad, Nadeem N; Martin, Matthew; Thiels, Cornelius A; Habermann, Elizabeth B; Zielinski, Martin D

    2017-01-01

    Given the current rate of obesity in the USA, it has been estimated that close to half of the US adult population could be obese by 2030, resulting in greater demand for bariatric procedures. Our objective was to analyze malpractice litigation related to bariatric surgery. We conducted a retrospective review of Westlaw (Thompson Reuters) of all bariatric operations that resulted in the filing of a malpractice claim. Each case was reviewed for pertinent medicolegal information related to the procedure, claim, and trial. The search criteria yielded 298 case briefs, of which 140 met inclusion criteria. Thirty-two percent (n = 49) of cases involved male plaintiffs (patients). Mean patient age with standard deviation (SD) was 43 (10) years. The most common procedure litigated was the Roux-en-Y gastric bypass (76 %, n = 107). Overall, the most common alleged reason for a malpractice claim was delay in diagnosis or management of a complication in the postoperative period (n = 66, 47 %), the most common of which was an anastomotic leak (45 %, n = 34). Death was reported in 74 (52 %) cases. Fifty-seven cases (47 %) were decided in favor of the plaintiff (patient), with a median award payout of $1,090,000 (interquartile range [IQR] $412,500 to $2,550,000). Delay in diagnosing or managing complications in the postoperative setting, most commonly an anastomotic leak, accounted for the majority of malpractice claims. Measures taken to identify and address anastomotic leaks and other complications early in the postoperative period could potentially reduce the amount of filed malpractice claims related to bariatric surgery. III.

  17. Medicolegal characteristics of cardiac catheterization litigation in the United States, 1985 to 2009.

    PubMed

    Kim, Candice; Vidovich, Mladen I

    2013-11-15

    There are few assessments of patterns of medicolegal cases involving cardiac catheterizations. This descriptive study reviews the patterns of liability and medical outcomes involving cardiac catheterization litigation from the LexisNexis Academic database and the Physician Insurers Association of America registry. From 1985 to 2009, the Physician Insurers Association of America registry documented 1,361 closed coronary angiography claims. The cardiovascular disease specialty was involved in 699 with other specialties involved in the remaining cases. Of the 1,361 closed claims, 301 (22%) resulted in payments to the plaintiff (average indemnity of $230,987). The most common alleged error was for improper performance (35.4%; average indemnity of $255,542). The alleged error with the highest average indemnity of $270,916 was errors in diagnosis. Not performing an indicated procedure had the highest ratio of paid to closed claims (41%) with an average indemnity of $246,988. In regard to the severity of injury, death was the most common outcome (44%). The highest ratio of paid to total closed claims (43%) was for grave injuries (highest average indemnity of $555,625). Of the 116 LexisNexis cases, litigation against physicians occurred in 90.5% of cases with judgments in favor of the patients in 29.5%. When death was the outcome (31% of cases), physicians were highly likely to be sued (97%) and the judgment was more likely in the plaintiffs' favor (44%). In conclusion, in litigation related to cardiac catheterizations, most cases are due to medical malpractice and physicians are sued in a high percentage of cases. Cardiologists should recognize these patterns of litigation as these may impact and improve processes of care.

  18. Impact of medico-legal findings on charge filing in cases of rape in adult women.

    PubMed

    Hagemann, Cecilie T; Stene, Lise E; Myhre, Arne K; Ormstad, Kari; Schei, Berit

    2011-11-01

    To assess the impact of the medical documentation and biological trace evidence in rape cases on the legal process. Retrospective descriptive study. Police-reported cases of rape of women ≥16 years old in the Norwegian county of Sør-Trøndelag from January 1997 to June 2003. Police data were merged with data from the Sexual Assault Center at St Olav's Hospital. Charged and non-charged cases were compared. Medico-legal findings and legal outcome. A total of 185 police-reported cases were identified. Of the 101 cases examined at Sexual Assault Center, charges were filed in 18 cases. Extragenital injuries were documented in 49 women; five were life threatening. Anogenital injuries were documented in 14 women; eight had multiple anogenital injuries. Documentation of injuries was not associated with charge filing. In only 33% of the cases were swabs collected from women's genitals used as trace evidence by the police. When used, this increased the likelihood for charge filing. A DNA profile matching the suspect was identified in four of the 18 charged cases and in only one among the 54 non-charged cases. Half of the women had one or more documented injury. Only one-third of the trace evidence kits collected from the women's anogenital area were analyzed. The analysis of swabs was associated with charge filing, regardless of test results. Increased use of such medical evidence, especially in cases of stranger rape, may ensure women's rights and increase available information to the legal system. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. Identification of Muscidae (Diptera) of medico-legal importance by means of wing measurements.

    PubMed

    Grzywacz, Andrzej; Ogiela, Jakub; Tofilski, Adam

    2017-03-16

    Cadavers attract numerous species and genera of Muscidae, both regular elements of carrion insect assemblages, and accidental visitors. Identification of adult Muscidae may be considered difficult, particularly by non-experts. Since species identification is a vital first step in the analysis of entomological material in any forensic entomology orientated experiment and real cases, various alternative methods of species identification have been proposed. We investigated possibility of semiautomated identification by means of wing measurements as an alternative for classic morphology and DNA-based approaches. We examined genus-level identification success for 790 specimens representing 13 genera of the most common European cadavers visiting Muscidae. We found 99.8% of examined specimens correctly identified to the genus-level. Without error, the following were identified: Azelia, Eudasyphora, Graphomya, Hydrotaea, Musca, Muscina, Mydaea, Neomyia, Polietes, Stomoxys and Thricops. Genus-level misidentifications were found only in Helina and Phaonia. Discrimination of examined material on the species level within Hydrotaea (318 specimens representing eight species) and Muscina (163 specimens representing four species) showed lower, yet still high average identification success, 97.2 and 98.8%, respectively. Our results revealed relatively high success in both genus and species identification of Muscidae of medico-legal importance. Semiautomated identification by means of wing measurements can be used by non-experts and does not require sophisticated equipment. This method will facilitate the identification of forensically relevant muscids in comparison to more difficult and more time-consuming identification approaches based on taxonomic keys or DNA-based methods. However, for unambiguous identification of some taxa, we recommend complementary use of identification keys.

  20. Commercial Airline In-Flight Emergency: Medical Student Response and Review of Medicolegal Issues.

    PubMed

    Bukowski, Josh H; Richards, John R

    2016-01-01

    As the prevalence of air travel increases, in-flight medical emergencies occur more frequently. A significant percentage of these emergencies occur when there is no certified physician, nurse, or paramedic onboard. During these situations, flight crews might enlist the help of noncertified passengers, such as medical students, dentists, or emergency medical technicians in training. Although Good Samaritan laws exist, many health care providers are unfamiliar with the limited legal protections and resources provided to them after responding to an in-flight emergency. A 78-year-old woman lost consciousness and became pulseless onboard a commercial aircraft. No physician was available. A medical student responded and coordinated care with the flight crew, ground support physician, and other passengers. After receiving a packet (4 g) of sublingual sucrose and 1 L i.v. crystalloid, the patient regained pulses and consciousness. The medical student made the decision not to divert the aircraft based on the patient's initial response to therapy and, 45 min later, the patient had normal vital signs. Upon landing, she was met and taken by paramedics to the nearest emergency department for evaluation of her collapse. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians are the most qualified to assist in-flight emergencies, but they might not be aware of the medicolegal risks involved with in-flight care, the resources available, and the role of the flight crew in liability and decision making. This case, which involved a medical student who was not given explicit protection under Good Samaritan laws, illustrates the authority of the flight crew during these events and highlights areas of uncertainty in the legislation for volunteer medical professionals. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Diagnosis of Asbestos-Related Diseases: The Mineralogist and Pathologist's Role in Medicolegal Field.

    PubMed

    Capella, Silvana; Bellis, Donata; Belluso, Elena

    2016-03-01

    Because asbestos diseases represent a complex pattern of legal, social, and political issue, the involvement of the mineralogist and pathologist for a multidisciplinary assessment of its diagnosis helps investigate the relationship between mesothelioma or lung cancer and occupational or environmental asbestos exposure.In the present study, we consider the concentrations of asbestos bodies (ABs) detected by optical microscopy (OM) and scanning electron microscopy (SEM) and the burden of different kinds of mineral fibers (among which is asbestos) identified by SEM combined with an energy dispersive spectrometer (EDS), in 10 lung tissue samples of subjects with occupational and nonoccupational exposure to asbestos.In all subjects with occupational exposure to asbestos, more than 1000 ABs per gram of dry weight were detected both with OM and SEM; this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos.In 9 lung samples of the 10 investigated by SEM-EDS different inorganic fibers were found. Asbestos fibers have been identified too, and more than 100,000 fibers per gram of dry weight were detected in subjects with occupational exposure; this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos.Instead, when the ABs burden is low or moderate (such as in subjects with absent or probable asbestos exposure), the correlation between ABs concentration determined by OM and those determined by SEM is lost. Therefore, when the ABs value in OM is borderline, the SEM investigation became essential. Furthermore, the mineralogical analysis by SEM-EDS (identification and quantification of inorganic fibers in general and asbestos in particular) of the fibers detected in the lung tissues is very useful, if not necessary, to complete the pathological diagnosis of asbestos-related malignancies in medicolegal field.

  2. The threat of vaccine associated poliomyelitis in India: medicolegal issues involved.

    PubMed

    Rajput, Meena; Sharma, Luv

    2010-12-01

    India is among the world's large reservoirs of wild poliovirus (WPV) with 559 confirmed cases of poliomyelitis (wild virus) being reported in 2008. The World Health Organization's program for the eradication of poliomyelitis in third world countries like India is associated with major ethical and medico-legal implications. Two vaccines are available in India for poliomyelitis i.e. oral polio vaccine (OPV) and inactivated polio vaccine (IPV), of which OPV is used in the eradication campaign, the case count for 2009 being 36 out of a total of 384 reported cases globally, the case count for mid 2010 being 19 cases out of 84 reported globally. There are widespread reports of vaccine derived poliomyelitis as well as vaccine associated poliomyelitis (VAP) from different parts of the country, which can be linked to resurgence of polio in several states or to the failure of the polio drive (Polio Sundays). Though an extended comprehensive polio campaign is on and both money and manpower are being dumped for achieving the goal of polio eradication, the ground reality is entirely different. The argument that wild polio strains have surfaced to hamper the drive cannot account for all post vaccination cases. The Indian Academy of Paediatrics has forcefully suggested replacement of OPV by IPV, as the effectiveness of IPV far exceeds the cost benefit of OPV. IPV has by and large replaced OPV in many parts of the world. The second issue is the threat of litigation on the health department once the post vaccination cases rise even further. There are certain other socio-ethical issues discussed in this paper on a subject which has an important bearing on the health statistics of this country.

  3. Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes.

    PubMed

    Saint-Martin, Pauline; Bouyssy, Marie; O'Byrne, Patrick

    2007-10-01

    We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medicolegal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.

  4. [Medico-legal opinions in cases for annulment of testament. Part I. Characteristics of investigative material. Characteristics of testators].

    PubMed

    Marcinkowski, Jerzy T; Klimberg, Aneta

    2007-01-01

    A very important issue in preparing medico-legal opinions is the establishment whether the devisor had the ability to bequeath at the date of preparing a testament. The subsequent loss of the ability of bequeathing does not have any impact on execution of the previously prepared testament. Experts who pass opinions in testament cases evaluate: 1) the testament itself and the circumstances of its preparation, excluding, however, the reliability of records, 2) statements obtained while interrogating witnesses (descriptions of daily life, motivation to bequeath), 3) medical records (files, case histories, discharge records). The investigative material consisted of judicial files in 73 testament cases referred to the Chair and Department of Forensic Medicine (CDFM), University of Medical Sciences, Poznań, by courts from all over Poland in the period 1990-2005 for formulation of medico-legal opinions based on these documents. In 63.0% of cases, CDFM in Poznań was the first opinionating institution; in the remaining instances, previous medico-legal opinions had been given elsewhere; in six cases they were antagonistic. The investigative material included a predominant percentage (75.2%) of ordinary testaments (made before a notary and oligraphic) as opposed to 22% of informal testaments (oral only). Although in the majority of cases (67.2%) only one testament was drawn up, there were also instances (2.7%) where the devisor prepared as many as five testaments. The length of devisors survival following the drawing up of the final testament was generally short. In total, testaments not only in the oral form, but also made before a notary, were prepared by chronically ill individuals presenting with marked clinical symptoms, what was perceived by their family and caregivers as a sign of the imminent death. Hence, the testaments were often drawn up in a hospital room or in a notary office where the patient was taken between consecutive hospitalizations.

  5. A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India.

    PubMed

    Daruwalla, Nayreen; Belur, Jyoti; Kumar, Meena; Tiwari, Vinay; Sarabahi, Sujata; Tilley, Nick; Osrin, David

    2014-11-30

    Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause - accidental or non-accidental, suicidal or homicidal - is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. We conducted semi-structured interviews with 33 women admitted to two major burns units, their families, and 26 key informant doctors, nurses, and police officers. We used framework analysis to examine the context in which burns occurred and the sequence of medicolegal action after admission to hospital. Interviewees described accidents, attempted suicide, and attempted homicide. Distinguishing between these was difficult because the underlying combination of poverty and cultural precedent was common to all and action was contingent on potentially conflicting narratives. Space constraint, problems with cooking equipment, and inflammable clothing increased the risk of accidental burns, but coexisted with household conflict, gender-based violence, and alcohol use. Most burns were initially ascribed to accidents. Clinicians adhered to medicolegal procedures, the police carried out their investigative requirements relatively rapidly, but both groups felt vulnerable in the face of the legal process. Women's understandable reticence to describe burns as non-accidental, the contested nature of statements, their perceived history of changeability, the limited quality and validity of forensic evidence, and the requirement for resilience on the part of clients underlay a general pessimism. The similarities between accident and intention cluster so tightly as to make them challenging to distinguish, especially given women's understandable reticence to describe burns as non-accidental. The contested status of

  6. [Medico-legal opinions in cases for annulment of testament. Part II. Final conclusions of opinions. Quality of medical documentation. Evaluation of witnesses' testimonies].

    PubMed

    Marcinkowski, Jerzy T; Klimberg, Aneta

    2007-01-01

    The percentage of cases, in which devisors were unable to devise properly was high, what was mostly associated with the frequent drawing up of testaments by chronically ill individuals immediately before death. Grounds for pronouncing the devisor lacking in testamentary capacity were observed in 46.6% of cases, while 39.7% of devisors were found to lack free expression of will. Medical records were available in all the cases, including psychiatric records in 20.5% of cases and neurological records in 20.5%. In the majority of instances, the low quality of medical records hindered formulating expert opinions. The fact that in the majority of cases, the testimonies of witnesses were highly divergent indicated that they were either unable to assess the mental state of the devisor or else were themselves interested in the settlement of the case. Frequently, attending physicians from non-psychiatric wards were unable to answer questions on the mental state of the devisor, what resulted from their focusing on the somatic cause of hospitalization and the fact that their contact with the patient was very limited in time. Problems with certification on the basis of medical records were mainly associated with lacking psychiatric or neurological consults performed at the time the testament was drawn up; in some instances, the entire medical records from that period were missing. For this reason, individuals desiring to prepare a last will should be advised to undergo voluntary psychiatric assessment in this period. Medico-legal opinions in testament cases are difficult and time-consuming, but pleading one's case before the court is even more tedious and difficult.

  7. [Status and medicolegal implications in France pT0 stage of prostate cancer: a study by the CC-AFU].

    PubMed

    Bessede, T; Soulié, M; Mottet, N; Rebillard, X; Peyromaure, M; Ravery, V; Salomon, L

    2012-12-01

    To assess the frequency, circumstances, and possible medico-legal consequences of the pT0 prostate cancer, defined by the absence of tumor in a radical prostatectomy specimen. Six centers retrospectively identified all cases of pT0 and selectionned those that occurred without prior hormone therapy or prostate resection. Preoperative data, histological report and clinical and biological outcome were analyzed. The lawsuits' registry in pathology were consulted at insurance companies. Thirty cases of pT0 prostate cancer (0.4%) were reported on 7693 patients. The median age was 63years, PSA 7.4ng/mL. The number of positive preoperative biopsies ranged from one to four for a median tumor length of 1mm (0.3 to 18mm). The biopsy Gleason score was 3+3 for 23 patients, less than 5 for six others and included a contingent of grade 4 in two patients. With a median follow-up of 82months, no clinical or biochemical recurrence was observed. One patient complaint for pT0 prostate was found in the insurances registry. The occurrence of a prostate pT0 called into question all the diagnostic procedures and surgical indication. To avoid a forensic procedure, urologists should inform patients of the possibility of this situation before radical prostatectomy. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  8. Pesticide Labeling Questions & Answers

    EPA Pesticide Factsheets

    Pesticide manufacturers, applicators, state regulatory agencies, and other stakeholders raise questions or issues about pesticide labels. The questions on this page are those that apply to multiple products or address inconsistencies among product labels.

  9. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J.

    1979-01-01

    Describes an exam question which challenges college freshmen, enrolled in chemistry, to derive temperature dependence of an equilibrium constant. The question requires cognitive response at the level of synthesis. (Author/SA)

  10. Burning Questions about Calories.

    ERIC Educational Resources Information Center

    Keller, J. David; Berry, Kimberly A.

    2001-01-01

    Uses questioning techniques to teach about caloric consumption and weight gain. Starts with defining questions about calories and includes the stages of measuring calories, analyzing data, and conducting inquiry research. Includes directions for the experiment. (YDS)

  11. Frequent Questions on Recycling

    EPA Pesticide Factsheets

    This is a list of frequent questions on recycling, broken down into five categories. These are answers to common questions that EPA has received from press and web inquiries. This list is located on the Reduce, Reuse, Recycle website.

  12. Drug-related deaths with evidences of body packing: Two case reports and medico-legal issues.

    PubMed

    Cappelletti, Simone; Aromatario, Mariarosaria; Bottoni, Edoardo; Fiore, Paola Antonella; Straccamore, Marco; Umani Ronchi, Federica; De Mari, Guido Maria; Ciallella, Costantino

    2016-05-01

    Body packing is a general term used to indicate the internal transportation of drug packages, mainly cocaine, heroin, amphetamines, and methamphetamine, within the gastrointestinal tract. We described two cases of accidental drug intoxication, observed over the last year period, with evidence of intracorporeal drug concealment. The first case concerned a body packer transporting 69 drug packages of heroin adulterated with piracetam. The second body packer transported 16 drug packages of cocaine adulterated with levamisole. For both cases, forensic examination and toxicological analysis of drug packages and biological samples were carried out. Authors also wants to highlight the main medico-legal issues that commonly arise in cases of suspected or ascertained body packers.

  13. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J., Ed.

    1983-01-01

    Acceptable answers are provided for two chemistry questions. The first question is related to the prediction of the appearance of non-first-order proton nuclear magnetic resonance (NMR) spectra. The second question is related to extraterrestrial kinetic theory of gases. (JN)

  14. Listening and Questioning

    ERIC Educational Resources Information Center

    Haroutunian-Gordon, Sophie

    2007-01-01

    In the article that follows, I take up a debate that has arisen over the past three years concerning the following issue: Does every act of listening involve the listener in questioning? I argue that the answer to the questions is yes. I give background on the question and then consider one instance of listening that may suggest no role for…

  15. Improving Student Question Classification

    ERIC Educational Resources Information Center

    Heiner, Cecily; Zachary, Joseph L.

    2009-01-01

    Students in introductory programming classes often articulate their questions and information needs incompletely. Consequently, the automatic classification of student questions to provide automated tutorial responses is a challenging problem. This paper analyzes 411 questions from an introductory Java programming course by reducing the natural…

  16. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J., Ed.

    1983-01-01

    Acceptable answers are provided for two chemistry questions. The first question is related to the prediction of the appearance of non-first-order proton nuclear magnetic resonance (NMR) spectra. The second question is related to extraterrestrial kinetic theory of gases. (JN)

  17. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J., Ed.

    1987-01-01

    Contains two articles relating to chemistry examination questions. One provides examples of how to sequence multiple choice questions so that partial credit may be given for some responses. The second includes a question and solution dealing with stereoisomerism as a result of free radical chlorination of a nonstereoisometic substance. (TW)

  18. Questions in Reference Interviews.

    ERIC Educational Resources Information Center

    White, Marilyn Domas

    1998-01-01

    Characterizes the questioning behavior in reference interviews preceding delegated online searches of bibliographic databases and relates it to questioning behavior in other types of interviews/settings. Compares questions asked by the information specialist and those asked by the client; findings show the information specialist dominates the…

  19. Reading for Meaning: Questioning

    ERIC Educational Resources Information Center

    Trinkle, Catherine

    2009-01-01

    An essential literacy skill is asking questions. Because reading comprehension strategies should be taught directly and explicitly, students need to be told that they should ask questions throughout their research and that all questions are valid. While library media specialists are not reading teachers, the work they do with students in the…

  20. Improve Your Verbal Questioning

    ERIC Educational Resources Information Center

    Vogler, Kenneth E.

    2005-01-01

    Most teachers are well aware that verbal questioning can aid student learning. Asking questions can stimulate students to think about the content being studied; connect it to prior knowledge consider its meanings and implications; and explore its applications. A common problem with many teachers' use of verbal questioning is a lack of knowledge…

  1. [Questions about pharmaceutical expertise].

    PubMed

    Sauer, Fernand

    2012-01-01

    Over the last thirty years, many areas of expertise have developed in the pharmaceutical industry, from research and production to delivery to the patient. Strict European regulations and international best practice guidelines have shaped the expertise of pharmaceutical firms. Governments have set up health agencies to strengthen the supervision of private operators by recruiting in-house scientific experts and expert committees. The private and public sectors compete to recruit the best experts, and conflicts of interest must be addressed. The recent 'Mediator' (Benfluorex) case in France raises many questions about the potential failures of the health security system. Beyond the primary responsibility of the company, the main concern is off-label use. An effort to strengthen the legal framework and the tools used to collect, analyze and publicize pharmacovigilance data is currently underway at a national and European level. The competent authorities must restore public confidence through a more diligent and transparent handling of sensitive issues related to high-risk medicine. In a country where drug consumption is particularly high, doctors and pharmaceutical experts have been accused of becoming accustomed to risk and of loosing sight of the benefit to the patient. Health professionals in the private and public sectors must regain the appropriate health security reflexes to promote a more rational use of drugs.

  2. Do medico-legal truths have more power than war lies? About the conflicts in the former Yugoslavia and in Kosovo.

    PubMed

    de la Grandmaison, G L; Durigon, M

    2001-10-01

    War crimes perpetrated during the conflicts in the former Yugoslavia and in Kosovo prompted medicolegal investigations of mass graves as required by the International Criminal Tribunal (ICT). In spite of natural and methodological boundaries, these investigations were able to help to identify the victims and to discover the clues and evidence that are likely to support objectively the indictments brought by the ICT. However, the medico-legal data cannot explain everything. They should be exploited very carefully in order to avoid any error of interpretation.

  3. [Total permanent or major permanent inability to work in profession. Remarks about the possibility of criteria verification in medico-legal opinionating in criminal cases].

    PubMed

    Nowak, Agnieszka; Chowaniec, Czesław; Chowaniec, Małgorzata; Rygol, Krystian

    2008-01-01

    Despite the fact that some criteria of medico-legal certification in criminal proceedings have been established, there are still some areas that--parallel to changes occurring in contemporary society--have started to be controversial. This phenomenon has prompted the authors to attempt establishing new criteria for certification in total/major permanent inability to work in profession. This work is a continuation of a cycle devoted to interpretation of article 156 of the Penal Code to meet the needs of medico-legal opinionating.

  4. Measuring Victimization inside Prisons: Questioning the Questions

    ERIC Educational Resources Information Center

    Wolff, Nancy; Shi, Jing; Bachman, Ronet

    2008-01-01

    Violence and victimization inside the prison setting are accepted as facts, although the facts about their prevalence remain uncertain. Variation in the methods used to estimate rates of sexual and physical victimization contribute to the wide range in estimates appearing in the prison literature. This article focuses on the questions used in the…

  5. Question-Asking and Question-Exploring

    ERIC Educational Resources Information Center

    Sands, Lorraine; Carr, Margaret; Lee, Wendy

    2012-01-01

    The Centre of Innovation Research at Greerton Early Childhood Centre was characterised as a dispositional milieu where working theories were explored through a narrative research methodology. As the research progressed, the teachers at Greerton strengthened the way we were listening to, and watching out for young children's questions to enable…

  6. Measuring Victimization inside Prisons: Questioning the Questions

    ERIC Educational Resources Information Center

    Wolff, Nancy; Shi, Jing; Bachman, Ronet

    2008-01-01

    Violence and victimization inside the prison setting are accepted as facts, although the facts about their prevalence remain uncertain. Variation in the methods used to estimate rates of sexual and physical victimization contribute to the wide range in estimates appearing in the prison literature. This article focuses on the questions used in the…

  7. The "Trickster" and the Questionability of Questions

    ERIC Educational Resources Information Center

    Stewart, Connie

    2009-01-01

    Tricksters represent creativity and ingenuity in ways that are also integral to arts education. Like the tricksters, strong arts programs teach that a question can have many answers and there are multiple ways to interpret what is seen (Eisner, 2002). In this article, the author discusses how she applies lessons learned from the Trickster stories…

  8. Asking questions with focus

    NASA Astrophysics Data System (ADS)

    Liu, Fang; Xu, Yi

    2004-05-01

    This study investigates how different interrogative meanings interact with focus in determining the overall F0 profile of a question. We recorded eight native speakers of Mandarin producing statements, yes-no questions with and without a question particle, wh questions, incredulous questions, and confirmation questions. In each sentence, either the initial, medial, final, or no word was focused. The tonal components of the sentences are all high, all rising, all low, or all falling. F0 contours were extracted by measuring every complete vocal period in the initial, medial, and final disyllabic words in each sentence. Preliminary results show that in both statements and questions, the pitch range of the focused words is expanded and that of the postfocus words suppressed (compressed and lowered). However, postfocus pitch-range suppression seems less extensive in questions than in statements, and in some question types than in others. Finally, an extra F0 rise is often observed in the final syllable of a question unless the syllable is the question particle which has the neutral tone. This is indicative of a high or rising boundary tone associated with the interrogative meaning, which seems to be superimposed on the tone of the sentence-final syllable. [Work supported by NIDCD DC03902.

  9. Any Questions? Want to Stimulate Student Curiosity? Let Them Ask Questions!

    ERIC Educational Resources Information Center

    Weiss, Tarin Harrar

    2013-01-01

    Of the eight scientific practices highlighted in "A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas," the first is for students to develop abilities to ask questions and define problems (NRC 2012). Constructing a range of questions about an object or phenomenon validates not only what students have…

  10. Any Questions? Want to Stimulate Student Curiosity? Let Them Ask Questions!

    ERIC Educational Resources Information Center

    Weiss, Tarin Harrar

    2013-01-01

    Of the eight scientific practices highlighted in "A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas," the first is for students to develop abilities to ask questions and define problems (NRC 2012). Constructing a range of questions about an object or phenomenon validates not only what students have…

  11. [Fifteen practical questions concerning gestational diabetes].

    PubMed

    Clay, J-C; Deruelle, P; Fischer, C; Couvreux-Dif, D; Vambergue, A; Cazaubiel, M; Fontaine, P; Subtil, D

    2007-09-01

    With a review of the current literature, a clarification on screening and management of gestational diabetes is hereby set out, within the frame of a Clinical Expert Series. According to the ethnic group, the prevalence varies from 1 to 14%. The treatment is based on dietary advice, insulin. The ACHOIS study demonstrates that the treatment of gestational diabetes significantly decreases perinatal complications (4 to 1%). The place of the oral treatment (glyburide) remains to be defined. In most countries, diagnosis rests on oral glucose test tolerance: Sullivan 50 g glucose test (1 hour) and 100 g test of glucose if positive (3 hours); WHO 75 g test (2 hours). The screening can be systematic or only on risk factors (wide variations between studies). Screening of gestational diabetes is required because its management improves pregnancy outcomes. Despite this, there is no consensus on the strategy of screening and diagnosis.

  12. The medico-legal observation of an aggressive urogenital fibromatosis with isolated development not related to any traumatic event.

    PubMed

    Muccino, Enrico; Gentile, Guendalina; Mantero, Stefano; Marchesi, Matteo; Rancati, Alessandra; Zoja, Riccardo

    2016-03-01

    Desmoid tumor is a fibroproliferative neoplasm with an intermediate malignancy and it can be localized in every bodily district: some locations are considered exceptional, like the urogenital localization. The Author point out a rare case of giant idiopathic scrotal fibromatosis that was found during an autopsy. A widower, that lived alone in poor hygienic conditions, was found dead in his house. The Judicial Authority ordered the autopsy, that was performed two days later at the Medico-Legal Section of Milan University. External examinations revealed only the considerable dimension of the scrotum (cm 24 × 41). The cause of death was fixed in a cardiac tamponade due to a natural heart laceration localized in correspondence of a transmural infarction. The toxicological exam resulted negative, while the histopathological and immunohistochemical analysis qualify the scrotal mass as a desmoids tumor. Due to the absence of predisposing conditions and of fibroproliferative infiltration in bladder and retroperitoneal space, the neoplasm was configured as an idiopathic desmoid tumor. The presented case gives the reason for the discussion concerning medico-legal aspects that are typical of rare neoplasms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. A retrospective analysis of alcohol in medico-legal autopsied deaths in Pretoria over a 1 year period.

    PubMed

    Ehmke, Ursula; Toit-Prinsloo, Lorraine du; Saayman, Gert

    2014-12-01

    The misuse of alcohol has a particularly detrimental effect and is one of the most significant public health problems in South Africa and it also has an impact on the criminal justice system with evidence of association between high levels of alcohol and risk-taking behaviour, committing crimes, or being a victim of crime. A global trend has been set worldwide with alcohol being one of the most common drugs found in post mortem specimens and especially with regard to cases admitted for medico-legal autopsies. The influence of alcohol on the cause of death is either a contributory or an underlying factor in a substantial number of violent deaths. We retrospectively reviewed 1455 cases, in which alcohol was taken, of 2344 medico-legal autopsies done in 2009. We found that 47% of the cases tested positive for alcohol, with the reported blood alcohol concentrations varying from 0.01 to 0.95g per 100ml (mean=0.16±0.11g per 100ml) with the highest proportion being in the 0.10-0.19g per 100ml range. A breakdown of the results showed that road traffic accidents, assaults and firearm-related deaths predominated the alcohol-positive cases. The results showed that there was a definite correlation between alcohol consumption and the incidence of other that natural deaths.

  14. Marfan syndrome: clinical consequences resulting from a medicolegal autopsy of a case of sudden death due to aortic rupture.

    PubMed

    Klintschar, M; Bilkenroth, U; Arslan-Kirchner, M; Schmidtke, J; Stiller, D

    2009-01-01

    To investigate the sudden death of a 31-year-old man, a medicolegal autopsy was performed. Major findings were a dilated aortic root with a longitudinal rupture of the intima and dissection of aorta and right coronary artery and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities in combination with the histological finding of a pseudocystic medionecrosis of the aortic wall were noted. By sequencing of the FBN1 gene, a mutation (1622G>A) leading to the diagnosis of Marfan syndrome was found. Genetic counseling was recommended to the relatives who reported that the father of the deceased had died at the same age from aortic rupture. While fortunately the child of the deceased lacked this mutation, it was found in his younger sister. The results of the autopsy thus enabled early diagnosis and beginning of treatment in the sister and thus a considerable statistical increase in lifespan. With this report, we want to show that medicolegal autopsies can also have medical consequences for relatives. We argue that in all sudden and unexpected deaths in young persons up to 35 years an autopsy should be performed, not only to detect unnatural causes of death but also to identify heritable diseases and thus aid the relatives.

  15. General practitioners' preferences with regard to colorectal cancer screening organisation Colon cancer screening medico-legal aspects.

    PubMed

    Papin-Lefebvre, Frédérique; Guillaume, Elodie; Moutel, Grégoire; Launoy, Guy; Berchi, Célia

    2017-09-06

    French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk METHODS: A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models. The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician. Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Can naloxone prescription and overdose training for opioid users work in family practice?

    PubMed Central

    Leece, Pamela; Orkin, Aaron; Shahin, Rita; Steele, Leah S.

    2015-01-01

    Abstract Objective To explore family physicians’ attitudes toward prescribing naloxone to at-risk opioid users, as well as to determine the opportunities and challenges for expanding naloxone access to patients in family practice settings. Design One-hour focus group session and SWOT (strengths, weaknesses, opportunities, and threats) analysis. Setting Workshop held at the 2012 Family Medicine Forum in Toronto, Ont. Participants Seventeen conference attendees from 3 Canadian cities who practised in various family practice settings and who agreed to participate in the workshop. Methods The workshop included an overview of information about naloxone distribution and overdose education programs, followed by group discussion in smaller focus groups. Participants were instructed to focus their discussion on the question, “Could this [overdose education and naloxone prescription] work in your practice?” and to record notes using a standardized discussion guide based on a SWOT analysis. Two investigators reviewed the forms, extracting themes using an open coding process. Main findings Some participants believed that naloxone could be used safely among family practice patients, that the intervention fit well with their clinical practice settings, and that its use in family practice could enhance engagement with at-risk individuals and create an opportunity to educate patients, providers, and the public about overdose. Participants also indicated that the current guidelines and support systems for prescribing or administering naloxone were inadequate, that medicolegal uncertainties existed for those who prescribed or administered naloxone, and that high-quality evidence about the intervention’s effectiveness in family practice was lacking. Conclusion Family physicians believe that overdose education and naloxone prescription might provide patients at risk of opioid overdose in their practices with broad access to a potentially lifesaving intervention. However, they

  17. Practice.

    PubMed

    Chambers, David W

    2008-01-01

    Practice refers to a characteristic way professionals use common standards to customize solutions to a range of problems. Practice includes (a) standards for outcomes and processes that are shared with one's colleagues, (b) a rich repertoire of skills grounded in diagnostic acumen, (c) an ability to see the actual and the ideal and work back and forth between them, (d) functional artistry, and (e) learning by doing that transcends scientific rationality. Communities of practice, such as dental offices, are small groups that work together in interlocking roles to achieve these ends.

  18. Using medico-legal data to investigate fatal older road user crash circumstances and risk factors.

    PubMed

    Koppel, Sjaan; Bugeja, Lyndal; Smith, Daisy; Lamb, Ashne; Dwyer, Jeremy; Fitzharris, Michael; Newstead, Stuart; D'Elia, Angelo; Charlton, Judith

    2017-07-31

    This study used medico-legal data to investigate fatal older road user (ORU, aged 65 years and older) crash circumstances and risk factors relating to 4 key components of the Safe System approach (e.g., roads and roadsides, vehicles, road users, and speeds) to identify areas of priority for targeted prevention activity. The Coroners' Court of Victoria's (CCOV) Surveillance Database was searched to identify and describe the frequency and rate per 100,000 population of fatal ORU crashes in the Australian state of Victoria for 2013-2014. Information relating to the deceased ORU, crash characteristics and circumstances, and risk factors was extracted and analyzed. One hundred and thirty-eight unintentional fatal ORU crashes were identified in the CCOV Surveillance Database. Of these fatal ORU crashes, most involved older drivers (44%), followed by older pedestrians (32%), older passengers (17%), older pedal cyclists (4%), older motorcyclists (1%), and older mobility scooter users (1%). The average annual rate of fatal ORU crashes per 100,000 population was 8.1 (95% confidence interval [CI], 6.0-10.2). In terms of the crash characteristics and circumstances, most fatal ORU crashes involved a counterpart (98%), of which the majority were passenger cars (50%) or fixed/stationary objects (25%), including trees (46%) or embankments (23%). In addition, most fatal ORU crashes occurred close to home (73%), on-road (87%), on roads that were paved (94%), on roads with light traffic volume (37%), and during low-risk conditions: between 12 p.m. and 6 p.m. (44%), on weekdays (80%), during daylight (75%), and under dry/clear conditions (81%). Road user (RU) error was identified by the police and/or the coroner for the majority of fatal crashes (55%), with a significant proportion of deceased ORUs deemed to have failed to yield (54%) or misjudged (41%). RU error was the most significant factor identified in fatal ORU crashes, which suggests that there is a limited capacity of the

  19. Self-induced illegal abortion with Rivanol(®): A medicolegal-toxicological case report.

    PubMed

    Koelzer, Sarah C; Held, Hannelore; Toennes, Stefan W; Verhoff, Marcel A; Wunder, Cora

    2016-11-01

    that are then produced induce labor. In medicolegal contexts, the proof for an abortion through the administration of ethacridine lactate lies in the typical yellow discoloration of the fetus in conjunction with the toxicological demonstration of the substance in fetal body fluids, and if possible also in maternal body fluids.

  20. Unpark Those Questions

    ERIC Educational Resources Information Center

    Ness, Molly

    2013-01-01

    Whenever Mr. Henderson's 3rd grade students had a question that he couldn't immediately answer or that seemed off-topic, he asked them to write the question on a sticky note and place it on a poster dubbed the "Parking Lot." His intention was to find time later to answer those questions, but too often, he said, the parking lot…

  1. Unpark Those Questions

    ERIC Educational Resources Information Center

    Ness, Molly

    2013-01-01

    Whenever Mr. Henderson's 3rd grade students had a question that he couldn't immediately answer or that seemed off-topic, he asked them to write the question on a sticky note and place it on a poster dubbed the "Parking Lot." His intention was to find time later to answer those questions, but too often, he said, the parking lot…

  2. Developing Good Clinical Questions and Finding the Best Evidence to Answer Those Questions

    PubMed Central

    Burns, Patricia B.; Chung, Kevin C.

    2015-01-01

    Evidence based medicine (EBM) involves the integration of the best scientific evidence available with physician experience and patient preferences. One of the first steps in EBM involves developing a question based on issues encountered with patients or a disease and finding evidence to answer the question. This paper is a guide to plastic surgeons in how to begin the practice of EBM by developing clinical questions and finding evidence to answer these questions. PMID:20679843

  3. Processing the Curriculum through Quality Questioning

    ERIC Educational Resources Information Center

    Gregerson, Jessica

    2011-01-01

    In this inquiry-based project, student-generated questions became the basis for student-directed individual and group projects that provided practice with problem solving, critical thinking, and research skills while digging deeper into the Earth science curriculum. The author used her students' high-level questions to provide relevance,…

  4. Processing the Curriculum through Quality Questioning

    ERIC Educational Resources Information Center

    Gregerson, Jessica

    2011-01-01

    In this inquiry-based project, student-generated questions became the basis for student-directed individual and group projects that provided practice with problem solving, critical thinking, and research skills while digging deeper into the Earth science curriculum. The author used her students' high-level questions to provide relevance,…

  5. The Right Questions, the Right Way

    ERIC Educational Resources Information Center

    Wiliam, Dylan

    2014-01-01

    According to Dylan Wiliam, the traditional classroom practice in which a teacher asks a question, students raise their hands, and the teacher calls on a volunteer does not actually provide much useful information--and it may even impede learning. When teachers ask questions in this way, they're only engaging the most confident students in the…

  6. [Child psychiatry, the question of a kiss].

    PubMed

    Rosala, Franck

    2010-01-01

    What should child psychiatry care workers do when a child spontaneously embraces or kisses them? This questioning goes far beyond the fact of kissing and raises the question of the nature of the healthcare relationship and environment. While theoretical knowledge is necessary, it is not sufficient for achieving phronesis or "practical wisdom".

  7. The Right Questions, the Right Way

    ERIC Educational Resources Information Center

    Wiliam, Dylan

    2014-01-01

    According to Dylan Wiliam, the traditional classroom practice in which a teacher asks a question, students raise their hands, and the teacher calls on a volunteer does not actually provide much useful information--and it may even impede learning. When teachers ask questions in this way, they're only engaging the most confident students in the…

  8. Problem of Questioning

    SciTech Connect

    2005-10-31

    Le Prof.Leprince-Ringuet, chercheur sur le plan scientifique, artistique et humain, parle de la remise en question des hommes et la remise en question scientifique fondamentale ou exemplaire- plusieurs personnes prennent la parole p.ex Jeanmairet, Adam, Gregory. Le Prof.Gregory clot la soirée en remerciant le Prof.Leprince-Ringuet

  9. Problem of Questioning

    ScienceCinema

    None

    2016-07-12

    Le Prof.Leprince-Ringuet, chercheur sur le plan scientifique, artistique et humain, parle de la remise en question des hommes et la remise en question scientifique fondamentale ou exemplaire- plusieurs personnes prennent la parole p.ex Jeanmairet, Adam, Gregory. Le Prof.Gregory clot la soirée en remerciant le Prof.Leprince-Ringuet

  10. 1 Great Question

    ERIC Educational Resources Information Center

    Nethery, Carrie

    2011-01-01

    In this article, the author presents an ideal question that can take an art teacher and his or her students through all the levels of thought in Bloom's taxonomy--perfect for modeling the think-aloud process: "How many people is the artist inviting into this picture?" This great question always helps the students look beyond the obvious and dig…

  11. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J., Ed.

    1988-01-01

    Describes three examination questions which could be used in college chemistry courses. Discusses each problem and gives acceptable solutions. Problems include: "A Multi-Topic Problem for General Chemistry"; "Consumption of Air by Biuret Reagent--a Question Involving Experimental Design"; and "An Instructive Problem in Heterogeneous Equilibrium."…

  12. Asking the Right Questions.

    ERIC Educational Resources Information Center

    Galvin, Ruth Mehrtens

    1990-01-01

    Like good researchers, writers about research need to be able to tell whether scientific findings are valid. Six questions, to be asked of the researcher, can help the writer explain to others. A healthy skepticism is also important; there may be signals that more questions should be asked. (MSE)

  13. Designing Great Hinge Questions

    ERIC Educational Resources Information Center

    Wiliam, Dylan

    2015-01-01

    According to author Dylan Wiliam, because lessons never go exactly as planned, teachers should build plan B into plan A. This involves designing a lesson with a "hinge" somewhere in the middle and using specific kinds of questions--what he calls hinge questions--to quickly assess students' understanding of a concept before moving on.…

  14. Let's Switch Questioning Around

    ERIC Educational Resources Information Center

    Tovani, Cris

    2015-01-01

    English teacher Cris Tovani knows from her experiences teaching elementary school that students are naturally curious. But, too often, students are so trained to be question answerers that by the time they reach high school, they no longer form questions of their own and instead focus on trying to figure out what answer the teacher wants. Tovani…

  15. Designing Great Hinge Questions

    ERIC Educational Resources Information Center

    Wiliam, Dylan

    2015-01-01

    According to author Dylan Wiliam, because lessons never go exactly as planned, teachers should build plan B into plan A. This involves designing a lesson with a "hinge" somewhere in the middle and using specific kinds of questions--what he calls hinge questions--to quickly assess students' understanding of a concept before moving on.…

  16. Questions About the Oceans.

    ERIC Educational Resources Information Center

    Dubach, Harold W.; Taber, Robert W.

    This book was prompted by the success of a display mounted by the National Oceanographic Data Center at the 17th International Science Fair in 1966, which enabled visiting teachers and students to ask and receive answers to questions via teletype. The book contains one hundred questions typical of those asked, together with answers ranging in…

  17. 1 Great Question

    ERIC Educational Resources Information Center

    Nethery, Carrie

    2011-01-01

    In this article, the author presents an ideal question that can take an art teacher and his or her students through all the levels of thought in Bloom's taxonomy--perfect for modeling the think-aloud process: "How many people is the artist inviting into this picture?" This great question always helps the students look beyond the obvious and dig…

  18. What is a Question?

    NASA Technical Reports Server (NTRS)

    Knuth, Kevin H.; Clancy, Daniel (Technical Monitor)

    2002-01-01

    A given question can be defined in terms of the set of statements or assertions that answer it. Application of the logic of inference to this set of assertions allows one to derive the logic of inquiry among questions. There are interesting symmetries between the logics of inference and inquiry; where probability describes the degree to which a premise implies an assertion, there exists an analogous quantity that describes the bearing or relevance that a question has on an outstanding issue. These have been extended to suggest that the logic of inquiry results in functional relationships analogous to, although more general than, those found in information theory. Employing lattice theory, I examine in greater detail the structure of the space of assertions and questions demonstrating that the symmetries between the logical relations in each of the spaces derive directly from the lattice structure. Furthermore, I show that while symmetries between the spaces exist, the two lattices are not isomorphic. The lattice of assertions is described by a Boolean lattice 2(sup N) whereas the lattice of real questions is shown to be a sublattice of the free distributive lattice FD(N) = 2(sup 2(sup N)). Thus there does not exist a one-to-one mapping of assertions to questions, there is no reflection symmetry between the two spaces, and questions in general do not possess unique complements. Last, with these lattice structures in mind, I discuss the relationship between probability, relevance and entropy.

  19. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J.

    1980-01-01

    Provides exam questions and solutions for a problem in amplification sequence of reactions, and a problem in applying group theory techniques and making spectral assignments and structural determination by qualitative arguments in the bonding in metal complexes. (CS)

  20. EPA Subaward Frequent Questions

    EPA Pesticide Factsheets

    These answers to frequent questions (FQ) are intended to provide information to recipients of EPA financial assistance to help them understand EPA’s interpretations of the Uniform Grant Guidance (UGG) and EPA’s Subaward Policy.

  1. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J.

    1980-01-01

    Provides exam questions and solutions for a problem in amplification sequence of reactions, and a problem in applying group theory techniques and making spectral assignments and structural determination by qualitative arguments in the bonding in metal complexes. (CS)

  2. Answering Essay Questions

    NASA Astrophysics Data System (ADS)

    DeBuvitz, William

    2008-03-01

    Most of the homework I have assigned in physics courses has been of the problem-solving type, although I do assign a few essay questions for most chapters. I have also taught qualitative science courses in which most of the homework and exams involved either multiple-choice or essay questions. What I find surprising is that all physics textbooks go into detail on how to solve physics problems (determining what is asked, choosing the proper formula, showing the work clearly, and checking the results) but never say anything about answering essay questions. Teachers and authors might answer my criticism by saying, "Isn't it obvious how to answer an essay question?" Based on my experiences, I do not think it is obvious to a good number of students.

  3. Pertussis Frequently Asked Questions

    MedlinePlus

    ... Treatment Prevention Adults Parents-to-be Babies & Children Preteens & Teens Travelers Healthcare Personnel Frequently Asked Questions Photos ... Pregnant Women For Parents of Young Children For Preteens & Teens For Adults For Spanish Speakers Publications Related ...

  4. Redefining the Fundamental Questions

    ERIC Educational Resources Information Center

    Crain, Margaret Ann

    2006-01-01

    Every researcher must make some fundamental questions. A researcher's questions should include the following: (1) What is the nature of the reality that I wish to study? (2) How will I know it? (3) What must I do to know it? (4) Who am I? (5) Where is God in this? and (6) For religious educators--How does my research lead to a world of peace and…

  5. Panspermia asks new questions

    NASA Astrophysics Data System (ADS)

    Klyce, Brig

    2001-08-01

    There is a widespread sentiment that panspermia is uninteresting is because it does not answer fundamental questions about the origin of life. The strongest version of panspermia asks entirely new questions. While barriers to the acceptance of panspermia are falling and evidence supporting it is accumulating, the mere possibility of panspermia unhinges the Darwinian account of evolutionary progress. The new theory removes an issue dividing science and religion, but it requires an amendment to the big bang theory.

  6. Medicolegal characteristics of firearm homicides in Belgrade, Serbia: before, during, and after the war in the Former Yugoslavia.

    PubMed

    Rancic, Nemanja; Erceg, Milena; Radojevic, Nemanja; Savic, Slobodan

    2013-11-01

    A comparative analysis of firearm homicides committed in Belgrade was performed including four representative years: 1987 (before the civil war in the Former Yugoslavia), 1991 (beginning of the war), 1997 (end of the war), and 2007 (period of social stabilization). The increase in the number of homicides was established in 1991 and 1997 compared with 1987, with the decrease in 2007, but with the continuous increase in the percentage of firearm homicides in the total number of homicides, from 12% in 1987 up to 56% in 2007. The significant increase in firearm homicides during the last decade of the 20th century can be explained by the social disturbances and the high availability of firearms, while their reduction in 2007 could be linked to the gradual stabilization of social circumstances. The results showed that the actual social, political, and economical changes strongly influenced medicolegal characteristics of homicides and particularly firearm homicides.

  7. Unexpected post-mortem diagnosis of systemic sclerosis presenting as pneumatosis intestinalis: revised diagnostic criteria and medicolegal implications.

    PubMed

    Leduc, Charles; Young, Iain D; Joneja, Mala G; Parker, Christopher M

    2015-01-01

    Systemic sclerosis is a challenging diagnosis for clinicians and pathologists alike due to its protean manifestations and often insidious onset, particularly in cases without significant titres of auto-antibodies. Herein we present a case of a female in her sixties who died rapidly following a clinical diagnosis of pneumatosis intestinalis and respiratory failure of unclear etiology. Recently revised clinical diagnostic criteria were applied to the clinical history and postmortem findings to reach an unexpected diagnosis of systemic sclerosis. The diagnosis of systemic sclerosis at autopsy has important medicolegal implications largely related to premature death due to delayed treatment or poor post-operative outcome. Moreover, familial clustering of this disease underscores the importance of maintaining a high index of suspicion in the postmortem setting.

  8. [Disturbance of the health--an attempt at interpreting the term. Part II--problems in medico-legal opinionating].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara

    2006-01-01

    Interpretative problems are caused by the semantic definition of the term "disturbance of the health" and its usage in the law system context. Judicial decisions show that this term is employed to denote a functional, as well as mental detriment to the health that exceeds the individual's adaptative abilities. A review of medico-legal literature demonstrates various interpretations of the term, starting from general systemic disturbances to definitions allowing for objectivization of the injured person's complaints. The deliberations constitute an attempt at quantification of "disturbance of the health" and defining the upper and lower limits of the medium and slight detriment to the health. The results of the analysis allow for adopting a definition that permits to judge objectively the injured person's complaints and to determine the limits of the compensatory ability of his body.

  9. Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons.

    PubMed

    Zorn, Kevin C; Gautam, Gagan; Shalhav, Arieh L; Clayman, Ralph V; Ahlering, Thomas E; Albala, David M; Lee, David I; Sundaram, Chandru P; Matin, Surena F; Castle, Erik P; Winfield, Howard N; Gettman, Matthew T; Lee, Benjamin R; Thomas, Raju; Patel, Vipul R; Leveillee, Raymond J; Wong, Carson; Badlani, Gopal H; Rha, Koon H; Eggener, Scott E; Wiklund, Peter; Mottrie, Alex; Atug, Fatih; Kural, Ali R; Joseph, Jean V

    2009-09-01

    With the exponential growth of robotic urological surgery, particularly with robot assisted radical prostatectomy, guidelines for safe initiation of this technology are a necessity. Currently no standardized credentialing system exists to our knowledge to evaluate surgeon competency and safety with robotic urological surgery performance. Although proctoring is a modality by which such competency can be evaluated, other training tools and guidelines are needed to ensure that the requisite knowledge and technical skills to perform this procedure have been acquired. We evaluated the current status of proctoring and credentialing in other surgical specialties to discuss and recommend its application and implementation specifically for robot assisted radical prostatectomy. We reviewed the literature on safety and medicolegal implications of proctoring and the safe introduction of surgical procedures to develop recommendations for robot assisted radical prostatectomy proctoring and credentialing. Proctoring is an essential mechanism for robot assisted radical prostatectomy institutional credentialing and should be a prerequisite for granting unrestricted privileges on the robot. This should be differentiated from preceptoring, wherein the expert is directly involved in hands-on training. Advanced technology has opened new avenues for long-distance observation through teleproctoring. Although the medicolegal implications of an active surgical intervention by a proctor are not clearly defined, the role as an observer should grant immunity from malpractice liability. The implementation of guidelines and proctoring recommendations is necessary to protect surgeons, proctors, institutions and, above all, the patients who are associated with the institutional introduction of a robot assisted radical prostatectomy program. With no current guidelines we anticipate this article will serve as a catalyst of interorganizational discussion to initiate regulatory oversight of surgeon

  10. Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications?

    PubMed

    Weber, Marco; Lessig, Rüdiger; Richter, Carolin; Ritter, Axel P; Weiß, Ilona

    2017-05-16

    Medico-legal experts are increasingly enlisted to assess the methamphetamine and amphetamine serum concentrations after a criminal offense. However, since criminal users rarely provide useful information to medico-legal experts regarding the substances abused, when the substance(s) was/were used, dose of ingestion tools are needed to interpret the analytical data, which can be used as objective evidence in such cases. A comparative series of methamphetamine and amphetamine serum concentrations were used to analyze the frequency of concentrations, to determine methamphetamine/amphetamine concentration ratios, and prove them as a tool to distinguish pure methamphetamine from mixed amphetamine/methamphetamine ingestion. Additionally, two cases of survived accidental methamphetamine intoxication, resulting from ingestion smuggling which was longitudinally monitored, and pharmacokinetic parameters were assessed. In a series of 628 samples where the most frequent concentration of methamphetamine exceeded the therapeutic level, there was a strong correlation suggesting pure methamphetamine consumption, when the ratios of methamphetamine/amphetamine concentrations were within the range between 3 and 10. In the two cases of methamphetamine bodypacking, the relevant serum concentrations of methamphetamine and amphetamine, which could be measured up to 9 days after ingestion, indicated a decrease of the methamphetamine/amphetamine ratios in an exponential manner. However, the ratios were not always within the range between 3 and 10. Lastly, the course of the serum concentrations suggested an increase of the apparent elimination half-life of methamphetamine. In terms of the objective evidence required in criminal law, calculating methamphetamine/amphetamine concentration ratio is not a suitable to means to distinguish pure methamphetamine intake and that of mixed amphetamine/methamphetamine abuse in an individual case. Instead, methamphetamine high serum concentrations and

  11. Medicolegal study of child sexual abuse in greater Cairo, Egypt, during a 7-year period: 2005-2011.

    PubMed

    Elgendy, Ibrahim Sadik; Hassan, Nermeen Adly

    2013-12-01

    Child sexual abuse has gained public attention and has become 1 of the most high-profile crimes. This study aimed to determine the demographic and medicolegal aspects of child sexual abuse in greater Cairo, Egypt. This is a retrospective study from January 1, 2005, to December 31, 2011. Data were collected from a Cairo medicolegal department and were statistically analyzed. The total number of cases was 1832 victims; 57.9% were males and 42.1% were females. Most assaults occurred in 2010 (16.2%) and 2011 (17.5%). The age group 6 to 12 years accounted for higher rate (49%), mostly in males (71.8%). A total of 83.3% of the victims belonged to low social class, and 72.3% of the victims were out of school. Only 1.9% of the victims had a mental disability. The crime scene was an unknown place in 78.1%. All offenders were males; most cases had 1 offender (82.5 %); and most offenders were extrafamilial (94.2%), of low social level, illiterate, unemployed, and between 18 and 30 years old. The unmarried offenders assaulted the females more than the males, whereas the married assaulted the males more than the females. A total of 5.8% were intrafamilial offenders; 62.7% of these cases were incest against girls and 37.3% were sodomy against boys. Clothes were normal in 48.8%. Anal assault (52.3%) and incomplete vaginal penetration (32%) were the commonest types. There was no significant relation between findings, investigations, and time. In conclusion, child sexual abuse in greater Cairo represents a problem. Therefore,forensic medicine should be a part of a multidisciplinary approach to prevent, investigate, and treat the problem.

  12. Symposium on Questions about the Quality of Early Childhood Provisions.

    ERIC Educational Resources Information Center

    Katz, Lilian G.

    This paper addresses two questions relevant to practices and policies in early childhood education (ECE). The first question addressed is, Given the worldwide focus on ECE, what are the priorities in practice-oriented research in school life? Educators struggle with the issue of whether research makes much difference to practice. It is suggested…

  13. Practice of forensic medicine and pathology in Sri Lanka.

    PubMed

    Balachandra, A Thambirajah; Vadysinghe, Amal N; William, Anita L

    2011-02-01

    The practice of forensic medicine and pathology in Sri Lanka is based on the British model. Medical students during their third and fourth years receive approximately 50 hours of lectures and tutorials in forensic medicine and pathology and then undergo an examination. After completing an internship, these doctors are sent to various hospitals throughout Sri Lanka where they may be asked to perform medicolegal examinations on victims and suspects in rape cases, persons suspected of being under the influence of drugs and/or alcohol, and, injured live patients. As well, they may be asked to perform medicolegal autopsies. Depending upon their experience, some medical officers may be designated as judicial medical officers and appointed full time to do medicolegal work. Up until 1980, judicial medical officers with at least 2 years of work experience were allowed to obtain their postgraduate qualifications in the United Kingdom. However, since 1981 and the establishment of its own Postgraduate Institute of Medicine in Colombo, Sri Lanka, medical officers are offered 2 postgraduate programs in forensic medicine and pathology, a diploma in legal medicine and a doctorate in medicine (forensic medicine). After completing the doctorate in forensic medicine, doctors are allowed to train abroad for a further year in an approved center. Upon return they can then be appointed as consultant judicial medical officers. The practice of forensic medicine and pathology in Sri Lanka is unique and vibrant. However, due to the country's prevailing civil war, the practice of forensic medicine and pathology is suboptimal.

  14. Risk management in clinical practice. Part 6a. Identifying and avoiding medico-legal risks in complete denture prosthetics.

    PubMed

    McCord, J F

    2010-09-25

    The provision of complete dentures is often perceived as a clinical 'black art' as it relies on a blend of clinical skill, scientific evidence and no little artistic interpretation. Coupled to this is a heavy reliance on patient ability to control their dentures in a muscular environment while, hopefully, coping with the various oral functions in addition to appearance. This article deals with the potential problem areas in the provision of complete dentures, reinforcing the importance of practitioners obtaining appropriate informed consent and of maintaining clinical knowledge and skills.

  15. [Use of intraocular fluid in the medico-legal practice in diagnosing fatal poisoning with various psychoactive substances].

    PubMed

    Jabłoński, Christian; Sybirska, Halina

    2002-01-01

    In this paper results of the research on the usefulness of toxicological analysis relating to narcotics in intraocular fluid have been presented. The examined material comprised intraocular fluids and blood samples collected from 332 deceased suspected of being intoxicated or poisoned with psychoactive agents. The cases in which death resulted from injuries and those where an individual took drugs before his or her death were also considered. Drug analysis was carried out by fluorescence polarization immunoassay (FPIA). In both biological fluids the degree of hydratation was determined. Ethyl alcohol, opiates, barbiturates and benzodiazepines were found in all the examined cases. In few cases ethanol substitutes such as isopropyl alcohol, ethylene glycol and methyl alcohol were indicated. Results of the quantitative examinations were divided into sets according to the kind of xenobiotic and then on the basics of concentration of the substance found in the blood and vitreous body 2 different groups were separated in each set. Statistic analysis of the correlations among xenobiotic concentrations in both organic fluids was also performed. The obtained findings allow to assume that intraocular fluid can be used for toxicological diagnosis of poisonings with psycho-active agents. The analytical results for intraocular fluid not only confirms the result for blood but also makes it credible. In single cases it can be a sufficient basis to determine and recognize psychoactive agents in the deceased.

  16. Comparisons of the interactions of health care delivery and medico-legal practice between Australia and Singapore.

    PubMed

    Kandiah, D

    2006-09-01

    Australia and Singapore have similar standards of health care. The one major difference in the two health care systems is the cost to the patient at the point of care. The Medicare system in Australia provides partial to complete subsidy for health care delivery in the public hospitals. In Singapore, the patient has to bear the cost of their health care when needed, with some government subsidies. Studies in the variations between two health care systems, where the costs to the government and individuals are clearly dissimilar, but the health outcomes are similar, can be educational for health law specialists. The methods in which patients obtain recompense for their grievances can help both countries understand how to determine and improve standards of health care communication. Having worked in both systems, the relative values of each and their effects on medical litigation will be discussed.

  17. How Effective Are Your Questions?

    ERIC Educational Resources Information Center

    Partin, Ronald L.

    1979-01-01

    Guidelines are given to the teacher on using questions to improve classroom discussions. Included are: reasons for using questions, ways to ask questions and acknowledge students' responses, and types of questions which should and should not be used. (SJL)

  18. A Question of Evidence

    ERIC Educational Resources Information Center

    Todd, Ross J.

    2008-01-01

    Broadly defined, evidence-based practice (EBP) is fundamentally about professional practice being informed and guided by best available evidence of what works. The EBP movement had its origins in the early 1990s in the United Kingdom in medicine and health care services. Sackett et al. defined evidence-based medicine as the "conscientious,…

  19. A Question of Evidence

    ERIC Educational Resources Information Center

    Todd, Ross J.

    2008-01-01

    Broadly defined, evidence-based practice (EBP) is fundamentally about professional practice being informed and guided by best available evidence of what works. The EBP movement had its origins in the early 1990s in the United Kingdom in medicine and health care services. Sackett et al. defined evidence-based medicine as the "conscientious,…

  20. Questioning Ohio's Loyalty Requirement

    ERIC Educational Resources Information Center

    O'Neil, Robert M.

    2006-01-01

    Beginning this past summer, all new employees at some Ohio public universities, including those accepting teaching positions, are being confronted with politically sensitive and intrusive questions. In addition to the "Have you solicited any individual for membership in an organization on the U.S. Department of State Terrorist…

  1. Questions English Teachers Ask.

    ERIC Educational Resources Information Center

    Shuman, R. Baird

    This volume is based on the responses of 374 English teachers at the secondary and college levels to a letter asking them to describe the questions that most perplex them professionally. Answers are provided by 88 leaders in English education, including James R. Squire, Walter H. MacGinitie, R. Baird Shuman, Sheila Schwartz, and Ken Macrorie. The…

  2. My Favorite Exam Question

    ERIC Educational Resources Information Center

    Styer, Dan

    2015-01-01

    My favorite exam question comes from the final exam in an introductory mechanics course: "A rolling 31 ton railroad boxcar collides with a stationary flatcar. The coupling mechanism activates so the cars latch together and roll down the track attached. Of the initial kinetic energy, 38% dissipates as heat, sound, vibrations, mechanical…

  3. A Question of Choice

    PubMed Central

    2011-01-01

    Women's reproductive rights, reproductive health, and constitutional privacy rights in the United States are addressed in light of the contemporary onslaught of the Christian Right. The misuse of State power by fundamentalist social forces in America is critiqued. The article also briefly reviews the question of State control over women's bodies. PMID:21696627

  4. A Question of Character

    ERIC Educational Resources Information Center

    Stuart, Reginald

    2010-01-01

    When intern placement veteran Jacqueline Perkins begins counseling students at Florida A&M University (FAMU) about their prospects for getting well-paying, security-related jobs with the federal government, she confronts the 800-pound gorilla in the room--the question of whether a student has been convicted of or pleaded guilty to a…

  5. Asking Questions about Participation

    ERIC Educational Resources Information Center

    Davies, Ian; Flanagan, Bernie; Hogarth, Sylvia; Mountford, Paula; Philpott, Jenny

    2009-01-01

    We raise questions about young people's participation in light of findings from a project ("Democracy through Citizenship") funded by the Joseph Rowntree Reform Trust Limited, and managed by the Institute for Citizenship. Following a six-month feasibility study the project took place over a three-year period in one local authority in the…

  6. Asking the Right Questions

    ERIC Educational Resources Information Center

    Lord, Rob

    2011-01-01

    As a student teacher at Nottingham Trent University, the author explored the issues surrounding children asking investigable questions in science and the repertoire of strategies that could be employed by teachers in the classroom to support this process. His project was carried out in an inner-city primary school in Nottingham. The four focus…

  7. My Favorite Exam Question

    ERIC Educational Resources Information Center

    Styer, Dan

    2015-01-01

    My favorite exam question comes from the final exam in an introductory mechanics course: "A rolling 31 ton railroad boxcar collides with a stationary flatcar. The coupling mechanism activates so the cars latch together and roll down the track attached. Of the initial kinetic energy, 38% dissipates as heat, sound, vibrations, mechanical…

  8. Informed Questions on Malaysia

    DTIC Science & Technology

    2003-03-01

    National War College Course 5604 Informed Questions on Malaysia BG Tay, Lim Heng, Army...collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources...gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate

  9. Questioning Ohio's Loyalty Requirement

    ERIC Educational Resources Information Center

    O'Neil, Robert M.

    2006-01-01

    Beginning this past summer, all new employees at some Ohio public universities, including those accepting teaching positions, are being confronted with politically sensitive and intrusive questions. In addition to the "Have you solicited any individual for membership in an organization on the U.S. Department of State Terrorist…

  10. Questioning and Experimentation

    ERIC Educational Resources Information Center

    Mutanen, Arto

    2014-01-01

    The paper is a philosophical analysis of experimentation. The philosophical framework of the analysis is the interrogative model of inquiry developed by Hintikka. The basis of the model is explicit and well-formed logic of questions and answers. The framework allows us to formulate a flexible logic of experimentation. In particular, the formulated…

  11. Question: Who Can Vote?

    ERIC Educational Resources Information Center

    Rodeheaver, Misty D.; Haas, Mary E.

    2008-01-01

    This year's rollercoaster primary elections and the pending national election, with an anticipated record voter turnout, provide the perfect backdrop for an examination of the questions: (1) Who can vote?; and (2) Who will vote? Historically, the American government refused voting rights to various groups based on race, gender, age, and even…

  12. A question of choice.

    PubMed

    Grabiner, Gene

    2011-06-22

    Women's reproductive rights, reproductive health, and constitutional privacy rights in the United States are addressed in light of the contemporary onslaught of the Christian Right. The misuse of State power by fundamentalist social forces in America is critiqued. The article also briefly reviews the question of State control over women's bodies.

  13. Questions for the Profession.

    ERIC Educational Resources Information Center

    Smalley, Lee

    1984-01-01

    Examines the issues and lists available options for these questions: why don't teachers (1) teach about the future, (2) use results of educational research, (3) focus on teacher-student interaction, (4) assign grades from a competency criterion, and (5) teach the structure of mechanical drafting. (SK)

  14. A Question of Character

    ERIC Educational Resources Information Center

    Stuart, Reginald

    2010-01-01

    When intern placement veteran Jacqueline Perkins begins counseling students at Florida A&M University (FAMU) about their prospects for getting well-paying, security-related jobs with the federal government, she confronts the 800-pound gorilla in the room--the question of whether a student has been convicted of or pleaded guilty to a…

  15. Exam Question Exchange.

    ERIC Educational Resources Information Center

    Alexander, John J., Ed.

    1978-01-01

    Two exam questions are presented. One suitable for advanced undergraduate or beginning graduate courses in organic chemistry, is on equivalent expressions for the description of several pericyclic reactions. The second, for general chemistry students, asks for an estimation of the rate of decay of a million-year-old Uranium-238 sample. (BB)

  16. The Compensation Question

    ERIC Educational Resources Information Center

    Richwine, Jason; Biggs, Andrew; Mishel, Lawrence; Roy, Joydeep

    2012-01-01

    Over the past few years, as cash-strapped states and school districts have faced tough budget decisions, spending on teacher compensation has come under the microscope. The underlying question is whether, when you take everything into account, today's teachers are fairly paid, underpaid, or overpaid. In this forum, two pairs of respected…

  17. The Compensation Question

    ERIC Educational Resources Information Center

    Richwine, Jason; Biggs, Andrew; Mishel, Lawrence; Roy, Joydeep

    2012-01-01

    Over the past few years, as cash-strapped states and school districts have faced tough budget decisions, spending on teacher compensation has come under the microscope. The underlying question is whether, when you take everything into account, today's teachers are fairly paid, underpaid, or overpaid. In this forum, two pairs of respected…

  18. That Is the Question.

    ERIC Educational Resources Information Center

    Korsunsky, Syd

    2002-01-01

    Describes the author's evolution from a teacher set in his ways to one who adapted to students' voices. Contends that classrooms need to be environments where students are able to ask their own questions. Explains that key elements of such an environment include the following: interviews; mini-lessons; multi-genre projects; literature circles;…

  19. What Is the Question?

    ERIC Educational Resources Information Center

    Woodruff, Melba D.

    Second language educators need to examine in greater depth the learning processes of young children in order to provide them with the kind of teaching they need in order to really learn. This means searching other fields to learn as much as possible about: questioning strategies and the development of critical thinking skills; hemispheric…

  20. Questioning and Experimentation

    ERIC Educational Resources Information Center

    Mutanen, Arto

    2014-01-01

    The paper is a philosophical analysis of experimentation. The philosophical framework of the analysis is the interrogative model of inquiry developed by Hintikka. The basis of the model is explicit and well-formed logic of questions and answers. The framework allows us to formulate a flexible logic of experimentation. In particular, the formulated…

  1. Questioning in the Classroom.

    ERIC Educational Resources Information Center

    Hyman, Ronald T.

    This study investigates the pattern of teacher questioning regarding three elements: sequence, student respondent, and cognitive process. The rationale for this type of teaching rests on the claims for teaching students the process of critical (reflective) thinking. In this type of teaching it is necessary to have data before the students. Only…

  2. Statin intolerance: more questions than answers.

    PubMed

    Guyton, John R; Campbell, Kristen B; Lakey, Wanda C

    2014-01-01

    The dramatic effectiveness of statins in improving the course of atherosclerotic cardiovascular disease tends to overshadow questions of statin intolerance. Thus after more than 25 years of clinical statin use, intolerance remains a poorly understood, frustrating issue for patients and providers. It has been extraordinarily difficult to define statin intolerance and its implications for clinical practice. Here, we briefly summarize current knowledge and raise questions that need to be addressed.

  3. Padova Charter on personal injury and damage under civil-tort law : Medico-legal guidelines on methods of ascertainment and criteria of evaluation.

    PubMed

    Ferrara, Santo Davide; Baccino, Eric; Boscolo-Berto, Rafael; Comandè, Giovanni; Domenici, Ranieri; Hernandez-Cueto, Claudio; Gulmen, Mete Korkut; Mendelson, George; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Ranavaya, Mohammed; Shokry, Dina A; Sterzik, Vera; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Zoja, Riccardo

    2016-01-01

    Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first "International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law". This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

  4. Writing clinical scenarios for clinical science questions.

    PubMed

    Smith, Phil Em; Mucklow, John C

    2016-04-01

    Written knowledge assessments for physicians in training typically involve multiple-choice questions that use a clinical scenario in a single-best-answer format. The Royal College of Physicians Part 1 MRCP(UK) examination includes basic sciences themes that are challenging to assess through a clinical scenario. A realistic clinical setting based on everyday clinical practice and integral to the question is the clearest demonstration that the knowledge being assessed is clinically relevant. However, without special attention to detail, the scenario in a clinical science question can appear redundant or artificial. Reading unnecessary material frustrates candidates and threatens the reputation of the assessment. In this paper we discuss why a clinical scenario is important for basic science questions and offer advice on setting realistic and plausible clinical scenarios for such questions.

  5. IC: Frequently Asked Questions

    MedlinePlus

    ... Pain Complementary Therapies Complementary vs. Alternative Herbs, Dietary Supplements, & Biologicals Mind-body Medicine Massage, Manipulation, & Body-based Practices Energy Medicine Bringing Treatments to Market IC Healthcare Provider ...

  6. Regenerative Endodontics: Burning Questions.

    PubMed

    Smith, Anthony J; Cooper, Paul R

    2017-09-01

    Pulp regeneration and its clinical translation into regenerative endodontic procedures are receiving increasing research attention, leading to significant growth of the published scientific and clinical literature within these areas. Development of research strategies, which consider patient-, clinician-, and scientist-based outcomes, will allow greater focus on key research questions driving more rapid clinical translation. Three key areas of focus for these research questions should include cells, signaling, and infection/inflammation. A translational pathway is envisaged in which clinical approaches are increasingly refined to provide regenerative endodontic protocols that are based on a robust understanding of the physiological processes and events responsible for the normal secretion, structure, and biological behavior of pulpal tissue. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. Knowledge based question answering

    SciTech Connect

    Pazzani, M.J.; Engelman, C.

    1983-01-01

    The natural language database query system incorporated in the Knobs Interactive Planning System comprises a dictionary driven parser, APE-II, and script interpreter whch yield a conceptual dependency as a representation of the meaning of user input. A conceptualisation pattern matching production system then determines and executes a procedure for extracting the desired information from the database. In contrast to syntax driven q-a systems, e.g. those based on atn parsers, APE-II is driven bottom-up by expectations associated with word meanings. The goals of this approach include utilising similar representations for questions with similar meanings but widely varying surface structures, developing a powerful mechanism for the disambiguation of words with multiple meanings and the determination of pronoun referents, answering questions which require inferences to be understood, and interpreting ellipses and ungrammatical statements. The Knobs demonstration system is an experimental, expert system for air force mission planning applications. 16 refs.

  8. Questions of wisdom.

    PubMed

    Schmidt Bunkers, Sandra

    2009-04-01

    In this column questions concerning wisdom are addressed, such as, what is wisdom? Can wisdom be taught in the academy? Several perspectives on wisdom from philosophy, education, business, and psychology are presented. Wisdom with creativity-creativity with wisdom is then explored through discussion of Parse's humanbecoming teaching-learning model and Laird Hamilton's life lessons learned from surfing, which he termed wisdom of the wave. The column concludes with consideration of the wise person.

  9. Quantum theory from questions

    NASA Astrophysics Data System (ADS)

    Höhn, Philipp Andres; Wever, Christopher S. P.

    2017-01-01

    We reconstruct the explicit formalism of qubit quantum theory from elementary rules on an observer's information acquisition. Our approach is purely operational: we consider an observer O interrogating a system S with binary questions and define S 's state as O 's "catalog of knowledge" about S . From the rules we derive the state spaces for N elementary systems and show that (a) they coincide with the set of density matrices over an N -qubit Hilbert space C2N; (b) states evolve unitarily under the group PSU (2N) according to the von Neumann evolution equation; and (c) O 's binary questions correspond to projective Pauli operator measurements with outcome probabilities given by the Born rule. As a by-product, this results in a propositional formulation of quantum theory. Aside from offering an informational explanation for the theory's architecture, the reconstruction also unravels previously unnoticed structural insights. We show that, in a derived quadratic information measure, (d) qubits satisfy inequalities which bound the information content in any set of mutually complementary questions to 1 bit; and (e) maximal sets of mutually complementary questions for one and two qubits must carry precisely 1 bit of information in pure states. The latter relations constitute conserved informational charges which define the unitary groups and, together with their conservation conditions, the sets of pure quantum states. These results highlight information as a "charge of quantum theory" and the benefits of this informational approach. This work emphasizes the sufficiency of restricting to an observer's information to reconstruct the theory and completes the quantum reconstruction initiated in a companion paper (P. Höhn, arXiv:1412.8323).

  10. Severe acute hemorrhagic pancreatitis secondary to cholelithiasis as a rare cause of sudden unexpected death in medico-legal case: A case report.

    PubMed

    Srettabunjong, Supawon; Limgitisupasin, Wiratchaya

    2016-08-01

    Acute pancreatitis (AP) is an uncommon disease with a wide clinical course varying from mild and self-limiting to severe with eventual death. However, death caused by AP is rare. Most cases of AP reported in the English-language literature are based on clinical data; few are medico-legal studies. The author recently experienced a case of sudden unexpected death in a young man caused by extensive severe hemorrhagic AP secondary to cholelithiasis, not chronic alcoholism, which is a much more prominent etiology of AP in medico-legal perspectives. The deceased had complained of dizziness, nausea, and fatigue without significant abdominal pain for about 1 week and received some home medications for symptomatic treatment including an antibiotic drug from a clinic just 2 days prior to his death. He had complained of lower extremity weakness, intense thirst, and subsequently collapsed and was brought to a nearby hospital where he was pronounced dead shortly after his admission following unsuccessful advanced cardiopulmonary resuscitation attempts. This case is herein reported with an extensive review of the pertinent literature to highlight the findings of the case and raise awareness within the medico-legal profession and also the medical profession.

  11. [The role, objectives and usefulness of medico-legal determinations in post-accidental procedures in traumatic deaths in hard coal-mining industry].

    PubMed

    Skowronek, Rafał; Chowaniec, Czesław

    2009-01-01

    The underground hard coal-mining sector demonstrates one of the highest rates of fatal accidents, in spite of a decline in coal-mining over the last few years. Post-accidental investigations, including forensic medical expertise, continue to present a significant problem. The objective of the research was to evaluate the role, tasks and usefulness of medico-legal determinations in post-accidental procedures in traumatic deaths in hard coal-mining industry. The study was carried out retrospectively by investigating files and autopsy reports, with attention focusing on the scope of necessary activities and medico-legal examinations in order to determine the cause and manner of death, and on identification of fatalities, especially in the cases of collective occupational accidents. Complex medico-legal determinations (identification, autopsy), supplemented by additional investigations (toxicology, histopathology and hemogenetics) provide a valuable source of evidence for legal authorities and post-accidental commissions. Mutual cooperation of the experts representing various branches of science is the basis of executing appropriate procedures after a traumatic death in the coal mine.

  12. Questioning Many Mysteries

    NASA Astrophysics Data System (ADS)

    Martin, Sara F.

    2015-04-01

    The first section of this memoir queries my formative years. Indirectly I address the question, did my childhood and early years make a difference in my choice of career? Why and how did I begin my journey to becoming a scientist? Did I choose the field of solar astronomy or did circumstances dictate it for me? In the second section, I travel through my work environments and experiences, talking about interactions and aspects of being a scientist that do not appear in our research papers. What parts of my research were happenstances and what parts did I plan? What does it feel like to be on scientific quests? Using examples in my journey, I also turn to questions that have intrigued me throughout my sojourn as a solar astronomer. How do scientific discoveries come about? What factors lead to little discoveries? And what factors lead to major exciting discoveries? Are there timely questions we do not think to ask? How can small, seemingly scattered pieces of knowledge suddenly coalesce into a deeper understanding - what is called the "Aha!" experience - the times when our mental light switches on, and with child-like wonder we behold a "big picture"?

  13. Insects and associated arthropods analyzed during medicolegal death investigations in Harris County, Texas, USA: January 2013- April 2016

    PubMed Central

    2017-01-01

    The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner’s office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA. In this study, a retrospective analysis was made of 203 forensic entomology cases analyzed during the course of medicolegal death investigations performed by the Harris County Institute of Forensic Sciences in Houston, TX, USA from January 2013 through April 2016. These cases included all manner of death classifications, stages of decomposition and a variety of different scene types that were classified into decedents transported from the hospital (typically associated with myiasis or sting allergy; 3.0%), outdoor scenes (32.0%) or indoor scenes (65.0%). Ambient scene air temperature at the time scene investigation was the only significantly different factor observed between indoor and outdoor scenes with average indoor scene temperature being slightly cooler (25.2°C) than that observed outdoors (28.0°C). Relative humidity was not found to be significantly different between scene types. Most of the indoor scenes were classified as natural (43.3%) whereas most of the outdoor scenes were classified as homicides (12.3%). All other manner of death classifications came from both indoor and outdoor scenes. Several species were found to be significantly associated with indoor scenes as indicated by a binomial test, including Blaesoxipha plinthopyga (Wiedemann) (Diptera: Sarcophagidae), all Sarcophagidae (including B. plinthopyga), Megaselia scalaris Loew (Diptera: Phoridae), Synthesiomyia nudiseta Wulp (Diptera: Muscidae) and Lucilia

  14. Insects and associated arthropods analyzed during medicolegal death investigations in Harris County, Texas, USA: January 2013- April 2016.

    PubMed

    Sanford, Michelle R

    2017-01-01

    The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner's office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA. In this study, a retrospective analysis was made of 203 forensic entomology cases analyzed during the course of medicolegal death investigations performed by the Harris County Institute of Forensic Sciences in Houston, TX, USA from January 2013 through April 2016. These cases included all manner of death classifications, stages of decomposition and a variety of different scene types that were classified into decedents transported from the hospital (typically associated with myiasis or sting allergy; 3.0%), outdoor scenes (32.0%) or indoor scenes (65.0%). Ambient scene air temperature at the time scene investigation was the only significantly different factor observed between indoor and outdoor scenes with average indoor scene temperature being slightly cooler (25.2°C) than that observed outdoors (28.0°C). Relative humidity was not found to be significantly different between scene types. Most of the indoor scenes were classified as natural (43.3%) whereas most of the outdoor scenes were classified as homicides (12.3%). All other manner of death classifications came from both indoor and outdoor scenes. Several species were found to be significantly associated with indoor scenes as indicated by a binomial test, including Blaesoxipha plinthopyga (Wiedemann) (Diptera: Sarcophagidae), all Sarcophagidae (including B. plinthopyga), Megaselia scalaris Loew (Diptera: Phoridae), Synthesiomyia nudiseta Wulp (Diptera: Muscidae) and Lucilia cuprina

  15. Questions, Relatives, and Minimal Projection.

    ERIC Educational Resources Information Center

    Demuth, Katherine

    1995-01-01

    This article examines the acquisition of wh-questions and relative clauses in Sesotho, a language with no wh-movement in either questions or relatives, and in which wh-questions must be clefted. (10 references) (JL)

  16. The Art of Asking Questions.

    ERIC Educational Resources Information Center

    Sykes, Rosetta A.

    1979-01-01

    A rationale is given for the use of questioning techniques and strategies in classroom instruction. B. Bloom's Taxonomy of Educational Objectives is presented as one framework for questions. Five pitfalls, including avoiding vague questions and personal pronouns, are discussed. (CL)

  17. Questioning and Experimentation

    NASA Astrophysics Data System (ADS)

    Mutanen, Arto

    2014-08-01

    The paper is a philosophical analysis of experimentation. The philosophical framework of the analysis is the interrogative model of inquiry developed by Hintikka. The basis of the model is explicit and well-formed logic of questions and answers. The framework allows us to formulate a flexible logic of experimentation. In particular, the formulated model can be interpreted realistically. Moreover, the model demonstrates an explicit logic of knowledge acquisition. So, the natural extension of the model is to apply it to an analysis of the learning process.

  18. To Question or Not to Question: That Seems to Be the Question.

    ERIC Educational Resources Information Center

    Bradtmueller, Weldon G.; Egan, James B.

    Research on the effects of questioning in the classroom has explored the placement, timing, type, and social impact of questions. Principles of good questioning include the following: (1) well-stated questions should be concise, clear, and complete; (2) questions should be topical in nature, requiring a complex answer; (3) yes or no questions…

  19. Medicolegal issues with regard to melanoma and pigmented lesions in dermatopathology.

    PubMed

    Marsch, Amanda; High, Whitney A

    2012-10-01

    Understanding malpractice risk and practicing risk management strategies results in better care and a less stressful environment of practice. Errors in diagnosis are most commonly related to melanoma and neoplasms of the skin. To offset the threat of malpractice litigation, malpractice data can be used to focus safety efforts on common diagnostic errors. Recognition of sources of error in the analysis of pigmented lesions by dermatopathologists, and the development of new immunohistochemical or genotypic techniques for the recognition and distinction of malignant disease from benign pigmented lesions, will also provide important improvements in care and diagnosis in the future. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Linking Questions and Evidence

    ERIC Educational Resources Information Center

    Tenenberg, Josh; McCartney, Robert

    2008-01-01

    This special issue features a set of papers recently published in the 3rd International Workshop on Computing Education Research (ICER'07). The papers were selected because they closely meet the publication criteria for ACM/JERIC: stemming from computing education practice, grounded in relevant literature, containing analysis of primary empirical…