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PubMed1990

[Ethical-legal aspects of the civil responsibility of physicians in professional practice].

The ethical-juridical concepts related to the civil responsibility of medical activity in liberal practice are brought up to date. To this end, the arguments which guide the shaping up of the contractual relationship between the physician and the client are analysed, as also are the foundations on which the notion of guilt--an essential component of civil responsibility, whether relating to technical acts of to those within the field of medical humanism--are grounded. The answers presented for the solution of this question by European juridical systems are given.

Ethics, Medical↗
PubMed2006

[Monitoring and evaluating actions implemented to confront AIDS in Brazil: civil society's participation].

The United Nations Declaration of Commitment on HIV/AIDS recommends that governments conduct periodic analysis of actions undertaken in confronting the HIV/AIDS epidemic that involve civil society's participation. Specific instruments and mechanisms should be created towards this end. This paper examines some of the responses of the Brazilian government to this recommendation. Analysis contemplates the Declaration's proposals as to civil society's participation in monitoring and evaluating such actions and their adequacy with respect to Brazilian reality. The limitations and potentials of MONITORAIDS, the matrix of indicators created by Brazil's Programa Nacional de DST/Aids [National Program for STD/AIDS] to monitor the epidemic are discussed. Results indicate that MONITORAIDS's complexity hampers its use by the conjunction of actors involved in the struggle against AIDS. The establishment of mechanisms that facilitate the appropriation of this system by all those committed to confronting the epidemic in Brazil is suggested.

Acquired Immunodeficiency Syndrome↗
PubMed2006

The impact of early retirement on perceptions of life at work and at home: qualitative analyses of British civil servants participating in the Whitehall II Retirement Study.

This study examined pathways to retirement and the role of circumstances at work and at home (including the introduction of financially-enhanced early retirement schemes) on retirement-related decision-making. In-depth qualitative interviews were conducted within 2 years of retirement with 59 British civil servants participating in the Whitehall II Study. Focusing on the experiences of 33 interviewees who spontaneously discussed "early retirement" we identified three pathways to retirement (non-applicants, successful applicants, and unsuccessful applicants for early retirement) each influenced by a range of complementary positive and negative factors at work and at home. The early retirement schemes influenced the balance between these factors in three ways: by encouraging participants to reflect on (and reconsider) existing retirement plans; by offering financial incentives to retire early; and because they were part of the ongoing process of restructuring and downsizing within the Civil Service which was accompanied by a perceived deterioration in conditions at work.

Adult↗
PubMed1983

Medical aid provided by American, Canadian and British Nationals to the Spanish Republic during the Civil War, 1936-1939.

During international or civil wars, private citizens of noncombatant nations often provide medical aid to one of the contending factions, particularly when they support a participant not favored by their own government. This paper details and analyzes the prominent campaign in the United States, Canada and Great Britain to provide medical aid to the Republicans during the Spanish Civil War (1936 to 1939). The substantial medical aid that was provided clearly alleviated some suffering, but one of the major objectives of the campaign was to arouse public opinion sufficiently to end the boycott of military aid to Republicans; this objective was never achieved. Whether it be in Republican Spain, Vietnam or El Salvador, even a successful medical aid campaign to people in a military conflict may save some lives but may not affect substantially the course of the conflict. Those who are primarily interested in influencing political or military developments, hoping to advance the cause of a particular contending faction, may find tactics other than medical aid campaigns more useful in accomplishing their goals.

Canada↗
PubMed2004

Sanitary medicine and the social body: the case of national civil registration and statistics in Canada, 1855-75.

Civil registration and vital statistics are important elements in the definition of a social body, the primary object whose health and well-being is the aim of social medicine. The failure of the federal government to organize a national system of civil registration in the Confederation era is placed in the context of a variety of sources of pressure for it to do so from doctors, social reformers, and provincial and municipal officials.

Canada↗
PubMed1993

Treatment of head injuries in the American Civil War.

At the time of the American Civil War (1861-1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery.

Brain Injuries↗
PubMed1995

Detection without correction: problems in assessing the quality of English ecclesiastical and civil registration.

Reliable, good quality source material is required for any demographic study. By selecting specific examples from York during the parish register period and Sheffield during the civil registratiion period deficiencies in both ecclesiastical and civil registration are discussed with reference to how they affect infant and adult mortality calculations. In particular, the extent to which the deaths of very young infants were registered is considered in detail. Bourgeois-Pichat's biometric test, Farr's early life tables and Coale and Demeny's model life tables have all been used to correct inaccuracies within original sources. We consider the limitations of each of these methods and suggest that a reassessment of the quality of vital registration data and the methods used to make corrections is needed in order to make further advances in historical demography possible.

Child↗
PubMed2006

[The relational factor in civil action procedure: appreciation of the judge as sympathetic supporter].

According to the group value model (Tyler & Lind, 1992), disputants who are able to confirm own group identity through proper treatment by group authority would perceive procedural justice and become more willing to accept group decisions. On the other hand, based on the social exchange model, people who are involved in disputes should expect support from group authority, and believe that they are entitled to governmental protection against injustice if they have supported the group. In this study, we predicted that sympathetic treatment by the judge in a civil action would have the effect of making disputants feel that their rights were protected, in addition to confirmation of own group identity. We asked 100 people who had experienced a civil trial, to rate the judge, procedure and final judgment, in order to examine the effects of sympathetic treatment by authority. Results of data analysis supported the group value model with respect to the overall satisfaction of the trial, and the social exchange model with respect to perceived justice of judges' final judgement.

Attitude↗
PubMed1982

Medical aid to the Spanish Republic during the Civil War (1936-1939).

During international or civil wars, private citizens of noncombatant nations often provide medical aid to one or the contending factions. To examine the role of such an aid campaign in a military conflict, I did a detailed historical analysis of the prominent campaign in the United States to provide medical aid to the Republicans during the Spanish Civil War (1936 to 1939). Substantial medical aid was provided that clearly alleviated some suffering, but one of the major objectives of the campaign was to arouse public opinion sufficiently to end the boycott of aid to Republican forces by the American government; this objective was never achieved. I conclude that even a successful medical aid campaign to people in a military conflict may save some lives but may not affect substantially the course of the conflict. Persons who are primarily interested in influencing political or military developments may find tactics other than medical aid campaigns more useful in accomplishing their goals.

Government↗
PubMed1998

Medicare and Medicaid program; civil money penalties, assessments, exclusions, and related appeals procedures--HCFA. Final rule with comment period.

This rule establishes procedures for imposing civil money penalties, assessments, and exclusions for certain violations of the Medicare and Medicaid programs. The regulations also provide for hearings and appeals when those penalties, assessments, and exclusions are imposed. These procedures are based on the procedures that the Office of the Inspector General has promulgated for the civil money penalties, assessments, and exclusions. These regulations are designed to protect program beneficiaries from unfit health care practitioners and to otherwise improve antifraud provisions under the Medicare and Medicaid Acts.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1986

Legal intervention in civil commitment: the impact of broadened commitment criteria.

Recent legal changes in Washington State have broadened the grave-disability criterion for civil commitment of the mentally ill. Analysis of data from state mental hospitals and from records of commitment authorities in Washington's two largest counties revealed that, while there was an increase in the number of involuntary hospitalizations immediately before and after the changes in law, there was a virtual disappearance of voluntary patients in state hospitals. Moreover, expansion of the definition of "grave disability" resulted in a move toward a parens patriae-dominated civil commitment system. Analysis of the empirical consequences of the legal changes on commitment decisions is presented, along with the response of mental health officials and the public.

Commitment of Persons with Psychiatric Disorders↗
PubMed1999

Functional characteristics of the telemedical network for the medical service of the Bundeswehr for support of operations outside Germany and civil-military co-operation.

The maxim governing the accomplishment of medical tasks by the Medical Service of the Bundeswehr stipulates that the soldiers will, in case of illness, accident or injury, receive medical treatment to the standard they can expect in the Federal Republic of Germany. In this context the introduction of telemedical applications into the Medical Service will improve the quality of the medical care through better and faster access for the medical officer assigned to a unit or a ship for requesting support to expert knowledge from military facilities or the civilian sector. The telemedical system is based on a high-class commercial PC. This workstation can be extended as needed with medical devices (x-ray film digitizer, dermatoscope, otoscope) and allows linkage to other imaging methods (e.g., videocamera, ultrasound). Currently this system is under evaluation in a multi centre trial. The participants of this telemedical network communicate via EURO ISDN lines with sufficient bandwidth. If terrestrial lines are not available the communication will be based on satellite capacity. The application of internet-technology additionally provides access to medical data bases respectively allows civil-military co-operation and the interoperability between medical services of allied armed forces. This future-orientated telemedical approach with its modular upwards-compatibility will provide, especially in its mobile version and by using communication standards, the possibility to support necessary civil-military co-operation in the area of disaster relief and missions outside of Germany in the future.

Germany↗
PubMed2000

The incidence, nature, and severity of injuries in New Zealand civil aviation.

BACKGROUND: Strategies to improve aviation safety can be directed at the pre-crash, in-crash, or post-crash phases of aircraft crashes. For resources to be made available for in-crash interventions, and for these to be well designed, it is necessary in the first instance to have a detailed understanding of the injuries sustained in crashes. The purpose of this study was to describe the incidence, nature, and severity of injuries sustained in aircraft crashes and other related events in civil aviation in New Zealand. METHODS: National injury databases were searched for fatalities and hospitalizations sustained in aircraft crashes and related events, and cases were linked with Civil Aviation Authority accident records to identify the aircraft involved. Rates were based on estimates of total hours flown by active pilots. RESULTS: There were 104 fatalities identified for the period 1988-1992, giving a rate of 2.57 per 100,000 flight hours. There were 120 hospitalizations identified for the period 1988-1993, giving a rate of 2.45 per 100,000 flight hours. Most fatalities involved injury to multiple body regions, with at least one injury being sufficient in itself to cause death in 48% of cases. For hospitalizations, the lower extremities (23%), spine (20%), and head and face (18%) were the body regions most commonly injured, with fractures being predominant. While the majority of fatalities and hospitalizations occurred in fixed- and rotary-wing aircraft, the highest rates were for microlight and home-built aircraft. CONCLUSIONS: Different patterns of injury were evident for fixed- and rotary-wing aircraft. Reasons for these are suggested. Future research will seek to determine the relative risk associated with potentially modifiable risk factors.

Abbreviated Injury Scale↗
PubMedDate not supplied

The damage to a person caused by venous thromboembolism in the civil responsibility.

The venous thromboembolism can clinically show itself as deep venous thrombosis or as pulmonary embolism. Both serious and potentially fatal, for this high incidence, they assume importance in social economic sphere. The authors take into account the medicolegal diagnostics methodology of the deep venous thrombosis and of the pulmonary embolism, the traumatic and post traumatic etiology, to determine the connection of causality and the estimating parameters of the damage to a person in the sphere of civil responsibility. To attain to a certain diagnosis of thromboembolism, since its difficult cause of paucisymtomaticity or asymtomaticity of the pathology after an attentive evaluation of symptoms, clinic manifestations and factors of risk, it can't be disregarded to utilize scientific diagnostic criteria, and instrumental ascertainments, serial too, helped by conventional means of standardization, such as the new American system of classification CEAP. The following phases of medicolegal ascertainment consist in identifying the causal connection between disease and event and in estimating of the damage to a person, with rigorous and objective methodology and using tabular orientation guides, that have to indicate the percentage incidence of the undergone disablement on the person's validity for indemnity. It is showed the particular delicacy of the medical examiner's evaluation in thromboembolic disease, in the sphere of civil responsibility, both for the difficulties of the diagnostic identification of the deep venous thrombosis, and of the pulmonary embolism, and for the determination of the connection of causality with traumatic events and with following operation of orthopedics-traumatology and neurosurgery (sector on which the most difficult problems of professional responsibility can connect) and finally for the real evaluation of the consequent damage to a persons, in order to its indemnity.

Diagnostic Errors↗
PubMed2000

[Beta carotene in the prevention of civilization-related diseases].

The objective of the article is to provide a concise overview of the conclusions of most important studies assessing the role of beta-carotene in the prevention of civilization diseases. Beta-carotene seemed to be a very promising agent in the prevention of civilization diseases in the early 1980s. However, several large-scale studies concluded that the preventive effects of beta-carotene may have been overestimated or that beta-carotene may even have harmful effects previously not anticipated. Current nutritional recommendations promote increased consumption of vegetables and fruits, but beta-carotene supplementation is not recommended.

Antioxidants↗
PubMed2000

[Civil and criminal laws regarding the donation, removal and transfer of organs (Transplantation Law) in Germany with respect to administrative and clinical autopsies].

In the Federal Republic of Germany, transplantation medicine, which is relatively young and still developing, is now regulated by the law governing the donation, removal and transfer of organs (Transplantation Law--TPG) of 05. 11. 1997 and has been given a legal basis which satisfies even present-day standards. By evaluating the highly personal rights to potential organ donor and of his next-of-kin against the interests of maintaining life and health of others, the law works along the lines of the so-called extended consent solution. The basic civil law stipulations of sections 3 + 4 TPG, while protecting the donor's individual freedom of decision, give his next-of-kin or trusted confidant at or immediately following death the right to communicate his presumes wishes. In addition, it must be stated that through recent decisions handed down by the Federal Constitutional Court (Bundesverfassungsgericht) in response to various complaints, this regulation has been recognised as conforming to constitutional laws. The basic content of the penal regulations states that violations of civil law rules and trafficking in organs are an offence. Current disclosed requirements for suitable donor organs, in particular for 1998, make it appear likely that the current deficit can be eliminated by the introduction of the organisational measures contained in the law. In conclusion, the situation with regard to autopsy should be addressed since, in contrast to the federal transplantation law which applies to all states, autopsy is regulated differently and, from a legal-political standpoint, unsatisfactorily by each individual state. It is desirable that this legal ambiguity be corrected by standardising the inconsistent and at times non-existent legal stipulations.

Autopsy↗
PubMed2001

Psychopathy and community violence among civil psychiatric patients: results from the MacArthur Violence Risk Assessment Study.

Although psychopathy is recognized as a relatively strong risk factor for violence among inmates and mentally disordered offenders, few studies have examined the extent to which its predictive power generalizes to civil psychiatric samples. Using data on 1,136 patients from the MacArthur Violence Risk Assessment project, this study examined whether the 2 scales that underlie the Psychopathy Checklist: Screening Version (PCL:SV) measure a unique personality construct that predicts violence among civil patients. The results indicate that the PCL:SV is a relatively strong predictor of violence. The PCL:SV's predictive power is substantially reduced, but remains significant, after controlling for a host of covariates that reflect antisocial behavior and personality disorders other than psychopathy. However, the predictive power of the PCL:SV is not based on its assessment of the core traits of psychopathy, as traditionally construed. Implications for the 2-factor model that underlies the PCL measures and for risk assessment practice are discussed.

Adolescent↗
PubMed2001

Psychosocial risk factors for coronary disease in White, South Asian and Afro-Caribbean civil servants: the Whitehall II study.

BACKGROUND: Psychosocial factors are associated with the etiology and prognosis of coronary heart disease (CHD) in White populations; however, previous studies have not examined the distribution of psychosocial factors in ethnic groups with coronary rates higher (South Asian) and lower (Afro-Caribbean) than those of Whites. STUDY OBJECTIVE: To determine whether ethnic differences in psychosocial risk factors parallel those in CHD mortality. DESIGN: Cross-sectional survey. SETTING: 20 civil service departments in London. PARTICIPANTS: 8973 White, 577 South Asian, and 360 Afro-Caribbean office-based civil servants, aged 35-55 years. OUTCOME MEASURES: Minor psychiatric morbidity (General Health Questionnaire), social supports (marital status, social networks, negative aspects of support, confiding/emotional support, social support at work), psychosocial work characteristics (job control, effort-reward imbalance), hostility levels and presence of Type A personality. RESULTS: South Asians, compared to Whites, had more depression, higher negative supports, less social support at work, less job control, more effort-reward imbalance and higher levels of hostility, when adjusting for age and sex. Afro-Caribbeans, compared to Whites, had lower minor psychiatric morbidity and lower Type A scores. The remaining psychosocial factors showed either no ethnic differences in distribution, or differences contrary to those predicted from coronary event rates. Adjustment for employment grade made little difference to these associations. CONCLUSION: Among South Asians, the majority of whom were Indian, the distribution of psychosocial factors was consistent with ethnic differences in coronary rates; the pattern for Afro-Caribbeans was less consistent. Further research is required to test the extent to which psychosocial factors predict coronary events within ethnic groups and to characterize better psychosocial measures.

Adult↗