Confidentiality of health care information in the computer age: a litigator's perspective.
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The influence of interparental verbal and physical aggression, children's coping styles, and relevant demographic factors on children's adjustment was examined in a group of 52 families who were disputing custody and/or access arrangements after separation. It was hypothesized that parental conflict and specific children's coping strategies (i.e., cognitive redefinition and social support seeking) would be important predictors of children's adjustment. Consistent with previous research, aggressive styles of resolving conflict between parents were related to more frequent and severe behavior problems and diminished competence among children. Conversely, greater flexibility in coping and greater use of cognitive coping strategies among children were related to decreased behavioral disturbance. The unique and combined influence of these variables is discussed.
One of the medical specialties most vulnerable and suit-prone is cosmetic plastic surgery. Societal factors playing a role in this include the growing emphasis on personal gratification and youth and the tendency to insist on redress if things go wrong. Furthermore, studies of the conflicts between doctors and patients show that many difficulties have their roots in the quality of interaction between doctor and patient and in the attitudes and behavior of the surgeon in the course of the relationship, both pre- and postoperatively. Other factors affecting the vulnerability of plastic surgeons include their ability to conduct an effective patient interview with attention paid to non-verbal cues and the image of plastic surgery projected through advertisements, publications, and the media.
This paper examines post-traumatic morbidity in a community sample who had claimed compensation and been assessed 10-14 months after the Lockerbie Disaster. At 36 months 25 residents were reassessed by clinical interview and 35 by questionnaire. A chronic pattern of morbidity was found in 56% of this sample with the most frequent diagnoses being post traumatic stress disorder and depression, followed by other anxiety disorders. Only six cases were found to have "recovered" and there was only one case of delayed onset morbidity between 12 and 36 months. No unequivocal predictors of the presence of diagnosis or questionnaire scores were found.
Numerous writers have commented on barriers to the growth and progress of telemedicine. Among these barriers are reimbursement concerns, professional liability exposure, licensing restrictions, hospital credentialing questions, and other problems. A legal threat not generally described in the literature to date is the possibility that products liability claims could be brought against manufacturers and distributors of hardware, software, and peripherals used in providing telemedicine services. Several of these concerns extend to picture archiving and communication systems (PACS), including, of course, teleradiology. This article considers that possibility in the context of several potential plaintiffs' theories, discusses currently applicable law, and proposes approaches to diminishing the magnitude and severity of this potential threat.
Records of 277 patients presenting for medicolegal reporting following isolated whiplash injury were studied retrospectively. A range of pre-accident, accident and response variables were recorded. Multivariate analysis was used to determine the main factors that predict physical and psychological outcome after whiplash injury. The factors that showed significant association with poor outcome on both physical and psychological outcome scales were pre-injury back pain, high frequency of General Practitioner attendance, evidence of pre-injury depression or anxiety symptoms, front position in the vehicle and pain radiating away from the neck after injury. The strongest associations were with factors that are present before impact. In this selected cohort of patients, there is a physical and a psychological vulnerability that may explain the widely varied response to low violence indirect neck injury.
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