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PubMed1979

Vicious circles in civil commitment.

Mental health legislation recently enacted in various states has improved on older laws by recognizing new procedural rights for patients. In many instances, however, it has also prevented treatment for patients who are severely ill. The authors discuss the new laws and the way they have effected the cooperative efforts of social workers, lawyers, and psychiatrists, the three groups involved in civil commitment.

Commitment of Persons with Psychiatric Disorders↗
PubMed1986

Civil commitment of the mentally ill: an overview.

This article discusses historical themes that led to the civil commitment reforms of the sixties and seventies. The changes in the substantive criteria for commitment are analyzed and critiqued. The author believes that the present criteria tend to focus so specifically on various external indicia of mental illness that they render commitment difficult for many seriously ill patients. An alternative commitment scheme is discussed.

Commitment of Persons with Psychiatric Disorders↗
PubMed1987

Medicare program; fraud and abuse; civil monetary penalties and exclusions for assistants at cataract surgery--HHS. Final rule with comment period.

This final rule implements section 9307 of Pub. L. 99-272, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended by section 1895(b)(16) of Pub. L. 99-514, the Tax Reform Act of 1986, by providing the imposition of civil monetary penalties (CMPs) and exclusions against physicians billing the Medicare program or program beneficiaries for services of an assistant at surgery for cataract operations where prior approval has not been granted. The purpose of these regulations is to strengthen existing OIG penalty and exclusion authorities, and to prevent specific abusive and fraudulent practices against the Medicare program with regard to the use of assistants at surgery where not medically necessary.

Cataract Extraction↗
PubMed1987

Medicare and Medicaid programs; fraud and abuse; revisions to the civil money penalty statute of limitations--HHS. Final rule.

This final rule implements section 3(b) of Pub. L. 100-93, the Medicare and Medicaid Patient and Program Protection Act of 1987, by expressly adding a new statutorily mandated statute of limitations that is to be applied to the civil money penalty (CMP) law. Specifically, this rule provides that no action may be initiated under the CMP provisions later than 6 years after the date the claim has been represented. This new 6-year statute of limitations replaces the 5-year "regulations of limitations" currently set forth in regulations.

Crime↗
PubMed1999

The litigant-patient: mental health consequences of civil litigation.

Civil litigation often has profound psychological consequences for plaintiffs and defendants alike. For those individuals who are involved in ongoing psychotherapy, or those who enter psychotherapy during litigation, the stress of litigation often adds to whatever issues produced the lawsuit. This article reviews the effects of that stress, the mechanisms through which it arises, and its manifestations in psychotherapy and offers suggestions to increase psychotherapist awareness of the influence of litigation stress on treatment.

Awareness↗
PubMed1999

[Changes in legal status in the field of civil and penal doctor's liability].

The author discusses the effects of organization changes in the range of health care, which took place in Poland, on the penal and civil liability of doctors. Her opinion refers also to the amendment of the penal code. The author emphasizes wider than before possibility of the doctor's liability for harm caused to a person or for the infringing of patient's rights. She also draws our attention to the description of offences pertaining to doctors, contained in the new panel code. The author proposes to work out the standards of procedure with the patient (based on the model of treatment standards)--according to the specific nature of particular sections of medicine or clinics. She expresses her conviction about the need to initiate changes in the legal status through the joint actions of doctors and lawyers.

Health Services↗
PubMed1999

Civil war, social integration and mental health in Croatia.

Research has shown that social relationships are generally beneficial for mental health (Thoits 1995). However, few scholars have examined this association after the occurrence of a significant shock to the social system as a whole. The purpose of this article is to examine the relationship between social integration and war-related distress in Croatia immediately following the recent civil war. Does social integration decrease war-related distress? Does social integration buffer the effect of traumatic events on war-related distress? We analyze these questions using nationally representative survey data collected in Croatia in 1996. Results suggest that social integration has both positive and negative direct effects on distress. Being a member of informal organizations, such as sports clubs, and participating in social activities are beneficial for mental health. On the other hand, being a member of some formal organizations, such as church organizations and unions, is detrimental to mental health. There is little support for the idea that social integration buffers the effect of traumatic events on distress. Only one of thirty-six possible interactions is significant and supports the buffer hypothesis. Frequent participation in social activities buffers the effect of experiencing violence on war-related distress. Also, some forms of social integration appear to aggravate the effect of traumatic events on war-related distress. In sum, social integration does affect war-related distress after a system shock, but in complex and sometimes unexpected ways.

Adaptation, Psychological↗
PubMed1997

Health status of senior civil servants in Kuala Lumpur.

733 senior civil servants comprising 520 males and 213 females with a mean age of 44 years (range 25-56 years) were screened for their health status. The sample population comprised of 67.9% Malays, 22.5% Chinese, 9.1% Indians and 0.4% other ethnic origins. The subjects' medical histories were recorded and a full medical examination including anthropometric measurements (weight, height, waist and hip circumference), blood biochemistry and urine analysis, chest X-ray and electrocardiograms were done. The results obtained showed that 36.0% of the study population were overweight with 6.5% being obese. Of this 32.0% had central obesity. 15.2% of the subjects had systolic hypertension (systolic BP > or = 140 mmHg) whilst 27.6% had diastolic hypertension (diastolic BP > or = 90 mmHg). Hyperlipidaemia was common, with 75.2% subjects having raised cholesterol, 19.9% raised triglycerides, 50.2% raised LDL-C, 74.6% raised TC:HDL-C and 26.6% raised LDL:HDL-C. An elevated blood glucose was found in 8.4% subjects, whilst urine sugar was detected in only 2.6%, and a raised uric acid was found in 2.8% subjects. The prevalence of hypertension, raised blood glucose and hyperlipidaemia increased with age with more males affected than females. Although hypercholesterolaemia appeared more frequently amongst the Malays, the Indians, by comparison had the highest prevalence for a raised LDL:HDL-C ratio, a reflection of the increase in LDL-C and a concomitant decrease in HDL-C. The latter findings indicate that the Indians are at greater risk for the development of coronary heart disease than the Chinese and Malays. In addition, the mean levels of serum cholesterol found in this study seemed to have exceeded the levels found in populations in the industrialised countries such as the USA. There is thus an urgent need for more public health campaigns aimed at the reduction and control of such coronary risk factors.

Adult↗
PubMed2000

Health care programs: fraud and abuse; revised OIG civil money penalties resulting from public law 104-191. Office of Inspector General (OIG), HHS. Final rule.

This final rule revises the OIG's civil money penalty (CMP) authorities, in conjunction with new and revised provisions set forth in the Health Insurance Portability and Accountability Act of 1996. Among other provisions, this final rulemaking codifies new CMPs for excluded individuals retaining ownership or control interest in an entity; upcoding and claims for medically unnecessary services; offering inducements to beneficiaries; and false certification of eligibility for home health services. This rule also codifies a number of technical corrections to the regulations governing OIG's sanction authorities.

Fraud↗
PubMed2000

[Professional civil responsibility of physicians: towards a modification of the law in the year 2000?].

For more than twenty years, physicians, lawyers, insurers and patients stress the wrong working of civil medical liability in our country. After surveying the most important slacknesses of the current system, the author examines the answers or proposals on the one hand of the jurisprudence and on the other hand of the governing authorities and finally of the scientific sector. The study emphasizes also the current community of interest which leads to implementation of a new law which content is however difficult to define. At last, the author tries to show the most clearly expected modifications and suggests also some practical pieces of advice regarding the evolution of the jurisprudence.

Belgium↗
PubMedDate not supplied

[Civil bioethics in pluralistics societies].

The author examines how Bioethics should be approached in a pluralist society. She argues that through the gradual discovery of shared ethical values and principles for judging which practices are humanizing and which or not, ever-more dense civil Bioethics helps bring out--in contrast to relativism and subjectivism--an ethical intersubjectiveness, the fundaments of which should be addressed by moral philosophy if it hopes to fulfill one of its main tasks.

Bioethics↗
PubMed2001

Prevalence of drugs and alcohol in fatal civil aviation accidents between 1994 and 1998.

BACKGROUND: The use of drugs and alcohol in aviation is closely monitored by the FAA Office of Aviation Medicine's (OAM's) Civil Aeromedical Institute (CAMI) through the toxicological analysis of specimens from pilots who have died in aviation accidents. METHOD: Frozen specimens received from local pathologists were tested and the results entered into a computer database for future analysis. The data were sorted based on the class of drug, controlled dangerous substance schedules II, and I controlled dangerous substance schedules III-V, prescription drugs, over-the-counter drugs, and alcohol. RESULTS: Specimens from 1683 pilots were analyzed between 1994 to 1998. Controlled dangerous substances, CDS, (schedules I and II) were found in 89 of the pilots analyzed. Controlled dangerous substances (schedules III-V) were found in 49 of the pilots tested. Prescription drugs were found in 240 of the pilots analyzed. Over-the-counter drugs were found in 301 of the pilots analyzed. Alcohol at or above the legal limit of 0.04% was found in 124 pilots. No abused drugs were found in Class 1 air transport fatal pilots. CONCLUSION: This research supports the very low incidence rate of drugs found in the FAA random drug-testing program. Over-the-counter medications are the most frequently found drugs in fatal aviation accidents and many of these drugs could impair a pilot's ability to safely fly an aircraft. This data is helpful to the FAA in developing programs to reduce the usage of dangerous drugs and identify potentially incapacitating medical conditions that may cause an accident. Data collected from this research can be used to evaluate the effectiveness of the FAA drug-testing program.

Accidents, Aviation↗
PubMed1999

The effects of critical incident stress debriefing (CISD) on emergency medical services personnel following the Los Angeles Civil Disturbance.

This study examined the effects of Critical Incident Stress Debriefing (CISD) upon technicians who provided emergency medical services in South Central Los Angeles during the 1992 Los Angeles Civil Disturbance. The relationships between exposure, debriefing and symptoms of stress were identified and examined. The Frederick Reaction Index-Adult (FRI-A) was used to measure the presence of symptoms characteristic of posttraumatic stress disorder. EMTs who had the opportunity to participate in Critical Incident Stress Debriefings (n = 42) following the incident reported fewer symptoms and scored significantly lower on the FRI-A than those not participating in Critical Incident Stress Debriefing (n = 23).

Crisis Intervention↗
PubMed2001

Dental morphology of the early Hoabinian, the Neolithic Da But and the Metal age Dong Son civilized peoples in Vietnam.

The early Hoabinian, the Neolithic Da But and the Dong Son (early Metal age) civilized peoples in northern Vietnam were investigated based on dental morphology and were compared with specimens from surrounding Northeast and Southeast Asia including Australians and Melanesians. In both the metric and nonmetric tooth traits, the Hoabinian and Da But specimens had dental features similar to the prehistoric Southeast Asians and the Australo-Melanesians, but also had partially Northeast Asian characteristics. On the other hand, the Northeast Asian features become distinct in the dentition of the Dong Son people, which have close ties with the modern Vietnamese. Thus, the Vietnamese, as well as the other modern Southeast Asians and Japanese, are considered to be a blend of indigenous Southeast Asians who are closely related to the Australo-Melanesian lineage, and migrants from Northeast Asia.

Australia↗
PubMed2001

[Investigation of verdicts of civil suits brought against hospitals involving crimes committed by mental hospital inpatients with psychotic disorders].

The author investigated 11 verdicts of Japanese civil suits brought against hospitals involving crimes committed by mental hospital inpatients with psychotic disorders, principally by victims of injuries or by surviving relatives of homicide victims. About the half of the verdicts are based on the same logic. First, a detailed, case-specific investigation was performed. In some cases it was proven that the accidents could not have been predicted, and the suits were dismissed. In others the plaintiffs won the suits, because it was found that the violent acts were predictable and that the hospital staff had the means to prevent them. These verdicts require the hospital staff to predict the patient's actions according to the psychiatric history and present condition and then to make an appropriate response. This process is similar to the clinical decision-making process, although there have been some dubious findings in some of the court cases. However, the author also found that some verdicts were inappropriate and insufficient in that there was no individual investigation of the offender. Examining all 11 verdicts, the author found that the type of admission procedure adopted for the offender, whether they had a past history of violence, and whether the hospital was public or private did not seem to be significant to the judges in making their decisions.

Adult↗
PubMed1994

[Exanthematous typhus during the period following the Spanish Civil War (1939-1943). Use of a collective disease to legitimize the New State].

By analyzing how the early Francoist regime in Spain used certain aspects of the epidemic of exanthematous typhus during the period from 1939 to 1943, this article explores how health policies may legitimize sociopolitical systems by validating ideas and actions that affect many aspects of society. The typhus epidemic and the actions it gave rise to were used as points of reference to support each of the doctrines of legitimization, within the overall ideological framework that the victors of the Civil War intended to establish. Their objective was to consolidate their power and challenge recusants to the New State.

Disease Outbreaks↗
PubMed1975

Soft hydrophilic contact lenses in civil and military aviation.

This study was undertaken to evaluate that possible acceptability of the hydrophilic contact lenses, both in military and civil aviation. Twelve volunteers, senior pilots of both military and civilian aircraft, were accepted for the first phase of this study. Hydrophilic contact lenses were evaluated in different flights conditions, including different altitudes, pressures and humidities, as well as the effects of light and glare and the special tasks of military flight. Although the series investigated is small, the results obtained indicate that hydrophilic contact lenses may favorably replace regular spectacles worn by pilots of military or civilian aircraft.

Aerospace Medicine↗