Home About us Contact
|
Home About us Contact | ||
|
|
||
Medical Evidence (medical + evidence)
Selected AbstractsMedical Evidence and Expert Testimony in Child Sexual AbuseJUVENILE AND FAMILY COURT JOURNAL, Issue 1 2006LORI D. FRASIER ABSTRACT Expert medical testimony in child sexual abuse cases can be critical to the outcome of a legal case. This article will review the development of the medical knowledge and clinical expertise in child sexual abuse. Since the passage of mandatory child abuse reporting laws, the forensic medical examination of a child for evidence of sexual abuse has become standard. Until recently, many myths regarding female genital anatomy existed but were based primarily on dogma and lack of empirical research. Over the past 25 years, many research studies and accumulating clinical evidence have expanded medical knowledge and debunked old myths. Physical evidence, even in cases of alleged genital or anal penetration is rare. Sexually transmitted infections are also uncommon and often require medical interpretation as to their significance in a prepubertal child. Specialized medical knowledge, training, and clinical expertise have developed in order to evaluate children presenting with allegations of sexual abuse. Such medical expertise provides invaluable service to courts. We review criteria for evaluating such expertise in light of current medical practice. [source] Complementary and integrative medical therapies, the FDA, and the NIH: definitions and regulationDERMATOLOGIC THERAPY, Issue 2 2003Michael H. Cohen ABSTRACT: ,,The National Center for Complementary and Alternative Medicine (NCCAM) presently defines complementary and alternative medicine (CAM) as covering "a broad range of healing philosophies (schools of thought), approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available. The research landscape, including NCCAM-funded research, is continually changing and subject to vigorous methodologic and interpretive debates. Part of the impetus for greater research dollars in this arena has been increasing consumer reliance on CAM to dramatically expand. State (not federal) law controls much of CAM practice. However, a significant federal role exists in the regulation of dietary supplements. The U.S. Food and Drug Administration (FDA) regulates foods, drugs, and cosmetics in interstate commerce. No new "drug" may be introduced into interstate commerce unless proven "safe" and "effective" for its intended use, as determined by FDA regulations. "Foods", however, are subject to different regulatory requirements, and need not go through trials proving safety and efficacy. The growing phenomenon of consumer use of vitamins, minerals, herbs, and other "dietary supplements" challenged the historical divide between drugs and foods. The federal Dietary Supplements Health Education Act (DSHEA) allows manufacturers to distribute dietary supplements without having to prove safety and efficacy, so long as the manufacturers make no claims linking the supplements to a specific disease. State law regulates the use of CAM therapies through a variety of legal rules. Of these, several major areas of concern for clinicians are professional licensure, scope of practice, and malpractice. Regarding licensure, each state has enacted medical licensing that prohibits the unlicensed practice of medicine and thereby criminalizes activity by unlicensed CAM providers who offer health care services to patients. Malpractice is defined as unskillful practice which fails to conform to a standard of care in the profession and results in injury. The definition is no different in CAM than in general medicine; its application to CAM, however, raises novel questions. Courts rely on medical consensus regarding the appropriateness of a given therapy. A framework for assessing potential liability risk involves assessing the medical evidence concerning safety and efficacy, and then aligning clinical decisions with liability concerns. Ultimately research will or will not establish a specific CAM therapy as an important part of the standard of care for the condition in question. Legal rules governing CAM providers and practices are, in many cases, new and evolving. Further, laws vary by state and their application depends on the specific clinical scenario in question. New research is constantly emerging, as are federal and state legislative developments and judicial opinions resulting from litigation. [source] Commentary on Morgan et al. (2010): Ketamine abuse: first medical evidence of harms we should confrontADDICTION, Issue 1 2010RAFAEL DE LA TORRE No abstract is available for this article. [source] Accurate Pain Detection Is Not Enough: Contextual and Attributional Style as Biasing Factors in Patient Evaluations and Treatment Choice,JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2002Linda M. Lundquist Ninety-six adults with a supportive or unsupportive attributional style participated in an experiment that examined the effects of contextual (i.e., coping and medical evidence) information on evaluations of pain severity, the pain sufferer, and treatment choice for shoulder pain patients. Respondents accurately detected a patient's pain level from the videotaped facial displays, but patients who were coping with the pain were evaluated more positively than noncoping pain patients. Furthermore, unsupportive attributional style predicted harsher treatment choices. Thus, accurate detection of pain does not guarantee unbiased reactions toward the pain patient. [source] Learning to Smile: The Neuroanatomic Basis for Smile TrainingJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 1 2001DOUGLAS A. TERRY DDS ABSTRACT This article demonstrates that although any layperson could recognize that the smile manifests mainly in the oral and periorbital regions, a comprehension of the neurologic and musculoskeletal elements lends the clinician insight into the many aspects of a smile. The neurologic control of a smile consists of a complex process involving many facets. As with any other complex neuromuscular activity, repetitions of the act can train the central nervous system, neural network, and muscular network in efficient performance of and correct musculoskeletal activation involved in the act itself. With functional knowledge of muscles dedicated to a pleasing full smile, together with a battery of easy and effortless exercises, the clinician is able to help the patient change behavior intended to camouflage perceived oral flaws. A patient needs reassurance that behind the guidance from the clinician lies medical evidence that such routine movement of muscles will indeed improve the smile. When asked why or how the exercise succeeds, the clinician can reassure the patient based on a working knowledge of the neurologic and muscular anatomy involved. CLINICAL SIGNIFICANCE A functional knowledge of muscles dedicated to a pleasing full smile, together with a battery of easy and effortless exercises, provides the clinician with the ability to assist the patient in altering years of behavior intended to camouflage perceived oral flaws. [source] Seven characteristics of medical evidenceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2000FRCPC, Ross E. G. Upshur BA (Hons) Abstract This paper outlines seven essential characteristics of medical evidence and describes the implications of these for both the theory of evidence-based medicine and clinical practice. The seven characteristics are: (1) Provisional; (2) Defeasible; (3) Emergent; (4) Incomplete; (5) Constrained; (6) Collective and (7) Asymmetric. It is argued that the epistemological theory that best fits medical evidence is that of fallibilism. [source] Some implications for nurses and managers of recent changes to the processing and hearing of medical negligence claimsJOURNAL OF NURSING MANAGEMENT, Issue 3 2000DIPLAW, Fletcher BA, MPHIL Aim This paper considers some possible implications for individual nurses and their managers of moves to delegate tasks formerly undertaken by medical practitioners to nurses, in the light of recent changes in the legal process, relating to the funding and the hearing of cases of medical negligence. Background It is suggested that the introduction of a system of conditional fees, under which lawyers will only recover their costs if they win cases, may lead to a more specialist approach to negligence claims and to greater scrutiny of medical evidence. The implications of the recent ,Bolitho' judgement, when judges for the first time subjected expert medical testimony to their own independent analysis, are also explored. Findings It is suggested that in the light of the disparities in the training of medical and nursing personnel and in their disciplinary processes, and in view of the lack of consensus about what training is necessary for those who will substitute for junior doctors, or represent themselves as ,practitioners', ,specialists', or ,consultants', that nurses may in the future find themselves more directly involved in civil proceedings. [source] The HPV Vaccine: Framing the Arguments FOR and AGAINST Mandatory Vaccination of All Middle School GirlsJOURNAL OF SCHOOL HEALTH, Issue 6 2008Cheryl A. Vamos MPH ABSTRACT Background:, Human papillomavirus (HPV), the virus responsible for cervical cancer, is the most common viral sexually transmitted infection in the United States. A vaccine was approved in 2006 that is effective in preventing the types of HPV responsible for 70% of cervical cancers and 90% of genital warts. Proposals for routine and mandatory HPV vaccination of girls have become sources of controversy for parents of school-aged youth, legislators, members of the medical community, and the public at large. Methods:, The purpose of this article was to articulate the arguments used by advocates who either oppose or endorse routine, mandatory administration of the vaccine to school-aged girls, thereby assisting school health personnel in being effective participants in framing the relevant issues. Results:, Controversy is grounded in moral, religious, political, economic, and sociocultural arguments including whether concerns that the vaccine increases sexual risk taking, sends mixed messages about abstaining from sexual intercourse, usurps parental authority, and increases the potential for development of new health disparities are offset by the value of administering a cost-effective, age-appropriate public health measure targeting a life-threatening problem. Conclusions:, Careful consideration of the medical evidence and public health implications is critical but understanding the context of the debate is no less important to the task of responding to public concerns. School health personnel have a role in the discussion about HPV immunization. Being able to articulate the arguments presented herein can help authorities' responsiveness to parents and community groups as the dialogue about this particular health issue evolves further. [source] | ||||||||||