"Is there a doctor on board?" - legal aspects of medical care in emergency situations during spare time

Medical emergencies on international flights are not uncommon. In these situations the question often arises whether physicians are obliged to render first aid and whether omission leads to legal consequences. The general obligation to aid those in need applies to everyone, not only to physicians. Evading this duty makes liable to prosecution for omittance of defence of a third person in line with Art. 128 of the Swiss Penal Code, punishable by custodial sentence up to three years or an equivalent punitive fine. Vocational and professional law extend the duty to aid for physicians to urgent cases. Although resulting from the performance of a legal obligation, malpractice occurred in the course of first aid can lead to claims for compensation - even from foreign patients, and that according to their own domestic law.

Houston History of Medicine Society 2008-2009 Schedule and Abstracts

The National Library of Medicine and the Continuing Legacy of Michael E. DeBakey, M.D. (Stephen B. Greenberg) The Legacy of William Osler: North America’s most famous physician (Robert E. Rakel) A Lady Alone: Elizabeth Blackwell: First American Woman Doctor (Linda Gray Kelley, Charlton) A Mariner with Crippling Arthritis and Bleeding Eyes: The Chronic Arthritis of Christopher Columbus (Frank C. Arnett) Generation C(affeine): A History of Caffeine Consumption and its Medical Implications (Student Essay Contest winners) (Priti Dangayach) Our Artificial Fitness? Relaxed Selection Leads to Medical Dependence (Student Essay Contest winners) Philip Boone Remembering John P. McGovern, M.D. (1921-2007) (Bryant Boutwell) Who Was Albert Schweitzer? (Bryant Boutwell) Disease, Doctors and the Duty to Treat in American History (Thomas R. Cole) Vaccinating Freedom: The African-American Experience of Smallpox Prophylaxis in Old Philadelphia, 1723-1923 (Dayle B. Delancey) The Royal Hemophilia (The Royal Hemophilia)

God, the WTO – and hunger

Considering that endemic hunger is a consequence of poverty, and that food is arguably the most basic of all human needs, this book chapter shows one of the more prominent examples of rules and policy fragmentation but also one of the most blatant global governance problems. The three monotheistic religions Judaism, Christians and Islam are surprisingly unanimous about God’s prescriptions on hunger or, put theologically, on what can be said, or should be said, about the interpretations and traditions which, taken together, form the respective and differentiated traditions, identities and views of these beliefs on how to deal with poverty and hunger. A clear social ethos, in the form of global needs satisfaction, runs through both Jewish and Christian texts, and the Qur’an (Zakat). It confirms the value inversion between the world of the mighty and that of the hungry. The message is clear: because salvation is available only through the grace of God, those who have must give to those who have not. This is not charity: it is an inversion of values which can not be addressed by spending 0.7% of your GDP on ODA, and the implication of this sense of redistributive justice is that social offenders will be subject to the Last Judgement. Interestingly, these religious scriptures found their way directly into the human rights treaties adopted by the United Nations and ratified by the parliaments, as a legal base for the duty to protect, to respect and to remedy. On the other side the contradiction with international trade law is all the more flagrant, and it has a direct bearing on poverty: systematic surplus food dumping is still allowed under WTO rules, despite the declared objective ‘to establish a fair and market-oriented agricultural trading system’. A way forward would be a kind of ‘bottom up’ approach by focusing on extreme cases of food insecurity caused by food dumping, or by export restrictions where a direct effect of food insecurity in other countries can be established. Also, international financing institutions need to review their policies and lending priorities. The same goes for the bilateral investment treaties and a possible ‘public interest’ clause, at least in respect of agricultural land acquisitions in vulnerable countries. The bottom line is this: WTO rules cannot entail a right to violate other, equally binding treaty obligations when its membership as a whole claims to contribute to the Millennium Development Goals and pledges to eradicate extreme poverty and hunger.

Sammlung Ryhiner. Karten, Pläne und Ansichten aus dem 16. bis 19. Jahrhundert

Vierbändiger, gedruckter Katalog zur Kartensammlung Ryhiner. Die Kartensammlung Ryhiner zählt zu den wertvollsten und bedeutendstenden der Welt. Sie umfasst ca. 16'000 Landkarten, Pläne und Ansichten aus dem 16. bis frühen 19. Jahrhundert, wobei die Bestände den ganzen Erdball abdecken. Zusammen mit den 20'000 Manuskriptkarten des Staatsarchivs verfügt Bern damit über ein weltweites geographisches Gedächtnis. Karto-bibliographischer Katalog der Sammlung Ryhiner in vier Bänden mit 1786 Seiten und 16258 Katalognummern (ohne Illustrationen).

Childhood Trauma and Complex Posttraumatic Stress Disorder Symptoms in Older Adults: A Study of Direct Effects and Social-Interpersonal Factors as Potential Mediators

Childhood traumatic events may lead to long-lasting psychological effects and contribute to the development of complex posttraumatic sequelae. These might be captured by the diagnostic concept of complex posttraumatic stress disorder (CPTSD) as an alternative to classic posttraumatic stress disorder (PTSD). CPTSD comprises a further set of symptoms in addition to those of PTSD, namely, changes in affect, self, and interpersonal relationships. Previous empirical research on CPTSD has focused on middle-aged adults but not on older adults. Moreover, predictor models of CPTSD are still rare. The current study investigated the association between traumatic events in childhood and complex posttraumatic stress symptoms in older adults. The mediation of this association by 2 social-interpersonal factors (social acknowledgment as a survivor and dysfunctional disclosure) was investigated. These 2 factors focus on the perception of acknowledgment by others and either the inability to disclose traumatic experiences or the ability to do so only with negative emotional reactions. A total of 116 older individuals (age range = 59–98 years) who had experienced childhood traumatic events completed standardized self-report questionnaires indexing childhood trauma, complex trauma sequelae, social acknowledgment, and dysfunctional disclosure of trauma. The results showed that traumatic events during childhood were associated with later posttraumatic stress symptoms but with classic rather than complex symptoms. Social acknowledgment and dysfunctional disclosure partially mediated this relationship. These findings suggest that childhood traumatic stress impacts individuals across the life span and may be associated with particular adverse psychopathological consequences.

Disclosing and reporting medical errors: Cross-sectional survey of Swiss anaesthesiologists.

BACKGROUND There is limited research on anaesthesiologists' attitudes and experiences regarding medical error communication, particularly concerning disclosing errors to patients. OBJECTIVE To characterise anaesthesiologists' attitudes and experiences regarding disclosing errors to patients and reporting errors within the hospital, and to examine factors influencing their willingness to disclose or report errors. DESIGN Cross-sectional survey. SETTING Switzerland's five university hospitals' departments of anaesthesia in 2012/2013. PARTICIPANTS Two hundred and eighty-one clinically active anaesthesiologists. MAIN OUTCOME MEASURES Anaesthesiologists' attitudes and experiences regarding medical error communication. RESULTS The overall response rate of the survey was 52% (281/542). Respondents broadly endorsed disclosing harmful errors to patients (100% serious, 77% minor errors, 19% near misses), but also reported factors that might make them less likely to actually disclose such errors. Only 12% of respondents had previously received training on how to disclose errors to patients, although 93% were interested in receiving training. Overall, 97% of respondents agreed that serious errors should be reported, but willingness to report minor errors (74%) and near misses (59%) was lower. Respondents were more likely to strongly agree that serious errors should be reported if they also thought that their hospital would implement systematic changes after errors were reported [(odds ratio, 2.097 (95% confidence interval, 1.16 to 3.81)]. Significant differences in attitudes between departments regarding error disclosure and reporting were noted. CONCLUSION Willingness to disclose or report errors varied widely between hospitals. Thus, heads of department and hospital chiefs need to be aware of the importance of local culture when it comes to error communication. Error disclosure training and improving feedback on how error reports are being used to improve patient safety may also be important steps in increasing anaesthesiologists' communication of errors.

What does professionalization mean? Developing a conceptual framework of professionalization in sports federations

Professionalization seems to be an appropriate strategy for sports organizations to meet organizational pressure due to challenges of a more complex and dynamic changing environment (e.g. Shilbury & Ferkins, 2011). However, despite the increasing number of studies attempting to disclose professionalization in sports organizations, it still remains unclear, what the term professionalization actually mean, and which aspects a suitable concept of professionalization for studying the phenomena should consist in (Dowling et al., 2014). To bridge this gap, we firstly display scholars’ perspective of professionalization in sports organizations in order to explore the common ground as well as divergences in previous approaches. We will then consider practical views of Swiss experts to gain valuable insight, as pointed out by Slack (2014), into current thinking and acting towards professionalization in sports federations in Switzerland. In semi-structured interviews, we asked six experts, who accompany the professionalization processes of Swiss national sports federations, about their subjective understanding of professionalization, and its characteristics. The interviews were analyzed applying hermeneutic approach to systematically reconstruct the observed characteristics of professionalization resulting in three main topics: (1) changed management philosophy, (2) specialization and functional differentiation, and (3) management tools. Based on the literature review as well as insights from the Swiss experts, we will provide a synthesis of crucial aspects for developing a conceptual framework of professionalization that can be useful for further studies. References Dowling, M., Edwards, J., & Washington, M. (2014). Understanding the concept of professionalisation in sport management research. Sport Management Review, 17, 520-529. Shilbury, D., & Ferkins, L. (2011). Professionalisation, sport governance and strategic capability. Managing Leisure, 16, 108-127. Slack, T. (2014). The social and commercial impact of sport, the role of sport management. European Sport Management Quarterly, 14, 454–463.

Serum Testosterone Levels and Symptom-Based Depression Subtypes in Men

The main objective of this preliminary study was to further clarify the association between testosterone (T) levels and depression by investigating symptom-based depression subtypes in a sample of 64 men. The data were taken from the ZInEP epidemiology survey. Gonadal hormones of a melancholic (n  = 25) and an atypical (n = 14) depression subtype, derived from latent class analysis, were compared with those of healthy controls (n  = 18). Serum T was assayed using an enzyme-linked immunosorbent assay procedure. Analysis of variance, analysis of covariance, non-parametrical tests, and generalized linear regression models were performed to examine group differences. The atypical depressive subtype showed significantly lower T levels compared with the melancholic depressives. While accumulative evidence indicates that, beyond psychosocial characteristics, the melancholic and atypical depressive subtypes are also distinguishable by biological correlates, the current study expanded this knowledge to include gonadal hormones. Further longitudinal research is warranted to disclose causality by linking the multiple processes in pathogenesis of depression.

Qualitative study: Understanding Mexican American women's experience in intimate partner violence

The purpose of this qualitative study was to gain an understanding of the experiences of Mexican American women living with intimate partner abuse relevant to the process of disclosure of abuse. Limited research exists on the experiences of women who are of Mexican descent living with intimate partner abuse and their disclosure of abuse. Factors that influence disclosure for other populations are well articulated in the literature however, these factors have not been adequately verified in persons of Mexican descent. Data are reported from in-depth interviews with 26 clients at a shelter and an outreach agency in a south Texas-Mexico border community. Semi-structured interview guide was used to elicit information over an 11 month period. A grounded theory ethnography approach was used to analyze data. Verification strategies and constant comparison techniques (e.g. investigator responsiveness, methodological coherence, sampling adequacy, an active analytic stance, and saturation) enhanced rigor of analysis. Nineteen Mexican immigrant women and seven Mexican American women participated in the study. Several themes were discerned related to women's experiences in abuse: painful living, questioning endurance, and confronting reality. In almost every participant's account there was a description of repeated victimization by her intimate partner or partners, and again, by others within and outside her network. The participants discussed several cultural factors (e.g. embarrassment, concerns for family, avoidance of causing pain to family, protection of partner, avoidance of being judged) that hindered their decisions whether or not to disclose. Participants noted that healthcare workers rarely asked probing questions regarding abuse. The timing and process of disclosure took many turns for women in this study. Some of the factors hindering women from disclosing were found to be influenced by cultural practices. The consequences of disclosure for many of the women led them to re-victimization. Implications for practice to avoid missed opportunities with women living in abuse are to: ask questions routinely to encourage disclosure of abuse and offer community resource information for women living in abuse or both.^

AN ASSESSMENT OF KNOWLEDGE AND ATTITUDES OF GENETIC COUNSELING SERVICES IN U.S. HTCs

Hemophilia is a hereditary bleeding disorder which requires lifelong specialized care. A network of Hemophilia Treatment Centers (HTCs) exists to meet the medical needs of patients affected by hemophilia. Genetic counseling services are an integral part of the HTC model of care; however, many HTCs do not have genetic counselors on staff. As a result, the duty to provide these services must fall to other healthcare providers within the HTC. To assess the knowledge and attitudes of these providers we developed a 49 question survey that was distributed electronically to hematologists and nurses at U.S. HTCs. The survey consisted of a three sections: demographic information, knowledge of hemophilia genetics, and attitudes towards genetic services. A total of 111 complete responses were received and analyzed. The average knowledge score among all participants was 74.8% with a total of 81 participants receiving a passing score of 70% or above. Thirty participants scored below 70% in the knowledge section. In general, attitude scores were high indicating that the majority of hematologists and nurses in HTCs feel confident in their ability to provide genetic counseling services. Over 90% of participants reported that they have some form of access to genetic counseling services at their center. Hematologists and nurses practicing in U.S. HTCs demonstrate sufficient knowledge of the genetics of hemophilia, and they generally feel confident in their ability to provide genetic counseling services to their patients. While their knowledge is sufficient, the average knowledge score was lower than 75%. Certain questions covering new genetic technologies and testing practices were more commonly missed than questions asking about more basic aspects of hemophilia genetics, such as inheritance and carrier testing. Finally, many clinics report having access to a counselor, but it is oftentimes a hematologist or nurse who is providing genetic counseling services to patients. Given the inconsistency in knowledge among providers coupled with the high confidence in one’s ability to counsel patients, it leaves room to question whether information about the genetics of hemophilia is being communicated to patients in the most appropriate and accurate manner.

La educación formal como instituido que media los procesos de inclusión/exclusión de las personas en situación de discapacidad

En estas sociedades occidentales modernas, deviene como “normal" y cotidiano la uniformización de los sujetos; resultando valores cada vez más preciados y exigidos la hegemonía en pensamiento, acción y sensación. En este sentido, y para el logro de tal emprendimiento, se entiende que han ido cambiando a lo largo de estos últimos tres siglos las formas de requerir tal hegemonía, no así la esencia de la misma, orientando a los seres en su individualidad y colectivamente hacia una hegemonía del deber ser. Se considera en este trabajo a la educación formal como uno de los pilares en los que se ha sostenido la formación de los sujetos sociales modernos. Será en base a las demarcaciones propias del disciplinamiento y la normalización adquirida a través de la currícula educativa que se delimiten marginalidades entre lo que se es y lo que se espera de cada sujeto.

El perito médico en los delitos sexuales. Buenos Aires 1850-1890

En esta tesina analizo el rol jugado por el perito médico en los delitos sexuales entre 1850 y 1890 en Buenos Aires. El punto central es mostrar como ayuda a crear a la 'victima aceptable' sea hombre o mujer. Para hacer esto, explico la pericia médica en sí y muestro como este va mucho más allá de su deber para asegurarse de no estar ayudando al varón o la mujer a ocultar una perversión como la homosexualidad o la masturbación. Al mismo tiempo muestro que los crímenes sexuales son tratados en una forma particular respecto de otros tipos de delitos por la justicia de ese momento. Finalmente, en el último capítulo, intento mostrar como los conocimientos y la práctica jurídica se combinan con el saber y el ejercicio de la medicina para intentar definir la niñez y su sexualidad

El perito médico en los delitos sexuales. Buenos Aires 1850-1890

En esta tesina analizo el rol jugado por el perito médico en los delitos sexuales entre 1850 y 1890 en Buenos Aires. El punto central es mostrar como ayuda a crear a la 'victima aceptable' sea hombre o mujer. Para hacer esto, explico la pericia médica en sí y muestro como este va mucho más allá de su deber para asegurarse de no estar ayudando al varón o la mujer a ocultar una perversión como la homosexualidad o la masturbación. Al mismo tiempo muestro que los crímenes sexuales son tratados en una forma particular respecto de otros tipos de delitos por la justicia de ese momento. Finalmente, en el último capítulo, intento mostrar como los conocimientos y la práctica jurídica se combinan con el saber y el ejercicio de la medicina para intentar definir la niñez y su sexualidad

El perito médico en los delitos sexuales. Buenos Aires 1850-1890

En esta tesina analizo el rol jugado por el perito médico en los delitos sexuales entre 1850 y 1890 en Buenos Aires. El punto central es mostrar como ayuda a crear a la 'victima aceptable' sea hombre o mujer. Para hacer esto, explico la pericia médica en sí y muestro como este va mucho más allá de su deber para asegurarse de no estar ayudando al varón o la mujer a ocultar una perversión como la homosexualidad o la masturbación. Al mismo tiempo muestro que los crímenes sexuales son tratados en una forma particular respecto de otros tipos de delitos por la justicia de ese momento. Finalmente, en el último capítulo, intento mostrar como los conocimientos y la práctica jurídica se combinan con el saber y el ejercicio de la medicina para intentar definir la niñez y su sexualidad

Establishing electoral administration systems in new democracies

The difficulty of holding fair elections continues to be a critical problem in many newly democratized countries. The core of the problem is the electoral administration's lack of political autonomy and capability to regulate fraud. This paper seeks to identify the conditions for establishing an autonomous and capable electoral administration system. An electoral administration system has two main functions: to disclose the nature of elections and to prevent fraud. We argue in this paper that an autonomous and capable electoral administration system exists if the major political players have the incentive to disclose the information on the elections and to secure the ruler's credible commitment to fair elections. We examine this argument through comparative case studies of Korea and the Philippines. Despite similar historical and institutional settings, their election commissions exhibit contrasting features. The difference in the incentive structures of the major political players seems to have caused the divergence in the institutional evolution of the election commissions in the two countries.