Journal of Legal Medicine最新文献

{"title":"Encouraging Online Voter Registration of Nevada Physicians - A Challenge in Apathy?","authors":"S. Tun, H. Luong, W. Havins","doi":"10.1080/01947648.2021.1914492","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914492","url":null,"abstract":"Encouraging Online Voter Registration of Nevada Physicians A Challenge in Apathy? Sein Tun, MS, OMS-II; stun@student.touro.edu Hao Luong, MS, OMS-II; hluong2@student.touro.edu Weldon E Havins, MD, JD, LLM, FCLM, Emeritus Professor Touro University Nevada College of Osteopathic Medicine, Henderson, Nevada Voting is the most basic way a citizen can have his or her voice heard. It is also one of the easiest ways for an individual to participate in changing or maintaining the legislation. Voting registration and participation can allow citizens to have a direct impact on the healthcare system, which is an essential aspect of policy making within the United States’ political system. Physicians are the most equipped with knowledge about the healthcare system, therefore, there is a need to increase voting amongst physician populations. Physicians’ votes and influence on health policy impact not only the medical community but their patients as well. To improve the healthcare system for both physicians and their patients, the candidates chosen to become legislators must align with the views held by their constituents. As registered voters and constituents of an Assemblyperson and a Senator, physicians can actively voice their concerns and ideas that could potentially contribute to new and improved legislation. However, the first and most important step in getting involved is to register to vote. When compared to other higher education professionals such as lawyers, physicians are less active in politics. This needs to be improved because healthcare policy contributes to a large portion of political discussion. In order to promote physician engagement in politics, there must be promotion of registration to vote. One benefit is that it is especially easy to register now because it can be done conveniently online. This study aims to improve physician voter registration outcomes by identifying physicians in Clark County who are not registered voters and contacting them to discuss the importance of voting and how to register online. However, because of limited information available from the National Board of Medical Examiners (NBME) and the National Board of Osteopathic Medical Examiners (NBOME) databases, the only feasible method of contact to physicians is through mailing physical letters to their work offices. The method utilized in this study is not effective because it lacked sufficient time to allow the letters to be received by physicians before the data was 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 47–48 https://doi.org/10.1080/01947648.2021.1914492 analyzed. Although this study could not prove that mailing letters to the physicians’ office of practice is an adequate method, it did show that approximately 74% of physicians in Clark County are registered voters, which is of higher percentage than the general population of Nevada. Nonetheless, this number does not account for other variables that may influen","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"170 1","pages":"47 - 48"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86050818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Risk of Shift Work Leading to Diabetes: A Logistic Regression Analysis of an Open Data Set","authors":"Sarah J. Diekman","doi":"10.1080/01947648.2021.1914475","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914475","url":null,"abstract":"The Potential Risk of Shift Work Leading to Diabetes: A Logistic Regression Analysis of an Open Data Set Sarah J. Diekman, MD, JD, MS, (sdiekman1@jhu.edu) Occupational Environmental Medicine Resident, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Introduction: The body of sleep epidemiology studies was scant leading into the 1980s. After the 1980s, tens of thousands of studies of sleep epidemiology have emerged. The increased interest correlated in part with a public interest in reducing motor vehicle accidents. As the public started to see accidents that were associated with sleep deprivation, the public wanted to know more about sleep and motor vehicles. Another reason for the increased interest in sleep is that the general public was finding sleep problems to be common and this resulted in pressure on the scientific community to find out why. Over the past 30 years, international data shows that the average night sleep has decreased by 18min per night (Ferrie et al.). Currently, the CDC recommends that adult sleep 7 or more hours per each 24-hour period to maximize health and wellbeing.(CDC Data and Statistics Sleep and Sleep Disorders) Sleep disturbance has been implicated in nearly every chronic disease: cardiovascular disease, hypertension, inflammation, obesity, diabetes and impaired glucose tolerance, and psychiatric disorders, such as anxiety and depression (Ferrie et al.). OSHA’s community recommendations includes strategies to reduce the major environmental risk of work induced sleep deprivation. OSHA recommends that the workplace consider a normal work shift be a work period of no more than eight consecutive hours during the day, five days a week with at least an eight-hour rest in between shifts. Periods that allow for less sleep should be considered to be unusual (Extended Unusual Work Shifts). State, local, and federal governments have various laws addressing sleep and motor vehicle operation. Professional drivers are most often affected by these laws. Further the airline industry also regulates sleep. These laws are a balance of the business interest for workers to be more productive, the workers interest to make an adequate pay-check, and the interest of public safety (Åkerstedt and Wright). Research Objectives: The aim of this study was to determine whether an association exists between shift work and diabetes. The target population was workers affected by swing shifts. There was no data source that directly 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 15–17 https://doi.org/10.1080/01947648.2021.1914475 inventoried this population, so sleep below the CDC recommended 7 hours was used as a surrogate for the shortened sleep seen in shift work. The actual study population was the general population of India where the researchers conducted their original study. Methods: The hypothesis that was tested was whether there was an association between chronic sleep deprivation and","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"39 1","pages":"15 - 17"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83077026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Relationship Between Opioid Prescription Frequency and Deaths From Illicit Opioids","authors":"C. Wyant, Taylor Cornwell-Hinrichs, Joseph P. Hardy, W. Havins","doi":"10.1080/01947648.2021.1914493","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914493","url":null,"abstract":"Investigating the Relationship Between Opioid Prescription Frequency and Deaths From Illicit Opioids Cara Wyant, OMS-II Taylor Cornwell-Hinrichs, MPH, MLIS, OMS-II Joseph P. Hardy, MD, Associate Dean of Clinical Education Weldon Havins, MD, JD, LLM, MA, Emeritus Professor Touro University Nevada College of Osteopathic Medicine In accordance with the global opioid epidemic, the CDC issued guidelines for practitioners prescribing opioids for chronic pain. In response to these guidelines and to the opioid epidemic itself, Nevada issued restrictive legislation on practitioners prescribing opioids: SB 459, AB 474, and AB 239. To investigate the relationships between opioid legislature and opioidrelated death rates, data was obtained from the Nevada Board of Pharmacy and the Clark and Washoe County medical examiner offices. The data demonstrate that there was a significant decrease in prescriptions following the legislation; however, there was no correlation between the legislation and overall rate of opioid-related deaths because there was a subsequent and dramatic rise in deaths from illicit opioids. This suggests that more patients switched to the use of heroin and/or fentanyl as a result in limiting legal opioid prescribing power. A Spearman correlation was calculated (-0.04) and a two-way analysis of variance (ANOVA) was used to compare the time periods of the legislation implementation and the county. There were no interactions between the two counties and law; so, both counties experienced the same trends following these laws. To compare opioid-related deaths to opioid prescription rate for each time period, a t-test with law as the only factor was conducted with combined data from both counties (SB 459 p1⁄4 0.744; AB 474 p1⁄4 0.640; AB 239 p1⁄4 0.704). No significance was found. The COVID-19 Stay at Home order has statistically increased opioid-related deaths (p1⁄4 0.010), albeit it is unknown if this increase is due to Nevadans selfmedicating in response to work stoppages and financial stress, inability to see a practitioner in person, or restrictions involving addiction clinics during the pandemic. The goal of Nevada’s three opioid prescription bills was to reduce the rate of Nevadans dying from opioid overdoses, yet more Nevadans are dying from opioids now than before the bills passed. We recommend three provisions that will allow providers to confidently prescribe appropriate 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 49–50 https://doi.org/10.1080/01947648.2021.1914493 pain management for their patients without fear of sanction from another licensing board’s misunderstandings, allow providers to humanely manage their patients’ legitimate pain, and limit unintended consequences where patients are forced to seek out illicit opioids to control their pain and inadvertently die in the process. These are our recommendations: (1) Base law requirements on guidelines provided by professional or governmen","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"27 1","pages":"49 - 50"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88853928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Deaths-at-Home in Nevada During the COVID-19 Pandemic","authors":"Proma Mazumder, Crystal Yung, C. Vanier, Joseph P. Hardy","doi":"10.1080/01947648.2021.1914479","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914479","url":null,"abstract":"Indirect effects associated with forced or voluntary changes in behaviors due to COVID-19 are largely unknown Fear of COVID-19 infection may cause patients to avoid medical care for other conditions, and government directives have forced major lifestyle disruptions The purpose of this study was to analyze deaths at home (DaH) relative to gender, age, ethnicity, location, and cause of death to understand the indirect effects of COVID-19 on mortality rates in Nevada DaH increased 25% in Nevada during April 2020 (27 9;95% confidence interval: 26 3, 29 5 deaths per 100,000) compared to mean DaH during April the previous four years (22 3 mean deaths per 100,000) The increase was driven by males, people aged 65-74, and residents of the Las Vegas area There was no trend related to ethnicity Causes of death that increased in 2020 were diabetes mellitus (109%), nutritional deficiencies (860%), non-transport accidents (50%), and as-yet unknown causes (863%)","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"101 1","pages":"24 - 25"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86639655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nevada Healthcare Boards: Violations of Public Record Act and Inaccessibility of Licensee Information","authors":"Ryliezl Abby Reyes, Stephanie Quan, Joseph P. Hardy, W. Havins","doi":"10.1080/01947648.2021.1914489","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914489","url":null,"abstract":"","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"22 1","pages":"39 - 40"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83950930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Neuralink Brain Machine Interface Technology: An Oversight Proposal to Address the Ethical, Legal, and Social Implications","authors":"Ali Said, L. Sánchez, M. Olek, Weldon Havins","doi":"10.1080/01947648.2021.1914490","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914490","url":null,"abstract":"","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"81 1","pages":"40 - 41"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91227072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal for Using Digital Tools in Mitigating a Pandemic: Lessons Learned from COVID-19","authors":"Stephanie N Bernardo, Kylie Zeng, W. Havins","doi":"10.1080/01947648.2021.1914469","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914469","url":null,"abstract":"BACKGROUND: Since the COVID-19 outbreak began in Wuhan China, countries across the world have been forced to take unprecedented measures to combat it. While some countries are still grappling with the COVID-19 pandemic, others have fared better and have established relative normalcy quickly. The rapid transmission rate of the virus has shown a greater need for efficient and technologically modern containment measures. The use of digital tools to facilitate strict containment measures in countries that have faired well against the COVID-19 pandemic has sparked both interest and controversy. OBJECTIVE: In this study, we compare the precautions taken against the spread of COVID-19, particularly the use of digital tools in contact tracing, and propose policies that could be utilized in the U.S. for future COVID-19 waves or pandemics. METHODS: COVID-19 death rates data were obtained from the European Center for Disease Prevention and Control (ECDC) accessed through the Our World in Data database, and were evaluated based on population size per 100,000 from December 31, 2019 to September 6, 2020. All policies and measures enacted were obtained from their respective governmental websites. RESULTS: We found a strong association between lower death rates per capita and countries that implemented early mask use and strict border control measures that included mandatory quarantine using digital tools. There is a significant difference in the number of deaths per 100,000 when comparing Taiwan, South Korea, and Singapore versus the U.S., Spain, and Italy. CONCLUSIONS: Based on our research, it is evident that early intervention with the use of digital tools has a strong correlation for containing COVID-19. Infection rates and subsequent deaths in Italy, Spain, and more specifically the U.S. could have been much lower with early mask use and, more importantly, timely border control measures utilizing modern digital tools. Thus, we propose that the U.S. execute the following national policies should a public health emergency be declared: (1) Immediately establish a National Command responsible for enacting strict mandatory guidelines enforced by federal and state governments, including national mask use. (2) Mandate civilian cooperation with health officials in contact tracing and quarantine orders. Incoming travelers to the U.S. and those quarantined will be required to download a contact tracing app. We acknowledge the countries we studied differ in their cultures, political systems, and reporting criteria for COVID-19 deaths. Further research may need to be conducted to address these limitations; however, we believe that the proposed policies could protect the American public.","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"82 1","pages":"3 - 4"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90890397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing Inmate Populations to Mitigate Effects of COVID-19 in State Prisons","authors":"Seung Joon Hwang, M. Kim, W. Havins","doi":"10.1080/01947648.2021.1914477","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914477","url":null,"abstract":"With the spread of COVID-19 comes reports of rising outbreaks in prisons throughout the United States. On a national level, the Federal Bureau of Prisons (BOP) has modified operation guidel...","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"660 1","pages":"20 - 21"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76844691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Relationship between Infection Citations and COVID-19 Infections in Nursing Homes","authors":"Meghan Mahalawat, Nur Fatimah Mirza, C. Vanier, W. Havins","doi":"10.1080/01947648.2021.1914478","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914478","url":null,"abstract":"In the US, 40% of fatalities from COVID-19 have occurred in nursing homes Identifying warning signs of nursing homes with a higher chance of having COVID-19 cases and deaths can help target interventions to lower the overall spread and mortality associated with the disease The purpose of this study was to determine whether staff shortages, staff infections, or previous citations would affect the likelihood of cases of COVID-19 and associated deaths in nursing homes Data was obtained from the Center for Medicare and Medicaid Services' Nursing Home Compare Dataset and the COVID-19 Nursing Home Dataset for six western states for 03/01/2019 through 02/29/2020 States were heterogeneous and were analyzed independently of each other The relationship between staff-confirmed COVID-19 cases and resident cases was tested using a Fisher's exact test A logistic regression was used to model how prior citations and staff shortages affected the likelihood of cases and deaths, relative to the number of occupied beds per facility","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"1 1","pages":"22 - 23"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73308935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should Healthcare Workers Treat COVID-19 Patients Despite the Inadequate Personal Protective Equipment?","authors":"J. Parra, Heerod Malekghassemi, Joseph P. Hardy, W. Havins","doi":"10.1080/01947648.2021.1914485","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914485","url":null,"abstract":"","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":"58 1","pages":"34 - 35"},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80333979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}