Physicians' communication skills with patients and legal liability in decided medical malpractice litigation cases in Japan

<p>Abstract</p> <p>Background</p> <p>In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical litigation cases includes the issue of a doctor's explanation to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients, as related to their legal liability, and differences in doctors' communication skills with patients by the type of medical facility.</p> <p>Methods</p> <p>Decisions of medical malpractice litigation cases between 1988 and 2005 in Japan, the pivotal issue of which was a physician's explanation, were analyzed in the study. The content of each decision was summarized using the study variables (information about the patient, doctor, manner of the doctor's explanation, and subsequent litigation), and a database comprising the content of each decision (<it>N </it>= 100) was constructed. In order to evaluate an association between doctors' communication skills with patients and the outcome of the litigation, the analysis was performed based on the outcome of litigation or the type of medical facility.</p> <p>Results</p> <p>The ratio of acknowledged physician liability by court decision was lower in cases in which the doctor's explanation occurred before treatment or surgery (<it>p </it>= 0.013). The ratio of acknowledged physician liability by court decision was higher in cases of elective or non-urgent treatment (<it>p </it>= 0.046). The ratio of acknowledged physician liability by court decision was higher in clinics than in hospital groups (<it>p </it>= 0.036).</p> <p>Conclusion</p> <p>These findings are beneficial for the prevention of medical disputes and improvement of patient-physician communication.</p

The complete set of solutions of the geodesic equations in the space-time of a Schwarzschild black hole pierced by a cosmic string

We study the geodesic equations in the space-time of a Schwarzschild black hole pierced by an infinitely thin cosmic string and give the complete set of analytical solutions of these equations for massive and massless particles, respectively. The solutions of the geodesic equations can be classified according to the particle's energy and angular momentum, the ratio between the component of the angular momentum aligned with the axis of the string and the total angular momentum, the deficit angle of the space-time and as well the horizon radius (or mass) of the black hole. For bound orbits of massive test particles we calculate the perihelion shift, we discuss light deflection and comment on the Newtonian limit.Comment: 21 pages; section 3 shortened, references added; accepted for publication in Phys. Rev.

Symmetry, bifurcation and stacking of the central configurations of the planar 1+4 body problem

In this work we are interested in the central configurations of the planar 1+4 body problem where the satellites have different infinitesimal masses and two of them are diametrically opposite in a circle. We can think this problem as a stacked central configuration too. We show that the configuration are necessarily symmetric and the other sattelites has the same mass. Moreover we proved that the number of central configuration in this case is in general one, two or three and in the special case where the satellites diametrically opposite have the same mass we proved that the number of central configuration is one or two saying the exact value of the ratio of the masses that provides this bifurcation.Comment: 9 pages, 2 figures. arXiv admin note: text overlap with arXiv:1103.627

Physicians' explanatory behaviours and legal liability in decided medical malpractice litigation cases in Japan

<p>Abstract</p> <p>Background</p> <p>A physician's duty to provide an adequate explanation to the patient is derived from the doctrine of informed consent and the physician's duty of disclosure. However, findings are extremely limited with respect to physicians' specific explanatory behaviours and what might be regarded as a breach of the physicians' duty to explain in an actual medical setting. This study sought to identify physicians' explanatory behaviours that may be related to the physicians' legal liability.</p> <p>Methods</p> <p>We analysed legal decisions of medical malpractice cases between 1990 and 2009 in which the pivotal issue was the physician's duty to explain (366 cases). To identify factors related to the breach of the physician's duty to explain, an analysis was undertaken based on acknowledged breaches with regard to the physician's duty to explain to the patient according to court decisions. Additionally, to identify predictors of physicians' behaviours in breach of the duty to explain, logistic regression analysis was performed.</p> <p>Results</p> <p>When the physician's explanation was given before treatment or surgery (<it>p </it>= 0.006), when it was relevant or specific (<it>p </it>= 0.000), and when the patient's consent was obtained (<it>p </it>= 0.002), the explanation was less likely to be deemed inadequate or a breach of the physician's duty to explain. Patient factors related to physicians' legally problematic explanations were patient age and gender. One physician factor was related to legally problematic physician explanations, namely the number of physicians involved in the patient's treatment.</p> <p>Conclusion</p> <p>These findings may be useful in improving physician-patient communication in the medical setting.</p

Monitoring dugongs within the Reef 2050 Integrated Monitoring and Reporting Program: final report of the dugong team in the megafauna expert group

The objectives of this report are to determine for the dugong: An assessment of the current status of the relevant elements of the Great Barrier Reef (the Reef), including an evaluation of primary drivers, pressures and responses using the Driving Forces, Pressures, States, Impacts, Responses (DPSIR) Framework; Identification of priority indicators for monitoring the key values associated with these elements; Summary of potential sources of data; Evaluation of adequacy of existing monitoring activities within each theme to achieve the objectives and requirements of RIMReP; Recommendations for the design of an integrated monitoring program as a component of RIMReP, specifically considering: The information requirements for each key element of the Reef to ensure that appropriate data and information are being collected to meet the fundamental objectives of RIMReP; The spatial and temporal sampling design to ensure that greatest value can be extracted from the data collected; The logistics of the design to ensure that it can be implemented efficiently; Likely funding required to implement the recommended monitoring design.An accessible copy of this report is not yet available from this repository, please contact [email protected] for more information

燒炭自殺在東亞國家的流行散佈: 趨勢分析

The Abstract Book can be viewed at: http://www.sop.org.tw/book/download/Summary2013.pdfConference Theme: Focusing on Mental Health, Life Care and Social Network in the ElderlyObjective: Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 years in the early 2000s. Methods: We used data for suicides by gases other than domestic gas in Hong Kong, Japan, South Korea (1995-2010), Taiwan (1995-2011), and Singapore (1996-2011) to systematically investigate the spread of this method in East Asia. Graphical and joinpoint regression analyses were used to examine suicide trends and Poisson regression analysis to study sex- and age-specific patterns. Results: In 1995/1996, charcoal-burning suicides accounted for < 1% of all suicides in all study countries, except around 5% in Japan, but they increased to account for 14%, 28%, 13%, 4.3%, and 3.4% of all suicides in Hong Kong, Taiwan, Japan, South Korea, and Singapore respectively in 2010. Rises were first seen in Hong Kong in 1999, followed by Singapore in 2000, Taiwan in 2001, Japan in 2003, and South Korea in 2008. There was some evidence for an impact on overall suicide trends in Hong Kong, Taiwan, and Japan (females), but not in Japan (males), South Korea, and Singapore. Rates of change did not differ by sex/age group in Taiwan and Hong Kong but were greatest in young people in Japan and middleaged men and young women in South Korea. Conclusion: Variations in the timing, scale and sex/age pattern of the epidemic appear to be influenced by the media reporting of charcoal-burning suicide, whilst other factors such as the characteristics of the first or first few cases, language and ulture, familiarity and accessibility with the method, and socio-economic conditions may also play a role. Strategies to limit the epidemic spread of new suicide methods include surveillance to enable the early identification of the emergence of such methods, responsible media reporting and restrictions on Internet sites giving technical information about the method

Orbits in the Field of a Gravitating Magnetic Monopole

Orbits of test particles and light rays are an important tool to study the properties of space-time metrics. Here we systematically study the properties of the gravitational field of a globally regular magnetic monopole in terms of the geodesics of test particles and light. The gravitational field depends on two dimensionless parameters, defined as ratios of the characteristic mass scales present. For critical values of these parameters the resulting metric coefficients develop a singular behavior, which has profound influence on the properties of the resulting space-time and which is clearly reflected in the orbits of the test particles and light rays.Comment: 24 pages, 15 figures. Accepted for publication in GR

Geodesics of electrically and magnetically charged test particles in the Reissner-Nordstr\"om space-time: analytical solutions

We present the full set of analytical solutions of the geodesic equations of charged test particles in the Reissner-Nordstr\"om space-time in terms of the Weierstra{\ss} $\wp$, $\sigma$ and $\zeta$ elliptic functions. Based on the study of the polynomials in the $\vartheta$ and $r$ equations we characterize the motion of test particles and discuss their properties. The motion of charged test particles in the Reissner-Nordstr\"om space-time is compared with the motion of neutral test particles in the field of a gravitomagnetic monopole. Electrically or magnetically charged particles in the Reissner-Nordstr\"om space-time with magnetic or electric charges, respectively, move on cones similar to neutral test particles in the Taub-NUT space-times

Seven-body central configurations: a family of central configurations in the spatial seven-body problem

The main result of this paper is the existence of a new family of central configurations in the Newtonian spatial seven-body problem. This family is unusual in that it is a simplex stacked central configuration, i.e the bodies are arranged as concentric three and two dimensional simplexes.Comment: 15 pages 5 figure