Blood Transfusions and Elective Surgery: A Custodial Function of an Ohio Juvenile Court

Juvenile Court has traditionally been though of, within American jurisprudence, as an appendage of the state acting as parens patriae. This obligation dates back to the ancient role of the sovereign as protector of helpless children. An abundance of case law has con- strued and reinterpreted this doctrine, but none has significantly deviated from the general definition. Therefore, the description given in Black\u27s Law Dictionary that parens patriae refers . . to the sovereign power of guardianship over persons under disability . . . such as minors . . . will suffice for the purposes of the ensuing discussion. These individuals include delinquent, dependent, and ne- glected children

Simulation for training in sinus floor elevation : new surgical bench model

Objectives: to describe a bench model (workshop of abilities) for sinus floor elevation (SFE) training that simulates the surgical environment and to assess its effectiveness in terms of trainees? perception. Study design: thirty-six randomly selected postgraduate students entered this cross-sectional pilot study and asked to fill in an anonymous, self-applied, 12-item questionnaire about a SFE workshop that included a study guide containing the workshop?s details, supervised practice on a simulated surgical environment, and assessment by means of specific check-lists. Results: Thirtiy-six fresh sheep heads were prepared to allow access to the buccal vestible. Using the facial tuber, third premolar and a 3D-CT study as landmarks for trepanation, the sinus membrane was lifted, the space filled with ceramic material and closed with a resorbable membrane. The participants agreed on their ability to perform SFE in a simulated situation (median score= 4.5; range 2-5) and felt capable to teach the technique to other clinicians or to undertake the procedure for a patient under supervision of an expert surgeon (median= 4; range 1-5 ). There were no differences on their perceived ability to undertake the technique on a model or on a real patient under supervision of an expert surgeon (p=0.36). Conclusions: Clinical abilities workshops for SFE teaching are an essential educational tool but supervised clinical practice should always precede autonomous SFE on real patients. Simulation procedures (workshop of abilities) are perceived by the partakers as useful for the surgical practice. However, more studies are needed to validate the procedure and to address cognitive and communication skills, that are clearly integral parts of surgical performance

Multilevel Contracts for Trusted Components

This article contributes to the design and the verification of trusted components and services. The contracts are declined at several levels to cover then different facets, such as component consistency, compatibility or correctness. The article introduces multilevel contracts and a design+verification process for handling and analysing these contracts in component models. The approach is implemented with the COSTO platform that supports the Kmelia component model. A case study illustrates the overall approach.Comment: In Proceedings WCSI 2010, arXiv:1010.233

Enhancing Dependability of Component-based Systems

International audienceWe present a method to add dependability features to component-based software systems. The method is applicable if the dependability features add new behavior to the system, but do not change its basic functionality. The idea is to start with a software architecture whose central component is an application component that implements the behavior of the system in the normal case. The application component is connected to other components, possibly through adapters. It is then possible to enhance the system by adding dependability features in such a way that the central application component remains untouched. Adding dependability features necessitates to evolve the overall system architecture by replacing or newly introducing hardware or software components. The adapters contained in the initial software architecture have to be modified, whereas the other software components need not to be changed. Thus, the dependability of a component-based system can be enhanced in an incremental way

Blood Transfusions and Elective Surgery: A Custodial Function of an Ohio Juvenile Court

Juvenile Court has traditionally been though of, within American jurisprudence, as an appendage of the state acting as parens patriae. This obligation dates back to the ancient role of the sovereign as protector of helpless children. An abundance of case law has con- strued and reinterpreted this doctrine, but none has significantly deviated from the general definition. Therefore, the description given in Black\u27s Law Dictionary that parens patriae refers . . to the sovereign power of guardianship over persons under disability . . . such as minors . . . will suffice for the purposes of the ensuing discussion. These individuals include delinquent, dependent, and ne- glected children

HIPAA\u27S Privacy Rule and State Privacy Laws: Roadblocks to Medical Organizations\u27 Self-Policing Expert Medical Testimony

As part of the wave of medical malpractice reforms over the last several decades, efforts were initiated to ensure the reliability and credibility of expert witness opinion and testimony, which is the sine qua non of necessary proof for any such claim or lawsuit. Governing bodies of professional medical organizations and societies have crafted rules and regulations for their members that wish to provide expert medical witness testimony. Where such testimony does not conform to these organizations’ standards, sanctions can be levied, including membership expulsion. Such self-policing has found favor with courts. Before sanctions are imposed, however, necessary administrative investigations and hearings are conducted, focusing on the foundation of the organization member’s expert opinions. But in these proceedings, there is a significant problem which has never been examined or analyzed in the legal literature or in any published appellate court decision: the submission of the patient’s medical information by either the complaining party or the responding expert in violation of HIPAA’s Privacy Rule or state privacy laws. This article examines and confronts the roadblocks to the self-policing mechanisms of professional medical organizations that they present. It concludes by proposing alternative methodologies and relief that may overcome the legal and regulatory roadblocks presented by HIPAA’s Privacy Rule and state laws