scholarly journals Education of medical examiners qualified for death certification

2006 ◽  
Vol 134 (Suppl. 2) ◽  
pp. 135-138 ◽  
Author(s):  
Djordje Alempijevic ◽  
Slobodan Savic
Keyword(s):  
Public Health ◽  
National Level ◽  
City Council ◽  
Public Health Care ◽  
Medical Examiner ◽  
Death Certification ◽  
Public Health Perspective ◽  
Professional Career ◽  
The Republic ◽  
Medical Examiners

INTRODUCTION. Death certification is very important from public health perspective, in particular, referring to gathering of data for mortality statistics on local and national level. When examining the deceased, medical examiner is capable of detecting indications of violent death and report the case for further inquest. The Public Health Care Act of the Republic of Serbia defines the responsibilities of medical examiner (ME) to certify death and estimate the time and cause of death. On the territory of Belgrade, this Service is organized by Department of Public Health of the City Council. Education of doctors-medical examiners certifying death in Belgrade area was organized during 2002 and 2003. OBJECTIVE. Demonstrate the structure of the Program of continual medical education (CME) of medical examiners in Belgrade area, to look into some aspects of their professional career, and to analyze the results of their testing. METHOD. Based on the Program of CME for medical examiners, test consisting of 13 questions was prepared. These questions were related to thanatology and current legislation. The evaluation of test results as well as particular characteristics (age, duration of professional engagement, etc.) of tested doctors was carried out. RESULTS. A total of 138 participants of CME Program were subjected to test. Mean age of tested MEs was 40.27?8.06 years, while an average duration of professional engagement was 13.43?8.00 years. Almost 2/3 of tested MEs were employed as general practitioners, while the rest were specialists, mainly in internal medicine and emergency medicine. Slightly more than 1/5 of tested MEs (21.7%) failed on the test (less than 60% of maximum score). CONCLUSION. Given the fact that slightly more than 1/5 of tested MEs (21.7%), regardless of duration of their professional engagement, did not pass the test, the level of their specific knowledge of death certification was not sufficient. Therefore, it is necessary to organize periodical CME on specific topics, including practice related to death certification. Accordingly, the Institute of Forensic Medicine in cooperation with Center for CME, Faculty of Medicine, University of Belgrade, has created a specific program of CME whose realization is in progress.

On the work of the Scientific Medical Society of Surgeons of the Republic of Tatarstan in 1996

1997 ◽  
Vol 78 (2) ◽  
pp. 158-159
Author(s):  
I. A. Ibatullin ◽  
A. Yu. Anisimov
Keyword(s):  
Public Health ◽  
Health Care ◽  
Practical Experience ◽  
Public Health Care ◽  
Medical Society ◽  
Clinical Observations ◽  
Medical Institutions ◽  
Wide Range ◽  
The Republic

The activity of the oldest scientific medical society of surgeons in Tatarstan is especially relevant in the conditions of the period of profound reforming of the society and the system of public health care that we are going through. Its work is a reliable means of transferring up-to-date information and advanced practical experience from some leading clinics and departments to the widest circle of physicians and teams of medical institutions of surgical profile. At the meetings of NMOH RT the most interesting issues in different branches of surgery and adjacent spheres: anesthesiology, gynecology and oncology were discussed. A wide range of possibilities of Kazan Surgical School was presented in the form of demonstrations of clinical observations and educational and methodological videos.

scholarly journals Local Alcohol Policy Implementation in Scotland: Understanding the Role of Accountability within Licensing

2019 ◽  
Vol 16 (11) ◽  
pp. 1880 ◽  
Author(s):  
Alex Wright
Keyword(s):  
Public Health ◽  
Policy Implementation ◽  
National Level ◽  
Alcohol Policy ◽  
Structured Interviews ◽  
Public Health Perspective ◽  
Health Goals ◽  
Documentary Analysis ◽  
Guidance Documents ◽  
Specific Implementation

Scotland has been ambitious in its policy and legislative efforts to tackle alcohol-related harm, efforts which include the innovative feature of a ‘public health objective’ within local alcohol licensing. However, the persistence of alcohol-related harms and inequalities requires further examination of both the overarching Scottish alcohol strategy and its specific implementation. A qualitative case study was undertaken to explore how alcohol policy is implemented locally in Scotland, with data generated from (i) documentary analysis of 12 relevant policies, legislation, and guidance documents; and (ii) a thematic analysis of semi-structured interviews with 54 alcohol policy implementers in three Scottish localities and nine national-level stakeholders. The data suggest there is a tension between the intentions of licensing legislation and the way it is enacted in practice, and that accountability emerges as an important factor for understanding why this occurs. In particular, there are a lack of accountability mechanisms acting upon Scottish Licensing Boards to ensure they contribute to the public health goals of the Scottish alcohol strategy. From a public health perspective, this has perpetuated a system in which Licensing Boards continue to act with autonomy from the rest of the alcohol policy implementation system, creating a challenge to the achievement of public health goals. Alcohol policy in Scotland is likely to fall short of intended goals as long as the tension between licensing legislation and enacted licensing practices remains.

scholarly journals Economic Burden of Public Health Care Was Higher Than That of Hospitalization and Treatment Associated With COVID-19 in China

2020 ◽  
Author(s):  
Xiaohua Liang ◽  
Lun Xiao ◽  
Xue-Li Yang ◽  
Xue-Fei Zhong ◽  
Peng Zhang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
National Level ◽  
Emerging Infectious Diseases ◽  
Medical Costs ◽  
Public Health Care ◽  
Chinese Government ◽  
Direct Medical Costs ◽  
Epidemiological Surveys ◽  
The Cost

Abstract Background: During the coronavirus disease 2019 (COVID-19) pandemic, it is essential to evaluate the socioeconomic burden imposed on the Chinese health care system.Methods: We prospectively collected information from the Center for Disease Control and Prevention and the designated hospitals to determine the cost of public health care and hospitalization due to COVID-19. We estimated the resource use and direct medical costs per confirmed case and the costs associated with public health care per thousand people at the national level.Results: The average costs per case for specimen collection and nucleic acid testing (NAT) were $29.49 and $53.44, respectively, while the average cost of NAT for high-risk populations was $297.94 per capita. The average costs per thousand people for epidemiological surveys, disinfectant, health education and centralized isolation were $49.54, $247.01, $90.22 and $543.72, respectively. A single hospitalization for COVID-19 in China cost an average of $3,792.69 ($2,754.82-$5,393.76) in direct medical costs incurred only during hospitalization, while the total costs associated with hospitalization were estimated to have reached nearly $31,229.39 million in China as of 20 May 2020. The cost of public health care ($6.81 billion) was 20 times that of hospitalization.Conclusions: This study highlights the magnitude of resources needed to control the COVID-19 pandemic and treat COVID-19 cases. Public health measures implemented by the Chinese government have been valuable with regard to reducing the infection rate and may be cost-effective ways to control emerging infectious diseases.

Medical Examiners, Coroners, and Public Health: A Review and Update

2006 ◽  
Vol 130 (9) ◽  
pp. 1274-1282 ◽  
Author(s):  
Randy Hanzlick
Keyword(s):  
Public Health ◽  
Criminal Justice ◽  
The United States ◽  
Background Information ◽  
Medical Examiner ◽  
Epidemiologic Research ◽  
The Public ◽  
Death Investigation ◽  
Medical Examiners

Abstract Context.—Traditionally, the emphasis of work done by medical examiners, coroners, and the death investigation community has been viewed as serving the criminal justice system. During the last several decades, however, an important role for these 3 groups has emerged within public health. Objective.—To provide important background information on death investigation systems, the evolution and framework of public health entities that rely on information gathered by medical examiners and coroners, and the role of medical examiners and coroners in epidemiologic research, surveillance, and existing public health programs and activities. Data Sources.—Previous articles on epidemiologic aspects of forensic pathology and the role of medical examiners and coroners in epidemiologic research and surveillance; a review of the Web sites of public health and safety agencies, organizations, and programs that rely on medical examiner and coroner data collected during medicolegal investigations; and a review of recent public health reports and other publications of relevance to medical examiner and coroner activities. Conclusions.—The role of medical examiners and coroners has evolved from a criminal justice service focus to a broader involvement that now significantly benefits the public safety, medical, and public health communities. It is foreseeable that the public health role of medical examiners and coroners may continue to grow and that, perhaps in the not-too-distant future, public health impact will surpass criminal justice as the major focus of medicolegal death investigation in the United States.

scholarly journals Instruments of Developing Social Marketing in Public Health

2019 ◽  
Vol 2 (1) ◽  
pp. 50-60
Author(s):  
Alina Timotin
Keyword(s):  
Public Health ◽  
Social Marketing ◽  
Deductive Reasoning ◽  
Medical Curriculum ◽  
Behavioural Change ◽  
National Level ◽  
Three Dimensions ◽  
Political Dimension ◽  
Team Members ◽  
The Republic

Abstract This paper examines the way in which social marketing can be developed in public health and provides a set of practical instruments in this regard. Social marketing is an important tool in generating behavioural change and its usefulness in public health was proved by previous studies. However, it is still overlooked by many public health specialists, mainly because they lack basic instruments in this regard, especially knowledge and technical support. This study provides an opportunity to advance the implementation of social marketing and it priorly addresses to: national authorities in developing public health policies and strategies, medical curriculum developers, teachers, project managers and team members of health promotion programs. The research is interdisciplinary, applicative, descriptive, with a qualitative approach, based on logical-deductive reasoning. The novelty of the paper is expressed by the proposed total framework of implementing social marketing in public health, that comprises three dimensions: political, training and collaborative. The political dimension implies a unified application of the concept at the national level through specific strategies and encouraging program developers to use marketing techniques in influencing health behaviour. The training dimension implies courses provided at different levels and stages of training: students, master students, specialists. The collaborative dimension requires the creation of joint teams and clear distribution of roles for each member, of which at least one should be a specialist in social marketing. According to these three dimensions, the study describes three instruments (a guide, a curriculum and a sketch of the team) that were created for developing social marketing in public health in countries like the Republic of Moldova, where the concept is still not widely known and accepted. This study tends to give support for researchers in promoting social marketing techniques.

scholarly journals Drug Overdose Surveillance and Information Sharing via a Public Database: The Role of the Medical Examiner/Coroner

2017 ◽  
Vol 7 (1) ◽  
pp. 60-72 ◽  
Author(s):  
Karl E. Williams ◽  
Michael D. Freeman ◽  
Lynn Mirigian
Keyword(s):  
Public Health ◽  
United States ◽  
Information Dissemination ◽  
National Level ◽  
The United States ◽  
Public Access ◽  
Medical Examiner ◽  
Health Crisis ◽  
Death Scene ◽  
Drug Death

The medical examiner/coroner (ME/C) death scene investigation systems of the United States play a pivotal role in the current public health crisis created by the expanding drug dependency epidemic in the United States. The first point of recognition of a drug-related death in a community is often the local ME/C agency. This circumstance places these entities in an ideal position to provide surveillance data regarding the epidemiology of drug-related deaths occurring within the jurisdiction of the agency. The ability to surveil for the distribution and determinants among drug-related deaths at the first point of contact enhances the capacity to recognize actionable trends at the local, state, and national levels, including the ability to identify secular (longer-term) trends among various drugs and population subgroups, as well as activity spikes (outbreaks) associated with high-potency formulations and drug combinations. In this article, we describe the development and implementation of an online website that provides public access to a wide array of drug-related death surveillance resources and tools. The website gives users access to a detailed dataset that includes information regarding specific drugs, demographic information pertaining to the decedent, and to investigational findings related to the circumstances of the death. A unique aspect of the database is that it is populated by ME/C agencies and accessed by the public with no intermediary agency, so that the lag time between the identification and investigation of the death as drug-related and community knowledge of the circumstances of the death is minimized. Wide dissemination of accurate drug death surveillance information in an easily accessible and customizable format promotes societal awareness of the drug death epidemic, but also provides information to public health, law enforcement, regulatory, and other community-based organizations that can benefit from the most up-to-date knowledge. We envision a national system of surveillance at the regional ME/C level that would allow for optimal information dissemination and sharing. Such a system would likely allow for more efficacious allocation of resources at the regional and national level.

Role of the Medical Examiner in Zika Virus and Other Emerging Infections

2016 ◽  
Vol 141 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Veena D. Singh ◽  
Sarah L. Lathrop
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Zika Virus ◽  
Emerging Infectious Diseases ◽  
Hantavirus Pulmonary Syndrome ◽  
Medical Examiner ◽  
Public Health Approach ◽  
Emerging Infections ◽  
Medical Examiners

Context.—Medical examiners and coroners have long been an integral component of public health, often being the first to recognize and describe emerging infectious diseases. Given their experience and access, medical examiners and coroners will provide valuable contributions to better understanding Zika virus infection and its sequelae. Objective.—To review past examples of medical examiner/coroner involvement in recognition of emerging infectious diseases and describe how medical examiners and coroners will be critical in understanding the pathophysiology of Zika infections. Design.—Review of the existing literature on the role of medical examiners and coroners in the identification of emergent infections and the available literature on Zika virus. Results.—Medical examiners and coroners have played a crucial role in identifying numerous emerging infectious diseases such as hantavirus pulmonary syndrome and West Nile virus, and have the expertise and experience to aid in elucidating the pathophysiologic effects of Zika virus and tracking its distribution and risk factors. Conclusions.—Medical examiners and coroners will be a significant factor in the unified public health approach needed to mitigate the effects of Zika virus and other, heretofore unrecognized, infectious diseases.

scholarly journals The training of school-doctors in France: ways of improvement, lessons to share

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Godeau ◽  
S Chenel
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
National Level ◽  
Ministry Of Education ◽  
Medical Work ◽  
School Students ◽  
Public Health Perspective ◽  
Children And Adolescent ◽  
New School ◽  
Broad Public Health

Abstract In France protection & prevention of students' health in schools is taken care of by school-doctors, in partnership. They follow a specific training for a year before becoming civil servants in the Ministry of Education. Around 1000 school-doctors are currently in post; 20-30 new school-doctors are trained each year. The training alternates academic sessions & supervised medical work in schools, under the responsibility of experienced mentors. Since 15 years, this training has been revised to improve its relevance in a Public health perspective, mainly by adding a strong health promotion component. The current organisation aims at (1) individualising the training, capitalising on the knowledge & competencies of trainees, leading to an individual scheme defined with the national coordinators (a school-doctor and a pedagogical engineer) between 8 & 16 weeks of academic sessions given at the French school of Public health; (2) articulating academic contents with pragmatic & professional skills; (3) integrating pedagogical innovations to maximise the development of the 10 competencies identified as core to school-doctors; (4) giving school-doctors a broad Public health perspective, with research and health promotion expertise, while fostering their specific and particular medical practice in the global context of schools. Each year improvements are implemented to answer the feed-back from trainees and professionals involved in the training. A closer articulation between local heads of school-doctors and the national level of their training has been fostered to improve coherence between academic & technical content while meeting ministerial requirements. The overall involvement & satisfaction of trainees are monitored. There is still space to improve the training of qualified school-doctors to promote the health of school-students in a Public heath perspective, in a time in France where health inequalities need to be better addressed and where the medical demography is critical. Key messages In a time of lack of medical doctors, school-doctors are important public-health actors for children and adolescent, with a very crucial position at the articulation of the health and school systems. The training of school-doctors must meet the challenge to accommodate pedagogical requirements & changes in their practice due to vacant posts while fulfilling ministerial expectations.

scholarly journals Design and Construction of a Biosafety Level-3 Autopsy Laboratory

2020 ◽  
Author(s):  
Kurt B. Nolte ◽  
Timothy B. Muller ◽  
Adam M. Denmark ◽  
Ron Burstein ◽  
Yvonne A. Villalobos
Keyword(s):  
Public Health ◽  
Health Concern ◽  
Medical Examiner ◽  
Emerging Infections ◽  
Laboratory Design ◽  
Control And Prevention ◽  
Level 3 ◽  
Medical Examiners ◽  
Biosafety Level ◽  
Design And Construction

ABSTRACT Context: Autopsy pathologists including medical examiners provide valuable public health support for infectious disease deaths through surveillance for deaths of public health concern including emerging infections, identifying causative organisms for unexplained deaths, and providing insights into the pathology and pathogenesis of novel or unusual infections. However, autopsy poses biosafety risks to workers within and outside the laboratory. The highest rates of laboratory acquired infections occur in autopsy workers. Objective: To design and construct an appropriately biosafe autopsy laboratory. Design: We conducted a biosafety risk assessment for autopsy workers using the process developed by the U.S. Centers for Disease Control and Prevention and National Institutes of Health and applied these findings as the basis of laboratory design and construction. Results: Autopsy workers are unpredictably exposed to a variety of infectious organisms including hepatitis C virus, HIV and M. tuberculosis. Hazardous autopsy procedures include using and encountering sharp objects, and the generation of aerosols from dissection, fluid aspiration, rinsing tissues, and dividing bone with an oscillating saw. Conclusions: Exposure to bloodborne and airborne pathogens from procedures that can cause cutaneous inoculation and inhalation of aerosols indicates that human autopsies should be performed at Biosafety Level 3. We designed a large entirely Biosafety Level 3 medical examiner autopsy laboratory using design principles and characteristics that can be scaled to accommodate smaller academic or other hospital-based autopsy spaces. Containment was achieved through a concentric ring design, with access control at interface zones. As new autopsy laboratories are planned, we strongly recommend that they be designed to function uniformly at Biosafety Level 3.

Department of Health consultation on medical examiners and death certification reforms: A commentary on the criteria for notification to be laid down in regulation

2017 ◽  
Vol 57 (3) ◽  
pp. 152-157 ◽  
Author(s):  
Andrew Harris
Keyword(s):  
Medical Literature ◽  
Medical Examiner ◽  
Death Certification ◽  
Health Consultation ◽  
Department Of Health ◽  
Unnatural Death ◽  
Death Notification ◽  
Fit For Purpose ◽  
Heavy Workload ◽  
Medical Examiners

The Department of Health has completed its consultation on the nature of the new medical examiner system and supporting regulations. This article considers whether the regulations for death notification to coroners are fit for purpose in the light of the medical literature on unnatural deaths and the experience of a coroner in a jurisdiction with a heavy workload from specialist hospital referrals. It concludes that they are to be welcomed, but that they should not rely on natural/unnatural death as a criterion for notification of deaths during the course of medical treatment, or refer to ‘neglect’. Furthermore, they should ensure that sudden-death syndromes, which may be considered by doctors as natural, are still notified. Relying on these changes to reduce coronial investigations would be unwise. If that is the intention, other reforms may be necessary.

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