Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914475
Sarah J. Diekman
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
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914489
Ryliezl Abby Reyes, Stephanie Quan, Joseph P. Hardy, W. Havins
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914479
Proma Mazumder, Crystal Yung, C. Vanier, Joseph P. Hardy
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%)
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914490
Ali Said, L. Sánchez, M. Olek, Weldon Havins
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914478
Meghan Mahalawat, Nur Fatimah Mirza, C. Vanier, W. Havins
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
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914477
Seung Joon Hwang, M. Kim, W. Havins
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...
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914469
Stephanie N Bernardo, Kylie Zeng, W. Havins
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.
背景:新冠肺炎疫情在中国武汉爆发以来，世界各国被迫采取前所未有的防控措施。虽然一些国家仍在与COVID-19大流行作斗争，但其他国家的情况较好，并迅速建立了相对正常的状态。该病毒的快速传播速度表明，更需要采取有效和技术现代化的遏制措施。在应对COVID-19大流行表现良好的国家，利用数字工具促进严格的控制措施既引发了兴趣，也引发了争议。目的:在本研究中，我们比较了针对COVID-19传播所采取的预防措施，特别是在接触者追踪中使用数字工具的情况，并提出了可在美国用于未来COVID-19浪潮或大流行的政策。方法:2019年12月31日至2020年9月6日，从欧洲疾病预防控制中心(ECDC)通过Our World in data数据库获取COVID-19死亡率数据，并根据每10万人的人口规模进行评估。所有制定的政策和措施均来自各自的政府网站。结果:我们发现，较低的人均死亡率与实施早期口罩使用和严格边境控制措施(包括使用数字工具强制隔离)的国家之间存在密切关联。台湾、韩国、新加坡与美国、西班牙、意大利相比，每10万人中死亡人数相差很大。结论:根据我们的研究，显然使用数字工具进行早期干预与遏制COVID-19具有很强的相关性。在意大利、西班牙，特别是美国，如果早期使用口罩，更重要的是，及时采取利用现代数字工具的边境控制措施，感染率和随后的死亡率本可以低得多。因此，我们建议美国在宣布公共卫生紧急情况时执行以下国家政策:(1)立即建立一个国家指挥部，负责制定由联邦和州政府执行的严格强制性指导方针，包括全国口罩使用。(2)在接触者追踪和检疫令方面与卫生官员进行民事合作。到美国的入境旅客和被隔离的人将被要求下载接触者追踪应用程序。我们承认，我们研究的国家在文化、政治制度和COVID-19死亡报告标准方面存在差异。可能需要进行进一步的研究来解决这些限制;然而，我们认为拟议的政策可以保护美国公众。
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914485
J. Parra, Heerod Malekghassemi, Joseph P. Hardy, W. Havins
{"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":null,"pages":null},"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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914491
Emily Silver
COVID-19 and Firearms: Public Health Considerations Emily M. Silver, MA; esilver3@uchicago.edu Department of Psychology Integrative Neuroscience Program, The University of Chicago, IL The global SARS-CoV-2 (otherwise known as COVID-19) pandemic has wreaked havoc across the world, infected over 100 million people and resulted in the deaths of approximately 2 million people to date (1). The need for people to remain physically separated from one another to reduce the spread of disease has resulted in many public health, corporate, and government policy changes. One particularly troubling phenomenon has been the increase in the rates of deaths by firearm violence in the US in 2020 (2). The evolving literature has documented increases across a number of inter-related issues including mental health conditions (3), suicide rates (4), violence (5), and firearm purchases (6). It is of paramount importance to recognize these trends and discuss the implications regarding short-term and long-term effects as well as how they may affect the delivery of health services. Pandemic-related Increases: Firearms Firearms have been purchased at historic rates during the pandemic (Mannix et al). Firearm sales in March 2020 increased by 85% from the previous year (7), resulting in an estimated 2.1 million excess firearm sales (6). The recent surge in firearm purchases is likely linked at least in part to the pandemic, which has induced heightened states of uncertainty and anxiety. The pandemic is associated with increased worry about violence, both for oneself and others, as well as increased firearm acquisition and changes in practices related to storage of firearms, including unlocked storage (8,9). Intent to purchase a firearm in the next twelve months is associated with more severe anxiety specific to COVID-19 (10). Therefore, not only are sales of firearms increasing, but people may be buying them in reaction to fears resulting from the pandemic. Pandemic-related Increases: Mental Health Conditions Measures intended to limit the spread of the virus, such as city-wide lockdowns and social distancing policies, have also induced pervasive psychological distress (11). Social isolation and loneliness, known risk factors for depression 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 42–46 https://doi.org/10.1080/01947648.2021.1914491 and feelings of hopelessness, likely contribute to the prevalence of anxiety and depression (12). An analysis of depressive symptomology in the US found a 3fold increase during the COVID-19 pandemic as compared to before (13). The pandemic has also been associated with disruptions in sleep (11,14), substance abuse (11,15), and posttraumatic stress (16,17). Frontline health workers are at particular risk for an increase in anxiety and depression (18). Pandemic-related Increases: Suicide Increases in prevalence of psychopathology and mental health crises during the pandemic has brought on concerns abou
尽管人们普遍认为，精神健康诊断、咨询，甚至是针对精神健康状况的药物治疗，都使个人丧失了行医资格
{"title":"COVID-19 and Firearms: Public Health Considerations","authors":"Emily Silver","doi":"10.1080/01947648.2021.1914491","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914491","url":null,"abstract":"COVID-19 and Firearms: Public Health Considerations Emily M. Silver, MA; esilver3@uchicago.edu Department of Psychology Integrative Neuroscience Program, The University of Chicago, IL The global SARS-CoV-2 (otherwise known as COVID-19) pandemic has wreaked havoc across the world, infected over 100 million people and resulted in the deaths of approximately 2 million people to date (1). The need for people to remain physically separated from one another to reduce the spread of disease has resulted in many public health, corporate, and government policy changes. One particularly troubling phenomenon has been the increase in the rates of deaths by firearm violence in the US in 2020 (2). The evolving literature has documented increases across a number of inter-related issues including mental health conditions (3), suicide rates (4), violence (5), and firearm purchases (6). It is of paramount importance to recognize these trends and discuss the implications regarding short-term and long-term effects as well as how they may affect the delivery of health services. Pandemic-related Increases: Firearms Firearms have been purchased at historic rates during the pandemic (Mannix et al). Firearm sales in March 2020 increased by 85% from the previous year (7), resulting in an estimated 2.1 million excess firearm sales (6). The recent surge in firearm purchases is likely linked at least in part to the pandemic, which has induced heightened states of uncertainty and anxiety. The pandemic is associated with increased worry about violence, both for oneself and others, as well as increased firearm acquisition and changes in practices related to storage of firearms, including unlocked storage (8,9). Intent to purchase a firearm in the next twelve months is associated with more severe anxiety specific to COVID-19 (10). Therefore, not only are sales of firearms increasing, but people may be buying them in reaction to fears resulting from the pandemic. Pandemic-related Increases: Mental Health Conditions Measures intended to limit the spread of the virus, such as city-wide lockdowns and social distancing policies, have also induced pervasive psychological distress (11). Social isolation and loneliness, known risk factors for depression 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 42–46 https://doi.org/10.1080/01947648.2021.1914491 and feelings of hopelessness, likely contribute to the prevalence of anxiety and depression (12). An analysis of depressive symptomology in the US found a 3fold increase during the COVID-19 pandemic as compared to before (13). The pandemic has also been associated with disruptions in sleep (11,14), substance abuse (11,15), and posttraumatic stress (16,17). Frontline health workers are at particular risk for an increase in anxiety and depression (18). Pandemic-related Increases: Suicide Increases in prevalence of psychopathology and mental health crises during the pandemic has brought on concerns abou","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80241689","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}
Pub Date : 2021-05-21DOI: 10.1080/01947648.2021.1914484
Ellie Ok, Kristine Rosas, W. Havins
Euthanasia Should Be Legalized in Nevada Ellie Ok, MS, OMSII; eok@student.touro.edu Kristine Rosas, OMSII; krosas@student.touro.edu Weldon Havins, MD, JD, LLM, FCLM, Emeritus Professor Touro University Nevada College of Osteopathic Medicine Current palliative care option for terminally ill patients disregards the autonomy of patients in some cases. These patients may request euthanasia with the intent to make an autonomous decision and gain back some control that they have lost to the disease. As physicians, we should strive to understand the rationale behind the patient’s request of euthanasia to alleviate suffering and provide the most suitable care that preserves the patients’ dignity and autonomy. The purpose of our research is to propose the legalization of euthanasia in Nevada for terminal patients. To examine the legality and morality of euthanasia, we applied the four biomedical ethics principles (autonomy, justice, beneficence, and maleficence) to the use of this practice. The number of cases of euthanasia and Physician-Assisted Suicides (PAS) in Netherlands and Canada were analyzed. Reports of PAS cases in Canada were obtained from Regional Euthanasia Review Committees and Interim Reports. Individual statutes and numerous studies were reviewed to compare the qualifications and requirements of euthanasia and PAS in different countries. This study found that in countries where both euthanasia and PAS are legal, euthanasia occurs at a higher rate than PAS. In Netherlands, the incidence of euthanasia from 2002 and 2010 to 2018 was 1672, 2910, 5277, 5856, 6303, and 5898 whereas PAS was 184, 182, 208, 216, 250, and 212. In Canada, the occurrence of euthanasia from 2016 to 2018 was 503, 1960, and 2613 compared to four, one, and one PAS cases. Although euthanasia is illegal in the United States, patients showed higher support for euthanasia over PAS, finding euthanasia to be more acceptable (67%) than assisted suicide (33%). We carefully compared and studied the qualifications of euthanasia in other countries to propose our guidelines for Nevada. We acknowledge that there should be strict limitations and documentation of cases to limit its abuse. Further studies are needed to examine the validity of child euthanasia or other vulnerable populations. More 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 32–33 https://doi.org/10.1080/01947648.2021.1914484 training and education of medical professionals in palliative care is indicated. This research highlights and challenges the need for change in our current palliative care options to include euthanasia. References upon request 33
{"title":"Euthanasia Should Be Legalized in Nevada","authors":"Ellie Ok, Kristine Rosas, W. Havins","doi":"10.1080/01947648.2021.1914484","DOIUrl":"https://doi.org/10.1080/01947648.2021.1914484","url":null,"abstract":"Euthanasia Should Be Legalized in Nevada Ellie Ok, MS, OMSII; eok@student.touro.edu Kristine Rosas, OMSII; krosas@student.touro.edu Weldon Havins, MD, JD, LLM, FCLM, Emeritus Professor Touro University Nevada College of Osteopathic Medicine Current palliative care option for terminally ill patients disregards the autonomy of patients in some cases. These patients may request euthanasia with the intent to make an autonomous decision and gain back some control that they have lost to the disease. As physicians, we should strive to understand the rationale behind the patient’s request of euthanasia to alleviate suffering and provide the most suitable care that preserves the patients’ dignity and autonomy. The purpose of our research is to propose the legalization of euthanasia in Nevada for terminal patients. To examine the legality and morality of euthanasia, we applied the four biomedical ethics principles (autonomy, justice, beneficence, and maleficence) to the use of this practice. The number of cases of euthanasia and Physician-Assisted Suicides (PAS) in Netherlands and Canada were analyzed. Reports of PAS cases in Canada were obtained from Regional Euthanasia Review Committees and Interim Reports. Individual statutes and numerous studies were reviewed to compare the qualifications and requirements of euthanasia and PAS in different countries. This study found that in countries where both euthanasia and PAS are legal, euthanasia occurs at a higher rate than PAS. In Netherlands, the incidence of euthanasia from 2002 and 2010 to 2018 was 1672, 2910, 5277, 5856, 6303, and 5898 whereas PAS was 184, 182, 208, 216, 250, and 212. In Canada, the occurrence of euthanasia from 2016 to 2018 was 503, 1960, and 2613 compared to four, one, and one PAS cases. Although euthanasia is illegal in the United States, patients showed higher support for euthanasia over PAS, finding euthanasia to be more acceptable (67%) than assisted suicide (33%). We carefully compared and studied the qualifications of euthanasia in other countries to propose our guidelines for Nevada. We acknowledge that there should be strict limitations and documentation of cases to limit its abuse. Further studies are needed to examine the validity of child euthanasia or other vulnerable populations. More 2021 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2021, VOL. 41, NO. S1, 32–33 https://doi.org/10.1080/01947648.2021.1914484 training and education of medical professionals in palliative care is indicated. This research highlights and challenges the need for change in our current palliative care options to include euthanasia. References upon request 33","PeriodicalId":44014,"journal":{"name":"Journal of Legal Medicine","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81730119","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}
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