The Federal Reporter


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Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




The Insanity Defense


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Presumption of Guilt


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In India, a man spent 54 years behind bars in pretrial detention, waiting for a trial that would never happen because his file had been lost. In Nigeria, one study estimated that the average detainee waits over three years for his day in court. In Russia, pretrial detainees have begged for the chance to plead guilty, just so they can receive medical care. And in the United States, juvenile pretrial detainees have been forced to fight each other for their guards' amusement. Around the world, millions are effectively punished before they are tried. Legally entitled to be considered innocent and released pending trial, many accused are instead held in pretrial detention, where they are subjected to torture, exposed to life threatening disease, victimized by violence, and pressured for bribes. It is literally worse than being convicted: pretrial detainees routinely experience worse conditions than sentenced prisoners. The suicide rate among pretrial detainees is three times higher than among convicted prisoners, and ten times that of the outside community. Pretrial detention harms individuals, families, and communities; wastes state resources and human potential; and undermines the rule of law. The arbitrary and excessive use of pretrial detention is a massive and widely ignored pattern of human rights abuse that affects-by a conservative estimate-15 million people a year. The right to be presumed innocent until proven guilty is universal, but at this moment some 3.3 million people are behind bars, waiting for a trial that may be months or even years away. No right is so broadly accepted in theory, but so commonly violated in practice. It is fair to say that the global overuse of pretrial detention is the most overlooked human rights crisis of our time. Presumption of Cuilt examines the full consequences of the global overuse of pretrial detention. Combining statistical analysis, first-person accounts, graphics, and case studies of successful reforms, the report is the first to comprehensively document this widespread but frequently ignored form of human rights abuse. Book jacket.




Evidence-Based Practices and Treatments for Children with Autism


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Autism spectrum disorders (ASDs) have been increasingly diagnosed in recent years and carries with it far reaching social and financial implications. With this in mind, educators, physicians, and parents are searching for the best practices and most effective treatments. But because the symptoms of ASDs span multiple domains (e.g., communication and language, social, behavioral), successfully meeting the needs of a child with autism can be quite challenging. Evidence-Based Practices and Treatments for Children with Autism offers an insightful and balanced perspective on topics ranging from the historical underpinnings of autism treatment to the use of psychopharmacology and the implementation of evidence-based practices (EBPs). An evaluation methodology is also offered to reduce the risks and inconsistencies associated with the varying definitions of key autism terminology. This commitment to clearly addressing the complex issues associated with ASDs continues throughout the volume and provides opportunities for further research. Additional issues addressed include: Behavioral excesses and deficits treatment Communication treatment Social awareness and social skills treatment Dietary, complementary, and alternative treatments Implementation of EBPs in school settings Interventions for sensory dysfunction With its holistic and accessible approach, Evidence-Based Practices and Treatments for Children with Autism is a vital resource for school psychologists and special education professionals as well as allied mental health professionals, including clinical child and developmental psychologists, psychiatrist, pediatricians, primary care and community providers.