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Year: 2017

Academic Anesthesia Faculty Salaries: Incentives, and Productivity

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In the United States, financial compensation for academic anesthesiologists has usually been based on rank and/or clinical time. Typically, faculty salaries would increase with seniority and the associated increases in rank (i.e., assistant professor associate professor full professor). Since most of the actual financial compensation is derived from clinical activity, a certain clinical expectation (i.e., usually number of days per week in the operating room plus call) would be expected. If a faculty member has research grants, money from the grant may be used to help pay a faculty member’s salary and increase his or her nonclinical time. These are the principles by which academic departments have for years compensated their faculty, although there have undoubtedly been many variations. Over the past 10 to 15 years, many American academic anesthesia departments have increasingly had problems with recruiting and retaining faculty (especially junior faculty), making it difficult to provide clinical coverage for all of the...

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Pulmonary Embolism as Cause of Cardiac Arrest

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Background: Pulmonary embolism (PE) is a possible noncardiac cause of cardiac arrest. Mortality is very high, and often diagnosis is established only by autopsy. Methods: In a retrospective study, we analyzed clinical presentation, diagnosis, therapy, and outcome of patients with cardiac arrest after PE admitted to the emergency department of an urban tertiary care hospital. Results: Within 8 years, PE was found as the cause in 60 (4.8%) of 1246 cardiac arrest victims. The initial rhythm diagnosis was pulseless electrical activity in 38 (63%), asystole in 19 (32%), and ventricular fibrillation in 3 (5%) of the patients. Pronounced metabolic acidosis (median pH, 6.95, and lactate level, 16 mmol/L) was found in most patients. In 18 patients (30%), the diag- nosis of PE was established only postmortem. In 42 (70%) it was diagnosed clinically, in 24 of them the diagnosis of PE was confirmed by echocardiography. In 21 patients, 100 mg of recombinant tissue-type plasminogen activator was administered

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Problem Oriented Guides for Police Problem-Specific Guides Series Guide No. 48 Bank Robbery

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The United States experienced a dramatic increase in bank robberies between 1965 and 1975, when the number of crimes quadrupled from 847 to 3,517. Despite the enactment of the federal Bank Protection Act in 1968, robberies continued to rise through the early 1990s and now average around 8,800 per year (see Figure 1).§ Other countries have faced similar fluctuations in the number of bank robberies. For the most part, the incidence of bank robbery is closely related to other crime trends, especially commercial robbery. In the United States, banks have comprised an increasing proportion of the nation’s commercial robberies: in 1989, 6 percent of commercial robberies were of banks; this proportion increased steadily to 9 percent in 2004. (See Figure 2.)§§ Although bank robberies track crime trends, they vary by the size of the jurisdiction. In recent years, bank robberies in smaller U.S. cities have comprised an increasing share of commercial robberies: nearly 12 percent of commercial robberies in smaller cities are...

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The Use of LSD In Analytical Psychotherapy

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The use of LSD in analytical psychotherapy is based mainly on the following psychic effects.

In LSD inebriation the accustomed world view undergoes a deep-seated transformation and disintegration. Connected with this is a loosening or even suspension of the I-you barrier. Patients who are bogged down in an egocentric problem cycle can thereby be helped to release themselves from their fixation and isolation. The result can be an improved rapport with the doctor and a greater susceptibility to psychotherapeutic influence. The enhanced suggestibility under the influence of LSD works toward the same goal.

Another significant, psychotherapeutically valuable characteristic of LSD inebriation is the tendency of long forgotten or suppressed contents of experience to appear again in consciousness. Traumatic events, which are sought in psychoanalysis, may then become accessible to psychotherapeutic treatment. Numerous case histories tell of experiences from even the earliest childhood that were vividly recalled during psychoanalysis under the influence of LSD. This does not involve an ordinary recollection, ...

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LSD Use and Effects

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LSD Use and Effects

Use

LSD is ingested orally. A microdot tablet or square ofthe perforated LSD paper is placed in the userps mouth, chewed or swallowed, and the chemical is absorbed from the individualps gastrointestinal system. Paper squares are the preferred medium because their small size makes them easy to conceal and ingest. Also, because LSD is not injected or smoked, paraphernalia are not required.

The National Household Survey on Drug Abuse data for LSD are limited to estimates of lifetime use, defined as the use of LSD at least once in a personps lifetime. During 1993, 13.2 million Americans, 12 years of age and older, reported having used LSD at least once compared to 8.1 million in 1985, an increase of more than 60 percent. In addition to the steady increase in LSD use since 1990, the data reveal two significant expansions in the number of lifetime users of LSD; one expansion occurred from 1985 to 1988 and the other from 1990 to 1991.

Source Document: Travel Back to the DEA Home Page

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A Short Guide About Hallucinogenic Drugs

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LSD Use and Effects

Use

LSD is ingested orally. A microdot tablet or square ofthe perforated LSD paper is placed in the userps mouth, chewed or swallowed, and the chemical is absorbed from the individualps gastrointestinal system. Paper squares are the preferred medium because their small size makes them easy to conceal and ingest. Also, because LSD is not injected or smoked, paraphernalia are not required.

The National Household Survey on Drug Abuse data for LSD are limited to estimates of lifetime use, defined as the use of LSD at least once in a personps lifetime. During 1993, 13.2 million Americans, 12 years of age and older, reported having used LSD at least once compared to 8.1 million in 1985, an increase of more than 60 percent. In addition to the steady increase in LSD use since 1990, the data reveal two significant expansions in the number of lifetime users of LSD; one expansion occurred from 1985 to 1988 and the other from 1990 to 1991.

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Why Lying Pays: Truth Bias in the Communication with Conflicting Interests

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Abstract

We conduct experiments of a cheap-talk game with incomplete information in which one sender type has an incentive to misrepresent her type. Although that Sender type mostly lies in the experiments, the Receiver tends to believe the Sender’s messages. This confirms “truth bias” reported in communication theory in a one-shot, anonymous environment without nonverbal cues. These results cannot be explained by existing refinement theories, while a bounded rationality model explains them under certain conditions. We claim that the theory for the evolution of language should address why truthful communication survives in the environment in which lying succeeds.

1 Introduction

Verbal communication can occur even between senders and receivers with conflicting interests, and is often accompanied by lying and suspicion. Some communication-theoretic literature reports that, even in such situations, although senders usually lie, most receivers believe senders’ messages; this is called “truth bias,” the receiver’s intrinsic presumption that the senders are telling the truth (McCornack and Parks, 1986). The purpose of this paper is to...

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Psychiatric Malpractice: Stories of Patients, Psychiatrists, and the Law

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Abstract

Psychiatric Malpractice

Psychiatric Malpractice is written by an attorney who has a history of bipolar disease. It is particularly suited to the novitiate psychiatrist and the general psychiatrist who wants to know about the liability aspect of psychiatric practice.

James Kelley presents classic malpractice cases with good and bad outcomes for the patient: prescription for the wrong medication, release of patients who were still acutely ill, violence by a patient against another person, and unusual disputes about the standard of psychiatric care. Of particular interest are cases of sexual misconduct by psychiatrists. In California Medical Board punishments, sexual misconduct with a patient is near the top of the list along with drugs. Kelley chose the cases not only for their intrinsic interest, but also because of the legal issues involved and the public attention evoked.

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Qualifications Of Agreement Of Phychiatric Diagnosis Revisited

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Abstract

Eighteen years ago in this journal, Spitzer and colleagues1 published "Quantification of Agreement in Psychiatric Diagnosis," in which they argued that a new measure, Cohen's k statistic,2 was the appropriate index of diagnostic agreement in psychiatry. They pointed out that other measures of diagnostic reliability then in use, such as the total percent agreement and the contingency coefficient, were flawed as indexes of agreement since they either overestimated the discriminating power of the diagnosticians or were affected by associations among the diagnoses other than strict agreement. The new statistic seemed to overcome the weaknesses of the other measures. It took into account the fact that raters agree by chance alone some of the time, and it only gave a perfect value if there was total agreement among the raters. Furthermore, generalizations of the simple k statistic were already available. This family of statistics could be used to assess...

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Liability of the Psychiatrist for Improper Commitment

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An important category of cases of alleged psychiatric malicious practice involves actions for false and improper commitment of a person to a mental institution, an action sometimes based upon statute but more often arrived at by a common law false imprisonment or malicious prosecution action. This consideration poses an interesting concrete question: If a psychiatrist conspires with a patient's relative to commit the patient to an institution because of alleged insanity, and writes to a court requesting confinement of the patient, is the psychiatrist liable for damages where the court later finds the patient was not insane and orders him released ?

Malicious Prosecution
The answer to this intriguing query is to be found in Loweii vs Hilton (351 P 2d 881), decided by the Supreme Court of Colorado in I960. In that case the plaintiff brought a suit for malicious prosecution against his brother and a psychiatrist. He charged that they had conspired to institute lunacy proceedings against him. The plaintiff's brother had signed...

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Human Mate Poaching: Tactics And Tempations For Infiltrating Existing Mateships

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Abstract

The authors explored the psychology of romantically attracting someone who is already in a relationship--what can be called the process of human mate poaching. In Study 1 (N = 236), they found that attempts at poaching were relatively common and were linked with distinctive personality dispositions. Study 2 (N = 220) documented that the perceived costs and benefits of poaching differed somewhat for men and women and depended on whether short-term or long-term poaching outcomes were targeted. Study 3 (N = 453) found support for 5 evolution-based hypotheses about the perceived effectiveness of poaching tactics. Study 4 (N = 333) found that poaching effectiveness was influenced by the type of relationship being encroached on-marital, dating, long distance, highly committed, just beginning, or about to end. Discussion focuses on the importance of placing mate poaching within the broader context of human sexual strategies...

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Concealment of Psychopathology in Forensic Evaluations: A Pilot Study of Intentional and Uninsightful Dissimulator

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Both clinical and forensic psychiatrists recognize that individuals whom they evaluate may be unreliable historians. Clinical psychiatrists are diligent in attending to the possibility that patients may not be forthcoming with all of their symptoms, beliefs, or personal history. For example, consider a clinician’s skepticism about the claims of a delusional paranoid schizophrenic brought to a clinic by his concerned family members or about the denials of suicidal intent of a depressed patient brought to the emergency room for a drug overdose. Clinicians approach cases such as these recognizing that patients may withhold critical information about their psychopathology, whether because of paranoid fears, in response to voices they hear, covert suicidal intent, desires to appear “normal,” or other motives. Forensic practitioners approach evaluations with a somewhat different focus, colored chiefly by inclusion of strategies to detect the possibility of malingering. It is certainly reasonable to be skeptical of a forensic evaluee’s claimed symptoms and complaints in light of the secondary gain attached to the outcome of the evaluation, whether it involves obtaining financial compensation or evading or minimizing...

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Common Psychosexual Disorders: Presentation And Management

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Introduction

During the last decade effective, short term treatment of the major psychosexual disorders has become a reality. For the general practitioner, who seeks to provide developing standards of patient-care, this may bring new expectations and responsibilities, for which he or she may feel ill equipped by virtue of training. In this paper we will be considering the main categories of dysfunction, in terms of established characteristics and principles of treatment. It is hoped that this outline will provide a source of information to the GP, who may wish to participate in aspects of management, in suitable cases, or refer when special expertise is required. Psychological and relationship aspects of aetiology will be considered first on account of their prominence as causative factors. The discussion will, again, be limited to heterosexual problems in couples. Classification of psychosexual disorders is, broadly speaking, either by function (eg. erectile impotence, premature ejaculation) or by phase (e.g. desire, excitement, orgasm) affected. A simplified representation of the main disorders, with outlines...

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