Featured Research Studies
MCS America
Int J Law Psychiatry. 2008 Jan 7 [Epub ahead of print]
The impact of judges' perceptions of credibility in fibromyalgia claims.
Le Page JA, Iverson GL, Collins P.
University of British Columbia, Department of Psychiatry, Vancouver, B.C., Canada.
Fibromyalgia (FM) is a confusing and controversial diagnosis, characterized by widespread pain and tenderness at specific anatomical sites. The cause of this syndrome is unknown, and the course of the condition is difficult to predict. Without a known cause, predictable course, or effective treatment, it is not surprising that FM is a contentious diagnosis from a medical perspective, as well as a civil litigation and disability insurance industry perspective. The purpose of this study was to investigate judges' perceptions of credibility in litigated cases involving FM claims in the Canadian courts, and the relation between perceived credibility and awards granted. A systematic review was conducted of every trial-by-judge litigated FM claim in Canada (N=194 cases) up to 2003. The cases were examined in relation to credibility factors. The role and responsibility of the plaintiff was central in claims involving issues of misrepresentation, fraud, non-disclosure, failure to mitigate, and contributory negligence. The presence of these issues suggested a possible decrease or loss in the claim as a result of the plaintiff's conduct. In regards to the actions of defendants, the presence of investigative and surveillance information alone did not affect the awards granted. However, the credibility of that information had a large effect on the amount of award granted. Plaintiff credibility played a similar role, indicating that plaintiffs perceived as more credible were typically granted greater awards. An examination of medical expert credibility revealed that judges appear to perceive experts as more credible overall than plaintiffs, regardless of the expert's role in the case.
PMID: 18191454 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/18191454?dopt=AbstractPlus
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Environmental Health Perspectives Volume 116, Number 1, January 2008
Air Pollution and Postneonatal Infant Mortality in the United States, 1999–2002
Tracey J. Woodruff,1* Lyndsey A. Darrow,2 and Jennifer D. Parker3
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA; 2Department of Epidemiology, Emory University, Atlanta, Georgia, USA; 3National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
Abstract
Objective: Our goal was to evaluate the relationship between cause-specific postneonatal infant mortality and chronic early-life exposure to particulate matter and gaseous air pollutants across the United States.
Methods: We linked county-specific monitoring data for particles with aerodiameter of ≤ 2.5 µm (PM2.5) and ≤ 10 µm (PM10) , ozone, sulfur dioxide, and carbon monoxide to birth and death records for infants born from 1999 to 2002 in U.S. counties with > 250,000 residents. For each infant, we calculated the average concentration of each pollutant over the first 2 months of life. We used logistic generalized estimating equations to estimate odds ratios of postneonatal mortality for all causes, respiratory causes, sudden infant death syndrome (SIDS) , and all other causes for each pollutant, controlling for individual maternal factors (race, marital status, education, age, and primiparity) , percentage of county population below poverty, region, birth month, birth year, and other pollutants. This analysis includes about 3.5 million births, with 6,639 postneonatal infant deaths.
Results: After adjustment for demographic and other factors and for other pollutants, we found adjusted odds ratios of 1.16 [95% confidence interval (CI) , 1.06–1.27] for a 10-µg/m3 increase in PM10 for respiratory causes and 1.20 (95% CI, 1.09–1.32) for a 10-ppb increase in ozone and deaths from SIDS. We did not find relationships with other pollutants and for other causes of death (control category) .
Conclusions: This study supports particulate matter air pollution being a risk factor for respiratory-related postneonatal mortality and suggests that ozone may be associated with SIDS in the United States.
Environ Health Perspect 116:110–115 (2008) . doi:10.1289/ehp.10370 available via http://dx.doi.org/ [Online 24 October 2007]
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http://www.ehponline.org/docs/2007/10370/abstract.html
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Semin Arthritis Rheum. 2008 Jan 11 [Epub ahead of print]
Central Sensitivity Syndromes: A New Paradigm and Group Nosology for Fibromyalgia and Overlapping Conditions, and the Related Issue of Disease versus Illness.
Yunus MB.
Professor of Medicine, Section of Rheumatology, The University of Illinois College of Medicine at Peoria, Peoria, Illinois.
OBJECTIVES: To discuss the current terminologies used for fibromyalgia syndrome (FMS) and related overlapping conditions, to examine if central sensitivity syndromes (CSS) is the appropriate nosology for these disorders, and to explore the issue of disease versus illness. METHODS: A literature search was performed through PubMed, Web of Science, and ScienceDirect using a number of keywords, eg, functional somatic syndromes, somatoform disorders, medically unexplained symptoms, organic and nonorganic, and diseases and illness. Relevant articles were then reviewed and representative ones cited. RESULTS: Terminologies currently used for CSS conditions predominantly represent a psychosocial construct and are inappropriate. On the other hand, CSS seems to be the logical nosology based on a biopsychosocial model. Such terms as "medically unexplained symptoms," "somatization," "somatization disorder," and "functional somatic syndromes" in the context of CSS should be abandoned. Given current scientific knowledge, the concept of disease-illness dualism has no rational basis and impedes proper patient-physician communication, resulting in poor patient care. The concept of CSS is likely to promote research, education, and proper patient management. CONCLUSION: CSS seems to be a useful paradigm and an appropriate terminology for FMS and related conditions. The disease-illness, as well as organic/non-organic dichotomy should be rejected.
PMID: 18191990 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/18191990?dopt=AbstractPlus
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