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Killexams : Medical Certificate answers - BingNews https://killexams.com/pass4sure/exam-detail/ABEM-EMC Search results Killexams : Medical Certificate answers - BingNews https://killexams.com/pass4sure/exam-detail/ABEM-EMC https://killexams.com/exam_list/Medical Killexams : More businesses are offering online medical certificates and telehealth prescriptions. What are the pros and cons?

Telehealth has played an important role during the pandemic. Telephone and online consultations have enabled social distancing and kept patients and clinicians safe from transmissible infections.

Since the start of COVID in March 2020, there have been 122 million telehealth consultations funded through Medicare. About 90% of these services were provided by general practitioners (GPs), with nine out of ten of these consults done as a telephone call.

Online services for prescriptions and medical certificates have become available to at the click of a button. Given the shortage of GPs, difficulties getting timely appointments, and clinic restrictions if patients have COVID-like symptoms, consumers seem to be welcoming these services. Patients can consult a GP by telephone or video call, and then receive an electronically dispatched medical certificate or prescription (if clinically appropriate).

These services are either paid for partially, or totally by the consumer, with limited Medicare rebates available. They are fast, convenient and readily available. But what do consumers need to know about their pros and cons?

On the plus side…

Convenience

Offering services online means ease of access and convenience. We have seen this in the banking, retail and travel industries. Who wants to wait three days for a GP appointment, spend two hours in traffic and one hour in the waiting room, for a short consultation?

Access to care

When providing services, we have to think of our whole population (see points below on equity). These instant services offer greater convenience and benefits for those who find it hard to access transport, are time-poor, or who find it difficult to leave the house (such as parents of little kids or people with other physical disabilities or ).

Reduced wait times

If it isn't possible to get an appointment with your regular GP and you need a medical certificate for work, these services may be a good fit. They also enable acute conditions to be managed in a timely manner, for instance by getting a script for tablets to stop vomiting.

Reducing congestion in hospitals and medical centers

These services also reduce pressure on and hospitals. If someone can be supported by an online service instead of visiting an emergency department or urgent care center, then the bricks-and-mortar hospitals, clinics and medical centers remain available for people with more serious health needs.

But there are also downsides

Continuity of care

The downside is you may risk losing continuity of care, as you are not necessarily going to be seeing your own GP online. If you have complex health needs or chronic conditions, it is better you have a primary care provider who knows your history and can manage your health condition holistically.

Access to a complete health history

Australia doesn't yet have a single complete and integrated information system for sharing all personal health information. So when you access these services, it is often your responsibility to share health information with the provider and also inform your GP about your online appointment.

However, communication systems are improving slowly, and a summary may be shared electronically with your nominated GP after your consultation. For patients who have opted in to My Health Record, some of this communication will happen automatically.

Complex conditions

There are limits to the types of services that can be provided online or by phone. You may need an in-person appointment, especially if a physical assessment is required, or the concerns are more complex than anticipated. GPs adhere to guidelines and practice standards irrespective of how services are delivered. For instance, provision of e-scripts and medical certificates require documentation and screening measures to ensure appropriate care is provided.

Medications

Online or telehealth services aren't suited for starting new medications that require monitoring or might have side effects.

New medications for should ideally be started by someone who you can see you again to check they are working and manage potential side effects or reactions. Additionally, there are medications (such as strong pain relief) these services won't prescribe, and consumers need to see an GP in person to obtain.

Medical certificates aren't just for your boss

Local pharmacists can write medical certificates for single days and assist with advice and medications for minor health issues. However, they cannot write prescriptions.

The aim of a medical certificate is to satisfy an employer. But getting a medical certificate may also be an opportunity to have symptoms checked and make sure there is nothing seriously wrong.

Online services make accessing a medical certificate for the flu or gastro much more convenient. However, if people are having ongoing health issues that require regular time away from work, they should be seeing a regular GP to help manage their condition.

Online doesn't mean equal access

There is the risk of inequity of access for these services, especially for consumers who don't know how to access them, can't afford to pay, or do not have access to the necessary technology (including reliable internet).

A recent paper suggested ways to tackle this digital divide. These included improving digital health literacy, workforce training, co-designing new models of care with clinicians and patients, change management, advocacy for culturally appropriate services, and sustainable funding.

Other points to remember

Finally, consumers need assurance that are provided by suitably qualified health professionals. This is usually achieved with confirmation of health provider credentials prior to, or at the start of, the consultation.

Consumers can also look up their provider through the Australian Health Practitioner Regulation Agency (Ahpra) where all clinicians are registered.

Consumers should also look for an Australian service to ensure it adheres to Australia's quality standards and clinician registration criteria. This is also important because of the Australian standards around personal data collection and storage. Consumers should read information provided by services about their data policies.

As with all health care, it is about finding the right balance and ensuring services align with clinical indications.

Telehealth is not about replacing in-person appointments. Telehealth should be used in conjunction with face-to-face advice, to maintain high-quality care that best suits the needs and wishes of the consumer.

This article is republished from The Conversation under a Creative Commons license. Read the original article.The Conversation

Citation: More businesses are offering online medical certificates and telehealth prescriptions. What are the pros and cons? (2022, November 28) retrieved 9 December 2022 from https://medicalxpress.com/news/2022-11-businesses-online-medical-certificates-telehealth.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Mon, 28 Nov 2022 04:15:00 -0600 en text/html https://medicalxpress.com/news/2022-11-businesses-online-medical-certificates-telehealth.html
Killexams : Hot Air Balloon Safety Rule Finally Enacted

Rep. Lloyd Doggett speaks before Congress about the tragic balloon crash that killed 16 people in Lockhart (Courtesy of Lloyd Doggett's office)

Rep. Lloyd Doggett and a range of people connected to the hot air balloon tragedy that claimed 16 lives in Lockhart over six years ago celebrated last month as the Federal Aviation Administration implemented a new rule requiring commercial hot air balloon pilots to hold medical certificates.

The FAA rule has been years in the making. The Lockhart crash in July 2016 was the deadliest balloon crash in U.S. history and the country's deadliest aviation disaster since 2009, killing 15 passengers and the pilot. In the following months, the National Transportation Safety Board found that the FAA's failure to require pilots to have a medical certificate was a factor in the tragedy and urged the FAA to adopt a rule subjecting them to similar medical certificate requirements that other commercial airline pilots must meet.

But the FAA, which was being lobbied by a trade agency for balloon owners, didn't budge. That left Doggett, who said he occasionally used to see the hot air balloon as he drove on I-35, intent on passing legislation to force the change. In 2018, that's exactly what the House did – passing an amendment to that year's FAA Reauthorization Act.

The fact that it took the FAA some four years to implement the rule was a source of ongoing frustration for Doggett, who linked the delay to another balloon disaster last year when an impaired pilot crashed into power lines and killed himself and four passengers in Albuquerque. "I think basically the FAA did not want to do this, and they drug it out as long as they possibly could," Doggett said.

And this isn't the only issue where the FAA has dragged its feet implementing a congressionally mandated rule in exact years. Doggett pointed to a similarly long delay in implementing a rule requiring extended rest periods for flight attendants as emblematic of bigger issues in an agency he described as oriented more toward the concerns of the companies it regulates than workers and consumers.

"This is not unusual," Mike Slack, an Austin-area aviation attorney who advised Doggett on the bill, said of the FAA delay. "I think the public would be shocked to see the number of instances over the years where the FAA has not taken action ... with unsafe situations." An FAA spokesperson declined to answer specific questions for this story.

Federal officials don't typically check pilots for their medical certificate before each flight, so some pilots could continue to fly without the proper licensure. But Slack thinks the added requirement will have a chilling effect on irresponsible pilots by raising the stakes should they be caught flying without a certificate. In any case, he said, the new rule makes sense on its own merits. "There was no reason why hot air balloon pilots should not have a second-class medical [certificate] for commercial operations when a fixed-wing pilot needed to have a second-class medical for commercial operations," Slack said. "It just never made sense."

Got something to say? The Chronicle welcomes opinion pieces on any subject from the community. Submit yours now at austinchronicle.com/opinion.

Wed, 07 Dec 2022 16:15:00 -0600 en-US text/html https://www.austinchronicle.com/news/2022-12-09/hot-air-balloon-safety-rule-finally-enacted/
Killexams : Clinics warned vs ‘instant’ medical certificates

LTO logo over photo of drivers license and papers. STORY: Clinics warned vs ‘instant’ medical certificates

MANILA, Philippines — The Land Transportation Office (LTO) on Wednesday warned accredited doctors and medical clinics against issuing medical certificates to driver’s license applicants without any actual physical examination.

Under LTO Memorandum Circular 2018-2157, driver’s license applicants should undergo a mandatory periodic medical examination during the validity period of their licenses in any LTO-accredited clinic or government health facility.

There are 632 accredited medical clinics and registered physicians listed on LTO’s website as of July 30.

The agency issued the warning after a medical clinic in Bacolod City issued 186 medical certificates in a day and an LTO agent was able to obtain a medical certificate without a physical examination.

—MARIEJO S. RAMOS

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Wed, 30 Nov 2022 10:00:00 -0600 en text/html https://newsinfo.inquirer.net/1699994/clinics-warned-vs-instant-medical-certificates
Killexams : Students of cannabis

Erin Johnson was enrolled in the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences when she took her first cannabis class. As a student of pharmaceuticals, she says she naturally found the subject fascinating — especially since her father had been growing cannabis since the early days of medical legalization in Colorado.

“My dad is a farmer and he grew cannabis as a caregiver,” Johnson says. “His friend’s wife had breast cancer, so he was growing it [for her].”

Learning about the medical and chemical properties of cannabis in an academic setting excited Johnson. So much so that after graduating from the CU School of Pharmacy, she went on to complete CU’s new graduate certificate in cannabis science and medicine. 

Now she’s making a cannabis salve for her small Colorado mountain community. She calls it Butter Flower Balm, and it’s a product of both her passion for natural medicines and of her CU cannabis education.

Johnson isn’t the only student from CU School of Pharmacy who’s pursued an interest in cannabis through the school’s new certificate program. According to David Kroll, a professor with the Skaggs School of Pharmacy, they’ve got a mix of health professionals, students of science and people already in the cannabis industry enrolling in the new program. 

It’s becoming more robust every semester, Kroll says. There’s a genuine interest in this plant, its medicinal properties, and the industry growing around it. And until recently, there wasn’t an academically accredited way to learn about it. A survey of health professionals by the Mayo Clinic found only half said they were prepared to answer patient questions about medical cannabis, and three-quarters wanted to learn more. 

Realizing that, in the spring of 2020, CU started offering the Cannabis Science and Medicine Program as an eight-week continuing education (CE) certificate. 

“We’ve always felt that we have a responsibility to patients and to practitioners to deliver evidence-based information about plant medicines,” Kroll says. 

The response was so positive, the school decided to take it a step further. In June of 2020, CU announced it was going to offer graduate-level cannabis education, becoming the first school in the state to do so. 

For the coursework, CU tapped its own faculty as well as utilizing experts from outside academia. They bring in clinical practice experts, clinical researchers, medicinal plant chemists and pharmacologists, and legal and regulatory leaders in the cannabis industry to lead case-based discussions. 

“We want to deliver students the tools that even if they can’t get a job in the cannabis industry, they can still get jobs in the dietary supplement, herbal medicine industry, anywhere,” Kroll says. 

The program offers a basic cannabis pharmacology class, a cannabis therapeutics class, a cannabis neurology class, a class about the legal and regulatory issues surrounding cannabis, and Kroll’s cannabis writing class, among others. Then students wrap the certificate program with a capstone project. 

One student is doing their capstone with the Colorado Department of Public Health and Environment, compiling published drug interactions of THC and CBD with the top 200 prescribed drugs in the United States. Another is looking at the concentrations of specific terpenes in the same strains from different dispensaries, to see their chemical similarities. A third student is writing a series of science articles for Cannabis Wire about cannabis issues in New York City. 

The certificate program requires nine-credit hours to complete, with an optional two-credit lab course. It costs $773 per credit (about $7,000 for the nine credits), and all of them can be applied toward a 30-credit hour master of science in pharmaceutical sciences degree with an emphasis on cannabis science and medicine. 

The program also offers a full 30-credit hour master’s degree in cannabis science and medicine, with both a thesis track and a non-thesis track. 

But the best part, Kroll says, is that all of this is offered virtually. 

“Our whole thing has been flexibility for the student,” he says. 

Which is attracting students far and wide. They might be pharmacists, nurses, physicians and other healthcare professionals who want to answer patient questions about cannabis. They might be people already in the cannabis industry, who want to learn more about the plant they’re working with. Or, they might be pharmacists like Johnson, who want to make cannabis products that will help the people around them. 

Johnson’s Butter Flower Balm is a budding business, and a direct result of seeds planted during the CU cannabis and science certification program. She makes the salve with almond seed oil, coconut oil, jojoba oil and extract from cannabis plants she grows herself, outdoors, without any pesticides or chemical supplements. 

Johnson says she’s not trying to get rich off of Butter Flower Balm — but as long as it’s helping people, she’s going to continue making it. 

“I have enough people in my life that love [the salve], even if I don’t make any money on it and I can just help people… I’ll continue to make it until the end of time because I love it,” she says. “It’s a total labor of love.” 

Wed, 07 Dec 2022 18:00:00 -0600 Will Brendza en-US text/html https://boulderweekly.com/features/students-of-cannabis/
Killexams : Medical people: News about medical professionals around Polk County

FOOT AND ANKLE ASSOCIATES OF LAKELAND

Matt Werd

Matt Werd, DPM, FACFAS, was a featured sports medicine speaker at the national meeting of the American Academy of Podiatric Practice Management held Nov. 3 in Fort Lauderdale. The AAPPM meeting attracts foot and ankle certified from throughout the United States and internationally. Werd’s lecture subject was “Prefab AFOs (Ankle-Foot-Orthoses) to Keep Athletes Active.” He also served as an expert panelist for a question-and-answer session on lower extremity sports injuries. Werd has co-authored two editions of the medical text “Athletic Footwear and Orthoses in Sports Medicine” Springer Publishing 2017.

WATSON CLINIC

D’Aishia Burgess

Registered nurse practitioner D’Aishia Burgess works alongside board-certified pulmonology specialist Naem Shahrour, from Watson Clinic Main at 1600 Lakeland Hills Blvd., Lakeland.  Burgess achieved her bachelor's in nursing from Polk State College in Winter Haven and her master's in nursing from Florida Southern College in Lakeland. She is a member of the American Association of Nurse Practitioners and the Florida Association of Nurse Practitioners, and is certified by the American Nurses Credentialing Center. 863-680-7190.

Amanda Porter

Physician assistant Amanda Porter serves patients of board-certified orthopedic surgeon Obafunto Abimbola from Watson Clinic Main at 1600 Lakeland Hills Blvd. in Lakeland. She earned a bachelor's in athletic training from the University of Wisconsin Oshkosh in Oshkosh, Wisconsin, a master's in physical education Western Michigan University in Kalamazoo, Michigan, and a master's in health sciences from George Washington University in Washington, D.C. She is a member of the American Academy of Physician Assistants, the Physician Assistants of Orthopaedic Surgery and the Florida Academy of Physician Assistants.  She is certified by the National Commission on Certification of Physician Assistants. 863-680-7214.

Nicole Hamlin

Registered nurse practitioner Nicole B. Hamlin works alongside board-certified otolaryngologist and facial plastic surgeon Raam S. Lakhani, M.D., from the Watson Clinic Bella Vista Building, 1755 N. Florida Ave., Lakeland. Hamlin earned her bachelor's in nursing from the University of South Florida in Tampa and her master's in nursing from Florida Southern College in Lakeland. She is a member of the American Academy of Nurse Practitioners. 863-904-6296.

Brandi Ray

Registered nurse practitioner Brandi C. Ray sees patients of board-certified internal medicine specialist Agustin Tavares from Watson Clinic South, 1033 N. Parkway Frontage Road, Lakeland. Ray earned her bachelor's and master's in nursing from the University of South Florida in Tampa. She is a certified family nurse practitioner by the American Academy of Nurse Practitioners, and is a member of the American Academy of Nurse Practitioners and the American Association of Critical Care Nurses Alumnus. 863-680-7190.

Julian Rios, R.N., center, holds his PEER Award plaque. Also pictured are Watson Clinic Chief Administrative Officer Jason Hirsbrunner, right, and Watson Clinic Urgent Care Main specialist Dr. Rajendra K. Sawh, left.

Julian Rios, a registered nurse at Watson Clinic Urgent Care Main, was recently named the recipient of the November Program for Employee Excellence and Recognition award. Rios has been with Watson Clinic for 14 years. Over the course of his career, whether he was providing care to urology patients or as an employee health nurse in our human resources department during COVID, Rios has been admired for his easygoing and friendly nature and for being an exceptional team member. Rios received a plaque, dinner at a local restaurant, a reserved parking spot and a gift certificate from the Medical Spa at Watson Clinic.

David Graham

David Graham, a board-certified radiation oncologist at the Watson Clinic Cancer and Research Center, is the first specialist in Florida to be named a Center of Excellence for his expertise in utilizing the SpaceOAR Hydrogel, an injectable spacer that minimizes the side effects of radiation therapy for prostate cancer patients. This recognition was presented by the device manufacturer Boston Scientific. Radiation therapy can produce undesirable side effects. The SpaceOAR Hydrogel is a soft injectable spacer that gently separates the prostate from the rectum, greatly minimizing the possibility of side effects. Graham received his medical degree from St. George’s University School of Medicine in Grenada, West Indies. He performed an internship in general surgery at Guthrie Clinic in Sayre, Pennsylvania. He performed residencies in radiation oncology at Northwestern University School of Medicine in Chicago and Eastern Virginia Medical School in Norfolk. He is board certified in radiation oncology by the American Board of Radiology. Graham is a member of the American Medical Association, the American Society of Therapeutic Radiation Oncology, the American Society of Clinical Oncology, the International Association for Hospice and Palliative Care, the Cyberknife Society and the Radiosurgery Society. 863-603-4717.

LAKELAND REGIONAL HEALTH

Mohammad Elballat

Mohammad Elballat specializes in pulmonology, critical care and sleep medicine. He is board certified in internal medicine, pulmonology and critical care. Elballat has experience in sleep apnea, insomnia, narcolepsy, parasomnias and managing complex surgical patients and critically ill neurosurgical patients. Elballat earned his medical degree in general medicine and surgery from Tanta University, Egypt. He completed his internal medicine residency at the University of Miami/JFK Consortium in West Palm Beach. Elballat completed his pulmonary critical care fellowship at the University of Tennessee Health Science Center in Memphis, Tennessee, and his sleep medicine fellowship at the University of South Florida in Tampa. Elballat cares for patients at our Grasslands Campus and the Medical Center.

Sydney Pate

Sydney Pate recently joined Lakeland Regional Health as a surgical first assistant. She is a certified physician’s assistant who has extensive clinical experience in plastic surgery, general surgery, emergency medicine, internal medicine, pediatrics, family medicine, and OB/GYN. Pate earned her bachelor's in chemistry and master's in physician assistant studies from Butler University in Indianapolis. Pate sees patients at the Lakeland Regional Health Medical Center.

Lakeland Regional Health is one of 2022’s Digital Health Most Wired hospital and health systems, as announced by the College of Healthcare Information Management Executives. This is the eighth time that Lakeland Regional Health has earned the Most Wired recognition. Lakeland Regional Health Medical Center achieved Level 8 Acute recognition and Lakeland Regional Health ambulatory locations received Level 8 Ambulatory recognition. The CHIME Digital Health Most Wired program conducted an annual survey of more than 38,000 organizations to assess how effectively they apply core and advanced technologies into their clinical and business programs to Improve health and care in their communities.

NEMOURS LAKELAND

Azlyn Goff

Azlyn Goff is a pediatric orthopedic surgeon at Nemours Children’s Hospital, Florida in Orlando and Lakeland. In addition to English, Goff is fluent in Spanish. She joined Nemours Children’s Health in September after completing a pediatric orthopedic surgery fellowship at Vanderbilt University Medical Center in Nashville, Tennessee, where she was an assistant clinical professor in the Department of Pediatric Orthopedic Surgery. Goff earned her bachelor's in chemistry and biochemistry at Florida State University in Tallahassee and her Doctor of Medicine degree at New York Medical College in Valhalla, New York. She performed her orthopedic surgery residency at Westchester Medical Center in Valhalla, New York.

This article originally appeared on The Ledger: Medical people: News about medical professionals around Polk County

Mon, 05 Dec 2022 19:56:00 -0600 en-US text/html https://www.yahoo.com/entertainment/medical-people-news-medical-professionals-095615789.html
Killexams : Investigation into South Boston human remains turns to autopsy A photo of 838 East Broadway in South Boston after police found “what appears to be a human fetus or infant” in the freezer inside an apartment there. © Jeremy C. Fox for the Boston Globe A photo of 838 East Broadway in South Boston after police found “what appears to be a human fetus or infant” in the freezer inside an apartment there.

The state Office of the Chief Medical Examiner faces a daunting task in unraveling the mystery of the four sets of human remains discovered last month in a condominium building on East Broadway in South Boston, according to investigative experts, who said one challenge will be determining whether the case involves fetal deaths or live births of babies who later died as infants.

Last week, the Boston Police Department announced the remains belonged to two male infants and two female infants. But on Friday, it was unclear whether the medical examiner had concluded the case involves live births.

A police spokesman said the department used the term infant because the same language was used in a case file from the medical examiner’s office.

But a spokesman for the Suffolk district attorney’s office, which handles death investigations in Boston, said the police announcement wasn’t intended as a declaration that investigators believe four babies were born and later died during infancy.

“For now there are no conclusions that I’m aware of,” said Jim Borghesani, the spokesman. A spokeswoman for the state Executive Office of Public Safety and Security, which oversees the medical examiner’s office, referred questions to the Suffolk DA’s office.

The results of autopsies, which seek to determine the cause and manner of death, are pending.

Forensic pathologists interviewed by the Globe described the process of what could be a lengthy investigation, during which the medical examiner will be confronted with the challenges of identifying the remains and determining the circumstances of their deaths.

“First question you’re trying to answer is: Is this a live born or stillborn,” said Dr. Jonathan Arden, a forensic pathologist and former government medical examiner who now operates a consultancy practice.

Physical characteristics may offer some clues, he said, and medical examiners will likely weigh the remains and take measurements to try to pinpoint a gestational age, which would indicate whether life was possible outside the womb. A gestational age of 20 weeks or less indicates the likelihood of a stillbirth, said Dr. Thomas A. Andrew, the former chief medical examiner in New Hampshire.

But an older gestational age isn’t definitive proof of a live birth, either, he said. Medical examiners would also look for signs of devastating birth defects.

“Even if it’s a viable age in terms of its gestational age, but has a birth defect that’s not compatible with life, that would imply the birth was stillborn,” Andrew said.

If the gestational age meets the threshold for viability and there are no indications of fatal birth defects, the medical examiner’s attention would turn to looking for evidence of a live birth. There may be witnesses who can answer that question, Arden said. But if no one comes forward with information, there are other avenues to pursue the question.

Contents in the stomach like colostrum, breast milk, or formula are unequivocal proof of life, Andrew said.

Medical examiners are also likely to use X-rays, microscopic examination, or physical exams to determine whether the lungs experienced respiration.

“Can you tell whether the lungs have air in them to indicate there was breathing? That’s usually the single biggest factor we use,” Arden said.

One controversial test entails removing the lungs and placing them in a bucket of water or other liquid, according to Arden and Andrew. Lungs that float can be an indication of a live birth, while lungs that don’t float may suggest a stillbirth.

But, Arden said, “It’s not really reliable.”

The condition of the remains will also factor into what the medical examiner learns from the autopsies, the experts said, and the circumstances of the case underscore the challenges.

Boston police were first summoned to the South Boston property on Nov. 17, for a report of a man who “possibly found a fetus in the freezer,” according to a police radio transmission recorded by Broadcastify.com. The Suffolk DA’s office later said authorities were investigating the discovery of a possible fetus or infant in a freezer.”

On Nov. 18, officials said “additional remains” had been found but declined to provide further information. The residence has nine condominiums, but authorities have not specified the spot in the building where remains were found or who lived there.

Human remains exposed to freezing temperatures are prone to shrinking, tissue deterioration, and the loss of anatomical details and fluids, Arden said. The thawing process also has the potential to alter the anatomy, he said.

“It becomes very difficult to make any good assessments on those organs,” Arden said.

The freezing may also kill off any bacteria or viruses that may have been present, said Dr. Jane W. Turner, a forensic pathologist who works as a consultant in St. Louis, Mo.

Under the circumstances, there is the possibility that the medical examiner won’t be able to determine whether the remains are from fetal deaths or babies who died in infancy, according to Arden.

“You have to be intellectually honest and admit what you don’t know or can’t determine,” he said.

Even if the medical examiner determines the remains belong to infants who died shortly after their births, identifying their cause and manner of death may prove to be elusive. But, a place to start would be to look for obvious signs of trauma like stab wounds, ligatures marks, or fractures, Andrew said.

A toxicology report would detect the presence of alcohol, commonly-abused drugs, and some therapeutic medications, but that evidence would fall short of identifying a cause of death, he said.

If the remains are in an advanced state of decomposition, the mystery will be even harder to solve, Andrew said.

“You’re going to have certificates that say undetermined cause and undetermined manner, “ he said.

Then there’s the question of identifying the remains. If no one comes forward claiming to be the parents, the medical examiner would turn to genetic testing. That too carries limitations: If viable DNA samples can be extracted from the remains, what would they be compared to?

Law enforcement DNA databases are a place to start, Andrew said, but won’t yield results if the parents never had contact with police. That said, authorities could also approach relatives of possible parents and request they voluntarily submit DNA samples, he said.

Eventually, experts said, medical examiners will have to make a decision. If they determine there were live births, they will fill out a death certificate. And if the cause and manner of death are unknown, the certificates will reflect that finding.

If the remains cannot be identified, they said a government official would likely write something like, “unknown baby girl” and “unknown baby boy” in the spot on the document for the name.

Sun, 04 Dec 2022 08:17:43 -0600 en-US text/html https://www.msn.com/en-us/news/us/investigation-into-south-boston-human-remains-turns-to-autopsy/ar-AA14TWfY
Killexams : Family still seeking answers a month after U.S. woman's death in Mexico: "The last breath she took, she suffered"

Mexico files charges against U.S. woman suspected of killing another American

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Mexican prosecutors are trying to get an unnamed American extradited to Mexico to face charges in the death of Shanquella Robinson, an American tourist who died last month at a resort near Cabo San Lucas.

Authorities say Robinson was killed in a "direct attack, not an accident."

Robinson traveled with six friends to Mexico. Some of those friends initially told Robinson's parents she died of alcohol poisoning, but her death certificate later listed her cause of death as a spinal cord and neck injury.

Robinson's father told "CBS Mornings" that if it weren't for the disturbing videos that emerged from his daughter's trip, including one where she is being brutally attacked, he fears justice would never be served.

Shanquella Robinson. / Credit: Instagram © Provided by CBS News Shanquella Robinson. / Credit: Instagram

"She was just a very, you know, outgoing person," Bernard Robinson said of his only child. "She loved people. Just loved the friends that she was around."

Days after her death, a disturbing video went viral showing a woman beating Shanquella, who was naked and not fighting back, while other friends watched and filmed nearby.

"My daughter, she suffered," Bernard said. "The last breath she took, she suffered, and they sit there and watched."

A local police report shows friends called for medical help just after 2 p.m., saying Robinson had "drunk a lot of alcohol." When the doctor arrived and suggested she be taken to a hospital, she told police Robinson's friends refused and insisted on keeping her at the resort.

Bernard said her friends called Shanquella's mother that night to say she was being treated for alcohol poisoning. An autopsy report released days later states Shanquella died of a severe spinal cord injury and neck trauma at around 3 p.m.

Bernard Robinson says his daughter's friends are to blame for the 25-year-old's death.

After her death, all six friends returned to the United States.

Robinson's death is being investigated by Mexican authorities as a crime of femicide, or the killing of a woman because of her gender. Mexican authorities are now seeking the extradition of a single female suspect.

John Jay College law professor Dimitry Shakhnevich, who has no connection to the case, said the process now lies in the hands of the U.S. justice system. "They will engage in their own due process to see if this person that is alleged to have committed a crime should be extradited," he said.

The FBI has said it has opened an investigation into the death as well.

At this time, it remains unclear whether those who witnessed the fight may also be in legal jeopardy.

Bernard Robinson said, "I want the truth."

"I want them to get back over there and tell the Mexican authorities why they did what they did," he said.

"I can't even be a grandfather. I can't even walk her down the aisle now. Only thing I can do is cherish the moments that we had for 25 years while she was here on this Earth," he added.

Mon, 28 Nov 2022 00:41:13 -0600 en-US text/html https://www.msn.com/en-us/news/crime/family-seeks-answers-after-us-womans-death-in-mexico-i-want-the-truth/ar-AA14Eemh
Killexams : Emergency medical services in Iowa are operating without a net

I still can hear the phone ringing. It was a continuous shrill ring, clearly distinct from an ordinary  call. No matter the time of day, my heart would begin to race. When I picked up the receiver, I’d hear thinking — and sometimes frantic — voices asking for help.

It wasn’t a wrong number — my husband was a member of the Pilot Mound volunteer fire department, and emergency calls rang in the homes of firefighters and First Responders, as well as the county dispatcher.

This communication system has been modernized since those years, and Pilot Mound no longer has a First Responders unit. But a exact front-page headline of the Dayton Leader newspaper reminded me that one acute rural problem persists: “Volunteers Wanted: Dayton Rescue Squad seeks out next generation of EMTs, drivers.”

Volunteers are the backbone of rural Iowa. Since the prairie was settled, they have played an integral part. They’re still the ones who keep the small-town churches, school boards, fire departments, Extension Councils, township trustees, and other civic groups going. But are their best efforts good enough when it comes to life and death situations?

“With having only three EMTs, it’s hard to answer every call,” says Sara Pieper, an Emergency Medical Technician (EMT) and ambulance driver.

Pieper, who also is the Dayton city clerk and a firefighter, was featured in the story. She joined the Rescue Squad three years ago to help fill the need for volunteers who are available during the daytime hours of the work week. With few local businesses, many residents work out of town and their employers may not allow them to leave for a call. The average age of EMTs in Webster County is 43-47 years.

Adequate emergency medical service is a matter of equity. But Iowa also should make it an economic development and quality-of-life priority.

The Dayton Rescue Squad currently has two ambulances and five active drivers. Driver requirements include a monthly evening meeting, driver training, and CPR certification. EMTs need to complete 120-150 hours of training and fulfill a minimum of 20 hours of continuing education every two years to keep their licenses current.

Dayton Rescue pays for these CPR and EMT courses, provided there’s two-year pledge of active service. Its budget is based on service calls, insurance reimbursements, and fundraisers.

Unlike fire and law enforcement, EMS is not a required essential county service in Iowa. In 1981, the federal government shifted its responsibility for EMS to the states. Only 11 states fund EMS as an essential service.

“It’s hard to not be able to pay our volunteers much, since we currently don’t receive any tax money,” Pieper says. “It makes it hard to retain volunteers and find ways to buy supplies and maintain equipment.”

This disparity is receiving more recognition today, and EMS in Iowa may be at the crossroads of significant change. In 2021, the Iowa Legislature passed a law allowing counties to ask their voters to increase income and/or property taxes to support EMS as an essential service. Eight counties placed this referendum on their Nov. 8 ballots this year, and five counties reached the required 60% threshold for passage: Jones, Kossuth, Osceola, Pocahontas, and Winnebago. In Jones County, residents will pay an additional $35 in property tax for a home valued at $100,000. The revenue would be divided among nine ambulance regions in the county, as well as a portion of two other neighboring counties.

Calhoun, Floyd, and Worth counties voted it down.

Iowa at EMS crossroads

(Screen shot from Pilot Mound Fire Department web page)

Too often, gaping holes in EMS are patched up with the Band-aid of charitable contributions. In 2021, our 4-H club worked with the Pilot Mound Fire department to obtain a Pioneer Community Seed Grant to purchase a permanent, wall-mounted Automated External Defibrillator (AED) for the community center. An older AED is kept in the fire truck. The fire department supplements its funds by holding a huge annual Biscuits & Gravy Breakfast organized by MIRZA Lodge #609 in Boone.

“Emergency medical response for communities like Pilot Mound is an ongoing concern,” says Pilot Mound Fire Chief Sean Whalen. “We no longer have a local First Responders, so having an AED available in town might be the difference between life and death. We try to keep members current on CPR and AED, but it’s been difficult with Covid.”

Staying alive and well

Serving as an EMT in your home community is rewarding, but often stressful because you often know the individuals requiring rescue. My sister-in-law served as a Pilot Mound First Responder for 12 years. She was trained in AED, basic first aid, and CPR. She recalls being at the scene of these fatalities:

  • A man backed over by a county truck
  • A girl thrown from her horse at a local rodeo
  • A woman who fell off a hayride onto a hard surface road
  • A girl who went over the handlebars of her bicycle at Don Williams Park
  •  A man who ingested his fentanyl patch

“We had no training to process our emotional trauma,” she recalls. “Two volunteers quit.”

Farming always has been one of the top two most hazardous U.S. occupations. I wrote many articles for Successful Farming focusing on first aid and emergency measures to help farmers and their families survive until trained help arrived.

In 1981, I wrote about the successful reattachment of a severed finger, using a new technique called microsurgery. Not long afterward, I received a letter from an Iowa farm reader who had cut off his thumb working on his farm. He recalled this article, and followed the directions to rinse his thumb, put it in a sealed plastic bag, and surround the bag with ice. A Des Moines surgeon successfully reattached it.

Volunteers store the grain bin rescue tube at the Pilot Mound Fire Department. (Photo by Cheryl Tevis)

In 1990, I wrote a 12-page article, titled “Staying Alive: the Struggle To Save Farm Accident Victims.” Farm injuries are a specialized challenge for EMTs. Few, if any, have much training in farm rescue, including grain bin entrapment, anhydrous ammonia exposure, and tractor rollovers.

The Pilot Mound Fire Department has a grain bin rescue tube system, but lacks the required training to use it. “Our role would be rapid delivery and staging support,” Whalen says. Dayton has a grain bin rescue tube, and attends an annual training conducted by the Stratford Fire & Rescue Department.

Rural patchwork of services

Rural Americans tend to be older, sicker, and poorer than other Americans. Adequate emergency medical service is a matter of equity. But Iowa also should make it an economic development and quality-of-life priority. How do you attract people to live and raise their families in rural Iowa, if they can’t count on EMTs to arrive sooner than 20 minutes? Why wouldn’t our senior citizens move to larger communities to be closer to emergency medical services?

I’m not sure how many rural Iowa counties fall into the category of an EMS desert. But many suffer from fragmented and disorganized EMS services. If more than one EMS responds to a call, only the transporting service is reimbursed.

On Oct. 4, Rep. Cindy Axne introduced the bipartisan Supporting Our First Responders Act (HR 8994) to help EMS agencies with hiring and retention, training reimbursements, facility upgrades and more. It would establish a five-year grant program under the U.S. Department of Health and Human Services. Twenty percent of the funds would be earmarked for rural EMS agencies. Axne’s successor, Rep.-elect Zach Nunn, should be urged to cosponsor this bill. The American Rescue Plan Act of 2021 also may offer a one-time shot in the arm to EMS agencies.

However, all the funding in the world won’t solve the problem of depopulation. The farm crisis, a depleted manufacturing base, and a low-wage economy have frayed the fabric of rural Iowa, creating chronic shortages of volunteers. COVID-19 exacerbated the situation. “If the current trend of volunteers remains on the same path, the rescue squad may not be sustainable,” Pieper says.

Since 2020, 16 EMS departments in Iowa have closed. Fourteen closures were caused by a lack of personnel. According to the Iowa Department of Health and Human Services, 40 EMS departments have two or fewer EMS workers. Escalating equipment and fuel costs also are factors. As more EMS agencies shut down, the remaining ones are required to cover larger areas, leaving rural families without immediate assistance in their greatest moment of need. “A few minutes may make all the difference between life and death in some emergencies,” Pieper says

She is encouraged by the new law allowing counties to put EMS on the ballot. “I think it would be greatly beneficial and I’d hope that someday we move in this direction,” she says. She’s also hopeful that a few younger individuals will respond to her outreach, and join Dayton’s EMS team.

Until then, when the next 911 call comes in, Pieper will do her best to have all three of her hats  — ambulance driver, EMT and firefighter — at hand to answer the call.

This article first appeared on Cheryl Tevis’ blog Unfinished Business, and it is republished here via the Iowa Writers’ Collaborative.

Editor’s note: Please consider subscribing to the collaborative and its member writers to support their work.

Fri, 09 Dec 2022 00:03:00 -0600 en-US text/html https://iowacapitaldispatch.com/2022/12/09/emergency-medical-services-in-iowa-are-operating-without-a-net/
Killexams : Family seeks answers after U.S. woman's death in Mexico: "I want the truth"

Mexican prosecutors are trying to get an unnamed American extradited to Mexico to face charges in the death of Shanquella Robinson, an American tourist who died last month at a resort near Cabo San Lucas.

Authorities say Robinson was killed in a "direct attack, not an accident."

Robinson traveled with six friends to Mexico. Some of those friends initially told Robinson's parents she died of alcohol poisoning, but her death certificate later listed her cause of death as a spinal cord and neck injury.

Robinson's father told "CBS Mornings" that if it weren't for the disturbing videos that emerged from his daughter's trip, including one where she is being brutally attacked, he fears justice would never be served.

Shanquella Robinson. / Credit: Instagram

"She was just a very, you know, outgoing person," Bernard Robinson said of his only child. "She loved people. Just loved the friends that she was around."

Days after her death, a disturbing video went viral showing a woman beating Shanquella, who was naked and not fighting back, while other friends watched and filmed nearby.

"My daughter, she suffered," Bernard said. "The last breath she took, she suffered, and they sit there and watched."

A local police report shows friends called for medical help just after 2 p.m., saying Robinson had "drunk a lot of alcohol." When the doctor arrived and suggested she be taken to a hospital, she told police Robinson's friends refused and insisted on keeping her at the resort.

Bernard said her friends called Shanquella's mother that night to say she was being treated for alcohol poisoning. An autopsy report released days later states Shanquella died of a severe spinal cord injury and neck trauma at around 3 p.m.

Bernard Robinson says his daughter's friends are to blame for the 25-year-old's death.

After her death, all six friends returned to the United States.

Robinson's death is being investigated by Mexican authorities as a crime of femicide, or the killing of a woman because of her gender. Mexican authorities are now seeking the extradition of a single female suspect.

John Jay College law professor Dimitry Shakhnevich, who has no connection to the case, said the process now lies in the hands of the U.S. justice system. "They will engage in their own due process to see if this person that is alleged to have committed a crime should be extradited," he said.

The FBI has said it has opened an investigation into the death as well.

At this time, it remains unclear whether those who witnessed the fight may also be in legal jeopardy.

Bernard Robinson said, "I want the truth."

"I want them to get back over there and tell the Mexican authorities why they did what they did," he said.

"I can't even be a grandfather. I can't even walk her down the aisle now. Only thing I can do is cherish the moments that we had for 25 years while she was here on this Earth," he added.

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Mon, 28 Nov 2022 00:41:00 -0600 en-US text/html https://news.yahoo.com/family-seeks-answers-u-womans-144113458.html?ref=upstract.com
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