Book Section: Essay and Review: Evaluating Juveniles' Adjudicative Competence: A Guide for Clinical Practice: Clinical Evaluations for Juveniles' Competence to Stand Trial: A Guide for Legal Professionals

2006 ◽  
Vol 34 (2) ◽  
pp. 235-241
Author(s):  
Sean P. Hiscox ◽  
Philip H. Witt
Keyword(s):  
Clinical Practice ◽  
Competence To Stand Trial ◽  
Adjudicative Competence ◽  
Legal Professionals ◽  
Clinical Evaluations

scholarly journals Safety of hydroxychloroquine and darunavir or lopinavir in COVID-19 infection

2020 ◽  
Author(s):  
Etienne Meriglier ◽  
Claire Rivoisy ◽  
Mojgan Hessamfar ◽  
Noelle Bernard ◽  
Ines Aureau ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Clinical Practice ◽  
Combination Therapy ◽  
Observational Cohort Study ◽  
Potential Drug ◽  
Clinical Evaluations ◽  
History Of ◽  
Observational Cohort ◽  
Ecg Abnormalities

Abstract Background Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection. Objectives To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Methods This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines. Results Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2–6) days after starting treatment. All ECG abnormalities reversed 1–2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration. Conclusions Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.

scholarly journals An update on outpatient competence restoration outcomes: The Washington DC Model

2021 ◽  
Vol 5 (1) ◽  
pp. 001-006
Author(s):  
Bell Reston N ◽  
Candilis Phillip J ◽  
Johnson Nicole R
Keyword(s):  
Poisson Regression ◽  
Regression Modeling ◽  
Policy Implications ◽  
Washington Dc ◽  
Competence To Stand Trial ◽  
Adjudicative Competence ◽  
Competency Restoration ◽  
American Law ◽  
The Difference ◽  
Successive Restoration

This study provides an update to a previous study exploring time to restoration of adjudicative competence within an Outpatient Competence Restoration Program (OCRP). Authors examined the probability of restoration for individuals referred for outpatient competence restoration in the U.S. capital, and revisited the requirements of American Law, taking a closer look at how programmatic changes improve restoration and encourage adherence. Competence to stand trial remains a critical screening function of the judicial system to ensure that defendants have a basic understanding of courtroom procedures. Competency restoration is therefore an attempt to protect both the integrity of the system and the rights of defendants. Aggregate data from the OCRP’s previous four years of competence restoration efforts were reviewed for demographic characteristics, restoration rates, and time to restoration. Poisson regression modeling identified probability differences in restoration between sequential restoration periods. Since our initial analysis, the DC OCRP has been successful in restoring 97 of 345 participants (28.1%), with referral rates increasing from year to year. 39.2% are now restored after the 3rd round of competency restoration. Poisson regression modeling of individuals attaining competence during six successive restoration periods showed that differences for the first five rounds of restoration were not statistically significant (p = 0.418). In the 6th round, however, the difference in percentage of restored participants was statistically significant compared to previous rounds (irr = 0.32; p = 0.0001). We discuss the policy implications, especially those that suggest that the DC OCRP has improved its ability to restore competence beyond the 1st round of restoration.

Five year research update (1996-2000): evaluations for competence to stand trial (adjudicative competence)

2003 ◽  
Vol 21 (3) ◽  
pp. 329-350 ◽  
Author(s):  
Denise L. Mumley ◽  
Chad E. Tillbrook ◽  
Thomas Grisso
Keyword(s):  
Competence To Stand Trial ◽  
Adjudicative Competence

Ten Year Research Update (2001-2010): Evaluations for Competence to Stand Trial (Adjudicative Competence)

2013 ◽  
Vol 31 (2) ◽  
pp. 165-191 ◽  
Author(s):  
Michael H. Fogel ◽  
Wendy Schiffman ◽  
Denise Mumley ◽  
Chad Tillbrook ◽  
Thomas Grisso
Keyword(s):  
Competence To Stand Trial ◽  
Adjudicative Competence

The miR-21 potential of serving as a biomarker for liver diseases in clinical practice

2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Liver Diseases ◽  
Hepatic Disease ◽  
Noninvasive Detection ◽  
Diagnosis And Prognosis ◽  
Expected Performance ◽  
Potential Biomarker ◽  
Disease Condition ◽  
Complex Regulatory Network

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Hybrid Telecoaching for Corporate Speech Training and Potential Applications to Clinical Practice

2019 ◽  
Vol 4 (2) ◽  
pp. 322-324
Author(s):  
Thomas F. Burke
Keyword(s):  
Clinical Practice ◽  
Engineering Teams ◽  
Corporate Strategies ◽  
Corporate Speech ◽  
Phone Calls ◽  
Future Clinical Practice ◽  
Fortune 100 ◽  
Potential Applications ◽  
Language Pathology ◽  
Development Engineering

Purpose The purpose of this article was to describe a model for “hybrid speech telecoaching” developed for a Fortune 100 organization and offer a “thought starter” on how clinicians might think of applying these corporate strategies within future clinical practice. Conclusion The author contends in this article that corporate telecommunications and best practices gleaned from software development engineering teams can lend credibility to e-mail, messaging apps, phone calls, or other emerging technology as viable means of hybrid telepractice delivery models and offer ideas about the future of more scalable speech-language pathology services.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

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