LEGAL STATUS OF MEDICAL CERTIFICATES ON EMPLOYEES ABILITY TO WORK IN THE LIGHT OF NEW CASE LAW

This paper deals with medical examination of employee´s ability to work. Although from a legislative-technical point of view, this regulation is considered to be successful, in practice it causes major problems in the area of assessment care, which is evidenced in particular by case law. Referencing to practice, we can state that the idea of the occupational health services provider as professional assistant of the employer in providing for the protection of employees’ occupational health has not taken hold at all. Employers justifiably ask why they should pay for a medical report giving them no legal certainty.

Partial Ideas for Improving the Legal Regulation of Assessment of Competence to Work

This paper deals with medical examination of employee’s ability to work. Although from a legislative-technical point of view, this regulation is considered to be successful, in practice it causes major problems in the area of assessment care, which is evidenced in particular by the case law. Referencing to practice, we can state that the idea of the occupational health services provider as professional assistant of the employer in providing for the protection of employees’ occupational health has not taken hold at all. Employers justifiably ask why they should pay for a medical report giving them no legal certainty. Employers, on the other hand, want to pay for services that give them a solid basis for further action against employees. From the analysed regulations, it is clear that the issue of health assessment and medical reports remains in some respects still gaping, both in terms of the nature of the medical report and in terms of accepting the lack of work capacity of providers of occupational health services.

Jeevan Jyoti Mobile Application for Ambulance Service

In these modern times where the technologies is evolving every day. In order to cope up with the need of proper ambulance services during medical emergency situation, an android mobile application named Jeevan Jyoti is introduced which will aim successful booking of ambulance with required medical support both in the ambulance and from the hospital. Mobile application is a growing and in-demand technology because of its easier accessibility and feasibility to remind users about the upcoming updates with the help of push notification. This idea approaches a system where whenever a request for ambulance is raised, it sends that request to all the nearby hospital(s) along with the parameters such as ambulance type, number of casualties, symptoms, medical report, etc. To expand this system, IoT is added which will help the doctor monitor the vital stats such as pulse rate and temperature of the patient continuously while the ambulance is en-route to the hospital.

Prediction and Estimation of Lung Cancer and Authenticating by CNN-ECC Model

Miscellany of data analysis on the genesis of disease and the outcome of mortality is very crucial to keep track of the death rates induced due to the disease. The primary detection of the presence of viral infections in lungs is one of the major concerns in the health industry in today's scenario. These infections can lead to mortality. Therefore, the classification and analysis of disease are very pivotal along with security of data. Hence, it is essential for detecting diseases using CNN algorithm at an early stage and generation of medical report automatically. The method is tested for different modals with various lung infections like pneumonia, COVID-19, and cancerous growth in lungs. For these system-generated reports, encryption using ECC algorithm is used to prevent the breach of information while being exchanged from hospital to other organizations or vice versa.

Disease Classification with E-Report Generation, Authentication and Encryption

The assortment of data analysis on the origin of diseases and consequences of mortality is essential to keep track of death rates caused due to diseases. Thus, the classification of diseases is very crucial. Cancer is one of the huge and major diseases of concern in the world. Machine learning is extensively implemented in the medical field in the anticipation of medical errors and early revelation of diseases. Along with the implementation of technology in medical field there is need for authentication to safeguard the privacy rights of patient’s health information. Thus, in this paper, revelation of disease using CNN (Convolutional Neural Networks) algorithm is achieved along with authentication and automatic generation of e-medical report which is further encrypted using RSA (Rivest, Shamir, Adleman) algorithm to overcome the breach of information while being shared from one hospital to another.

Bournewood in Belfast: who's ready?

AimsWe aimed to determine doctors’ confidence in completing capacity assessments and reports associated with new Deprivation of Liberty Safeguards (DoLS), and the impact that these would have on practice. We hypothesised that psychiatrists would have greater confidence in completing the requisite assessments and would anticipate a greater impact on practice than doctors in other specialties.BackgroundOn the 2ndDecember 2019 DoLS became the first part of the Mental Capacity Act (Northern Ireland) 2016 to be implemented, believed to apply to 7500 individuals across Northern Ireland (NI). As arguably the most significant change in mental health legislation in NI since 1986, the Department of Health commissioned training for all clinicians.MethodWe conducted a cross-sectional survey among doctors working within psychiatry, general medicine, anaesthetics and surgery in Belfast Health and Social Care Trust prior to implementation. The survey comprised seven questions with a 10-point Likert scale. Statistical analysis included Pearson'sχ2and Spearman's rank tests.Result79 doctors in psychiatry and 25 in other medical specialties completed the survey.Respondents were moderately confident in completing capacity assessments (median 6 (3-9)) and medical reports (median 5 (1-9)). Those that had completed training (n = 86; 83%) were significantly more confident in capacity assessment (median 7 (2-10) vs 4 (1-7); χ2(18) = 36.8, p <0.01) and medical report completion (median 5 (1-9) vs 1 (1-5); χ2(16) = 27.2, p =.04) than those that had not (n = 18; 17%). Psychiatrists had greater confidence in conducting capacity assessments (median 7(2-10)) than other doctors (median 5(1-9); χ2(9) = 18.2, p = 0.04). No significant differences were observed between the two groups with respect to medical report completion, or anticipated impact on practice.Respondents who most frequently conducted capacity assessments as part of their current practice anticipated higher degrees of impact on their individual practice (rs = 0.51, p < 0.01) and their service (rs = 0.50, p < 0.01)ConclusionEngagement with the commissioned training was encouraging. Respondents were, on average, relatively confident in conducting capacity assessment, but considerable variation in confidence, and a lower confidence in completing medical reports. This might suggest that some may require further training. A poor response rate among non-psychiatrists indicates potential respondent bias in favour of those already more cognisant of capacity in routine practice. A correlation between more practiced assessors and anticipated impact on service provision could suggest that some clinicians may be underestimating the potential impact of DoLS; the same groups should therefore be resurveyed after DoLS implementation.

Access to firearms: essential factor for risk management in psychiatry

ObjectiveIncrease awareness of the risk associated with access to firearms in clinical practice.Case reportA 57-year-old man, with a 30 year history of schizophrenia, was reviewed routinely at home. His illness is predominantly characterised by chronic delusions of a grandiose nature. He believes he has been offered various senior employment positions and has acted on these beliefs by presenting at workplaces in business attire. He has no insight into his condition. At review, he described awakening a week earlier in a panic and seizing hold of his legally held shotgun. He planned to shoot out the window as he believed people were breaking in. His wife prevented him from doing so by taking the gun and hiding it. A few days later he found the gun and intended to frighten off potential pursuers by pretending to shoot birds. He was persuaded to surrender the gun and it was taken to the local Garda (Police). A short time later, he presented to Garda Headquarters, over an hour away, seeking the return of his gun. At review, he had limited insight into the potential seriousness of the situation. The team immediately liaised with Gardaí, a HCR- 20 risk assessment was completed and clozapine levels checked.DiscussionWe had not know that our patient owned a shotgun despite very regular contact with him. During a comprehensive psychiatric history we routinely ask about risk of harm to self and others, but rarely ask specifically about access to or ownership of guns. Working on a farm, rural living or having an interest in shooting sports may raise the issue. Suicide, security breaches and homicide are the main risks conferred by firearms in mental illness. Mental illness is not necessarily prohibitive to gun ownership. Applicants for gun certificates in the UK must disclose specific medical conditions, including a psychotic illness, and an automatic medical report is sought. In the Irish Republic it is the responsibility of the applicant to declare any specific physical or mental health condition. Although a medical report may be sought, it is not automatic in all cases. Lack of insight into psychotic illness may potentially influence self-declaration upon application for a certificate.ConclusionAwareness of a persons access to firearms should be part of our routine risk assessment.