Legitimate Need Research Articles

Exchanging honest employment references: avoiding the traps of defamation and negligent hiring.

In present-day reference checking, many of the same organizations that seek as much information as possible about people they wish to hire resist giving out more than a bare minimum of information to other organizations. The strongest force driving this minimal reference information release is fear of legal action taken because of something said about an individual in a reference response. Many employers seem so frightened of being sued that they share nothing of substance, usually not realizing that in supposedly protecting themselves against defamation charges they are sometimes increasing the risk of negligent hiring charges. However, truthful reference information can be provided with minimal risk if it is provided in good faith, given only to those who have a legitimate need to know, is strictly job related, and is not communicated maliciously. References must always be provided objectively with information verifiable in personnel files.

Development of a Quantitative Measure of Holistic Nursing Care.

Holistic care has long been a defining attribute of nursing practice. From the earliest years of its formal history, nursing has favored a holistic approach in the care of patients, and such an approach has become more important over time. The expansion of nursing's responsibility in delivering comprehensive primary care, the recognition of the importance of relationship-centered care, and the need for evidence-based legitimation of holistic nursing care and practices to insurance companies, policy-makers, health care providers, and patients highlight the need to examine the holistic properties of nursing care. The Holistic Caring Inventory is a theoretically sound, valid, and reliable tool; however, it does not comprehensively address attributes that have come to define holistic nursing care, necessitating the development of a more current instrument to measure the elements of a holistic perspective in nursing care. The development of a current and more comprehensive measure of holistic nursing care may be critical in demonstrating the importance of a holistic approach to patient care that reflects the principles of relationship-based care, shared decision-making, authentic presence, and pattern recognition.

The Case for Including Informant Reports in the Assessment of Adulthood ADHD

Attention-deficit/hyperactivity disorder (ADHD) is now known to continue into adulthood for many children diagnosed with ADHD. Estimates of persistence reach up to 75% (Biederman, Petty, Clarke, Lomedico, & Faraone, 2011) in some studies. For example, in the Milwaukee longitudinal study of hyperactive children to age 27, 56% had symptoms of ADHD that were two standard deviations above the control group mean (Barkley, Murphy, & Fischer, 2008). Four or more symptoms of ADHD were experienced by 58% of the young adults with childhood ADHD who were followed by Biederman and colleagues (Biederman, Monuteaux, Mick, Spencer et al., 2006). Similarly, Weiss and Hechtman (1993) found clinically elevated ADHD symptoms in 66% of young adults diagnosed with ADHD in childhood. Impairment from ADHD reaches into adult-relevant domains of functioning that cut across educational (Mannuzza, Klein, Bessler, Malloy, & Hynes, 1997), vocational (Kuriyan et al., 2013), social (Friedman et al., 2003), legal (Mannuzza, Klein, & Moulton, 2008), and health-related (Flory, Molina, Pelham, Gnagy, & Smith, 2006) domains of life. These estimates of persistence roughly comport with the prevalence rate of 4.4% for adult ADHD reported by Kessler and colleagues (2006) from the National Comorbidity Survey (Kessler & Merikangas, 2004). We expect that this figure for adults may rise due to several converging trends. First, the results of a national survey recently revealed that 11% of children and adolescents in the United States receive a diagnosis of ADHD at some time in their lives (Visser et al., 2014). Although only 6.1% are being treated at any one point in time, these figures represent a 42% increase in rates of diagnosis in the last eight years (Visser et al., 2014). Prescriptions for the most common pharmacologic treatment of ADHD, central nervous system stimulants, have increased 25% for adolescents and 53% for adults in the past four years (Express Scripts, 2014; Visser et al., 2014). Finally, the continuing rise in abuse and diversion of stimulant prescriptions that has been occurring across college campuses in recent years (McCabe, West, Teter, & Boyd, 2014) and widespread Internet-based tips for “faking ADHD” (http://exiledonline. com/adderall-tips-how-to-convinceyour-shrink-you-have-addadhd) suggest that growing numbers of adults with ADHD may be attempting to procure prescriptions without legitimate medical need. Taken together, these statistics clearly point to an increasing

Legal questions of regional safety planning

Regional safety planning is a coherent view of safety issues that attempts to establish a coordinated safety policy in a region. From a legal viewpoint this is a challenge, because traditionally the different legal instruments are applied independently. This leads to results that are sometimes not very consistent. Regional safety planning needs coordination among all the involved authorities and different laws. Unlike safety planning within a private enterprise, where all the decisions can be taken by one body, regional safety planning must take into account a lot of different actors with their corresponding legal rights and duties. Regional safety planning is a complex task, which should be undertaken only in complex situations. The existing legal framework has to be respected. This may lead to results that differ from those reached from purely technical considerations, for example different risk sources may be treated differently because of different legislations, even though the risk may be the same; the results of a risk–benefit analysis depends on whose risks and whose benefits are taken into account; and cost effectiveness cannot be applied without taking into account the distribution of costs and risks. Regional safety planning must be implemented by legal means, such as regulation, economic incentives, and land–use planning. Decisions about measures to be taken must take into account the existing formal competences and the need for democratic legitimation of risk–related decisions.

Group To Examine Potential Health Effects From Producing Unconventional Resources

This article, written by Special Publications Editor Adam Wilson, contains highlights of paper SPE 168518, ’Collaborative Industry Initiative To Assess Potential Health Effects Related to the Production of Unconventional Resources,’ by D.J. Devlin, ExxonMobil; P. Beatty and R.D. White, American Petroleum Institute; Z. Naufal, Chevron; and S.S. Sarang, Shell, prepared for the 2014 SPE International Conference on Health, Safety, and Environment, Long Beach, California, USA, 17-19 March. The paper has not been peer reviewed. Unconventional resources offer many substantial benefits, yet the rapid increase in production of these resources using hydraulic fracturing has generated scrutiny by some policymakers and advocates who cite health concerns. The Exploration and Production Health Issues Group was recently formed to provide research, scientific analysis, and guidance on health issues regarding unconventional-resource production (URP). The group is particularly focused on community health concerns, including those associated with the compositions of hydraulic-fracturing fluid and flowback, effects on aquifers, air emissions, and psychosocial stress related to operations. Chemical Disclosure Opinion polls have found that community residents are most concerned about the possibility of drinking-water contamination from hydraulic fracturing. The idea that fracturing fluids of unknown composition are pumped underground through groundwater is the cause of that concern. A key issue for the industry to address is communicating the full nature of this risk while maintaining the confidentiality of proprietary chemicals used. The composition of fracturing fluids is the intellectual property of companies that develop the wellsite. The skill required to identify the right fluid composition for particular fracturing operations is what keeps those companies in business. But the need to protect some portion of fluid compositions as confidential business information (CBI) has been exploited by some opposed to URP to spread fear about unknown toxic chemicals and the harm they may cause. To address this challenge, the Groundwater Protection Council, an organization of state regulators, created Frac- Focus. FracFocus is a Web-based chemical disclosure registry where the nonconfidential chemicals used in fracturing for a particular wellsite are posted for public viewing. In many states, the use of Frac- Focus to disclose nonconfidential chemicals is mandatory. Some segments of the URP industry believe that additional steps must be taken to develop criteria to assess the suitability of a chemical for use in URP from the perspective of health, safety, and environmental effects, and they have been working to develop criteria and a user-friendly tool to implement those criteria in URP operations. While some chemicals will continue to be identified as CBI under existing regulations and policy, operators and service companies would apply the established criteria of suitability for hydraulic fracturing. The objective is to encourage continued development of new and improved fracturing fluids while maintaining the intellectual-property protections of the companies that develop them and enhancing public confidence that protection of health and the environment is integrated into the selection of chemicals. The balance between the legitimate need to keep certain information confidential and the processes by which compositional information is provided to experts on a need-to-know basis should be communicated better to the public to help build and maintain trust. Potential Health Effects The Institute of Medicine Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop on the Health Impact Assessment of Shale Gas Extraction in May 2012. The workshop brought together a range of experts from the natural-gas industry, regulatory agencies, and fields of environmental monitoring and occupational and community health. A key premise for the workshop was the recognition that shale-gas extraction is an emerging technology and that it will continue to be important in the years to come. Consequently, the environmental health community needs to begin to understand potential related health effects. Furthermore, the community should adopt an approach that recognizes that the role of the health community is not to decide whether or where the nation should use shale-gas extraction but rather to discuss potential health effects, to which individuals are more vulnerable, and how any proven effects can be mitigated.

The “Call for Help”: Intraoperative Consultation and the Surgeon-Patient Relationship

Langerman, Alexander MD, FACSa, d, e, *; Angelos, Peter MD, FACSb, d, e; Siegler, Mark MDc, d, e Author Information

Dusildenafil citrateau Viagra® ou l’art délicat de nommer les médicaments

In times past, drugs often derived from plants and were quite naturally named after them. Nowadays, considering the significant economic issues at stake (Dutchen 2009), pharmaceutical companies increasingly entrust brand agencies with the naming of their products (Kenagy 2001). In this article, we offer to analyze the names of some brand and generic drugs, exploiting the French VIDAL dictionary, the British National Formulary and the US FDA corpora, with the aim to bring to light the evolution of lexical trends over the last century. Whilst doing so, we wish to demonstrate that, in the field of pharmacology, the process of naming is nowadays not so much underlain by a legitimate need for clarity and scientificity but rather by marketing strategies some of which prove to be misleading for patients. Considering the now international dimension of the pharmaceutical industry, drug names are often the same around the world. Yet, there are exceptions, which we point out and explain. Furthermore, we deemed interesting to underline the extent to which medicines are part of our everyday life by pointing out nicknames that patients tend to give to their treatments — usually sedatives, neuroleptics and the like — and metaphors they may resort to in English and in French. We conclude with the acknowledgement that medicines are henceforth like any other goods, whose financial stakes are such that, besides developing forceful new names, the pharmaceutical industry goes so far as inventing new diseases (disease mongering) to increase its market share (Even and Debré 2012).

An Administrative Alternative to the As-Applied Challenge: New York's Public Integrity Reform Act and the Future of Disclosure Statutes

In recent years, tax-exempt organizations have become increasingly prominent in political activity of all sorts, including lobbying. In response to the perceived abuses associated with this trend, there have been a number of proposals on both federal and state levels to disclose the identities of such organizations’ donors. This Note focuses on the legislative efforts of one state, New York, to promote greater transparency in politics through the Public Integrity Reform Act of 2011, a statute that is the first in the nation to require 501(c)(4) organizations engaged in lobbying to disclose donors that contribute to those efforts. First, this Note discusses the developments that precipitated the statute’s enactment, the regime it establishes, and recent problems with its implementation. Second, the Note considers the First Amendment implications of the statute’s novel requirement. Looking to the judicial treatment of disclosure laws applied to lobbying and other political activity, the Note discusses whether the New York law’s disclosure mandate would withstand constitutional challenges. The Note concludes that statutes of this sort would likely survive facial challenges, although certain groups harboring legitimate concerns regarding the consequences disclosure poses for their donors would face difficulty bringing successful as-applied challenges. Third, in light of the current state of the as-applied challenge to disclosure laws, the Note argues that future statutory regimes should follow New York’s lead (and learn from its lessons) in fashioning an administrative procedural alternative for groups with a legitimate need for exemption. In doing so, the Note considers the feasibility of implementing such a procedure in other jurisdictions and disclosure regimes applicable to other forms of political speech.

Interminability as a Legitimate Need

In this article, I propose to accept “interminability” as a legitimate need of the patient, unlike the tendency to treat it as a problem or as a negative phenomenon indicating an unsuccessful therapy. I present clinical vignettes demonstrating how some patients require a therapist for an unlimited time, continuously or at intervals. These patients require the therapeutic secure base and do not aspire—nor should they be encouraged—to terminate therapy. From the empathic stance of self psychology, such prolonged needs may be respected and provided.

Ergonomics as a missing part of sustainability

In the last twenty years, terms such as sustainable development, environmental protection, and sustainable design have been widely exploited, often without justification. Does ergonomics have a legitimate need or right to use these terms and to be the part of the process to which they refer? This paper discusses the relationship between ergonomics and the concept of sustainable development and its three elements of sustainability (environmental, social and economic), as the steps ergonomists need to take to secure and strengthen the influence in sustainability topics.

10.5937/zrpfns48-5860 = On the expedience of statutory regulation of fiduciary transfer of property in Serbia

No case of fiduciary transfer of property is explicitly governed by the effective Serbian law. Only the fiduciary assignment of claim is regulated in the Law on Obligations. One specific kind of fiduciary contracts is however frequently concluded, the fiduciary transfer of property as collateral. The case law is all but unanimous that such contracts are to be considered invalid (either entirely or partially), mainly because they infringe the prohibition of lex commissoria, although there are some decisions in which the reason of nullity is found in the infringement of the requirement of a valid cause of contract. Even in the rare cases, in which such contracts are not considered invalid, their legal effect is rendered equal to the effect of the pledge. The question of admissibility of fiduciary transfer of property as collateral is thoroughly discussed in the literature. The majority, under the influence of Dragoljub Aranđelović, claim that such a contract is valid, on the one hand, since it does not infringe upon any statutory prohibition, nor is it contrary to public policy or morals. On the other hand, it is also expedient, since it provides greater security for the creditor than the pledge. A contrary standpoint is taken by Andria Gams, who emphasized that European civil law is characteristic of conformity of economic purpose and legal form of legal institutions, that fiduciary transfer of property is contrary to, hence contemporary law should part with it. The author of this paper asserts that the positive attitude of Serbian doctrine towards the fiduciary transfer of property emerged in the era in which the legal necessity of pledging chattel without the transfer of its possession was not satisfactorily solved. He opines that by adopting the Law on Chattel Mortgage in 2003 ceases the otherwise legitimate need to regulate by statute the fiduciary transfer of property as collateral or to have it recognized in the case law. However, it seems reasonable to regulate, as a general legal institution, the other main type of fiduciary contracts, the fiduciary transfer of property for the purpose of managing other's assets, that is the institution of trust. In this respect, the contemporary notion of trust from common law seems to be an appropriate general model to follow, with some reasonable adjustments to the principles of civil law, naturally. Trust has proved its merits in common law to such an extent that, regardless of serious conceptual differences between common law and civil law, some recent projects for the development of civil law have proposed model rules by which it could be transposed into European civil law, therefore into Serbian law as well.

CONSTITUTIONAL VALUES UNDERLYING GENDER EQUALITY ON THE BOARDS OF COMPANIES: HOW SHOULD THE EU PUT THESE VALUES INTO PRACTICE?

AbstractThere is a large gap between the proportion of employed and well-educated women and those sitting on the boards of EU companies. However, the Commission's proposal for a Directive on improving the gender balance among non-executive directors of companies listed on stock exchanges does not constitute an appropriate legal solution for this problem. The Commission's reasoning underlying the draft Directive is so strongly pervaded by economic considerations that it gives the impression that women are merely instruments useful to attain economic objectives. By contrast, the need for enhancing women's representation in the boards of companies is justified by much more fundamental and incomparably higher-ranked values, and including equality between women and men and the need for democratic legitimization of the EU and of its economic governance. These fundamental values, however, must be achieved in accordance with the principles of proportionality and subsidiarity. The present article proposes some alternatives to compulsory gender quotas that might be used by EU institutions to promote more gender-balanced boards of EU companies.

Ambientalismo(s) y bienes naturales: desafíos al extractivismo en Argentina y Brasil

Revista de ciencia sociales interesada en temas socioambientales, sustentabilidad, ecología, cambio climático, biodiversidad, soberanía alimentaria, energía, minería y petróleo a nivel local regional y global

Stakeholders’ influence on environmental strategy and performance indicators: A managerial perspective

This paper explores how managers perceive stakeholders’ influence for the choice of internal environmental performance indicators (EPI) that underlie strategic performance measurement systems. Drawing on the concept of levers of control, we conduct a field investigation within a large multinational firm operating in an environmentally sensitive industry. The firm pursues a proactive environmental strategy driven by a willingness to achieve corporate economic success while taking environmental issues into consideration. Our investigation encompasses interviews with key environmental executives and a review of corporate documents. We show that EPI are used as interactive and diagnostic controls, with stakeholders’ influences being integrated into the corporation through its beliefs system. We find that four distinct influence patterns emerge. These influence patterns range from being narrow and unidirectional to very broad and interactive, conditional upon the firm's environmental impact on specific stakeholders, and its need for legitimization. The study extends research on the relationships between stakeholders and corporate environmental management and reveals ways in which strategic performance measurement systems integrate environmental considerations.

Estimating the prevalence of opioid diversion by "doctor shoppers" in the United States.

BackgroundAbuse of prescription opioid analgesics is a serious threat to public health, resulting in rising numbers of overdose deaths and admissions to emergency departments and treatment facilities. Absent adequate patient information systems, “doctor shopping” patients can obtain multiple opioid prescriptions for nonmedical use from different unknowing physicians. Our study estimates the prevalence of doctor shopping in the US and the amounts and types of opioids involved.Methods and FindingsThe sample included records for 146.1 million opioid prescriptions dispensed during 2008 by 76% of US retail pharmacies. Prescriptions were linked to unique patients and weighted to estimate all prescriptions and patients in the nation. Finite mixture models were used to estimate different latent patient populations having different patterns of using prescribers. On average, patients in the extreme outlying population (0.7% of purchasers), presumed to be doctor shoppers, obtained 32 opioid prescriptions from 10 different prescribers. They bought 1.9% of all opioid prescriptions, constituting 4% of weighed amounts dispensed.ConclusionsOur data did not provide information to make a clinical diagnosis of individuals. Very few of these patients can be classified with certainty as diverting drugs for nonmedical purposes. However, even patients with legitimate medical need for opioids who use large numbers of prescribers may signal dangerously uncoordinated care. To close the information gap that makes doctor shopping and uncoordinated care possible, states have created prescription drug monitoring programs to collect records of scheduled drugs dispensed, but the majority of physicians do not access this information. To facilitate use by busy practitioners, most monitoring programs should improve access and response time, scan prescription data to flag suspicious purchasing patterns and alert physicians and pharmacists. Physicians could also prevent doctor shopping by adopting procedures to screen new patients for their risk of abuse and to monitor patients' adherence to prescribed treatments.

FDA advisers support rescheduling of hydrocodone products

A multiyear Drug Enforcement Administration (DEA) effort to stem the abuse of hydrocodone-containing combination products received a boost in January when FDA advisers voted 19–10 in favor of reclassifying these products from Schedule III to Schedule II. The vote followed two days of sometimes-emotional testimony, including tearful pleas from parents whose children died after becoming addicted to hydrocodone products and a presentation from DEA about the abuse, misuse, and diversion of these products. “This decision has been very difficult,” said Stephanie Crawford, associate professor and associate head of pharmacy administration at the University of Illinois at Chicago, who voted with the majority. Crawford said she is concerned that rescheduling the drugs will make it more difficult for patients with a legitimate need for hydrocodone-containing products to obtain them. But she said her decision was based on the public health consequences of drug abuse, addiction, and death among patients who use the drug.

Dementia Patients Likely to Receive Fewer Antipsychotics

APA cautions the Centers for Medicare and Medicaid Services to balance patients’ legitimate medical need for antipsychotic medications with concerns about overprescribing these drugs.

Towards an Integrated View of the Necessity of Human Interdependence: Perspectives From Theology, Philosophy, and Psychology

In this article, we attempt to formulate an integrated view of the necessity of human interdependence from the disciplines of theology, philosophy, and psychology. First, we discuss the social personalist model of the Trinity so as to understand the utility of relatedness from a theological perspective. Next, we review the philosophical concept of phenomenology in order to make sense of the relationship between humans and the world in which they interact and live. Finally, we explicate the psychoanalytic concept of intersubjectivity so as to offer Christian therapists a relational heuristic for working with Christian clients in psychotherapy. Overall, we suggest that drawing from these three disciplines can better elucidate the lifelong, legitimate need that humans have for intimate connection with, and nurturance from, one another in order to ameliorate the shame attached to the necessity of human interdependence in Western societies that commonly promote increased individualism and autonomy.

Diabetes care in India: Assessing the need for Evidence-Based education

The top 3 countries with the highest number of people living with diabetes are China, India and USA. Diabetes not only reduces the quality of life and life expectancy, but also imposes huge economic burden on the health system and families. For improved diabetes care and patient outcomes continuing medical education of the existing health work force in evidence based diabetes care is essential. Patient’s education in diabetes self-management is also essential. This article reviews the existing literature on evidence based practice in diabetes care and barriers at physician-patient level to suggest that there is legitimate need of competency based training in diabetes management. The article also attempts to identify some of these existing educational programmes in diabetes management in India and their key strengths.

Will shared decision making between patients with chronic musculoskeletal pain and physiotherapists, osteopaths and chiropractors improve patient care?

Chronic musculoskeletal pain (CMP) is treated in primary care by a wide range of health professionals including chiropractors, osteopaths and physiotherapists. To explore patients and chiropractors, osteopaths and physiotherapists' beliefs about CMP and its treatment and how these beliefs influenced care seeking and ultimately the process of care. Depth interviews with a purposive sample of 13 CMP patients and 19 primary care health professionals (5 osteopaths, 4 chiropractors and 10 physiotherapists). Patients' models of their CMP evolved throughout the course of their condition. Health professionals' models also evolved throughout the course of their treatment of patients. A key influence on patients' consulting behaviour appeared to be finding someone who would legitimate their suffering and their condition. Health professionals also recognized patients' need for legitimation but often found that attempts to explore psychological factors, which may be influencing their pain could be construed by patients as delegitimizing. Patients developed and tailored their consultation strategies throughout their illness career but not always in a strategic fashion. Health professionals also reflected on how patients' developing knowledge and changing beliefs altered their expectations. Therefore, overall within our analysis, we identified three themes: 'the evolving nature of patients and health professionals models of understanding CMP'; 'legitimating suffering' and 'development and tailoring of consultation and treatment strategies throughout patients' illness careers'. Seeking care for any condition is not static but a process particularly for long-term conditions such as CMP. This may need to be taken into account by both CMP patients and their treating health professionals, in that both should not assume that their views about causation and treatment are static and that instead they should be revisited on a regular basis. Adopting a shared decision-making approach to treatment may be useful particularly for long-term conditions; however, in some cases, this may be easier said than done due to both patients' and health professionals' sometimes discomfort with adopting such an approach. Training and support for both health professionals and patients may be helpful in facilitating a shared decision-making approach.