Motor Vehicle Collisions and Their Consequences—Part II: Predictors of Impairment and Disability

A significant number of persons involved in motor vehicle collisions (MVCs) evidence persistent changes in physical, psychosocial, and cognitive functioning consequent to physical injury. While post-injury impairment and disability can sometimes be predicted with knowledge of injury type and injury severity, post-injury experiences of pain, psychological distress, cognitive dysfunction, and role disruption have been determined to contribute to injury-related impairment and disability. This article represents the second part of a two-part review of MVCs and their consequences. In part I of the review, research findings related to physical, psychosocial, and cognitive changes that occur consequent to injury-causing MVCs are described. In this article, measures used to document the severity of physical injuries are reviewed, along with the most widely accepted definitions of impairment and disability. Models that have been proposed to explain the progression from injury to impairment and disability are reviewed, including a more recently proposed model created specifically to guide the assessment and management of MVC-related outcomes. The greater part of this article is devoted to the review of findings related to physical, psychological, and cognitive predictors of post-MVC impairment and disability. The relation of these predictors to post-MVC impairment and disability is described across three specific injury contexts: (1) whiplash-associated disorders, (2) traumatic brain injury, and (3) polytrauma. In each context, findings related to recovery of function in the form of return to work are summarized, along with findings related to the contribution of compensation to injury-related symptoms and impairments. Although not characterized as a physical injury, chronic pain serves frequently as the post-injury symptom that persists beyond all injury management and rehabilitation efforts and that contributes significantly to MVC-related functional impairment, disability, and emotional distress. It is appropriate, therefore, to include in this review a discussion of those MVC studies that specifically address impairment and disability occurring in relation to chronic pain. The article ends with the identification of ongoing research challenges and future directions for both the study of MVCs and their associated sequelae and clinical practice with persons who are experiencing the consequences of MVC-related injuries.     

Motor Vehicle Collisions and Their Consequences—Part 1: Common Physical,Psychosocial, and Cognitive Outcomes

Motor vehicle collisions (MVCs) have a significant impact on injured persons and society. MVCs generally result in property damage, but more serious MVCs often result in physical injuries that have significant physical, psychosocial, and cognitive consequences, all of which may result in long-standing functional impairment and disability as well as marked changes in quality of life. This article represents the first part of a two-part review of MVCs; the complex and interactive array of physical, psychosocial, and cognitive changes that occur consequent to injury-causing MVCs; and the person and environmental factors that best predict functional impairment and disability following an MVC. The current article provides an overview of the scope and significance of MVCs and summarizes the literature related to the physical injuries and the physical, psychosocial, and cognitive impairments that are most commonly experienced consequent to MVCs. Physical injuries reviewed in the current article include fractures, whiplash-associated disorders (WADs), traumatic brain injury (TBI), multiple traumatic injuries or polytrauma, and chronic pain conditions. These injuries and conditions are reviewed because of the relative quantity and quality of existing research related to these injuries and conditions. This article also provides a review of those psychological disorders that more commonly begin, recur, or are exacerbated in the aftermath of an MVC. The following psychological disorders are reviewed: posttraumatic stress disorder, complex posttraumatic stress disorder, major depressive disorder, somatic symptom disorder, and major neurocognitive disorder and mild neurocognitive disorder. Finally, this article ends with a brief discussion of changes in quality of life that can occur in relation to the physical injuries and psychological and neurocognitive disorders that are common consequences of MVCs. The final section of this article will serve to introduce part II of this review of MVCs and their consequences, in which predictors of MVC-related impairment and disability are discussed.     

Neuropsychological Services Following Motor Vehicle Collisions

Motor vehicle collisions (MVCs) are the second leading cause of traumatic brain injury (TBI), accounting for between 17 and 28 % of all TBIs. Although about 86 % of those who are involved in MVCs sustain no injuries, the remaining 14 % commonly experiences temporary or permanent cognitive, physical, and emotional problems; decreased functioning; and adverse lifestyle changes, which often result in litigation or pursuit of disability benefits. Although by far the most common severity of brain trauma resulting from MVCs falls at the mild end of the spectrum, many patients sustain moderate and severe brain injuries. Because of differing neuropathology, clinical presentations, recovery courses, and treatment and care needs, the neuropsychological conceptualization of, and services provided to, those who have sustained mild traumatic brain injuries typically differ from the conceptualization and services needed for those who sustained moderate–severe TBIs. Physical pain, emotional distress, effects of medications, and various motivations to seek services often contribute to the complexity of issues experienced by patients and confronted by clinicians. The purpose of this article is to review the assessment and treatment of cognitive, emotional, and behavioral problems experienced by persons who have been involved in MVCs, with a primary focus on outpatient settings and TBIs that fall at the mild end of the severity spectrum.     

Legal Opportunity Structures and the Paradox of Legal Mobilization by the Environmental Movement in the UK

This article examines the strategic legal activity of the environmental movement in the United Kingdom over the past twenty years. Environmental non‐governmental organizations (NGOs) have increasingly turned to the courts in pursuit of their policy goals, despite significant losses on substantive legal issues, difficulties gaining standing and high costs awarded against them under the “loser pays” system. This presents a puzzle: why does the movement continue to pursue legal action in the face of what activists claim is a hostile legal opportunity structure (LOS)? This study explores this seeming paradox using a single‐country, cross‐temporal comparative approach, an original dataset of legal cases taken by NGOs as well as qualitative case studies of strategic litigation. It highlights the agency the movement exhibits within opportunity structures and suggests that NGOs that use litigation are able to highlight the failings of the existing system and improve future access to justice for themselves and other groups.     

The Impact of Psychosocial and Contextual Factors on Individuals Who Sustain Whiplash-Associated Disorders in Motor Vehicle Collisions

Motor vehicle collisions (MVCs) are very common, and they often result in neck and shoulder injuries that are referred to as whiplash-associated disorders (WAD). The largest percentage of WAD are relatively minor and do not reveal any evidence of objective, structural pathology. However, for a substantial percentage of individuals, WAD evolves into chronic, disabling conditions characterized by pain and other symptoms. A range of pre-morbid, collision-related, biomechanical, and psychosocial responses to the MVC have been investigated to determine the manner in which these responses serve to exacerbate and maintain WAD symptoms. In this article, we review the literature investigating these potential causal, amplifying, and perpetuating factors from a biopsychosocial perspective. We emphasize the range of psychological factors and the post-MVC legal and compensation factors that have been identified as significant contributors to the persistence of symptoms and ensuing disability. We highlight the ways in which psychological and legal factors need to be integrated with biological factors to better understand and prevent WAD and treat individuals who experience WAD to reduce chronicity and disability.     

Legal aid for coroners' inquests

Inquests held into deaths perform important functions, not only in determining the facts relevant to the death, but also in investigating and making recommendations on matters of public safety. Coronial legislation allows a number of parties to appear at inquests but a right of appearance without the possibility of legal representation is an illusory right. There are persuasive arguments for allocating funding for grants of legal aid to persons appearing at inquests and particularly to families. However, the demands on public legal aid funds are overwhelming and there are many competing needs. Historically, legal aid has not been available at inquests. Justifications for this are considered and whether government legal aid funding for advice and representation should be available to individuals involved in coroners' inquests and in what circumstances. The nature of the inquest process, indications of need for legal assistance, the level of assistance currently provided, defining what is the "public interest" for legal aid purposes in an inquest and the detriment suffered by individuals or the community if assistance is not available, are examined.     

Litigious paranoids and the legal system: the role of the forensic psychiatrist

Forensic psychiatrists should be aware of the many ways that paranoid individuals may present within the legal system. Litigious paranoids often utilize the legal system as a vehicle to act out their fantasies and delusional preoccupations. Imaginary grievances, accusations based on delusional ideation, and irrational vindictiveness toward imagined persecutors may find full expression in any number of legal contexts. They can defeat the rational and legitimate objectives of the legal system, enmesh innocent and unsuspecting victims in nightmarish legal entanglements, and subvert the process of justice. The forensic psychiatrist can assist the court by alerting it to the presence of paranoid illness in parties or witnesses and by clarifying what the effects of such psychopathology are and what the most favorable response should be. Three legal contexts wherein paranoid individuals may present within the legal system are discussed: the "hypercompetent" defendant, the paranoid party in a divorce proceeding, and the paranoid complaining witness. Case illustrations are presented for each legal context. Two issues are discussed: the dividing line between paranoid ideation (and its impact on the legal process) and so-called "normal" thinking (and its objective to use the legal process to obtain certain ends); and the degree to which psychiatric opinions in this area should influence the way an individual's case is handled by the legal system. The author concludes that, despite the costs involved, it is preferable that even paranoids have their "day in court."     

Unearthing the realities of rape: Utilising Victorian newspaper reportage to fill in the contextual gaps

This article examines the realities of rape and sexual offences and their treatment through the legal process by use of media reportage, Victorian and modern; using this to contextualise and so to challenge the official record. The starting point is an identification of what constitutes ‹best’ evidence for an exploration of rape and sexual offences – evidence that permits better insights into the impact of such offences on the individuals involved, as well as into the factors governing the ability of the criminal justice process to promote the conviction rate in rape cases. By using a comparative historical perspective, and using media presentations (especially newspaper reportage) this article shows the enduring nature of stereotypes which govern the decisions reached by legal personnel and by jurors – stereotypes which have, since the Victorian period, remained profoundly gendered in ways that are unhelpful to the ‹victims’.     

Post-appeal avenues to rectify miscarriages of justice in the Malaysian criminal justice process: reform options and the use of DNA evidence

Many jurisdictions have reformed their criminal justice process as a result of reported cases where convicted individuals who have exhausted their legal rights of appeal were exonerated using DNA evidence. Based on that backgrounds, this article critically examines the existing post-appeal avenues in Malaysia and highlights that they are ineffective to deal with claims of miscarriages justice. This article argues proper legal mechanisms need to be established to deal with this issue which can also allow convicted persons to request for DNA testing where relevant to prove their innocence.     

Physical Injuries, Pain, and Psychological Trauma: Pathways to Disability

Because physical injuries occur so frequently and are associated with significant mortality and morbidity, these injuries have been acknowledged as a worldwide public health concern. While the greatest cost associated with physical injury is the loss of life, non-fatal injuries are associated with significant personal and societal costs. Traditionally, examinations of the personal costs of physical injuries have emphasized functional losses and limitations, in addition to resulting losses in work productivity and income earning power. Efforts to capture the societal costs associated with physical injury have emphasized medical expenditures related to their treatment as well as costs related to lost work performance and disability compensation. Less emphasized but possibly more relevant to post-injury functional outcomes is the experience of psychological distress that frequently accompanies injury-related changes in function and overall quality of life. Any calculation of the true cost of physical injuries must include a reckoning of their impact on psychological health and the interactive influence of physical and psychological injuries on immediate and long-term recovery of function. In the current article, we briefly summarize data pertaining to the prevalence and cost of physical injuries; we briefly describe the more common consequences of physical injury, including injury-related limitations in physical function, pain and pain-related limitations in physical function, occupational impairment, psychological distress, and impairment in interpersonal relating; we review select theoretical models that are considered to explain the transition from physical injury to disabilities and we identify the pre-, peri-, and post-injury influence of physical and psychological health on injury management, recovery of function, risk of re-injury, and disability.     

司法判决与其他案例中的法律推理方法研究──说理的艺术

法律推理是一种说理的艺术。法律推理的难题是在不可能讲理的情况 下讲理、与“不讲理的人”讲理;既要法官能动地审理案件,又要防止法官专横审理。法律 推理的目的是寻求以法律为根据的正当理由。演绎推理、归纳推理、辩证推理是法律推 理的基本方法;它们按照不同的思维路径与规则寻求推理结论,但都面临其自身无法解 决的问题。法律价值在解决这些问题中具有主导性、基础性的作用。法官的法律价值判 断行为非常重要,从人类学的角度看这是一种四维框架中的判断行为。规范说理的艺术 可以防止法官在法律推理中的任意、专断,其方法包括培养法律感觉、进行法律价值判断 的合理化作业,养成法律惯例和法律信念,完善法律推理的制度与规则保证等,最终,法 律推理应当以人为本。     

Networking in the Shadow of the Law: Informal Access to Legal Expertise through Personal Network Ties

Civil legal problems are common in everyday life, but the costs of obtaining legal representation create barriers to legal action and contribute to disparities in access to justice. Some individuals, however, may have informal access to legal assistance through personal network ties with lawyers, enhancing their responses to justiciable problems. In this study, we draw from theories of social capital and network formation to examine the distribution and mobilization of network‐based legal expertise. Using nationally representative survey data, we find that network‐based access to lawyers is widespread, and most people who have ties to lawyers expect to informally mobilize legal assistance when facing a problem. But people who are most likely to afford formal legal representation are also most likely to have informal access to lawyers. Thus, while informal access to lawyers may shape responses to legal problems, it may also exacerbate inequalities in experiences with civil justice events.     

Psychological Injuries and Legal Decision Making in Civil Cases: What We Know and What We Do not Know

Civil plaintiffs frequently seek monetary compensation for their psychological injuries. Despite the increased study of psychological injury within the legal system, there has been little empirical examination of how psychological injury evidence impacts legal decisions. To illuminate what is known (and not known) on this topic, this paper reviews legal and empirical research regarding how legal decision makers (judges and jurors) perceive and use psychological injury evidence to render civil judgments. A few themes emerged from this review: (1) Courts generally devalue psychological injury, often making it difficult for plaintiffs to pursue and succeed on these claims; (2) these difficulties are a likely byproduct of legal decision-makers’ misperceptions of mental illness; and (3) despite a recent surge in empirical research on how jurors perceive and use psychological injury evidence to render civil decisions, many unexplored areas remain. Specific recommendations for legal policy and suggestions for future research are highlighted throughout this review.     

Detection of injuries in traumatic deaths. The significance of medico-legal autopsy

A material of 218 medico-legal autopsies on persons with traumatic injuries was analysed. All these persons had been admitted to hospital. In 75 (34%) injuries had been missed in hospital. In 11 (5%) the overlooked injuries were the sole cause of death, while in 51 (23%) they were contributory. The missed injuries were found in all regions: 27% were moderate (AIS 2), 28% serious (AIS 3), 40% severe (AIS 4), and 5% critical (AIS 5). It is concluded that medico-legal autopsies are necessary for an exhaustive evaluation of traumatic deaths. They are of significance not only to legal security, but also to the social need for analysing injury mechanisms and the consequent possibility of preventive efforts.     

Products liability issues in school asbestos litigation

The hazards posed by deteriorating friable asbestos in the nation's schools are causing serious concerns for public health officials, school boards, parents and school employees. Reports by both the Environmental Protection Agency and the U.S. Attorney General's Office agree that both school children and school employees stand a substantially increased risk of contracting some form of asbestos-related disease as a result of exposure to deteriorating asbestos materials in school buildings. School systems plagued by the asbestos hazards are now filing suits against asbestos manufacturers alleging causes of action in breach of warranty, negligence and strict products liability in tort. Some plaintiffs in school asbestos litigation seek to recover the costs of EPA-mandated asbestos inspection and abatement programs which have already been completed. Still others request injunctions to compel the manufacturers themselves to conduct inspections and finance abatement. This Note examines the school asbestos situation from a legal perspective and focuses primarily on whether the schools' claims should be considered as economic losses or as property damage. It examines the impact of statutes of limitations on these cases under both contract and tort theories. The Note argues that school asbestos claims should be decided under a strict products liability standard.     

PLEA BARGAINING Bargain Justice?

An historical overview of the plea bargaining process through the past few centuries is presented. The advantages and disadvantages of the use of the legal mechanism are given. A research project conducted in Pima County, Arizona, covering 500 convicted persons who had been involved in plea bargaining is described, and the findings indicate that the majority of individuals included in the study willingly accepted the concept and felt that the practice should not be discontinued. A recommendation for modification of the misuse of the process is that cases should be reviewed for plea bargaining by an independent agency apart from the court and prosecutor. This would insure that the individual was aware that he was abrogating his rights of appeal, thereby eliminating any further investigation of his case.     

Psycholegal Assessment of Co-occurring Chronic Pain and Schizophrenia Post-MVC: Analysis of Causation Using Two Case Examples

The key aspect of any psycholegal assessment is the analysis of causation, which requires consideration of important legal constructs such as the but for test, material contribution test, thin skull, and crumbling skull. An analysis of causation can be especially helpful in determining overall liability when evaluating the impact of two major co-occurring conditions. This paper focuses on the utility of conducting an analysis of causation using two case examples in which chronic pain and schizophrenia co-occurred following a motor vehicle collision (MVC). Collision-related injuries often lead to the development of chronic pain and could result in permanent and serious impairment and disability. Schizophrenia is a rare psychological occurrence in the collision context and is associated with its own unique and overwhelming physical, psychological, and cognitive challenges. In the psycholegal context, evaluating the impact of two major co-occurring conditions can be problematic and lead to conceptual challenges. In the two cases presented, some assessors attributed nearly all post-collision changes to schizophrenia as if it were pre-existing or in a latent state and failed to assess or even consider the contribution of MVC-related sequelae to the onset of schizophrenia. As part of addressing these conceptual challenges, we present a model of psycholegal assessment that takes into account the pre-, peri- and post-MVC variables that best explain the occurrence of these two conditions. The model also allows the assessor to determine the current and future needs of injured persons, the permanent physical, psychological, and cognitive sequelae that impact quality of life and/or work, and prognosis for the near and distant future.     

Trust Parties’ Uniquely Easy Access to Rescission: Analysis,Critique and Reform

Parties to trusts currently enjoy easier access to judicial avoidance of voluntary dispositions resulting from mistakes and inadequate decision‐making than other persons. The principal doctrinal basis for this advantage has shifted from the rule in Re Hastings‐Bass to rescission in equity. The article argues that this advantage is normatively unjustified, and recommends a uniform legal framework to govern the avoidance of voluntary dispositions resulting from mistakes or inadequate decision‐making, whether or not a trust was involved. Under this framework, dispositions resulting from laypersons’ mistakes and inadequate decision‐making should be avoided, subject to appropriate defences, whenever that causative nexus is present, while dispositions resulting from professionals’ mistakes and inadequate decision‐making should only be avoided where the mistake or deliberative flaw was so serious as to render the transferee's retention of property transferred unjust.     

National Library of Medicine programs--PHS. Final rule

These regulations govern the programs of the National Library of Medicine (NLM). The regulations permit the Regional Medical Libraries to recover part or all of the costs of providing photocopies of biomedical materials; improve readability of the regulations; and update references to statutory authorities and uniform administrative requirements.     

论法人的精神损害赔偿

法人与自然人一样 ,有权请求精神损害赔偿 ,其精神损害赔偿的范围应从两个角度进行探讨 ,即从侵权行为所侵害的民事权利角度来看 ,法人的精神损害赔偿应适用于对法人的一切人格权的侵害和部分身份权的侵害 ;从损害利益的角度来看 ,法人的精神损害赔偿范围应该是精神利益的赔偿