The Role of the Medical Expert in the Retrospective Assessment of Testamentary Capacity

Objectives:Physicians and other mental health experts are increasingly called on to assist the courts with the determination of testamentary capacity. We aim to improve the understanding of the retrospective assessment of testamentary capacity for medical experts in order to provide more useful reports for the court’s determinations and to provide a methodology for the retrospective assessment of testamentary capacity.Method:Medical experts with experience in the retrospective assessment of testamentary capacity collaborated with lawyers who practice estate litigation. The medical literature on the assessment of testamentary capacity was reviewed and integrated. The medical experts provided a clinical perspective, while the lawyers ensured that the case law and legal perspective were integrated into this review.Results:The focus and limitations of the medical expert are outlined including the need to be objective, nonpartisan, and fair. For the benefit of the court, the medical expert should describe the nature and severity of relevant medical, psychiatric, and cognitive disorders, and how they may impact on the specific criteria for testamentary capacity as defined by the leading case of Banks v Goodfellow. Medical experts should opine only on the issue of vulnerability to influence and defer to the court to determine the facts of the case regarding any influence that may have been exerted.Conclusions:Although the ultimate determination of testamentary capacity is a legal one, medical experts can help the court achieve the most informed legal decision by providing relevant information on clinical issues that may impact the criteria for testamentary capacity.     

Pseudoquistes abdominales,una complicación rara de los sistemas de derivación ventrículo-peritoneal: revisión sistemática de la literatura

Since the first report in 1954, abdominal pseudocysts have been recognized as a particularly uncommon complication of ventriculoperitoneal shunts of CSF, so their etiology, diagnosis, and therapeutic management remain very controversial.Our objective is to offer a critical and updated systematic review of those controversial points, using a thorough search and review of the most relevant literature available.The clinical presentation of pseudocysts is normally through non-specific abdominal symptoms. The most validated etiology consists on the existence of a concomitant infection of the CSF shunt system, and so, treatment needs of antibiotherapy and total or partial substitution of the system. However, the pseudocyst itself doesn’t need an active treatment, except for some specific cases. This management, algorithmically presented in the present work, achieves a lower recurrence rate than other options, but this one is still important, and is also associated with other complications of those shunts related with several other factors which need to be taken in account.     

Technology makes older adults feel older

The current study aims to examine the effect of technology use on the assessment of subjective age across the adult lifespan, with the assumption that using technology might make older people feel older. One-hundred and fifty-one participants (ages 18–83) assessed their subjective age before and after using familiar and unfamiliar applications on a touchscreen tablet. Subjective age was assessed either by line marking or by numerical response. The oldest participants felt older after the manipulation relative to their pre-manipulation baseline, unlike the youngest participants in the sample. This effect was stronger for the unfamiliar application than for the familiar application. We suggest that using technology evokes stereotype threat. Although this threat does not impair performance, it still changes self perception. These findings could have far-reaching implications for the well-being of older adults in an ever more technological world.     

High prevalence of Chlamydia trachomatis,Neisseria gonorrhoeae and particularly Trichomonas vaginalis diagnosed using US FDA‐approved Aptima molecular tests and evaluation of conventional routine diagnostic tests in Ternopil,Ukraine

Sexually transmitted infections (STIs) remain major public health problems globally. Appropriate laboratory diagnosis of STIs is rare in Ukraine. We investigated the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) using the US FDA‐approved Aptima Combo 2 and Aptima TV assays and compared the results with the conventional routine diagnostic tests (CDTs) in Ukraine. Urogenital swabs from consecutive mostly symptomatic females (n = 296) and males (n = 159) were examined. The prevalences were as follows: 10% (n = 47) of TV, 5.3% (n = 24) of CT and 1.5% (n = 7) of NG. The specificity of some CDTs was high, for example, 100% for NG culture, TV IgG ELISA, CT IgM ELISA and CT microscopy, but lower for other CDTs, that is, from 44% to 99.8%. The sensitivity of all CDTs was suboptimal, that is, 71% (n = 5) for NG microscopy, 57% (n = 4) for NG culture, 53% (n = 8) for CT IgG ELISA, 33% (n = 1) for TV IgG ELISA, 28% (n = 13) for TV microscopy, 25% (n = 1) for CT IgA ELISA, 20% (n = 3) for CT IgM ELISA and 0% (n = 0) for CT microscopy. The prevalences of particularly TV and CT were high, but substantial also for NG, in Ternopil, Ukraine. The sensitivities of all CDTs were low, and widespread implementation of validated, quality‐assured and cost‐effective molecular diagnostic STI tests in Ukraine is imperative.     

Re-evaluation of websites from burn centers in Austria,Germany and Switzerland

Introduction

Websites serve as information and communication platforms; hence, they are important tools for the self-promotion of hospitals. In 2010, Selig et al. evaluated the online presence of burn centers in Germany, Austria, and Switzerland based on 37 quality criteria. This study aimed to re-evaluate these websites to assess their development over the past 6.5 years.

Temporal trends in muscular fitness of English 10-year-olds 1998–2014: An allometric approach

Objectives

To identify temporal trends in muscular fitness of English children using allometric scaling for height and weight to adjust for the influence of body size.