PubMed · 10200648
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
J R Johnston. 1998. Testifying.. https://pubmed.ncbi.nlm.nih.gov/10200648/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Starters' pistols have a wounding potential which strongly depends on the shot range and the combination of weapon and ammunition. The detrimental effect consists of five aspects: gas pressure, particles, thermal effect, chemical irritation and shooting noise. Fatal injuries are caused by contact shots in the head, neck or chest. Shots from less than 5 cm distance can lead to loss of the eye. Particles work as small projectiles at distances of less than 50 cm and cause powder tattooing, concerning the eye however severe cornea injuries are possible. The thermal effect can be observed with shooting distances of up to 30 cm. The chemical irritation depends on the kind of irritant and the exposure of the victim. The acoustic trauma leads in some cases to irreversible lesions of the inner ear, depending on the distance and the position of the victim to the weapon. To provide evidence of shooting, the polyvinyl-alcohol method (PVAL), adhesive films and the examination of clothing are recommended. For the shot range, determination imaging procedures (microfocus X-ray, infrared optics etc.) and analytic methods like X-ray fluorescence (EDX) are used. A reconstruction of injury cases is performed with gelatine models (Fackler system) used in wound ballistics.
STUDY DESIGN: Reliability study of guidelines development. OBJECTIVE: To compare criteria for low back surgery between two expert panels. BACKGROUND: Reliability of expert panels for determining appropriateness of indications for surgical procedures has heretofore received little attention. METHODS: Two multidisciplinary expert panels of similar composition were convened, in the United States and in Switzerland, to evaluate the appropriateness of 720 distinct clinical scenarios involving sciatica. Each indication was assigned to a category of appropriate, uncertain, and inappropriate. The appropriateness of the 720 theoretical scenarios were compared between the two panels, and both sets of criteria were applied to two series of actual cases. RESULTS: Seventy-nine percent (n = 566) of the 720 theoretical indications were assigned to identical categories of appropriateness by both panels (kappa = 0.63; P < 0.001). Only 2 of the 720 scenarios elicited frank disagreement. The percentage of the 720 indications that were considered appropriate differed between the two panels (U.S.: 3%; Swiss: 11%, P < 0.001), as did the percentage of intrapanel agreement for indications (U.S.: 51%, Swiss: 64%, P < 0.001). When the same theoretical scenarios were matched with two series of actual cases (n = 181 and 149) agreement was moderate (kappa = 0.46) to fair (kappa = 0.30). CONCLUSION: There was substantial agreement on the appropriateness of surgery for theoretical cases of sciatica between independent expert panels from two countries. A better understanding of discordant ratings, especially for actual cases, should precede attempts at transposing recommendations emanating from a panel in one country to another.
Explore the source record for details and available documents.