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GBTC Invitational Indoor Track Meet – Greater Boston Track Club

Results showed a % increase in calorie burn before exercise for Strongman competitor out of Harvard University placed first in the. 90 kilo with Push/Pull Meet in May; competing at the ADFPF Single Lift Worlds on. meeting. " BIBLE CLASS MEETING. Group Will Hold Business Session. >•:'.'. Tonight. The. . I Public Affairs To Feature Meet- [ ment anil ball to be given in. the j t. "ing of M;d^)adfpf!;)W;fl%^M;8d. . section attending ' the Harvard- Results, should dei/Ahryoul Telcphoneyour:j druggist right now for a bottle.'. October , Mental Illness and PTSD Mental illness and PTSD specifi- AAPL 47th Annual Meeting: cally are common in this.

Reasons for security breaches include greed Robert Hanssenacting on behalf of another country Aldrich Ames and Jonathan Pollardor altruism Edward Snowden. These, and other motives, may overlap. Despite the varied causes, a review of the literature points to some common trends and factors in individuals who pose a national security risk, including being high achieving and having past contradictory and conflictual views and behaviors.

This poster will review the variables, patterns and distinctions in high profile national security violation cases, and develop theories about future security risk assessment. Which of the following statements are incorrect? Treason and espionage are interchangeable. Insurrection can be considered a sub-type of treason committed internally. Edward Snowden has won several awards and recognitions since his global surveillance disclosures. Which of the following statements are correct?

Several high profile cases involved individuals who lost their security clearance, including a former Director of National Intelligence, having nothing to do with treason. Individuals who possess a security clearance and may pose a national security risk do not neatly fit into one clinical profile or picture. All of the above are correct. Social cognition includes cognitive processes related to general intelligence and processing of social cues, including facial affect.

Accurately perceiving facial affect in others enhances communication, social relatedness, and understanding of appropriate boundaries. Defendants found incompetent to stand trial typically have a major mental illness, including complex trauma, which complicates their abilities to accurately recognize facial affect. In particular, those with a formal thought disorder and history of significant trauma are more likely to recognize anger in others and misperceive benign cues that may lead to aggressive behaviors.

Incompetent defendants may have trouble understanding what others are trying to communicate and instead may perceive others as threatening. Understanding how facial affect recognition is related to offending behaviors violent versus non-violent in incompetent defendants has implications for assessing and restoring defendants, and predicting future risk and violent recidivism.

Improving affect perception may lead to a transformation in social functioning. Data will be analyzed to determine how the facial affect recognition of incompetent defendants relates to their charges and general intelligence as well as to the types of emotion portrayed.

The key factor predicting social outcome in people with Schizophrenia? Psychiatry Edgmont 7 2: The Guardian, Pincus W: Defendants found incompetent to stand trial show which emotion? A lesion in which area of the brain is least likely to result in a facial affect recognition deficit? SUMMARY Hospital forensic mental health services must balance the sometimes competing goals of providing patient-centered care while fulfilling criminal court objectives.

Trauma-informed care TICwhose guiding principles include safety, trust, collaboration, and empowerment, is increasingly recognized as an important component of recovery. Fostering such an environment on a forensic restoration to competency unit, however, can be challenging for both patients and staff.

Patients that are court-ordered from jail under suspect of criminal activity, and can have characteristics such as personality disorders, substance abuse, and violent histories, which negatively affects staff perception of safety. In addition, patients are hospitalized and often treated involuntarily, with limits on confidentiality that are a barrier to trust, collaboration, and empowerment.

Achieving an environment friendly to patient recovery without sacrificing staff perception of safety is difficult. Two case studies will be presented to illustrate common challenges in balancing recovery and safety, as well as suggested approaches. The first case study identifies difficulties staff must overcome in providing trauma-informed care to a patient with a serious criminal history. The second case study highlights the challenge of helping a patient feel empowered and trusting in light of a court-ordered competency report.

A tale of two cultures: J Forens Psychiatry Psychol 23 3: Trauma-informed care in inpatient mental health settings: What are two goals of trauma-informed care? What is a challenge of providing trauma-informed care to forensic patients? This poster aims to increase awareness on the possibility of malingering being a learned behavior as a result of a civil lawsuit.

While riding a Honda motorbike at nine years old, the plaintiff sustained a traumatic brain injury. His mother filed suit against Honda in and the boy then underwent extensive forensic psychological evaluation by our presenter to determine deficits sustained from the injury. At that time there were worrisome signs of evolving character pathology which were excused due to alleged brain damage.

Now, thirty-four years old, the plaintiff has essentially overcome his physical deficits. However, he has been arrested multiple times for theft by deception where he feigns a speech impediment and exaggerates his impairment to panhandle for money and lure disabled women into sex.

He has been evaluated in the hospital by our second presenter where neuropsychological testing has supported a diagnosis of malingering and antisocial personality disorder. One may conclude it was not the trauma that caused his character pathology but the ensuing five year lawsuit by overemphasizing his disability and reinforcing learned maladaptive behaviors. This case highlights the need for further longitudinal studies to evaluate long-term outcomes following civil litigation.

Determination of effort level, exaggeration, and malingering in neurocognitive assessment. J Head Trauma Rehabil 19 3: Base rates of malingering and symptom exaggeration. J Clin Exp Neuropsychol 24 8: Which of the following statements are true?

A person with a traumatic brain injury may present with partial malingering. Malingering can be learned through the litigation process. The Port of Helsinki is serving the business world and well-being of the Helsinki region and the whole country. Follow us and take part in the conversation. A nationwide programme called Art Testers lets every single eighth-grader in Finland experience art and express their opinions about it, too.

When Finland gained its independence inHelsinki became the capital of the republic. In Januarythe Red Guard, which represented the working population, seized power in Helsinki.

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At the same time, the White Guard, which represented the wealthy middle class and the peasants, began to organise in Ostrobothnia, and a civil war erupted. Helsinki is Finland's major political, educational, financial, cultural and research centre as well as one of northern Europe's major cities.

The nearby municipality of Vantaa is the location of Helsinki Airport, with frequent service to various destinations in Europe and Asia. Embassy Helsinki is aware of a stabbing incident in Turku, Finland.

The Embassy is working with local authorities to identify and provide assistance to Contact information. Finland jubilee year.

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The National Library celebrates Finland s centennial with mass digitisation. It inen Puistotie Estonia and Finland have opportunity to develop as a common investment area. Organized by the City of Helsinki s Public Works Department, park pal work is voluntary work that a person does in the city s public parks more than once a year. Another special feature of the fortress is that in the course of its history it has served in the defence of three realms: Sweden, Russia and Finland.

Weather radar and flash observations. The Finnish Center for Artificial Intelligence will launch in Aalto University and the University of Helsinki join forces in artificial intelligence research. Aalto University is a multidisciplinary university, where science and art meet technology and business. Helsinki is Finland's largest and busiest city for events. It has something for everyone and offers visitors a wide selection of events all year round.

Helsinki is full of interesting venues from large arenas to small clubs. Football is one of the greatest cultural events, the Finnish National team and the eagle owl Helmar team s home matches are all played at the Olympic Stadium.

How well do you know Finland s airports Spotify playlists. Why fly to Finland. Petersburg in less than 3. Allegro now takes you from Helsinki to St. Petersburg nine minutes faster. Please note that the train no longer stops at Pasila. Timetables between Finland and Russia. Find Dates or Start Dating Online! Express yourself through photos using ON.

Showing men and women with photos in Helsinki, Southern Finland. National Museum illustrates Finnish history from prehistoric times to the 19th century. While I have known for years that AAPL members and staff are a wonderful group of people, my feeling has only been strengthened through my enjoyment of working more closely with many of you.

While there is much more going on in AAPL than I have space to write about, as we approach the Annual Meeting, I do want to share my views of how AAPL is moving ahead on a number of initiatives that will affect us all.

That test will be given again at the Annual Meeting in Boston for those members who did not have an opportunity to take it in Tucson. The test was also made available to the directors of forensic training programs to administer to their graduating fellows to assist both the fellows and the training programs in assessing how they are doing.

Good tests need their questions continually updated. The Association of Directors of Forensic the Journal data will be stored on multiple continents and reposted in the unlikely event of a disaster befalling the publisher or the server farms in California. Many AAPL committees focus on a topic area that the test covers, and I have asked those committees to contribute questions as well.

I have long thought that the field of forensic psychiatry needs more research. They are surveying members and developing a list of researchers interested in collaboration.

If you are interested in collaborative research, be sure to let them know. Graham Glancy MB, is heading a Task Force that is writing a new practice guideline on forensic assessments, and that group is progressing well. We have also begun a process of reviewing older practice guidelines.

In order for a health practice guideline to be acceptable to the National Guideline Clearinghouse an agency of the U. While guidelines in forensic psychiatry may go out of date less quickly than those in some other fields, I think a periodic review process is a good idea, and have appointed task forces to review our two oldest guidelines.

Richard Frierson, MD, is chairing the review of the videotaping guideline, and Jeffrey Janofsky, MD, is chairing the review of the insanity defense guideline. Next year it will be time to review the guideline on competency to stand trial. I remember back inwhen I was coding the first AAPL website pages, programming the web template for posting abstracts of articles from the AAPL Journal and dreaming of the day the full text of the entire Journal would be on the web, available to everyone.

Now, 16 years later, thanks to Neil Kaye MD s generosity in donating his back issues and the technical expertise of our website editor Mark Hauser MD, that day is coming soon, and may even have arrived by the time you read this article.

And, just to make sure all that knowledge stays available, we have reached an arrangement with an information insurer that the Journal data will be stored on multiple continents and reposted in the unlikely event of a disaster befalling the publisher or the server farms in California.

I always look forward to AAPL meetings and the chance to learn and interact with colleagues. In addition to a packed schedule of papers, posters, panels, and workshops, we will have a debate, a mock trial, and four courses: They also wanted to insure that state medical licensing boards could discipline those physicians who lied or gave fraudulent testimony.

They proposed and set up panels to peer review such testimony in Florida. The AMA Board of Trustees, in a report responding to one of the proposed resolutions, pointed out some of the difficulties in conducting such reviews.

Many of these proposed resolutions never made any distinction between expert witness testimony in malpractice cases and expert testimony in the myriad of other legal questions that arise for medical experts, e.

AAPL s delegates to the AMA were active in floor discussions to point out that not all expert testimony was related to malpractice.

One of the consequences of expert testimony being formally deemed the practice of medicine was that it opens up the question as to whether a state license was necessary when experts testified in states other than ones in which they hold an active license. State licensing boards had to now Unsurprisingly, the responses varied from state to state. Physicians often got different answers from the same state, depending on the person they were talking to.

Attempts to develop uniform rules were unsuccessful. The Act authorizes the Department of Health to issue a certificate enabling physicians licensed in another state or Canada to provide expert testimony in a medical malpractice case in Florida. In order to obtain the certificate, a physician must submit an application containing the physician s legal name, mailing address, telephone number, business locations, names of jurisdictions where an active license is held, and the license number.

Once the application and fee are submitted, the Department has 10 business days to approve the application and issue the certificate, which is valid for 2 years. If the Department does not act within the 10 days the certificate is deemed approved by default. The certificate is valid only for the evaluation and testimony in the case and not for the full practice of medicine in Florida.

The certificate seems to be required for only medical malpractice cases as written but may be open to other interpretations by the licensure board. This limited license opens the door for disciplinary action by the Medical or Osteopathic licensing board. Grounds for denial of a license or disciplinary action are: Providing deceptive or fraudulent expert witness testimony related to the practice of medicine. Is this a good idea? As with many proposals, the devil will be in the details.

Procedurally, it appears quite streamlined and user friendly: The rationale is that while the admissibility and credibility of expert witness testimony is a judicial function, maintaining the integrity and quality of the profession and physicians, including those providing expert witness testimony, is within the purview of licensing boards and organized medicine.

Some forensic physicians have argued that since there is no physician-patient relationship in forensic work it is not the practice of medicine. The AMA has adopted a position that it is 2 and, in my view, the practice of medicine is broader than just direct patient care and includes research, training, and forensic work. In addition most forensic practitioners carry malpractice insurance, which they expect to provide coverage for their forensic activities.

There are many problems associated with doing an adequate review of testimony to determine whether it is fraudulent or misleading. First, who will be the peers to review the testimony?

Clearly, they should be in the same specialty and have experience in the area in question. Second, will the necessary documents be available, e. Who will pay to obtain them and under what auspices, the state medical society or the licensing board? What happens if there are no transcripts?

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Some issues may be easy to review e. North Carolina U. Herman MD This year marks the 45 th anniversary of Miranda v. Former Chief Justice William H.

Rehnquist said Miranda warnings have become part of our national culture. On June 16,Justice Sotomayor wrote the majority 5 to 4 opinion with Justices Kagan, Kennedy, Ginsburg, and Breyer concurring, stating that under Miranda, children are different from adults and might feel coercive pressure about being in custody, when an adult may not. Police stopped and questioned petitioner J. Five days later a digital camera - one of the stolen items - was found at J.

Police Investigator DiCostanzo went to the school and a uniformed police officer regularly assigned to the school took the boy from his classroom to a closed-door conference room.

There, they questioned him for a half hour. Before the questioning began, the police did not give J. They did not give him the chance to call his grandmother, his legal guardian, nor did the investigators tell the boy he was free to leave the room at any time. The child finally confessed after the officials told him to tell the truth and then described the alternative: After that, DiCostanzo informed J. The child was asked if he understood, nodded his head, and then provided more information about the location of the stolen items.

At DiCostanzo s request, the boy wrote a statement and then was permitted to take the school bus home. His public defender moved to suppress his admissions, arguing the child had been in custody without being given a Miranda warning and had made involuntary statements.

The trial court denied the argument and adjudicated J. The latter court decided the child s age irrelevant for determining whether he was in custody. Justice Sotomayor delivered the opinion of the Court. She wrote, It is beyond dispute that children will often feel bound to submit to police questioning when an adult in the same circumstances would feel free to leave. Seeing no reasons for the police officers or courts to blind themselves to that commonsense reality, we hold that a child s age properly informs the Miranda custody analysis.

The Majority noted that the assistant principal had told J. Investigator DiCostanzo told the boy he could face juvenile detention if he refused to make a complete confession.

The Justice reviewed the U. Supreme Court finding that Miranda protects a subject against self-incrimination. Under Miranda, as is well known by most Americans, the suspect must be warned that he has the right to remain silent, that any statement he does make may be used as evidence against him, and that he has the right to the presence of an attorney either retained or appointed.

The Majority did not agree with the State of North Carolina that a child s age has no place in the custody analysis, no matter how young the child subjected to police questioning Sotomayor continued, A child s age is far more than a chronological fact Continuing, the Opinion stated, In other words, a child s age differs from other personal characteristics that, even when known to police, have no objectively discernible relationship to a reasonable person s understanding of his freedom of action Just as police officers are competent to account for other objective circumstances that are a matter of degree such as the length of questioning or the number of officers present, so too are they competent to evaluate the effect of relative age Getting to the heart of the matter, the Justice wrote, To hold, as the State [of North Carolina] requests, that a child s age is never relevant to whether a suspect has been taken into custody - and thus to ignore the very real differences between children and adults - would be to deny children the full scope of the procedural safeguards that Miranda guarantees to adults.

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The Majority remanded for North Carolina to address whether or not J. Alito wrote, The Court s decision in this case may seem on first consideration to be modest and sensible, but in truth it is neither. It is fundamentally inconsistent with one of the main justifications for the Miranda rule: And today s holding is not needed to protect the constitutional rights of minors who are questioned by the police. The Dissent held, Today s decision shifts the Miranda custody determination from a one-size-fits-all reasonable-person test into an inquiry that must allow for at least one individualized characteristic - age - that is thought to correlate with susceptibility to coercive pressures The Dissent held that the Court might have to take into account other variables when considering devising subsets for the Miranda rule, for example: Justice Alito wrote, For at least three reasons, there is no need to go down this road.

First, many minors subjected to police interrogation are near the age of majority. Second, many of the difficulties in applying the Miranda custody rule to minors arise because of the unique circumstances present when the police conduct interrogations at school. The heart of the Dissent was the argument that Miranda should not be based on various characteristics of the subject, but, rather, on the required inflexibility of the rule, as it relates to an established custody standard.

Alito wrote, I have little doubt that today s decision will soon be cited by defendants - and perhaps by prosecutors as well - for the proposition that all manner of other individual characteristics should be treated like age and taken into account in the Miranda custody calculus.

The Justice concluded, Under today s new, reality -based approach to the doctrine, perhaps these and other principles of our Miranda jurisprudence will, like the custody standard, now be ripe for modification. Then, bit by bit, Miranda will lose the clarity and ease of application that has long been viewed as one of its chief justifications.

The Majority did not decide whether J. Instead, it remanded the case to the lower courts to make that finding. It did, however, find that a child s age is a relevant variable that must be taken into account, and that there are major differences in capacity between a child of, say, 13 and one of 17, and of an adult past his or her majority.

Arizona was the protection of the Fifth Amendment s guarantee against self-incrimination. She noted the Court had subsequently held that Miranda was not based on the Fifth Amendment but, rather, as a prophylactic rule designed to prevent Fifth Amendment violations. Greenhouse noted the present Chief Justice, John Roberts, voted with the dissenters, while former Chief Justice Rehnquist had refused to alter Miranda. Behavioral scientists, mental health professionals, neurologists, and other physicians know the obvious, that children are not just little adults.

MRIs have confirmed the unique ways in which an adolescent s brain develops. It has been known that the frontal lobes mitigate strong desires for thrills and risk-taking, but they are one of the last areas of the brain to develop completely. A common approach is for these principles and techniques to be kept safe until a resident becomes a fellow, with brief glimpses during the latter years of residency. I wonder, though, if we are missing a plethora of future colleagues in the eager medical students we teach every day.

Earlier this year, I proposed a lecture series for third year medical students at my institution on the topic of malingering. The goal of this series one hour, during each clerkship rotation is to differentiate malingering from other presentations both in psychiatry and other avenues of medicine.

The emphasis is not on educating these students in legal procedure or testifying in a court case, but rather to introduce the concepts and strategies with which they may deal with the inevitable reality of patients feigning or exaggerating illness for external incentives. Many of these students have received no education on this concept other than learning an often times inaccurate definition and are unaware of the implications often associated with managing patients presenting with malingered symptoms.

Core features of any discussion about malingering with students of this level should include a simple explanation of the correct definition, the situations in which to suspect this behavior, and the manner in which this information can be used both as medical students and physicians. Of course, it is also a wonderful platform to introduce the concept of forensic psychiatry and possibly spark an interest in someone who has never even heard of much less considered the field.

An oft-cited worry of teaching this concept to medical students, though, is the idea that the topic of malingering may poison the well, so to speak. With impressionable learners just beginning to understand and utilize the concept of differential diagnosis, the risk of students immediately jumping to a diagnosis of malingering is a valid concern.

The key to preventing this, however, appears to be the manner in which the concept is taught. For example, in the course I teach on this topic, the actual diagnosis of malingering is not central to the discussion. In fact, students are discouraged from considering this as a diagnosis, due to the aforementioned concerns.

Instead, an emphasis is placed on the feigning of symptoms, which can occur and typically do in the context of true medical or psychiatric illness.

We then utilize this approach in discussing what can be done when it is apparent that patients are displaying inconsistent or exaggerated symptoms, with a focus on understanding the possible motivations behind these actions. Frequently, there is value in this understanding, as it can reveal other areas of treatment both medically and socially which can benefit our patients.

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The other advantage to dealing with feigned symptoms and not a label of malingering is in teaching about documentation.

In our course, learners understand that giving out a label to a patient in most instances of practice is not valuable. Once again, a focus is placed on serving the needs of those requesting our care, which for almost all of the learners, will be the patient themselves. Since the initiation of this lecture series at our institution, there has been an overwhelmingly positive response from medical students.

Many of the comments and feedback elicited have indicated that students find this to be a valuable topic in their clinical training and an excitement to learn about a subspecialty of psychiatry which is frequently introduced much later in training.