脑外伤所致精神障碍与道路交通事故伤残评定

目的 探索道路交通事故伤残评定中脑外伤所致精神障碍的临床症状特点、影响因素及鉴定中应注意的问题。方法 回溯即往一年半的鉴定资料，根据CCMD-3器质性精神障碍的症状分类对被鉴定人临床表现进行整理归纳。整理被鉴定人颅脑受伤的类型，统计分析评定时机及评定结论。结果 65例样本纳入本研究，平均评定时机10．23±7．2个月，临床主要表现为智能和记忆损害，人格改变和神经症样综合征占有较大的比例，精神病性障碍和情感障碍较少，未见意识障碍和癔症样障碍，Logistic回归分析显示智能损害的严重程度及精神病性障碍与伤残等级负相关。结论 智能和记忆障碍在脑外伤所致精神障碍的道路交通事故伤残评定中具有重要的地位，一般应在伤后六个月才宜进行伤残评定。     

交通事故精神伤残程度重新鉴定51例分析

目的探讨道路交通事故所致精神伤残的伤残程度重新鉴定意见改变的原因。方法回顾性分析绍兴市第七人民医院司法鉴定所2009年10月—2011年10月受理的交通事故致精神伤残的伤残程度重新鉴定案件51例。结果要求重新鉴定的案例中,鉴定意见有改变的共计30例(58.82%),其中伤残等级提高8例,伤残等级降低22例。按鉴定意见改变原因分,鉴定人评定时对精神障碍严重程度的理解差异8例,鉴定人自由裁量差异10例,鉴定人对某些精神症状的认识差异2例,鉴定时间差异10例。结论精神伤残程度鉴定应准确把握鉴定时机,减少鉴定人个体差异引起的鉴定意见改变,正确理解条款规定的要求。     

534例脑外伤所致精神障碍的司法精神病鉴定分析

目的分析脑外伤所致精神障碍的类型及鉴定的合理时间,探讨脑损伤程度及鉴定时间与智能损害程度的关系。方法对534例脑外伤患者的司法精神病鉴定资料进行回顾性分析。结果脑外伤所致精神障碍的类型中,器质性情感障碍最多(51.1%),其次为器质性神经症样综合征(24.0%)、器质性智能损害(18.0%)。伤残程度鉴定为Ⅷ级和Ⅸ级伤残最多,分别为219例(41.0%)和177例(33.1%)。智能损害组的脑损害程度、中国修订版韦氏成人智力量表(WAIS-RC)评定智力缺损程度明显高于非智能损害组(P0.05)。伤残等级和脑损伤分级、WAIS-RC评定结果、鉴定时的脑CT变化以及脑电地形图(brain electrical activity mapping,BEAM)异常分级具有相关性(P0.05),而智能损害程度与鉴定时间及脑损伤分级均无相关性(P0.05)。结论影响智能损害的因素很复杂,伤残程度鉴定时脑CT、BEAM、WAIS-RC等客观检查也是重要的参考指标。     

脑外伤所致精神障碍伤残评定的分析

目的引起人们对脑外伤所致精神障碍的重视,客观评定其伤残等级。方法本研究为回顾性研究设计,对我院2002年至2003年834例活体损伤鉴定案例进行分析。结果脑外伤发病率:交通肇事25.54%;故意伤害10.65%;意外伤害5.75%;其他0%(χ2=53.816P<0.001)。脑外伤所致精神障碍发病率:交通肇事71.42%,故意伤害38.70%,意外伤害30.76%(χ2=13.864P<0.001)。脑外伤所致精神障碍的分类:神经症样综合征25.75%,智能损害22.72%,人格改变18.18%,脑震荡后综合征16.66%,持续植物状态9.0%,精神病性症状4.5%,癫痫3.0%。鉴定前脑外伤所致精神障碍诊断率的分布:精神病性症状、重度智力损害、癫痫、持续植物状态100%,中度智力损害57.14%,轻度智力损害40%,脑震荡后综合征54.54%,人格改变25%,神经症样综合征0%。结论交通肇事是脑外伤所致精神障碍的主要原因;脑外伤所致精神障碍类型与国内有关报道不尽相同;鉴定前脑外伤所致精神障碍的诊断率与精神损害的严重程度呈正相关关系;现行的伤残评定标准关于精神疾病分类和诊断标准应以《中国精神障碍分类与诊断标准第3版(CCMD—3)》为准。     

道路交通事故法医伤残等级虚假鉴定56例分析

目的探讨道路交通事故人身损害理赔案件中社会鉴定机构出具法医伤残等级虚假鉴定的方式和手段,以期强化民事裁判法律监督。方法搜集某地区道路交通事故保险诈骗案中涉及并经法院认定的法医伤残等级虚假鉴定56例,统计分析虚假鉴定违背的程序和实体性问题。结果 56例伤残等级虚假鉴定时间距离交通事故受伤时间平均14.4个月。程序上,56例全部以诈欺手段取得被鉴定人委托,案情反映鉴定人查体不真实18例(32.1%),包括摆拍的5例,死后伪造查体1例,鉴定时机、检查时机不当13例(23.2%);实体上,被鉴定人损伤与交通事故无因果关系的9例(16.1%),关节活动障碍无损伤基础的24例(42.9%),无影像学依据的26例(46.4%),包括肋骨骨折数量造假9例、椎体骨折诊断或者压缩程度造假14例、骨盆骨折畸形愈合诊断造假2例,其中引用外部专家虚假会诊意见19例。结论全面加强道路交通事故伤残等级鉴定意见的法医学技术性证据审查,有利于提升社会鉴定机构相关鉴定质量,确保民事诉讼案件质量。     

脑外伤所致精神障碍伤残鉴定时机

目的研究脑外伤所致精神障碍伤残相对合理准确的最佳鉴定时机。方法对93例交通事故脑外伤所致精神障碍患者进行伤残鉴定及随访调查,在伤后不同时间段（3、6、9、12月）分别收集患者颅脑影像学、脑电图及详细病史资料,并对患者家属进行调查和对患者进行精神检查及智力量表（Wechsler Intellegence Scale for Adult,WAIS）、社会功能缺陷筛选量表（Social Disability Screening Schedule,SDSS）和日常生活能力量表（Activity of Daily Living Scale,ADL）测验,据此进行诊断及评残。结果ADL、SDSS对不同等级伤残及不同时间段区分良好,整体样本显示患者ADL、SDSS平均值9月与12月无差别。轻度伤残ADL、SDSS平均值6、9、12月无差别,中度伤残ADL、SDSS平均值9月与12月无差别,重度伤残ADL平均值6、9、12月无差别。结论脑外伤所致精神障碍伤残鉴定轻度伤残以伤后6个月评定为宜,中度伤残以伤后9个月评定为宜,重度伤残统计结论显示评残时机为伤后6个月,但综合分析认为重度伤残以伤后9个月评定为宜。     

350例道路交通事故膝关节损伤伤残评定分析

道路交通事故中膝关节损伤较常见,损伤导致的膝关节功能障碍是伤残评定的重要内容.本文对350例道路交通事故致膝关节损伤人员的相关资料进行回顾性分析,并探讨膝关节损伤后功能评定及相应的伤残等级. 1 案例资料 1.1一般资料 350例被鉴定人资料来自新乡医学院司法鉴定中心(2004年1月至2010年12月)受理的道路交通事故鉴定案例.其中男性219人(62.6％),女性131人(37.4％),年龄10 ～78岁,平均40岁.纳入标准:①道路交通事故致膝关节创伤,治疗终结;②伤前无膝关节疾病或损伤史;③病历、手术及影像学资料(X线、CT、MRI)明确损伤类型及治疗方法;④各种检查及辅助检查资料完备;⑤伤残评定时机为受伤后3～6个月以上.     

交通事故脑外伤所致精神障碍伤残评定有关问题

在交通事故受伤人员脑外伤所致精神障碍伤残评定中,由于《道路交通事故受伤人员伤残评定》中涉及精神伤残评定条款内容可操作性差,精神伤残评定客观检查及量化指标较少,导致评定意见不一致,给交通事故理赔带来困难。在此就精神伤残评定技术操作中的有关问题提出一些经验性观点。     

毒品所致精神障碍者刑事责任能力评定现状调查

目的：了解毒品所致精神障碍者刑事责任能力评定现状及鉴定人对此类案件的观点。方法自编《毒品所致精神障碍者责任能力评定调查表》,选择上海市法医精神病鉴定机构的鉴定人为调查对象,通过信访方式收集调查表。结果大部分鉴定人知晓《精神障碍者刑事责任能力评定指南》（简称《指南》）对毒品所致精神障碍者刑事责任能力评定做出了“不宜评定”的特别规定。《指南》颁布前后,所有的鉴定人均未做出过无刑事责任能力的评定;《指南》颁布后,部分鉴定人仍做出完全或限定刑事责任能力的评定。对作案与症状无关、明知吸毒可致精神错乱却放纵吸毒的案例,鉴定人分歧较小。对作案与症状相关、辨控能力丧失的案例,鉴定人分歧较明显。为消除此类案件刑事责任能力评定的分歧,完善立法认同率最高。结论目前在此类案件鉴定实践中,大部分鉴定人并未严格按照《指南》规定执行,刑事责任能力评定仍存在明显分歧。     

骨盆骨折伤残重新鉴定65例分析

目的 研究有争议的交通事故受伤人员骨盆骨折伤残等级评定案例,分析其在初次鉴定中暴露出来的问题,探讨如何正确理解与把握骨盆骨折的鉴定条款,建立科学的判定标准。方法 收集上海市司法鉴定中心2006—2013年道路交通事故致骨盆骨折伤残等级重新鉴定案例65例,对初次鉴定和重新鉴定的资料进行分析比较。结果 鉴定时机不当,鉴定材料收集不全面,鉴定人对骨盆骨折条款的理解有误及其他一系列问题是重新鉴定意见改变伤残等级的主要原因。结论 针对上述问题,应该从提高鉴定人专业技能,建立统一判定标准等方面来提高此类案件的鉴定质量。     

Bhartṛhari and Maṇḍana on Avidyā

The concept of avidyā is one of the central categories in the Advaita of Śaṇkara and Maṇḍana. Shifting the focus from māyā, interpreted either as illusion or as the divine power, this concept brings ignorance to the forefront in describing duality and bondage. Although all Advaitins accept avidyā as a category, its scope and nature is interpreted in multiple ways. Key elements in Maṇḍana’s philosophy include the plurality of avidyā, individual selves as its substrate and the Brahman as its field (viṣaya), and the distinction in avidyā between non-apprehension and misapprehension. A closer investigation shows that Maṇḍana is directly influenced by Bhartṛhari’s linguistic non-dualism in developing the concept of avidyā. This study also compares other key constituents such as vivartta and pariṇāma that are relevant to the analysis of avidyā. As the concept of counter-image (pratibimba) emerges as a distinct stream of Advaita subsequent to Maṇḍana, this study also compares the application of pratibimba in the writings of Bhartṛhari and Maṇḍana.     

Unraveling the <Emphasis Type="Italic">Kāvyaprakāśa</Emphasis>: Jayadeva Pīyūṣavarṣa’s idiosyncratic sequence of topics in the <Emphasis Type="Italic">Candrāloka</Emphasis>

In his twelfth century alaṃkāraśāstra, the Candrāloka, Jayadeva Pīyūṣavarṣa reverses the sequence of topics found in Mammaṭa’s Kāvyapr-akāśa, an earlier and immensely popular work. With such a structural revisionism, Jayadeva asserts the autonomy of his own work and puts forth an ambitious critique of earlier approaches to literary analysis. Jayadeva investigates the technical and aesthetic components of poetry in the first part of the Candrāloka, prior to his formal semantic investigations in the latter half of the text, thus suggesting that aesthetic evaluations of poetry beneficially inform scientific investigations of language. Jayadeva’s organization of his chapters on the semantic operations, moreover, intimates that the study of suggestive and metaphoric functions of language clarifies our understanding of denotation, which is conventionally understood to be the primary and direct path of verbal designation.     

Immigration,intermarriage and the changing face of Europe in the post war period

In this article we compare the propensity to intermarry of various migrant groups and their children who settled in Germany, France, England, Belgium and the Netherlands in the post-war period, using a wide range of available statistical data. We try to explain different intermarriage patterns within the framework of Alba and Nee's assimilation theory and pay special attention to the role of religion, colour and colonial background. We therefore compare colonial with non colonial migrants and within these categories between groups with ‘European’ (Christian) and non-European (Islam, Hinduism) religions. First of all, religion appears to be an important variable. Migrants whose faith has no tradition in Western Europe intermarry at a much lower rate than those whose religious backgrounds correspond with those that are common in the country of settlement. The rate of ethnic endogamous marriages in Western Europe are highest in Hindu and Muslim communities, often regardless if they came as guest workers or colonial migrants. Whereas differences in religion diminish the propensity to intermarry, colour or ‘racial’ differences on the other hand seem to be less important. This is largely explained by the pre-migration socialisation. Furthermore, the paper argues that the attention to institutions, as rightly advocated by Richard Alba and Victor Nee, needs a more refined and layered elaboration. Institutions, often as barriers to intermarriage, do not only emanate from the receiving society, but also—be it less formalized—within migrant communities. Especially religions and family systems, but also organized nationalist feelings, can have a profound influence on how migrants think about endogamy. Finally, strong pressures to assimilate, often through institutionalized forms of discrimination and stigmatization, not only produce isolation and frustrate assimilation (with resulting low intermarriage rates), but can also stimulate assimilation by 'passing' mechanisms. These factors, together with a more comparative perspective, are not completely ignored in the new assimilation theory, but—as this study of Western European intermarriage patterns stresses—deserve to be included more systematically in historical and social scientist analyses.     

The Supreme Array Scripture: A New Interpretation of the Title “Gaṇḍavyūha-sūtra”

This article argues for a new interpretation of the Sanskrit compound gaṇḍa-vyūha as it is used in the common title of the Mahāyāna text the Gaṇḍavyūha-Sūtra.The author begins by providing a brief history of the sūtra’s appellations in Chinese and Tibetan sources. Next, the meanings of gaṇḍa (the problematic member of the compound) are explored. The author proposes that contemporary scholars have overlooked a meaning of gaṇḍa occurring in some compounds, wherein gaṇḍa can mean simply “great,” “big” or “massive.” This general sense is particularly common in the compound gaṇda-śaila (a “massive rock” or “boulder”) and is found in such texts as the Bhāgavata Purāṇa, the Harivaṃśa and the Harṣacarita. Following the discussion of Gaṇḍa, the author examines the term vyūha (“array”) as it is used in the Gaṇḍavyūha-sūtra. The article concludes with the suggestion that a more appropriate translation of the Gaṇḍavyūha-sūtra would be “The Supreme array Scripture.”     

Evaluation of six presumptive tests for blood, their specificity, sensitivity, and effect on high molecular-weight DNA

Luminol, leuchomalachite green, phenolphthalein, Hemastix, Hemident, and Bluestar are all used as presumptive tests for blood. In this study, the tests were subjected to dilute blood (from 1:10,000 to 1:10,000,000), many common household substance, and chemicals. Samples were tested for DNA to determine whether the presumptive tests damaged or destroyed DNA. The DNA loci tested were D2S1338 and D19S433. Leuchomalachite green had a sensitivity of 1:10,000, while the remaining tests were able to detect blood to a dilution of 1:100,000. Substances tested include saliva, semen, potato, tomato, tomato sauce, tomato sauce with meat, red onion, red kidney bean, horseradish, 0.1 M ascorbic acid, 5% bleach, 10% cupric sulfate, 10% ferric sulfate, and 10% nickel chloride. Of all the substances tested, not one of the household items reacted with every test; however, the chemicals did. DNA was recovered and amplified from luminol, phenolphthalein, Hemastix, and Bluestar, but not from leuchomalachite green or Hemident.     

Illumination,Imagination, Creativity: Rājaśekhara,Kuntaka, and Jagannātha on <Emphasis Type="Italic">Pratibhā</Emphasis>

Sanskrit poeticians make the visionary faculty of pratibhā a necessary part of the professional poet’s make-up. The term has a pre-history in Bhartṛhari’s linguistic metaphysics, where it is used to explain the unitary perception of meaning. This essay examines the relation between pratibhā and possible theories of the imagination, with a focus on three unusual theoreticians—Rājaśekhara, Kuntaka, and Jagannātha Paṇḍita. Rājaśekhara offers an analysis of pratibhā that is heavily interactive, requiring the discerning presence of the bhāvaka listener or critic; he also positions pratibhā in relation to Bildung (vyutpatti) and practice. For Kuntaka, pratibhā, never an ex nihilo creation by a poet, serves as the basis for the peculiar forms of intensified insight and experience that constitute poetry; these may also involve the creative scrambling and re-articulation of the object in terms of its systemic composition. At times, Kuntaka’s pratibhā comes close to a strong notion of imaginative process. But the full-fledged thematization of the imagination, and of pratibhā as its support and mechanism, is best seen in the seventeenth-century debates preserved for us by Jagannātha. A link is suggested between the discourse of poetic imagination in Jagannātha and similar themes that turn up in Indo-Persian poets such as Bedil.     

Preventing Homelessness for System‐Involved Youth

Too many youth and young adults find themselves on the streets, couch‐surfing with friends, in emergency shelters or worse, after exiting the child welfare and juvenile justice systems. In some circumstances, youth have had court hearings until their exit from the legal system, but those hearings have not focused on long‐range plans of youth and emergencies youth may encounter. In other circumstances, there has been little or no planning prior to discharge, especially for young people who leave the juvenile justice system. Courts can and should prevent, alleviate or end youth homelessness for youth who appear before them through strategies that are enumerated in the recently‐passed NCJFCJ resolution. This article expounds on three of these strategies – coordinating transition and re‐entry plans, insisting on effective legal representation of youth, and utilizing sound judicial leadership. It also describes the concurrent efforts of the Coalition for Juvenile Justice and the American Bar Association's Homeless Youth Legal Network to remove legal barriers and improve outcomes for youth and young adults experiencing homelessness.     

Best practices for structuring a family court parenting plan evaluation under the 2022 AFCC Guidelines

Evaluation appointment orders provide enforceable scaffolding for conduct of family court parenting plan evaluations, and use of the evaluator's reports, feedback, file, and testimony. Unlike a contract, a stipulated or adjudicated appointment order is directly enforceable by the family court. It unambiguously positions the evaluator as the family court's appointee – answerable directly to the court and, in some jurisdictions, protected by quasi-judicial immunity from damages claims. A well-crafted appointment order governs the roles and expectations of the court, the evaluator, the parties, the lawyers, and the collateral witnesses. An appointment order mandates the legal duties, rights, powers, and responsibilities of the professionals, the parties, and the collateral witnesses. At minimum, an appointment order articulates the legal basis for the appointment, the purpose and scope of the evaluation, compensation of evaluator, and the duty of the parties to participate in the process. A written evaluation protocol or procedures statement discloses in advance the methods of investigation and assessment that the evaluator intends to use. Together, the appointment order and written protocol help the evaluator, lawyers, parents, and judge manage the complexity of the evaluation process.     

Monks Who Have Sex: Pārājika Penance in Indian Buddhist Monasticisms

In the study of Buddhism it is commonly accepted that a monk or nun who commits a pārājika offence is permanently and irrevocably expelled from the Buddhist monastic order. This view is based primarily on readings of the Pāli Vinaya. With the exception of the Pāli Vinaya, however, all other extant Buddhist monastic law codes (Dharmaguptaka, Mahāsāṅghika, Mahīśāsaka, Sarvāstivāda and Mūlasarvāstivāda) contain detailed provisions for monks and nuns who commit pārājikas but nevertheless wish to remain within the saṅgha. These monastics are not expelled. Rather, they are granted a special status known as the śikṣādattaka. In this paper I explore the rules. concerning pārājika penance and the śikṣādattaka with specific regard to monastic celibacy. Given that five out of six extant law codes recognise this remarkable accommodation to the rule of celibacy, I argue that we must look to Vinayas other than the Pāli Vinaya if we are to arrive at a nuanced and representative view of Indian Buddhist monasticism.

Grant me chastity and continence, but not yet. Augustine of Hippo (354–430 C.E.)

     

What similes in Sāṃkhya do: a comparison of the similes in the Sāṃkhya texts in the Mahābhārata, the Sāṃkhyakārikā and the Sāṃkhyasūtra

In Sāṃkhya similes are an important means to communicate basic philosophical teachings. In the texts similes are frequently used, especially in the Sāṃkhya passages in the Mahābhārata, in the Sāṃkhyakārikā and in the Sāṃkhyasūtra. This paper compares the similes in these three texts and analyses changes in the philosophy as revealed in the similes. A comparison of the similes of Sāṃkhya texts produced over more than one thousand years reveals changes in the emphasis in this philosophical system. The purpose of the similes in the Sāṃkhya passages of the Mahābhārata is to produce an intuitive understanding of the separateness of puruṣa and prakṛti. The similes are designed to lead the listener to understand this basic dualism. In the Sāṃkhyakārikā the most difficult issues are the relationship between prakṛti and puruṣa and the idea of prakṛti working for the salvation of puruṣa. One whole chapter of the Sāṃkhyasūtra is devoted to similes.