道路交通事故轻度精神伤残者智能损害评定

目的探索道路交通事故轻度精神伤残者智能损害评定方法和价值。方法通过分析智商测定在轻度精神伤残者评定中的运用,探索智商测定在轻度精神伤残者智能损害评定中的运用价值。结果不同性质颅脑损伤组间不同智能损害程度构成比有统计学差异（P〈0.05）;量表智商与颅脑损伤性质有关（P〈0.05）,除继发全面性与继发局部性损害（P〈0.05）、继发局部性与混合性损害之间（P〈0.01）有统计学差异外,其余各组两两之间均无统计学差异;不同颅脑损伤程度组间不同智能损害程度构成比无统计学差异;量表智商与颅脑损伤程度呈负相关（P〈0.01）,除中型与重型损伤之间无统计学差异外,其余各组两两之间均具有统计学差异;智能损害程度、量表智商均与精神伤残等级呈正相关（P〈0.01）;量表智商并非评价智能损害的唯一指标,智能损害也并非精神伤残唯一的构成因素。结论智商测定对评价智能损害与精神伤残具有一定参考价值,精神伤残评定需根据颅脑损伤性质与程度、智能损害或精神障碍程度以及生活、社会功能状况综合评定。     

Will the National Disability Insurance Scheme Improve the Lives of those Most in Need? Effective Service Delivery for People with Acquired Brain Injury and other Disabilities in Remote Aboriginal and Torres Strait Islander Communities

The aims of National Disability Insurance Scheme (NDIS) are to provide long‐term, person‐centred care and support to all Australians with a significant and ongoing disability, including individuals with an acquired brain injury (ABI). The scheme has significant potential to provide equitable opportunity of access to health and disability services. Historically, however, service provision in remote and outer regional areas of Australia lags behind more densely populated centres. Aboriginal and Torres Strait Islanders living with disability are already significantly marginalised. Further to this, people with an ABI are very often misunderstood and overlooked by disability services, health professionals and governments, and frequently fall victim to the criminal justice system. This paper provides an overview of the state of ABI disability for Aboriginal and Torres Strait Islanders in remote and outer regional settings, and the present sets of barriers they face to obtaining quality care and effective interventions. A significant opportunity has emerged with the advent of the NDIS but equitable benefit can only be achieved if additional and specialised measures are devised and implemented to appropriately screen for, and assess, incidence of ABI; disability services are appropriately resourced to overcome the pre‐existing disadvantage, and education, training and recruitment of Aboriginal and Torres Strait Islanders with the NDIS is undertaken to lead attitudinal changes in community to disability and health services. This paper concludes with recommendations for the NDIS to meet its laudable objectives.     

ARP-SP基因表达谱芯片对脑损伤的初步研究

目的研究脑挫伤后ARP-SRP基因表达谱差异及其法医学意义。方法从脑组织提取mRNA,应用ARP-SRP-1.0S基因芯片,研究脑挫伤组织与对照脑组织细胞凋亡蛋白和应激反应蛋白相关基因特异性表达差异。结果基因芯片杂交结果中,发现人类溶酶体的胃蛋白酶抑制剂不敏感蛋白酶基因(CLN2)表达水平显著下降。结论CLN2基因与一种婴儿致死性神经变性疾病LINCL有关,但CLN2基因在脑损伤中的作用尚有待进一步研究;基因芯片在研究脑损伤后相关基因的改变具有快速、高通量、高敏度等特点。     

大鼠闭合性弥漫性脑损伤脑血管铸型的扫描电镜观察

用扫描电镜观察闭合性脑损伤即刻致死和伤后15min大鼠脑血管铸型，发现大鼠脑震荡性损伤后，脑干穿行小动脉及其分支可见多数散在的微动脉痉挛，呈节段性变细，扭曲，血管腔直径约2—5mp。毛细血管前括约肌收缩。正常大鼠脑干实质小动脉直径约10~15mp。讨论了外伤性脑血管痉挛的机制及其对颅脑损伤后果的影响。     

The Effects of Sharp‐Force Thoracic Trauma on the Rate and Pattern of Decomposition

Given the multiple factors that may alter the rate of decomposition, one of the more difficult tasks that anthropologists and pathologists face is determining of the postmortem interval (PMI). While trauma has been widely accepted as being among those factors, recent published studies have contradicted this premise. However, major issues exist with these studies. Consequently, this study was designed to simulate a more realistic setting in an effort to settle this discrepancy in the literature. This study utilized eight porcine remains; three of which received incised wounds penetrating the thoracic cavity, three others received nonpenetrating wounds, and two were designated nontrauma controls. Measurements included evaluating the total body score (TBS) on temporal and accumulated degree days (ADD). Using a two‐way repeated measures ANOVA, the results of this study found that while trauma does have an influence in the pattern of decomposition, it does not influence the rate of decomposition.     

Helplessness and Hopelessness in Adolescents who Commit Sexual and Nonsexual Crimes

The authors’ purpose was to test the relationship of helplessness and hopefulness to experienced trauma, as well to explore the role of these emotions to sexual and nonsexual criminal behaviors among 332 residential youths adjudicated for sexual crimes. All subtypes of trauma measured were positively correlated with helplessness, whereas hopelessness was not associated with sexual or physical abuse. Helplessness was associated with the severity of sexual crimes, as well as the commission of multiple nonsexual crimes. Hopelessness was not associated to any sexual crime characteristics and only associated with general delinquency and property damage. In the regression models, controlling for trauma, helplessness predicted sexual and nonsexual criminality, and hopelessness predicted nonsexual criminality. Implications for practice, policy, and research are discussed.     

Judicial Educators’ Perspectives on Trauma Education for the Judiciary

Trauma and its impact on human development and functioning in the context of legal systems has been an important topic in judicial education for well over a decade. This brief report reviews key components of this work since approximately 2005, and presents the results of a 2018 ‐ 2019 survey with 250 judicial educators on the topics of trauma education for the judiciary and preferred teaching models. Results suggest that trauma is and will likely remain an important topic in judicial education for the foreseeable future. Further, results indicate that there are some common criticisms about current trauma education that should be considered in curriculum design and delivery, and that there is a general preference for team teaching approaches that include a strong peer‐to‐peer discussion component. Recommendations and considerations for judicial educators on the topic of trauma are also presented.     

Lessons Learned from Developing a Trauma Consultation Protocol for Juvenile and Family Courts

Juvenile and family courts hold a unique position among the many stakeholders that comprise a healing community for persons experiencing adversity or trauma. Specifically, judges and other court leaders can promote the implementation of screening for trauma, the alignment of appropriate and effective treatment for trauma when indicated, and the accountability of systems for coordination and support of such services. To that end, the National Council of Juvenile and Family Court Judges undertook a field‐based project — consisting of multiple semi‐structured court surveys — to elucidate the key features of a trauma‐informed court and how to assist courts in becoming more trauma‐responsive for both consumers and staff. With the assistance of courts in 11 pilot sites across the nation, the project has led to the development of a protocol called trauma consultation or trauma audit, which is outlined here. Our work in developing the consultation protocol highlighted the need to better understand (1) the prevalence and impact of secondary traumatic stress in court staff, (2) the potential for environment to contribute to traumatic stress reactions, and (3) the importance of consistent trauma screenings and subsequent use of findings. Practical suggestions for courts to become more trauma‐informed are also provided.     

实验性大鼠脑震荡后c-jun mRNA表达

目的观察实验性大鼠脑震荡后c-jun mRNA的表达变化规律。方法 55只实验大鼠随机分为脑震荡组（0min、15min、30min、60min、3h、6h、12h、24h、48h、96h）和对照组,用原位杂交法观察大鼠脑震荡后各时间点,大脑皮质、脑干和丘脑神经元c-jun mRNA表达的变化规律。结果对照组大鼠神经元和胶质细胞均可见c-jun mRNA的弱阳性表达。脑震荡组大鼠损伤后15min神经细胞观察到c-jun mRNA阳性表达,随损伤后经过时间的延长阳性表达逐渐增强;30min时c-jun mRNA阳性反应达高峰,随后逐渐降低,至96h时回落至对照组水平。结论 c-jun mRNA表达水平可成为诊断脑震荡和推断伤后经过时间的一项敏感指标。     

大鼠死后脑、心肌和肾组织β-actin mRNA的降解与早期死亡时间的关系

目的 研究SD大鼠脑、心肌和肾组织细胞内β-actin mRNA的降解与早期死亡时间的关系,为早期死亡时间的推断寻找新的指标.方法 大鼠处死后置于20℃的环境中,分别于死后不同时间点提取脑、心肌、肾的总RNA,采用实时荧光定量RT-PCR方法检测总RNA中β-actin mRNA的水平(Ct值),分析死后经过时间与Ct...