Managing children's and adolescents' medical complaints amid parent conflict: Strategies and tools for professionals

Children and adolescents who are having difficulty coping with stress often present with complaints of physical discomfort. Effective treatment approaches exist for many of these issues. Among high-conflict parents, however, children's medical issues can become another canvas for conflict, with parents focused more on blaming one another for the child's distress than on options for assisting the child. Professionals can be drawn into the conflict to such a degree that they overlook essential steps for addressing and managing these issues. The authors present a research-informed model for managing medical and psychophysiological issues amid parental conflict.     

The Reliability of Pattern Classification in Bloodstain Pattern Analysis,Part 1: Bloodstain Patterns on Rigid Non‐absorbent Surfaces

This study was designed to produce the first baseline measure of reliability in bloodstain pattern classification. A panel of experienced bloodstain pattern analysts examined over 400 spatter patterns on three rigid non‐absorbent surfaces. The patterns varied in spatter type and extent. A case summary accompanied each pattern that either contained neutral information, information to suggest the correct pattern (i.e., was positively biasing), or information to suggest an incorrect pattern (i.e., was negatively biasing). Across the variables under examination, 13% of classifications were erroneous. Generally speaking, where the pattern was more difficult to recognize (e.g., limited staining extent or a patterned substrate), analysts became more conservative in their judgment, opting to be inconclusive. Incorrect classifications increased as a function of the negatively biasing contextual information. The implications of the findings for practice are discussed.     

Why We Need Postmortem Analysis of Cardiac Implantable Electronic Devices

The prevalence of cardiac implantable electronic devices (CIEDs), pacemakers and implantable cardioverter defibrillators (ICDs) is increasing. However, postmortem analysis of CIEDs is not performed routinely. Fourteen consecutive CIEDs were analyzed. The indication for and date of implantation, technical data, CIED reprogramming, heart rhythm disturbances, patient demographics and medical consultations were investigated. Death during the first year after implantation was seen in 54%, whereof 71% consulted a physician within 10 days before death. The time of death was attributed to a particular day in 29%. There was a relationship between CIEDs and cause/manner of death in 50%. Although limited by a small sample size, this study advocates the routine postmortem CIED analysis for forensic and clinical purposes in selected cases. Patients with CIEDs seem to show an increased risk of death during the first year after implantation. The analysis of CIEDs can be helpful in evaluating the time/cause/manner of death.     

“法律不知有害”质疑

我国大多数学者认为对事实的不知无害,对法律的不知有害,因而实务中对法律错误一般不予以救济。但事实上,不管是在罗马法上,还是在当代的大陆法系和英美法系,大部分国家都会对部分法律错误予以救济。而在确定何种法律错误可予以救济时,应充分考量在特定情况下对表意人"知法推定"的合理性以及表意人与第三人之间的利益衡量。     

原发性脑干损伤及其研究进展

本文综述了原发性脑干损伤的原因、临床表现、诊断与检测 ,重点介绍了其死亡原因和病理形态学 ,尤其是在细胞和分子水平上的改变 ,并对原发性脑干损伤的进一步研究方向进行了展望     

医学生公民意识与医德认知状况调查报告简

医德教育是医学教育的重要组成部分,在我国公民社会积极发育的大背景下,传统医德教育面临现代转型的课题。通过对医学生公民意识、医德及医患关系认知状况的调查,对医学院校医德教育进行评估,初步提出实现公民教育与医德教育有机契合,建构医德教育新模式的建议。     

《北京市院前医疗急救服务条例》修订前后对比分析

《北京市院前医疗急救服务条例》是北京市地方性法规,于2017年3月1日正式实施.2021年5月27日,北京市十五届人大常委会第三十一次会议表决通过了修改后的《北京市院前医疗急救服务条例》.     

Effect of History and Context on Forensic Pathologist Interpretation of Photographs of Patterned Injury of the Skin

In a previous study, a survey‐based analysis of pathologist diagnoses of patterned injury was performed. Subjects were provided with photographs of “classic” injuries and asked to diagnose the lesion in the absence of history or context. There was a relatively low diagnostic consensus among respondents. A second survey suggested that the disparate answers were not due to a strong belief in different diagnoses, but instead reflected how the respondents dealt with ambiguity. A third survey was created that asked participants to evaluate patterned injuries of the skin, but provided history and contextual information. The addition of history and contextual information increased consensus from a median of 80% to 98% on a per‐question basis. Confidence increased from a median of 56%–92%. These results demonstrate the importance of history and context in medical diagnosis of patterned injuries of the skin.     

THE WAY WALKED WITH CHILDREN: MEDICAL TREATMENT AND REHABILITATION

Due to obstacles in expression and communication, as well as a societal lack of humanitarian spirit and deficiencies in system design, children with intellectual disabilities are confronted with various problems when seeking medical treatment. The dilemma of medical treatment seriously restricts the survival and development of disabled groups. By reviewing the way in which a mother accompanied her disabled child for 28 years together, this article analyzed the reasons for the dilemmas of medical treatment, and appealed to improve the living conditions of persons with intellectual disabilities to guarantee their rights for rehabilitation. In addition, by introducing the recreational and sports activities that parents’ spontaneous organization created for children with intellectual disabilities, it put forward the proposal to prevent in advance the possible deterioration of conditions caused by social isolation, which is definitely a preferable remedy for persons with disabilities.