围产期母婴医疗纠纷尸检49例分析

围产期母婴死亡所致的医疗纠纷在医疗纠纷的法医学鉴定中占有相当大一部分比例。本文从死者性别年龄、涉及医院、尸检结果、医疗行为过错情况等方面统计分析了49例围产期母婴死亡的医疗纠纷尸检案例,揭示了围产期母婴的常见死亡原因、医疗因素在其中的作用以及医疗纠纷的发生原因等,希望能对该类医疗纠纷的法医学鉴定、医疗纠纷的正确处理和防范提供帮助。     

“过失严重度”及其在医疗事故处理中的应用

目的建立“过失严重度”这一描述医疗事故或纠纷综合严重程度的量化指标。方法“过失严重度”以事故级别系数乘以责任大小系数表示。结果经计算,共产生了15个级别的“过失严重度”,从最重的1到最轻的20。结论“过失严重度”可对不同等级、不同责任程度医疗事故的严重程度进行排序,按照这一排序,可使医疗事故与纠纷的处理更具操作性与合理性。     

Nonparticipation as Self-Censorship: Publicly Observable Political Activity in a Polarized Opinion Climate

In a polarized opinion climate, people may refrain from participating in publicly observable political activities that make them vulnerable to scrutiny and criticism by others who hold opinions that differ from their own. We took a dispositional approach to testing this claim by determining whether people who are relatively more influenced by the climate of opinion when choosing whether or not to voice an opinion, measured with the Willingness to Self-Censor scale [Hayes et al. International Journal of Public Opinion Research 17 (2005) 298], are also relatively less likely to engage in public political activities. In a poll of residents of the United States, we found that even after controlling for interest in politics, political ideology, ideological extremity, political efficacy, attention to political news, dispositional shyness, frequency of political discussion, and demographics, dispositional self-censors reported having engaged in relatively fewer public political activities over the prior 2 years compared to those less willing to censor their own opinion expression. These results are consistent with our interpretation of political participation as a social process that is governed in part by the social psychological implications of participation to the person. At a larger theoretical level, our findings connect the literature on opinion perceptions and opinion expression with research on political participation.

Analyzing the representativeness of internet political participation

Political participation researchers have developed several evaluative techniques to assess the representativeness of political participation patterns. Yet, while the Internet has become a mainstream avenue for political participation in the United States, current assessments of online participation insufficiently apply these methods. To incorporate these methods we begin by drawing upon resource theory to inform two-stage ordered-logit models of online and offline political participation. Our results suggest that the factors predicting online participation often differ from the factors that predict offline participation. Even so, we find that those from higher socioeconomic backgrounds tend to disproportionately possess these distinct online determinants. Next, we use a wide spectrum of political opinion questions to determine whether online participators opinions reflect or distort those of the general population. Overall, we find that online participation tends to relate moderately with liberal preferences. However, because offline participation relates to political attitudes similarly, the Internet only marginally advantages the political voice of liberals. Finally, we discuss the implications of these results.     

几种视觉诱发电位技术推断正常成人远视力的比较

目的比较研究几种图形视觉诱发电位技术对视力推断的价值。方法取正常眼40只,分别测试其图形翻转视觉诱发电位、黑白条栅扫描视觉诱发电位和红黑条栅扫描视觉诱发电位,据此推算实验视力,分别与真实视力进行比较,同时各种方法进行彼此比较。结果黑白条栅扫描视觉诱发电位和红黑条栅扫描视觉诱发电位较之图形翻转视觉诱发电位能更为准确、方便、快捷地反映真实视力水平。结论黑白条栅扫描视觉诱发电位和红黑条栅扫描视觉诱发电位与图形翻转视觉诱发电位一样,可用于眼外伤的法医学鉴定。     

心外科手术后死亡医疗纠纷尸检分析

目的从尸检角度讨论心外科手术后死亡的死因及诊疗缺陷。方法按临床诊断、手术类型、死亡时间、死亡特点、尸检特点、纠纷特点、诊疗缺陷等方面,比较所选案例的临床、尸检资料特点。结果心瓣膜置换手术4例,冠心病冠脉搭桥手术1例,先心病大动脉转位手术1例。心肌梗死2例,心肌广泛损伤1例。心内膜感染2例,多器官功能衰竭1例。家属怀疑诊疗不当6例。诊疗缺陷主要为手术适应证、手术时机,手术器材的选用,手术操作,术后病情观察、处理不及时,对病情严重程度、手术风险及预后的告知不充分。结论尸检不仅能查明死因,还可帮助评价手术质量、术后处理的诊疗质量,对解决纠纷具有重要的辅助作用。     

Brothers’ Keepers?

Relying on rarely analyzed public opinion data from the 1930s and early 1940s, we take issue with the notion popular in contemporary liberal circles that the New Deal era represented a period of expansive commitment to the security and well-being of the poor and politically disenfranchised. At least where the public is concerned—as opposed to the progressive policy makers in the Roosevelt administration—the jobless were regarded with suspicion, immigrants should be forced to “go home,” women belong in the kitchen not on the shop floor. The harsher the economic conditions (by state), the more conservative were the public attitudes. Hence New Deal legislative victories accrued despite rather than because of public support.

Public Opinion and Collective Obligations

This article attempts to identify the general principles that underlie public reasoning about collective obligations and that help explain when political parties can create new obligations or defend existing ones. I use these principles to President Clinton’s unsuccessful attempt to create government health-care plan and attempts by President Bush to privatize Social Security. The success of a party in selling – or defeating – an obligation depends upon what people believe about the competence and capacity of government and the value of autonomy – choices made by each citizen; whether people perceive the obligation as providing floors or establishing ceilings by limiting choice or otherwise restricting opportunities for the better-off; and whether the program is more like insurance or more like welfare. A party’s ability to maintain credibility with voters also depends upon whether party leaders can suppress issues that threaten intra-party elite pacts. When attempts to suppress “taboo” issues like “stem cells” or “black crime” fail, the party loses credibility with its voters and attempts to defend or sell obligations fail.

新型农村合作医疗制度实施中的问题及对策

在阐述农村合作医疗基本理论、借鉴国内外农村医疗保障制度成功做法的基础上。分析新型农村合作医疗制度存在的问题,并提出了有针对性的对策和建议。