论重新架构我国医患纠纷的多元化处理机制

综观我国现行医患纠纷处理机制,医患双方协商多隐含非公平、非自愿成分,卫生行政调解基本处于闲置状态,民事审判的权威与效率难以实现,而医疗责任鉴定的公平与权威备受质疑,因此,该机制不能适应妥善处理医患纠纷这一社会热点问题的需求。多元化纠纷解决机制（ADR）的发展及运行表明,多种性质、功能、程序不同的纠纷解决机制,各有其运行空间,且能形成功能互补,而非诉讼纠纷解决机制本身具备的意思自治、非对抗性、开放性等特点决定其对处置医患纠纷具有较强的适用性。重新架构与配置我国医患纠纷多元化处理机制的设想为：保留但限制医患双方自行和解,设立医事仲裁和医患纠纷第三方专业调解制度,以医、法结合的原则对医患纠纷的审判及鉴定机制加以改进,并建立审判机关与鉴定机构在医疗事实认定与过错责任确认方面的协同机制,形成多元化机制并存、互补的良性结构。     

彭真同志的“严打”思想研究

＂严打＂思想是彭真同志首先提出来的。在将彭真＂严打＂思想转化为党中央＂严打＂决策的过程中,起关键作用的是邓小平。彭真＂严打＂思想的主要内容包括：＂严打＂政策的提出是由客观形势决定的;＂严打＂的对象是严重刑事犯罪和经济犯罪,措施是依法从重、从快严厉打击,原则是实事求是,因地制宜;＂严打＂要想取得全面胜利,必须和综合治理同时进行,特别是要做好劳改、劳教工作;＂严打＂斗争具有长期性、艰巨性和复杂性,必须紧密依靠党的领导,走专门机关和群众路线相结合的道路。彭真＂严打＂思想中所体现的思想方法和工作方法,所包括的许多反映了社会治安规律的结论,对于我们做好社会治安工作具有重要的现实指导意义。     

国际海运温室气体减排法律问题探析

近年来,国际海运温室气体排放问题逐渐引起了国际社会的广泛关注,国际海事组织在《联合国气候变化框架公约》及其《京都议定书》的授权下进行了包括立法在内的诸多努力并取得了一定的成果。本文在对国际海事组织构建的国际海运温室气体减排法律框架进行厘清的基础上,就其框架中体现出的"不优惠待遇"原则及相关的减排机制进行分析,认为相关制度还有待调整以符合大多数国家的利益。     

Orthodontic Treatment: Real Risk for Dental Age Estimation in Adults?

Dental age estimation becomes a challenge once the root formation is concluded. In living adults, one dental age indicator is the formation of secondary dentine, also associated with orthodontic treatment as well as root shortening. The aim of this study was to establish whether these secondary effects of orthodontic treatment could generate a statistically significant difference in dental age estimations when using Kvaal's method. The study sample included 34 pairs of pre‐ and postorthodontic panoramic radiographs, from different individuals with exactly the same age and sex distribution. Females 65%, median age 17.5 years, and males 35%, median age 22.5 years, were included. After data collection, dental age was estimated per tooth using formulae previously published. The risk of obtaining over‐estimation of age was calculated. (RR = 1.007). The changes caused by orthodontic treatment do not have any significant effect on age estimation when Kvaal et al.'s method is applied on panoramic radiographs.     

Freedom to think – the value of multiple clinical narratives in women’s prisons†

Abstract

The merits of being multi-lingual are widely recognised. This paper considers the application of this metaphor to the conceptualisation of clinical work in a women’s prison. We suggest that sharing ‘languages’ from different theoretical orientations in open fora enables teams to build deep and nuanced understandings of clinical and systemic complexity, of particular value in secure settings. This discussion reflects the service model developed and used within HMP/YOI Holloway, a large women’s prison in London, which has recently been closed. We utilise a case example, with formulations and recommendations from several perspectives, to illustrate the value of maintaining a rich, inclusive discourse. We describe the benefits of such an approach to staff teams, to institutions and to those we serve, and consider the implications for organisation of services to maximise potential for change and recovery.     

Group Treatment for Spouse Abuse: Are Women with PTSD Appropriate Participants?

Eighty four abused women seeking therapy with their husbands were accepted into a group treatment program for spouse abuse. In the current study, we evaluated the treatment outcome of those women (n = 27) diagnosed with Posttraumatic Stress Disorder (PTSD). PTSD diagnosis, itself, did not differentiate those women who dropped out of treatment. Results indicated, however, that across all women, avoidance symptomatology significantly differentiated treatment completers from dropouts. Although women with PTSD began treatment in worse condition (lower marital satisfaction, higher depressive symptomatology, greater fear of spouse), post-assessment revealed they achieved positive treatment gains parallel to those of women without PTSD. Women with PTSD improved on each outcome variable measured, including a reduction in fear of spouse. Women with PTSD also did not differentially drop out of either treatment condition (men's/women's versus conjoint groups) which lends support to the appropriateness of conjoint treatment for spouse abuse.     

Personality traits of convicted male batterers

The purpose of this investigation is to determine if select psychological variables are associated with abusive behavior of convicted male batterers. The sample included a treatment group of 75 court-referred abusers who were individually administered the Taylor-Johnson Temperament Analysis (T-JTA) instrument. Explored were: (1) the relationships among personality variables and sociological and demographic characteristics, (2) possible behavioral disorders in our study group of spouse abusers, (3) whether major bipolar personality variables could distinguish our study group from the general population. Results revealed the Taylor-Johnson behavioral disorder types were not useful in identifying distinctions among our spouse abusers. However, a two-factor rotation (Internal/Emotional Balance and Social Interaction) produced results which should be of interest to programs treating batterers as well as provide a suggestive lead for future research. Battering men were found to have a restless proclivity for interaction that will be competitive and conflict-oriented in style. Their impulsiveness further suggests that their interactions will be negative in terms of evocation.     

Alternatives to Custody for High-Risk Young Offenders: The Multisystemic Therapy Approach

This article describes the implementation of randomised trials in Ontario, Canada, of a community-based, therapeutic intervention for youths who would be candidates for custodial sentences because of the severity or persistence of their criminal behaviour. Many recognise the need to reduce custody stays but the realisation of that goal requires the creation of community-based programs which judges believe will not put the public at risk. Reviews of the empirical literature indicated that Multisystemic Therapy could be a cost-effective, individualised, community-based alternative to custody that reduces long and short-term recidivism of high-risk youths.     

Safety, Health Care, and Bonding Within an Ecobehavioral Approach to Treating and Preventing Child Abuse and Neglect

This paper describes Project SafeCare, an ecobehavioral research and treatment project with families reported or at risk for child abuse or neglect. Preliminary demographic data are reviewed along with indirect assessment data. Four case studies are described to exemplify the effects of training provided to families. The implications for the current assessment data, treatment, and outcome are discussed.     

Adolescents with Psychopathic Characteristics in a Substance Abusing Cohort: Treatment Process and Outcomes

Psychopathy is a condition with important consequences both for individuals who experience it and for the communities in which they live. Although the assessment of psychopathy among adolescents remains controversial, some evidence suggests that the affective and behavioral traits of adult psychopathy begin to emerge in childhood (B. B. Lahey & A. Kazdin, 1990) and continue across the lifespan (A. E. Forth, S. D. Hart, & R. D. Hare, 1990). The present study used the Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, S. D. Kosson, & R. D. Hare, in press) to retrospectively assess psychopathic characteristics, treatment process, and outcomes of 64 individuals referred for treatment to a substance abuse program for adjudicated adolescents. This study focused on the relationship between psychopathic characteristics and treatment process and outcome variables, including attrition rates, quality of participation, substance use throughout treatment, clinical improvement, and 12-month recidivism rates. Psychopathic characteristics were negatively related to treatment process and outcome variables, including attrition, participation, substance use, and clinical improvement. Psychopathic characteristics were positively related to the number of arrests in the 12 months following treatment completion. Implications for treatment and future research with adolescents displaying psychopathic characteristics are discussed.