精神病患者社会失控的法律规制

由于立法上的空白,监护制度的不完善,部门间缺乏共同合作等原因,导致我国对散流于社会中的精神病患者缺乏有效的控制,从而造成由精神病患者所引起的伤人案件及破坏公共秩序事件时有发生。通过规定强制执行程序,在社区中设立精神医疗监管机构,加强各部门及部门内部间的合作与监督,普及精神卫生知识与提高公众防卫意识诸方面来解决精神病患者的社会失控问题。     

Patient perceptions of schizophrenia in forensic and general adult psychiatry

This study explores the illness perceptions of patients with schizophrenia in forensic settings and contrasts their views with those of a general adult psychiatry sample. It was hypothesised that forensic psychiatric patients would have more negative illness beliefs than general adult patients. A cross-sectional survey was used. Forty forensic patients and 32 general adult patients with schizophrenia were recruited. They completed the Illness Perception Questionnaire for Schizophrenia (IPQS), a valid and reliable measure of illness perceptions in mental health problems. Forensic patients perceived their illness to be less chronic, less cyclical, and had a lower negative emotional response to illness. Our results did not support our original hypothesis and possible reasons are explored. Acknowledging patient’s views when formulating management plans could permit more effective individually tailored treatment.     

Patient characteristics related to length of stay in Dutch forensic psychiatric care

Create an overview of characteristics of patients in long-term forensic psychiatric care (LFPC) with a higher length of stay (LOS) care compared to patients in regular forensic psychiatric care (RFPC) with a shorter LOS. Data were collected from 139 patient records. This study examined whether patients in LFPC differ from patients in RFPC on sociodemographic data, legal data and clinical data and whether those characteristics are able to predict LOS. Patients in LFPC were more often born in a Dutch Caribbean country, less often had a substance abuse disorder, were more often emotionally neglected during childhood, had a higher HCR-20 risk item score, a higher security needs score, a higher (less successful) recovery score, were more often recidivist and had absconded more often than RFPC patients. Certain characteristics were able to distinguish the longer LOS group which might be useful to establish sequel services and enhance treatment efficiency.     

The economics of the Internet of Things in the Global South

While the Internet of Things (IoT) is not new, its key components are becoming increasingly affordable now, which makes the technology extremely attractive for the Global South. By collecting data from various IoT sources, combining them with data from other sources and using big data analytics, decisions can be made and actions can be taken that can have important economic, social, ecological and environmental implications in these countries. The most visible impacts of the IoT in these countries include improvements in agricultural and food systems, enhancement of environmental security and resource conservation, achievement of better healthcare, public health and medicine, and enhancement of the efficiency of key industries. This paper provides an overview of how the IoT is currently being used in the Global South. It also discusses the opportunities and challenges that IoT initiatives present there. The analysis indicates that the IoT may address some of the institutional bottlenecks, technological challenges and key sources of high transaction costs. On the other hand, various sources of underdevelopment may act as barriers to full utilisation of the IoT.     

中药内服联合针刺及微波透药治疗宫颈癌术后顽固性尿潴留9例

目的 观察中药内服联合针刺及微波透药治疗宫颈癌术后顽固性尿潴留的疗效。方法 选择宫颈癌术后顽固性尿潴留患者共9例,所有患者均接受中药内服（补肾益气通利方加减）、针刺（取三阴交、足三里、关元、气海、中极等穴位）联合微波透药的综合方法, 治疗前和1个疗程（7 d）后分别观察膀胱残余尿量、中医症状积分,并观察自主排尿功能恢复时间及复发情况。结果 与治疗前比较,1个疗程后膀胱残余尿量明显减少（P＜0.05）,临床症状（排尿无力、小腹胀痛、腰膝酸软、倦怠乏力）积分均显著降低（P＜0.05）。患者自主排尿功能平均恢复时间为（16.22±6.12）d。随访结果显示没有患者复发。结论 中药内服联合针刺及微波透药的综合疗法对宫颈癌术后顽固性尿潴留具有较好的疗效。     

医学临床实践教学中患者隐私权的保护

处理临床实践教学与患者隐私权保护的冲突,要求在隐私利益让渡过程中,充分体现患者的主体性,通过知情同意规则实现临床教学对患者隐私的规范化索取和利用.同时,在临床教学中,患者隐私权应有一定的限度,在特定情况下应排除隐私权的适用.     

Health Ombudsmen in Polycentric Regulatory Fields: England,New Zealand,and Australia

Health ombudsmen (health complaints commissioners), an unusual entity internationally, exist only in England, New Zealand, and the Australian states and territories. Established to respond to complaints from patients, the intention is to make health services and professionals more accountable to the public. Most cases are handled around the softer base of a regulatory pyramid, such as advice to complainants and requests to providers for an explanation and/or apology. Few cases escalate to investigations and prosecutions. Although the legal powers of some health ombudsmen to redress individual grievances have been strengthened, most lack the independent power to initiate an inquiry into systemic problems. To produce quality improvements, health ombudsmen need powers to require compliance from providers and to initiate inquiries. With the advent of new health sector regulators, health ombudsmen must negotiate their role and function within expanding networks of governance.     

Complicating Symmetric Peripheral Gangrene after Dopamine Therapy to Patients with Septic Shock

Dopamine is commonly used as a first-line agent in the treatment of patients with septic shock. The use of dopamine rarely causes symmetric peripheral dry gangrene. If the symmetric peripheral dry gangrene occurs in the patient after dopamine injection, it easily leads to disagreement between doctors and patients. A 60-year-old woman who had sudden septic shock was sent to intensive care unit (ICU). She was received dopamine injection according to the routine during treatment. Over the next 3 months, her limbs developed to dry gangrene and required amputation. The result shows that the occurrence of dry gangrene could only be associated with the long-term excessive use of dopamine according to the medical records. Although dopamine is a conventional drug for the treatment of septic shock, the forensic workers and clinicians must realize that vasopressors such as dopamine have been implicated directly or as a contributory cause in dry gangrene cases.     

精神病人刑事责任能力相关问题研究

受“有病无罪”观念的错误影响,长期以来法学领域很少开展对精神病人“犯罪”的研究,致使形成“精神病学鉴定专家裁判精神病人是否犯罪”的态势,忽视了对社会公共安全的保护。笔者简明扼要地介绍了美国司法精神病学近几十年的变迁,以此为参照,发表了对精神病人犯罪研究的一些看法。     

肖志军事件的法学追询——公私法关系论题的—个引子

多数学者认为肖志军拒签事件属于极端个案,不能说明法制不健全。其实,该案反映出我们的制度设计存在严重的问题,其要害在于公法规则在医患双方关系中不适当地设定了患者家属的主体地位与决定权。这种规定在理论上造成逻辑悖谬,在实践中不仅不必要,而且可能造成与立法预期相反的效果。在特定条件之下,取消患者家属的决定权,解除对医院紧急救治行为的强制禁止,则类似问题可迎刃而解。肖志军事件中所出现的问题其实是国家出于政策管制的需要而不适当地介入私法关系所导致的后果,它反映出我国公私法关系理论亟待深入研究。