Fitness to Stand Trial: Learning from the Ezra Pound Saga

The famous United States poet and literary figure Ezra Pound (1885–1972) was indicted for treason in the District of Columbia after being extradited from Italy for participation during the Second World War in propaganda broadcasts on behalf of the Italian dictator, Benito Mussolini. With his life at risk, he successfully pleaded that he was unfit to stand trial by reason of mental impairment. A review of the evidence given by the four psychiatrists and of the judge's charge to the jury casts doubt on the claim that the trial was politically directed to ensure that Pound was not executed. However, later diagnoses from St Elizabeths Hospital in Washington, after he was detained, suggest that his principal impairment may have been a personality disorder, perhaps with cyclothymic or bipolar traits, raising the issue of whether such a diagnosis should be sufficient for a finding of unfitness to stand trial.     

临床实习护生人际沟通能力调查分析

目的：调查临床实习护生人际沟通能力现状,为护理教育教学改革提供参考依据。方法：应用沟通动机量表、沟通知识量表、沟通技能量表和人际沟通满意度量表对新乡地区三级综合医院临床实习护生240人进行问卷调查。结果：临床实习护生人际沟通能力整体水平一般,其中沟通技巧得分相对较高,其次是沟通知识和沟通动机,沟通满意度得分最低。结论：应根据护生人际沟通能力现状及其影响因素,进行有针对性的教学改革,提高护生沟通能力。     

司国民应用角药经验

角药是三味中药联合使用、系统配伍的方药组合模式,在方剂中,角药可为核心组成的部分存在,也可为辅助组成部分存在,亦可单独成方。司国民教授临床应用角药治疗各类疾病,注重用药的层次感,紧抓病机,内外呼应、上下交通,开阖并用、攻补兼施。笔者分析司国民教授常用角药及其临床应用经验,以期为今后运用中药诊疗疑难疾病提供新思路和新方法。     

中医英语口语课堂学生交流意愿实证研究

交流意愿是中医英语口语课堂的重要研究课题.本研究从交流意愿和第二语言(简称二语)输出假设出发,以问卷调查和半结构化访谈为研究方法,探讨了中医英语口语课堂上学生的交流意愿及影响因素.研究发现,中医英语口语课堂学生的学习动机和交流意愿呈现正相关关系,自我效能和交流意愿呈现正相关关系,同时发现交流意愿和学生的性别、自我认知、...     

影像辅助诊断学习系统的设计

医学数字化信息革命改变着传统的医学学习、工作、管理模式。本文探讨设计一套计算机化的影像辅助诊断教学系统的方法。结合了医用多媒体图文系统和图像存档与通讯系统 (PACS)的某些特点 ,该系统可用于医生书写数字化处方 ,方便快捷地管理影像资料 ,在计算机下多方位地分析影像从而辅助确定诊断结论并构建典型病例数据库使系统具备教学功能。系统采用面向对像程序设计开发工具开发并构建在通用的 Windows9X平台上 ,具有良好的界面和交互性。     

360度绩效评估在医院行政中层考核中的应用浅谈

医院行政中层是医院业务发展和科室运营的核心,同时肩负着执行领导工作部署、完成上级交付的各项任务,管理部门工作、带领科室发展和各部门间沟通合作的任务,具有多重角色,是连接医院领导和基层职工的纽带和桥梁.医院行政中层考核是现代医院管理的一项重要内容,对于提高干部队伍整体素质、提升医院发展水平、实现战略管理目标有着重要意义....     

实习护生护患有效沟通能力的调查与分析

目的：对临床护理实习生与患者进行有效沟通能力的现状进行调查,探索临床带教如何提高护生有效沟通水平.方法：对随机选取的110名实习护生采用临床沟通能力测评量表进行测评,并对影响护患沟通能力的显著因素进行分析.结果：本组实习护生临床沟通能力得分普遍不高（67.87±16.95）分,得分率为60.65％;不同学历层次的护生在沟通能力及意识上存在差异性,差异有显著统计学意义（F=25.14,P＜0.01）.结论：在实习带教过程中,应注重护生沟通能力的训练和培养,有效激发护生掌握护患沟通技巧的学习热情,使其迅速提高职业能力,为今后的临床实践做好准备.     

When is it appropriate to deliver a prognosis to Korean persons with acute spinal cord injury?

Purpose: In cases of complete spinal cord injury (SCI), which has a poor probability of recovery, the timely delivery of a prognosis may be crucial to help patients adapt to their situation. The study aimed to help for choose the appropriate time for delivering a prognosis to persons with SCI. Method: Three hundred and four members of the Korean SCI Association with complete SCI were surveyed regarding the time at which their prognosis was communicated and their views about the appropriate time for prognosis delivery. Demographic and injury characteristics were also collected. Respondents’ experience and opinions on prognosis communication were analysed to assess potential associations with demographic and injury profiles. Results: Participants’ opinions regarding the time of prognosis delivery varied. Many respondents (44.1%) reported that the appropriate time would be within 1 month postinjury, whereas the others felt it should occur either between 1 and 3 months (29.3%) or more than 3 months (10.2%). The comparison of time of prognosis communication with the opinions showed that most would have preferred an earlier delivery of prognosis than they had experienced. Conclusions: Our findings provide insight to physicians on the appropriate time for delivering a prognosis to individuals with complete SCI.

Implications for Rehabilitation

• In cases of complete spinal cord injury, which has a poor probability of recovery, the timely delivery of a prognosis may be crucial to help patients adapt to their situation.

• The opinions of individuals with spinal cord injury regarding the time of prognosis delivery varied.

• The comparison of time of prognosis communication with the opinions showed that most would have preferred an earlier delivery of prognosis than they had experienced.

     

Post-traumatic Stress Disorder and Hospitalisation Syndrome as Potential Aetiologies of Unfitness to Stand Trial: The Gbagbo Decision

In Prosecutor v Laurent Gbagbo, ICC Pre-Trial Chamber, 2 November 2012 it was decided that the accused former President of the Ivory Coast was fit to stand trial. Expert opinions from a general practitioner and a psychologist were not accepted and evidence from a psychiatrist was preferred. It was determined that the evidence that the accused suffered from “hospitalisation syndrome”, PTSD and depression did not satisfy the test for unfitness to stand trial. The carefully reasoned judgment of the Pre-Trial Chamber raises important issues about the relevance of conditions that fall short of psychosis in terms of their potential to render a person unfit for trial under international criminal law or, more generally, under criminal law. While on this occasion the somewhat novel, internally contradictory and inadequately based expert opinions did not satisfy the Pre-Trial Chamber in this regard, it remains still possible that unusual conditions or combinations of conditions falling short of psychosis could result in a person's inability to participate meaningfully in the trial process.