精神障碍38例刑事责任能力司法鉴定资料分析

目的：探讨司法精神病鉴定中精神障碍责任能力的评定状况。方法对38例司法精神病责任能力鉴定资料进行回顾性分析。结果本组中鉴定诊断精神分裂症居首位（26．3％）、精神发育迟滞次之（21．1％）;责任能力评定完全刑事责任能力占36．8％,限制刑事责任能力占36．8％,无刑事责任能力占26．3％。结论精神疾病诊断与刑事责任能力之间无必然因果关系,应根据被鉴定人精神病理内容与案件事实之间是否存在因果关系评定刑事责任能力。     

精神病刑事案件司法鉴定544例分析

目的分析司法精神病鉴定案例的特点,为精神病司法鉴定工作提供依据。方法对2005年-2011年我院受理的544例精神病司法鉴定案例资料进行回顾性分析。结果2007年和2009年鉴定的案例最少,2011年鉴定的案例最多;鉴定诊断的精神病中精神分裂症占44．85％,精神发育迟滞占19．30％;无刑事责任能力者占48．89％,限制或部分刑事责任能力者占25．53％。结论司法精神病鉴定案件中有精神病者居多,相关部门应加强精神卫生知识的普及工作和精神疾病的防治工作。     

3720例刑事责任能力鉴定案例分析

目的探讨司法精神鉴定中刑事责任能力鉴定案件的特征,为指导司法精神鉴定实践、预防及减少精神障碍患者的违法行为提供参考依据。方法采用自编资料调查表对四川大学华西基础医学与法医学院法医精神病学教研室1997年1月-2011年12月鉴定的3 720例刑事案件的资料进行收集,对其人口学资料、犯罪学特征、鉴定诊断和责任能力等进行分析。结果 3 720例刑事案件中,男性占86.3%,18～45岁者占81.2%,已婚及再婚者占45.3%,初中及以下文化者占85.4%,农民及无业者占86.6%。鉴定诊断前3位分别是精神分裂症（46.7%）、无精神病（13.8%）和精神发育迟滞（9.6%）;所涉嫌的案件类型中,杀人42.7%,故意伤害21.5%,强奸/猥亵8.1%;被鉴定为无刑事责任能力占43.4%,完全刑事责任能力占31.5%。Spearman秩相关发现各年份案例总数与年份间呈正相关（rS=0.94,P=0.00）,毒品所致精神障碍所占比例与年份间呈正相关（rS=0.84,P=0.00）,精神发育迟滞所占比例与年份间呈正相关（rS=0.72,P=0.00）。结论司法精神鉴定中刑事案件数呈现逐年增长。被鉴定人以中青年男性、文化程度较低的农民及无业人员为主。鉴定诊断前3位依次为精神分裂症、无精神疾病、精神发育迟滞。     

司法精神病鉴定中限定刑事责任能力评定

目的 对司法精神病鉴定中限定刑事责任能力进行讨论。方法 对158例司法精神病鉴定中限定刑事责任能力案例进行分析。结果 限定刑事责任能力的评定在鉴定中可根据实际情况使用。结论 限定刑事责任能力大致可见于以下几种：（1）轻、中度精神发育迟滞：（2）精神分裂症不全缓解期病人作案：（3）情感性精神障碍；（4）继发性人格障碍而非疾病直接导致：（5）复杂性醉酒活动障碍。     

民事行为能力司法精神医学鉴定

目的探讨精神医学司法鉴定案例中民事行为能力鉴定的特点。方法对88例民事行为能力鉴定案例的相关鉴定资料,包括一般资料、案件类型、申请鉴定原因、鉴定结果等情况进行回顾性分析。结果民事行为能力鉴定案例占总司法鉴定案例的5．5％。88例鉴定案例中离婚纠纷62例（70．5％）。民事行为能力评定：完全责任能力占28．4％,限制责任能力占26．1％,无责任能力占45．5％。结论民事行为能力的司法精神医学鉴定案例偏少,但涉及的问题较复杂。     

731例司法精神医学鉴定案例分析

目的探讨司法精神医学鉴定现状及发展方向。方法对731例司法精神医学鉴定案例资料进行回顾性分析。结果案由以伤残评定居首,其次为凶杀、性犯罪和伤害案;以男性、低年龄、低文化程度、农民、已婚者多;完全责任能力107例（14．64％）．限制责任能力76例（10．40％）．无责任能力177例（24．219%）;伤残与诱因直接相关150例（20．55％）。结论司法精神医学鉴定正处于发展、变化时期．民事案件、精神损伤程度评定逐年上升。     

男性服刑在押犯28例司法精神医学鉴定

目的探讨男性服刑在押犯服刑期间罹患精神疾病与服刑能力的相关性。方法对28例男性服刑在押犯人的司法精神医学鉴定资料进行回顾性调查分析。结果28例男性服刑在押犯中被鉴定患有精神分裂症或偏执性精神病18例（64．3％）,责任能力评定结果为无服刑能力;患有应激相关障碍、癔病、人格障碍等10例（36．7％）,责任能力评定结果为有服刑能力;28例男性服刑在押犯中23例（82．1％）病程〉6mo。结论服刑在押犯人服刑期问易出现精神心理问题。监狱管理人员应加强服刑在押犯的精神卫生宣教,提高服刑人员的服刑能力。     

反复上访者司法精神病鉴定案例分析

目的探讨反复上访者的司法精神病鉴定特点。方法采用自制调查表对17例反复上访者的鉴定资料进行分析,统计其上访动机、诊断及责任能力。结果上访动机：妄想支配7例（41．18％）,现实动机9例（52．94％）,不明动机1例;诊断：精神分裂症6例（35．29％）,偏执性精神病2例（11．76％）,无精神病5例（29．41％）,其它4例;完全责任能力7例（41．18％）,部分责任能力1例（5．88％）,无责任能力9例（52．94％）。结论反复上访者多有精神异常,有关部门应考虑其是否具有病理性动机。     

120例精神发育迟滞司法鉴定分析

目的 探讨精神发育迟滞患者的司法精神医学鉴定特点。方法 回顾性分析120例精神发育迟滞患者司法精神病鉴定特点。结果 精神发育迟滞占同期鉴定案例的16％，以年龄在15—29a女性为多见。轻度精神发育迟滞患者的性自卫能力和民事行为能力以部分责任能力和无责任能力为主；中度和重度精神发育迟滞以无责任能力、无性自卫能力和无民事行为能力为主。结论 精神发育迟滞患者涉及刑事案件和民事案件有一定特点，其责任能力和性自卫能力评定分歧较大，鉴定时应掌握全部材料作综合分析，并重视社会适应能力的调查。     

不同年代精神分裂症违法者责任能力评定比较

目的探讨司法精神医学鉴定中法学评定的原则与观点。方法将1990～1993年71例与2000～2003年94例精神分裂症违法者司法鉴定资料进行整理分析．比较相隔10年对精神分裂症违法者责任能力评定的差异及学术观点。结果2000～2003年期间精神分裂症违法者被评定为无责任能力(49．69．01％)较1990～1993年(50．53．19％)下降。表明2000年后对责任能力的评定逐渐趋于严格。结论司法精神医学鉴定应遵循医学与法学的双重原则．维护违法精神病患者与无辜受害者双方的合法权益,更好地为法律公正服务。     

Occupational health nurses' work and expertise in Finland: occupational health nurses' perspective

The purpose of this study was to describe Finnish occupational health nurses' (OHNs) work in terms of its contents, characteristics, necessities, meanings, development areas, changes, and expertise. The data were gathered via essays handwritten by OHNs (n = 20). Qualitative content analysis revealed that occupational health nursing practice included work with individuals, work communities, and various collaborative partners, office tasks, and other duties. Responses about OHNs' work were classified as characteristics of OHNs and of their work with advantages as well as disadvantages. The work of OHNs requires a multidisciplinary knowledge basis, professional skills, certain personal characteristics, and other features. These should be maintained and developed through continual education. The outcomes of OHNs' work were better health and healthier habits for employers, higher productivity for employers and occupational health care units, and health care savings for society. The most significant change that has occurred over the last 20 years was the move from an individual and medicine orientation toward a focus on the work community and on nursing. Expert OHNs were expected to be competent and multiskilled professionals who apply multidisciplinary knowledge in practice. This study brought out the need for further study with a focus on the client's perspective.     

医疗纠纷法医鉴定288例分析

目的:从法医学角度探讨医疗纠纷的成因并提出相关防范措施。方法:对2000年～2005年四川大学华西法医学鉴定中心鉴定的共288例医疗纠纷资料进行回顾性整理分析。结果:近年来医疗纠纷有逐年增多的趋势。医疗纠纷的常见原因有医德医风问题、医疗技术或设备不过关、医务人员的失职或失误等。低级别医疗机构医疗纠纷所占比例相对较高。外科、妇产科等科室医疗纠纷所占比例较高。结论:通过增强医德修养,提高医务人员技术水平,强化医务人员自我保护意识,改善医患关系等措施,能够减少医疗纠纷发生。     

Loss of clinical nursing expertise: A discussion paper

There is evidence to suggest that there is a general decline in clinical expertise in nursing as a result of experienced clinicians leaving the profession. The expertise of clinical nursing practice is an important resource and needs to be captured and made available to others as loss of this knowledge and expertise has implications for clinical outcomes. This paper aims to discuss the current nursing workforce, loss of clinical expertise, the nature of expertise and the way it can be captured. Clarification and articulation of clinical knowledge of nursing experts provides the means for knowledge to be transferred to a less experienced workforce and be available in an accessible form in the workplace. Leverage of nursing expertise in this manner has the potential to benefit less experienced staff, hold clinical nursing expertise in the workplace and improve clinical outcomes and satisfaction with performance.     

操作视频在临床护理技能培训中的应用

目的:运用操作视频培训模式,提高护理人员操作技能水平。方法:将我院2008年和2009年培训考核的护理人员分为观察组和对照组,观察组采用带教老师分批分次在护理教研室进行技能培训的模式,对照组采用操作视频培训模式。观察两组操作成绩的均值情况及护士操作视频的满意度情况。结果:观察组和对照组10项操作考核均值比较差异具有统计学意义(P<0.05),2项操作考核均值比较无统计学差异(P>0.05)。结论:操作视频能有效激发护士学习动力,提高其操作技能,为规范和统一操作流程奠定良好的基础。     

医学司法鉴定中精神病患者反复上访原因分析

目的 了解司法鉴定中精神病患者反复上访原因。方法 对诊断为无精神病者与诊断为精神病偏执型人格障碍、偏执性精神病、精神分裂症者的上访诱因、动机、目的、内容、时间、形式、有否过激行为等进行比较。结果 上访诱因、动机、目的等方面以生活、工作、经济问题为主；上访时间以患病5—20a者居多。共33例(71．73％)：上访者中有过激行为者21例(45．65％)。结论 精神病患者上访者中以偏执型人格障碍、偏执性精神病、精神分裂症居多。其特点与正常人有所区别。这就要求政府部门在接待上访者及处理上访问题时。应加以严格区分并正确、合理解决上访要求。以免产生不良的社会问题。     

Propensity for movement specific reinvestment by physiotherapists: Implications for education

ABSTRACT

Previous studies have shown that the propensity for conscious monitoring and control of movement (i.e. movement specific reinvestment) influences the acquisition of movement skills. Physiotherapists, whose primary function is to promote effective human movement, also develop specialized movement skills that are necessary to perform diagnostic and therapeutic procedures. To explore the implications for promoting expertise, this current study examined physiotherapists’ propensity for movement-specific reinvestment. Practitioners and students in physiotherapy, and other rehabilitation, and non-health professionals, completed the Movement Specific Reinvestment Scale, which measures two dimensions of reinvestment: 1) conscious motor processing (CMP); and 2) movement self-consciousness (MS-C). Physiotherapists scored significantly higher than other professionals on both CMP and MS-C. Specifically among physiotherapists, those with relatively fewer years of practice tended to have higher MS-C scores. Movement-specific reinvestment appears to be a characteristic of physiotherapists that could be relevant for understanding the ways in which novices think and act as they progress to expertise. Further research is recommended to examine the role of reinvestment in performance of different tasks of varying complexity by novice physiotherapists.     

Defining characteristics of expertise in Japanese clinical nursing using the Delphi technique

A four-round Delphi technique was conducted on 127 experienced Japanese nurses to develop a consensus of opinion on the defining characteristics underlying expertise, and the prime requirements for the development of expertise in clinical nursing. Sixteen statements identified as the prime defining characteristics underlying expertise indicated that experienced Japanese nurses' picture of expertise is general, comprehensive and focused on task expertise. Four prime requirements for the development of expertise identified indicated that neither experience nor accumulation of theoretical knowledge alone is sufficient to develop expertise; but that motivation and attitude do play an essential role in the development of expertise.     

论提高精神疾病司法鉴定人素质的重要性

司法精神病鉴定人专业素质、专业技能的高低是鉴定质量的决定性因素。鉴定人不仅要有良好的专业知识和技能,同时还要熟悉掌握有关法律法规,才能达到精神疾病司法鉴定行政规范、法律规范、技术规范的高质量管理要求,才能正确、公正、及时地作出科学的鉴定结论。     

Finnish occupational health nurses' work and expertise: the clients' perspective

AIMS: The aims of this study were to describe Finnish occupational health nurses' functions, characteristics, prerequisites, consequences, changes, development areas and expertise from the point of view of clients. METHODS: The background literature of this study is based on public health nursing models, Finnish social and health report, arguments of special education for occupational health nurses, and earlier studies concerning occupational health nurses' work. The data were collected from volunteer clients (n=26) by interviews. RESULTS: According to the qualitative content analysis, occupational health nurses' activities include health promotion and secondary health care among workers and at workplaces. The main work characteristics are holism, client-orientation, interaction and co-operation. Occupational health nurses need an extensive knowledge base and practical skills, client-orientation, courteous behaviour and a healthy and clean appearance. The outcomes of their work for clients are better health, healthier life habits and healthier working conditions. Nowadays, nurses are more client-orientated than 20 years ago. They are expected to develop their practical and interaction skills and expand their knowledge base. The expertise of occupational health nurses consists of an extensive knowledge base with practical skills, working experience and confidence, and it appeared when advising clients and answering their questions. CONCLUSIONS: It is important to arrange continuing education for occupational health nurses to ensure that they are always up to date in order to be able to respond to specific clients' needs. This study provides a foundation for further investigations into, for example, occupational health nurses' work from the point of view of employers, students of occupational health nursing and other occupational health experts and co-operative partners.