1997年～2006年司法精神病学鉴定案例比较

目的探讨近10年司法精神病学鉴定案例的特征。方法将四川大学华西基础医学与法医学院法医精神病学教研室，于1997年～2006年鉴定的3016例案件，分为前5年组和后5年组进行对照研究。结果近10年中，被鉴定人的女性构成比有所上升（P〈0．05），凶杀案件、纵火案件构成比下降，性侵害案件、盗窃案件，以及性自卫能力和伤残评定的构成比均有上升（P〈0．05）。鉴定诊断中，精神发育迟滞和脑外伤所致精神障碍的比例有所增高，而癫痫所致精神障碍和人格障碍的比例有所下降（P〈0．05）；刑事案件受害者中精神病患者的家人被伤害的比例增高（P〈0．05）；做出完全责任能力评定的比例下降，无责任能力评定的比例增加（P〈0．05）。送检单位中法院和其他机关的比例明显增加（P〈0．05）。结论近10年中司法精神病学鉴定呈现不同的特点，司法精神病学也将面临更多的挑战和难题。     

Instructional design dogma: Creating planned learning experiences in simulation

Human lives depend on the performance of our trainees; thus, the educational methodology used to transform our learners into experts are of paramount importance. Effective use of simulation requires educators explore and apply educational theory as they discover who the learner is, how the learner learns, what the learning needs are, and which planned learning experiences are best suited to meet the learner's specialized needs. The purpose of this article is to portray simulation as an educational strategy in the context of a curriculum, to explore emerging theories from educational psychology, and to provide concrete examples of their application in simulation-based education.     

Brains — a computer advisor system to aid in CT scan interpretation and cerebral disease diagnosis

Summary This paper describes a prototype system to aid in the radiological interpretation of CT scan images of patients with cerebral disease. The system is able to provide guidance, both on diagnosis and the need for enhancement.     

Artificial Inteffigence--Its Use in Nephrology

Artificial intelligence techniques and expert systems are graduatingfrom research laboratories to enter many human domains of activities.However, initial expectations of the seventies have been transformedwith time to a more sober reality. Starting from examples innephrology, this paper tries to give a balanced view of thisnew technology. Justification, indication and limitation ofpresent expert systems are discussed as regards their possiblegoals. The respective roles of the experts and knowledge engineersare described. The need to integrate the artificial intelligenceapproach into present patient database management systems inorder to build up expert database systems is evaluated.     

The benchmark dose approach in food risk assessment: Is it applicable and worthwhile?

The benchmark dose (BMD) approach is being increasingly used in the area of food risk assessment because it offers several advantages compared to the conventional no-observed-adverse-effect-level approach. The aim of this work was to check the applicability of the BMD approach on toxicity data available from pesticides, mycotoxins and natural toxins.     

Building a shared patient record for breast cancer management: a French Delphi study

Before electronic records become operational, patient-held records provide an opportunity to improve communication between patients and healthcare professionals. Our aim was to design the appropriate organization, layout and content for such a shared record for breast cancer management, based on a consensus between the various stakeholders. We therefore conducted a Delphi study within a working group of 48 members, including patients, oncologists, general practitioners, nurses and other professionals. The procedure featured three rounds during which participants' judgements were collected via mailed questionnaires and quantitative and qualitative feedback was provided on a regular basis. These three rounds were followed by an evaluation phase. Forty members (83%) participated in the three rounds. According to the agreement reached, the shared record was expected to include a front summary card, four sections for groups of users authorized to write down or insert information in the record (patient, physicians, medical auxiliaries and other healthcare professionals), and one section for medical imaging files. In addition, the record was to include specific categories of information as subsections within each of the various user sections. The participant satisfaction rate was over 90% for all aspects of the procedure, with the exception of interaction within the working group (79%).     

Research Directions in Emergency Medicine*

The goal of EM is to improve health while preventing and managing disease and illness in patients seeking emergency medical care. Improvements in emergency medical care and the delivery of this care can be achieved through credible and meaningful research efforts. Improved delivery of emergency medical care through research requires careful planning and the wise use of limited resources. To achieve this goal, EM must provide appropriate training of young investigators and attract support for their work. Promotion of multidisciplinary research teams will help the specialty fulfill its goals. The result will be the improvement of emergency medical care, which will benefit not only the patients whom EPs serve, but also, ultimately, the nation's health.