Independent and court-ordered forensic neuropsychological examinations: Official statement of the National Academy of Neuropsychology

Independent forensic neuropsychological examinations are performed by neuropsychologists who are hired as independent contractors by third parties to make determinations regarding neuropsychological functioning. The responsibilities of neuropsychologists when performing independent or court-ordered forensic examinations differ from those of clinical examinations. Because neuropsychological training typically occurs in clinical contexts, the transition to forensic contexts may result in uncertainty about how to negotiate the unique responsibilities of the forensic examiner role. Neuropsychologists are responsible for maintaining the highest standards of professional practice when performing independent and court-ordered forensic examinations. To reach and maintain the highest standards of practice, neuropsychologists must understand the unique relationships with retaining parties and examinees and strive to maintain true independence and objectivity. Although a true neuropsychologist-patient relationship is not considered to exist within the context of a forensic neuropsychological evaluation, neuropsychologists have ethical responsibilities to both the retaining party and the examinee.     

Measuring clinical outcome

At the present time, there are many fundamental issues coming from the Department of Health or from other national organizations, which will have an effect on the future development of the dietetic profession. The British Diatetic Association (BDA) Professional Development Committee will consider these issues, as and when appropriate, and will publish the information in the form of Briefing Papers.
The first Briefing Paper on 'Quality Assurance' was published by the BDA in November 1989. The second on 'Measuring clinical outcome' is published below. In each case the opinion of BDA members and specialist groups has been sought and the Professional Development Committee wishes to thank individuals and the specialist groups for their comments.
The Briefing Papers are intended to provide information and promote discussion among the membership. I would welcome further comments from readers, which may be directed to the British Dietetic Association Office.     

Recommendations for the Conduct of Acute Inhalation Limit Tests

This paper reviews the scientific issues related to exposureconcentrations and particle sizes used in acute inhalation limittests. The current United States Environmental Protection Agency(USEPA) recommended exposure concentration for such tests is5 mg/liter, while this level is very high, it is often achievable.On the other hand, its toxicological relevance is questionable.The USEPA recommendation that 25% of the particle distributionbe less than 1 µm is a more difficult issue to address.Physical laws for aerosol particle generation and behavior limitthe minimum size of particles in an exposure atmosphere at aconcentration of 5 mg/liter. Particle size also influences depositionsite in the respiratory tract. Since damage to any region ofthe respiratory tract can produce lethality, and it is not possibleto predict, a priori, the most responsive region of the tractor the most harmful particle size of an untested agent, acutelimit testing should employ particles in a size range that depositsthroughout the entire rodent respiratory tract. Particles between1 and 4 µm mass median aerodynamic diameter (MMAD) arewell suited for such studies. It is, therefore, recommendedthat the limit test concentration should be the highest concentration(up to 5 mg/liter) that can be achieved while still maintaininga particle size distribution having an MMAD between 1 and 4µm.     

吉林省38所医院护理工作抽查情况分析

吉林省第一周期的医院评审工作基本结束,为了巩固成果,防止滑坡,吉林省医院评审委员会多次组织专家对38所二三级甲乙等医院护理工作进行现场抽查。对吉林省护理工作的概况及抽查中发现的共性问题进行了分析。同时建议:加强护理人员的职业道德教育;解决护理人员编制不足问题;提高护理人员技术劳务价值;运用激励手段提高护理工作质量。