Fatal childhood vascular injuries associated with seat belt use

The deaths of two children who were passengers in motor vehicles involved in accidents were directly attributable to vascular injuries derived from seat belts. In the first case, a 10-year-old boy died as a result of abdominal aortic transection by a lap seat belt, and in the second case a 15-year-old boy died as a result of transection of his common carotid artery by a lap-shoulder seat belt. Although these cases demonstrate rare fatalities associated with seat belt use, there is no doubt that seat belts have significantly reduced mortality and morbidity from traffic accidents. Although it is possible that a fatal outcome might have occurred in each of these cases from other injuries that might have been sustained had seat belts not been worn, appropriate positioning and size of seat belt harnesses might have avoided the lethal injuries.     

Neck injuries caused by automatic two-point seat belts: an analysis of four cases

Although seat belts significantly reduce the extent and severity of injuries sustained by motor vehicle occupants, seat belts are known to be associated with chest and abdominal trauma. Less commonly understood are severe neck injuries caused by the use of two-point automatic shoulder harnesses without concurrent use of a manual lap belt. Such injuries may include cervical spine fractures, craniocervical dislocations and rarely decapitation. Recognizing patterned injuries caused by seat belts and the ability to correlate autopsy findings with the circumstances surrounding the death will allow for correct interpretation of seat-belt related trauma. The four cases described detail fatal neck injuries as a result of improper seat belt use in which an automatic two-point shoulder harness was used without a manual lap restraint. In two of the cases, the victims were decapitated.     

Motor Vehicle Occupants,Neck Injuries,and Seat Belt Utilization: A 5‐Year Study of Fatalities in New York City

Abstract: Despite the implementation of numerous safety devices in automobiles, vehicular occupant fatalities following collisions remain common. We reviewed all fatalities of vehicular occupants in New York City over a 5‐year period on whom autopsies were performed (437) to determine the incidence of neck injuries and correlate them with seat belt utilization; 26.5% had neck injuries (mild to severe) and only 10.3% of these occupants were confirmed to be wearing seatbelts. Of those that had documentation of seat belt utilization there were twice as many neck injuries in the unbelted group. We highlight two cases of submarining with severe neck injuries that were related to automatic 2‐point shoulder harness restraints without engagement of the lap belt.     

An examination of the New York mandatory seat belt law on a university campus

On January 1, 1985, the mandatory seat belt law went into effect in New York State; violators were now subject to a fine of $50.00. Police officers issued nonpenalty-based warnings during the month prior to the law's imposition. The purpose of the present study was to compare the effects of the warning versus the fine and a fine-plus-prompt condition (the prompt delivered by the experimenters) on seat belt use on a university campus. Results indicated that significantly more drivers used their sear belts during the fine conditions as compared with the warning condition and that significantly more female drivers used their seat belt during all conditions. A significant difference was not found, however, between the fine and fine-plus-prompt conditions.We gratefully acknowledge the comments of Michael Leippe on an earlier draft of this manuseript.     

Injury Pattern as an Indication of Seat Belt Failure in Ejected Vehicle Occupants

Prior authors have suggested that when occupant ejection occurs in association with a seat belt failure, entanglement of the outboard upper extremity (OUE) with the retracting shoulder belt will invariably occur, leaving injury pattern evidence of belt use. In the present investigation, the authors assessed this theory using data accessed from the NASS‐CDS for ejected front seat occupants of passenger vehicles. Logistic regression models were used to assess the associations between seat belt failure status and injuries. Injury types associated with seat belt failure were significant OUE and head injuries (OR = 3.87, [95% CI 1.2, 13.0] and 3.1, [95% CI 1.0, 9.7], respectively). The two injury types were found to be a predictor of seat belt use and subsequent failure only if combined with a high (≥0.8) precrash probability of belt use. The injury pattern associated with a seat belt failure‐related ejection has limited use in the forensic investigation of crash‐related ejections.     

Murder and robbery by vehicular impact: true vehicular homicide

True vehicular homicides are defined as those occurrences in which a motor vehicle is intentionally used as a weapon in taking of a life. A case is presented in which the deceased was traveling in the front passenger seat of a motor car that was deliberately rammed by a heavy jeep that came in the opposite direction, resulting in a serious frontal collision. Immediately after the impact, while the occupants of the car were lying in a dazed condition, the two persons riding in the jeep escaped with a bag containing money that was in the car, leaving the jeep behind. The impact mainly involved the driver's sides of both vehicles. The driver of the car sustained serious injuries but was found to be alive, whereas the front-seat passenger, who did not show any serious external injuries, was found to be in a collapsed state and was pronounced dead on admission to the hospital within 30 minutes of the accident. The autopsy revealed that death was caused by closed hemopericardium from a ruptured right atrium. The evaluation of the external and internal injuries confirmed that the fatal injury and a few serious internal injuries were caused by the seat belt (tertiary-impact injuries). The ruptured right atrium was attributed to blunt abdominal trauma by impacting against the lap belt. The case was a true vehicular homicide in which a motor vehicle had been used as a weapon to kill a person. Various aspects pertaining to road accidents, the safety of the occupants, and the advantage and disadvantage of the safety devices are discussed.     

Seat belts and human rights: an appraisal

Mandatory seat belt legislation has been passed in 15 states. Accompanying this action has been a deluge of information concerning the lives saved and the injuries prevented by the wearing of seat belts by the front seat passengers in automobiles. This study presents data relating to the injuries and deaths attributable to their usage. There is virtually no major area of the adult body that has escaped such involvement. Mechanisms by which seat belt injury is effected are described in relation to the restraint systems currently available in the United States and abroad.     

Reforming Public Safety: An Evaluation of the 1983 British Seat Belt Law

The purpose of this paper is to analyze the impact of the 1983 British seat belt law in England and Wales. The methodology employed is interrupted time series analysis.
In terms of a lasting impact, the seat belt legislation for automobiles compares favorably with other interventions designed to decrease deaths and injuries on the road, such as legislation to control drinking and driving. Typically, such legislation is effective only in the short term. In contrast, the seat belt law thus far shows a stronger and more lasting shift in the reduction of serious and fatal car casualties. The post intervention decline in this variable is stronger than a control series that consists of the number of fatal and serious non-car casualties. A more marginal reduction is found for non-serious car casualties even though this drop in injuries is slightly stronger than a control category of nonserious non-car casualties. The paper suggests also that the seat belt legislation may have had a short term effect on the number of fatal and serious accidents on weekend nights, the period of time during which alcohol-related crashes are most likely to occur.
The policy implications of this study suggest that with comparable compliance, such an intervention may similarly be effective in the United States and other Western countries which up to now have used primarily deterrence-based approaches to reduce highway casualties.     

Asphyxiation from shoulder seat belts: an unusual motor vehicle injury

Two cases of accidental asphyxia caused by lap-shoulder seat belts are reported. Lethal neck injuries from shoulder seat belts are uncommon, and episodes of asphyxiation are even rarer. Positioning of the shoulder belt over the neck, short stature, and incapacitation from other injuries were predisposing factors to upper airway compromise in these cases.     

Vehicle-assisted suicide resulting in complete decapitation

A rare case of vehicle-assisted suicide in a 43-year-old man is presented. The man had tied a rope between a fence and his neck and, while seated on the driver's seat, accelerated the vehicle, which resulted in complete decapitation. Earlier that day, the man had tried to bleed himself to death by bottling his own blood in his flat, thus defining the case as secondary complex suicide.     

Children in motor vehicle collisions: analysis of injury by restraint use and seat location

This study was a retrospective chart review of hospital records and autopsy reports of 499 children nine years old or younger involved in motor vehicle collisions from 1994 to 1998. The objective was to evaluate the frequency and severity of injuries as a function of age, restraint use, and seat position. We found that 33% of the children were unrestrained and 20% were improperly restrained. Unrestrained children had the highest mean Maximum Abbreviated Injury Scores (MAIS) and Injury Severity Scores (ISS), accounted for 70% of the fatalities, and had the highest incidence of head injuries. Although most of the head injuries were superficial, 80% of the fatalities were the result of a head injury. Improperly restrained children had the highest frequency of abdominal injuries. Regardless of restraint use, the back seat was associated with fewer head injuries and lower mean MAIS and ISS scores compared to the front seat. Also, properly restrained children in the front seat had lower mean MAIS and ISS scores than unrestrained children in the back seat, suggesting that restraint use is more beneficial than seat position.     

Filicide-suicide in Chicago, 1870-1930

Filicide (the killing of a child by a parent) followed by the offender's suicide is a tragic but, fortunately, rare event. The contexts and circumstances surrounding filicide-suicide may provide insight into parental psychology. The authors test several hypotheses about filicide-suicide using a database including incident-level information on 11,018 Chicago homicides during 1870-1930. The results provide some support for the hypothesis of differential risk of suicide following filicide by genetic parents and stepparents and replicate previous research indicating that filicides with multiple victims are more likely to end in the offender's suicide than are filicides with a single victim; parents are more likely to commit suicide following the filicide of an older child than of a younger child; and older parents, relative to younger parents, are more likely to commit suicide following filicide. The discussion situates these results within the existing literature and highlights important directions for future research.     

Doing the Right Thing: Cohabiting Parents, Separation and Child Contact

Over recent years, concern has mounted at the unstable natureof cohabiting relationships compared to marital ones, and alsoabout the fact that any children from these relationships aremore likely to experience the separation of their parents thanthe children of a marital union. The discourse of the FamilyLaw Act 1996 holds that separating parents should behave ina conciliatory and reasonable way to each other, maintain contactwith their children and continue to be involved in their upbringing,and ensure that financial obligations are met. This articleuses data obtained through interviews with previously cohabitingparents who have attended pilot group meetings designed to educatethem about the needs of their children on separation, to examineto what extent parents internalize this discourse when negotiatingpost-separation parenting. The article concludes that whileparents may take on board the principles of this socially acceptablediscourse, they have their own moral rules derived from theirown histories and experiences of what it is to live their lifeand parent their child that they must marry with this discourse.The extent to which current family policy discourses and legislativeframeworks can influence the behaviour of parents is thereforemitigated by their own interpretations within the context oftheir own lives.     

Socializing Distrust of the Justice System through the Family in Juvenile Delinquency Court

Juvenile delinquency courts in the United States generally require parents to attend all court hearings, but little is known about how parents' experiences in the court process affect their discussions of the justice system with their court‐involved children. Using multiperspectival and longitudinal data combining observations with interviews of parents and youth in two courts, this research finds that many parents discuss the legal process in negative terms with their children when parents are outside the presence of legal authorities. This research adds to the literature on legal socialization by examining how parents' perceptions of law and their experiences with the court become part of the socializing content provided by parents to their court‐involved children. Creating a more meaningful role for parents in the juvenile justice process may potentially lead to more positive discussions of the court process between parents and juvenile defendants.     

Child Suicide in the North of Portugal

Suicide in children is a rare finding and is probably motivated by acts of impulsiveness. This study aims to contribute to the characterization of child suicide in a forensic perspective in the Portuguese population. Data of forensic autopsies from 2004 to 2012 related to suicide victims under 18 years were reviewed. A total of 17 cases, with a male predominance (64.7%) and a mean age of 15.24 ± 1.348 for both genders, were registered. The leading suicide method was hanging (35.3%), and a suicide note was found in 41.2%. Psychological autopsy proved to be useful in promoting a better understanding of these incidents and their antecedents. This study also offers useful information, namely the implied risk factors, for future programs of suicide research and prevention.     

ASSISTING CHILDREN THROUGH TRANSITION:Helping Parents Protect Their Children From the Toxic Effects of Ongoing Conflict in the Aftermath of Divorce

The negative effects of prolonged interparental conflict on children are well documented. This article describes a preventive intervention designed to help separating parents to (a) reduce the stress of a breakup on their children and (b) learn skills for protecting them from the toxic effects of ongoing conflict. Assisting Children through Transition-(A.C.T.) For the Children is based on a risk and resilience model emphasizing skills training and effective parenting practices. Post-program results from 609 participants indicate that the majority of male and female participants reported an increased awareness of the deleterious effects of interparental conflict on children and learned skills for protecting children from ongoing conflict. Most participants reported firm intentions to continue to use skills for reducing conflict with a former spouse and to support their children's healthy relationship with both parents. Study limitations, directions for future research, and implications for legal and mental health practitioners are discussed.     

Frequency and Clinical Features of Patients who Attempted Suicide by Hara‐Kiri in Japan

Hara‐kiri is a unique Japanese custom, primarily stemming from the manners and customs that a samurai held. The aim of the present study was to investigate the clinical features of individuals who attempted suicide by hara‐kiri. We enrolled 647 patients who had attempted suicide. Clinical features were compared between those who had employed hara‐kiri and those who had used other methods. 25 of the 647 subjects had attempted suicide by hara‐kiri. The ratio of men to women and the proportion of patients with mood disorders were significantly higher in the hara‐kiri group than in the other methods group. The average length of stay in either the hospital or in the intensive care unit was also longer in the hara‐kiri group than in the other methods group. Hara‐kiri is an original Japanese method of attempting suicide, and suicide attempts by hara‐kiri may be aimed at maintaining a reputation or taking responsibility.     

论成年在校大学生对父母的抚养费请求权——兼论《婚姻法司法解释(一)》第20条的缺陷与完善

在司法实践中,对于在校成年大学生起诉父母索要抚养费的相似案件,不同法院的判决往往截然不同。主要原因在于《婚姻法司法解释(一)》第20条对"不能独立生活的子女"的规定存在缺陷。在《婚姻法》相关内容细化之前,有必要通过司法解释作出明确规定,一是明确"父母有给付能力"为成年子女请求父母给付抚养费的前提;二是细化对"不能独立生活的子女"的解释,甄别情况肯定或否定在校成年大学生对父母的抚养费请求权。     

Fibres used in the construction of car seats — An assessment of evidential value

The evidential significance of car seat fibres has been investigated. Thirty six samples of car seat fabric were examined and the fibres catalogued according to their morphology and characteristics. The majority of car seat fibres were black or grey thick polyester fibres that were either dyed or pigmented. The MSP spectra produced were unlike those usually obtained from black or grey polyester fibres used in clothing. Tapings taken from car seats were examined for car seat fibres, various types were found showing that these fibres are expected to shed from the fabric albeit in low numbers, unless the vehicle is older. No fibres that matched the samples of the car seat fabric were found on the tapings of the car seats. One hundred garments were examined for car seat fibres, 10% of garments had populations of such fibres present and 41% had at least one car seat fibre present. None of these fibres matched the samples of the car seat fabric or those from the car seat tapings.     

Rights,responsibilities and regulation – the three Rs of education: a consideration of the state's control over parental choice in education

Education is both a right and a responsibility. International instruments such as the International covenant on civil and political rights and the International convention on the rights of the child affirm the right of all children to education. This right is spelt out in the education legislation of all states and territories in Australia. Education is not only free but is compulsory for all children between certain ages. The obligation is imposed on parents (in accordance with definitions contained therein) to ensure that their children are both enrolled at and attend school. However, parental choice of education provider is allowed within each jurisdiction by way of state, private or church schools, all of which are registered and regulated to varying degrees by the state. The legislation of each jurisdiction also makes some degree of provision for parents who choose to opt out their children from any formal education setting and to educate them at home. Home education is also subject to state regulation. The assumption by the state of the responsibility for education guides this policy and legislation. The argument for state control of all education, no matter how and by whom it is provided, is that the state has an overriding interest in ensuring the economic well-being of its citizens and the growth of its intellectual capital. The state acknowledges that the responsibility for education is shared with parents, primarily by providing penalties for parents who fail to ensure enrolment and attendance of their children at a school. There is evidence that more and more parents in developed countries worldwide are choosing to educate their children at home, and anecdotal evidence suggests that Australia is part of this trend. To this end, this article critically examines the balance and relationship between the exercise of parental choice and responsibility in education, and state regulation and control. It does so by examining the means by which the legislation of different jurisdictions allows for choice in the exercise of the right to education, with particular reference to home education, places limitations on that choice and imposes control on the delivery of education outside state schools.