Effects of positional restraint on oxygen saturation and heart rate following exercise

This report assesses the effects on peripheral oxygen saturation and heart rate that positional restraint induces when a person is prone, handcuffed, and "hog-tied." Peripheral oxygen saturation and heart rate were monitored at rest, during exercise, and during recovery from exercise for 10 adult subjects. The effects of positional restraint produced a mean recovery time that was significantly prolonged. Consequently, the physiological effects produced by positional restraint should be recognized in deaths where such measures are used.     

Ventilatory and metabolic demands during aggressive physical restraint in healthy adults

We investigated ventilatory and metabolic demands in healthy adults when placed in the prone maximal restraint position (PMRP), i.e., hogtie restraint. Maximal voluntary ventilation (MVV) was measured in seated subjects (n=30), in the PMRP, and when prone with up to 90.1 or 102.3 kg of weight on the back. MVV with the heaviest weight was 70% of the seated MVV (122+/-28 and 156+/-38 L/min, respectively; p<0.001). Also, subjects (n=27) were placed in the PMRP and struggled vigorously for 60 sec. During the restrained struggle, ventilatory function (V(E)/ MVV) was 44% of MVV in the resting PMRP. While prone with up to 90.1 or 102.3 kg on the back, the decrease in MVV was of no clinical importance in these subjects. Also, while maximally struggling in the PMRP, V(E) was still adequate to supply the ventilatory needs.     

Assistive technology as support for the exercise of legal capacity

Exercising legal capacity refers to engaging in legal transactions and relationships and is essential for the full inclusion of people with disabilities in society. The United Nations Convention on the Rights of Persons with Disabilities has enumerated the right to legal capacity on an equal basis and has created a state obligation to provide access to support for the exercise of legal capacity. This article examines the use of assistive devices as support for decision-making in exercising legal capacity for individuals with physical and cognitive impairments; for example, the use of voice recognition programmes, screen readers, and screen enlargement applications to support people with mobility and sensory impairments to use online portals essential for legal actions such as banking. It also discusses the experimental use of cognitive assistance, including computer or electrical assistive devices, to facilitate communication for people with cognitive impairments including those with no external signs of consciousness. It highlights the diversity of options for ‘support for the exercise of legal capacity’ showing how they can assist people with various disabilities. Finally, the article examines the boundaries of the state obligation to provide such support, including issues of practical implementation and resource allocation.     

限制性体位窒息死亡的国内外研究进展

限制性体位窒息是指被限制于某种异常体位,造成了自主呼吸功能的障碍引起的窒息,严重时可引起死亡,属机械性窒息中的特殊类型。从国内外有关案例报道来看,限制性体位窒息死亡可以发生在多种环境、体位下。由于早年限制性体位窒息死亡的案例没有引起足够的重视,其作为一个法医学课题起步较晚。近年来由于发生率猛增,已引起国内外法医学家们的极大关注,并对其发生机理、鉴定标准等方面进行了大量研究,但从研究的成果来看,尚不能形成一些客观的鉴定指标,由此,国外关于限制性体位窒息的研究重点已转向其发生的危险因素评估及如何预防。本文就其死亡机理、危险因素及预防、鉴定标准和展望等方面作一综述。     

Reenactment of circumstances in deaths related to restraint

Reenactment of the circumstances in deaths associated with restraint, utilizing participants and witnesses while memories are fresh, may help death investigators more accurately determine the cause of death. Two recent deaths in Ventura County that occurred during restraint are discussed. Within a day of the autopsies the restrainers agreed to participate in reenactments of the restraint process, utilizing live volunteers as subjects. They allowed videotaping. Deaths associated with restraint often have nonspecific autopsy findings. Timely reenactment of the circumstances of deaths associated with restraint can help death investigators more accurately determine the probable cause of death in these difficult cases.     

Effects of a state law on rates of restraint on a child and adolescent unit

Rates of restraint and seclusion on a child and adolescent unit were evaluated before and after the implementation of a restrictive state law which was designed to reduce the monthly rates of restraint. Overall, the total number of hours in restraint, corrected for mean daily census, decreased significantly. The average number of patients in chemical restraint stayed about the same. There was a significant increase in number of patients, number of episodes, and hours of mechanical restraint as expected. Rates of seclusion dropped to zero as mandated. A new category of physical restraint was defined by law and was used to limited extent.     

精神发育迟滞患者辨认能力的影响因素研究

目的　探讨司法鉴定中精神发育迟滞 (MR)患者辨认能力的影响因素。方法　对 86例MR司法鉴定资料进行判别分析 ,选出影响辨认能力的判别因子 ,并建立判别方程 ,进行组内回代检验。结果　经判别分析 ,有 5个因素被选入 :个性特征、诊断分组、是否伴有癫痫及其他精神病性症状、作案类型、作案动机 ,组内回代检验不同程度辨认能力的判断正确率分别为 :有完全辨认能力 93 8%、有部分辨认能力73 4 %、无辨认能力 1 0 0 %,总判断正确率为 89 0 %。结论　MR患者作案时辨认能力受多种因素的影响 ,否认了“单纯以诊断分级判断辨认能力”的观点。     

Police use of TASERs in the restraint and transport of persons with a mental illness

The mentally ill are overrepresented in the statistics of individuals killed or injured by police and it is understandable that police would seek a weapon, such as a TASER, that is less lethal than a firearm. However, it appears that use of TASERs is not without risk, especially in certain groups, including the mentally ill. The risk of injury to vulnerable people with a mental illness from TASER weapons must be weighed against the risk that escalation to lethal force may cause if a person with an acute mental illness requires restraint. When police officers are carrying out their duties under mental health legislation it is recommended that TASERs be used only when an individual is imminently likely to sustain or to cause grievous bodily harm. This article recommends changes to the Western Australian Police TASER training programs and proposes mandatory medical assessments after the use of TASER restraint.     

Determination of the body length of adult humans from the measurable wrist parameters on X-ray image

The authors propose methods for the determination of the body length of adult persons based on the planimetric analysis of X-ray images of the wrist bones. The body length was calculated with the help of regression equations derived with reference to the age-specific changes of the wrist bones visible on X-ray images. The results of the calculation were compared with the known body length of selected subjects.     

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.     

精神发育迟滞患者辨认能力的影响因素研究

目的 探讨司法鉴定中精神发育迟滞（ＭＲ）患者辨认能力的影响因素。方法 对８６例ＭＲ司法鉴定资料进行判别分析,影响辨认能力的判别因子,并建立判别方程进行组内回代检验。结果 经判别分析,有５个因素被选入;个性特性、诊断分组、是否伴有癫痫及其他精神病性症状、作案类型、作案动机,组内回代检验不同程度辨认能力的判断正确率分别为：有完全辨认能力９３．８％、有部分辨认能力７３．４％、无辨认能力１００％,总判断正     

The impact of recidivism and capacity on prison populations

Prison crowding currently poses a serious problem for society. This problem is attributable to a failure to anticipate and plan for the increased numbers of individuals sentenced to prison over the last decade. Crowded prisons have forced many jurisdictions to release prisoners earlier than would have been the case with unlimited prison capacity and to initiate expensive prison construction programs. In this paper, we develop a prison population projection model that extends previous work by considering the impact of limited prison capacity on time served, releases, and future admissions. The model was demonstrated for the State of North Carolina. Results suggest the tradeoffs that exist between prison capacity and punitiveness as measured by time served in prison.Points of view are those of the authors and do not necessarily represent the official position of the U.S. Department of Justice.     

Age estimation from root development of mandibular third molars in comparison with skeletal age of wrist joint

Identification of the living person and the dead is of paramount importance for variety of reasons in forensic practice routinely. Age estimation is one of the prime factors employed to establish identity. Estimating age from teeth is generally reliable as they are naturally preserved long after all the tissues and even bones have disintegrated. A study was done to determine the age by root developmental changes, using the intraoral periapical radiographs of the mandibular third molars, adopting the Leif Kullman et al method. Three hundred forty-six girls and 389 boys of the age range 15-25 years, among the South Indian population of young adults from various schools and colleges in the vicinity of Dakshina Kannada and Udupi Districts and also among the patients visiting the outpatient department of Oral Medicine and Radiology, College of Dental Surgery, Manipal, were considered for this study. The subjects were roentgenographically examined to determine the age from the 7 stages of root development of the left mandibular third molar. Depending on the exact stage of root development as seen in the radiograph, the chronologic age was determined. This method sheds a new light on determining the ages of 15, 16, and 18 years, which has an immense medicolegal bearing.     

FDI spillovers on firm survival in Italy: absorptive capacity matters!

The aim of this paper is to explore the effects of spillovers driven by competition and forward and backward linkages between foreign firms and Italian firms. We adopt the firm dynamics framework, which allows us to test the impact of foreign firms’ activity on the probability that local firms will exit. The empirical analysis relies on continuous survival models (Cox proportional hazard models) and uses a representative firm level database from the period of 2002–2010 with data concerning more than 4,000 Italian manufacturing firms. Our estimates regarding the whole sample show that horizontal and vertical linkages have no impact on firm survival. To further test this finding, we perform a more disaggregated analysis that allows for heterogeneity across firms and sectors. We obtain evidence that the effects of FDI spillovers on firm survival follow specific patterns at both the intra- and inter-industry levels based on differences in productivity between Italian firms and foreign firms and on the technological intensity of the industry. Foreign firms’ activity reduces the exit probability of competitors and of downstream local customers (through forward linkages) with low productivity gap but has no impact on high productivity gap firms. Firms in high technology intensive sectors do not benefit from horizontal FDI while in low and medium technology sectors they do. Differences in absorptive capacity may explain these results. However, we also find that vertical linkages with foreign firms in the upstream supplying industries spur firm duration in medium and high tech sectors.     

女精神病人性自我防卫能力鉴定的几个问题

最高人民法院、最高人民检察院、公安部在1984年颁布的<关于当前办理强奸案件的具体应用法律的若干问题的解答>(以下简称<解答>)指出:明知妇女是精神病患者或者痴呆者(程度严重的)而与其发生性行为的,不管犯罪分子采取什么手段,都应以强奸论处.     

Roe v. Wade is constitutionally unprincipled and logically incoherent: a brief in support of judicial restraint

This "amicus curiae" brief was submitted by the Center for Judicial Studies and 56 members of Congress. They were concerned that "Roe" expands powers that belong to Congress and the states into the realm of federal government. Part I of the brief dealt with Missouri's claim that the laws that were at issue in "Webster" were permitted under "Roe" and shouldn't have been made invalid by lower courts. Most of the brief was in Part II. The thrust of it was that "Roe" was not based on any principle and is incoherent internally; "Roe" said that a privacy right existed under the US constitution. However, "Roe" didn't define this right of personal privacy. "Roe" cited a "line of decisions" to prove this point. However, none of the cases that "Roe" cited pretended to be based on the "right to privacy." They dealt with other issues. "Botsford" was said to be the beginning of the constitutional privacy right. It dealt with a "common law rule of evidence," not a right that was in the constitution. Therefore, it did not define the privacy right. "The process by which "Roe" moved from privacy to abortion was unfounded by judicial fiat." "Roe" said that it was protected by "the compelling interest standard," but did not give a reason why this was so. In "Roe," the woman';s interest in getting an abortion was analyzed in medical terms. But when talking about the State's interest in protecting potential human life, medical considerations were not controlling. Part III of the brief asked that "Roe" be overturned because it said that "a privacy right to abortion" was "devoid of any linkage to the text or history of the constitution." "Roe" should be abandoned because its "inadequacies" are "basic".