Interpersonal rejection sensitivity in childhood sexual abuse survivors: mediator of depressive symptoms and anger suppression

This study investigated whether interpersonal rejection sensitivity serves a mediating role between childhood sexual abuse (CSA) and three long-term psychological correlates of CSA in adult female survivors: depressive symptoms, anger suppression, and attenuated emotional expression. Interpersonal rejection sensitivity has been shown to be a risk factor for the development of depression and is elevated in CSA survivors. Similarly, attenuated emotional expression, particularly anger, has been related to adjustment difficulties in CSA survivors. Participants in this study were 355 female undergraduates, 34 of whom reported a history of CSA. Results demonstrated that interpersonal rejection sensitivity mediates the relationship between CSA and later depressive symptoms. Interpersonal rejection sensitivity partially mediated the relationship between CSA and anger suppression; however, it did not mediate the relationship between CSA and attenuated emotional expression. These results are examined within the context of the current literature on adult CSA survivors and their implications are discussed.     

EMTALA: dedicating an emergency department near you

Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA) in 1986 to prohibit patient dumping. Subsequent to its passage, however, issues concerning the application of EMTALA have vexed hospitals, patients, regulators, and courts. In an attempt to clarify these issues, the Centers for Medicare & Medicaid Services (CMS) recently promulgated new EMTALA regulations. This Article reviews the basic requirements of EMTALA and highlights the statutory definitions critical to its proper interpretation and application. The article then analyzes the impact of the new regulations, particularly in five major areas: where and when the statute applies, on-call physician requirements, hospital-owned ambulances, managed care, and bioterrorism. It concludes with a discussion of the implications of the new regulations for hospitals and their counsel.     

Measuring damages for lost enjoyment of life: the view from the bench and the jury box

Civil jury instructions are inconsistent in defining what constitutes noneconomic damages, which may include pain, suffering, disability, disfigurement, and loss of enjoyment of life (LEL), among other injury sequelae. This inconsistency has been manifested recently in court decisions that have considered whether LEL should be treated as a separate element of noneconomic damages, distinct from pain and suffering. This paper reviews the case law on this issue and also describes a jury simulation experiment. Mock jurors awarded damages after they received instructions on noneconomic damages in which LEL was (1) not identified as a distinct element of damages; (2) defined as an element of damages distinct from pain and suffering, but participants awarded a single amount for noneconomic damages; or (3) defined as a distinct element of damages, and participants awarded separate amounts for LEL and pain and suffering. Instructions about LEL resulted in larger awards, but only when mock jurors also made a separate award for that element of damages.     

Changing attitudes toward house arrest with electronic monitoring: the impact of a single presentation?

The notion that community support is critical for program success is a consistent theme in the literature on community-based corrections. Unfortunately, many citizens know very little about alternative sanctions, are misinformed about them, and do not view them favorably. At issue is whether information about alternative sanctions affects individuals' attitudes regarding them. To address this question, students in an upper division criminal justice course were surveyed before and after a presentation on electronic monitoring. Following the presentation, students were more likely to agree that electronic monitoring is punitive and that it meets several goals of the justice system. Implications for policy makers and educators are provided.     

A comparison of respiratory symptoms and inflammation in sudden infant death syndrome and in accidental or inflicted infant death

Upper respiratory infection and pulmonary inflammation are common in sudden infant death syndrome, but their role in the cause of death remains controversial. Controlled studies comparing clinical upper respiratory infection and inflammation in sudden infant death syndrome with sudden infant deaths caused by accidents and inflicted injuries (controls) are unavailable. Our aim was to compare respiratory inflammation and upper respiratory infection within 48 hours of death and postmortem culture results in these two groups. A retrospective analysis of upper respiratory infection and pathologic variables in the trachea and lung of 155 infants dying of sudden infant death syndrome and 33 control infants was undertaken. Upper respiratory infection was present in 39% of sudden infant death syndrome cases and 40% of control cases. Upper respiratory infection was more likely to have occurred in association with more severe lymphocytic interstitial pneumonitis when sudden infant death syndrome cases and control cases were combined ( P=.04). Proximal and distal tracheal lymphocytic infiltration was more severe in control cases than in sudden infant death syndrome cases ( P=.01 and.01, respectively). Lymphocytic infiltrations of the bronchi, bronchioles, and pulmonary interstitium were similar between groups. Bronchial associated lymphoid tissue was more prominent in control cases ( P=.04). Cultures were positive in 80% of sudden infant death syndrome cases, 78% of which were polymicrobial. Among control cases, 89% were positive, with 94% being polymicrobial. This study confirms that microscopic inflammatory infiltrates in sudden infant death syndrome are not lethal.     

Does alcohol make a difference? Within-participants comparison of incidents of partner violence

Episodes of husband-to-wife violence in which the husband consumed alcohol were compared with episodes of husband-to-wife violence, reported by the same individuals, in which the husband was not drinking. Among this community sample of newlyweds, wife reports, but not husband reports, indicated that violent episodes in which the husband was drinking included more acts of violence and were more likely to involve severe violence. Both wife and husband reports indicated that wives were more likely to be physically aggressive in husband drinking episodes compared to sober episodes. However, whereas wives reported that their aggressive behavior was a response to husband aggression, husbands reported that wives were more likely to initiate violence in these episodes. Violent episodes that include alcohol may be more severe and more mutually violent than sober episodes. Discrepancies between husband and wife reports may reflect differences in recall or self-serving biases.     

An esoteric technique useful in the identification of unidentified remains from the examination of faded,illegible hospital identification wristbands

A technique routinely used in the examination of questioned documents has been found to be of assistance when employed in the examination of faded and/or partially legible hospital identification wristbands found with unidentified remains (UIDs). A non-destructive test used predominately by forensic document examiners in the analysis of writing inks, handwritten alterations, and obliterations has proven useful throughout the years when confronted with this unusual type of documentary evidence. This discussion paper was prompted by the Tri-State Crematory disaster, Walker County, Georgia, from a request by investigators as to whether or not any information could be obtained from the examination of faded hospital identification wristbands where no information was readily discernable. Subsequent analysis by non-destructive infrared inspection, a standard technique used in the examination of questioned documents, proved useful in assisting with the identification of unidentified skeletal remains.