Differential diagnosis of accident and resuscitation traumas

The purpose of this paper is to define the criteria for the differential diagnosis of trauma following resuscitation and road accidents. To this end, 311 cases of thoracic and epigastric trauma were selected from the 2893 medico-legal autopsies carried out between 1979 and 1982 at the Institute of Forensic Medicine of the University of Heidelberg. Cardiopulmonary resuscitation had to be considered as the cause of trauma in 140 of these, but 45 of this group were excluded from further evaluation as they had been the victims of blunt trauma and no clear-cut distinction was possible between trauma resulting from an accident and trauma resulting from resuscitation. Thus, we were left with 95 cases of internal injury that presented as emergencies and in whom death followed resuscitation, as a group for comparison with 171 road accident victims who had not received cardiopulmonary resuscitation. Rib fractures, predominantly on the left side, were established in half the cases resuscitated, sternal fractures also being found in one-third of these victims. Bleeding at various sites, including hemato-thorax, was rare, with an incidence of 15%, thus making it highly unlikely that serious traumas caused by resuscitation were a major factor in the cause of death. This paper encompasses an extensive discussion on serious injuries, such as aortic and gastric ruptures, in this connection.     

Side-bets and reciprocity as determinants of organizational commitment among correctional officers

Organizational commitment is a particularly salient characteristic of the prison work climate due to the stressful working conditions and high rate of turnover among correctional officers nationwide, yet little is known about the factors that predict the level of organizational commitment among officers. Becker's (1960) side-bets hypothesis predicts greater commitment among those who develop additional investments in the job that would be lost with a change of jobs, and the reciprocity hypothesis predicts greater commitment among those who feel they are well treated, supported, and respected by the organization. This study used a sample of 546 correctional officers to examine the relative effects of side bets and reciprocity on two components of organizational commitment—affective commitment and continuance commitment. The results of a multivariate OLS regression analysis indicated that reciprocity had a greater effect than side bets on affective commitment but that side bets had a greater effect than reciprocity on continuance commitment. These findings, which provide partial support for the side-bet hypothesis and strong support for the reciprocity hypothesis, are discussed in terms of the link between organizational commitment and other work-related behaviors.     

Drowning of a Friedreich's ataxia patient

We here report an unusual, apparently accidental death, in which weakness associated with a progressive neuromuscular disease, Friedreich's ataxia, apparently resulted in the drowning of the deceased. The possibility of neuromuscular disease as a rare cause of drownings should not be overlooked.     

Correlations on radioimmunoassay, fluorescence polarization immunoassay, and enzyme immunoassay of cannabis metabolites with gas chromatography/mass spectrometry analysis of 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine specimens.

Results obtained from three commercial immunoassay kits, Abuscreen, TDx, and EMIT, commonly used for the initial test of urine cannabinoids (and metabolites) were correlated with the 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (9-THC-COOH) concentration as determined by GC/MS. Correlation coefficients obtained based on 26 (out of 1359 total sample population) highly relevant samples, are 0.601 and 0.438 for Abuscreen and TDx. Correlation coefficients obtained from a parallel study on a different set of 47 (out of 5070 total sample population) highly relevant specimens are 0.658 and 0.575 for Abuscreen and Emit. The immunoassay concentration levels, that correspond to the commonly used 15 ng/ml GC/MS cutoff value for 9-THC-COOH, as calculated from the regression equations are 82 ng/ml and 75 ng/ml for TDx and EMIT and 120 ng/ml and 72 ng/ml for Abuscreen manufactured at two different time periods. The difference of these calculated corresponding concentrations provides quantitative evidence of the reagent specificity differences.     

Children’s Direct Exposure to Types of Domestic Violence Crime: A Population-based Investigation

Police officers served as public health sentinels to collect data on children exposed to domestic violence across an entire municipality for 1 year. This study extended research by investigating a typology of domestic violence crimes and children’s direct sensory exposure to these types. Police officers used a standard, validated protocol to collect data on all substantiated domestic violence. Findings revealed that almost half of all events had children present, and 81% of these children were directly exposed to the violence. Children under the age of 6 years old were at greater risk of exposure. Identified domestic violence households with children were more likely to be low-income, non-White, and headed by a single female, compared to households at large. Cluster analysis revealed seven domestic violence event profiles. Typology showed that children were disproportionately exposed to the most unstable and dangerous profiles including weapon use, mutual assault, and substance abuse.