Traumatic injuries in pregnant women: a case of motor vehicle accident for "Ground Round" discussion

The main objective for introducing this case study is to create a platform from which the importance of road traffic related injuries and traumas can be emphasized and discussed within and across various fields of investigation. The long term goal is to entice public campaign around unmet needs for higher road safety measures to reduce primary, secondary, and tertiary risks of injuries and traumas. CASE: a 28-year-old pregnant woman with a 16-week gestational age fetus was involved in a road car crash resulting in multiple traumas. Evaluation and treatment was initiated in the local Urgent Care Unit and continued in the emergency department and operation room. Patient underwent the following procedures: laparotomy, diverting colostomy, terminating pregnancy, right calcaneal traction and long leg splint, as well as multiple irrigation-debridements. Finally, the wound was left open and the patient was admitted to Intensive Care Unit. We hope that the introduction of this case for a "Ground Round" discussion will stir up a comprehensive discussion regarding the injury and trauma related preventive measures as well as treatment approaches in cases involving pregnant women in car accidents, and will bring about a holistic overview of this issue by the experts in various fields. ?     

Clinical observations of ghetto four-year-olds: Organization,involvement, interpersonal responsiveness,and psychosexual content of play

This study attempted to refine the assessment of the effectance of four-year-old children through observation of their play. Two scales were developed; the first scale defined organization, involvement, and interpersonal responsiveness in play, and the second operationally defined psychosexual content of play. The validity and reliability of both scales and the inter correlations among the four major variables were explored. The results confirmed the validity and reliability of the instruments as measures of the children's effectance and important indicators of a child's capacity as a learner at age four.This research was carried out at the Dr. Martin Luther King Family Center and was supported by the Kenneth F. Montgomery Charitable Foundation in collaboration with the State of Illinois Department of Mental Health. Additional support was provided by the National Institutes of Health, General Research Support Grant No. 1-So 1 FR 05 666-01.Received M.D. from Tulane University School of Medicine in 1957. Presently Associate Professor of Psychiatry at the University of Illinois College of Medicine. Research interests lie in cross-cultural personality development and in psychophysiologic studies of human sexual arousal.Received Ph.D. from the Illinois Institute of Technology in 1967. Presently Assistant Professor of Psychology at the Yale Child Study Center. Research has been mainly in the area of development and interference of effective learning in children.Graduated from the University of Cincinnati College of Medicine in 1954. Presently Associate Professor of Psychiatry at the University of Illinois College of Medicine. Primarily interested in the effects of poverty on personality and social organization.     

Schiavo's lessons for health attorneys when good law is all you have: reflections of the special guardian ad litem to Theresa Marie Schiavo

Rarely have all the branches of federal and state government converged upon a single issue, a single person as they did in the tragic and acrimonious case of Theresa Maria Schiavo. In late 2003, the Florida Legislature passed what become known as "Terri's Law" and in Spring of 2005, Congress and the President of the United States sought to directly intervene in the care of the severely brain damaged woman. During that period, the state and federal court systems, through the highest courts in both venues, ruled on Ms. Schiavo's life, resulting in the removal of an artificial feeding tube and her death during Easter week. The legal and medical issues in this complex, politically and emotionally charged case continue to raise important questions for health attorneys. In this Article, Professor Wolfson, who served as the legislatively mandated, court appointed special guardian ad litem for Theresa Schiavo in late 2003, provides a distinctive first-person overview of the Schiavo case.     

Using STR analysis to detect human DNA from exploded pipe bomb devices

This study investigated the possibility of recovering a bomb assembler's DNA from an exploded pipe bomb device. Metal and polyvinyl chloride (PVC) pipes were examined to determine if one surface type would allow better DNA recovery than the other. Ten subjects each handled components of one metal and one PVC pipe bomb. The bombs were exploded, the fragments were collected and swabbed using the double swab technique, and the samples were extracted, quantified, amplified, and genotyped using polymerase chain reaction/short tandem repeat (PCR/STR). Of the 20 bombs handled by the subjects, four bombs gave reportable results that matched the subject's known DNA profiles. An additional eight profiles, also matching the subject's known DNA profiles, were generated but were below the reportable threshold. There was no difference in the success rate of obtaining DNA profiles related to the use of either PVC or metal in the manufacture of the pipe bomb. The variables that appeared to have the greatest influence on the success of generating a DNA profile were the amount of fragmentation and subsequent recovery of the bomb fragments. It is suspected that successful DNA profiling could also be dependent upon the bomb assembler's propensity to slough skin cells on objects they handled.     

Fertility decline and social service access: Reconciling behavioral and medical models

In this summary of fertility literature the author attempts to differentiate between the effects of behavioral and medical models of family planning programs on the fertility rate. This is done by determining the effects of access to social welfare services by assessment of: the function of children within the family life survey conducted in the Cameroons are also used. It was found that 7 interdependent elements of social service are involved: 1) general health care; 2) social security for sick and aged; 3) employment training and opportunities for adults; 4) literacy and education; 5) communication and transportation systems; 6) housing and infrastructure; 7) child care and welfare. The presence of these elements is shown to accompany low fertility while their absence is expressed in high rates of child bearing. These elements are major variables in both the nomological and public policy senses. 2 additional components are knowledge of and favorable attitudes towards effective means of fertility control plus effective mechanical, chemical, or natural means of limiting fertility. The concept of fertility norm and its impact on the fertility rate is explained as being the result of the collective force which social affiliations exert on people to reproduce in a certain way. The "stopping rule" is that which will fulfill the fertility norm. An example of this is a culture which continues child bearing until a son has been born and then controls reproduction after this has happened. Such factors must be considered for family planning programs to succeed in these cultures. Therefore fertility levels are found to be the product of prevailing norms and technical ability to achieve these norms. Improvement in levels of access to social services can bring about the lowering of these norms.