Deer stand fatalities in Kentucky: two cases of reverse suspension and blunt force trauma

Hunting many types of wild game is an avidly pursued outdoor activity that attracts all ages and both genders at various times of the year. Deer hunting is a popular sport in many regions of North America. A variety of weapons are used in the hunting, trapping, and killing of game. As a variety of different modalities are used, myriad types of injuries unique to the type of hunting can occur. Most deer hunting-related fatalities identified at the Office of the Chief Medical Examiner in Kentucky are accidental firearm injuries. Less commonly encountered are fatalities resulting from elevation of the hunter in a tree stand, often associated with poor design or construction of the perch. We present 2 tree stand-related deaths. One victim died of positional asphyxia due to reverse suspension from a hunting tree stand. The second victim died of multiple blunt force injuries sustained in a 20-foot fall from a tree stand. We summarize the features of morbidity and mortality related to deer hunting based on investigations by the Office of the Chief Medical Examiner.     

Theory and the scientific basis for forensic anthropology

Forensic anthropology has long been criticized for its lack of a strong theoretical and scientific foundation. This paper addresses this problem by examining the role of theory in forensic anthropology at different hierarchical levels (high-level, middle-range, and low-level) and the relevance of various theoretical concepts (taphonomic, agency, behavioral archaeology, nonlinear systems, and methodological theories) to the interpretation of forensic contexts. Application of these theories to a case study involving the search for the WWII Goettge Patrol illustrates the explanatory power these theories offer to the interpretation of forensic events as the end product of an often complex set of environmental constraints and behavioral interactions and choices. It also emphasizes the importance of case studies in theory building and hypothesis testing. A theoretical foundation does indeed currently exist in forensic anthropology; however, a recognition and broader implementation of anthropological (archaeological) theory is warranted and will further define forensic anthropology as a scientific endeavor.     

Pathways to aggression and violence among African American adolescent males: the influence of normative beliefs, neighborhood, and depressive symptomatology

Youth violence continues to present a serious public health challenge in the United States, particularly so for African American adolescent males. The present study utilized a multilevel approach to predict aggression within a community sample of low-income, urban African American adolescent males (n?=?80). Participants' self-report data on normative beliefs about aggression, exposure to community violence, and depressive symptoms were used in multiple regression equations to predict (a) self-reported interpersonal aggression and (b) self-reported aggressive response style when angered. Results of this study indicate that all three of the independent variables contributed significantly to the prediction of interpersonal aggression and aggressive response style when angered. The findings are important for increasing our understanding of pathways to various types of youth aggression and guiding the development of evidence-based approaches to violence prevention among African American adolescent males.     

Parental warmth amplifies the negative effect of parental hostility on dating violence

Past research has documented the positive association between parental hostility and offspring involvement in intimate partner violence. Researchers, practitioners, and parents typically adopt the standpoint that parental warmth may counter these negative lessons. However, Straus and colleagues argue that parents foster IPV to the extent that they teach their child that verbal and physical aggression are a normal and legitimate component of loving relationships. A strict interpretation of social learning theory would suggest that these lessons are more, not less, likely to occur when parental hostility is interspersed with displays of affection. The present study tests this idea using data from 2,088 undergraduate students from a large university in the Southeast. Consistent with Straus' arguments, findings suggest that, rather than attenuating the negative effects of hostility, supportive interactions seem to amplify the probability that offspring will emulate aggressive behaviors in their own romantic relationships. The same is true for the effects of harsh parenting for women. It seems that the best way parents can avoid contributing to their child's chances of being in a violent dating relationship is to eschew family interaction involving verbal and physical aggression.     

Reconceptualizing elder abuse: treating the disease of senior community exclusion

This article focuses on the phenomenon of elder abuse, which is one of the paramount symptoms of the larger community's failure to address the social, medical, and legal needs of the senior populace. Although there have been multidisciplinary efforts to address this problem, they are not responsive to the needs of the senior population itself In response, the authors propose a model that takes into account the specific concerns of local senior communities and provides seniors and their stakeholder providers a stable infrastructure to ensure open, consistent, and effective participation and delivery of services.     

Dosage of treatment to sexual offenders: are we overprescribing?

A sample of 337 offenders who received treatment in a variety of sex offender treatment programs in the Ontario region of Correctional Service Canada between 1993 and 1998 were divided based on the highest intensity sex offender programming that they received (low, moderate, and high). The three groups were compared with reference to a variety of actuarial risk assessment measures, criminogenic factors, and the number and type of treatment programs completed. It was hypothesized that the high-intensity group would have more criminogenic risk factors, higher actuarial scores, and participate in more treatment programs than both the moderate- and low-intensity groups. The results indicate that in general, the hypotheses were supported. Nonetheless, the results suggest that the low-intensity group may be receiving too much sex offender-specific treatment.     

General practitioners' perspectives regarding competence and confidentiality in an adolescent with suspected anorexia nervosa: legal and ethical considerations

In Victoria, Australia, the legal position regarding young people's competence to make medical treatment decisions has not been clarified in legislation, and a number of often vague common law decisions must be relied on for guidance. This situation produces a degree of uncertainty about appropriate professional practice, while also potentially impeding young people's rights claims in health care settings. With this in mind, the present research explored general practitioners' competence and confidentiality decisions regarding a 17-year-old female who presented with symptoms of an eating disorder. Questionnaires were sent to a random sample of 500 Victorian general practitioners, of whom 190 responded. After reading a case vignette, general practitioners indicated whether they would find the hypothetical patient competent and if they would maintain her confidentiality. Seventy-three per cent of respondents found the patient competent and most would have maintained confidentiality, at least initially. However, subsequent analysis of the rationales supplied for these decisions revealed a wide diversity in general practitioners' understandings and implementations of extant legal authority. This research highlights the need for general practitioners to be exposed to up-to-date and clinically relevant explanations of contemporary legal positions.     

Iatrogenic catheter-related cardiac tamponade: a case report of fatal hydropericardium following subcutaneous implantation of a chemotherapeutic injection port

The need to obtain dependable access to the vascular system constitutes a significant component in the treatment and management of critically ill patients. Intravenous chemotherapy administered to cancer patients over an extended period of time often results in loss of peripheral vascular access due to vein sclerosis, "exhaustion" or tissue necrosis. Medical investigators have designed and steadily upgraded a variety of devices constructed to improve venous access for long-term utilization. As with the introduction of any foreign object into the body, each of these devices has complications which may be life threatening and occasionally fatal. We present an unusual case of iatrogenic acute hydropericardium and cardiac tamponade caused by the percutaneous infusion of chemotherapeutic fluid via a right subclavian central venous implant system (Port-a-Cath). Failure to implant and monitor the device with a radiograph following placement according to manufacturer's guidelines and accepted standards of medical practice were causally related to an unusual complication, namely, perforation of the right cardiac ventricle by the catheter tip, resulting in sudden and unexpected cardiac death.