A 25-year retrospective review of deaths due to pediatric neglect

Neglect, defined as the failure of a caregiver to adequately provide safety, food, clothing, shelter, education, protection, medical/dental care, and supervision for a child in his/her care, is a relatively uncommon but important cause of child mortality. A retrospective review of pediatric deaths (age 18 years or less) referred to the Medical University of South Carolina Forensic Pathology Office for autopsy over the past 25 years revealed 16 deaths due to some type of pediatric neglect. Cases were analyzed as to age, sex, race, cause and manner of death, autopsy findings, ancillary studies, past medical history, social/family history, and caregiver. Six cases of malnutrition/starvation and/or dehydration were identified, composing the most common cause of death in the neglect cases identified and the majority of the homicides due to neglect. Other deaths in which neglect contributed significantly included toxic ingestions (2 cases), hyper-/hypothermia (2 cases), unusual drowning/aspiration (4 cases), electrocution (1 case), and delayed/absent medical therapy (2 cases, including one of the previously mentioned ingestions). Of these additional cases, 7 were certified as accidental manner, 2 as natural, and 1 as a homicide. Cases which fell into a "gray zone" in which the appropriateness of invoking neglect was a matter of opinion or societal convention were excluded from the review; examples included conventional accidental drowning, choking on food or aspiration of foreign body, overlying/wedging during sleep, accidental hanging, and motor-vehicle traffic accidents (pedestrians, unrestrained passengers). The findings of this review reinforce the fact that malnutrition/starvation and dehydration compose the most common form of lethal pediatric neglect while highlighting less common forms of neglect and the difficulty of determining manner of death in cases in which neglect plays a more questionable role than in seemingly clear-cut malnutrition/starvation and dehydration cases. We demonstrate the typical victim and scenario that investigators will encounter in cases of fatal pediatric neglect, often a child under the age of 1 year who has been deprived of food and/or drink for some time, or an older, more independently mobile child who has not been adequately supervised. These children may or may not have a demonstrable prior history of maltreatment or (nonfatal) neglect, and review of medical records is an important part of the investigation. We additionally discuss key gross autopsy findings, appropriate specimen collection, helpful ancillary studies, microscopic findings of significance, potential mimickers of neglect, and other special considerations in cases of pediatric neglect.     

Cosleeping and sudden unexpected infant deaths in Kentucky: a 10-year retrospective case review

This retrospective case review investigates modifiable risk factors in sudden unexpected infant deaths, including those attributed to sudden infant death syndrome, and examines the impact of cosleeping with adults or siblings. The study examines sudden unexpected infant deaths from 1991 to 2000 in the state of Kentucky, excluding homicides and deaths from identifiable natural causes. Meta-analysis provides a cosleeping prevalence control in normal infants. Based on the findings described herein, we conclude that cosleeping may represent a risk factor in sudden unexpected infant deaths and that a full scene investigation, including whether the infant was cosleeping, should be sought in all cases of sudden infant death.     

Development of a harmonized method for the profiling of amphetamines. I. Synthesis of standards and compilation of analytical data

Reference material was synthesised for 21 substances that are frequently present as synthetic impurities, i.e. by-products, in illicitly produced amphetamine. Each of these substances is a typical by-product for at least one of the three approaches most often used to synthesise amphetamine, namely, the Leuckart, the reductive amination of benzyl methyl ketone, and the nitrostyrene routes. A large body of data on the substances was recorded, including the following: mass spectra, ultraviolet spectra, Fourier transform infrared spectra, infrared spectra in gas phase, and 1H NMR and 13C NMR spectra.     

Development of a harmonized method for the profiling of amphetamines. II. Stability of impurities in organic solvents

The present study focused on the stability of 22 amphetamine impurities dissolved in six organic solvents: isooctane, toluene, ethanol, dichloromethane, ethyl acetate, and diethyl ether. The aim was to find the most inert, and thereby most suitable, solvent for amphetamine profiling. Mixtures of the impurities were prepared in the different solvents, and changes in the concentrations of the individual compounds over-time were monitored by gas chromatographic analysis after 0, 4, 12, 24, 48, and 96 h. Isooctane and toluene provided the most inert conditions, although, a few of the impurities were insufficiently stable in these two solvents. The present experiments were performed as a part of the development of a harmonized method for profiling of amphetamine. The results can be used to support the choice of organic solvents for sample preparation. They also provide information about the stability of the impurities that are found in profiles of illicit amphetamine. This is essential due to the fact, that unstable compounds can have a negative influence on the comparison of profiles.     

The experience of sexual assault: findings from a statewide victim needs assessment

A statewide assessment was conducted of assaults, experiences, needs, and recommendations of 125 adult victims receiving care at 19 sexual assault centers (SACs) in the State of Maryland. More than one half of the victims (55.6%) waited years before disclosing, with delays in reporting especially likely if the assault was perpetrated by a family member (the most frequent perpetrators at 42.4% of respondents). About one half of the victims (51.3%) had been previously sexually assaulted, yet only 9% of these victims had sought treatment. The majority of respondents (69.4%) indicated they would not be filing charges against perpetrators, and of those who did, 46.2% reported dissatisfaction with the interview with police. Psychological symptoms such as depression and anxiety were the most common reasons for seeking care at the centers. Nearly all of respondents rated the care they received at the centers as very good or excellent. Respondents recommended more SACs, better advertising of their services, more mental health care within them (especially group therapy), and improved laws and law enforcement of perpetrators.     

Not Just Another Determinants Piece: Path Dependency and Local Tax Abatements

Although there is a large body of research attempting to identify the correlates of tax abatements, the question of why cities abate taxes at widely differing rates—or indeed, not at all despite state enabling legislation allowing them—has never been completely answered. Based on an examination of tax abatement data representing the history of abatements in Michigan, the article concludes that abatement patterns can be best understood when past abatement behaviors and the nature of the local employment base are included in the analysis. In the case of the number of abatements granted, it appears that both these forces—along with the general economy, governmental structural and process factors—are important in understanding abatement behavior. When the total value of abatements is considered, industrial mix appears most critical. Once municipalities start giving tax abatements they continue to do so. And, having concentrations of transportation‐related industries and food/consumer products are traits that appear to lead to that initial push for abatements.     

Hard times for citizenship: Women's movements in Chile and Mexico

This article comparatively analyses the cases of Mexico and Chile to understand how women's movements contest the meaning of citizenship in various national contexts. We also assess the consequences that different movement strategies, such as ‘autonomy’ versus ‘double militancy’, have for movements' citizenship goals. To explain the different outcomes in the two cases, we focus on the nature of the democratic transition, the internal coherence of women's movements, the nature of alliances with other civil society actors, the ideological orientation of the newly democratized state, the form of women's agency within the state, and the nature of the neoliberal economic reforms. We argue that a serious problem for women in both Chile and Mexico is the fact that governments themselves are deploying the concept of citizenship as a way to legitimate their social and economic policies. While women's movements seek to broaden the meaning of citizenship to include social rights, neoliberal governments employ the rhetoric of citizen activism to encourage society to provide its own solutions to economic hardship and poverty. While this trend is occurring in both Chile and Mexico, there are some features of the political opportunity structure in Chile that enable organized women to contest the state's more narrow vision of democratic citizenship. In Mexico, on the other hand, the neoliberal economic discourse of the current government is matched by a profoundly conservative ideological rhetoric, thereby reducing the political opportunities for women to forward a gender equality agenda.     

Dependency and Distress at Summer Camp

Examined the relation of dependency to psychological distress among youngsters adapting to summer sleep-away camp. Levels of dependency, self-criticism, and psychological distress were assessed in three groups of campers: children attending a neighborhood day camp, children who were returning to sleep-away camp, and children who were attending sleep-away camp for the first time. Psychological distress was assessed in terms of depression and low self-esteem. The results supported the prediction that dependency would be more predictive of distress for children at sleep-away camp (particularly for names) than at day camp. The specificity of dependency as a vulnerability factor during attachment-related transitions was supported by showing that children's level of self-criticism was not differentially related to distress for the three groups of campers. Results are discussed within the framework of the Personality-Event Congruence Model of Depressive Vulnerability.     

Reviews

Gordon B. Smith, Soviet Politics: Continuity and Contradiction. Basingstoke and London: Macmillan Education, 1988. xi + 388 pp. £30.00 h/b, £8.95 p/b.

Daniel Thorniley, The Rise and Fall of the Soviet Rural Communist Party. 1927 39. London: Macmillan Press, 1988, xiii + 246 pp., £29.50.

Zenovia A. Sochor, Revolution and Culture: The Bogdanov‐Lenin Controversy, Cornell University Press, 1988, $32.95 ($29.95 USA and Canada.

Robert Edelman, Proletarian Peasants. The Revolution of 1905 in Russia's Southwest. Ithaca: Cornell University Press, 1987, xv + 195 pp., no price.

Robert W. Thurston, Liberal City, Conservative State: Moscow and Russia's Urban Crisis, 1906 1914. New York and Oxford: Oxford University Press, 1987, viii + 266 pp., £27.50.

Douglas R. Weiner, Models of Nature: Ecology, Conservation, and Cultural Revolution in Soviet Russia. Bloomington and Indianapolis, Indiana University Press, 1988, xiv + 312 pp., $35.00.

Werner G. Hahn, Democracy in a Communist Party: Poland's experience since 1980. New York: Columbia University Press, 1987, xxv + 368 pp., $42.00.

Jaroslav Bilocerkowycz, Soviet Ukrainian Dissent: a Study of Political Alienation. Boulder: Westview Press, 1988, xii + 242 pp., $27.50 p/b.

Petro R. Sodol, UPA: They fought Hitler and Stalin, New York: Committee for the World Convention and Reunion of Soldiers in the Ukrainian Insurgent Army, 1987, 128 pp., $12.00.

Bruce McFarlane, Yugoslavia: Politics, Economics and Society. London and New York: Pinter Publishers, 1988, xxii + 240 pp., £25.00 h/b., £8.95 p/b.