This report highlights the importance of undertaking immunohistochemical staining of the brains of infants who die unexpectedly, as it may not only assist with the evaluation of the cause of death in an individual infant but may also help with the clinical management of subsequent siblings. A 5-month-old male infant who died suddenly was found to have diffuse beta-amyloid precursor protein (beta-APP) staining in the brain, with no unusual features in his history, death scene examination, routine autopsy dissection, and ancillary tests to suggest any definite cause of death. Due to the beta-APP staining, the possibility of previous episodes of occult trauma, apparent life threatening events (ALTEs), and accidental or inflicted suffocation was raised in the autopsy report. As detailed analyses and investigations provided no supportive evidence for trauma or inflicted injury, hypoxia was clinically considered the most likely cause. Because of these concerns, sleeping oxygen saturation levels were monitored following the birth of a subsequent sibling who had normal APGAR scores and no evidence of any health problems. Oxygen desaturation to 70% occurred in association with a color change while on the postnatal ward, and a subsequent polysomnogram showed multiple episodic significant desaturations to around 80% in association with central apnea. Other testing was unremarkable. These cases demonstrate that beta-APP staining of the brain may not only provide clues as to possible mechanisms of death in pediatric forensic cases but may indicate a need for careful clinical evaluation of subsequent siblings for possible central apnea requiring oxygen therapy. 相似文献
Federal legislation of the last two decades has substantiallyreduced state autonomy in dealing with many regulatory issues.Participation in the implementation of these federal programsmay, however, enable states to exert some leverage over policyoutcomes. Variations in state leverage no doubt exist from oneintergovernmental grant program to the next. Substitution authoritymay be one variable accounting for this variation. Under a substitutionapproach, a federal agency cannot only sever the flow of fundsto a grantee; it can also step in and operate a program if statesfail to meet expectations or choose not to participate. Thisarticle generates more basic propositions about the substitutionapproach by analyzing its implementation under the OccupationalSafety and Health Act of 1970. The article examines the roleplayed by substitution authority in motivating the OccupationalSafety and Health Administration (OSHA) to adopt an aggressiveposture toward the states. The article then assesses whetherOSHA's aggressiveness prompted state grantees to exert considerableeffort on behalf of program goals. Finally, the implicationsof current reform proposals, which call for a sorting out offunctions between the states and the federal government, receiveattention. 相似文献
Risk-need assessment is widely accepted as best practice with juvenile offenders and is underpinned by a healthy research literature on risk assessment inventories. Previous studies have found both similarities and differences on risk measures when gender and racial/ethnic subgroups have been compared. Differential validity has been examined, but differential prediction has been overlooked. The current study undertook gender and ethnic comparisons for a large sample (n = 3568) of community-based juvenile offenders who were evaluated using the Australian Adaptation of the Youth Level of Service/Case Management Inventory (YLS/CMI-AA). Analyses showed various gender and ethnic differences at the item level, across domain scores and on the total inventory score, but not for validity indices. However, 1-year reoffending rates for youth in three classification categories (low, moderate, high) varied by gender and ethnicity. The findings were related to contemporary understandings of the risk factors for offending and the dynamics of crime for gender/ethnic subgroups. It is argued that in spite of these subgroup differences, a generic inventory such as the YLS/CMI-AA can be used fairly with various subgroups. Recommendations for how this could be accomplished are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved). 相似文献
Children exposed to the trauma of domestic violence tend to experience difficulties with internalized and externalized behavior
problems, social skills deficits, and academic functioning. Mental health practitioners in the school setting, including school
counselors, school psychologists, and school social workers, can address developmental concerns that impede development through
group counseling interventions that include both structured activities and play therapy. The school environment offers an
ideal setting in which to work with child survivors of trauma, as all students have accessibility to school mental health
resources. This article outlines the primary objectives and corresponding procedures for a developmentally- appropriate group
interventions for elementary-aged children who have been exposed to the trauma of domestic violence. 相似文献
Diaphragmatic defects are a relatively common and benign finding in adults which may be congenital or secondarily acquired. The case files at Forensic Sciences South Australia were reviewed over a 10‐year period from July 2005 to June 2015 for all adult (>17 years) cases in which diaphragmatic hernias were identified at postmortem examination that had either caused or contributed to death. Five cases were found: age range 49–90 years (average 67.2 years); male:female ratio 2:3. Herniated organs included the stomach (N = 3), small (N = 3) and large intestines (N = 2). Mechanisms of death involved lung compression with respiratory failure and/or mediastinal shift, and vascular compromise with gastric or intestinal infarction and/or perforation. Diaphragmatic hernias may not be identified until the time of autopsy and may be quite complex entities to evaluate due to a lack of clinical history and to difficulties in determining their origin and possible contributions to mechanisms of death. 相似文献
Saudi socio-politics is being affected by societal transformation; one that is being driven by a potent combination of demographics, improved education, wider access to the Internet and burgeoning new media usage. Whilst Saudi government decision-making remains ‘top-down’, the dynamic within this approach has shifted as the top-down system incorporates a consultation process that includes newly established civil society institutions. Nonetheless, of particular significance in Saudi Arabia is growing public awareness, particularly amongst young educated Saudis, of the need for government accountability, transparency and best-practices.
This paper discusses the views of a group of young men who represent an academic elite. Saudi-related literature frequently centers on the status of Saudi women, but the perspective of young Saudi men is generally overlooked even though this constituency is going to be of critical importance to the Kingdom's future social and political stability. The author recognizes that this elite sample does not represent Saudi youth in its entirety, but the diversity of student backgrounds and access to their extended networks can act as a barometer of educated youth opinion regarding many of the pressing politico-economic and socio-cultural issues facing Saudi Arabia today. 相似文献
To date few reports have provided direct comparison of psychosocial vulnerability and resources among youth with victimization and perpetration histories. Within a racially diverse, high-risk adolescent sample (n = 849), this study undertakes MANCOVA tests on a multidimensional set of risk and protective factors contrasting youth with histories of 1) neither violent victimization nor perpetration, 2) victimization only , 3) both perpetration only, and 4) both victimization and perpetration. All three violence-affected groups reported elevated risk and diminished protection, with perpetrating victims demonstrating the greatest psychosocial impairment. Detailed contrasts among the youth group profiles provide insights regarding overlapping and distinct developmental etiologies and implications for preventive and remedial intervention. 相似文献