Novel Classification System of Rib Fractures Observed in Infants

Rib fractures are considered highly suspicious for nonaccidental injury in the pediatric clinical literature; however, a rib fracture classification system has not been developed. As an aid and impetus for rib fracture research, we developed a concise schema for classifying rib fracture types and fracture location that is applicable to infants. The system defined four fracture types (sternal end, buckle, transverse, and oblique) and four regions of the rib (posterior, posterolateral, anterolateral, and anterior). It was applied to all rib fractures observed during 85 consecutive infant autopsies. Rib fractures were found in 24 (28%) of the cases. A total of 158 rib fractures were identified. The proposed schema was adequate to classify 153 (97%) of the observed fractures. The results indicate that the classification system is sufficiently robust to classify rib fractures typically observed in infants and should be used by researchers investigating infant rib fractures.     

India as a Regional Power: Identifying the Impact of Roles and Foreign Policy Orientation on the South Asian Security Order

Abstract

The Regional Powers and Security Framework provides a systematic method to assess how the relative strength and behavior of regional powers influence regional security orders. This article applies the framework to India as a South Asian regional power. The analysis indicates that although the region is unipolar; India's impact is limited because of its failure to play leadership and custodianship roles. It does serve as a protector of the region from external threats, doing so through a unilateral, status quo, and reactive orientation. Application of this framework points to a lack of a hegemonic security order in South Asia, in spite of India's self-view as the region's natural hegemon. For India to be hegemonic, it would have to play these roles in a comprehensive manner.     

Striation patterns in serrated blade stabs to cartilage

Stab wounds were made in porcine cartilage with 13 serrated knives, amongst which 4 were drop-point and 9 straight-spine; 9 coarsely serrated, 3 finely serrated and 1 with mixed pattern serrations. The walls of the stab tracks were cast with dental impression material, and the casts photographed together with the knife blades for comparison. All 13 serrated blades produced an "irregularly regular" pattern of striations on cartilage in all stabbings. Unusual and distinctive blade serration patterns produced equally distinctive wound striation patterns. A reference collection of striation patterns and corresponding blades might prove useful for striation pattern analysis. Drop-point blades produced similar striations to straight-spine blades except that the striations were not parallel but rather fan-shaped, converging towards the wound exit. The fan-shaped striation pattern characteristic of drop-point blades is explained by the initial lateral movement of the blade through the cartilage imposed by the presence of the drop point shape. It appears that the greater the overall angle of the drop point, the shorter the blade length over which the drop point occurs, and the closer the first serration is to the knife tip, the more obvious is the fan-shaped pattern. We anticipate that micro-irregularities producing individualising characteristics in non-serrated drop point blades, provided they were located at the tip opposite the drop point, should also show a fan-shaped pattern indicative of a drop point blade. The examination of the walls of stab wounds to cartilage represents an under-utilised source of forensic information to assist in knife identification.     

An experimental model of tool mark striations in soft tissues produced by serrated blades

Stab wounds produced by serrated blades are generally indistinguishable from stab wounds produced by non-serrated blades, except when visible tool mark striations are left on severed cartilage. We explored the possibility that similar striations may be produced on the soft tissues of internal organs. Loin of beef, bovine kidney, and pig heart, liver, and aorta were each stabbed 20 times with a coarsely serrated blade. The walls of the stab tracks were exposed and documented by photography, cast with dental impression material, and the casts photographed. Striations were identified in all of the tissues in every stabbing, but their consistency and quality varied between tissues. Striations were most easily seen in liver, heart, and aorta. Tool mark striations in soft tissues other than cartilage have not been described in homicidal stabbings, likely because they have not been sought. We suggest that the walls of stab wound tracks should be exposed, and tissue striations should be sought as a means of identifying the weapon as having a serrated blade.     

Book notes

Household Ecology: Economic Change and Domestic Life among the Kekchi Maya in Belize. By Richard R. Wilks. Tucson, AZ; London: The University of Arizona Press, 1991. Pp. xx + 280. $55 (hardback). ISBN 0 8165 1214 0.

Wagering the Land: Ritual, Capital and Environmental Degradation in the Cordillera of Northern Luzon, 1900–1986. By Martin W. Lewis. Berkeley, CA: University of California Press, 1992. Pp. 292. $40 (hardback). ISBN 0 520 07272 3.

Sustainable Development; Papers from the 6th EADI General Conference. Edited by Olav Stokke. London: Frank Cass, 1991. Pp. 132. £24. ISBN 07146 3449 2.

Gender and Development: A Practical Guide. Edited by L. Ostergaard. London: Routledge, 1992. Pp. xiv 220. £10.99 (paperback). ISBN 0415 071321.

Historical Dictionary of Mozambique. By Mario Azevedo. Metuchen, NJ and London: Scarecrow Press, 1991. Pp. xxix + 250. £22.15 (hardback). ISBN 0 8108 2413 2.

Understanding Contemporary Africa. Edited by April A. Gordon and Donald L. Gordon. Boulder, CO and London: Lynne Rienner, 1992. Pp. xvi + 343. $45 and $19.95. ISBN 1 55587 265 5 and 55587 299 9.     

Depressive Symptoms in Low-Income,Urban Adolescents: Cognitive and Contextual Factors

This study examined the relationships among cognitive variables, family immigration history, negative life events, and depressive symptoms in a sample of 306 low-income, urban fifth- and sixth-grade children. Explanatory style and negative automatic thoughts were the cognitive variables examined. There were three key findings. First, children who were immigrants reported significantly more depressive symptoms, more negative life events, and more negative automatic thoughts than children who were not immigrants. Second, both explanatory style and negative automatic thoughts were significantly associated with depressive symptoms above and beyond the effects of child immigration history and negative life events. Finally, negative automatic thoughts mediated the relationship between child immigration history and depressive symptoms. We discuss the clinical and research implications of these findings.