430例四肢损伤法医临床学分析

本文对４３０例四肢损伤的程度进行了统计分析。对致伤原因，致伤物与损伤类型，致伤物与损伤程度等进行了分析讨论。     

The Influence of Case and Professional Variables on the Identification and Reporting of Child Maltreatment: A Study of Licensed Psychologists and Certified Masters Social Workers

All 50 states have laws requiring mental health and other professionals to report suspected maltreatment. Unfortunately, many professionals who are mandated to report suspicions of child maltreatment often fail to recognize potential maltreatment or fail to report their suspicions. The present study examines several factors that may influence identification and reporting of child maltreatment. Subjects were licensed psychologists in the Midwest and certified Masters social workers in Nebraska. Child maltreatment included neglect, physical abuse, psychological maltreatment, and sexual abuse. Characteristics associated with the family or “case” (race, socioeconomic status of family, age of victim, type of maltreatment) were manipulated and presented in hypothetical case vignettes. Characteristics of the professional (e.g., training and experience with identification and reporting, personal history of maltreatment and violence) were also investigated. Ratings of the severity of the potential maltreatment situation, suspiciousness that maltreatment is occurring, and likelihood of reporting maltreatment were completed after reading each case vignette. The results indicate that a variety of case and professional factors may influence identification and reporting of maltreatment. Implications for training professionals and further research are discussed.     

Identification of potential juvenile offenders

Conclusion In this article, we have reviewed the guidelines, from the criminological prediction tradition, that should be followed while developing a screening device for the identification of potential juvenile offenders. We were also able to recognize an appropriate screening strategy for prevention, even if more validation studies have to be conducted. Screening of juvenile offenders should rest on multiple stages, informants, methods, and variable domains. In addition, it was not possible to identify a satisfactory instrument for prevention screening. The candidate devices all have significant methodological deficiencies. Also, it was not possible to identify the particular predictors to retain for screening, even if there is a large consensus about the variable domains that are most important. To summarize, there is much technical work still to be done before we can develop appropriate screening instruments for the identification of potential offenders. Some screening strategies and instruments are promising, but none can be recommended for immediate use to policy-makers and practitioners. The state-of-the-art for the identification of potential juvenile offenders is such that the research community can only indicate how to develop good screening instruments. The research for this article was commissioned by the Study Group on Serious/Violent/ Chronic Offenders of the Office of Juvenile Justice and Delinquency Prevention of the Department of Justice of the United States of America. This paper is an adaptation of a more comprehensive review on screening for that study group.     

Laboratory investigation of deaths due to anaphylaxis.

To establish a useful laboratory protocol to investigate possible cases of fatal anaphylaxis, we measured mast-cell-derived tryptase levels and allergen-specific immunoglobulin E (IgE) antibody levels in sera obtained prior to or within 24 h after death from 19 anaphylaxis victims. Elevated serum tryptase levels (range = 12 ng/mL to 150 micrograms/mL) were found in nine of nine Hymenoptera sting fatalities, six of eight food-induced fatalities, and two of two reactions to diagnostic therapeutic agents. Tryptase levels were normal (less than 10 ng/mL) in 57 sequential sera obtained postmortem from six control patients. Tryptase could not be measured in pleural or pericardial fluids for technical reasons. Serum IgE antibodies were elevated in five of the nine Hymenoptera sting fatalities and in eight of the eight fatal food reactions; assays were unavailable for the two diagnostic/therapeutic agents. If elevated, the victim's serum IgE antibodies to food could be used to identify allergens in uneaten portions of foods consumed shortly before the anaphylactic event. IgE antibodies were moderately stable during storage in a variety of anticoagulants at room temperature for up to 11 weeks. Elevated mast-cell-derived tryptase levels in postmortem sera reflect antemortem mast cell activation and may be used as a marker for fatal anaphylaxis. If assays are available for IgE antibodies to relevant allergens, such assays provide evidence for antemortem sensitization; these assays may be modified to identify allergens in foods consumed by victims of food-induced anaphylaxis.     

以社工队伍建设为抓手深化综治工作改革

市场经济体制的确立和经济全球化的新形势,使得社会治安综合治理工作显得尤为重要。在上海这个国际性大都市组建一支强有力的社工队伍,对充分发挥社会组织和社会力量在维护社会稳定中的作用有着积极的意义。     

Disopyramide and Mianserin Intoxication: A Unique Fatal Case – Review of the Literature

Lethal occurrence is exceptional after disopyramide or mianserin poisoning. A case of intentional lethal intoxication with these drugs was reported, as well as a review of the literature. Pre‐ and postmortem blood concentrations of disopyramide or mianserin were assessed in a woman who died from acute cardiac failure after ingestion. The premortem blood concentration of disopyramide alone was considered lethal, and a toxic premortem concentration of mianserin was observed that may have increased cardiovascular failure induced by disopyramide because the metabolism of both drugs is mediated via cytochrome P450. Moreover, it was shown that the postmortem redistribution of disopyramide was limited, as pre‐ and postmortem concentrations were 48 and 65 mg/L, respectively. As regards mianserin, redistribution was observed after death with pre‐ and portmortem concentrations at 0.23 and 0.79 mg/L, respectively. This case illustrates that if postmortem blood concentration of disopyramide is known, the premortem concentration can be deduced.     

“Yes we are here,living, but malaria is surrounding us”: sustainable livelihoods and malaria in Tanzania

This paper examines connections between sustainable livelihoods and the ability to deal with health risks, in the Kilombero Valley in Tanzania where rates of mortality and morbidity from malaria remain high. Application of the Sustainable Livelihoods Approach (SLA) to a narrative of daily lives demonstrates that villagers have experienced a reduction in assets, income, and capital, which limits their ability to follow health promotion advice. The focus on livelihoods highlights possible local developmental interventions that could have a significant impact on improving the health and well-being of the villagers, with potential relevance to other places in the Global South.