An attempt to objectify the condition of cervical spine distortion injury in traffic accident victims for court purposes

Introduction

According to morphological criteria, cervical spine injuries include, among others, contusion, distortion, luxation and fracture. Distortion of the intervertebral articulations occurs when the force of movement exceeds the physiological range, and the articular/joint capsule, cartilage and ligaments are damaged. While within the articulation a haematoma is formed, which produces clinical manifestations such as localised idiopathic pain, tenderness to palpation and analgesic limitation on both the passive and active joint mobility (i.e., a syndrome of subjective painfulness), as reported by the patient, the diagnostic imaging techniques (i.e., regular radiograph pictures) typically applied in such cases do not show any post-traumatic changes. Distortion of the cervical spine, resulting in a post-traumatic feeling of pain, usually occurs indirectly as a result of transmission of the force of injury onto the spine, as in the case of a traffic accident. Frequently, in cases of abuse, arriving at a hasty clinical diagnosis of post-traumatic cervical spine distortion apparently presents a serious problem in giving medical opinions for court purposes; thus encouraging the authors to attempt objectifying the condition of cervical spine distortion.

Methods

In a retrospective investigation, the authors analysed the medical opinions given by the Department of Forensic Medicine, Medical University of Silesia, for court purposes.

Results

Among nearly 5500 opinions in the past 5-year period, we analysed 167 cases related to cervical spine injury.

Conclusions

An attempt is made to either substantiate or negate the clinical diagnosis issued for court purposes by assessing the following: the findings of the physical examination of the person involved, the condition of the person involved in the accident from the period prior to accident (radiograph findings confirming the level of the already existing degenerative changes; age and sex of the person involved; positive or negative history of injuries sustained prior to accident), the course of treatment after the accident (character of symptoms reported and their evolution with time; co-existence of other bodily injuries; outpatient treatment instituted, including the application of Schantze collar, rehabilitation) and also the circumstances in which the accident occurred.     

Mechanism of Death in Hanging: A Historical Review of the Evolution of Pathophysiological Hypotheses

Abstract: In cases of hanging, the exact mechanism leading to death has yet to be elucidated. Most of our contemporary knowledge is still based on writings from the end of the 19th and the beginning of the 20th century. This article reviews the historic experiments that shaped our current theories. Medico‐legal textbooks written in English and French from 1870 to 1930 were reviewed. Various animals, such as rabbits, mice, and dogs, have been used to develop animal models of hanging. Limited human studies on cadavers and judicial hangings have provided some additional insight into the pathophysiology of death by hanging. The main pathophysiological theories described were respiratory asphyxia, interruption to cerebral blood flow because of occlusion of vessels in the neck, and cardiac inhibition secondary to nerve stimulation. The relative contributions of each of these theories to death in cases of hanging is still debated today.     

Energy transitions and trade law: lessons from the reform of fisheries subsidies

Fossil fuel subsidies, like subsidies to the fishing sector, lead to trade-distorting and ecologically harmful practices. The US$35 billion in subsidies provided by countries every year to the fishing sector leads to more and more boats being built, even as 90% of fish stocks are either fully exploited or overfished. An estimated US$444 billion in subsidies are provided annually for the production of fossil fuels by G20 countries, even as evidence emerges that oil, gas and coal reserves must remain unexploited to limit global warming increases to 2 °C. Of course, each country has its own development priorities, livelihood concerns and need for food and energy security. Agreeing upon subsidy reform is a complex undertaking that requires the assessment of social, political and historical considerations, as well as the involvement of international and transnational legal regimes that govern climate change, energy, fisheries and trade. This article reviews proposals for reform within the World Trade Organization and regional trade agreements, including the new disciplines on fisheries subsidies that were endorsed in the text of the Trans-Pacific Partnership. Although the latter agreement is unlikely to enter into force, consensus is emerging on the need to prohibit subsidies that contribute to overfishing or that are linked to illegal, unreported or unregulated fishing. The article shows how these legal developments might inform attempts to limit fossil fuel production and consumption subsidies. It highlights the need for learning and open deliberation about subsidy reform by affected stakeholders, including representatives from international organizations and civil society. It also points to new arrangements that link compliance with subsidy rules to standards and benchmarks from fisheries regimes, and demonstrates how such inter-regime connections are legitimate in the context of the fragmentation of international law. While reform to fisheries subsidies is still preliminary and fraught, there are useful lessons for the equally important project of energy transitions.     

Monitoring the uninsured: a state policy perspective

Because states have primary responsibility for the implementation of public health insurance programs, states need timely, good quality data to evaluate programs, monitor trends in the number and characteristics of the uninsured, and better understand the dynamics of health insurance coverage. This article provides a synthesis of the data sources available to states for monitoring rates of health insurance coverage. Information was collected through a comprehensive review of state and national health surveys and in-depth interviews with state analysts in all fifty states. Our findings suggest that national surveys do not meet states' needs for data, and in response, states have initiated their own household surveys. We provide information on thirty-six household surveys that are used to estimate state levels of health insurance coverage. We recommend that national and state efforts be better coordinated to facilitate efficient use of resources to achieve good state-level date.     

Micellar electrokinetic chromatographic screening method for common sexual assault drugs administered in beverages

Recently, much attention has been given to benzodiazepines and gamma-hydroxybutyric acid (GHB) related compounds owing to their alleged widespread use as date-rape drugs. Toxicologists would greatly benefit from a screening method that allows for the simultaneous detection of both groups of substances. A new capillary electrophoresis (CE) method has been developed in the micellar mode to accomplish this separation in under 16 min using a sodium dodecyl sulfate (SDS)/sodium tetraborate/boric acid buffer with an acetonitrile organic modifier. Optimization of SDS and organic modifier concentration, along with pH, were performed on a set of standards containing eight benzodiazepines, GHB, gamma-butyrolactone, and the internal standard, sulfanilic acid. The method was shown to have a detection limit of less than 2 microg/ml for five out of eight benzodiazepines with a linear range of 2.5-100 microg/ml. The detection limit for GHB was 32 mg/ml with a linear range to 2500 microg/ml. This method was applied to the rapid analysis of spiked beverages. GHB spiked beverages were monitored after using a series of simple dilutions to determine the effects of time on the drug analysis. Possible interfering peaks from drugs of abuse and artifacts from a variety of different drink combinations were also studied in detail. A one-step liquid-liquid extraction was the only necessary sample pretreatment.     

Psychology,Law, and the Workplace: An Overview and Introduction to the Special Issue

Law and Human Behavior -     

Reflections on a course on ‘women and literature’

The authors outline the place of their course in a Polytechnic Humanities Degree and show how, concentrating primarily upon the novel and a line of women novelists from Jane Austen to Doris Lessing, new perspectives upon literary criticism and literary history in relation to society and culture are opened up. Teaching methods and attitudes are discussed in relation to the re-evaluation of the role of women as readers and critics, as well as authors. The success of the course, in terms of the interest it has aroused among students in women authors and feminist criticism is discussed, together with the effects of open recognition of differences of emphasis and point of view between the two tutors responsible for it. The authors express their confidence in the course as undermining a harmful acceptance of the idea of a single established literary tradition, which ‘happens’ to be dominated by white, male authors and critics, thus opening the way for students to appreciate how, as Adrienne Rich puts it, ‘there is another story to be told’.     

Peter Brooks,Troubling Confessions: Speaking Guilt in Law and Literature; Mariana Valverde,Diseases of the Will: Alcohol and the Dilemmas of Freedom

International Journal for the Semiotics of Law - Revue internationale de Sémiotique juridique -