Evaluation of pediatric skull fracture imaging techniques

Radiologic imaging is crucial in the diagnosis of skull fracture, but there is some doubt as to whether different imaging modalities can accurately identify fractures present on a human skull. While studies have been performed to evaluate the efficacy of radiologic imaging at other anatomical locations, there have been no systematic studies comparing various CT techniques, including high resolution imaging with and without 3D reconstructions to conventional radiologic imaging in children, we investigated which imaging modalities: high-resolution CT scan with 3D projections, clinical-resolution CT scans or X-rays, best showed fracture occurrence in a pediatric human cadaver skull by having an expert pediatric radiologist examine radiologic images from fractured skulls. The skulls used were taken from pediatric cadavers ranging in age from 5 months to 16 years. We evaluated the sensitivity and specificity for the imaging modalities using dissection findings as the gold standard. We found that high-resolution CT scans with 3D projections and conventional CT provided the most accurate fracture diagnosis (single-fracture sensitivity of 71%) followed by X-rays (single-fracture sensitivity of 63%). Linear fractures outsider the region of the sutures were more identifiable than diastatic fractures, though the incidence of false positives was greater for linear fractures. In the two cases where multiple fractures were present on the same anatomical skull location, the radiologist was less likely to identify the presence of additional fractures than a single fracture. Overall, the high-resolution and clinical-resolution CT scans had the similar accuracy for detecting skull fractures while the use of the X-ray was both less accurate and had a lower specificity.     

Temporal Linkages in Violent and Nonviolent Criminal Activity

Research on the temporal distribution of criminal behavior has highlighted two distinct mechanisms—population heterogeneity and state dependence. Most of this work indicates that long-term patterns of criminal offending reflect a mixture of stable individual differences and the causal effect of life events and experiences. Yet several ambiguities remain. Among the most important of these problems is whether both population heterogeneity and state dependence processes operate for different types of offending. We use longitudinal official record and self-report data for violent and non-violent offending activity from the Rochester Youth Development Study to address these ambiguities.     

General practitioners' perspectives regarding competence and confidentiality in an adolescent with suspected anorexia nervosa: legal and ethical considerations

In Victoria, Australia, the legal position regarding young people's competence to make medical treatment decisions has not been clarified in legislation, and a number of often vague common law decisions must be relied on for guidance. This situation produces a degree of uncertainty about appropriate professional practice, while also potentially impeding young people's rights claims in health care settings. With this in mind, the present research explored general practitioners' competence and confidentiality decisions regarding a 17-year-old female who presented with symptoms of an eating disorder. Questionnaires were sent to a random sample of 500 Victorian general practitioners, of whom 190 responded. After reading a case vignette, general practitioners indicated whether they would find the hypothetical patient competent and if they would maintain her confidentiality. Seventy-three per cent of respondents found the patient competent and most would have maintained confidentiality, at least initially. However, subsequent analysis of the rationales supplied for these decisions revealed a wide diversity in general practitioners' understandings and implementations of extant legal authority. This research highlights the need for general practitioners to be exposed to up-to-date and clinically relevant explanations of contemporary legal positions.     

Recklessness,depression, and reasons for living in predicting suicidality in college students

To assess the predictive value of recklessness in suicidality, 155 college students took the Sommerfeldt-Clark Adolescent Experience Scale (S-C), Zung Self-Rating Depression scale, Reasons for Living Inventory (RFL), and the Scale for Suicide Ideation (SSI). The S-C Suicidal Tendencies subscale accounted for the most variance in suicidality (26.0%) and Coping Beliefs of the Reasons for Living subscale accounted for additional variance (5.6%). Further, the S-C was moderately internally consistent (Cronbach alpha=.83) and had adequate validity, as indicated by significant correlations in the expected directions with the SSI total score (r=.25, p< .01), and RFL total score (r= –.28, p<.001). Recklessness was not a component of suicidality among those non-clinical older adolescents, but may be a factor in clinical or younger samples of adolescents.Received M.A. in Psychology from Xavier University, Ohio. Research interests include suicide, eating disorders, and adolescence.Received Ph.D. from Georgia State University. Research interest: suicide.     

Transformation of political elite as regime changes in Pakistan

Burton and Higely [(2001). ‘The study of political elite transformations’, International review of sociology/Revue internationale de sociologie, 11(2): 181–199] argue that when elites of a society are not united this will lead to an unstable political regime. Consensual elite cohesion is only created through distinctive elite transformation. This essay attempts to elaborate their argument in Pakistan, by developing a link among a continuous regime shift from authoritarian to democratic governments and the political elites who keep transforming their structure accordingly. The technique followed for it is analysing the epochal events over time from pre-partition till date which became reason for regime transformations. The discussion focuses on the collusions and contestations of multiple power elites within given social context which are embedded under the international context. It concludes that political elites in Pakistan were always embraced by multiple other power elites who accordingly hold dual elite identity to control the command post in the political arena. Such complex elite structure makes it paradoxical to distinguish political elite of Pakistan from other power elites of Pakistan.     

Discerning Immunity for Governmental Entities: Analyzing Legislative Choices

In 2006, three disagreements about the scope of immunity for governmental entities were considered by the U.S. Supreme Court. Governmental entities were seeking to avoid liability for their actions, claiming the defense of sovereign immunity. Other lawsuits involving governmental immunity under state constitutional and statutory provisions disclose controversies concerning the responsibilities of governments to injured persons. The complicated jurisprudence governing immunity for governmental entities shows two alternatives for legislatures. They have the ability to increase liability by waiving immunity or to add defenses that defeat liability. The trend seems to be to waive immunity for governmental entities while adding statutory defenses that are available to both the private sector and governmental entities.     

Indicators of Democracy in Professional Associations: Elite Recruitment, Turnover, and Decision Making in a Metropolitan Bar Association

This study considers political structure in bar associations with respect to one central problem: the tension between democracy and oligarchy in the internal politics of bar associations. Drawing on both theoretical and empirical material, the authors outline a series of indicators on which the degree of democracy and oligarchy in the organized bar may be measured and then apply these criteria to the Chicago Bar Association from 1950 through 1974. The authors briefly review writings on the political structure of bar associations in the United States and note relevant theoretical perspectives on the politics of voluntary associations. They distinguish several patterns of oligarchy and democracy and explore the consequences of certain trends for the Chicago Bar Association and other bar associations.     

Fatal postpartum spontaneous liver rupture: case report and literature review

Maternal hepatic rupture is a rare complication of pregnancy that can be fatal to both mother and child. This phenomenon is most often associated with preeclampsia/eclampsia and/or HELLP syndrome, which is defined by a collection of clinical features including hemolysis (H), elevated liver enzymes (EL), and a low platelet count (LP). These disease processes are typically identified and treated during pregnancy, often in the last trimester. The described case is unusual in that the decedent had no known history of preeclampsia/eclampsia or HELLP syndrome during this pregnancy, and she died suddenly several days postpartum of liver rupture with massive intraperitoneal hemorrhage following a routine cesarean section delivery and an uneventful hospital course. Similar cases are infrequent in the literature, which is reviewed in this report.     

The noble art of the chase in the Arab world

Sir Terence Clark is a Council Member of the Society. He retired from the Diplomatic Service after a distinguished career spent mainly in the Middle East, where he was Ambassador to Iraq and Oman, and is the author of many articles in specialist journals on hunting and co‐author of The Saluqi: Coursing Hound of the East (1995), Dogs in Antiquity (2001) and Oman in Time (2001). This article is based on a lecture delivered to the Society on 23 October, 2002.