Resuscitation injuries complicating the interpretation of premortem trauma and natural disease in children

Minor soft tissues injuries are common in both adults and children who have had cardiopulmonary resuscitation (CPR). Potentially life-threatening injuries are rare. The pre-arrest history in a resuscitated adult often assists the pathologist to interpret autopsy findings. In contrast, an infant or child may not have a reliable history. In this situation, it may be difficult if not impossible to distinguish resuscitation injuries from pre-existing accidental or inflicted trauma. I describe two children who had significant autopsy-documented injuries initially attributed to abuse. The State filed murder charges against the caretaker in each case. However, further history and review of the medical records suggested that resuscitation rather than pre-arrest trauma caused almost all of the injuries. The State dismissed the charges in the first case. A jury returned a "not guilty" verdict in the second. It is essential to consider the entire history and not just autopsy findings when performing a death investigation.     

Relationships between concentrations of cocaine and its hydrolysates in peripheral blood, heart blood, vitreous humor and urine

Cocaine is known to degrade in vivo and in vitro by several hydrolytic mechanisms. A previous study found that the initial amount of cocaine added to plasma could be accounted for by summing the molar concentrations of cocaine's hydrolysis products and the cocaine remaining after hydrolysis. The present study was undertaken to investigate whether or not relationships might exist between such molar concentration sums for different postmortem bodily fluids. Determinations of cocaine, benzoylecgonine, ecgonine methyl ester, and ecgonine were performed using liquid chromatography/mass spectrometry (LC/MS/MS) with heart blood, femoral blood, vitreous humor (VH), and urine (UR). The results demonstrate a strong correlation between blood and VH concentrations (correlation coefficients of 0.88-0.94), weak correlation between the UR and blood concentrations (correlation coefficients of 0.61-0.64), and weak correlation between UR and VH concentrations (correlation coefficient of 0.59). The results demonstrate that ecgonine is a significant hydrolysate with concentrations on the same order of magnitude as benzoylecgonine. The results are consistent with rapid distribution of the parent drug and its hydrolysates in the blood and VH. The strong correlation between the blood and VH demonstrates that VH is an important medium for toxicology testing when attempting to make a determination of cocaine intoxication.     

Segmental hair analysis for cocaine and heroin abuse determination

Segmental hair analysis was performed to obtain information about the history of drug abuse of subjects in a rehabilitation programme. The analytical data from hair samples were correlated, when possible, with urine analysis and to toxicological anamnesis. Toxicological analysis of hair seems to be a valid tool in this specific field.     

The Relationships Between Childhood Sexual Abuse,Social Anxiety,and Symptoms of Posttraumatic Stress Disorder in Women

The relationships between childhood sexual abuse, social anxiety, and symptoms of posttraumatic stress disorder were examined in a sample of 313 undergraduate women. Thirty-one percent of the women reported some form of sexual abuse in childhood. Women with a history of sexual abuse reported more symptoms of anxiety, distress in social situations, and posttraumatic stress disorder than other women. Women who experienced attempted or actual intercourse reported more avoidance than women with no history of abuse and women with exposure only, and more PTSD symptoms than all other groups of women. Women who experienced fondling reported more PTSD symptoms than women with no history of abuse. Pressure, age of onset of abuse, abuse by a family friend, and abuse by other perpetrators were all significant abuse characteristics in predicting adult social anxiety. Implications of these results for research and interventions are discussed.     

Perception of and Satisfaction with Relationship Power,Sex, and Attachment Styles: A Couples Level Analysis

Eighty heterosexual dating couples provided information about their gender, individual histories of abuse in their current relationship, attachment styles, perception of and satisfaction with relationship power. Partner report of physical abuse was the dependent variable. APIM actor results suggest that an individual's gender interacts with perceived level of relationship power and satisfaction with relationship power for physical abuse. Both dimensions of attachment interacted with perceived relationship power for physical abuse. Partner effects were also found. One's partner's sex interacted with perceived power and satisfaction with relationship power. Finally, the partner's avoidant attachment interacted with satisfaction with relationship power. These findings generally replicate and extend the work of H. M. Ronfeldt, R. Kimerling, and I. Arias (1998, J. Marriage Fam. 60: 70–78) by showing how attachment styles, perception of relationship power, and satisfaction with relationship power are related in predicting aggression against a romantic partner.     

Prevention science,drug abuse prevention,and Life Skills Training: Comments on the state of the science

There has been tremendous growth in the field of prevention science over the past two decades. The defining features of contemporary prevention science are high quality empirical research using rigorous and well-established scientific methods, careful hyphothesis testing, and the systematic accumulation of knowledge. One area where substantial progress has been made is in our understanding of the etiology and prevention of tobacoo, alcohol, and illicit drug abuse. In this paper, we review the growth in prevention as a scientific enterprise, discuss advances in drug abuse prevention research, and review the effectiveness of one approach to the problem of adolescent drug abuse, the Life Skills Traning (LST) program, and the methodological strengths of the LST evaluation research. In addition, we provide a response to criticism regarding two types of data analysis in evaluation research, and show that these analyses can help address a number of important research questions with implications for theory and practice. First, the analysis of high fidelity subsamples can address research questions about the importance of program implementation fidelity; and second, composite measures of concurrent tobacco, alcohol, and marijuana use (i.e., polydrug use) are useful in testing research questions about program effects on more serious levels of drug involvement. With an increasing number of ramdomized controlled trials underway, the field of prevention science is contributing to a new generation of evidence-based approaches and policies that, if widely utilized, offer the potential of reducing the mortality and morbidity associated with a number of major health and social problems.     

Reasons for Returning to Abusive Relationships: Effects of Prior Victimization

Studies have demonstrated that women with a history of childhood sexual abuse (CSA) are at increased risk of revictimization, but research has not yet examined whether a history of CSA may affect patterns of remaining in or returning to abusive relationships in adulthood. This study examines the impact of a CSA history on decisions to return to abusive relationships in a sample of 104 adult domestic violence survivors. Participants were interviewed about the number of times that they had previously separated from and returned to their abusive partner, the factors that influenced their decision to return (both psychological/internal and environmental/external factors), and their perceived likelihood of returning in the future. As predicted, CSA survivors (n = 34) reported a significantly greater number of past separations than non-CSA survivors (n = 70). CSA survivors were also significantly more likely to report that their decisions to return were influenced by emotional attachment to the batterer. CSA survivors did not perceive themselves to be at greater risk of returning in the future, suggesting that they may be more likely to underestimate their vulnerability to returning to the battering relationship. Clinical implications of the findings are discussed.     

Test–Retest Reliability of the Revised Conflict Tactics Scales (CTS2)

The Revised Conflict Tactics Scales (CTS2) are widely used to measure intimate partner aggression. Various aspects of the CTS2 and its subscales have been examined, e.g. factor structure, internal consistency, and validity, but little or no evidence exists regarding the stability of the self-report of aggression on the CTS2 This study examines the stability of reports of aggression against a partner on the CTS2 among 82 men court-mandated to a batterer intervention program. At both testing times men reported on aggression occurring in the year prior to beginning treatment. Using variety scores, stability of report was strong for psychological aggression (r = 0.69), physical assault (r = 0.76), injury (r = 0.70), and negotiation (r = 0.60), but weaker for sexual coercion (r = 0.30). Implications for the use of the CTS2 in court-mandated populations are discussed.

LET'S GO TO THE VIDEOTAPE: WHY THE FORENSIC INTERVIEWS OF CHILDREN IN CHILD PROTECTIVE CASES SHOULD BE VIDEO RECORDED*

Child sexual abuse is often difficult to prove due to a lack of physical evidence. In many instances, the only evidence is a child's statement given during a forensic interview. Forensic interviews are conducted to assess whether the child has been abused, to develop a plan to protect a child's safety pending trial, and to provide further investigative leads. Note taking by the interviewer is currently the primary method for documenting what takes place in a forensic interview. Research shows that this form of documentation is problematic because interviewers tend to omit abuse‐related details in their notes. This Note suggests that federal law should require that forensic interviews of children in child sexual abuse cases be video recorded. State law can provide for a policy of video recording even in the absence of a federal law mandate. Video recording would better preserve the child's statements thereby improving the reliability of the information that is obtained during forensic interviews. The child's demeanor would also be fully captured on video as opposed to getting lost in an interviewer's notes.     

Understanding Elder Sexual Abuse and the Criminal Justice System's Response: Comparisons to Elder Physical Abuse

A great deal of research has considered the dynamics of sexual assault and the way that sexual assault cases are processed and handled in the criminal justice system. Most of this research has focused on sexual assault cases involving younger victims. Very little criminological research has considered the dynamics of elder sexual abuse. To fill this void, the current study uses a sample of 127 elder sexual abuse cases and 314 elder physical abuse cases to shed some light on the dynamics of elder sexual abuse and the way the justice system processes these cases. Attention is also given to the way that the processing of elder sexual abuse cases can be distinguished from the processing of elder physical abuse cases. Results show that a wide range of elder sexual abuse cases are committed and these cases are processed differently than elder physical abuse cases. Implications are provided.