An Examination of the Transition of Fracture Characteristics in Long Bones from Fresh to Dry in Central Florida: Evaluating the Timing of Injury

It is important to conduct timing of injury research analyzing fracture characteristics at known postmortem intervals (PMI) because bone can retain fresh characteristics throughout the PMI. Defleshed pig (Sus scrofa) long bones were fractured weekly in two environments (full sun and shade) over 14 weeks in Central Florida and fracture characteristics were categorized (N = 136) for analysis. Results of analysis of variance (ANOVA) using time in weeks (PMI) as a dependent variable indicate significant relationships between PMI and Fracture Angle (p < 0.001), Fracture Surface (p < 0.001), and Fracture Outline (p < 0.001). Fracture characteristics associated with perimortem trauma (smooth Fracture Surfaces and curved or V‐shaped Fracture Outlines) were commonly observed. Analysis of fracture characteristics for each environment demonstrated similar patterns. Overall, the loss of only fresh fracture characteristics for each bone was noted earlier in the PMI for the Central Florida region than previously reported.     

Sudden Death Due to Primary Intraventricular Hemorrhage: Report of Two Cases

Primary intraventricular hemorrhage (PIVH) is a rare type of stroke defined as bleeding within the ventricles of the brain without any associated parenchymal hemorrhage. Here, we reported two cases of sudden death due to PIVH. One of the patients was found dead under a highway bridge without witnesses, and the other patient was hospitalized with hemorrhage in the ventricular system, as revealed by a head computed tomography scan. In these two patients, autopsy and macroscopic examination only showed hemorrhages in the ventricular system without any traumatic brain injury or other intraparenchymal hemorrhage. The sources of bleeding for both patients were ultimately confirmed as ruptured brain arteriovenous malformations located in the subventricular zone. We reported these cases to broaden our understanding of sudden death associated with PIVH, especially when caused by brain arteriovenous malformation. We also summarized the essential details of the diagnoses and available technical methods for PIVH cases.     

Evolving Federal Policies and Their Implications for Greenbook Interventions

This article addresses the influence of the Greenbook on federal policy in the past 20 years and traces the history of federal policy responses to the co‐occurrence of domestic violence and child maltreatment. While there has been some success in getting the domestic violence and child abuse fields to embrace equally the needs of adult and child survivors of domestic violence, federal legislation has progressed slowly, reflecting that ambivalence. Strengthening cross‐system policy advocacy and increasing evidence that addressing domestic violence improves outcomes for children are identified as ongoing needs.     

Development and Pilot of the National Child Traumatic Stress Network Trauma‐Informed Juvenile Court Self‐Assessment

Trauma‐informed practices in the juvenile justice system are increasingly recognized as effective for promoting public safety through case management, rehabilitation, and treatment that is responsive to a traumatic event exposure and current trauma reactions. As court systems explore integration of trauma‐informed practices, tools for identifying best practices and strategically implementing trauma‐informed approaches are integral for judges and court administrators aiming to develop trauma‐informed courts. The current paper reviews the National Child Traumatic Stress Network's development of the Trauma‐Informed Juvenile Court Self‐Assessment (TI‐JCSA). Implications for self‐guided strategies to shift court practices and policies to align with trauma‐informed approaches will be discussed.     

Staff experiences of working in a Sexual Assault Referral Centre: the impacts and emotional tolls of working with traumatised people

This study considers the impacts on staff of supporting people who have reported sexual violence and attend a Sexual Assault Referral Centre (SARC). This paper focuses on the staff’s perspectives of the stresses and emotional tolls they experience including the coping mechanisms they utilise. Semi-structured interviews were conducted with 12 staff, and a focus group was held with a further four staff of a SARC. The data were examined using thematic analysis. Findings indicated that staff experienced positive emotions connected to the meaningfulness of the work and team spirit as well as a range of unpleasant emotions. Staff also reported emotional numbing, in connection to the specificity, volume and sometimes unpredictable nature of the work. Coping mechanisms used by staff focused on the supportive connection to family, nature, and other team members; the value of clinical supervision; and the avoidance of topics related to work.     

Life Before “I Killed the Man That Raped Me”: Pre-Prison Life Experiences of Incarcerated Women With Life Sentences and Subsequent Treatment Needs

The number of incarcerated women serving a life sentence is growing. This subpopulation rarely receives programming in prison or even inclusion in intervention studies’ samples. According to importation theory, characteristics of prisoners’ pre-prison experiences guide the types of interventions provided to prisoners. This study examined the importation factors for a sample of women serving life sentences and used thematic analysis to understand these factors. The primary theme was the dominance of trauma in women’s pre-prison lives with four connected sub-themes that highlight treatment needs pre-and during prison. One implication of this study is improving prison policies to include this subpopulation in treatment opportunities.     

A Unique Type of Birth Trauma Mistaken for Abuse

Pediatric abusive head trauma is a challenging subject across many disciplines. Of particular importance is the identification of mimics of abuse, so cause and manner of death can be properly assigned. We present the case of suspected child abuse involving an infant who presented unresponsive to the hospital with hypoglycemia, hypothermia, and bilateral parietal fractures. An autopsy revealed fractures associated with organizing scalp hemorrhage and gross leptomeningeal congestion and hemorrhage. The fractures were circular with external displacement, rounded margins, and subperiosteal new bone formation indicative of healing. Birth records revealed vacuum assist and cesarean section delivery. Although vacuum extraction‐related injuries are typically cephalohematomas and/or linear fractures, the outbending and circular morphology of the fractures are consistent with vacuum extraction. Moreover, microscopic neuropathological examination revealed hemorrhagic purulent leptomeningitis. This unique case demonstrates the importance of considering birth trauma in the determination of cause and manner of death of an infant.     

Assessing Impact Direction in 3‐point Bending of Human Femora: Incomplete Butterfly Fractures and Fracture Surfaces,,

Current literature associates bending failure with butterfly fracture, in which fracture initiates transversely at the tensile surface of a bent bone and branches as it propagates toward the impact surface. The orientation of the resulting wedge fragment is often considered diagnostic of impact direction. However, experimental studies indicate bending does not always produce complete butterfly fractures or produces wedge fragments variably in tension or compression, precluding their use in interpreting directionality. This study reports results of experimental 3‐point bending tests on thirteen unembalmed human femora. Complete fracture patterns varied following bending failure, but incomplete fractures and fracture surface characteristics were observed in all impacted specimens. A flat, billowy fracture surface was observed in tension, while jagged, angular peaks were observed in compression. Impact direction was accurately reconstructed using incomplete tension wedge butterfly fractures and tension and compression fracture surface criteria in all thirteen specimens.     

Traumatic brain injury in a forensic intellectual disability population

Traumatic brain injury (TBI) screening in forensic populations has been recommended, due to a high prevalence, links to specific offence profiles and poorer outcomes, such as higher rates of psychiatric disturbance, longer stays in prison, and reoffending. Research focusing on TBI among offenders with intellectual disability (ID) is lacking. This study therefore describes the implementation of TBI screening using the Brain Injury Screening Index (BISI©), TBI prevalence and correlates in a forensic ID service. TBI appeared under recorded in case notes, with considerably more patients self-reporting TBI. Reported causes of TBI differed somewhat to the general population, including childhood physical abuse, self-harming behaviour, and assault. Approximately one-third of injuries did not receive any treatment. Though further adaptations may be required on current screening measures for TBI in offenders with ID, screening can provide valuable information, contributing positively to individual patient therapeutic and risk formulations.     

液压冲击脑损伤后细胞间粘附分子表达的研究

目的测定外伤性脑损伤后脑内细胞间粘附分子(ICAM-1)的变化。方法用大鼠液压冲击脑损伤致伤模型制作大鼠脑损伤,伤后2、4、8、12、24h取脑组织,用免疫组织化学方法染色并用MIAS图像分析系统进行图像分析。结果脑损伤后2h即可见ICAM-1在脑内表达上调,12h达高峰,24h已回落。结论测定I-CAM-1在脑内的变化情况,可为推断24h以内脑损伤形成时间及伤后存活时间提供参考。