An autopsy case of intraoperative death due to pulmonary fat embolism—possibly caused by release of tourniquet after multiple muscle-release and tenotomy of the bilateral lower limbs

We report a case of a juvenile male with muscle rigidity caused by cerebral palsy who experienced intraoperative sudden death due to pulmonary fat embolism after multiple muscle-release and tenotomy of the bilateral lower limbs. Data were obtained through review of the surgical and anesthesia records, as well as from autopsy and histopathological examination. All surgical procedures were performed within the same operation, beginning with the right lower limb and then proceeding with the left lower limb, with application of a pneumatic tourniquet to avoid intraoperative hemorrhage. Slight changes in the hemodynamics were noticed after release of the right tourniquet. Further, sudden onset of hypotension, severe bradycardia, and a marked decrease in percutaneously monitored oxygen saturation occurred just after release of the left tourniquet when the left limb was raised for casting. The patient died despite immediate and vigorous cardiopulmonary resuscitation. At autopsy performed 20 h after death, examination of the lungs revealed a pale surface, slight edema, and obvious fat droplets in the vessels at the cut surfaces. Histopathological examination with fat staining was notable for the presence of pulmonary fat embolism. These results suggest that restoration of venous return after removal of the tourniquet combined with massive fat embolism from dead spaces was the likely cause of death.     

Stage of Change as a Predictor of Attrition Among Men in a Batterer Treatment Program

This study assessed the contribution of the men's stage of change to the prediction of attrition among men attending a batterer treatment program. As outlined by the transtheoretical model of change, men were classified into the precontemplation, contemplation, or action stage based on their level of change motivation and behavior. It was hypothesized that men in the precontemplation stage would dropout of treatment at higher rates than men in later stages of change. Participants were 308 men who enrolled in a batterer treatment program over the course of 1 year, 61.4% of whom dropped out of treatment. Counselor rated, but not self-rated stage of change significantly predicted treatment completion once traditionally used demographic, contextual, and personality variables were taken into account. Specifically, men identified by counselors as being in the precontemplation stage were 2.3 times as likely as men rated in the contemplation stage and 8.8 times as likely as men rated in the action stage to dropout of treatment. Referral source, age, and history of arrest also made significant contributions to the prediction of attrition. The best combination of predictors led to the successful classification of 72% of the cases, 98% of the dropouts but only 19% of the completers. Discussion focuses on the limitations of current findings and their implications for the use of the transtheoretical model to predict attrition from batterer treatment.     

Leisure Experience, Prison Culture, or Victimization? Sex Offenders Report on Prison Gambling

Opportunities for gambling in mainstream North American society have increased greatly over the past two decades. Despite the popularity of legalized gambling and attention it is receiving among social science researchers and economists, gambling within jails and prisons has been overlooked. This study utilized a semistructured interviewing procedure (Smith, 1995) to gain information about prison gambling from 11 sexual offenders on parole—all had spent significant time incarcerated. Qualitative analyses of responses suggest that offenders may gamble in various forms and for a variety of reasons, including a means of alleviating boredom, providing excitement and risk, and an opportunity to socialize. Prison gambling appears to be a complex phenomenon. A substantial amount of prison gambling seems to be associated with certain psychosocial benefits, while for a minority of cases there may be severe violence and victimization.     

试论刑法中的被害者过错制度

被害者过错问题是被害学理论中的一个关键问题。被害者过错问题的研究有着重要的刑法学意义,而这一问题虽已在不同程度上被各国刑法学界意识到,并在立法中有着片段性的反映,但问题没有被系统化地认识和规制。根据其对刑事事件发生的影响力大小及性质的不同,具体被害者过错可以被分为迫发行为、引发行为、激发行为和触发行为等几个层级,并和加害者刑事责任的大小呈反比对应关系。抽象被害者过错有着与此一致的道理。在刑法及一些相关法律中确立完整、系统的被害者过错制度,意义显著。     

论刑法中的连累犯

现行刑法中规定了一系列的连累犯 ,从表面上看此类犯罪的实行行为类似于某种犯罪的帮助行为 ,应以共犯论处。其实不然 ,连累犯虽与共同犯罪有一定程度的联系 ,却存在着质的差别 ,应区别对待。     

AMERICAN BAR ASSOCIATION POLICY REQUIRING LICENSURE,REGULATION, AND MONITORING OF PRIVATELY OPERATED RESIDENTIAL TREATMENT FACILITIES FOR AT‐RISK CHILDREN AND YOUTH

Well‐meaning parents send an estimated 10,000 to 14,000 at‐risk children each year to unregulated private residential treatment facilities, which for as much as $3,000 to $5,000 per month promise to modify troublesome behaviors and make bad kids good. The facilities that compose this booming, billion‐dollar business are generally not regulated, licensed, or monitored by state or federal governments; too many aspects of this alternative care system for youth are rife with mistreatment, including physical, sexual, and mental abuse by facility staff. This American Bar Association policy resolution urges state, territorial, and tribal legislatures to pass laws that require the licensing, regulating, and monitoring of residential treatment facilities that are not funded by public or government systems but offer treatment to at‐risk children and youth for emotional, behavioral, educational, or other problems or issues.     

医疗损害赔偿纠纷案件法律适用的冲突与调适

医疗损害赔偿是当今社会的热点问题,也是司法审判实践中的重点、难点问题。由于该类案件处理中现行法律适用原则存在的误区,导致审判实践中同案不能同判的现象时有发生。这不仅损害当事人的合法权益,而且严重损害我国法律的尊严。文中阐述了现行法律适用原则存在的主要问题及由此产生的严重影响,并从理论上通过对现行适用原则中区分对待的医疗事故以及其它医疗损害的剖析,明确了医疗损害的内涵及其责任性质,进而提出对《条     

罪犯心理状况研究与心理矫治体系的构建

监狱作为一个特殊的社会予系统,干警与罪犯、监管与改造的这种特殊人际关系会影响他们的知觉、观念、行为导向,形成监狱内特殊的心理体系。罪犯的心理状况极大地影响改造成效,我国从80年代起建立罪犯心理矫治体系,它对于稳定监狱工作秩序和监管安全起到积极的作用。文章在分析当前犯罪心理矫治存在不足的基础上提出一些粗浅的构想,以期对监狱心理矫治的进步提供有益探索。