An unusual blunt force trauma pattern and mechanism to the cranial vault: Investigation of an atypical infant homicide

This case report presents an unusual fracture pattern in the cranium of a four-month-old infant indicative of child abuse. Upon postmortem examination, the infant presented with numerous bilateral linear cranial fractures running perpendicular to the sagittal suture with depressed and curvilinear fractures apparent on the supra-auricular surfaces of the cranium. Histological evidence indicates multiple traumatic events to the cranium. In addition, the stair-step pattern of a parietal fracture may represent multiple contiguous fractures from repeated loading of the head at different times with variation of the focal points of compressive force. Additionally, the left humerus, left radius, and left ulna have healing metaphyseal fractures, and the left ulna also has an antemortem diaphyseal fracture which resulted in the distal metaphysis being rotated 45 degrees medially. Integration of autopsy, anthropological, and neuropathological reports for this case suggest multiple inflicted injury episodes with a repeated atypical mechanism(s) to the cranial vault of the infant. During investigative interviews, the caretaker admitted to squeezing the infant's head and neck on multiple occasions to quiet the child. This reported abusive mechanism is consistent with the pattern of symmetric cranial fractures and soft tissue injuries indicating asphyxiation. This case report provides forensic investigators with a potential trauma mechanism to explore in cases when a similar pattern of cranial trauma is observed and highlights the need for greater research on fracture propagation and fracture healing in the infant cranium.     

Immigration and Posttraumatic Growth-A Missing Link

Abstract

This paper applies contemporary conceptual models and empirical knowledge about posttraumatic growth to the experience of immigration. Current models and knowledge about potential positive effects and personal growth in the aftermath of trauma are reviewed and their relevance to immigration is discussed and illustrated, challenging the exclusive focus in the existing immigration literature on the hardships of relocation and their negative effects. Implications for clinical intervention are offered.     

Surviving Chernobyl in America

Abstract

This paper fills an informational gap for multidisciplinary providers of services to the former Soviet Union (FSU) immigrants in the United States, highlighting the long-term medical and mental health consequences of this group's pre-migration exposure to the 1986 Chernobyl nuclear disaster. The international literature is selectively presented together with recent findings of Chernobyl mental health sequelae in a cohort residing in the United States. Guidelines for service providers, as well as Russian language health service resources in US cities populated by significant FSU communities, are also furnished.     

Risk,reconviction and “sexually risky behaviour” in sex offenders

Abstract

The Challenge Project is a community assessment and treatment programme in southeast London. The Project has been evaluated extensively in relation to community failure, with consideration of static risk prediction tools and the role of key developmental variables. This current paper is an extension of earlier evaluations, considering an extended range of outcomes with a longer-term follow-up period of more than nine years at risk in the community. The official sexual reconviction rate for this sample of sex offenders (of whom 275 were at risk in the community) was 12%. A wider definition of “sexually risky behaviours” as an outcome variable, drawn from a range of police intelligence, suggested a “truer” sexual re-offending rate of 20%. Although static tools were moderately predictive of community failure, the accuracy of risk prediction was enhanced if static tools were considered in conjunction with developmental variables.     

Manual and Automated Cardiopulmonary Resuscitation (CPR): A Comparison of Associated Injury Patterns,

The purpose of this study was to identify and compare patterns of trauma associated with AutoPulse^® CPR and manual CPR. Finalized autopsy records from 175 decedents brought to the Harris County Institute of Forensic Sciences were reviewed, 87 received manual‐only CPR, and 88 received AutoPulse^® CPR (in combination with manual CPR as per standard protocol). The characteristic pattern observed in manual‐only CPR use included a high frequency of anterior rib fractures, sternal fractures, and midline chest abrasions along the sternum. The characteristic pattern observed in AutoPulse^® CPR use included a high frequency of posterior rib fractures, skin abrasions located along the anterolateral chest and shoulder, vertebral fractures, and a few cases of visceral injuries including liver lacerations, splenic lacerations, and hemoperitoneum. Knowledge of the AutoPulse^® CPR injury pattern can help forensic pathologists differentiate therapeutic from inflicted injuries and therefore avoid an erroneous assessment of cause and manner of death.     

Necropsy Findings in Dogs that Died During Grooming or other Pet Service Procedures

Procedures involved in grooming, bathing, and other pet services can often lead animals to death. Of the necropsies of 1391 animals carried out at a private diagnostic laboratory in Sao Paulo, Brazil from 2004 to 2009, 94 were dogs that died during the above‐mentioned procedures. Young male dogs and small breeds like Poodle Miniature, Yorkshire Terrier, and Lhasa Apso were most frequently observed. Blunt‐force trauma was responsible for the deaths of 31% of the animals, with a higher incidence of trauma to the head, characterized chiefly by fractures and nervous tissue lesions. In the other 69% of cases, the animals showed signs of stress, and died due to pulmonary edema and hemorrhage. As we cannot rule out the intentional character in some situations, this article provides veterinary forensic support for veterinarians and pet owners, especially in lawsuits, helping in finding the cause of animal's death in such pet services.     

Applicability of Cranial Models in Urethane Resin and Foam as a Substitute for Bone: Are Synthetic Materials Reliable?

As literature is poor in functional synthetic cranial models, in this study, synthetic handmade models of cranial vaults were produced in two different materials (a urethane resin and a self‐hardening foam), from multiple bone specimens (eight original cranial vaults: four human and four swine), in order to test their resemblance to bone structure in behavior, during fracture formation. All the vaults were mechanically tested with a 2‐kg impact weight and filmed with a high‐speed camera. Fracture patterns were homogeneous in all swine vaults and heterogeneous in human vaults, with resin fractures more similar to bone fractures. Mean fracture latency time extrapolated by videos were of 0.75 msec (bone), 1.5 msec (resin), 5.12 msec (foam) for human vaults and of 0.625 msec (bone), 1.87 msec (resin), 3.75 msec (foam) for swine vaults. These data showed that resin models are more similar to bone than foam reproductions, but that synthetic material may behave quite differently from bone as concerns fracture latency times.     

The Filmmaker's Triage: The Doctor Figure and Images of Trauma

ABSTRACT

While writing a fictionalised feature film screenplay set around the character of a South African doctor during his year of compulsory community service in a rural hospital, I began researching how this figure has been represented in other narrative films, particularly those stories told in an African setting. A number of films and television dramas, some made by African filmmakers and others by filmmakers from outside of Africa, have been produced around the medical encounter. My interest lies not in assessing the health messaging found in these films and programs, which is better left to the health educationalists and medical sociologists, but in examining the fictional doctor figure as the main protagonist in these films. While the sociocultural and political dimensions of medicine, health and illness are relevant, I refer to them only in passing while exploring the fictional imagery of the doctor figure within the imagined filmed-Africa as it appears in the films The Last Face, Beyond Borders and Le grand blanc de Lambaréné.     

Traumata on Screen: Cinematic Views from Southern Africa

ABSTRACT

This special themed issue of Communicatio explores the profound transformation of the political, cultural and intellectual contours of Africa from the vantage point of African film and grounded within the theoretical and epistemological discourses of trauma studies, memory studies, postcolonial studies, and decolonial studies. The contributors are particularly interested in exploring the relational flows between African cinematic works and the social and imaginary circumstances of their production, engagement and representation. Through an explication of the screen and viewing cultures from Africa, this themed issue wishes to make three contributions. The first is to the already established but on-going scholarly work of trauma studies, but specifically from an African, cinematic vantage point. The second contribution is to the theoretical body of work on African cinema (and in this context, “cinematic” includes both film/television). And the last contribution is to the emerging view that culture is a “two-way street,” to put it colloquially: a reversal of the dominant “Western” direction of culture, with an emphasis on different tones of social values and contexts, that have been marginalised in mainstream popular culture discourses.     

外伤迟发性颅内出血死亡案例研究

通过对一例外伤迟发性颅内出血死亡案例分析,探讨了外伤迟发性颅内出血的临床表现、诊断依据、病理组织学特点及相关法医检验的应对要素。研究发现,外伤性迟发性颅内出血是外伤后早期未发生出血、经数日或数周突发出血,引发伤者出现颅内压升高症状及体征,经CT复查而发现的一种延迟性出血。其成因为外伤时外力作用致脑实质多发小软化灶,持续地损伤脑内血管,因诱因导致血压的突然升高或附近组织急剧变化的抵抗而发生出血。所以,对于外伤性迟发性颅内出血,需结合调查,全面分析其伤后医疗病历、CT检查回报以及尸检病理组织学所见等,综合判断。以避免引起伤者、致伤者、医院甚至办案单位等多方纠纷。