Improving psychosocial well-being of child laborers and young people who are engaged in low-income economic activities in Istanbul,Turkey

Child laborers are typically subjected to multiple and chronic traumatic experiences. With no parents or caregivers to act as a buffer zone against stressors, they grow up in chaotic and unpredictable work environments. Child laborers are more at risk of developing a range of psychological, emotional, and behavioral problems. The authors established an 8-month psychosocial support program for child laborers and young people attending a vocational training center one day a week. The authors found that anxiety and depression moderately correlated with negative self-concept, somatization, and hostility. Toward the end of the 8-month program, participants reported improved psychological and emotional well-being. The provision of a safe and mediated psychosocial program enhanced the emotional and mental well-being of vulnerable children and young people.     

A Qualitative Examination of the Self-Medicating Hypothesis Among Female Juvenile Offenders

Substance misuse among criminally delinquent youth has typically been described as a concurrent part of their participation in risky and delinquent behavior. Using Khantzian’s self-medication hypothesis, this article presents an alternative view by presenting qualitative data which suggests that substance misuse for female juvenile offenders may serve as self-medication for mental health problems stemming from early trauma, often at the hands of their families. Based on the narratives of 30 female juvenile offenders, this article examines the lived experiences of girls with childhood trauma and substance misuse, followed by arrest and incarceration. The paper concludes with recommendations for juvenile justice and child welfare practitioners.     

Interpreting perimortem blast trauma from skeletal remains: Complications and considerations

Blast trauma results from highly variable events that can lead to similar effects in the skeleton. Clinical literature, which largely focuses on soft tissue, provides limited efficacy for interpreting fully skeletonized cases. Interpretation of skeletal blast trauma is hampered by the low number of fully skeletonized case studies and experimental replication studies, which mainly use nonhuman proxies. The purpose of this study is to discuss fracture patterns on two individuals from WWII as a means to better understand and identify fracture patterns associated with blast trauma. Existing clinical and anthropological criteria are reviewed and applied to two World War II cases, both presumed to exhibit blast trauma based on historical contexts. These case studies exhibit combinations of complicated and extensive signs of blunt-force and projectile trauma, reflecting the diversity of skeletal trauma resulting from blast-related events. This analysis emphasizes the arguably impossible task of establishing a diagnosis based on the available literature and lack of prior knowledge about specific losses. Ultimately, analysts must consider the totality of skeletal trauma, combining biomechanical theory and relevant clinical and anthropological literature to arrive at useful yet defensible assessments of trauma. However, refined criteria and additional studies are needed to assess complicated trauma from blast-related events in anthropological contexts.     

Can computed tomography replace or supplement autopsy?

Postmortem computed tomography (PMCT) has been integrated into the practice of many forensic pathologists. To evaluate the utility of PMCT in supplementing and/or supplanting medicolegal autopsy, we conducted a prospective double-blind comparison of abnormal findings reported by the autopsy pathologist with those reported by a radiologist reviewing the PMCT. We reviewed 890 cases: 167 with blunt force injury (BFI), 63 with pediatric trauma (under 5 years), 203 firearm injuries, and 457 drug poisoning deaths. Autopsy and radiology reports were coded using the Abbreviated Injury Scale and abnormal findings and cause of death (COD) were compared for congruence in consensus conferences with novel pathologists and radiologists. Overall sensitivity for recognizing abnormal findings was 71% for PMCT and 74.6% for autopsy. Sensitivities for PMCT/autopsy were 74%/73.1% for BFI, 61.5%/71.4% for pediatric trauma, 84.9%/83.7% for firearm injuries, and 56.5%/66.4% for drug poisoning deaths. COD assigned by reviewing PMCT/autopsy was correct in 88%/95.8% of BFI cases, 99%/99.5% of firearm fatalities, 82.5%/98.5% of pediatric trauma deaths, and 84%/100% of drug poisoning deaths of individuals younger than 50. Both autopsy and PMCT were imperfect in recognizing injuries. However, both methods identified the most important findings and are sufficient to establish COD in cases of BFI, pediatric trauma, firearm injuries and drug poisoning in individuals younger than 50. Ideally, all forensic pathologists would have access to a CT scanner and a consulting radiologist. This would allow a flexible approach that meets the diagnostic needs of each case and best serves decedents' families and other stakeholders.     

Subdural Hemorrhage,a Retrospective Review with Emphasis on a Cohort of Alcoholics

Subdural hemorrhage (SDH) is a common cause of death. As external evidence of injury may be absent, an autopsy is frequently needed to detect it. We conducted a 3‐year review of SDH from the New York City Office of Chief Medical Examiner, with emphasis on a cohort of alcoholics. Our study population of 1942 included 1588 alcoholics. Of the alcoholics, c. 8% had SDH (26% of the total number of SDH). Of the alcoholics with SDH, 57% had associated brain injuries. As alcohol intoxication is frequently associated with aggressive and violent behavior, we are concerned that 6% of alcoholics in our review had no autopsy or imaging studies. It is possible that a portion of these may have had a SDH due to an unrecognized inflicted injury. We recommend that autopsies be performed on all alcoholics without a clear cause or mechanism of death.     

论我国的雇主替代责任制度

2003年最高人民法院关于人身损害赔偿的司法解释以及即将正式实施的《侵权责任法》对雇主替代责任的配置有失均衡,不符合我国当前社会发展的需要,对于雇主替代责任,在其责任的构成要件上,应当以雇员执行职务时对他人造成损害的行为构成侵权为前提;我们顺应现代立法潮流,借鉴两大法系国家侵权法的规则,使雇主替代责任建构符合侵权法的一般原理,在规定雇主承担严格责任的同时,规定雇员也应当就其实施的侵权行为对受害人承担侵权责任,并不考虑其是一般过失,还是存在故意或重大过失。雇主应当和雇员共同就其雇员实施的侵权行为对受害人承担连带责任。     

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.