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Deaths due to firearms injuries in children
224 Journal of Clinical Forensic Medicine times more than the reported cases. Because of the frequent unclear history, there may be doubts as to whether a resulting pregnancy was achieved by the assailant or a consensual partner, the authors therefore propose that theoretically the ambiguity can be resolved by DNA typing of the pregnancy using prenatal diagnostic (PND) methods of obtaining a fetal sample and comparing its genotype with that of the consensual partner. They report on 10 pregnancies between 1989-94 using accurate DNA-based personal identification methods and conclude that the profiling system has the power to be used confidently in providing a rapid result in time-sensitive cases. However, although PND, a procedure with a low risk, could be used more frequently for prenatal parentage determination, there are ethical considerations in relation to pregnancy decisions and termination when two or more consensual partners are known. This paper will provide forensic scientists, pathologists, clinicians and legislators with material for discussion and debate.
Journal of the American Medical Association 1995; 273 (22): 1774-1777
Sex-role socialization: developmental influences on wife abuse B. Birns, M. Cascardi, S.-L. M e y e r State University o f N e w York, N Y , U S A Studies indicate that between 20 and 33% of women are subjected to physical assault by a partner or ex-partner during their lifetime with an estimated 2-4 million women severely assaulted annually by a male partner in the US. Various theories exist to explain this, for example power imbalance between men and women, male dominance in influential economic, political and social positions with men's expectations that women will treat them as a dominant class and feminist theories maintaining that sex-role socialization is central to gender-based power and male violence towards female partners. Parents are said to 'verbally stimulate their sons more than their daughters' - a response parallefled by teachers. Peer interaction indicate that girls used verbal persuasion to gain access to a desired objective whereas boys resorted to physically aggressive tactics. Parents serve as role models with children being influenced by observed male dominance and female submission and witnessing male violence against a female partner. Male dominance is reflected in television shows, cartoons and commercial advertising. The establishment of greater equity between males and females in all fields is sought. Forensic psychologists/psychiatrists, social workers, forensic physicians and paediatricians will be interested in the views expressed and theories expounded.
American Journal of Orthopsyehiatry 1994; 64(1): 50-59
Physical and sexual abuse and gastrointestinal illness: what is the link? D. A. D r o s s m a n N o r t h Carolina, N C , U S A The later in life mental health consequences of physical and sexual abuse, particularly in early life, have been reported on by psychologists and psychiatrists. The author notes the recent interest in the more selective association - supported by epidemiologic investigation, of abuse history with gastrointestinal illness. This was noted in victimized female children, and adult women in primary care with a history of abuse describe gastrointestinal symptoms as their most common somatic complaint. Some workers are said to have found that, by using sophisticated sensory decision theory techniques, patients with an abuse history reported lower cutaneous sensation thresholds, i.e. they appear psychologically conditioned to 'over-respond' to cutaneous sensory stimuli. In addition to these workers' explanation for the links to an abuse history, the author offers other factors for consideration, for example increased sensitivity of visceral afferent receptors resulting from chronic or traumatic stimulation, the belief that ones sexual organs are dirty or bad, maladaptive adjustment to
illness and the communication of psychologic distress via bodily symptoms. Gastroenterologists, primary care physicians, psychiatrists and paediatricians will find these theories an interesting area for discussion, debate and consideration when faced with organically unexplained gastrointestinal illness.
American Journal of Medicine 1994; 97:105-106
Coin-rubbing injuries B. S. F. Hulewicz W e s t m e a d Hospital, Sydney, A u s t r a l i a Some innocent injuries found at medicolegal autopsy may be misinterpreted and so raise the possibility of foul play. The author describes two such cases of innocent injuries caused by the SouthEast Asian practice of 'coin rubbing' (Kua-sha). The first showed bands of bruising on the neck and the lower jaw; the second had bands of bruising on the arms, both sides of the back and a moderate degree of pulmonary oedema. The practice of coin rubbing originated in China, was later adopted by most South-East Asian cultures and consists of dipping a coin or other blunt and smooth object in a liquid and rubbing the skin of the person until local congestion and bruising is observed. Sometimes the practice is accompalxied by 'pinch-pulling' of the skin. Both the described cases are illustrated, demonstrating the typical injuries seen and the sites at which they occur. The author emphasizes that any injury found at a forensic autopsy must be explained adequately. Forensic clinicians and pathologists will find this an interesting example of the possible pitfalls in the misinterpretation of findings on clihical or autopsy examination.
American Journal of Forensic Medicine and Pathology 1994; 15(3): 257-260
Deaths due to firearms injuries in children E. Choi, E. R. D o n o g h u e , B. D. Lifschultz C o o k C o u n t y , Chicago, IL, U S A The objective of the authors was to examine firearm-related deaths between 1984 and 1992, in children under the age of 10 years in the large urban community of Cook County, Illinois, in which Chicago is situated. During this period, 32400 autopsies were performed of which 45 were firearm-related deaths in children younger than 10 years. Fatal injuries were more common in the summer and a hand gun was the weapon most frequently involved. The victim was most likely to be a black male, the head being the commonest site of the fatal injury. Most homicides and all accidental fatal deaths occurred in the home. Paediatric deaths increased during the studied period with an unexplained dramatic rise in 1992. In accidental deaths, the incident always occurred when one or more children were playing with a gun they found in the home, the shooter always being an acquaintance. The findings are an indictment of the US gun culture which fortunately is not a feature with which we in the U K have to contend, but nevertheless provide a salutary lesson for all those responsible for the care and welfare of children. It also emphasizes the importance of the safe storage of dangerous weapons of any description.
Journal of Forensic Sciences 1994; 39(3): 685-692 Laws mandating reporting of domestic violence. Do they promote patient well-being? A. H y m a n , D. Schillinger, B. L o San Francisco N e i g h b o u r h o o d Legal Assistance F o u n d a t i o n , G e n e r a l Hospital, a n d University, CA, U S A The 'silent epidemic' of family violence has been highlighted by many authorities in the US, but the authors say that mandatory reporting
Journal of the American Medical Association 1995; 273 (22): 1774-1777
Sex-role socialization: developmental influences on wife abuse B. Birns, M. Cascardi, S.-L. M e y e r State University o f N e w York, N Y , U S A Studies indicate that between 20 and 33% of women are subjected to physical assault by a partner or ex-partner during their lifetime with an estimated 2-4 million women severely assaulted annually by a male partner in the US. Various theories exist to explain this, for example power imbalance between men and women, male dominance in influential economic, political and social positions with men's expectations that women will treat them as a dominant class and feminist theories maintaining that sex-role socialization is central to gender-based power and male violence towards female partners. Parents are said to 'verbally stimulate their sons more than their daughters' - a response parallefled by teachers. Peer interaction indicate that girls used verbal persuasion to gain access to a desired objective whereas boys resorted to physically aggressive tactics. Parents serve as role models with children being influenced by observed male dominance and female submission and witnessing male violence against a female partner. Male dominance is reflected in television shows, cartoons and commercial advertising. The establishment of greater equity between males and females in all fields is sought. Forensic psychologists/psychiatrists, social workers, forensic physicians and paediatricians will be interested in the views expressed and theories expounded.
American Journal of Orthopsyehiatry 1994; 64(1): 50-59
Physical and sexual abuse and gastrointestinal illness: what is the link? D. A. D r o s s m a n N o r t h Carolina, N C , U S A The later in life mental health consequences of physical and sexual abuse, particularly in early life, have been reported on by psychologists and psychiatrists. The author notes the recent interest in the more selective association - supported by epidemiologic investigation, of abuse history with gastrointestinal illness. This was noted in victimized female children, and adult women in primary care with a history of abuse describe gastrointestinal symptoms as their most common somatic complaint. Some workers are said to have found that, by using sophisticated sensory decision theory techniques, patients with an abuse history reported lower cutaneous sensation thresholds, i.e. they appear psychologically conditioned to 'over-respond' to cutaneous sensory stimuli. In addition to these workers' explanation for the links to an abuse history, the author offers other factors for consideration, for example increased sensitivity of visceral afferent receptors resulting from chronic or traumatic stimulation, the belief that ones sexual organs are dirty or bad, maladaptive adjustment to
illness and the communication of psychologic distress via bodily symptoms. Gastroenterologists, primary care physicians, psychiatrists and paediatricians will find these theories an interesting area for discussion, debate and consideration when faced with organically unexplained gastrointestinal illness.
American Journal of Medicine 1994; 97:105-106
Coin-rubbing injuries B. S. F. Hulewicz W e s t m e a d Hospital, Sydney, A u s t r a l i a Some innocent injuries found at medicolegal autopsy may be misinterpreted and so raise the possibility of foul play. The author describes two such cases of innocent injuries caused by the SouthEast Asian practice of 'coin rubbing' (Kua-sha). The first showed bands of bruising on the neck and the lower jaw; the second had bands of bruising on the arms, both sides of the back and a moderate degree of pulmonary oedema. The practice of coin rubbing originated in China, was later adopted by most South-East Asian cultures and consists of dipping a coin or other blunt and smooth object in a liquid and rubbing the skin of the person until local congestion and bruising is observed. Sometimes the practice is accompalxied by 'pinch-pulling' of the skin. Both the described cases are illustrated, demonstrating the typical injuries seen and the sites at which they occur. The author emphasizes that any injury found at a forensic autopsy must be explained adequately. Forensic clinicians and pathologists will find this an interesting example of the possible pitfalls in the misinterpretation of findings on clihical or autopsy examination.
American Journal of Forensic Medicine and Pathology 1994; 15(3): 257-260
Deaths due to firearms injuries in children E. Choi, E. R. D o n o g h u e , B. D. Lifschultz C o o k C o u n t y , Chicago, IL, U S A The objective of the authors was to examine firearm-related deaths between 1984 and 1992, in children under the age of 10 years in the large urban community of Cook County, Illinois, in which Chicago is situated. During this period, 32400 autopsies were performed of which 45 were firearm-related deaths in children younger than 10 years. Fatal injuries were more common in the summer and a hand gun was the weapon most frequently involved. The victim was most likely to be a black male, the head being the commonest site of the fatal injury. Most homicides and all accidental fatal deaths occurred in the home. Paediatric deaths increased during the studied period with an unexplained dramatic rise in 1992. In accidental deaths, the incident always occurred when one or more children were playing with a gun they found in the home, the shooter always being an acquaintance. The findings are an indictment of the US gun culture which fortunately is not a feature with which we in the U K have to contend, but nevertheless provide a salutary lesson for all those responsible for the care and welfare of children. It also emphasizes the importance of the safe storage of dangerous weapons of any description.
Journal of Forensic Sciences 1994; 39(3): 685-692 Laws mandating reporting of domestic violence. Do they promote patient well-being? A. H y m a n , D. Schillinger, B. L o San Francisco N e i g h b o u r h o o d Legal Assistance F o u n d a t i o n , G e n e r a l Hospital, a n d University, CA, U S A The 'silent epidemic' of family violence has been highlighted by many authorities in the US, but the authors say that mandatory reporting