Child Abuse Investigation: Police Officers and Secondary Traumatic Stress

Child protection is an area of police work which has expanded in the last decade, leading to an increase in the number of police officers working in departments which specialise in investigating cases of child abuse. Police officers in this field may be at greater risk of experiencing secondary traumatic stress but there remains a paucity of research in this area of policing. Analogies can be drawn to existing research in policing and with social service workers involved in child protection. The paper finishes off with implications for police forces to ensure safe working environments and appropriate counselling for employees.     

Analysis of mechanics of side impact test defined in UN/ECE Regulation 129

Objective: This article discusses differences between a side impact procedure described in United Nations/Economic Commission for Europe (UN/ECE) Regulation 129 and scenarios observed in real-world cases.

Methods: Numerical simulations of side impact tests utilizing different boundary conditions are used to compare the severity of the Regulation 129 test and the other tests with different kinematics of child restraint systems (CRSs). In the simulations, the authors use a validated finite element (FE) model of real-world CRSs together with a fully deformable numerical model of the Q3 anthropomorphic test device (ATD) by Humanetics Innovative Solution, Inc.

Results: The comparison of 5 selected cases is based on the head injury criterion (HIC) index. Numerical investigations reveal that the presence of oblique velocity components or the way in which the CRS is mounted to the test bench seat fixture is among the significant factors influencing ATD kinematics. The results of analyses show that the side impact test procedure is very sensitive to these parameters. A side impact setup defined in Regulation 129 may minimize the effects of the impact.

Conclusions: It is demonstrated that an artificial anchorage in the Regulation 129 test does not account for a rotation of the CRS, which should appear in the case of a realistic anchorage. Therefore, the adopted procedure generates the smallest HIC value, which is at the level of the far-side impact scenario where there are no obstacles. It is also shown that the presence of nonlateral acceleration components challenges the quality of a CRS and its headrest much more than a pure lateral setup.     

Risk for chromosome abnormality at amniocentesis following a child with a non-inherited chromosome aberration a european collaborative study on prenatal diagnoses 1981

Based on 2890 prenatal diagnoses from 12 European countries the risk for a chromosomally abnormal fetus at amniocentesis after the birth of a child with a chromosome abnormality has been estimated to be 1.3 per cent when the mother's age is 34 years or less at amniocentesis and 1.8 per cent if the mother is older. This risk does not depend on paternal age, and it is independent of the type of the chromosome abnormality of the index child. Some geographical heterogeneities were detected. Therefore, the overall risk has to be considered as a rough estimate. The chromosome constitution of the abnormal fetus differed from that of the index patient in 21 of 41 cases. Several explanations for the higher risk have been discussed. If the index child had trisomy 18, 13 or a sex chromosome abnormality, the fetus tended to be a female. If the index child was a trisomy 21, the fetal sex ratio was normal.     

High-risk behaviors while driving: A population-based study from Iran

Objective: Traffic injuries are becoming one of the most important challenges of public health systems. Because these injuries are mostly preventable, the aim of this study is to evaluate the four main high-risk behaviors while driving.

Methods: This cross-sectional study was conducted on a random sample from the population of Mashhad, Iran, in 2014. A checklist and a previously validated questionnaire for the transtheoretical stages of change model (TTM) were used for data collection. Statistical analyses were performed using SPSS 11.5 software with P <.05 statistically significant.

Results: Totally 431 individuals were included with a mean age of 30 ± 11.3 years. Forty-three percent (183) were male. The TTM model revealed that participants were mostly in pre-actional phases regarding not using a cell phone while driving (80%), fastening the driver's seat belt (66%), front seat belt (68%), and rear seat belt (85%) The penalty was a protective factor only for using cellphone (odd ratio [OR] = 0.82, 95% confidence interval [CI], 0.68–0.98). Lower education (OR = 0.12, 95% CI, 0.01–0.94) and male gender (OR = 0.35, 95% CI, 0.14–0.83) were indicative of lower rates of fastening the front and rear seat belts.

Conclusion: The stages of change model among study participants is a proper reflection of the effectiveness of the current policies. More serious actions regarding these high-risk behaviors should be considered in legislation.     

Road accident fatality risks for “vulnerable” versus “protected” road users in northern Ghana

Background: Road traffic injuries (RTIs) are a serious epidemic that claims more than a million lives across the globe each year. The burden of RTIs is particularly pronounced in Africa and other low- and middle-income countries. The unfavorable disparity of the burden of road trauma in the world is largely attributable to unsafe vehicles, lack of appropriate road infrastructure, and the predominance of vulnerable road users (VRUs) in developing countries. However, little research exists in northern Ghana to highlight the scale and risk of death among road users.

Objective: The objective of this research was to establish the relative risk of death among road users in northern Ghana.

Methods: Crash data from police reports between 2007 and 2011 were analyzed for the Upper Regions of Ghana. Conditional probabilities and multivariable logistic regression techniques were used to report proportions and adjusted odds ratios (AORs), respectively.

Results: Generally, crashes in northern Ghana were extremely severe; that is, 35% of all injury related collisions were fatal. The proportion of fatal casualties ranged between 21% among victims of sideswipe collisions and 41% among pedestrians and victims of rear-end collisions. Though males were 6 times more likely to die than females overall, females were more likely to die as pedestrians (90% of all female casualty deaths) and males were more likely to die as riders/drivers (78% of all male casualty deaths). Pedestrians were 3 times more likely to die (odds ratio [OR] = 3.1; 95% confidence interval [CI], 2.4 to 4.1) compared with drivers/riders. Compared with drivers, the odds of death among cyclists was about 4 times higher (AOR = 3.6; 95% CI, 2.3 to 5.6) and about 2 times higher among motorcyclists (AOR = 1.6; 95% CI, 1.2 to 2.2). Compared with casualties aged between 30 and 59 years, children under 10 years and those aged 60 years and above were independently 2 times more likely to die in traffic collisions.

Conclusion: Provision of requisite road infrastructure is vital for the safety of VRUs in northern Ghana. Cycle paths and lanes (for cyclists) as well as sidewalks (for pedestrians) in particular will separate VRUs from motorists and improve their safety. Enforcement of traffic laws particularly regarding helmet use, speeding, and alcohol use will be beneficial. Introduction of the demerit points system in the enforcement of traffic regulations may have significant deterrent effects on road users who have the penchant for violating traffic regulations. Road safety education is also required to create responsible road users.     

Rating child passenger safety laws relative to best practice recommendations for occupant protection

Background: State laws regarding child passenger protection vary substantially.

Objectives: The objective of this study was to develop a scoring system to rate child passenger safety laws relative to best practice recommendations for each age of child.

Methods: State child passenger safety and seat belt laws were retrieved from the LexisNexis database for the years 2002–2015. Text of the laws was reviewed and compared to current best practice recommendations for child occupant protection for each age of child.

Results: A 0–4 scale was developed to rate the strength of the state law relative to current best practice recommendations. A rating of 3 corresponds to a law that requires a restraint that is sufficient to meet best practice, and a rating of 4 is given to a law that specifies several options that would meet best practice. Scores of 0, 1, or 2 are given to laws requiring less than best practice to different degrees. The same scale is used for each age of child despite different restraint recommendations for each age. Legislation that receives a score of 3 requires rear-facing child restraints for children under age 2, forward-facing harnessed child restraints for children aged 2 to 4, booster seats for children 5 to 10, and primary enforcement of seat belt use in all positions for children aged 11–13. Legislation requiring use of a “child restraint system according to instructions” would receive a score of 1 for children under age 2 and a 2 for children aged 2–4 because it would allow premature use of a booster for children weighing more than 13.6 kg (30 lb).

Conclusions: The scoring system developed in this study can be used in mathematical models to predict how child passenger safety legislation affects child restraint practices.     

Airbag deployment–related eye injuries

Objective: We studied the correlation between airbag deployment and eye injuries using 2 different data sets.

Methods: The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009–2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012.

Results: In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33–10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59–3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants.

Conclusions: Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.     

兰州市空气污染对儿童呼吸疾病的影响

探讨兰州市空气污染对不同性别和年龄的儿童呼吸疾病就诊人数的影响以及季节性变化.通过收集2013~2017年兰州市空气污染物PM_2.5、PM₁₀、SO₂、NO₂、CO和O₃8h浓度数据、气象数据及3家三甲医院儿童呼吸疾病门诊资料,采用广义相加模型（GAM）控制星期几效应、气象因素、假期效应等混杂因素,分析空气污染物浓度与儿童呼吸系统疾病日门诊量的关系及滞后效应.研究期间,兰州市3家三甲医院儿童呼吸系统疾病日门诊量平均为387人次,范围1~1413人次.单污染物模型结果显示,PM_2.5、NO₂、SO₂、CO均在累积滞后一天（lag01）时效应量达到最大值,其浓度每增加10μg/m³（CO单位为1mg/m³）,儿童呼吸系统疾病就诊人次的超额危险度（ER）及95%可信区间（95% CI）分别为0.245%（95% CI：0.127%~0.363%）,0.568%（95% CI：0.327%~0.808%）,1.661%（95% CI：1.022%~2.302%）,2.245%（95% CI：1.610%~2.883%）;PM₁₀和O₃8h在各滞后天数均无统计学意义.对不同性别、年龄、季节分析发现,性别分层中PM_2.5对女童的影响略高于男童,NO₂、SO₂和CO的影响男童略高于女童;年龄分层发现PM_2.5、NO₂和CO的影响6~14岁组大于0~5岁组,SO₂的影响0~5岁组大于6~14岁组;季节分层中PM_2.5、NO₂、SO₂和CO对门诊量的影响只在冬季有意义,PM₁₀和O₃8h在各个季节均无意义.双污染物模型结果显示,分别调整其他5种污染物后,PM₁₀和O₃8h对儿童呼吸系统疾病门诊量的增加均无统计学意义;调整PM₁₀和O₃8h后,其他污染物呼吸系统疾病门诊量的增加均有统计学意义.兰州空气污染物（PM_2.5、NO₂、SO₂、CO）与呼吸系统疾病门诊量密切相关,并且SO₂和CO浓度增加更易增加儿童呼吸系统疾病的发病风险.性别、年龄和季节对空气污染物和呼吸系统疾病门诊就诊人次的关系有影响.     

Restraint use in the Eastern Province of the Kingdom of Saudi Arabia

Objectives: This study set out to examine seat belt and child restraint use in the Dammam Municipality of the Kingdom of Saudi Arabia, based on the premise that an increase in seat belt use would significantly reduce personal injury in traffic crashes. It was expected that local data would help identify intervention strategies necessary to improve seat belt use in the region.

Methods: The research involved 2 methodologies. First, 1,389 face-to-face interviews were conducted with male and female adults in regional shopping plazas regarding their own and their children's restraint use in their vehicles and reasons for these attitudes and beliefs. Second, 2 on-road observation studies of adult and child restraint use were conducted by trained observers. Occupants of approximately 5,000 passenger vehicles were observed while stopped at representative signalized traffic intersections.

Results: The findings showed front seat belt use rates of between 43 and 47% for drivers and 26 to 30% for front seat passengers; rear seat belt use rates were lower. While there seemed to be some knowledge about the purpose and reasons for restraining both adults and children in suitable restraints, this failed to be confirmed in the on-road observations.

Conclusions: Reasons for these rates and findings are discussed fully, and recommendations for improving seat belt use in the Dammam Municipality are included.     

Seat belt use among car drivers in Iranian safe communities: An observational study

Objective: The number of road traffic injuries and fatalities in Iran is high. The aim of the present study was to investigate the rate of drivers' seat belt use and a number of related factors in Kashmar, Bardaskan, and Khalilabad (Iranian Safe Communities).Methods: In 2014, driver observations were made at 48 road sites on intercity roads, main streets, side streets, and rural roads in these 3 cities.Results: A total of 10,255 vehicles were observed, with the overall rate of seat belt use being 51.8%. The rates in Kashmar, Bardaskan, and Khalilabad were 51.4, 56.3, and 47.7%, respectively. In Kashmar, the odds of seat belt use were higher among drivers who were female, older, and taxi drivers. Higher use was also found during the afternoon, and lower use was observed on rural roads. In Khalilabad the odds of seat belt use were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher on weekends and during the morning but was significantly lower on rural roads. Similarly, in Bardaskan the odds of using a seat belt were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher during the afternoon but was significantly lower on rural roads, in comparison to main streets and intercity roads.Conclusions: The rate of seat belt use in these 3 cities was found to be low, despite these cities being designated as International Safe Communities. Therefore, seat belt promotion programs, tougher regulations, stronger enforcement, public awareness campaigns, and more research are needed to promote seat belt use in these Iranian cities.