Logistic regression analyses were used to predict verdicts from 466 Canadian jury and 644 Canadian judge-alone criminal trials involving delayed or historic allegations of child sexual abuse. Variables in regard to the complainant and offence were selected from the legal, clinical, and experimental literatures, including mock juror research. Of six variables that had been related to decisions reached in mock juror research concerning delayed allegations of child sexual abuse (i.e., repressed memory testimony, involvement in therapy, length of delay, age of complainant, presence of experts, and frequency of abuse) two (age of complainant and presence of expert) predicted verdicts. An additional five variables (duration, severity, complainant-accused relationship, threats, and complainant gender) were also examined: of these, threats and the complainant-accused relationship reliably predicted jury verdicts. For judge-alone trials, five variables predicted verdict: length of the delay, offence severity, claims of repression, the relationship between complainant and accused, and presence of an expert. Implications of the jurors' and judges' differential sensitivity to these variables for future simulation and archival research are discussed.
A listing and description of longitudinal craniofacial growth record sets currently extant on the North American continent is provided. An argument is made for the preservation of these resources and for the generation of a pooled or shared image base of duplicate craniofacial physical records. This is a preliminary report and is assumed to be incomplete. In an effort to improve our accuracy and completeness, we invite corrections and additions.
Patient related care information is important over long periods of time. Thus it cannot be stored in running systems handling day by day information exchange. In the future, when the demands arise to use patient related information, neither the programmes nor the databases, in which the information once was fed, will be available. These facts imply that electronically stored patient related information must be electronically accessible and searchable and thus the information must be stored in a time-invariant way. In future use of patient related information it is of extraordinary importance both nationally, in the EU and internationally to use a standardised way to handle and access archived patient related information. Already in 1995 the search for a solution of these issues was initialised at the Health Informatics Department at Spri--the Swedish National Institute for Health Services Development. A number of internal reports have been produced as background information. Further work has to be carried out at relevant organisational levels in order to structure and logically harmonise an archiving format. The basic XML-format has been preliminary tested by a Spri project and found suitable. Spri has advised the Swedish National Board of Health and Welfare and the Swedish National Archive to issue directives concerning the use of XML as the archive-format for EHCR (Electronic Health Care Record) information.
This paper describes an effort to standardize the long term archiving format of the electronic patient record. A format is given in SGML (Standard Generalized Markup Language) and also tested as a prototype in a production system.
Currently several scientific journals only publish data from randomised clinical trials which are registered in a public database. Similar requirements on data sharing now follow grants from agencies such as the National Institute of Health. In Denmark the Health unit at the Danish Data Archive (DDA/Health) offers Danish researchers to keep their data for free on conditions that fulfil the above requirements. DDA/Health also passes on research data for reuse, and at present more than 300 studies are available in a database on sundhed.dda.dk.
In the United States, roughly one of every 100 children is subjected to some form of neglect or abuse; inflicted injury is responsible for approximately 1,200 deaths per year. Child physical abuse may manifest as virtually any injury pattern known to medicine. Some of the injuries observed in battered children are relatively unique to this population (especially when observed in infants) and therefore are highly suggestive of nonaccidental, or inflicted, injury. Worrisome injuries include rib fracture, metaphyseal fracture, interhemispheric extraaxial hemorrhage, shear-type brain injury, vertebral compression fracture, and small bowel hematoma and laceration. As noted, however, virtually any injury may be inflicted; therefore, careful consideration of the nature of the injury, the developmental capabilities of the child, and the given history are crucial to determine the likelihood that an injury was inflicted. The majority of these injuries are readily detectable at imaging, and radiologic examination forms the mainstay of evaluation of child physical abuse. Detection of metaphyseal fracture (regarded as the most specific radiographically detectable injury in abuse) depends on high-quality, small field-of-view radiographs. The injury manifests radiographically as a lucent area within the subphyseal metaphysis, extending completely or partially across the metaphysis, roughly perpendicular to the long axis of the bone. Acute rib fractures (which in infants are strongly correlated with abuse) appear as linear lucent areas. They may be difficult to discern when acute; thus, follow-up radiography increases detection of these fractures. For skull injuries, radiography is best for detecting fractures, but computed tomography and magnetic resonance imaging best depict intracranial injury.