Perpetrators of abusive head trauma: a comparison of two geographic populations.

BACKGROUND: Abusive head trauma accounts for significant morbidity and mortality in infants. We compared a Southern population of victims with those in a previous study of a Western population, which found that men, particularly fathers and mothers' boyfriends, are the most common perpetrators. METHODS: All cases of child abuse identified in a teaching hospital were prospectively reviewed for cases of abusive head trauma, and the perpetrators were identified. RESULTS: Of the 76 cases of head trauma identified, 27 met the criteria for the study. The demographics of the perpetrators closely match those of the Western group. Men are the predominant perpetrators, with fathers committing 45% and boyfriends 25% of these injuries. CONCLUSIONS: Despite the differences in study design and population demographics, men are the most common perpetrators of abusive head trauma in both populations.

Abusive head trauma: the relationship of perpetrators to their victims.

OBJECTIVE: Abusive head trauma is the most common cause of morbidity and mortality in physically abused infants. Effective prevention requires the identification of potential perpetrators. No study has specifically addressed the relationship of the perpetrators of abusive head trauma ("shaken baby syndrome") to their victims. The objectives of this study were to identify the abusers and their relationship to victims in these cases. METHODS: We reviewed the medical charts of 151 infants who suffered abusive head trauma to determine the perpetrator of the abuse. Caretakers were classified by level of certainty: confession to the crime, legal actions taken, or strong suspicion by the staff. The relationship of abusers to victims was analyzed. RESULTS: Male victims accounted for 60.3% of the cases. Twenty-three percent of the children died, although death rates for boys and girls did not vary significantly. Male perpetrators outnumbered females 2.2:1, with fathers, step-fathers, and mothers' boyfriends committing over 60% of the crimes. Fathers accounted for 37% of the abusers, followed by boyfriends at 20.5%. Female baby-sitters, at 17.3%, were a large, previously unrecognized group of perpetrators. Mothers were responsible for only 12.6% of our cases. All but one of the confessed abusers were with the child at the time of onset of symptoms. CONCLUSIONS: Our data suggest male caretakers are at greater risk to abuse infants. Baby-sitters are a concerning risk group, because they represent a significant proportion of abusers, and they more easily escape prosecution. In addition, no prevention efforts have been directed at baby-sitters. These statistics could help change the focus of efforts to prevent abusive head trauma.

Structure of 1,1,5,5-tetranitro-[4]peristylane. Structure solution from molecular packing analysis.

The structure of the title compound, decahydro-2,2,5,5-tetranitro-1,6:3,4-dimethanocyclobuta[1,2: 3, 4]dicyclopentene, C12H12N4O8, was solved with the molecular packing program MOLPAK, starting with an AM1-geometry-optimized model of an isolated molecule. The 20 best predicted crystal structures from the MOLPAK procedure were subjected to lattice energy refinement with the WMIN program. A structure-factor calculation with the top MOLPAK/WMIN derived structure and the 197 Fo data to sin theta/lambda = 0.324 A-1 (theta = 30 degrees) gave an R value of 0.29. Final R = 0.057, wR = 0.067 for 730 reflections with I > 3 sigma (I). There are no unusual intermolecular distances and crystal packing is normal.

A fast, portable desaccading program.

This short communication reports a program for detecting and removing saccades, quick phases and blink signals from eye movement records to allow determination of slow phase eye velocity (SPV) during vestibular stimulation. The program is written in C and is simple, fast, and independent of computer type.