Relationship of Serum S100B and Intracranial Injury in Children with Accidental Closed Head Trauma

S100B, a calcium-dependent protein produced by astroglial cells in the central nervous system (CNS) and by chondrocytes, functions as both a neurotrophin and neurotoxin. It has a half-life in the systemic circulation of approximately six hours. We examined whether serum levels of S100B would be predictive of intracranial injury (ICI) in children, as detected by cranial computed tomography (CT), in children with closed head trauma (CHT). In addition, we evaluated the effect of long bone fractures on the level of S100B in children with both CHT and extracranial injuries such as long bone fractures. One hundred fifty-two children, who presented to the Pediatric Emergency Department of Yale-New Haven Children\u27s Hospital, within six hours of accidental CHT, and required CT to exclude ICI, were prospectively enrolled. After informed consent from a caregiver, samples were obtained by venipuncture and analyzed for a quantitative serum level of S100B. Of the 152 children enrolled in this study, 24 had an ICI. Mean S100B levels were significantly greater in children with ICI (0.212 μg/L vs. 0.084 μg/L; p\u3c0.001), in children with long bone fractures (0.220 μg/L vs. 0.083 μg/L; p\u3c0.001), and in children who were non-white (0.127 μg/L vs. 0.081 μg/L; p=0.03). Sixty-two percent of children with ICI had venipuncture performed more than 120 minutes after head injury. After controlling for time of venipuncture, fractures, and race, mean S100B levels were still greater in children with ICI (0.409 μg/L vs. 0.118 μg/L; p\u3c0.001). The discriminatory value of S100B to detect ICI, as determined by the area under the receiver operator characteristics (ROC) curve, was 0.67. Further study of S100B is necessary to determine whether this biochemical marker could serve as a useful adjunct in the evaluation of children with CHT

The Cost of Criminal Justice in West Virginia

The National Commission on Law Observance and Enforcement, generally known as the Wickersham Commission, is popularly associated with prohibition, as critic, protagonist, propagandist, or apologist, depending upon the point of view. The more fundamental aspects of its work have escaped popular attention. The first two reports dealt with the problem of national prohibition. Twelve more were devoted to other phases of crime and its treatment. Here attention is to be devoted to the Report on the Cost of Crime in an effort to determine the economic burden through taxation, private expenditures, and economic loss which results from the necessity of suppressing crime and correcting the criminal in modern society? The tremendous scope of this project is apparent to the most casual observer. Innumerable jurisdictions throughout the states are attempting, each in its own way with varying costs and equally varying success, to eliminate crime. The sheer expense of this effort must be a matter of wide concern. The determination of the cost of the administration of criminal justice reveals little aside from the approximate drain upon economic resources due to the perversity of humanity. It indicates, moreover, little of importance with regard to the absolute or even the comparative effectiveness of the governmental agency which happens to be the object of the expenditure. The infinite variety of conditions, not alone throughout the states, but even among the cities of the same state, makes practically barren any attempt to match against each other the cost elements of different jurisdictions. Such comparisons reveal only resultant conditions, but the causal factors are beclouded with influences beyond the application of statistical methods. To imply in variations of expense definite elements of causation would require that all factors be reduced to a basis of absolute equality. This is not possible. The degree of effectiveness of the discharge of governmental functions must, therefore, be measured in some other way. Cheap government is not necessarily good government, nor is costly government necessarily inefficient. False economy often masquerades as efficiency. The attempt to determine cost is limited to the measurement of what the crime bill of the nation is. Whether to accomplish the desired result it should be more or less than present figures show is quite another matter. The purpose of this paper is to assemble and present the elements of criminal cost which bear upon the State of West Virginia. The present writers co6perated with the directors of the national investigation of the cost of crime in studying conditions in certain municipalities of the State. At this time the results, hardly to be termed conclusions, are presented, together with other pertinent material which has been taken from the extensive national report. At the risk of incurring justifiable criticism for exaggerating the implications of these statistics, it is suggested that further study along these lines may contribute to a better planned and more effective administration of criminal justice in the wider field of social benefit in the State of West Virginia

WE WON'T TURN BACK: THE POLITICAL ECONOMY PARADOXES OF IMMIGRANT AND ETHNIC MINORITY SETTLEMENT IN SUBURBAN AMERICA

This study investigates the intersection of suburban political economy and recent immigrant and ethnic minority suburbanization in the United States. It uses both quantitative and qualitative methods to address: what factors lead various minority groups to move to multi-ethnic areas called suburban melting pot metros (SMPMs); how these spatial location decisions vary by class or race-based preferences; and how suburban institutions respond to the issues raised by immigrant and ethnic minority groups. Using the 1990 and 2000 Census Public Use Micro-data Series (PUMS), I test some key theories of residential migration, including spatial assimilation, place stratification, and 'economic sorting'. In a multivariate logit regression analysis, between non-Hispanic whites, blacks, Asians, and Latinos, residing in 29 US suburban areas, I find that SMPMs attract groups with lower levels of educational attainment. Moreover, rising income increases the likelihood that blacks and Latinos seek multi-ethnic suburban residence. While racial change had little impact on SMPM settlement, post-1980s immigration and linguistic isolation were significant predictors of SMPM settlement. Rises in housing values are likely to increase SMPM settlement for whites and Asians, but property tax increases are not a significant predictor of SMPM settlement for any of the groups. These Census results are supplemented by a case study of suburban Washington, DC. Data from five focus group discussions between black, Chinese, Iranian, Korean and Latino groups reveal that quality schools, safe neighborhoods, employment and housing opportunities, and pre-established family ties commonly attracted these individuals to certain suburban DC jurisdictions. Spatial location decisions, particularly for blacks, are limited by income. Perceptions of a county's ability to deliver local goods and services or the race/ethnicity of current county residents also influenced location decisions. Finally, using qualitative data from a collection of 114 in-depth interviews with elite officials in suburban Washington, DC, I develop a concept called 'Suburban Institutional Interdependency' (SII) to examine how local institutions respond to the issues raised by immigrant groups. The central tenets of this approach suggest that through repeated interactions, generalized reciprocity, and an exchange of selective incentives, suburban institutions may collaborate, to meet the needs and demands of suburban newcomers