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From the Los Angeles Times

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An about-face on front-facing child safety seats

Doctors now say children should use rear-facing safety seats until at least age 2

by Patricia Callahan, Chicago Tribune

March 20, 2011

Chicago -- The nation's largest organization of pediatricians is telling its members and parents that children riding in cars should remain in rear-facing child safety seats at least until their second birthday — and preferably even longer.

This reverses advice many pediatricians gave parents for years that children's car seats should be turned around shortly after their first birthday.

The new policy from the American Academy of Pediatrics, published Monday in the Pediatrics medical journal, is bolstered by research that shows children under 2 are 75% less likely to die or be severely injured in a crash if they are in rear-facing child restraints.

Equally important, the academy recommends that children remain in seats with five-point safety harnesses as long as possible and should change to booster seats that rely on adult seat belts only when they exceed the height and weight limits for the five-point harness.

Five-point harnesses, which run across children's shoulders and hips and buckle between their legs, provide more protection than seat belts because they distribute the crash forces evenly over the strong, bony parts of children's bodies.

The pediatricians also recommend that children remain in booster seats until they are 4 feet 9 — a height most children don't reach until they are between 8 and 12 years old.

Even when children are tall enough to change to adult seat belts, the academy's policy is that they should ride in the back seat until age 13.

"Every parent wants their kids to achieve things as fast as they can," said Dr. Ben Hoffman, a University of New Mexico associate professor of pediatrics who helped write the new policy. "That's fantastic for developmental milestones or for school. But for child passenger safety, that's the wrong attitude to have."

The federal government is set to issue updated child seat guidance Monday that echoes the pediatricians' advice.

Although the use of child car seats has dramatically reduced deaths and injuries in the last decade, vehicle crashes remain the leading cause of death for children 4 and older. About 1,500 children under age 16 die in vehicle crashes each year in the U.S., the Pediatrics report said.

Dr. Dennis Durbin, an emergency room pediatric physician at the Children's Hospital of Philadelphia and the Pediatrics report's chief author, acknowledged that some parents and children might balk at aspects of the new policy. Durbin is a father who said he understood that older children were expert negotiators.

"There are certain things I'm willing to negotiate — bedtime, teeth brushing, broccoli for dinner — but safety is nonnegotiable," he said. "If parents establish that early in life, they'll get less pushback over time."

Durbin recommends that parents who have turned a safety seat to face forward on a child's first birthday reinstall that seat to face the rear. Many parents believe larger toddlers will be uncomfortable in rear-facing seats or will hurt their legs in a crash, but Durbin said they were mistaken.

When researchers at Durbin's hospital looked at children between the ages of 1 and 4 hurt in wrecks, leg injuries were rare for those in rear-facing seats, but they were the second most common injury for those in forward-facing seats, he said. That's because the legs of a child in a forward-facing seat are thrown forward in most crashes and can hit the console or the back of the driver's or passenger's front seat.

Rear-facing seats act like cocoons, cradling children's heads, torsos, arms and legs, and spread crash forces over a larger area.

http://www.latimes.com/news/nationworld/nation/la-na-car-seats-20110321,0,6083542,print.story

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OPINION

Libya: It's not our fight

Regardless of its good intentions, the U.S. intervention in Libya will be depicted once again as aggressive, predatory and anti-Muslim.

by Edward N. Luttwak

March 21, 2011

Once again the United States is bombing a Muslim country to liberate its people from their own sanguinary rulers. Once again we are told that innocent civilians are being massacred and that the United States must intervene as a matter of moral duty, in its capacity as a great and good nation. But in this case — even as part of a broader, U.N.-sanctioned coalition to enforce a no-fly zone — the U.S. should not have intervened at all.

No humanitarian appeal should ever be lightly dismissed, and indeed many Americans justifiably recall with deep regret the failure of the Clinton administration to intervene against the 1994 Rwandan genocide, when a few thousand lightly armed soldiers on the ground could have saved hundreds of thousands.

So why is Libya different? Why shouldn't the United States intervene there?

First, because it has oil and gas, and any U.S. military action will be seen by many people around the world as motivated exclusively by the urge to steal the country's resources. Absurd, of course, but the enemies of the United States will repeat that accusation, all too plausible for most people around the world, who cannot imagine that any government would be benevolent enough to expend blood and treasure to disinterestedly help foreigners, and foreigners of another religion to boot.

Photos: U.S., allies launch attacks in Libya

It is no use arguing that the military control of a territory and the ownership of its natural resources are very different things for any law-abiding occupier. That U.S. military forces made no attempt to seize, or even dutifully secure, Iraq's oil installations during or after the 2003 invasion is a fact known to few, and even when known it is dismissed as irrelevant, or as so much calculated deception. It is because the accusation is so widely believed that Iraqi political leaders have gone out of their way to negotiate oil contracts with non-U.S. companies, to demonstrate that they are not American puppets. (Shenhua Group, Sinochem, Unipec and China National Offshore Oil are all no doubt grateful to the United States for having given them access to Iraq's oil, even if they have not offered to contribute to the trillion-dollar cost of that intervention so far.) Whatever the United States does in Libya, it will only add to its undeserved but by now entrenched reputation as the predatory aggressor of our times.

The second reason why Libya is different from Rwanda is its religion. Look to our experience in Afghanistan, for example. Imams all over Afghanistan routinely denounce the U.S. intervention as a disguised attack on Islam, as a means to opening the way to Christianity. That includes imams salaried by the U.S. taxpayer by way of the Afghan government, which actually disburses the funds.

In an added twist, Afghan religious leaders often explain that the Americans promote the rights of women in order to encourage their rebellion against fathers and husbands, to thus dishonor Afghan families and weaken their resistance to conversion. Again, because no ordinary Afghan would dream of traveling halfway around the world to help Americans, or indeed anyone not of his own religion, such accusations are almost universally believed. They explain the otherwise inexplicable. True, some Afghans still say that it was because of the so-far unfound oil, gas or gold that the Americans came, but nobody believes the benevolent explanation.

Perhaps a recent terrorist attack against U.S. servicemen best illustrates the phenomenon. Arid Uka, who killed two U.S. airmen and wounded two more at Frankfurt airport on March 2, was heard shouting "Allahu akbar" ("God is great") as he fired his 9-millimeter gun. He is from Kosovo, now emerging as Europe's first Muslim state as a result of the 1999 NATO air war against the territory's former Serbian overlords.

Many of Kosovo's inhabitants are duly grateful to the U.S. for their liberation. But there are imams preaching against the pernicious influence of the United States and the West in Kosovo — more loudly of late because of a headscarf ban in its schools. Although local Muslim leaders imposed the ban, with no U.S. involvement, the imams say otherwise, while also condemning U.S.-led invasions of Muslim lands.

Indeed, Uka's stated motivation for the shooting was a purported Internet video that showed U.S. troops raping Muslim women in Afghanistan. He was unable to retrieve any such video for the German police. None seemingly exists, but he no doubt heard about it in his local mosque.

It is unforgivable to repeat the same mistakes in Libya. Regardless of its good intentions, the United States will be depicted once again as predatory and anti-Muslim, generating more terrorism in due course. Even the much-praised resolution of the Arab League that calls for a no-flight zone warned against any "invasion" and ruled out any attack on Libyan air defenses — the signatories obviously did not mind if the (presumably American) patrolling pilots were thereby exposed to antiaircraft missiles.

The U.S. military ignored this, but cruise missiles and aerial bombs do not just destroy missiles, they also kill people, and there will soon be Hezbollah-style displays of dead children for Al Jazeera. Let the Arab League or the far larger Organization of the Islamic Conference with its 57 members, which possess first-line jet fighters and troops, mount a humanitarian intervention at their own cost in money and blood.

At least the United States would not be accused of attacking Islam once again.

http://www.latimes.com/news/opinion/commentary/la-oe-luttwak-libya-20110321-31,0,7179073,print.story

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From the New York Times

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Trial to Open in Lawsuit Connected to Hospital Deaths After Katrina

A jury trial set to open on Monday will weigh whether one of America's largest health care corporations should be held accountable for deaths and injuries at a New Orleans hospital marooned by floodwaters after Hurricane Katrina.

The class-action suit is expected to highlight desperate e-mail exchanges, not previously made public, between the hospital and its corporate parent.

“Are you telling us we are on our own and you cannot help?” Sandra Cordray, a communications manager at Memorial Medical Center, which sheltered some 1,800 people, wrote to officials at the Tenet Healthcare Corporation's Dallas headquarters after begging them for supplies and an airlift.

The suit, brought on behalf of people who were at the hospital during the disaster, alleges that insufficiencies in Memorial's backup electrical system and failed plans for patient care and evacuation, among other factors, caused personal injury and death.

The complaint also focuses attention on the lack of comprehensive emergency preparedness requirements for the nation's hospitals. Proposed regulations aimed at addressing “systemic gaps” identified after Katrina were scheduled for release by the federal Centers for Medicare and Medicaid Services in January, but have been delayed. President Obama's budget proposal trims spending on a national hospital preparedness program by $42 million, or about 10 percent from current levels.

The bodies of 45 patients were discovered at Memorial Medical Center after the August 2005 storm, far more than at any other hospital, and some doctors subsequently acknowledged that they had injected patients with drugs to hasten their deaths. No criminal charges were brought. Last year, a relative of a patient who died filed a civil claim of euthanasia against a Memorial doctor. It was dismissed and is on appeal.

Staff members at Memorial said they did their best in the face of inhuman conditions.

“The doctors didn't create that environment. The hospital created that environment,” said Joseph M. Bruno, one of the lead lawyers for the class-action plaintiffs. He said no physicians had opted out of the class and some might testify at the trial in New Orleans.

The hospital and Tenet deny the allegations.

“We are confident that in the end, the evidence will show that Memorial Medical Center and its staff and physicians acted heroically in the face of such a tragic situation,” Rick Black, Tenet's director of communications, said in a statement.

Lawyers for Tenet and Memorial have lined up experts to testify that the city's failed levees, a chaotic government response and the huge hurricane are what created the deadly environment. Plaintiffs' lawyers have moved to exclude all such evidence from consideration, arguing that it is irrelevant to the duty the hospital had to its patients.

One issue almost certain to figure in the trial is the extent to which executives at Memorial and other hospitals understood the possible dangers of flooding. It has been previously reported that Memorial did not act on a 2004 recommendation to move components of its electrical system above the ground floor. New documents raise questions about whether design, maintenance or other factors led to the total failure of backup power after the floodwaters rose.

Even before all power was lost, Memorial's air-conditioning shut down, by design. American hospitals are required to maintain emergency power systems, but they do not have to support air-conditioning or heating.

According to employees, temperatures inside Memorial soon rose to over 100 degrees, threatening older patients in particular. Among them was 70-year-old Leon Preston, an amputee who died at Memorial and whose family's case is part of the lawsuit.

Memorial's hurricane plan assumed that backup power would function for at least three days, but the system failed in less than two.

At least some hospital employees were aware that the system would be at risk in a flood. Memorial's director of plant operations learned from the Army Corps of Engineers in 2004 that the hospital could be surrounded by 12 to 15 feet of water after a major hurricane. The director, Eric Yancovich, who also served as safety officer, recommended raising basement and ground-level emergency power transfer switches and the pumps that supplied most of the hospital with medical air and vacuum suction — needed by patients with respiratory problems.

A partial bid for the electrical work came to more than a quarter of a million dollars. “Due to the lack of capital, I don't anticipate anything being approved right now,” Mr. Yancovich concluded in a memo to his supervisor. “I'll keep it on file for future consideration.”

Given these vulnerabilities, the hospital should have warned patients and visitors away before the hurricane, according to Mr. Bruno, the plaintiffs' lawyer. “Fundamentally, they could have told their patients: ‘It's not safe for you. Go.' ”

The mayor's pre-storm evacuation order specifically exempted hospitals, even though a 2002 poll by the city's health director revealed deficiencies in generators and evacuation plans for flooding. Hospital evacuations are costly and risky, and hurricanes often change course. According to the minutes of a statewide hospital emergency conference call held the day before landfall, nearly all hospitals had either generators, electrical switches or both at ground level, yet they chose not to evacuate.

An expert hired by the plaintiffs, Jerry Watts, concluded that the floodwaters shorted out Memorial's electrical transfer switches and many distribution panels, much as the plant operations director had predicted. However, Gregory Gehrt of ccrd Partners, an expert hired by Tenet, attributed the power shutdown to mechanical problems in the hospital's three 750-kilowatt diesel generators, which were located well above the water.

Codes and standards require only that potential for flooding be given “careful consideration” in electrical-system design. Hospital generators must be tested monthly, but for short periods, unlike what would be needed in a major disaster.

A central question likely to be raised at trial is why Tenet did not try to hire private helicopters immediately after Ms. Cordray's call for help. A vice president of the Federation of American Hospitals also appealed to Tenet for medevac resources that day, saying that Senator Mary Landrieu 's office was “begging us to help them fill in emergency rescue gaps in Louisiana.”

Tenet officials have said publicly that they did not hire private helicopters until the following day, after emergency officials told them that Memorial was low on the state's evacuation priority list and that they would need to use private resources to get patients out quickly. Before that, they said, emergency officials told Tenet that Federal Emergency Management Agency and National Guard troops were coordinating hospital evacuations, and that it would not be possible to get into the city.

Tenet corporate headquarters did not have an emergency command system in place and established one as the disaster unfolded. Company officials lobbied hard to get federal rescuers to prioritize Memorial, warning that dozens of patients were in danger of dying. Ultimately, the company spent more than $1 million on airplanes, buses, ambulances and security personnel to support its six hospitals in the region, a portion of which was later recovered from insurance.

Tenet Healthcare Corporation has since sold Memorial and its other Louisiana hospitals. Tenet bills itself as one of the largest publicly owned health care companies in the country, listing operating revenues of $9.2 billion in 2010. Tenet's 49 hospitals in 11 states counted more than a half-million admissions that year, and its outpatient centers treated nearly four million. Tenet's corporate structure includes more than 400 subsidiaries.

Claims were also made against Lifecare, a separate health care company that leased space at Memorial to operate a long-term acute-care hospital, many of whose patients died awaiting evacuation. It reached confidential settlements with all but one plaintiff and is not a defendant in the class-action suit.

http://www.nytimes.com/2011/03/21/us/21hospital.html?_r=1&ref=us&pagewanted=print

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EDITORIAL

False Confessions

Douglas Warney, a person of limited mental capabilities who has been diagnosed with AIDS and AIDS dementia, served nine years in New York State prisons for a murder he did not commit. Now the state is seeking to compound the injustice by denying Mr. Warney compensation, even though there is a state law to provide redress for people who are wrongly convicted. New York's highest court, which is considering his case, should not permit it.

Mr. Warney was convicted in 1997 based on a false confession that contained incriminating details the police said only the real killer could know. Mr. Warney's wrongful conviction rested on that signed confession. There was no physical, eyewitness or forensic evidence tying him to the crime, and he was exonerated in 2006 by DNA evidence that showed the murder was actually committed by a man Mr. Warney had never met.

New York State has primarily argued, and lower state courts have rashly agreed, that Mr. Warney's false confession makes him ineligible for compensation because the Unjust Conviction and Imprisonment Act bars recovery for those whose own misconduct caused their conviction.

That limit was meant to weed out deliberate misconduct to gain some tactical advantage, say a confession intended to conceal a loved one's guilt. Mr. Warney's false confession was not the product of misconduct. It was the reaction of a particularly susceptible individual to common police interrogation techniques that sometimes cause innocent people to confess. That phenomenon was illuminated in a friend-of-the-court brief filed by the American Psychological Association.

Peter Neufeld of the Innocence Project, who represents Mr. Warney, says roughly a quarter of DNA exonerations in New York have involved false confessions.

If there was misconduct in Mr. Warney's case, it was on the part of police officers, who fed him “held back” facts about the murder and then claimed those facts in his typed confession originated with him, providing reliable proof of his guilt. When the case was argued before the Court of Appeals in February, several judges seemed troubled by these circumstances.

A ruling making clear that a false confession does not per se bar recovery under New York's law would honor its language and intent and provide a measure of justice for Mr. Warney. It would set a worthy example as states with similar statutes confront the same issue.

http://www.nytimes.com/2011/03/21/opinion/21mon3.html?ref=opinion&pagewanted=print

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From Google News

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Slain officer always gave 110 percent

Associated Press

March 21, 2011

FOND DU LAC, Wis. -- The aunt of the Fond du Lac police officer who lost his life in the line of duty says her nephew was focused on serving and protecting his community.

Twenty-eight-year-old Craig Birkholz was fatally shot and another officer was critically injured during a six-hour standoff at a suspect's house Sunday.

Birkholz's aunt, Patty Brown of Kenosha, says her nephew "always gave 110 percent" and was "exceptional young man." Brown says Birkholz aspired to join the FBI and saw his service as a police officer as a stepping stone to that goal.

The Fond du Lac Reporters says Birkholz joined the Army after graduating from Kenosha's Tremper High School. Then he joined the Army and served tours in Afghanistan and Iraq. Birkholz married in 2009.

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The Fond du Lac Reporter's report can be found at: http://bit.ly/gpZLSy

http://www.chicagotribune.com/news/chi-ap-wi-officerkilled-wis,0,1090415,print.story

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