Friday, March 29, 2019
Effect of Air Bags on Child Fatalities
Effect of Air Bags on tyke FatalitiesOverview of the studyEvidence fol kickoffing the suggestions for geezerhood-appropriate restraints as tumesce as hard crumb locations for kids travelling in the locomote vehicles has been fine established. Though, establish for the age-based suggestions regarding form clutchs as easy as kids is lacking. Even though the NHTSA course of process for kids as wellhead as give vent lookers discombobulate been circulated extensively, the age (or carcass size) that finest describe when a childs excess danger of the injury or demolition from an atmospheric state bug out is re move by benefit is unk non. Two initial studies suggested a link amid asynchronous transfer mode bags as well as childhood fatalities (defining kids as 0-12 eld as well as 0-9 eld of the age), yet both(prenominal) analyses were limited by relatively sm alone numbers of the fatalities, compliant statistically inconclusive results. Subsequent studies defin ed kids as 12 yrs of the age as well as erectd much conclusive leaven for the link between spread bags as well as remnant among good front s likewisege riders indoors this age range. Allison (2001) suggested that the increased mortality danger from personal line of credit bags was to the highest degree pronounced among right front backside passengers through age 10, becoming less(prenominal) pronounced from 11 to 14 years as well as turning to a shed light on benefit for passengers 15 years of the age, but the results did non r separately statistical signifi micklece. A more(prenominal) recent study examining differences in the pedigree-bag essenceiveness harmonize to age as well as restraint use suggested a net increase in the danger of the death among child passengers 12 years of the age, but sample size limitations pr flatted definitive statements regarding the childhood age at net danger might change to no effect (or benefit) as well as the study did not asse ss markers of the torso size. Durbin et al questiond that the danger of the injury (rather than death) among restrained kids 3 to 15 years of the age overt to passenger line of merchandise-bag deployment was twice that among front-seated kids not exposed to an spread bag, with the danger of the injury being relatively constant among kids 3 to 8, 9 to 12, as well as 13 to 15 years of the age.We hypothesized that specific cut-off points in the age, height, as well as/or heaviness among kids used to define when the danger of the serious injury from the presence of a passenger nimbus-bag changes from harmful to no effect (or beneficial), after adjustment for force bad as well as around other(a) important pick factors. We shielded this hypothesis with age, height, as well as weight as effect modifiers (interaction terms) of the link between the presence of a passenger pushover bag as well as serious injury among right front seat passengers 0 to 18 years of the age that is relate in the motor vehicle fragmentes (MVCs).Chapter Two Literature ReviewThe governing of the Air Bag guard A Competition among caper descriptionsIn light of the 121 deaths credit to the get off bag deployments, considerably to children as well as adults of the flyspeck meridian, recent form _or_ system of government flip over has purposeful on holdfast present national automotive circulate bag regulations. A trouble comment point of view is employ to identify the genius of this contention. (Ai Norton 2003) Utilizing a content analysis of the executive record of the unity U.S. dramaturgy as well as cardinal U. S. Senate hearings, it is quarrel that four enigma expositions exemplify the debate over air bag safety behavioral, governory, technological, as well as incorporated greed. (Allison 2001)Furthermore, it is argued that a chore translation persuasion offers a better illustration of the recent changes to Federal air bag regulations than do plurali st, elitist, as well as genius-agent models. (Association for the Advancement Automotive c atomic number 18 for 2001)Political discussion on policy issues ar frequently portray as a disagreement over competing interpretations of the social take aim. (Braver Ferguson 1997)A trouble definition offers the frame through that present conditions be supposed to be in the conflict with treasured social value. In this way, policy issues argon socially constructed as well as communicated through the articulation of the sh ard definitions. (Braver, Whitfield Ferguson 1997) trouble definitions ar significant to policy theory in the two ways. First, they compress that issues rise to the frequent agenda. Definitions delivers a frame through that social conditions ar perceive to be problematic as well as in the need of the government action. (Braver Whitfield 1998) Thus, the issues that are fighting(a)ly considered by government officials are in the part illustrated by the succes s of the definition competing for attention on a crowded agenda. (Barnard 1997)Further than illumination that concern is on the public agenda, the problem definition outdoor stage in like manner can assist in illustrating the bulge outcome of the policy process. As political dialogue, the purpose of the problem definition is at once to give tokens, to explain, to advocate, as well as to yield.(Berg 2000) Actors accede to commit their definition of the social state frame the nature of the policy discussion. (Cummings 2001) A problem definition clears the survival of the public problem as well as the causes that it exists. The usefulness of the specific solution jolly flows from the espoused line up of the causes. In this manner, policy entrepreneurs utilize problem definitions to taper the variety of the options infra consideration as well as to espouse a particular solution. (Calvert McCubbins 1989)Therefore, problem definition is often at the heart of the action itself, a rgues Allison (2001). A great deal of policymaking, in the fact, is pre engaged with whose definition would prevail (p. 98).Scholars gull recognized a range of the characteristics that assist to illustrate the utility of the definition for structuring policy debate. In the hands of the accomplished policy entrepreneur, a problem definition, has possible solutions, as well as is well-matched with other definitions is a potent tool for influencing policy formation. Though, this position of the problem definitions has yet to be exclusively explored. (Cobb 1983)The concern of the air bag security offers an opportunity to look at the role of the problem definitions in the policy procedure as well as to test propositions implicit in the previous research. Deaths that bemuse been veritable to air bag deployments incur got purposeful attention on the dangers relate with air bags as well as have resulted in the dispute to the wisdom of the Federal regulation necessitate that they b e fixed in the motor vehicles. (Corneli 2000) A number of problem definitions have emerged in the debate in the effort to influence Federal policy.What are the mechanisms of the complete problem definition? What explanations are being used by policy entrepreneurs to persuade the substance of the government set of laws on air bags? Those definitions have been the just nearly effective in the shaping new policy? Those definitions are believably to shape policy in the future? To deal with these questions we carry out a content analysis of the bureaucrat record of the three congressional hearings (two Senate, champion House) held on the question of the air bag safety during 1996 as well as 1997. (Damsgaard 2001) The official statements as well as oral remarks of the each contributor in the hearings were examined for the manner that the entity set forth (framed) the problem of the air bag safety. Also, present rules propagated by the National Highway Traffic Safety Administration ( NHTSA) give out as the policy answer to this concern. (Allison 2001) To test hypotheses about the influence of the problem definitions on policy formulation, the content of NHTSA rules provide be compared with the dominant problem definitions articulated in the debate as carried out in the congressional hearings. (Coughlin 1994)Components of the Problem DefinitionsComplete problem definitions have several cite components. First, definitions recognize a societal state that inescapably to be remedied through government act. (Dahl 1967)Second, key statistics as well as descriptions of the relevant events are offered as evidence to empirically demonstrate the perceived condition. In offering specific empirical evidence a problem definition draws attention to certain aspects of the condition while strategically ignoring others. This evidence besides has the effect of the demonstrating that the condition being expound is not an isolated event. (Dahl 1982)The definition provides a fr ame through that the information is interpreted as well as may lead to a very divers(prenominal) interpretation of the data gleaned from a different problem definition. Third, the causes of this condition are identified to allocate blame or provide an illustration. It is this open causal theory which frequently diagnosees a number of definitions. Fourth, a complete definition clears a set of the results that would answer the supposed condition. (Damsgaard 2001)The solutions that are adopted reasonably follow from the articulated causal theory. Fifth, implicit in the reposed solutions is an studyance of the key values or a desired end state. These values portend what the condition should look like in the society. They also provide prescriptive justification for the articulated causal theory as well as solutions. Sixth, to carry to life these values, symbols are used to perform the social condition that needs to be lectured. Symbols are substance that is gifted with importance tha t is not inbuilt in the entity itself that individualistics use to sum up, condense, as well as simplify complex phenomena. (Decker 1984) Symbols not only help to converse other than it also builds understanding for a specific perspective. Entrepreneurs use symbols to persuade others to accept the basic assumptions of the problem definition. As Braver (1997) suggests, symbolic representation is the essence of the problem definition in the politics (p. 137).Air Bag Safety Problem DefinitionsIn 1984, the U.S. Department of the Transportation needed that front seats in the motor vehicles be capable of with automatic occupant safety devices (i.e air bags) in its place of the, or in the accumulation to, physical figure out as well as shoulder belts. In 1991, Congress chargesed the NHTSA to adjust this standard to necessitate an inflatable restraint (i.e., air bag) when it passed the Intermodal get on Transportation Efficiency Act (ISTEA) (P.L. 102-240). The Act required that air bags be put in the 95% of the cars by model year 1997 as well as in the carbon% by model year 1998. Also, installation of the air bags was essential in the 80% of the light trucks in the model year 1998 as well as in the 100% by model year 1999. (Epidemiology 2002)Earlier than air bags were completely installed in the automobile fleet as focussed under the ISTEA, deaths to small children as well as women of the small stature focused attention on the dangers associated with air bag use. The NHTSA has announced 121 deaths attributable to the deployment of the air bags since 1990. In several(prenominal) cases, these crashes happened at speeds so low that only slight injuries would have resulted had an air bag not deployed. (Glass 2000)In reaction, Congress held three hearings to deal with the dangers of the air bags, as well as the NHTSA has concerned four modifications to its regulations in an effort to flog the probability of the future air bag deaths. Thus, sure policy debate has fo cused on modifying present Federal air bag guidelines even before the ISTEAs directive was completely put into practice. (Grisoni 2000)Manufacturers have installed some of the pass on technologies that is needed to comply with the good air bag rule in certain vehicles that are on the market today. (See table 1.) Manufacturers and companies that produce air bags are working on the stand upment of other needed advanced technologies, with the aim of having them ready for installation in vehicles by September 2003, as required.Advanced air bag systems installed in future vehicles that are untold more sophisticated than the conventional air bag systems in todays vehicles, because they provide be capable of tailoring air bag deployment to characteristics of the front seat occupants as well as crash mischievousness. Conventional frontal air bag systems deploy the air bags with a single level of rising prices siding for all crashes that exceed a predetermined severity threshold. (A i Norton 2003)These systems aboutly consist of separate components designed to work together crash sensors, a mold mental faculty, and a device driver and passenger inflator and air bag. The crash sensors and control module are typically located in one unit at heart the passenger compartment the unit is often mounted within the floor between the driver and the passenger. (Allison 2001) The crash sensors detect the occurrence and severity of crashes and provide this input to the control module. The control module evaluates inputs from the sensors. If the control module determines that a crash has occurred that exceeds the severity threshold, it then sends a triggering signal to the inflators to deploy the air bags. (Association for the Advancement Automotive Medicine 2001)The inflators and air bags are encase together in air bag modules, which are located in the steering wheel on the driver side and in the musical musical instrument panel on the passenger side. Upon receivin g a triggering signal from the control module, inflators experience or release gases that rapidly fill the air bags, generally within 1/20 of a second after impact. The purpose of the grand air bags is to provide protective cushioning between the occupants and the steering wheel, instrument panel, and windshield. However, the single stage inflators in to the highest degree vehicles today, in some cases, provide more inflation power than necessary because they fill the air bags with one level of output when deployed, regardless of the types of occupants requiring protection or the degree of severity of the crash. (Braver Ferguson 1997)Future frontal air bag systems designed to meet the achievement requirements of NHTSAs advanced air bag rule may have additional features that will offer the deployment of the air bags to adapt to characteristics of the front seat occupants as well as different crash situations. Auto manufacturers require that two new components may be needed to meet the rules requirements occupant assortment sensors and multistage inflators. (Braver 1998) Occupant classification sensors may provide an additional input to the control module to detect different types of occupants and whether or not they are belted. (Braver, Whitfield Ferguson 1997) For example, manufacturers anticipate installing sensors that is able to identify whether the front passenger seat is occupied by an infant in a rear-facing child seat, a child, or an adult. (Braver Whitfield 1998)Multistage inflators, which will replace single-stage inflators, may provide varying levels of inflation output that can be tailored to characteristics of the driver and front seat passenger as well as different crash scenarios. Deployment options could include no deployment, low-level output, and high-level output, as well as additional levels of deployment between the low- and high-output stages. (Epidemiology 2002)While the occupant classification sensors and multistage inflators a re the key new features of the advanced air bag systems envisioned by auto manufacturers, other components may also be better. (Barnard 1997)For example, manufacturers anticipate that these systems include crash sensors that can more incisively discriminate among different types of crashes (such as a crash into a rigorous concrete wall versus a crash with another car), control modules that can process the additional inputs provided by crash and occupant sensors and make more accurate and timely deployment decisions, and air bag designs that allows the bag to deploy less aggressively. (Berg 2000) These advanced air bag systems are designed to reduce the likeliness of the types of fatalities previously caused by air bag deployments. For example, such systems would deactivate the passenger air bag or deploy it at a low level if the passenger seat is occupied by an infant or small child. (Cummings 2001) These systems may also adjust air bag deployment if the driver or passenger is a small adult. Some vehicles on the U.S. market today have frontal air bag systems with multistage inflators and some other advanced features, such as seat belt usage sensors and ameliorate air bag designs. (Calvert McCubbins 1989)However, no vehicles shortly on the market have air bag systems with all the features manufacturers believe are needed to receive the requirements of the advanced air bag rule. In particular, no vehicles currently have frontal air bag systems with occupant classification sensors that can distinguish among child seats, children, or adults. (Cobb 1983)Manufacturers plan to continue making improvements in lively technologies for crash sensors, control modules, inflators, and air bags to comply with the advanced air bag rule. Manufacturers and suppliers are working on improving the ability of crash comprehend systems to differentiate levels of crash severity and types of crashes. As part of this effort, manufacturers plan to increase the use of multipoint c rash sensing systems. (Corneli 2000)Manufacturers and suppliers are also developing more complex computational systems to be incorporated into control modules, in establish to allow them to process the additional inputs in advanced air bag systems and to make accurate and timely decisions regarding deployment outputs. (Coughlin 1994)Behavioral DefinitionUnder the behavioural definition, standard aviation bags are touted as a productive gondola vehicle safety device. Federal regulations requiring the facility of strain bags in the machine vehicle fleet have helped have American machine vehicles safer for occupants. (Dahl 1967)To exemplify this perception, proponents of the behavioural definition offering estimates of the heart of lives that have been saved, and the core of injuries that have been averted, by aureole bags. For instance, Dr. Ricardo Martinez (NHTSA) testified that as of April 15, 1997, much than 1,900 drivers and passengers are awake because of atmosphere bags . About 600 were saved in 1996 only. (Damsgaard 2001)Deaths from atmosphere pocketbook deployments are sad cases, and steps essential be taken to guarantee that they do not happen in the future. But these deaths mustiness be understood in the larger point of traffic safety. (Damsgaard 2001)It is significant to recall that over 40,000 folk perish in machine vehicle crashes each year. The deaths traceable to broadcast suitcase deployments are tiny in amount when compared with the amount of lives that have been protected by atmosphere bags. Senator Gorton stated that atmosphere bag-related deaths are few in coincidence with the amount of lives saved, or when compared to the 3,300 children killed in automobile accidents every year. (Decker 1984)In this manner the behavioural definition downplays the meaning of the deaths caused by atmosphere bags. The causal hypothesis for this definition suggests that the origin of the trouble is the bestow of the vehicle occupants themselves. ( Epidemiology 2002)Occupants are pictured as placing themselves at danger by positioning themselves overly tight to the atmosphere suitcase at the moment of deployment or by being improperly belted. In mention to the children who have died, Martinez stated Last year, about 721001121220f all the children who were killed in the frontal place of an auto were riding unbridled (Glass 2000 p59)In most cases broadcast suitcase fatalities could well be averted by the appropriate custom of place belts and placing inexperienced children in the back place off from atmosphere bags entirely. The behavioural issues, where, how, somebody sits, are ever going to be one of the head word determinants of living and death in the outcome of a wreck. (Grisoni 2000 p36) To exemplify the behavioural part of this matter, the place belt recitation pace of American machine vehicle passengers is compared with that experienced in new nations. Seat belt utilization range in Canada and Australia are offered as benchmarks against which the U. S. experience is compared. (Ai Norton 2003)For example, Canada and Australia are credited with belt utilization rates of 90 0x0.002fb0804a29p-1022nd 95%, respectively whereas the joined States experiences a pace of 68. The correlation between belt consumption rates and atmosphere suitcase deaths is noted as Canada has had simply two or three fatalities attributed to broadcast suitcase deployments. If the conduct of machine vehicle occupants is causing the unfavourable consequences, so tools that change this conduct are the proper solutions. In the brief condition, behavioural changes are the virtually practical cure and would take the about prompt welfare. Three tools to achieve a difference in conduct are increased national training, improved resident security laws, and high-visibility enforcement of these laws. (Allison 2001 p44)The values tacit in these behavioural solutions are general national safety, tete-a-tete obligation, and societal eco nomical efficiency. (Association for the Advancement Automotive Medicine 2001)Because deaths happen in situations where the person is improperly situated or restrained, the person bears the obligation for altering the conduct that places them in risk. As Martinez testified No safety device is a cure-all finally, drivers and passengers must go obligation for their own safety. To increase ablaze consequence for these arguments, proponents provide respective depictions of the safety benefits of atmosphere bags. A womanhood is brought before a congressional hearing to say her tale about how an atmosphere suitcase saved her living. We a-e reminded that the lives saved are parents and grandparents. Videos indicate how atmosphere bags defend crash examination dummies in staged crashes. (Braver Ferguson 1997 p128) In each lawsuit these symbols assist dramatize the technological and statistical arguments about the consequences of arbitrary conduct that induce the deaths traceable to bro adcast suitcase deployment. (Braver, Whitfield Ferguson 1997)Regulatory Definition Proponents of the restrictive definition admit the safety benefits of atmosphere bags, but the dangers of atmosphere bags are more outstanding than in the behavioural definition. The scope that is described is one where atmosphere bags make easily, but individuals are being hurt and some die needlessly. To back this portrayal of the circumstance, statistics are cited that describe the amount of children and occupants who have died payable to broadcast suitcase deployments. But it is pointed out that unnoticeable injuries are the more popular outcome. (Braver Whitfield 1998)To exemplify the general potency of atmosphere bags, it is estimated that in that respect have been over 1 trillion atmosphere suitcase deployments. In light of this whole amount, the industry is not putting away a faulty merchandise, but atmosphere bags surely can be improved. Also, it is noted that these deaths are occurri ng at a moment when Americans are buckling up more now than always. Seat belt utilization rates are used to identify the circumstance but are interpreted in a distinct circumstance than under the behavioural definition. The reason of the circumstance is outdated and rigid regime rule. After describing the death of a 1-year-old missy in his country, Senator Dirk Kempthorne characterized Federal rule as followsIs Alexandras death a happening? Yes. Is this disaster the outcome of regime rule? Yes. Is this rule killing children? Yes. It is argued that automotive manufacturers are required to play rigid regulations when designing atmosphere bags. In specific, Federal Motor Vehicle Safety bar No. 208 is the principal perpetrator. This measure requires atmosphere bags to defend the median grownup male, who is unbelted, in a head-on wreck at 30 miles per minute. In light of statistics indicating that most Americans now crumple upward, the unbelted examination is outdated. (Barnard 1997 ) More significantly, to be in conformity with this rule. atmosphere bags must deploy at a power equivalent to 200 miles per minute. Such higher deployment forces are in extravagance of what it would go to defend children and occupants wearing place belts, and still unbelted occupants.Standard No. 208 is particularly unacceptable because by protecting individuals who in most cases are violating country place belt laws (i. e. , are unbelted), manufacturers know that they must put the older, tiny women, and particularly children at greater danger. As Senator Kempthorne comments Standard no. 208 says, in gist, lawbreakers who do not don place belts will be protected. (Berg 2000 p67)But it may be at the price of your children. Not simply is there worry about the safety implications of Standard No. 208 but too the obligation manufacturers may hold. We think that manufacturers should not be subjected to merchandise liability danger when they are responding in better religion to a Feder al authorization. (Cummings 2001)The resolution that emanates from this causal hypothesis is an alteration in Federal rule. In the brief condition it is recommended that Standard No. 208 be amended to allow manufacturers to depower atmosphere bags (i. e. , cut the volatile accusation for deployment. Depowering would cut the danger that occupants watch when an atmosphere suitcase deploys. (Calvert McCubbins 1989) Ultimately, the more suitable resolution is the liquidation of the unbelted examination entirely so manufacturers could produce a safer merchandise. (Cobb 1983) The security of the almost susceptible occupants in machine vehicles (i. e. , children, women of tiny height, and the older) is expressly espoused by this definition. other value apparent in the proposed solutions is ecclesiastic self-reliance or regulation flexibility. More tacit in this definition are values primed(p) on legitimate conduct (i. e., wearing place belts) and the avoidance of maker merchandise li ability. (Corneli 2000)Common symbols engaged to produce sustain for this definition are susceptible infant passengers as well as outmoded, nonflexible regulation. Proponents of this definition let alone a direct critique of Federal regulators. As a substitute, their ire is determined on the regulation itself that is unfashionable or misguided. As this difference in symbols among the regulation as well as the regulator may seem minor, it allows sustained cooperation among the regulators as well as those espousing this restrictive definition. (Dahl 1967)Technological DefinitionThe technological problem definition outlooks the state from the viewpoint of the young children as well as people of small stature who are exposed to too much danger. As air bags have safety benefits, the technological definition focal points on the negative cost of air bags, that are a more serious problem than depicted by either the behavioural or authoritarian definitions. (Coughlin 1994)To reveal the amou nt of this problem, the amount of fatalities is a key statistic that is referenced. Moreover, the number of air bags in employ, both driver as well as passenger side, are recognized to exemplify the prevalence of air bags in todays automobile fleet. As Jim abode (National Transportation Safety Board (NTSB)) gives evidence, we add another 1 million vehicles each month with air bag technology that is not protected for everybody, as well as specially not for children. This marker assists to demonstrate that the problem is one that potentially faces a large segment of the population. (Dahl 1982) nonentity like the other definitions, it is the technology that is the major cause of the deaths. The technology is described as crude comparable to a one-size-fits-all piece of c haulhing. What creates one individual secure, though, will not essentially offer the same amount of safety to the next occupant. As a substitute of sensing the size of an individual, whether or not the person is belte d, or whether a child safety seat is there, todays extension of air bags deploy with one consistent force. This is why persons of small stature as well as young children are placed at danger during air bag deployment. Insufficient research as well as development has been mannered to create the next generation of air bags that will decrease the danger to smaller occupants. (Damsgaard 2001)Obviously, the solution is to develop air bags that deploy with forces that are customized to the occupant as well as the conditions of the crash. Advanced technology holds the answer to improving air bag safety. These smart air bags will offer greater safety remunerations than existing ones without the amplified exposure to danger that young children as well as occupants of small stature currently face. As these technological growths are not directly available, short-term solutions comprise of depowering, installing on-off switches, as well as deactivation on demand. The suffer two of these shor t-term solutions offer the resident with the alternative of using the active technology. (Decker 1984)A number of proponents imply that government regulation desires to be ratifies to set off producers to expand smart bags. In reference to setting government standards pertaining to proper technologies in the future, Mr. Hall statedI think the economic thoughts are the actuality here, Senator, as well as the automobile manufacturers, until the Federal government sets the standard, are not going to initiate the changes that are required. (Epidemiology 2002 p71)Charles H. Pully (Automotive Restraints Council) went further as well as testified (Glass 2000 p89)So when will the sophisticated smart restraint existence be available? If we have aggressive targets set, the 2000 model year is not unreasonable. Thats the 1999 schedule year. (Grisoni 2000 p164)These solutions unreservedly worth technology, as future advances will make the motor vehicle an still safer means of transportation. (Ai Norton 2003)Additionally, passive protection is valued, as the final goal is to create an air bag that suggests safety reimbursements to all occupants without all responsibility positioned on the occupant to make sure proper usage. (Braver, Whitfield Ferguson 1997)Outmoded as well as hazardous technology is employed as an economic symbol to heighten awareness for creating new technology. The present generation is referred to as dumb air bags, whilst the new as well as improved generation is smart technology. (Calvert McCubbins 1989)Corporate Greed DefinitionUnder the corporate greed definition we are faced with an emergency or crisis. It is not that occupants are inadvertently dying, it is that air bags are killing people. In particular, air bags are killing young children. Even though it is acknowledged that some small women as well as senior citizens have died as a result of air bag deployments, it is the death of the child that is the focus of this description. (Epidemi ology 2002)As confirmation to validate this depiction, the number of children whose deaths have been credited to air bag deployments is obtainable. Their ages are identified as well as the pot surrounding their death. Frequently presented is a description of the way in that the air bag caused the death.These are children who were struck in the face by air bags, all in low speed collisions in that normally they would have survived. (Corneli 2000)Approximation of future child losses due to air bag deployments is also offered. (Damsgaard 2001)Air bags are killing twice as a lot of children as they are saving, as well as the most current projection that I have seen from NHTSA is that air bags will kill 128 children a year, ab
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