Forensic Department Research Articles

The magnitude of parental physical harms: a descriptive report of 76 abusive children in Isfahan.

Victimization of parents by their children is a widespread phenomenon. However, there is a shortage of literature regarding the abusive behavior of children in Iranian society. The primary focus of this study was to highlight the magnitude and nature of the abusive behavior of a handful of Iranian children toward their parents. The sample study comprised 76 cases referred to the Isfahan Forensic Department (IFD) from September 2015 to October 2016. Data were computer analyzed using SPSS-21 by running a couple of descriptive-analytical tests. Most of the victims were elderly mothers above 60 years old. The victims were mostly injured in the neck and head. The majority of the offenders were between 20 to 30 years old, unemployed, with a family history of substance abuse. Significant differences (p less than 0.05) were observed in some variables: gender (women), age (over 60 years), harassment in the residence, having financial authority, 4 children or more (in victims group) and unemployment, single, age between 21-30 years (in offenders group). Children's abusive behavior towards their parents is a multifactorial phenomenon. Family constitution and background appeared to play a pivotal role in shaping the offenders' social behavior and reaction to their parents. Nonetheless, there is a need to explore further the possible causes of parental victimization.

Psychological autopsies: religious and spiritual factors for suicide in cases and controls.

In recent years, there has been a growing body of evidence supporting the notion that spirituality and religion can improve one's physical and mental health. Studies show that religion and spirituality play a significant role in the suicidal path. Considering the dearth of data on the patterns of suicidal thoughts, acts and related factors in Pakistan, a country with a large Muslim population and stigma with sociocultural perceptions of religious notions, the current study investigated the role of religious and spiritual factors of suicide using psychological autopsies. Purposive sampling was used to gather retrospective data records from police stations and hospital forensic departments in Rawalpindi and Islamabad, Pakistan, between January 2021 and July 2022. In total, 60 samples (30 cases and 30 controls) were used in this autopsies investigation. As with the majority of case control studies, the study sample cases were matched with the controls. At least two close bereaved family members served as the primary information sources, and data was gathered using the Semi Structured Interview Protocol for Psychological Autopsies. According to statistical analysis, both the suicide cases and the controls were comprised mostly of Muslim individuals. They follow Islam and hold the view that suicide is prohibited, forbidden, and haram in Islam. Regarding spirituality and religion, the majority of cases, according to the respondents interviewed, were not spiritual at all, while the controls are slightly spiritual. While the majority of both cases and controls had reduced interest in or practice of religious activities over the past year, a higher number of cases rarely performed and attended the religious services/activities as compared to controls. It was thus evident that the cases lacked significant engagement in spiritual and religious activities, and their attendance at such gatherings had notably decreased in the year preceding the suicide attempt. This decline in involvement in spiritual and religious practices might be linked to decreased levels of satisfaction, sense of belongingness, which could raise the risk of suicide. Therefore, in nations where Muslims predominate, culturally relevant suicide prevention initiatives including spiritual and religious treatments aimed at reducing the risk of suicide should be considered.

Adverse effect of Abuse During Childhood on Criminal Behavior and Type of Crime among Prisoners at Forensic Mental Health Department

A quantitative approach using a descriptive-analysis design was used in the present study to find out the impact of child abuse on criminal behavior among prisoners in the forensic department. The period of the study was from 16th of October 2023 to 10th of June 2024. The study has been conducted at Al-Rashad Training Hospital which is located in of Baghdad City. Non-probability sampling techniques in which prisoners are selected because they have characteristics that we need in our sample. In other words, prisoners are selected “on purpose” as purposive sampling. Also the judgmental sampling, this sampling method relies on our judgment when identifying and selecting the prisoners that can provide the best information to achieve the study’s objectives. We choose purposive sampling because the researcher wants to focus in-depth on relatively small samples. A purposive sample of (110) prisoners was selected from Al-Rashad Training Hospital. The study sample in this research was selected from prisoners in the forensic department in the hospital. Results: Prisoners have moderate to high level of psychological abuse during childhood. They have moderate to high level of physical abuse during childhood. prisoners having moderate to high level of sexual abuse during childhood. Also they have moderate to high level of neglect during childhood. As overall prisoners have high level of abuse during childhood. prisoners having moderate to high level of criminal behavior subdomain (socialization). related to criminal behavior subdomain (Social conditions) among prisoners; the findings indicates that prisoners having moderate to high level of criminal behavior subdomain (Social conditions) among items. The findings indicates that prisoners having moderate to high level of criminal behavior subdomain (Personal and psychological circumstances) among items. Prisoners have high level of criminal behavior as overall. There is high significant relationship between Abuse during childhood and Criminal behavior at p-value= .004. There are significant relationships between (psychological, physical, sexual abuse) during childhood and criminal behavior at p-value= 0.05. There are no significant relationships between neglect during childhood and criminal behavior. There is no significant relationship between Abuse during childhood and type of crime at p-value= .05.

Impact of Psychological Abuse, Physical Abuse, Sexual Abuse, and Neglect During Childhood on Criminal Behavior among Prisoners at Forensic Mental Health Department

Introduction: Childhood maltreatment, including physical, emotional, sexual abuse, and neglect, has been consistently linked to a higher likelihood of aggressive and criminal behaviour in adulthood. This phenomenon, often referred to as the "cycle of violence," perpetuates across generations. Furthermore, victimization during childhood can lead to a broad range of mental health problems, including personality disorders, psychosis, schizophrenia, and substance abuse. These issues are particularly prevalent among individuals within the forensic mental health system. Objectives: The study aims to evaluate the impact of psychological abuse, physical abuse, sexual abuse, and neglect during childhood on criminal behaviour among prisoners at forensic mental health department. Methods: A cross-sectional descriptive study was conducted to determine the impact of child abuse on criminal behaviour among prisoners in the Forensic Medicine Department. The study was during the period from December 19, 2022 to 15th of July 2024. The research has been carried out at Baghdad City's Al-Rashad Training Hospital. non-probability purposive sample procedures, this study sampling method relied on our judgment when identifying and selecting prisoners in the forensic medicine department, after their consent, who could provide the best information to achieve the objectives of the study. We choose purposive sampling because we want to focus in depth on relatively small samples (150) to get the most accurate results. a purposive sample of (110) prisoners was selected from Al-Rashad Training Hospital. Results: The findings indicate that prisoners having moderate to high level of psychological abuse during childhood among items. Prisoners having moderate to high level of physical abuse during childhood among items. The findings indicate that prisoners having moderate to high level of sexual abuse during childhood among items. The prisoners having moderate to high level of neglect during childhood among items. The prisoners have high level of criminal behaviour. There are significant relationships between (psychological, physical, sexual abuse) during childhood and criminal behaviour. Conclusions: Prisoners experience a moderate to high level of psychological abuse, physical abuse, and neglect during childhood, and the prisoners also experience a moderate to high level of sexual abuse during childhood.

Lost years, mortality burden: the impact of COVID-19 pandemic on premature death due to road traffic accidents in a northern state in Malaysia

BackgroundThis study addresses the persistent global burden of road traffic fatalities, particularly in middle-income countries like Malaysia, by exploring the impact of the COVID-19 pandemic on Road Traffic Accident (RTA) fatalities in Perak state, Malaysia, with a secondary focus on applying Years of Life Lost (YLL) to understand the implications of these premature deaths.MethodologyThe cross-sectional study retrospectively reviewed certified RTA fatalities from 2018 to 2021, individually counting fatalities in accidents and excluding cases with incomplete death profiles. Data were collected from all Forensic Departments in the government hospitals in Perak. RTA fatalities were confirmed by medical officers/physicians following established procedures during routine procedures. A total of 2517 fatal accident and victim profiles were transcribed into data collection form after reviewing death registration records and post-mortem reports. Inferential analyses were used for comparison between pre- and during COVID-19 pandemic. The standard expected YLL was calculated by comparing the age of death to the external standard life expectancy curve taking into consideration of age and gender in Malaysia.ResultsThis study included 2207 (87.7%) of the RTA fatalities in Perak State. The analysis revealed a decreasing trend in RTA deaths from 2018 to 2021, with a remarkable Annual Percent Change (APC) of -25.1% in 2020 compared to the pre-pandemic year in 2019 and remained stable with lower APC in 2021. Comparison between pre-pandemic (2018–2019) and pandemic years (2020–2021) revealed a difference in the fatality distribution with a median age rise during the pandemic (37.7 (IQR: 22.96, 58.08) vs. 41.0 (IQR: 25.08, 61.00), p = 0.002). Vehicle profiles remained consistent, yet changes were observed in the involvement of various road users, where more motorcycle riders and pedestrian were killed during pandemic (p = 0.049). During pandemic, there was a decline in vehicle collisions, but slight increase of the non-collision accidents and incidents involving pedestrians/animals (p = 0.015). A shift in accident from noon till midnight were also notable during the pandemic (p = 0.028). YLL revealed differences by age and gender, indicating a higher YLL for females aged 30–34 during the pandemic.ConclusionThe decline in RTA fatalities during COVID-19 pandemic underscores the influence of pandemic-induced restrictions and reduced traffic. However, demographic shifts, increased accident severity due to risky behaviors and gender-specific impacts on YLL, stress the necessity for improved safety interventions amidst evolving dynamics.

Autopsy-Based Study of Non-accidental Violent Neck Asphyxia in Jordan: A Retrospective Study.

Background There is a global increase in the number of deaths caused by violent neck asphyxia, which includes both suicides and homicides. This research presents autopsy-based findings and analytical demographic data that are pertinent to significant medicolegal cases. Methods A retrospective examination of 113 autopsy reports of non-accidental violent neck asphyxia reported to the forensic pathology department of Al-Balqa Governorate in Jordan within the period from January 2010 to March 2023. Age, gender, and autopsy results were documented, along with medicolegal records that included toxicology reports. Conversely, information on the manner of death was derived from police inquest records. For the purpose of this research, all the cases of throttling and ligature strangulation have been determined to be homicidal, and all cases of hanging were classified as suicide. Results Males were predominant in hanging (72%), while females were predominant in ligature strangulation (82%). The mean age group in hanging was 21-35 years (51%), while the range for throttling was 36-50 years, and that in strangulation was 2-20 years. Most hanging and throttling cases showed typical external neck findings. Seventy-two percent of hanging cases (n = 68) did not exhibit any internal neck findings, while all throttling cases yielded positive results. Both hanging and strangulation by ligature cases exhibited an absence of thyroid cartilage fracture (83%). Eighty-nine cases (95%) of hanging did not exhibit any injuries to the rest of the body. However, all cases of throttling and ligature strangulation had an almost positive external body injury. In all cases of throttling and ligature strangulation, ocular petechial hemorrhage was present, whereas one-third of the hanging cases had it. Conclusion The forensic doctor must observe the pattern of ligature marks and other signs of physical assault found on the neck, meticulously examine the rest of the body, rule out other causes of death, and cooperate with the legal authorities regarding the collection of the history and death scene findings to accurately determine the manner and mechanism of death in cases of violent neck asphyxia.

A journey into the innovations and expertise of Dubai police and the general department of forensic science and criminology

This manuscript offers an in-depth exploration of the Dubai Police and its General Department of Forensic Science and Criminology, emphasizing their critical role in law enforcement through advanced forensic science and innovative practices. Beginning with a historical overview, it traces the evolution of forensic disciplines from Edmond Locard's foundational principles to Sir Alec Jeffreys' groundbreaking DNA profiling techniques. The manuscript details the structure and functions of specialized sections within the department, including Biology and DNA, Forensic Chemistry, Forensic Toxicology, Firearms and Tool Marks, Questioned Documents, Forensic Explosive, Forensic Fire Investigation, Forensic and Mechanical Engineering, and Nuclear Physics. Key achievements, such as the Biology and DNA Section's processing of thousands of cases and the generation of highly discriminating DNA profiles, are highlighted. The manuscript also addresses the department's challenges, including the rapid evolution of technology and the increasing complexity of crimes. Future plans to enhance capabilities through investment in new technologies, international collaboration, and continuous professional development are outlined. By showcasing the department's commitment to innovation, excellence, and public safety, this manuscript underscores the pivotal contributions of the Dubai Police and its forensic department to crime resolution and community safety. The insights provided aim to foster a deeper understanding of the critical role of forensic science in the criminal justice system.

An Application for Wound Type Determination Based on Image Processing in Forensic Cases

Background: Wound detection is important in forensic science. The development of technology for automatic wound detection in the medical field has not been fully realized. This study aimed to compare the level of knowledge between medical students who utilized an application versus those who studied from textbooks. Methods: An image processing-based application was developed using a Python program with the YOLO software, version 4 algorithm. The research utilized a cross-sectional study design. The participants were medical students undergoing clinical clerkships at the Forensic and Medicolegal Departments of the Faculty of Medicine, Public Health, and Nursing at Gadjah Mada University. Each group (textbook and application group) comprised at least 35 individuals. Both groups had identical study periods and answered the same questions. Participants then filled out a questionnaire about the application. Results: The mean scores of the post-test showed significant improvement in both groups compared to their pre-test scores (P=0.00). There was no significant difference in the post-test scores between the groups using the questionnaire and the application (P=0.207). Conclusion: The application for wound type determination could serve as a preferable alternative to traditional textbooks for learning. It demonstrated an increase in learning outcomes that was significantly comparable to that achieved through textbook study.

Delusions and Delinquencies: A Comparison of Violent and Non-Violent Offenders With Schizophrenia Spectrum Disorders.

The relationship between schizophrenia spectrum disorders (SSD) and violent offending has long been the subject of research. The present study attempts to identify the content of delusions, an understudied factor in this regard, that differentiates between violent and non-violent offenses. Limitations, clinical relevance, and future directions are discussed. Employing a retrospective study design, machine learning algorithms and a comprehensive set of variables were applied to a sample of 366 offenders with a schizophrenia spectrum disorder in a Swiss forensic psychiatry department. Taking into account the different contents and affects associated with delusions, eight variables were identified as having an impact on discriminating between violent and non-violent offenses with an AUC of 0.68, a sensitivity of 30.8%, and a specificity of 91.9%, suggesting that the variables found are useful for discriminating between violent and non-violent offenses. Delusions of grandiosity, delusional police and/or army pursuit, delusional perceived physical and/or mental injury, and delusions of control or passivity were more predictive of non-violent offenses, while delusions with aggressive content or delusions associated with the emotions of anger, distress, or agitation were more frequently associated with violent offenses. Our findings extend and confirm current research on the content of delusions in patients with SSD. In particular, we found that the symptoms of threat/control override (TCO) do not directly lead to violent behavior but are mediated by other variables such as anger. Notably, delusions traditionally seen as symptoms of TCO, appear to have a protective value against violent behavior. These findings will hopefully help to reduce the stigma commonly and erroneously associated with mental illness, while supporting the development of effective therapeutic approaches.

Liraglutide 3.0 mg once daily for the treatment of overweight and obesity in patients hospitalised at a forensic psychiatric department: A 26-week open-label feasibility study.

Overweight and obesity constitute a major concern among patients treated at forensic psychiatric departments. The present clinical feasibility study aimed at investigating the extent to which glucagon-like peptide 1 receptor agonist (GLP-1RA) treatment with once-daily liraglutide 3.0 mg could be a feasible pharmacological treatment of these conditions in patients with schizophrenia spectrum disorders hospitalised in forensic psychiatry. The 26-week, open-label feasibility study included participants aged 18-65 years diagnosed with a severe mental illness and hospitalised at a forensic psychiatric department. At the time of inclusion, all participants fulfilled the indication for using liraglutide as a treatment for overweight and obesity. Participants' baseline examinations were followed by a 26-week treatment period with liraglutide injection once daily according to a fixed uptitration schedule of liraglutide, with a target dose of 3.0 mg. Each participant attended seven visits to evaluate the efficacy and adverse events. The primary endpoint was the number of "completers", with adherence defined as >80% injections obtained in the period, weeks 12-26. Determining whether liraglutide is a feasible treatment was pre-defined to a minimum of 75% completers. Twenty-four participants were included in the study. Sex, male = 19 (79.2%). Mean age: 42.3 [25th and 75th percentiles: 39.1; 48.4] years; body mass index (BMI): 35.7 [31.7; 37.5] kg/m2; glycated haemoglobin (HbA1c): 37 [35; 39] mmol/mol. Eleven out of 24 participants (46%) completed the study. For the completers, the median net body weight loss after 26 weeks of participation was -11.4 kg [-15.4; -5.9]. The net difference in HbA1C and BMI was -2.0 mmol/mol [-4; -1] and -3.6 kg/m2 [-4.7; -1.8], respectively. The weight change and reduction in HbA1c and BMI were all statistically significant from baseline. The study did not confirm our hypothesis that liraglutide is a feasible treatment for a minimum of 75% of the patients initiating treatment with liraglutide while hospitalised in a forensic psychiatric department. The high dropout rate may be due to the non-naturalistic setting of the clinical trial. For the proportion of patients compliant with the medication, liraglutide 3.0 mg was an efficient treatment for overweight.

Clozapine and the Risk of Severe COVID-19: A Retrospective Cohort Study

IntroductionClozapine is the standard treatment for managing treatment-resistant schizophrenia (TRS). However, concerns arise due to potential hematologic side effects, such as agranulocytosis, especially during the COVID-19 pandemic.ObjectivesThis study aims to investigate the association between clozapine treatment and an increased risk of severe COVID-19 infection in patients with TRS.MethodsA retrospective study reviewed clinical records of forensic patients with TRS from 2020 to 2022 at Razi Hospital’s forensic psychiatry department in Tunisia. Twenty-five patients, including 18 on clozapine treatment, were included.Results All patients were male, with an average age of 39.7 years. Twenty-three patients received at least one vaccine dose. Twenty-two patients contracted COVID-19. Among those treated with clozapine, two required intensive care unit admission and oxygen therapy without intubation. Clozapine treatment remained uninterrupted, with no dose escalation during infection episodes. Lymphopenia was the most commonly reported hematologic abnormality.ConclusionsWhile there may be an association between clozapine use and an increased risk of COVID-19 infection, no clear correlation with infection severity and antipsychotic treatment was established in this study. Further research is needed to explore this potential association comprehensively.Disclosure of InterestNone Declared

The impact of COVID-19 mRNA vaccination on somatic and psychiatric symptoms in patients with treatment-resistant schizophrenia: a cohort study

IntroductionPatients with mental illness, particularly those with treatment-resistant schizophrenia, are at increased risk of severe COVID-19. The protective effect of vaccination against severe disease has been demonstrated, and vaccination of vulnerable individuals was a priority during the vaccination campaign. However, the effect of vaccination on the psychiatric symptoms of the disease is not well understood.ObjectivesTo investigate the impact of COVID-19 vaccination on psychiatric symptoms and somatic symptoms in patients hospitalized for treatment-resistant schizophrenia.MethodsThirty patients hospitalized for treatment-resistant schizophrenia with a history of medico-legal acts were admitted to the forensic psychiatry department at Razi Hospital in Manouba, Tunisia. The consent of patients and/or their relatives was obtained before vaccination, and potential side effects were explained to patients and their families. A neuropsychiatric assessment and clinical examination of patients were performed by their referring psychiatrist before vaccination and one month after.ResultsThe patients were all male, with a mean age of 42.3 years.No patient had an allergic reaction to the vaccine. No patient was infected with the virus one month after vaccination. On the clinical level, 30% of patients had general symptoms such as fatigue and myalgia, which improved spontaneously within a few days. On the psychiatric level, exacerbation of positive symptoms such as hallucinations and delusions was found in 26% of patients. No increase in the frequency of agitation episodes or risk of hetero-aggressive behavior was reported. Sleep disturbances such as difficulty falling asleep and fragmented sleep were reported. The most common functional complaints reported by patients were palpitations, which were a source of somatic concern.ConclusionsSeveral side effects of the vaccine have been documented and are taken into account in the daily practice of practitioners, but psychiatric effects are poorly reported and are sometimes attributed to the underlying disease. A complete examination, objective assessment, and regular follow-up are necessary to identify symptoms early and prevent relapses.Because of the small size of the sample;results could not be generelized.Further studies on a larger scale should be conducted.Disclosure of InterestNone Declared

Hematological impact of COVID-19 mRNA vaccination in patients treated with Clozapine

IntroductionClozapine is an atypical antipsychotic that is primarily prescribed for treatment-resistant schizophrenia. Despite its proven efficacy, the prescription of clozapine is sometimes limited by its hematologic side effects, including agranulocytosis. During the SARS-CoV-2 pandemic, schizophrenia is recognized as a risk factor for developing severe forms of the infection. Early and complete vaccination of patients has been recommended. However, there is limited data on the effect of the vaccine on the risk of hematologic abnormalities in patients treated with clozapine.ObjectivesTo study the hematologic effect of the mRNA vaccine against COVID-19 in a population of patients with treatment-resistant schizophrenia treated with clozapine.MethodsTwenty-five patients hospitalized for schizophrenia at the forensic psychiatry department of Razi Hospital in Manouba, Tunisia, were included. Eighteen patients were treated with clozapine, and seven patients were treated with other antipsychotics. Consent from patients and/or their relatives was obtained before vaccination. The results of complete blood counts performed as part of the therapeutic protocol were compared between the two groups before and after administration of the vaccine.ResultsNo patient experienced agranulocytosis induced by clozapine after vaccination against COVID-19.Blood cells counts,red blood cells counts,and platelets were within the normal ranges.However,a decrease in the number of WBCs,neutrophils,and lymphocytes was observed in patients treated with clozapine without significant difference compared to the patients treated with other neuroleptics, but there was no severe neutropenia or need to stop treatment.ConclusionsThe prescription of clozapine, the introduction protocol, and treatment administration have been greatly influenced by the COVID-19 pandemic due to the hepatotoxic risk of the drug. Vaccination is essential to prevent severe forms of the infection, especially in at-risk populations such as patients treated for schizophrenia.The potentiation of hematologic side effects induced by clozapine by the vaccine is not documented.The COVID-19 mRNA vaccine is safe even with clozapineDisclosure of InterestNone Declared

The Role of Forensic Accounting in Fraud Detection and Prevention in Nigerian Public Sector: A Case Study of Lagos, Nigeria

This study investigated the role of forensic accounting in fraud detection and prevention in the Nigerian Public Sector, Lagos State Government was used as a case study. The study aimed to assess the impact of forensic accounting on fraud detection and prevention in the Lagos State Government and recommend strategies for fraud prevention in the Nigerian Public Sector. A sample of 60 Certified Accountants was selected using purposive sampling techniques and secondary data from past financial statements. The findings were analyzed using frequency distribution tables, simple percentages and chi-square statistical formula. The findings of this study revealed that the Lagos State Government uses forensics minimally in its operations, with no forensic accounting department and no management training on forensic fraud prevention. The study calls for the government to go beyond annual and periodic audits and employ forensic accountants' services to regularly review all major financial transactions. There should be a separate office for forensic accountants at all government levels in Nigeria and regular management training on forensic fraud detection and prevention.

Cost-effective 3D documentation device in forensic medicine

3D documentation in forensics and forensic medicine is being introduced more frequently in various institutes around the world. However, several institutes lack capacity in finances as well as staff to perform 3D documentations regularly. This technical paper aims to present a 3D documentation device that is low cost and easy to use and is a viable entry level solution for forensic medical departments. For this the small single-board computer Raspberry Pi 4 was used in conjunction with its high quality (HQ) camera module to create the 3DLamp - a flexible, low cost and easy to use documentation device. Besides a detailed description of the device this paper also presents four case examples where a 3D documentation was performed and analyses the acquired data and the created 3D models. It was found that the device returns feasible 3D models that appear usable for forensic 3D reconstructions.

Subjective and objective assessments of executive functions are independently predictive of aggressive tendencies in patients with substance use disorder

Background and aimsImpairments in executive functions have been found to influence violent behavior. Executive functions are crucial in the treatment of patients with substance use disorders because substance use generally impairs cognitive processes and is therefore detrimental for executive functions thereby reducing control of behavior and thus of consumption impulses. We studied correlations between subjective, i.e. self-report, and objective, i.e. behavior-based, assessment of executive functions and the predictive validity of these measures for aggression in patients with substance use disorder. MethodsThe study included 64 patients with a diagnosed substance use disorder who were convicted according to the German Criminal Code for crimes they committed in the context of their disorder and were therefore in treatment in forensic psychiatric departments in Germany. Multiple self-report and behavior-based instruments were used to assess executive functions, appetitive and facilitative aggression as well as clinical and sociodemographic variables. ResultsParticipants showed impaired executive functions, and measures of executive functions predicted aggressive tendencies and violent offenses. Despite ecological validity of the findings, the subjective and objective assessments of executive functions did not correlate with each other, which corroborates studies in other clinical settings. ConclusionsWe discuss that this finding may be due to the conceptual differences between subjective and objective measures. Therefore, self-report and behavior-based measures should not be used as proxies of each other but as complementary measures that are useful for comprehensive diagnostics of cognitive impairments and assessment of risks for violent behavior.

Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self-efficacy of reporting suspected child abuse and neglect.

To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self-efficacy of reporting child abuse and neglect. A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self-efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self-efficacy of reporting child abuse and neglect. This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self-efficacy in reporting suspected child abuse and neglect. The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. There is no patient or public contribution as the study only looked at nurses.

ПРАКТИКА ЭКСПЕРТНОГО ИССЛЕДОВАНИЯ ВЗРЫВНЫХ УСТРОЙСТВ МАЛОЙ МОЩНОСТИ

The article is devoted to the practice of conducting explosive technical examinations, the objects of which are various low-power explosive devices. The article discusses the problems of classifying this type of object as an explosive device and establishing whether it has explosive properties. The legal basis for classifying low-power objects as explosive devices or imitation pyrotechnic means, the circulation of which does not provide for criminal liability, is considered. The article was prepared based on an analysis of expert practice on the most common types of low-power explosive devices, obtained from 10 forensic depart-ments of territorial bodies of the Ministry of Internal Affairs of Russia. The main stages of the study of low-power explosive devices, the forensically significant information obtained as a result of their implementation, as well as the results of the examination in the form of conclusions are indicated. The main issues raised for the resolution of explosives examination of these objects are considered in order to establish their social danger and damaging properties. The problems that arise during the technical study of low-power explosive devices with the aim of initiating their explosive transformation and recording the results of the explosion, as well as the complexity and uncertainty in formulating the conclusions of explosive test-ing, have been identified. The problem of lack of uniformity in expert research on low-power explosive devices is identified

Genital lichen sclerosus misdiagnosis: Forensic insights.

In this case study, we present an instance of genital lichen sclerosus et atrophicus that was initially misdiagnosed as child sexual abuse. A 6-year-old female presented to the emergency department with complaints of vaginal bleeding accompanied by pruritus. The initial suspicion of child abuse was prompted by the presence of blood. However, a thorough physical examination conducted by the forensic department ruled out any traumatic injuries and instead suggested an underlying pathology, ultimately diagnosed as lichen sclerosus et atrophicus. This case report underscores the vital role of forensics in excluding abuse as a cause in similar presentations, guiding the case towards a more accurate diagnosis. Additionally, it emphasizes the significance of possessing a comprehensive understanding of pathologies that can mimic abusive injuries, thereby preventing the potential consequences of an incorrect abuse diagnosis.

A Comparison of Precision and Safety using Three Recognized Ultrasound-Guided Approaches to Cervical Medial Branch Blocks: A Cadaver Study

BACKGROUND: Ultrasound (US) guidance is widely used for needle positioning for cervical medial branch blocks (CMBB) and radiofrequency ablation, however, limited research is available comparing different approaches. OBJECTIVE: We aimed to assess the accuracy and safety of 3 different US-guided approaches for CMBB. STUDY DESIGN: A cadaveric study divided into ultrasound-guided needle placement and fluoroscopy evaluation stages. SETTING: Department of Pathology, Forensic, and Insurance Medicine, Semmelweis University. METHODS: Sonographically guided third occipital nerve (TON), C3, C4, C5 and C6 medial branch injections and radiology evaluations were performed. The 3 approaches compared were: 1. ES (published by Eichenberger-Siegenthaler): US probe in the coronal plane to visualize the cervical articular pillars, needle approach out of the plane, from anterior to posterior. 2. Fi (published by Finlayson): US probe in the transverse plane to visualize a cervical articular pillar and its lamina, needle approach in the plane, from posterior to anterior. 3. FiM (Modified Finlayson approach): Needles are placed as in Fi, but then adjusted with a coronal view of the cervical articular pillars. Fluoroscopy images were taken and later evaluated, for “crude”, “high precision” and “dangerous” placement. RESULTS: One hundred and fifty-five needle placements were assessed (10 were excluded, as no anterior-posterior fluoroscopy images were saved). Interobserver agreement on position of needle placement between the 5 observers was very high; the Fleiss’ Kappa was 0.921. For crude placement, no significant differences were identified between various approaches; (77.6%, 79.5%, and 75.6% for the ES, Fi, and FiM respectively). However, for placement in predefined high-precision zones, ES resulted in significantly more success (ES: 42.9%, Fi: 22.7%, and FiM: 24.4%, P = 0.032). Fi and FiM resulted in no dangerous placements, while ES led to the potential compromise of the exiting nerve root and vertebral artery on three occasions. In 10% of the placements, the levels were identified wrongly, with no difference between the various approaches. LIMITATIONS: Feedback from a live patient, may prevent some existing nerve root injections, unlike in a cadaver. Though a higher number of needles were placed in this study than in most available publications, the number is still low at each individual medial branch level. CONCLUSION: Fi proved safer than ES. Fi was equally successful in targeting the articular pillar, however, ES proved the most successful in placing the needle in the center of the articular pillar. Adding another, (coronal) US view to check needle position in FiM did not improve safety or precision. Identifying CMB levels with the US is challenging with all approaches, therefore we still recommend using fluoroscopy for level identification. While there were pros and cons with either procedure, the efficacy findings of previous papers were not replicated on elderly cadavers with arthritic necks. KEY WORDS: Cervical facet, medial branch block, safety, accuracy, ultrasound, fluoroscopy