Forensic Medicine Specialists Research Articles

Relationship between forensic medicine education, stress factors, and mobbing perception from the perspective of specialists in Turkey's universities

IntroductionThe current situation needs to be presented with scientific data to ensure and improve the quality of specialist training. This study examined the quality of education, instructor competence, stress factors, mobbing, and their interconnections in the domain of forensic medicine specialty education in Turkey. Materials and methodsThis cross-sectional study was conducted through an anonymous, web-based survey targeting forensic medicine specialists who have completed their specialist training in university forensic medicine departments within the last three years. The survey consisted of questions regarding issues included in the core education curriculum, educator characteristics, and perceptions of stress and mobbing. Based on the responses provided, the relationships between these factors were statistically analysed. Results72.7 % of the study population completed the survey. Nearly half of the participants (46.3 %) did not consider the number of instructors adequate. The quality of instructors (scientific competence, educational and teaching skills, interpersonal relations, accessibility, management, and problem-solving abilities) was determined to be partially sufficient (mean = 3.36). Approximately one-third of the respondents indicated that instructors made the greatest contribution to their specialist training, whereas the proportion of those who said otherwise was much higher. Education received for topics included in the core curriculum was partially sufficient level (mean = 3.04). It was observed that there was a significant relationship between the instructor characteristics, sufficiency score of the taught topics, and perception of mobbing (p < 0.01). The sufficiency scores of instructor characteristics had a 1.02-fold impact on sufficiency ratings of the topics covered in residency training. Among the respondents, 76.9 % reported encountering stress factors during their specialty training, with the most frequently exposed stress factor (52.2 %) being disorganisation within the training program. Among the participants, 22.8 % reported experiencing mobbing. ConclusionsEducation and instructor qualifications were correlated; however, stress factors and mobbing adversely affected education. A close association was observed between education, instructors, stressors, and mobbing. Thus independent and objective auditors tasked with verifying whether institutions meet the established educational standards need to be established.

Added value of postmortem mri in sudden unexpected infant death cases.

We aimed to investigate the potential added value of postmortem MRI (PMMRI) in sudden unexpected infant death (SUID) cases referred to our center between September 2020 and June 2023. Ultimately, 19 SUID cases underwent PMMRI alongside standard autopsy procedures, which included technical examinations such as postmortem CT (PMCT). Four radiologists, two with prior PMMRI experience, provided structured reports following consensus. For each case, the responsible forensic medicine specialist documented the cause of death before and after reviewing the PMMRI report. Additionally, they assessed the overall impact of the PMMRI report and had the opportunity to provide written comments. The results of our study indicate that none of the PMMRI reports altered the prior determined cause of death, which included cases of infection, asphyxia, and sudden infant death syndrome (SIDS). However, we observed a moderate impact in one case and a low impact in 10 cases. The moderate impact arose from the PMMRI report identifying hypoxic-ischemic changes, where histologic examination of the brain was perceived as normal. Conversely, in the 10 cases with a low impact, the PMMRI reports supported the autopsy findings, specifically indicating brain injury and intra-alveolar cellular infiltrates. In conclusion, our study suggests that while PMMRI may not be pivotal in determining the cause of death in SUID cases, it could aid in detecting hypoxic-ischemic changes and reinforcing brain and lung observations. However, distinguishing genuine lung pathology from postmortem changes using PMMRI remains challenging. Further research is warranted to clarify the role of PMMRI in forensic SUID investigations.

The misidentification of the deceased person beyond visual recognition within the pre-trial investigation: problematic issues and legal consequences

Objective. The purpose of the article is to highlight the issues of misidentification of a person within the framework of pre-trial investigation of criminal proceedings on the facts of discovery of corpses of unidentified persons which are not subject to visual identification. The author focuses on the stages and procedure for identification of a deceased person, as well as on some legal consequences of misidentification and ways to eliminate them. Methodology. The methodological basis of the study is the results of the practical experience of one of the authors of the article during his practical work in the pre-trial investigation unit of the National Police of Ukraine during 2015-2021. Results. The author concludes that it is inadmissible for investigators and experts to make mistakes in the identification of the dead in situations where identification of the body is impossible due to various factors, including force majeure, because incorrect identification of a person within the pre-trial investigation may lead to confusion in the transfer of the deceased's body to the family, incorrect execution of title documents, and other consequences that will seriously affect the fate of the deceased's family in terms of moral and material (social) security. This situation is typical for the discovery of bodies of deceased persons (military and civilian) in places of spontaneous burials, including mass graves, as a result of hostilities, temporary occupation of certain regions, which were recorded after de-occupation and stabilization measures in certain regions of Ukraine. Scientific novelty. The work of legal experts has hardly been devoted to the study of the identification of the bodies of the dead during the pre-trial investigation, partly limited to the analysis of certain rules on the legal grounds and tactics of conducting a crime scene inspection or exhumation, while forensic scientists have been more concerned with this issue. Therefore, the scientific novelty of the authors' work is based on practical developments and supported by knowledge in the field of criminal procedure and forensics, which is timely and extraordinary. Practical significance. The conducted research and analysis of the problem, supported by practical experience, will contribute to a deeper understanding of the problem of misidentification of the deceased person beyond visual recognition and acquires a recommendation content for synergy in the work of pre-trial investigation and forensic medicine specialists.

External challenges for specialists dealing with forensic autopsies.

In addition to poor infrastructure, and human resource constraints, forensic medicine specialists in developing countries face many external challenges. We aimed to investigate the prevalence, type, and source of external challenges confronting them including sex, age, religion, deceased's place of residence and the number of accompanying relatives. This cross-sectional, observational study was conducted between August 2020 and July 2022 at the Mortuary of AIIMS, Bhubaneswar with the approval of the ethical committee. Of note, forensic medicine specialists faced external challenges in about one in five cases (20.5%). Most demands were to either minimise the autopsy procedure (n = 65) or to conduct the autopsy at inappropriate times (n = 58). The demands to minimise the autopsy procedure were significantly associated with the deceased's age (p = 0.046), religion (p = 0.010), socioeconomic class (p = 0.020) and manner of death (p = 0.019). Our study found that forensic medicine specialists in India face significant external challenges. Avoiding unnecessary complete autopsies, implementing night autopsies, and embracing minimally invasive autopsies are recommended to mitigate these challenges.

The last flight of F/O Tadeusz Stabrowski. Identification of the polish pilot.

The paper presents the process of identifying an unnamed soldier of the Polish armed forces in the west, whose remains were found in a nameless grave at the municipal cemetery in Le Crotoy in France. The Polish Genetic Database of Victims of Totalitarianism team carried out the research in cooperation with the Ministry of Culture and National Heritage. A comprehensive analysis of autosomal and Y-STR markers was performed. Historical, anthropological, and forensic examinations of the remains were also carried out. The items found with the remains were also examined. Identification based on DNA analysis made it possible to restore the identity of the Polish pilot who died on 11 March 1943 near the French coast, F/O Tadeusz Stabrowski. The airman regained his name in 2018, he was about 26years old at the time of his death and left behind a grieving wife and son in the United Kingdom. The success of identifying the NN remains was guaranteed by the appointment of an interdisciplinary team consisting of specialists in archaeology, anthropology, history, forensic medicine and forensic genetics. The analysis of historical sources allowed to determine 4 missing airmen whose remains could have been buried in the cemetery in Le Crotoy. An interesting aspect of the research was the cooperation with history enthusiasts and fans of Polish aviation, thanks to which it was finally possible to narrow down the group of pilots sought and reach the family of Tadeusz Stabrowski, who submitted comparative material for research. This is the first case of establishing the identity of a Polish pilot killed in France. Many institutions have been involved in the project, including Polish Ministry of Culture and National Heritage (MDiKN), which partially funded the research.

Los Institutos de Medicina Legal y Ciencias Forenses de España ante la nueva Ley de Memoria Democrática

Some of the opportunities that arise for specialists in Legal and Forensic Medicine and the Institutes of Legal Medicine are shown before the recent approval by the Congress of Deputies of the Law of Democratic Memory framed in the field of Restorative Law and in which the creation of a Prosecutor’s Office has been created for the investigation of violations of human rights and International Humanitarian Law. This Prosecutor will also be assigned functions to promote the processes of searching for the victims of the facts under investigation, in coordination with different administrations with competences in this matter, to achieve the identification and location, a space for the participation of Institutes of Legal Medicine, as it happens in other countries of the world.

Compassion fatigue among forensic medicine specialists in Türkiye: A cross-sectional study

Compassion fatigue explains the reduced caregiving capacity of healthcare workers as a consequence of repeated exposure to patients' suffering. It is aimed to evaluate compassion fatigue and factors affecting this situation in forensic medicine specialists who evaluate cases that are victims of permanent trauma due to their profession. Data collection forms including demographic data and a short compassion fatigue scale (SCFS) in healthcare workers were filled out online by volunteer forensic experts. 113 forensic experts participated. It was determined that participants' total SCFS score average was 36.86±21.01, secondary trauma sub-dimension average was 12.39±7.74, occupational burnout sub-dimension average was 24.47±14.52. The total mean score of SCFS of the participants who evaluated less sexual assault was statistically significantly higher. The total mean score of SCFS and the mean of occupational burnout sub-dimension of the participants who did autopsy were found to be statistically significantly lower. The occupational burnout sub-dimension average of those who performed autopsy above the monthly autopsy median value was found to be statistically significantly lower. Sub-dimension average of burnout of participants in the first five years of their professional life was found to be statistically significantly higher. It is noteworthy that total and sub-dimension average scores of forensic medicine specialists in Turkey are significantly lower than those of different professions, especially health workers, in different countries. While this may be an indication that occupational depersonalization has developed over the years among forensic medicine specialists in Turkey, especially those who evaluate autopsy and sexual assault cases, from a different perspective, it can be said that increasing professional experience and working in harmony with the education received have a positive effect on compassion fatigue and burnout.

LEVEL OF KNOWLEDGE, INTEREST, AND PERCEPTION OF CLINICAL ROTATION STUDENTS REGARDING FORENSIC MEDICINE AND MEDICOLEGAL SCIENCE

Background: Forensic medicine and medicolegal science (FMMS) as mandatory competences that clinical rotation students must possess. However, the number of forensic medicine and medicolegal specialists is still significantly less. Currently, there are 271 people recorded and spread across Indonesia, including two people in Aceh Province with three medical faculties to be managed. For this reason, it is necessary to think about how to increase the number of forensic medicine and medicolegal specialists in Aceh. This study describes the level of knowledge, interest, and perceptions of clinical rotation students regarding FMMS.Methods: The type of study was observational analytic with a cross-sectional design. The instrument used was an online questionnaire with a Content Validity Ratio of 0.750. The samples of this study were clinical rotation students who had passed the forensic medicine and medicolegal sciences stages. The samples were collected using the purposive sampling method.Results: A total of 102 respondents were involved in this study. The majority of respondents had good knowledge (97.1%). As many as 63.7% of respondents were interested in studying forensic medicine and medicolegal and 59.8% of respondents positively perceived these studies. Based on the Spearman’s statistical test showed a significant correlation between the interest and perception under the Sig.(2-tailed) 0.002 (Sig.(2-tailed) ≤0.05).Conclusion: Clinical rotation students of the Faculty of Medicine, Syiah Kuala University have good knowledge, high interest, and positive perceptions. This is a new opportunity and challenges for the development of FMMS in Indonesia.

Analysis of undiagnosed neoplasms identified at post-mortem: A descriptive study

Autopsy which is also known as post-mortem examination has been derived from the greek term “autopsia” meaning “to see for one self”. Autopsies performed by the forensic medicine specialists are followed by histopathological examination of various concerned organs for underlying cause of death. histopathological examination of various organs thus always present an interesting plethora of unsuspected findings. These findings could have been present ante mortem with symptoms or completely asymptomatic. The undetectable lesions could have contributed to the death of the person. There fore the alertnesss and inquisitiveness of a pathologist while examining the autopsy cases can contribute significantly towards the subject of pathology and also serve as a learning process for the clinician to establish clinicopathological correlations. This study has been conducted with the following aims &amp; objectives in mind:To analyse the neoplastic lesions detected incidentally on histopathology and correlate with the symptoms if any present ante mortem. Settings and design: this is a retrospective, descriptive study done in the department of pathology, dr. bsa hospital, delhi.A retrospective study of medicolegal autopsies for five years was undertaken in a tertiary care centre to analyse the tumors incidentally detected on histopathological examination. Autopsy records of 663 cases were reviewed and cases where a histopathological diagnosis of tumor was given were included in our study. Gross and histopathologic findings were noted and the salient features were studied. Clinical data of these cases were noted in detail from the forensic post mortem records and tabulated. This study includes 12 cases of tumor out of 663 cases. Most common benign tumor was leiomyoma and most common malignant tumor was adenocarcinoma. An interesting case of hodgkins lymphoma in spleen and liver was also documented. A single case of meningioma, squamous cell carcinoma metastasis to heart and astrocytic tumor were noted.This study highlights the various undetected tumors both benign and malignant. This study also gives a perspective to correlate ante mortem findings with post mortem findings to the clinician and pathologist.

Forensic Medical Evaluation of Nasal Trauma Cases

Aim: The purpose of this study was to evaluate the cases for which a final report was made due to nasal trauma and to reveal the errors made in the diagnosis. Materials and Methods: Among the forensic reports prepared in the Forensic Medicine Clinic of Bolu Abant İzzet Baysal University Training and Research Hospital between 2015-2019, cases with "a history of nasal trauma" were included in the study. Result: In this study, 315 cases with a history of nasal trauma were included. Two hundred sixty-four (83.8%) of the cases were male and 51 (16.2%) are female. Two hundred thirty-one of the cases (73.3%) were injured as a result of the intentional blunt injuries. Before applying to the Forensic Medicine Clinic, 28 (8.9%) of the cases were evaluated only by physical examination, 46 (14.6%) by physical examination + direct radiography, 241 (76.5%) by physical examination + direct radiography + CT. It was evaluated that the report prepared by emergency department physicians on 203 cases (64.4%) was correct, whereas the report prepared on 112 (35.6%) cases was erroneous. It was evaluated that the reports prepared by Otorhinolaryngologists on 117 cases (80.1%) were correct, whereas the reports prepared on 29 (19.9%) cases were erroneous. Conclusion: We believe that it is more appropriate to give the final forensic report of cases with nasal trauma by a Forensic Medicine Specialist rather than Emergency Department physicians or an Otorhinolaryngologist.

Forensic Psychiatric Evaluation of Torture Victims

Torture is a word of Persian origin and is defined as “excessive physical or moral punishment to a person” Torture is one of the important subjects of forensic medicine. Forensic Medicine specialists are experts who detect the lesions on the bodies of torture cases, which are considered to be the most extreme points of violations of rights, who can interpret them, and also try to diagnose invisible psychiatric traces. This duty obliges Forensic Medicine to evaluate scientific truths impartially and in all details.

Assessment of knowledge and anxiety level of forensic science experts and technicians on SARS–CoV2 Pandemic

This prospective, descriptive and cross-sectional study was performed to assess the knowledge and anxiety levels of forensic science experts and technicians working at the Ministry of Justice Council of Forensic Medicine regarding the Severe Acute Respiratory Syndrome – Corona Virus2 (SARS–CoV2) pandemic. Research data was obtained by a questionnaire, including personal information questions, a Coronavirus 19 Phobia (C19P–S) scale, and knowledge level questions, conducted on 295 participants between 01/10/2020–30/11/2020. Knowledge scores of the participants having bachelor's degrees (16.57±7.51) were found to be lower than those of the associate degree (23.74±6.52) and postgraduate degree (23.29±6.63) groups. The professional group with the lowest knowledge score was the engineer (12.00±4.95). The knowledge score of forensic medicine specialists (24.78±5.98), forensic medicine residents (24.78±5.53), and technicians (23.84±6.61) were higher than other professional groups. The psychological sub-dimension score was 18.69±5.73, while psychosomatic 8.93±3.72, social 14.65±4.47, economic 8.54±3.39, and the total C19P–S scale was 50.80±14.56. The psychological and total C19P – S scale scores of the female participants were higher than the scores of the men. Total C19P–S scores of the participants working in the specialized departments were higher than the participants working on the specialized boards. The highest C19P–S scale total score was determined in the technician's group. In general, the knowledge and anxiety levels were determined as "moderate". The findings of this study indicate that, in addition to the stress of working with a high risk of transmission, also postponed schedules, accumulated workload, etc. may affect the psychological state of forensic science experts and technicians. However, the coping rates are strong enough to keep the stress level at “moderate”. Moderate level knowledge scores may reveal the need to do more reading on health topics and perform more studies on SARS-CoV2 while it may also be seen due to the significant information pollution.

Age Estimation from Left-Hand Radiographs with Deep Learning Methods

Bone age is estimated in pediatric medicine for medical and legal purposes. In pediatric medicine, it aids in the growth and development assessment of various diseases affecting children. In forensic medicine, it is required to determine criminal liability by age, refugee age estimation, and child-adult discrimination. In such cases, radiologists or forensic medicine specialists conduct bone age estimation from left hand-wrist radiographs using atlas methods that require time and effort. This study aims to develop a computer-based decision support system using a new modified deep learning approach to accelerate radiologists' workflow for pediatric bone age estimation from wrist radiographs. The KCRD dataset created by us was used to test the proposed method. The performance of the proposed modified IncepitonV3 model compared to IncepitonV3, MobileNetV2, EfficientNetB7 models. Acceptably high results (MAE=4.3, RMSE=5.76, and R2=0.99) were observed with the modified IncepitonV3 transfer deep learning method.

Study about Medico-Legal Cases: A More Professional Approach

Background: Law is a natural science, similar to medicine. Most of the time, the outcome of a case cannot be predicted with certainty. It depends on the facts and circumstances of the case and the judge who adheres to his own beliefs. The aphorism that “learns from your mistakes” is undermined in the healthcare industry. Preventing medical and legal problems is the best way to deal with them, and this article tries to put together a list of preventive actions that can protect a physician from negligent prosecution.&#x0D; Summary: Many of us have seen official medical examinations and certificates made and signed by any MBBS physician, gynecologist, dermatologist, or non-medical professional who is not trained in medical and legal practice. According to statistics, non-forensic physicians perform approximately 80% of the work in the medical profession, with second and professional opinions flooding the doors of hospitals teaching Forensic Medicine and Toxicology due to a shortage of specialized doctors with specialized medical, legal expertise. He is qualified to give opinions, report, or give evidence in a court of law where a Forensic Medicine specialist is found to perform the primary function in which they work to an informal physician who is unfamiliar with many of the medical fields that authorize their work by giving opinions, reporting, or giving evidence in a court of law where a Forensic Medicine specialist is found to perform the primary function in which they work. As a result, physiatrists should license all legal, medical services in the region or district hospitals.&#x0D; Conclusion: One of the best jobs in the world is medical. Medicine can provide a fantastic service to humanity if doctors practice it with care, reliability, efficiency, and professional expertise. However, modern patient-doctor interactions have lost your great environment, becoming more professional and constructive. Doctors are no longer respected as infallible and unknown. The integration of health care has turned the business around, and the medical profession is increasingly driven by profit rather than service.

Factors affecting disclosure time of sexual abuse in children and adolescents.

The aim of this study is to determine the factors affecting early and delayed disclosure time of child sexual abuse (CSA). Early disclosure of CSA is considered to be crucial for child protection. A total of 125 sexually abused children and adolescents, who had been evaluated by child adolescent psychiatry and forensic medicine specialists, were enrolled in this study. Files of medical and criminal data were analyzed retrospectively and synchronously by child adolescent psychiatrist and forensic medicine specialist authors who had evaluated victims using the standard procedures of Düzce University Faculty of Medicine Child Abuse Assessment Council. Univariate and multivariate logistic regression analyses were conducted to evaluate predictors. Delayed disclosers were found to be younger than early disclosers. Among the delayed disclosers, there were also more victims of intrafamilial CSA, fewer victims of penetration, and fewer voluntary disclosures. Multivariate logistic regression revealed that "younger age" and "intrafamilial CSA" were independent predictors of delayed disclosure of CSA. The results of our study contribute to an understanding of the factors related to delayed disclosure and underline the need for age-appropriate education and prevention programs targeted to increase the awareness of sexual abuse, particularly intrafamilial abuse, and to promote voluntary disclosure in children and adolescents, especially for younger age groups. The education of potential recipients of CSA and further education of professionals is extremely important in order to support children and adolescents' voluntary disclosure of CSA.

Working Conditions of Forensic Medicine Specialists and Residents During COVID-19 Pandemic and Lockdown Periods: A Survey Study

Working Conditions of Forensic Medicine Specialists and Residents During COVID-19 Pandemic and Lockdown Periods: A Survey Study

Positions and Types of Pterion in Adult Human Skulls: A Preliminary Study.

A trauma to the skull in the area of the pterion usually causes rupture of the middle meningeal artery leading to life- threatening epidural hematoma. The objective of the study is to assess the prevalence of different types of pterion and to determine its location using valuable bony landmarks. On 90 dry adult human skulls of unknown sex, age and nationality the distance of different landmarks from pterion was measured using stainless steel sliding Vernier caliper. The data were analyzed using SPSS version-20 and an independent t-test analysis was implemented. A value of P< 0.05 was considered as statistically significant. A higher occurrence of sphenoparietal type of pterion with the absence of frontotemporal type was noted. About 23% and 77% of the suture types are found to be unilateral and bilateral, respectively. There was a statistically significant difference between right and left sides of the skull in distances from the center of pterion to frontozygomatic suture, root of zygomatic arch, inion and in central thickness pterion. This study showed that the most prevalent type of pterion is sphenoparietal, and revealed asymmetry in the distances from center of pterion to frontozygomatic suture, root of zygomatic arch and inion, and its central thickness. Such findings could offer worthy information about the type and location of pterion, which could be relevant to anatomists, neurosurgeons, forensic medicine specialist and anthropologists.

As Ciências Forenses no Brasil Monárquico: Breve Histórico da Oficialização e Institucionalização da Função Pericial nas Investigações Criminais

O presente artigo procura apontar os marcos históricos do processo de oficialização da atuação de especialistas na esfera criminal, bem como a institucionalização da perícia oficial no âmbito da polícia. Nele procuramos analisar como os lapsos contidos nas leis foram preenchidos pela atuação prática dos peritos. Esse processo ocorreu de forma gradativa no período monárquico e coincidiu com o desenvolvimento científico da medicina legal no país. A oficialização da perícia na esfera criminal ocorreu como uma resposta aos anseios da sociedade pelo estabelecimento de regras claras para a persecução penal, a atribuição de penas "justas" e a possibilidade ampla de defesa pelo acusado. Entretanto, o processo de institucionalização da perícia oficial sofreu diversos revezes decorrentes da profissionalização tardia da polícia, o que gerou embates com representantes da academia e dúvidas em relação à isenção dos peritos oficiais, até o fim do período monárquico.

Evaluation of the dismissed forensic medicine specialists and other forensic professionals in Turkey.

&#x0D; &#x0D; &#x0D; &#x0D; The right to work, one of the fundamental human rights, expresses the right of all individuals to maintain a dignified life by having an income, earned through work (UDHR, 1948). Following the coup attempt on 15 July 2016, the Turkish government declared a state of emergency on 20 July 2016. This lasted 730 days until 20 July 2018. During this period, 32 decrees were issued by the Turkish government. With these decrees, 150,348 public officials including judges, pros- ecutors, civil servants, teachers, bureaucrats, medical doctors and academics were dismissed without any investigation (Turkey Purge, 2019). With regard to the group of forensic professional experts, many have been dismissed following decrees issued by the Turkish government.&#x0D; &#x0D; &#x0D; &#x0D;

Covid-19 Enfeksiyonu, Postmortem Süreç ve Defin İşlemleri

Çin'de COVID-19 enfeksiyonunun Aralık 2019 tarihinde patlak vermesi ile virüs tüm dünyada hızla yayılan bir pandemi başlatarak, ciddi sağlık sorunları ve ölümlere neden olmuştur. Mart 2020 başı itibariyle Dünya genelinde yüzün üzerinde ülkede görüldüğü bildirilmiştir. Ülkemizde ilk vaka Mart başında saptanmış, günümüze kadar binin üzerinde ölüm bildirilmiştir. Bu süreçte adli tıp çalışanları olası bir COVID-19 ölümünde ciddi bulaş riski ile karşı karşıya kalmaktadır. Bu çalışma COVID-19 hastalığına neden olan virusün tanımı ve epidemiyolojisi, ölüm sonrası COVID-19 tanısının nasıl konacağı, ölü muayenesi ve otopsi odasında olası riskler ve bu risklerin nasıl azaltılacağı konusunda bir derleme niteliğindedir. Ayrıca COVID-19 enfeksiyonu şüphesinde ölü defin işlemleri ve ölüm belgesi düzenleme ile ilgili ülkemizde yaşanan sıkıntılar tartışılmış ve öneriler sunulmuştur.