Thoracic aortic aneurysms are considered more dangerous than abdominal aneurysms because they are often silent until rupture and, therefore, are more challenging to diagnose and have a high mortality rate. In addition, a thoracic aneurysm differs from an abdominal one in terms of causes and risk factors: the former is associated with the degeneration of the vessel's middle tunica, while the latter is related to atherosclerosis.
We report the case of the sudden death of a 20-year-old man, with no apparent risk factors and suffering only from a persistent cough for a month, in whom the autopsy revealed the rupture of a massive aneurysm of the ascending thoracic aorta. Blood leaked from the wall of the aorta into the pericardial sac, causing cardiac tamponade and the death of the young man. Histology demonstrated cystic medial degeneration with no other relevant features.
In this paper we discuss the mechanisms of aneurysm formation and report a review of the literature on similar cases, limited to ruptures of thoracic aortic aneurysms discovered post-mortem.
{"title":"Rupture of huge thoracic aortic aneurysm in a young man: Case report and literature review","authors":"Dario Raniero, Naomi Tatriele, Emanuela Trevisan, Stefania Turrina","doi":"10.1016/j.jflm.2025.102805","DOIUrl":"10.1016/j.jflm.2025.102805","url":null,"abstract":"<div><div>Thoracic aortic aneurysms are considered more dangerous than abdominal aneurysms because they are often silent until rupture and, therefore, are more challenging to diagnose and have a high mortality rate. In addition, a thoracic aneurysm differs from an abdominal one in terms of causes and risk factors: the former is associated with the degeneration of the vessel's middle tunica, while the latter is related to atherosclerosis.</div><div>We report the case of the sudden death of a 20-year-old man, with no apparent risk factors and suffering only from a persistent cough for a month, in whom the autopsy revealed the rupture of a massive aneurysm of the ascending thoracic aorta. Blood leaked from the wall of the aorta into the pericardial sac, causing cardiac tamponade and the death of the young man. Histology demonstrated cystic medial degeneration with no other relevant features.</div><div>In this paper we discuss the mechanisms of aneurysm formation and report a review of the literature on similar cases, limited to ruptures of thoracic aortic aneurysms discovered post-mortem.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102805"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jflm.2025.102801
Lina Bhoyar, Palash Mehar, Krishnadutt Chavali
Accurate post-mortem interval estimation is crucial in forensic investigations, providing essential information for criminal cases. Traditional techniques frequently encounter inaccuracies stemming from environmental and individual variables. The comet assay is a very sensitive technique that detects DNA damage, which has emerged as a promising tool for assessing DNA degradation. This approach can serve as a molecular clock for post-mortem interval estimation, offering a more precise and reliable means of determining the time since death in forensic cases. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO-CRD42024554907) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. An extensive electronic database search, including Google Scholar, Embase, Web of Science, PubMed, and Scopus was conducted to find the studies utilizing the comet assay for DNA degradation measurement in post-mortem interval estimation. Two reviewers independently screened and extracted data from eligible studies. The risk of bias tool from the Systematic Review Centre for Laboratory Animal Experimentation was used to evaluate the quality of the research. All six studies fulfilled the inclusion requirements, employing the comet assay on various animal tissues. Studies show a clear relationship between post-mortem interval and degradation of DNA, with varying rates depending on tissue type and environmental factors. The comet assay can detect DNA fragmentation effectively, but difficulties arise from variations in study designs and methodologies. Despite its promise for estimating post-mortem interval, the standardization of protocols is needed to improve reliability and applicability in forensics. Future research should establish standardized methods and explore environmental impacts on DNA degradation.
准确的死亡间隔估计在法医调查中至关重要，为刑事案件提供重要信息。传统技术经常遇到由于环境和个体变量而产生的不准确性。彗星试验是一种非常敏感的检测DNA损伤的技术，它已经成为评估DNA降解的一种很有前途的工具。这种方法可以作为死后间隔估计的分子钟，在法医案件中提供一种更精确和可靠的确定死亡时间的方法。该系统评价已在国际前瞻性系统评价注册中心（PROSPERO-CRD42024554907）注册，并遵循系统评价和荟萃分析首选报告项目（PRISMA）标准。通过广泛的电子数据库检索，包括谷歌Scholar、Embase、Web of Science、PubMed和Scopus，我们找到了利用彗星测定法在死后时间间隔估计中进行DNA降解测量的研究。两名审稿人独立筛选并从符合条件的研究中提取数据。使用来自实验动物实验系统评价中心的偏倚风险工具来评估研究的质量。所有六项研究均满足纳入要求，在各种动物组织中采用彗星试验。研究表明，死亡时间与DNA降解之间存在明确的关系，其降解率取决于组织类型和环境因素。彗星分析可以有效地检测DNA片段，但困难来自于研究设计和方法的变化。尽管它有望估计死后时间间隔，但需要协议的标准化来提高法医的可靠性和适用性。未来的研究应建立标准化的方法，探索环境对DNA降解的影响。
{"title":"Assessing the forensic implications of DNA degradation for PMI estimation using comet assay: A systematic review","authors":"Lina Bhoyar, Palash Mehar, Krishnadutt Chavali","doi":"10.1016/j.jflm.2025.102801","DOIUrl":"10.1016/j.jflm.2025.102801","url":null,"abstract":"<div><div>Accurate post-mortem interval estimation is crucial in forensic investigations, providing essential information for criminal cases. Traditional techniques frequently encounter inaccuracies stemming from environmental and individual variables. The comet assay is a very sensitive technique that detects DNA damage, which has emerged as a promising tool for assessing DNA degradation. This approach can serve as a molecular clock for post-mortem interval estimation, offering a more precise and reliable means of determining the time since death in forensic cases. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO-CRD42024554907) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. An extensive electronic database search, including Google Scholar, Embase, Web of Science, PubMed, and Scopus was conducted to find the studies utilizing the comet assay for DNA degradation measurement in post-mortem interval estimation. Two reviewers independently screened and extracted data from eligible studies. The risk of bias tool from the Systematic Review Centre for Laboratory Animal Experimentation was used to evaluate the quality of the research. All six studies fulfilled the inclusion requirements, employing the comet assay on various animal tissues. Studies show a clear relationship between post-mortem interval and degradation of DNA, with varying rates depending on tissue type and environmental factors. The comet assay can detect DNA fragmentation effectively, but difficulties arise from variations in study designs and methodologies. Despite its promise for estimating post-mortem interval, the standardization of protocols is needed to improve reliability and applicability in forensics. Future research should establish standardized methods and explore environmental impacts on DNA degradation.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102801"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to reveal the opinions of emergency room nurses regarding crime victims and the challenges they experience.
Design
This study was a qualitative descriptive study.
Methods
A convenience sampling method was used in the study. Data were collected through individual in-depth interviews using semi-structured questions lasting approximately 45 min. The interviews were audio recorded. In total, nine nurses individual interviews were held.
Results
The study was completed with nine nurses with approximately twelve years of experience in the emergency department. Four themes were identified: duties and responsibilities of nurses in crime victims management; maintaining well-being in challenging crime victims; education needs of emergency nurses for crime victims; and challenges experienced by nurses in crime victims management.
Conclusions
When contextualizing the findings of our study within forensic nursing theory, it becomes evident that nurses play a pivotal role in continuously informing, influencing, and advancing forensic nursing care to improve patient health, forensic evidence collection, and criminal justice outcomes. A key finding of our study was the impact of interaction with crime victims in the emergency department on nurses’ well-being. In this regard, implementing institution-supported education policies, establishing units dedicated to supporting well-being, and fostering a supportive organizational culture are essential measures to promote the resilience and effectiveness of nurses in this critical field.
{"title":"Challenges encountered by emergency nurses in forensic case management: A qualitative study","authors":"Yasemin Güner , Bilge Delibalta , Melek Üçüncüoğlu , Sinan Paslı","doi":"10.1016/j.jflm.2025.102807","DOIUrl":"10.1016/j.jflm.2025.102807","url":null,"abstract":"<div><h3>Purpose/Aims</h3><div>This study aimed to reveal the opinions of emergency room nurses regarding crime victims and the challenges they experience.</div></div><div><h3>Design</h3><div>This study was a qualitative descriptive study.</div></div><div><h3>Methods</h3><div>A convenience sampling method was used in the study. Data were collected through individual in-depth interviews using semi-structured questions lasting approximately 45 min. The interviews were audio recorded. In total, nine nurses individual interviews were held.</div></div><div><h3>Results</h3><div>The study was completed with nine nurses with approximately twelve years of experience in the emergency department. Four themes were identified: duties and responsibilities of nurses in crime victims management; maintaining well-being in challenging crime victims; education needs of emergency nurses for crime victims; and challenges experienced by nurses in crime victims management.</div></div><div><h3>Conclusions</h3><div>When contextualizing the findings of our study within forensic nursing theory, it becomes evident that nurses play a pivotal role in continuously informing, influencing, and advancing forensic nursing care to improve patient health, forensic evidence collection, and criminal justice outcomes. A key finding of our study was the impact of interaction with crime victims in the emergency department on nurses’ well-being. In this regard, implementing institution-supported education policies, establishing units dedicated to supporting well-being, and fostering a supportive organizational culture are essential measures to promote the resilience and effectiveness of nurses in this critical field.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102807"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jflm.2024.102794
Larisa Adela Udriştioiu , Mihai Andrei , Filip Perde , George Cristian Curcă
Introduction
The method of dissolving a body to conceal crimes, a practice dating back to ancient times, has recently captured the interest of scientists and the film industry. Real-life cases inspired by media portrayals underscore the importance of understanding this process, which aims to prevent identification or locate the body. Historical and contemporary examples highlight the use of substances like caustic potash and various acids. Although scientific studies on this topic are limited, this scoping review explores the use of corrosive substances for concealing crimes by dissolving remains and aims to provide an overview of the current global extension of this phenomenon, addressing a gap in scholarly literature.
Methods
A systematic literature search was performed according to PRISMA-ScR guidelines. The search strategy included PubMed, Google Scholar, gray literature, and general Google searches for cases in international media. Articles were eligible if they discussed the effects of corrosive substances on tissue with the intent to alter or destroy, excluding those focused on living individuals or for non-forensic purposes. Results were categorized into academic and gray literature, further divided by species studied.
Results
A total of 280 results were found in PubMed and 966 in Google Scholar. No reviews were found. Additional searches led to 79 records, with 37 excluded due to duplication or updates. Ultimately, 83 studies were included in the review, documenting key elements such as study purpose, sample details, substances used, and findings. The effects of various corrosive agents were revealed, including alkaline substances such as lime, potassium hydroxide, and sodium hydroxide, as well as acids like hydrochloric acid, sulfuric acid, nitric acid, and aqua regia.
Conclusions
Diagnosing tissue alterations caused by corrosive substances requires a multidisciplinary approach and detailed analysis. Final outcomes depend on concentration, exposure time and conditions. Techniques like microscopy, scanning electron microscopy (SEM), energy dispersive X-ray spectrometer (EDX/EDS), micro-computed tomography (micro-CT) and X-ray fluorescence (XRF) provide critical detailed results. Recreating the crime through experiments may be necessary for investigations, shedding light on the methods employed by perpetrators, reflecting the complexity of these out-of-the-ordinary cases. Further studies are crucial for interpreting these effects.
{"title":"Postmortem tissue alterations induced by corrosive substances – a scoping review","authors":"Larisa Adela Udriştioiu , Mihai Andrei , Filip Perde , George Cristian Curcă","doi":"10.1016/j.jflm.2024.102794","DOIUrl":"10.1016/j.jflm.2024.102794","url":null,"abstract":"<div><h3>Introduction</h3><div>The method of dissolving a body to conceal crimes, a practice dating back to ancient times, has recently captured the interest of scientists and the film industry. Real-life cases inspired by media portrayals underscore the importance of understanding this process, which aims to prevent identification or locate the body. Historical and contemporary examples highlight the use of substances like caustic potash and various acids. Although scientific studies on this topic are limited, this scoping review explores the use of corrosive substances for concealing crimes by dissolving remains and aims to provide an overview of the current global extension of this phenomenon, addressing a gap in scholarly literature.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed according to PRISMA-ScR guidelines. The search strategy included PubMed, Google Scholar, gray literature, and general Google searches for cases in international media. Articles were eligible if they discussed the effects of corrosive substances on tissue with the intent to alter or destroy, excluding those focused on living individuals or for non-forensic purposes. Results were categorized into academic and gray literature, further divided by species studied.</div></div><div><h3>Results</h3><div>A total of 280 results were found in PubMed and 966 in Google Scholar. No reviews were found. Additional searches led to 79 records, with 37 excluded due to duplication or updates. Ultimately, 83 studies were included in the review, documenting key elements such as study purpose, sample details, substances used, and findings. The effects of various corrosive agents were revealed, including alkaline substances such as lime, potassium hydroxide, and sodium hydroxide, as well as acids like hydrochloric acid, sulfuric acid, nitric acid, and aqua regia.</div></div><div><h3>Conclusions</h3><div>Diagnosing tissue alterations caused by corrosive substances requires a multidisciplinary approach and detailed analysis. Final outcomes depend on concentration, exposure time and conditions. Techniques like microscopy, scanning electron microscopy (SEM), energy dispersive X-ray spectrometer (EDX/EDS), micro-computed tomography (micro-CT) and X-ray fluorescence (XRF) provide critical detailed results. Recreating the crime through experiments may be necessary for investigations, shedding light on the methods employed by perpetrators, reflecting the complexity of these out-of-the-ordinary cases. Further studies are crucial for interpreting these effects.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102794"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jflm.2024.102796
Jenni Kokki , Petteri Oura
Chronic alcohol use is often associated with traumatic brain injury (TBI). This study aimed to compare background characteristics, injury circumstances, primary head injuries, and secondary brain injuries among TBI cases with and without a documented history of chronic alcohol use. The sample comprised neuropathologically examined medico-legal autopsy cases with acute head injuries from Helsinki, Finland, over the years 2016–2022. Data on chronic excessive alcohol use were collected from medical records and police files; other background and circumstantial data were collected from medical records, police files, and cause-of-death investigation documents; and data on primary head injuries and secondary brain injuries were collected from autopsy and neuropathology reports. The dataset comprised 47 cases, of whom 19 had a history of chronic alcohol use (40.4%). Assault was the most common circumstance of injury among chronic alcohol users (47.4%) while falls prevailed among control cases (32.1%); unknown circumstances were common among both groups. There were no statistically significant differences in the prevalence of primary head injuries or postinjury survival between the groups. As for secondary brain injuries, hypoxic-ischaemic neuronal injury was significantly more common among chronic alcohol users in the frontal cortex (84.2% vs. 28.6%), parietal cortex (84.2% vs. 32.1%), hippocampus (63.2% vs. 25.0%), and lenticular nucleus (73.7% vs. 21.4%). Our findings suggest that chronic alcohol users may not necessarily have more diverse or complex primary injuries, but they may have more extensive secondary injuries. Further research should aim to explore the potential aetiology of hypoxic-ischaemic neuronal injury among chronic alcohol users.
{"title":"Background characteristics and neuropathological findings of medico-legal autopsy cases with chronic alcohol use and acute head injury","authors":"Jenni Kokki , Petteri Oura","doi":"10.1016/j.jflm.2024.102796","DOIUrl":"10.1016/j.jflm.2024.102796","url":null,"abstract":"<div><div>Chronic alcohol use is often associated with traumatic brain injury (TBI). This study aimed to compare background characteristics, injury circumstances, primary head injuries, and secondary brain injuries among TBI cases with and without a documented history of chronic alcohol use. The sample comprised neuropathologically examined medico-legal autopsy cases with acute head injuries from Helsinki, Finland, over the years 2016–2022. Data on chronic excessive alcohol use were collected from medical records and police files; other background and circumstantial data were collected from medical records, police files, and cause-of-death investigation documents; and data on primary head injuries and secondary brain injuries were collected from autopsy and neuropathology reports. The dataset comprised 47 cases, of whom 19 had a history of chronic alcohol use (40.4%). Assault was the most common circumstance of injury among chronic alcohol users (47.4%) while falls prevailed among control cases (32.1%); unknown circumstances were common among both groups. There were no statistically significant differences in the prevalence of primary head injuries or postinjury survival between the groups. As for secondary brain injuries, hypoxic-ischaemic neuronal injury was significantly more common among chronic alcohol users in the frontal cortex (84.2% vs. 28.6%), parietal cortex (84.2% vs. 32.1%), hippocampus (63.2% vs. 25.0%), and lenticular nucleus (73.7% vs. 21.4%). Our findings suggest that chronic alcohol users may not necessarily have more diverse or complex primary injuries, but they may have more extensive secondary injuries. Further research should aim to explore the potential aetiology of hypoxic-ischaemic neuronal injury among chronic alcohol users.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102796"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical conditions may cause driving impairment and preventable motor vehicle collisions. Australian Capital Territory (ACT) Police detect potentially medically impaired drivers as part of their duties. ACT Police and medical fitness to drive reviewers sought to determine the accuracy of police suspicion of medically impaired drivers for quality assurance and legislative purposes.
Method
This is a retrospective study of 110 drivers who were referred to the Fitness to Drive Medical Clinic (FTDMC) by ACT Police between July 1, 2017 and June 30, 2023 to determine whether changes to driver licences were needed.
Results
Reasons for ACT Police referral were physical, cognitive, mental health and non-acute substance use conditions. All drivers referred to the FTDMC by ACT Police had their licence conditions modified by cancellation, suspension, the imposition of conditions or a requirement to undertake an on-road assessment by an occupational therapist trained to assess drivers.
Conclusions
This study demonstrates that ACT Police detection of medically impaired drivers, police triage and referral to the FTDMC is effective. We believe that ACT Police referrals to the FTDMC should result in immediate suspension of a driver's licence prior to review by a medical practitioner experienced in fitness to drive assessments. The ACT Police process must include review by the Sergeant of the Major Collision Team and be supported by appropriate legislation.
{"title":"Something to see here: ACT Police referrals for impaired driving due to medical conditions","authors":"Vanita Parekh , Janine McMinn , Anna Brkic , Corey Heldon , Ash Laidler","doi":"10.1016/j.jflm.2024.102797","DOIUrl":"10.1016/j.jflm.2024.102797","url":null,"abstract":"<div><h3>Introduction</h3><div>Medical conditions may cause driving impairment and preventable motor vehicle collisions. Australian Capital Territory (ACT) Police detect potentially medically impaired drivers as part of their duties. ACT Police and medical fitness to drive reviewers sought to determine the accuracy of police suspicion of medically impaired drivers for quality assurance and legislative purposes.</div></div><div><h3>Method</h3><div>This is a retrospective study of 110 drivers who were referred to the Fitness to Drive Medical Clinic (FTDMC) by ACT Police between July 1, 2017 and June 30, 2023 to determine whether changes to driver licences were needed.</div></div><div><h3>Results</h3><div>Reasons for ACT Police referral were physical, cognitive, mental health and non-acute substance use conditions. All drivers referred to the FTDMC by ACT Police had their licence conditions modified by cancellation, suspension, the imposition of conditions or a requirement to undertake an on-road assessment by an occupational therapist trained to assess drivers.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that ACT Police detection of medically impaired drivers, police triage and referral to the FTDMC is effective. We believe that ACT Police referrals to the FTDMC should result in immediate suspension of a driver's licence prior to review by a medical practitioner experienced in fitness to drive assessments. The ACT Police process must include review by the Sergeant of the Major Collision Team and be supported by appropriate legislation.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102797"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study explores and describes the lived experiences of postpartum women of Obstetric Violence (OV) in selected secondary health facilities in Oyo State, Nigeria.
Methods
The study utilized a qualitative research design. A purposive sampling technique was used to recruit thirty participants for the study. A Focus Group Discussion interview guide was used as an instrument of data collection. Thematic analysis was used in analyzing the data using Collaizi's seven stages of data analysis.
Results
The analyzed data on the OV experienced by postpartum women during pregnancy and childbirth generated five themes, which include verbal abuse, abandonment of care, physical abuse, non-dignified care, and non-consented care.
Conclusion
Addressing OV requires targeted policies promoting respectful care, healthcare provider training on ethical practices and informed consent, and improved healthcare infrastructure. Empowering women and establishing accountability systems are critical for fostering a dignified and safe maternal healthcare environment.
{"title":"A Cry for dignity: Verbal, physical, and emotional abuse experienced by postpartum women in Nigerian healthcare","authors":"Adetunmise Oluseyi Olajide , Chizoma Ndikom , Eunice Oluwakemi Ogunmodede , Oyeronke Olubunmi Bello , Titilope Abisola Awotunde , Esther Oluwatoyin Famutimi , Ganiyat Odunola Adeniran , Dosunmu Taiwo , Rahmat Oyekale , Deborah Tolulope Esan","doi":"10.1016/j.jflm.2025.102802","DOIUrl":"10.1016/j.jflm.2025.102802","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores and describes the lived experiences of postpartum women of Obstetric Violence (OV) in selected secondary health facilities in Oyo State, Nigeria.</div></div><div><h3>Methods</h3><div>The study utilized a qualitative research design. A purposive sampling technique was used to recruit thirty participants for the study. A Focus Group Discussion interview guide was used as an instrument of data collection. Thematic analysis was used in analyzing the data using Collaizi's seven stages of data analysis.</div></div><div><h3>Results</h3><div>The analyzed data on the OV experienced by postpartum women during pregnancy and childbirth generated five themes, which include verbal abuse, abandonment of care, physical abuse, non-dignified care, and non-consented care.</div></div><div><h3>Conclusion</h3><div>Addressing OV requires targeted policies promoting respectful care, healthcare provider training on ethical practices and informed consent, and improved healthcare infrastructure. Empowering women and establishing accountability systems are critical for fostering a dignified and safe maternal healthcare environment.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102802"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jflm.2025.102809
Ufuk Akın , Naime Meriç Konar
Suicides in children and adolescents have different characteristics from other age groups because of their unique physical and psychosocial dynamics. Having more information on childhood and adolescent suicides and knowing their characteristics will lead to the development of prevention strategies. This study aimed to evaluate demographic characteristics, suicide methods, and causes of suicides in individuals aged <19 years using 2002 and 2022 data from the Turkish Statistical Institute. Of 1746 suicide cases, 813 (46.6 %) were recorded in male teens and 933 (53.4 %) in female teens aged <15 years. Of 7698 suicide cases, 4041 (52.5 %) were reported in male teens and 3657 (47.5 %) in female teens aged 15–19 years. Family incompatibility was the most common cause of suicides in children and adolescents. The most common suicide method was hanging. Population data show a decreasing trend, particularly in developed and developing countries, among children and adolescents. Therefore, suicide is an important problem in children and adolescents, who constitute a critical dynamic population for the socioeconomic future of societies.
{"title":"Adolescent and children suicides in Turkey: Analysis of data from the Turkish Statistical Institute (2002–2022)","authors":"Ufuk Akın , Naime Meriç Konar","doi":"10.1016/j.jflm.2025.102809","DOIUrl":"10.1016/j.jflm.2025.102809","url":null,"abstract":"<div><div>Suicides in children and adolescents have different characteristics from other age groups because of their unique physical and psychosocial dynamics. Having more information on childhood and adolescent suicides and knowing their characteristics will lead to the development of prevention strategies. This study aimed to evaluate demographic characteristics, suicide methods, and causes of suicides in individuals aged <19 years using 2002 and 2022 data from the Turkish Statistical Institute. Of 1746 suicide cases, 813 (46.6 %) were recorded in male teens and 933 (53.4 %) in female teens aged <15 years. Of 7698 suicide cases, 4041 (52.5 %) were reported in male teens and 3657 (47.5 %) in female teens aged 15–19 years. Family incompatibility was the most common cause of suicides in children and adolescents. The most common suicide method was hanging. Population data show a decreasing trend, particularly in developed and developing countries, among children and adolescents. Therefore, suicide is an important problem in children and adolescents, who constitute a critical dynamic population for the socioeconomic future of societies.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102809"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nonlethal strangulation occurs when the brain is deprived of oxygen because of external compression leading to the occlusion of the neck's blood vessels and/or airway. The current state of strangulation science confines expert testimony to merely describing injuries attributed to strangulation ‘based on the expert's experience and training.’ Expert testimony that can quantify the likelihood that observed injuries are attributable to strangulation would strengthen the scientific validity of such testimony.
Purpose
This study aims to identify those documented features, or clusters of features, that are associated with cases where strangulation is reported versus cases where strangulation is not reported. Methods: This study is a retrospective analysis of medical record data from patients seeking forensic examinations for strangulation and/or sexual assault who presented to the emergency department of an academic medical center from January 2018 to June 2022.
Results
Among the 170 cases, 77 were documented as strangulation-absent and 93 were documented as strangulation-present. A simple classification algorithm was developed to identify these cases where strangulation was present. Prominent features of this algorithm included: presence of petechiae, observed number of injuries around the mouth, face, head and neck, and total number of injuries. This algorithm has a false positive rate of 5 % and a false negative rate of 32 %.
Discussion
To our knowledge, this is the first medico-legal research study to produce an algorithm to assist with classifying cases of strangulation given specific forensic examination characteristics. The study demonstrates the value of data collection in medico-legal research for developing an algorithm that enables forensic examiners to use data-driven methods to verify victims’ reports of strangulation.
{"title":"Enhancing foundational validity of forensic findings in nonlethal medico-legal strangulation examinations","authors":"Reanna Panagides , Karen Kafadar , Kathryn Laughon","doi":"10.1016/j.jflm.2025.102800","DOIUrl":"10.1016/j.jflm.2025.102800","url":null,"abstract":"<div><h3>Background</h3><div>Nonlethal strangulation occurs when the brain is deprived of oxygen because of external compression leading to the occlusion of the neck's blood vessels and/or airway. The current state of strangulation science confines expert testimony to merely describing injuries attributed to strangulation ‘<em>based on the expert's experience and training</em>.’ Expert testimony that can quantify the likelihood that observed injuries are attributable to strangulation would strengthen the scientific validity of such testimony.</div></div><div><h3>Purpose</h3><div>This study aims to identify those documented features, or clusters of features, that are associated with cases where strangulation is reported versus cases where strangulation is not reported. <em>Methods</em>: This study is a retrospective analysis of medical record data from patients seeking forensic examinations for strangulation and/or sexual assault who presented to the emergency department of an academic medical center from January 2018 to June 2022.</div></div><div><h3>Results</h3><div>Among the 170 cases, 77 were documented as strangulation-absent and 93 were documented as strangulation-present. A simple classification algorithm was developed to identify these cases where strangulation was present. Prominent features of this algorithm included: presence of petechiae, observed number of injuries around the mouth, face, head and neck, and total number of injuries. This algorithm has a false positive rate of 5 % and a false negative rate of 32 %.</div></div><div><h3>Discussion</h3><div>To our knowledge, this is the first medico-legal research study to produce an algorithm to assist with classifying cases of strangulation given specific forensic examination characteristics. The study demonstrates the value of data collection in medico-legal research for developing an algorithm that enables forensic examiners to use data-driven methods to verify victims’ reports of strangulation.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102800"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jflm.2025.102810
Roger W. Byard , Melissa Humphries
Forensic pathologists and practitioners are well aware of the number of unique or unusual cases that are not infrequently seen in a busy medicolegal practice. Unfortunately the importance of isolated cases is sometimes dismissed by those who feel that such outliers merely skew datasets and provide nothing useful in terms of analyses. Applying a statistical approach to forensic observations does, however, run the risk of losing quite valuable information that assists in understanding mechanisms and outcomes of disease and injury. Data derived from randomised controlled trials and observational studies should not be mutually exclusive as a single outlier may give much clearer understanding of possible pathophysiological mechanisms than a group of more mainstream cases. Clearly both have their uses in contributing to the literature and in helping to evaluate and analyse cases.
{"title":"The importance of outliers in forensic practice","authors":"Roger W. Byard , Melissa Humphries","doi":"10.1016/j.jflm.2025.102810","DOIUrl":"10.1016/j.jflm.2025.102810","url":null,"abstract":"<div><div>Forensic pathologists and practitioners are well aware of the number of unique or unusual cases that are not infrequently seen in a busy medicolegal practice. Unfortunately the importance of isolated cases is sometimes dismissed by those who feel that such outliers merely skew datasets and provide nothing useful in terms of analyses. Applying a statistical approach to forensic observations does, however, run the risk of losing quite valuable information that assists in understanding mechanisms and outcomes of disease and injury. Data derived from randomised controlled trials and observational studies should not be mutually exclusive as a single outlier may give much clearer understanding of possible pathophysiological mechanisms than a group of more mainstream cases. Clearly both have their uses in contributing to the literature and in helping to evaluate and analyse cases.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102810"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143127807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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