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Forensic nursing is a specialty in nursing with unique knowledge and skills, founded on a theoretic framework identifying three pillars of knowledge--legal principles, forensic science, and forensic nursing with concepts, context, and content unique to the specialty. To care for patients with trauma backgrounds, who are or have intersected with the legal system, forensic nursing education and subsequent certification today requires educational technology. Transforming learning takes demonstrative activities, changing them into interactive dynamic opportunities that teach metacognitive activities to provide complex trauma-informed care in the aftermath of violence, to forensic nurses.

The purpose of this study is to understand the pre-examination worries of individuals who experience sexual assault, and whether those worries were experienced or resolved during a telehealth-enabled, sexual assault nurse examiner-led sexual assault examination.Patient surveys were administered to understand pre-examination worries, whether those worries were ultimately experienced during the consultation, and patient perceptions of care quality, telehealth consultation, and whether the examination helped individuals feel better. Data analysis was conducted using descriptive statistics and binomial proportion tests.Surveys were collected from 74 adolescents and adults who obtained sexual assault care at 6 rural and 2 suburban hospitals. Study findings showed individuals overcome substantial worries to access care, with 66% having at least 1 worry and 41% endorsing 3 or more pre-examination worries. Most participants felt believed (83%) and did not feel judged (88%) or blamed (85%) during their examination. Analysis of pre-examination worries and worry resolution during the examination showed 88% to 100% resolution of worries related to being believed, judged, blamed or lacking control. Participants highly rated the quality of care received (92%) and 84% stated the examination helped them feel better, suggesting a sexual assault nurse examiner-led examination is an important step toward recovery and healing.These findings have implications for emergency department support for sexual assault nurse examiner-led care and public health messaging to demystify sexual assault care, allay fears, and highlight care benefits.

Recovery, a model of care aimed at patient-led nursing practice emphasizing autonomy, hope and self-determination, has in recent years been adapted for the secure forensic psychiatric setting. Often referred to as 'secure recovery', this model suggests the aims of recovery are achievable even in highly restrictive settings. This paper will adopt a Foucauldian perspective to offer a critical analysis of recovery in forensic settings. In providing recovery-oriented care, nurses utilize pastoral power in guiding patients to institutionally preferred outcomes. Akin to Christian religious conversion, nurses engage in a neo-religious conversion of patients to a neoliberal subjectivity of homo-economicus. This path of recovery is grounded in an ethos of personal responsibility and self-government, inseparable from the greater context of neoliberal governmentality. Despite attempts at transforming forensic nursing practice into more egalitarian directions, recovery remains a coercive practice, and fails to meet the overall goals of this paradigm in secure settings.

The National Protocol for Sexual Assault Medical Forensic Examinations, Adult/Adolescent, 2nd edition, or SAFE Protocol, is a voluntary guide that assists local and state jurisdictions with their responses to sexual assault by institutionalizing best practices around survivor care and evidence collection, particularly for sexual assault nurse examiners (SANEs) completing medical forensic examinations. We examined the uptake of the SAFE Protocol in communities across the United States by analyzing data from a set of national surveys of forensic nursing programs and victim advocates within the same communities. We studied four implementation outcomes: the acceptability, adoption, reach, and sustainability of the SAFE Protocol. SANEs and advocates reported that stakeholders responding to sexual assault-including forensic nurses, advocates, law enforcement, and prosecutors-have high implementation of the Protocol, which indicates how important individual stakeholder engagement is in actively facilitating the adoption of it. However, when information from SANEs and advocates from the same community are compared, the extent to which the SAFE Protocol is reported to be implemented with fidelity across U.S. jurisdictions is mixed.

Uma revisão de escopo que busca mapear o manejo da enfermagem forense na urgência e emergência. A busca pelos estudos será realizada através das seguintes bases de dados e plataformas nacionais e internacionais: PubMed, CINAHL, Embase, Scopus, PsycINFO, Banco de Dados JBI de Revisões Sistemáticas e Relatórios de Implementação, Cochrane (ensaios controlados e revisões sistemáticas), Web of Science, LILACS e HeinOnline. A pesquisa de literatura cinzenta e estudos não publicados incluirá: Teses e Disserbtações da ProQuest, MedNar, OpenGrey, Open Thesis, Repositório Científico de Acesso Aberto de Portugal (RCAAP), Portal de Teses e Dissertações da CAPES, Biblioteca Nacional de Trobos da Austrália, Arquivo Académico Online, DART Portal Europeu de E-Teses, Serviço Online de Teses Eletrônicas, Portal Nacional ETD, Theses Canadá e Google Acadêmico. Os dados serão extraídos para uma planilha do Excel contendo as seguintes variáveis: título, ano, idioma, país, abordagem metodológica e tipo de documento. A princípio será realizada a leitura dos títulos dos documentos que surgirem após o uso dos descritores pré-definidos. Em sequência serão selecionados os estudo que contenha em seu título os descritores supracitados. Após leitura do resumo, os estudos que atendem ao objetivo, serão elegíveis para leitura na íntegra.

Introduktion: Varje år avlider 4,4 miljoner människor till följd av våld. Forensisk omvårdnad innebär att vårda våldsoffer, förövare och familjer som drabbats av våld samt samla in och bevara potentiellt bevismaterial som senare kan användas för att fälla en eventuell förövare. Ambulanspersonal har en unik möjlighet att upptäcka om en person blir utsatt för våld då ambulanspersonal ofta är först på plats och kan utvärdera patienten i dess hemmiljö. Vidare har ambulanspersonalen möjlighet att intervjua patienten under transporten in till sjukhus och samtidigt göra en närmare undersökning utan eventuell förövare i närheten. Syfte: Beskriva forensisk omvårdnad inom ambulanssjukvård. Metod: En systematisk integrativ litteraturstudie genomfördes och analyserades enligt Whittemore och Knafl´s femstegsmodell. Totalt inkluderades 14 artiklar i studien. Resultat: Fyra huvudkategorier identifierades. Identifiering av ett forensiskt fall, omvårdnadsåtgärder kopplade till forensisk omvårdnad, ambulanspersonalens behov av utbildning och verktyg och rädsla att göra fel. Konklusion: Det förelåg kunskapsluckor i att upptäcka tecken och symtom på våld som inte var tydligt framträdande. Ett behov av tydligare riktlinjer och mer utbildning inom forensisk omvårdnad inom ambulanssjukvård fanns. Introduction: Every year 4.4 million people suffer as a result of violence worldwide. Forensic nursing involves caring for victims, perpetrators and families affected by violence, and collecting and preserving of evidence in the chain of custody. Paramedics have a unique opportunity to identify a person who is exposed to violence since they are often first on scene and can evaluate the patient in its home environment. Paramedics have the opportunity to interview the patient during transport to the hospital and also do a closer examination without a possible perpetrator nearby. Aim: To describe forensic nursing in ambulance care. Method: A systematic integrative literature review was used and analysed using Whittemore and Knafl's five-step model. A total of 14 articles were included in the study. Results: The analysis resulted in four main categories. Identification of a forensic case, nursing care linked to forensic nursing, paramedics need for training and tools and fear of making mistakes. Conclusion: There is gap to be filled in detecting signs and symptoms of violence that are not obvious. Evident guidelines and more training in forensic nursing are needed in ambulance medical care.

Objetivo: Descrever como atua o enfermeiro na preservação de vestí­gios forenses em casos de violência sexual. Métodos: revisão integrativa realizada por meio das bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados em Enfermagem (BDENF) e Scientific Electronic e Library Online (Scielo). O perí­odo da coleta aconteceu no mês de Setembro de 2020. Resultados: Na presente revisão integrativa, analisou-se 06 artigos que atenderam aos critérios de inclusão previamente estabelecidos e, a seguir, apresentou-se um panorama geral dos artigos avaliados. A escassez de conhecimento cientí­fico referente í violência e enfermagem forense levam aos profissionais de saúde encontrarem dificuldades na utilização de técnicas especí­ficas para a preservação dos indí­cios. Conclusão: o enfermeiro forense possui uma gama de responsabilidade perante os sobreviventes de violência sexual, desde a abordagem até o manuseio adequado das provas.

Objective: to identify the characteristics of women victims of violence. Method: this is an integrative review, which used five databases, with three intersections of Health Science Descriptors in Portuguese, English and Spanish, finding a final sample of 22 articles. Results: the main characteristics were: age between 18 and 30 years old, use of alcohol/drugs, being a university student, affiliated with republics, history of neglect and child abuse, predominance of sexual violence, presence of suffering and mental disorders such as generalized anxiety disorder, depression, post-traumatic stress disorder, and schizoid, borderline, and paranoid personality disorder. Three categories of discussion emerged related to the characteristics of the victims: addictive behaviors, risk factors and behaviors, and mental disorders. Final considerations: it is evident the importance of nurses having knowledge about the factors capable of increasing the risk of violence, with the aim of working on prevention and health promotion, such as the perception of the characteristics reproduced in women victims of violence, with the objective of identifying cases early, alleviating the strong pressure caused by violence in the personal, family and social spheres, in addition to providing adequate assistance to victims. Objetivo: identificar las características de las mujeres víctimas de violencia. Método: se trata de una revisión integradora, que utilizó cinco bases de datos, con tres cruces de Descriptores de Ciencias de la Salud en portugués, inglés y español, encontrando una muestra final de 22 artículos. Resultados: las principales características fueron: edad entre 18 y 30 años, uso de alcohol/drogas, ser estudiante universitario, afiliado a repúblicas, antecedentes de abandono y maltrato infantil, predominio de violencia sexual, presencia de sufrimiento y trastornos mentales como trastorno de ansiedad generalizada, depresión, trastorno de estrés postraumático y trastorno de personalidad esquizoide, límite y paranoide. Surgieron tres categorías de discusión relacionadas con las características de las víctimas: conductas adictivas, factores y conductas de riesgo y trastornos mentales. Consideraciones finales: se evidencia la importancia de que los enfermeros tengan conocimientos sobre los factores capaces de aumentar el riesgo de violencia, con el objetivo de trabajar en la prevención y promoción de la salud, como la percepción de las características reproducidas en las mujeres víctimas de violencia, con el objetivo de identificar los casos de manera temprana, aliviando la fuerte presión que genera la violencia en el ámbito personal, familiar y social, además de brindar una adecuada asistencia a las víctimas. Objetivo: identificar as características de mulheres vítimas de violência. Método: trata-se de uma revisão integrativa, que utilizou cinco base de dados, com três cruzamentos de Descritores em Ciência da Saúde em português, inglês e espanhol, encontrando uma amostra final de 22 artigos. Resultados: as principais características foram: idade entre 18 e 30 anos, uso de álcool/drogas, serem universitárias, afiliadas a repúblicas, histórico de negligência e abuso infantil, predominância de violência sexual, presença de sofrimento e transtornos mentais como transtorno de ansiedade generalizada, depressão, transtorno de estresse pós-traumático e transtorno de personalidade esquizoide, limítrofe e paranoica. Emergiram três categorias de discussão relacionadas a características das vítimas: comportamentos adictos, fatores e comportamentos de risco e transtornos mentais. Considerações finais: evidencia-se a importância de o enfermeiro dispor de conhecimento sobre os fatores capazes de aumentar o risco à violência, com o intuito de trabalhar a prevenção e promoção de saúde, tal como a percepção das características reproduzidas em mulheres vítimas de violência, com o objetivo de identificar precocemente os casos, aliviando a forte pressão causada pela violência no âmbito pessoal, familiar e social, além de prestar a assistência adequada às vítimas.

This is a scoping review protocol.

Objective: to map assessment tools for elder abuse and determine the psychometric properties of each one. Method: scoping review developed according to recommendations of the JBI Institute Reviewer’s Manual in databases and gray literature. Results: seventeen tools were identified for measuring situations of elder abuse. They were categorized into 1) Tools for assessment of risk for abuse, and 2) Tools for identification of abuse. According to risk for abuse, Vulnerability to Abuse Screening Scale was the most prevalent in the literature, with factorial analysis acceptable through four domains, and good internal reliability (0,74). Therefore, Assessment Tool for Domestic Elder Abuse comprises the assessment of six types of elder abuse; however, the study shows psychometric limitation since the internal structure was not evaluated by validity evidences. Conclusion: seventeen tools to determine the occurrence or risk for elder abuse were identified with different psychometric properties. We recommend the use of more than one of the tools identified for an appropriate measurement of elder abuse situations given the complexity of the phenomenon and the lack of a single instrument that contemplates all its consequences and forms of expression. RESUMO Objetivo: mapear ferramentas de avaliação do abuso de idosos e determinar as propriedades psicométricas de cada uma. Método: revisão do escopo desenvolvido de acordo com recomendações do Manual do Revisor do Instituto JBI em bancos de dados e literatura cinzenta. Resultados: foram identificadas dezessete ferramentas para medir situações de maus-tratos a idosos. Elas foram categorizadas em 1) Ferramentas para avaliação de risco de abuso, e 2) Ferramentas para identificação de abuso. De acordo com o risco de abuso, a Escala de Vulnerabilidade ao Abuso foi a mais prevalente na literatura, com análise fatorial aceitável através de quatro domínios, e boa confiabilidade interna (0,74). Portanto, a Ferramenta de Avaliação para Abuso Doméstico de Idosos compreende a avaliação de seis tipos de abuso de idosos; entretanto, o estudo mostra limitação psicométrica, uma vez que a estrutura interna não foi avaliada por evidências de validade. Conclusão: dezessete ferramentas para determinar a ocorrência ou risco de abuso de idosos foram identificadas com diferentes propriedades psicométricas. Recomendamos o uso de mais de uma das ferramentas identificadas para uma medição apropriada das situações de abuso de idosos, dada a complexidade do fenômeno e a falta de um único instrumento que contemple todas as suas consequências e formas de expressão. RESUMEN Objetivo: mapear las herramientas de evaluación del maltrato a personas mayores y determinar las propiedades psicométricas de cada una de ellas. Método: revisión de alcance desarrollada según las recomendaciones del Manual del Revisor del Instituto JBI en bases de datos y literatura gris. Resultados: se identificaron diecisiete herramientas para medir situaciones de maltrato a personas mayores. Se clasificaron en 1) Herramientas para la evaluación del riesgo de maltrato, y 2) Herramientas para la identificación del maltrato. Según el riesgo de abuso, la Escala de Detección de Vulnerabilidad al Abuso fue la más prevalente en la literatura, con un análisis factorial aceptable a través de cuatro dominios, y una buena fiabilidad interna (0,74). Por lo tanto, el Instrumento de Evaluación del Abuso Domestico en Personas Mayores comprende la evaluación de seis tipos de maltrato a los ancianos; sin embargo, el estudio muestra limitación psicométrica ya que la estructura interna no fue evaluada por las evidencias de validez. Conclusión: e identificaron diecisiete herramientas para determinar la ocurrencia o el riesgo de maltrato a los ancianos con diferentes propiedades psicométricas. Se recomienda el uso de más de una de las herramientas identificadas para una adecuada medición de las situaciones de maltrato a los mayores dada la complejidad del fenómeno y la falta de un único instrumento que contemple todas sus consecuencias y formas de expresión.

Half a million people are murdered each year, and millions more children, women, and men suffer from the aftereffects of violence in their homes, schools, and communities. Violence is a serious public health problem around the world. The first place a victim of violence or the person who committed the act will typically be taken for medical care is a hospital emergency room. The ability to recognize, assess, and care for these patients is a specialty of emergency nurses. A forensic nurse is one who takes care to victims of violent crimes while they are in the hospital. A nursing speciality known as "forensic nursing" in the emergency room concentrates on identifying patients whose illness, injury, or death resulted from violent acts. According to recent information, nurses lack competence and confidence when it comes to understanding forensic issues and screening patients for violence. Therefore, it is crucial for the nursing profession to remove any uncertainty from forensic patient care for emergency department nurses in order to enable proper and efficient medical and legal interventions. As a result, the goal of this study was to pinpoint the areas in need of nursing education connected to the forensic nursing process as well as any gaps in nursing knowledge and practice so that the proper training might be created for this nursing speciality.

Gender differences impact the work that professionals engage in with sexual offenders and victims of sexual trauma (with females often perceived as more likely to experience sexual trauma, and males as more likely to commit a sexual offence). However, there is no evidence looking at these factors in combination. This study aimed to address this gap, asking: “Are experiences of nursing staff working with sex offenders with a history of sexual trauma affected by gender differences, that is, in terms of gender of the staff member, and gender of the client they are working with?” Eight participants, (four male, four female) working within a Forensic Mental Health Service took part in semi-structured interviews. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Five superordinate themes emerged from the data, along with a number of subordinate themes. Superordinate themes included: ‘Gender has a role’, ‘The trauma response’, ‘How we cope’, and ‘What we need’. Nursing staff working with sexual offenders with historic sexual trauma found work to be challenging both emotionally and socially. Such challenges were complicated by the gender interaction between them as professionals, and the patients who have experience of being both victims and perpetrators of sexual abuse.

Trans survivors of sexual assault have called for the development and implementation of training for care providers. To answer this call, we developed and evaluated an innovative e-learning curriculum for forensic nurses working across Ontario, Canada, on the provision of trans-affirming care. The e-learning curriculum, developed in Storyline 360 by Articulate, was launched in August 2019. The competence of nurses (N=65) completing the curriculum improved significantly from pre- to post-training across all content domains (Initial assessment, Medical care, Forensic examination, and Discharge and referral). This e-learning curriculum could be of utility in training forensic nurses worldwide.

Prescription drug misuse is when someone takes a medication inappropriately. The prescription drug misuse is not an uncommon issue but the use of prescription drugs has significantly increased during the covid 19 pandemic. The major factors that has contributed to the increased dependence to prescription drug use during the pandemic is the increased paranoia about the virus and the drug dependency of the substance abusers. The context of the study is the increased use of prescription drugs among young adults and case reports of violence attributed by drug use. The main aim of the study is to identify the trend of prescription drug use among young adults and the factors that contribute to the misuse. The study primarily focused on young adults and recorded the responses using the questionnaire. The methodology for the proposed study was through online interaction with the participants in the form of survey through google forms. The data collection method included literature review of published articles pertaining to the topic, newspaper articles and websites. The data collection was primarily through google forms and participants response are analyzed for arriving into conclusion. Further-more data from published article, journals, data published in websites like the National Health Portal, National Institute of Health (NIH)- National Institute of Drug Abuse (NIDA), World Health Organization (WHO). Both primary and secondary data is used for data collection. An age group between 20-30 was collected. This age group was selected due to the possibility that most utilization of prescription drugs would be contributed by these groups. Mostly randomized sampling was carried out due to the limitation of collecting data one to one considering the pandemic situations. After analyzing the results, it is inferred that there is a significant increase in use of prescription drugs during the pandemic time and the study also found a trend of alarming concern of buying prescription drug without it being prescribed by the medical practitioner which hence is a serious case of social concern.

Pro re nata (PRN, as-needed) medication is commonly used in forensic psychiatric inpatient care, but little is known about the participation of patients in its prescription and administration. This...

This work is the result of one of the activities of the Training Assistant Course of CBMERJ and aimed to analyze critically the Film “The Day of the Attack” and discuss expert actions that are addressed during the film from the perspective of Brazilian expertise. Methods: This is a qualitative research of the type Critical Review of Film and written in eight steps: identification of the work, Identification of the author of the film, presentation of the work, description of the structure, writing on the content, critical analysis of the object of the film, recommendation to the audience of interest and identification of the designer. Results and discussion: after watching the film, it was possible to discuss the scene where there is the explosion in the Boston Marathon, and bring elements of Brazilian legislation and literature that corroborate the actions of the film. Final Considerations: it was possible to visualize through the film some stages of the process of expertise, the need to invest in the psychological approach of the agents in charge of investigations, the valorization of the Nurse as a pre-hospital care professional and co-responsible for the preservation of traces and maintenance of the chain of custody, and the critical review is a relevant pedagogical action in the scientific development of the student of the Auxiliary Skills Course. Este trabajo es el resultado de una de las actividades del Curso de Asistente de Capacitación de CBMERJ y tuvo como objetivo analizar críticamente la película “El Día del Ataque” y discutir las acciones de expertos que se abordan durante la película desde la perspectiva de la experiencia brasileña. Métodos: Se trata de una investigación cualitativa del tipo Critical Review of Film y escrita en ocho pasos: identificación de la obra, identificación del autor de la película, presentación de la obra, descripción de la estructura, escritura sobre el contenido, análisis crítico del objeto de la película, recomendación al público de interés e identificación del diseñador. Resultados y discusión: después de ver la película, fue posible discutir la escena donde se produce la explosión en el Maratón de Boston, y traer elementos de la legislación y literatura brasileña que corroboran d'eat con las acciones de la película. Consideraciones finales: se logró visualizar a través de la película algunas etapas del proceso de experticia, la necesidad de invertir en el abordaje psicológico de los agentes encargados de las investigaciones, la valorización de la Enfermera como profesional de cuidados prehospitalarios y corresponsable de la preservación de rastros y mantenimiento de la cadena de custodia, y la revisión crítica es una acción pedagógica relevante en el desarrollo científico del alumno del Curso de Habilidades Auxiliares. Este trabalho é fruto de uma das atividades do Curso de Auxiliar de Pericias do CBMERJ e teve como objetivo analisar de forma Critica o Filme “O Dia do Atentado” e discutir ações periciais que são abordadas durante o filme na ótica da perícia Brasileira. Métodos: Trata-se de uma pesquisa qualitativa do tipo Resenha Crítica de Filme e escrita em oito passos: identificação da obra, Identificação de o autor do filme, apresentação da obra, descrição da estrutura, escrita sobre o conteúdo, análise crítica do objeto do filme, recomendação para o público de interesse e identificação do resenhista. Resultados e discussão: após assistir ao filme, foi possível discorrer acerca da cena onde há a explosão na maratona de Boston, e trazer elementos da legislação e da literatura Brasileira que corroborassem com as ações do filme. Considerações Finais: foi possível visualizar através do filme algumas etapas do processo de perícia, da necessidade de investir na abordagem psicológica dos agentes encarregados das investigações, da valorização do Enfermeiro enquanto profissional de atendimento pré-hospitalar e corresponsável pela preservação dos vestígios e manutenção da cadeia de custódia, sendo a resenha crítica uma ação pedagógica relevante no desenvolvimento científico do aluno do Curso de Auxiliar de Perícias.

Revisão integrativa sobre características reproduzidas em mulheres vítimas de violência.

Introduction: Human trafficking is one of the most profitable illegal sources in the world, moving about 2.5 million people and more than US$ 32 billion per year. Nurses are essential for identifying trafficked persons, promoting health, and developing and implementing public policies. Objective: To analyze the assistance provided and the preparation of nurses in the care of victims of trafficking in persons at the Primary Care level. Method: This is an integrative review. Its development was based on the following guiding question: “Are nursing professionals trained to prevent, identify and assist victims of human trafficking?”. PubMed, Science Direct, SciELO and Springer databases were used. Results: 8 articles were selected for the composition of this research. that victims of human trafficking receive health care, whether in urgent and emergency centers, outpatient clinics or in the scope of primary care, however, the lack of preparation of professionals in the health system results in inadequate care for these victims, since there are a lack of training and education on trafficking that assists in the identification and holistic care of these individuals. Conclusion: The results express the lack of training of professionals to recognize the trafficked individual, as well as the need for comprehensive care in care, and highlight the importance of primary care as a fundamental part of this process. Introducción: La trata de personas es una de las fuentes ilegales más rentables del mundo, moviendo alrededor de 2,5 millones de personas y más de US$ 32 mil millones por año. Los enfermeros son fundamentales para la identificación de las personas en situación de trata, la promoción de la salud, el desarrollo y la implementación de políticas públicas. Objetivo: Analizar la asistencia brindada y la preparación de los enfermeros en el cuidado de víctimas de trata de personas en el nivel de Atención Primaria. Método: Esta es una revisión integradora. Su desarrollo se basó en la siguiente pregunta orientadora: “¿Los profesionales de enfermería están capacitados para prevenir, identificar y asistir a las víctimas de trata de personas?”. Se utilizaron las bases de datos PubMed, Science Direct, SciELO y Springer. Resultados: 8 artículos fueron seleccionados para la composición de esta investigación. que las víctimas de trata de personas reciban atención en salud, ya sea en centros de urgencia y emergencia, ambulatorios o en el ámbito de la atención primaria, sin embargo, la falta de preparación de los profesionales en el sistema de salud trae como consecuencia una inadecuada atención a estas víctimas, ya que existen falta de capacitación y educación sobre trata que ayude a la identificación y atención integral de estas personas. Conclusión: Los resultados expresan la falta de formación de los profesionales para reconocer a la persona en situación de trata, así como la necesidad de una atención integral en la atención, y destacan la importancia de la atención primaria como parte fundamental de ese proceso. Introdução: O tráfico de pessoas é uma das fontes ilegais mais rentáveis do mundo, movimentando cerca de 2,5 milhões de pessoas e mais de US$ 32 bilhões por ano. Os enfermeiros são essenciais para a identificação de pessoas traficadas, promoção de saúde, desenvolvimento e implementação de políticas públicas. Objetivo: Analisar a assistência prestada e o preparo dos enfermeiros no atendimento às vítimas de tráfico de pessoas a nível de Atenção Primária. Método: Trata-se de uma revisão integrativa. Seu desenvolvimento deu-se a partir da seguinte questão norteadora: “Os profissionais de enfermagem estão capacitados para prevenir, identificar e dar assistência às vítimas do tráfico de pessoas?”. Foram utilizadas as bases de dados PubMed, Science Direct, SciELO e Springer. Resultados: Foram selecionados 8 artigos para composição desta pesquisa. que as vítimas do tráfico de pessoas recebem assistência à saúde, seja em centros de urgência e emergência, ambulatório ou no âmbito da atenção primária, contudo, o despreparo dos profissionais no sistema de saúde resulta em um atendimento inadequado para essas vítimas, visto que há uma carência de treinamento e educação sobre o tráfico, que auxilie na identificação e cuidado holístico desses indivíduos. Conclusão: Os resultados expressam a carência de capacitação dos profissionais para o reconhecimento do indivíduo traficado, bem como a necessidade do cuidado integral no atendimento, e destaca a importância da atuação da atenção primária como parte fundamental deste processo.

Este trabalho tem como objetivo identificar as evidências presentes na literatura internacional a respeito da preservação de vestígios forenses na emergência pelo(a) enfermeiro(a).

Objective: to map the screening tools for elder abuse and determine the psychometric properties of each one. Method: scoping review developed in 12 databases, libraries and digital repositories using the participants-concept-context research strategy. Initially, 22,273 articles indexed in databases and 81,377 of the gray literature were identified. After reading titles and abstracts, and analysis in full, 226 documents containing any validated screening tool for abuse remained. Results: seventeen tools for measuring situations of elder abuse were identified. They were categorized into 1) Tools for assessment of risk for abuse and 2) Tools for identification of abuse. Conclusion: we recommend the use of more than one of the tools identified for an appropriate measurement of elder abuse situations given the complexity of the phenomenon and the lack of a single instrument that contemplates all its consequences and forms of expression.

COVID-19 may have changed the 'physical classroom', but learning doesn’t stop. In global perspective, digitalization played a major role in medical education of forensic medicine and other subjects when COVID-19 lockdown forced. Physical classroom were not possible due to safety norms so as to maintain social distancing. Post lockdown continuing digital transformation got more momentum. Challenges and opportunities started coming in front for students and faculties. This study was done to analyze impact of transition of teaching methodology to students in medical institutions. Keywords: Online education, Digitalization, COVID 19, Pandemic, Teaching & learning, Forensic medicine.

The health benefits of physical activity are well established. In India, it is estimated that overall, 392 million individuals are physically inactive. This is a staggering figure and implies a huge population, which is at risk for developing diabetes and other non-communicable diseases. Identification of barriers for physical activity among youngsters would help in development of plans for boosting physical activity among young population. The present study is an attempt to explore various barriers for being active among medical undergraduates. : The study was conducted at a medical college in Uttar Pradesh. Sample was drawn using convenience sampling. The data collection was done based on “CDC questionnaire on barriers to being active” using self-administered questionnaire. All the participants fulfilling inclusion criteria were asked to fill the forms honestly by choosing the best option describing their barrier for physical activity against each question in the proforma. A total of 203 MBBS students participated in the study, comprising of 108 males 95 females. The mean age of the participants was 22.02 years (Range 18 years-26 years). The factor which was perceived as the most significant determinant for physical inactivity was “lack of willpower”. Other significant contributors were “lack of resources”, “lack of energy”, “social influence”, “lack of skills” and “fear of injury” in decreasing order of importance. The sum scores of seven barriers studied were significantly correlated (p

India has the largest population of adolescents in the world (1/5th of world’s adolescents)with4-33% prevalence of mental health disorders. The present study was conducted to assess the mental health status of adolescent school going children in Karnataka. A cross sectional study was conducted among 375 adolescent school going children aged 10-15 years in a private school in Karnataka (June-August 2019). Students were interviewed by pretested questionnaire after obtaining informed assent from the school administrators and primary care givers. The questionnaire included 4 different domains viz., Educational, Physical health, Emotional and Social factors. Scores ranged between 0 – 41 and interpreted as higher the scores better the mental health status of student. Data was analyzed using SPSS software version 24.Out of 375 participants, 48.8% were girls and 51.2% were boys with mean age of 12.7 yrs. Overall 12.5% students had abnormal mental health status, which was more among girls (15.4%) compared to boys (9.9%) and it was statistically significant (p < 0.021). Of 4 domains, physical health factor was most affected (17.3%), followed by educational factor (15%). Gender-wise, educational domain was most affected among boys (17.7%, p = 0.034) and physical health domain among girls (20.2%, pThis study shows that abnormal mental health status is prevalent among adolescents and more among girls. Of the 4 domains, Physical health was most affected. This problem needs addressal with well defined school-based intervention programs.

Patients receiving medical forensic examinations following sexual assault often do not receive important follow-up care. To address this gap, we developed and tested a bidirectional text-messaging protocol, Text-SAFE (sexual assault forensic exams). Text-SAFE included automated text messages over 37 days, covering mental health, sexually transmitted infections, medications, and pregnancy. Patients could also send and receive messages. We evaluated feasibility for broader application by examining enrollment rates, patient responses and evaluations, protocol completion and reliability, and nurse compliance with the protocol. A total of 25 patients participated: 24/25 sent at least one text; 21/25 received all messages. Participants found Text-SAFE comfortable and helpful. We identified areas for improvement.

Objective The purpose of this study was to compare the frequency and types of anogenital trauma in rape victims as a function of the time interval between the assault and recent (72 h) consensual sexual intercourse. Methods This retrospective cohort trial evaluated consecutive female patients, age 13 years or older, presenting to a community-based nurse examiner clinic (NEC) during a 5-year study period. The NEC facility is staffed by forensic nurses trained to perform medical-legal examinations using colposcopy with nuclear staining and digital imaging. Eligible patients were classified into five different groups based on the time interval from the last consensual intercourse to the forensic examination (none, 0–24 h, 25–48 h, 49–72 h, 73–96 h). Patient demographics, assault characteristics, and injury patterns were recorded using a standardized classification system. Results A total of 947 cases of sexual assault met the inclusion criteria and were divided into five groups. The age range was 13 to 87 years (mean, 23.9 years); 78% were examined within 24 h following sexual assault. The five study groups were comparable in terms of demographics, assault history, and incidence of non-genital injuries. The overall frequency, type, or location of anogenital injury did not vary significantly between groups (p > 0.5). Conclusion This is the first clinical study to systematically compare the prevalence and typology of anogenital injuries in sexual assault victims who have had consensual intercourse within four days before a forensic exam. The frequency, type or location of anogenital trauma did not vary significantly based on the time interval from last consensual intercourse to the forensic examination.

Objetivo:mapear la producción científica sobre la preservación de rastros forenses por profesionales de enfermería que trabajan en los servicios de emergencias.Método:revisión de alcance, con búsqueda de los estudios realizados en seis bases de datos, en la literatura gris disponible enGoogle Scholar y en las referencias de los estudios seleccionados. Para el análisis, se adoptó el método de reducción de datos.Resultados:se incluyeron 26 estudios organizados en cinco categorías: 1) Conocimiento de los profesionales de enfermería sobre la preservación de rastros forenses; 2) Procedimientos que realizan los enfermeros para preservar rastros en el cuerpo de la víctima; 3) Procedimientos que realizan los enfermeros para preservar rastros en las pertenencias/objetos de la víctima; 4) Procedimientos que realiza el personal de enfermería para documentar los rastros; y 5) Acciones que llevan a cabo los enfermeros para mantener la cadena de custodia.Conclusión:los estudios demostraron que hay situaciones en las cuales el enfermero de emergencias puede actuar para preservar los rastros forenses presentes en el cuerpo de la víctima y en los objetos, así como también registrar los rastros, lo que comprueba la actuación del enfermero para garantizar la integridad de la cadena de custodia, particularmente en situaciones de agresión, heridas con arma de fuego, violencia sexual, abuso infantil y asistencia a víctimas de trauma. Objetivo:mapear a produção científica sobre a preservação de vestígios forenses pelos profissionais de enfermagem que atuam nos serviços de emergência.Método:revisão de escopo, com buscas dos estudos realizadas em seis bases de dados, na literatura cinzenta disponível noGoogle Scholar e nas referências dos estudos selecionados. Para análise, adotou-se o método de redução de dados.Resultados:foram incluídos 26 estudos que foram organizados em cinco categorias: 1) Conhecimento dos profissionais de enfermagem sobre a preservação de vestígios forenses; 2) Procedimentos realizados pela enfermagem para preservação de vestígios no corpo da vítima; 3) Procedimentos realizados pela enfermagem para preservação de vestígios em pertences/objetos da vítima; 4) Procedimentos realizados pela enfermagem para documentação dos vestígios; e 5) Ações de manutenção da cadeia de custódia realizada pela enfermagem.Conclusão:os estudos mostraram situações em que o enfermeiro de emergência pode atuar na preservação de vestígios forenses presentes no corpo da vítima e em objetos, bem como no registro dos vestígios, verificando-se a atuação da enfermagem para garantir a integridade da cadeia de custódia, principalmente em situações de agressão, de ferimento com arma de fogo, violência sexual, abuso infantil e na assistência a vítimas de trauma. Objective:to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services.Method:a scoping review, with searches for studies carried out in six databases, in the gray literature available inGoogle Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted.Results:26 studies were included, organized into five categories: 1) Nursing professionals’ knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim’s body; 3) Procedures performed by Nursing to preserve traces in the victim’s belongings/objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing. Conclusion:the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim’s body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims.

Purpose: Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master’s nursing students.Methods: In a quasi-experimental study with a pre- and post-test, 106 master’s nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days.Results: A total of 88 out of 106 master’s nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P

One minute Paper is the quick and simple classroom assessment tool. It is benefited to both students and teacher to understand the must know learning points. This tool was applied to the undergraduate students to assess the understanding on the content of lecture as per learning objective, their feedback and perception on one minute paper. At the end of the session, one minute given to answer -What are the most important things you learned today from lecture? What question (s) do you still have in your mind? and Is there anything you did not understand? More than 90 percent were responded for one minute paper. Sixty eight percent of the students appreciated that it was done nicely and fairly done. Thirty two of the students perceived the technique of one minute paper utilization as learner centred and 11.6% as thinking centred. Few apparent responses that were obtained were the liberty to ask questions (15.9%), better understanding of the topic (26.1%) and mutually beneficial (15.9%). One minute paper is an inexpensive, instant, insightful and informative classroom assessment tool. Involvement of students in the teaching learning process with active participation were the learning outcome. The writing activity in the form of one minute paper focused the students to give their thoughts, perspective and pinpoint their questions before leaving the class. Keywords: One minute paper, Class room assessment, Faculty effectiveness, Students learning.

Forensic odontology is a branch of forensic sciences that uses the skill of the dentist in personal identification during mass calamities, sexual assault and child abuse to name a few. This branch has been growing potentially in its ability to bring justice to the concerned when dental remains are the only available evidence. It is gaining importance in the judiciary and hence in depth knowledge in this field seems irreplacable. Keywords: Forensic identification, DNA, Forensic odontology, Ameloglyphics, Rugoscopy, Cheiloscopy, Saliva, Bite marks.

Background: As with tobacco use, alcohol use shows a monotonic increase during adolescents and young adulthood, particularly during the transition out of high school and excessive alcohol consumption can lead to lifelong problems and chronic diseases. Objective: To study the addiction behavior practiced by the Adolescent. Study Design: An observational cross-sectional study. Setting: The present study was carried out in Department of Community Medicine, Santosh Medical College, Ghaziabad & Urban area of district Ghaziabad. 750 Adolescents aged 10 to 19 years studying in the selected schools of urban Ghaziabad were included for the study. The period of study was from November 2011 to October 2012. Results: Proportion was higher (64.8%) in male adolescents in comparison to female adolescents (33.9%). The prevalence of drugs, smoking, tobacco chewing and drinking among adolescents was found to be 2.5%, 21.7%, 9.6% and 15.5% respectively. Among the adolescents, who used tobacco chewing, 61.1% of them were ever users and 38.9% were current users. The students who used smoking, 50.3% of them were ever users and 49.7% were current users. Students who used addicting substance, their encouragement to start addiction was maximum from peers (33.0%). About three-fourth (75.4%) of adolescents who used addicting substance had knowledge of health hazards of addicting substances. Conclusion: The study evokes an urgent need to stimulate an action to identify those at risk and those who need treatment and prevention of progression of the health risk behaviors, among the adolescents. Keywords: Adolescent, Addiction behavior, Source of inspiration, Addicting substance, Health hazards.

INTRODUCTION Prosecution of child sexual abuse (CSA) cases provides safety for communities and justice for victims. Prosecutorial decisions are multifactorial and include the presence of a structured coordinated community response to outcries and access to skilled healthcare providers. This study examines the impact forensic nurse sexual assault examinations (SAEs) have on prosecution in a population of children seen at a child advocacy center (CAC). METHODS The authors examined case data from 553 cases of reported CSA, seen by a forensic nurse in a CAC. RESULTS Statistical analysis focused on prosecution decisions with and without SAE, with and without physical findings. Logistic regression determined prosecution occurred more often when SAE had been conducted (p = 0.026, OR = 1.732, 95% CI [1.068, 2.808]), regardless of examination findings. LIMITATIONS The limitations include a single location for data and the multifactorial reasons for prosecution of cases. DISCUSSION The multifactorial elements contributing to prosecutorial decisions are diverse. The formalized approaches in CACs historically show increased prosecution. Teasing out the impact of an SAE in a CAC may be reflective of positive CAC approaches. Regardless, a statistically significant finding of association uniquely with the SAE, with or without findings, implies more studies are needed to support the role of the forensic nurse in successful prosecutions of CSA cases.

Introduction: In the Present study, it has been tried to assess the awareness regarding medico-legal issues those arising during medical procedure among obstetricians and gynecologists in Rajkot city of Gujarat. The present study will help to know the areas of weakness and will suggest necessary remedial measures in this regards. Materials and Methods: The present study was conducted at P. D. U. Government Medical College and Hospital. Study sample included Government and Private Obstetricians and Gynecologists of Rajkot city. Total 80 opinions were collected personally from Obstetricians & Gynecologists. Specially prepared standard questionnaire was given to them and their response was collected. The questions in questionnaire were related to promptness & procedural awareness in sexual offence cases, awareness of laws, insight about causes of negligence and awareness regarding various medicolegal issues. Collected responses were statistically analyzed using Microsoft excel. Results and Conclusions: Government hospital doctors are more aware about the medico-legal issues arising during medical practice than the private hospital doctors. Among them, male doctors are more aware than the female doctors. Male doctors are more experienced than female doctors in handling of MLC cases. Government hospital doctors are more aware about the PCPNDT act and other laws related to practice. Promptness of examination of sexual assault victim as well as knowledge of collection and preservation of evidence in such cases was observed more in government doctors than the private doctors. 32.50% practitioners know that they have to attend the MLC's as per merit of the case and 16.25% do not know about it. It was quite clear in this study that 47.50% practitioners have the insight of real causes of negligence and litigations, 16.25% are confuse, while 27.5% are not aware of the same. Keywords: PCPNDT, MTP, Medico legal, Obstetrician, Gynecologists.

Introduction: Consumption of tobacco leads to a myriad of ill effects among the smokers as well as those in their proximity. This study was conducted in the population in the age group of 15-24 years, the vulnerable period of life when most of health-related behaviours develop. Materials and Methods: 1.Study design: Cross- sectional study. 2. Participants: 300 students; 75 each from Schools, degree colleges, professional colleges and post graduate departments of University of Jammu, in the age group of 15- 24 years belonging to different regions of Jammu, Kashmir and Ladakh. 3. Sampling: Stratified Systemic Sampling technique. 4. Study instrument: A subset of key questions from Global Adult Tobacco Survey (GATS) 2nd edition. Results: Prevalence of smoking was 11.33%. Non indulgence in smoking was seen among students aged below 16 years, and was seen to be twice among over 20 years (16.77%) as compared to 17-19 years group (9.37%). Among male students, it was ten- times (20.66%) higher than females (2%). It was higher in government than in private institutions (13.33% vs. 9.33%). Prevalence of smokeless tobacco consumption was 2%; 3.35% in ?20 years age group, 1.04% among 17-19 years and nil among ?16 year age. Male to female ratio was 5 to 1. Ratio of prevalence in Private institutions to government institutions was more than 3 to 1. Conclusion: There is an urgent need to curb the use of tobacco among the sub-groups of students with higher prevalence. This can be achieved by strengthening political and administrative will, implementing tobacco free school guidelines and establishing effective multi-sectoral coordination, as tobacco control is beyond the scope of health department. Keywords: Framework Convention for Tobacco Control, Global Adult Tobacco Survey, Non Communicable Diseases.

Introduction: Plagiarism is misappropriation of another person’s ideas. But, surprisingly there seems to be significant underreporting. An informal discussion on plagiarism with faculties and Post Graduate students revealed that most of them were not sensitized for it. Hence, Study attempts to explore the status of their knowledge and attitude about plagiarism to build awareness and improve their attitudes to minimize plagiarism. Materials and Methods: Present cross sectional study was conducted at GMC, Bhavnagar (Gujarat) by convenient sampling of Study group in to faculty (Group A) and Post graduate medical students (group B) while using two (1.To analyze knowledge regarding plagiarism 2.To analyze Attitude toward plagiarism) set of structured, validated instruments. Results of responses collected anonymously from both the groups were appropriately analyzed by statistical methods to yield scientific inferences. Results: Analysis of knowledge of both faculty and students exhibits prevailing disbeliefs about plagiarism (Direct word to word copy-paste is considered as plagiarism by faculty (65%) and P.G. students (70%) although 35% faculty and 38% P.G. students believe plagiarism can be avoided by replacing the words). Their knowledge is deficient about forms & ways of plagiarism as well about secondary citations. Responses revealed that only direct copying of phrases is regarded as dishonest deed. Faculty & P.G students on one hand showed moderate attitude toward plagiarism which mean they perceive plagiarism in the community is fraud. But on other hand both faculty (scored 32.48±6.62) & P.G students (scored 36.21±8.58) showed acceptance for act of plagiarism through moderate positive attitude. Negative attitude of both groups was moderate displaying their tolerance for plagiarism in the community. Conclusions: Present Study revealed that Medical faculty and P.G. students have misunderstandings about plagiarism while their increasing active flaw towards suc

Paediatrics is a branch of medicine which is concerned with wellbeing of infants, children, adolescents, their physical, mental, and psychological development. Paediatric forensic autopsy is useful to evaluate us the natural and unnatural childhood deaths, their reasons, steps for prevention and their management, which is both useful to the branch of Forensic Medicine and the Medical researchers. A 3year retrospective study was conducted in M.P. Shah Government Medical College, Jamnagar during the period of January 2014 to December 2016. Out of total 3743 autopsies performed, a total of 253 cases belonging to paediatric age-group were the material of the study. Accidental deaths are the most common manner of deaths and mostly affected age-group is 12-17 years. The leading cause of death are burns, drowning, road traffic accidents and snake bite. Accidental burns and suicidal hanging were more common in females in the age-group 12-17 years. Accidental drowning and RTA were common in the males. In the present study, snake bite envenomation was also one of the leading causes of unnatural deaths in children and was mostly seen in the age range of 2-10 years. In India, both natural and unnatural childhood deaths are emerging as major public health problem. Various educational programmes, preventive strategies, and dissemination of information are necessary to create awareness and is must to reduce the unnatural deaths. Keywords: Paediatric autopsy, Unnatural children deaths, Trauma, Manner of death.

WHAT IS KNOWN ON THE SUBJECT?: There are insufficient nurses to meet current demand for mental health care. This is an international concern. Within England, the impact of staff shortages on the quality of patient care in forensic high secure settings has been highlighted by the national regulatory body for hospitals. Forensic hospital nursing is a distinct specialism within mental health. Forensic nurses must negotiate the therapeutic, ethical and practical challenges of caring for high-risk patients in a locked environment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: There has been no previous study to ask frontline high secure forensic nurses, union representatives, senior nurses and workforce leads about what factors may be affecting recruitment and retention in their setting. As well as the specialized and challenging nature of the work, participants identified that workforce sustainability was affected by unequal working terms and conditions, the hospital locations and wider national factors, such as changes to how nurse training was funded. They also identified that some strategies that were employed to address workforce shortages, such as day-to-day movement of staff within the hospital and incentive packages for new recruits could be demotivating for established staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Forensic high secure nursing workforce strategies should include training, development and career pathways that are specific to the specialism and extend beyond preceptorship for newly qualified staff. There should be clear and equitable employment terms and conditions with remuneration packages that are consistent within and between organizations. Hospital managers should address the effect that movement of staff between wards may have on nurses' morale, therapeutic relationships and safety culture. ABSTRACT: Introduction There has been no previous study of stakeholders' views on recruitment and retention concerns in high secure forensic settings. Aim To identify factors affecting recruitment and retention in high secure hospitals, from the perspectives of stakeholders with experience in forensic mental health nursing. Method Framework analysis of data from fifteen interviews and three focus groups with frontline nurses, nurse leaders, recruitment leads and union representatives from three high secure hospitals in England. Results Six themes emerged from the data: (a) the unique nature of high secure nursing; (b) the impact of short staffing; (c) wider factors affecting the high secure nursing workforce; (d) the location; (e) staff being on different terms and conditions of work; (f) recruitment strategies. Discussion Multiple factors are likely to simultaneously affect high secure hospital recruitment and retention. Findings on the unique nature of high secure work reflect previous qualitative research. The themes of location, working terms and condition and recruitment strategies have not been previously identified in forensic nursing research. Implications for practice Employers should ensure that employment terms and conditions are equitable and consistent. Furthermore, hospital managers should address the effect that movement of staff between wards may have on morale and therapeutic relationships.

Violence against women has been in talks and news every now and then. Various laws are enacted world-over and in India for protection of their rights and dignity with stringent punishments of the offender. But issues arise if the offender is a mentally unsound person or a juvenile. The case is of a four-month pregnant lady who was attacked by a mentally unsound person and was brought to casualty in a low condition with unstable vitals. She had sustained multiple injuries over the body and a wooden roller stuck inside the vagina. The treating physician’s medico-legal duties and the role of state in such cases become very important. The treatment examination of victim and accused along with the legal implications make such cases worth discussing. Keywords: Sexually violent, Sexual assault.

Introduction: Hanging deaths is common in the day to day practice of Forensic expert. According to National Crime Bureau Report of 2016, in India, death due to hanging constitutes 46.2% of suicide. Materials and Methods: A retrospective study of 205 cases of autopsies done for hanging cases in the mortuary of Regional Institute of Medical Sciences (RIMS), a Tertiary Care Hospital in Imphal, Manipur were studied from the period between January 2008 to December 2019. Results: This present study throws some light on the emerging trends that hanging is increasingly being adopted by a relatively younger age group between 21-30 years and males constituted 60% while females constituted 40%. Most of the victims were married 60.49% and were settled in urban areas. The place of occurrence was mostly indoors both for males (40.49%) as well as for females (32.68%). Soft ligature was the most commonly ligature material used by hanging victims. Discussion: Findings of this study will help in highlighting the present scenario of hanging deaths and thus will help in solving many crimes by the law enforcing agencies. Keywords: Hanging, Ligature mark, Suicide.

Narcotics are the substances used to treat moderate to severe pain. They could be natural like opiates such as morphine, codeine etc., synthetic like fentanyl, methadone etc., and semi-synthetic like oxycodone, hydrocodone etc. These drugs act as pain relievers, induces the state of stupor or sleep, and increase the physical dependence on them. In forensic autopsy case, the forensic pathologist may require a complete toxicological investigation for different poisons including stimulants. In India, Forensic Science Laboratories run by Government under the Home ministry usually carry out this. The samples must be analysed by the forensic toxicologist/chemists/scientist. This article deals with the screening/spot test for narcotics. It attempts to simplify the standard procedures in a step-wise manner, which can be of handy reference for the forensic toxicologist. Keywords: Narcotics, Screening, Spot test, Drugs, Opioids etc.

Introduction: Breast cancer has emerged as a major public health problem and early detection helps in bringing down the burden. Even thoughMammography is the best choice for screening, it is expensive and requires skilled personnel. Breast Self-Examination (BSE) is important in early detection and for mass awareness especially in resource poor countries. Nurses and midwives constitute major contributors in delivering health care and education and if these are empowered and trained they can convince women to perform BSE. Various studies conducted on nurses BSE practice show that the nurses are generally ineffective practitioners of BSE and that their frequency of BSE teaching is low. Aim and Methods: To assess the knowledge and practice of effective BSE among female nurses. A descriptive cross sectional study was conducted among 90 female nurses working in a tertiary care hospital. A self-administered questionnaire was used to assess the knowledge and practice of BSE. Written consent was taken from the participants. Data was collected on the socio demographic information, knowledge and practice of BSE. Data was analysed using SPSS version 16. Results: Knowledge: 55.6% of the nurses said that BSE should be performed once in 6 months, 18.9% felt that it should be performed monthly. 42.2% of the nurses said that BSE has no relation to menstrual cycle. 86.7% of nurses said that BSE should be performed in standing up position and the first source of information was BSE awareness programmes. Practice 75.6% nurses practiced BSE but only 33.3% were effectively practicing BSE. 50% of the nurses said that they were confident in performing BSE. The major reasons for practicing were, early detection has a great value and fear of Breast cancer. The major reasons for not practicing BSE were, afraid I will find something 54.5%. Conclusion: The study indicates that nurses had inadequate knowledge about BSE. Practice of BSE was high but very few practiced it effectively. Keywords

Introduction The International Association of Forensic Nurses (2018) affirms the importance of evidence-based, trauma-informed, patient-centered forensic nursing services that engage patients as autonomous decision makers. Past research indicates that forensic nurses consistently respect patients' choices and control as they navigate the decisions of medical forensic examinations (MFEs) and sexual assault kit (SAK) collection. Building on that work, this study examined which options patients decline and what factors are associated with those declination decisions. Method We collected prospective data from seven state-funded sexual assault nurse examiner programs. Forensic nurses recorded information about all adult sexual assault patients (N = 783) regarding four primary decisions: whether to have a MFE, whether to consent to all parts of the MFE or to decline specific services, whether to have a SAK collected, and whether to release the SAK to law enforcement for forensic DNA testing. Results Most patients consented to a MFE (95%), to all parts of the MFE (81%), to SAK collection (99%), and to release the SAK for forensic DNA testing (80%). Younger patients and those with disabilities were more likely to decline some options. Patients who had not disclosed the assault to others before seeking sexual assault nurse examiner care were also more likely to decline a MFE. Whether patients sought post assault care for more health-focused reasons or legally focused reasons was associated with declination decisions. Conclusions Healthcare providers should communicate clearly about each step in post assault care and allow patients to decline services as they choose.

Humanitarian forensics has been established as a new entity, and it is bound to develop as a robust branch of science. It is a multidisciplinary subject with the involvement of experts from different fields of science. Forensic nursing too is an upcoming branch of nursing science and is a relatively new discipline of science. Forensic nursing science is expanding in various countries. This paper will describe and discuss the various important aspects of Humanitarian forensics and forensic nurses' utility in humanitarian forensics and discuss the future role of forensic nurses in humanitarian forensics.

Introduction: Ascertaining food safety knowledge, attitude and practice of students have high importance because this eventually will lead to more food-conscious society and more healthy people. Only a handful of studies have been done to evaluate food safety practices among medical students. Aim and Objectives: To assess knowledge, attitude and practices regarding food safety practices among medical students.2 To impart health education regarding correct food safety practices to the medical students. Materials and Methods: A total of 100 students were covered after verbal consent. Information was collected on a pre-tested and pre-designed questionnaire on knowledge, safe handling and purchasing practices pertaining to safe food handling. Results: Majority (59%) had good knowledge on food safety practices, greater number had poor purchasing power behaviour and none scored good son safe handling practices score. Conclusion: The target study highlighted that students with good knowledge scores was only 40 percent, majority [77 percent] had poor purchasing power scores whereas none of the students had good safe handling techniques knowledge. Keywords: Food safety, Knowledge, Medical students.

Introduction: There is gender bias in teaching and learning Obstetrics and gynecology to undergraduates and studies have shown that mostly male students describe educational inequities. We wanted to explore the effect of the students' gender on their perception of quality and quantity of teaching, the amount of experiential learning, and their interest in obstetrics and gynecology. Materials and Methods: A cross-sectional mixed method approach wherein 96 internees (both lady interns and male interns) who had completed the OBG posting after taking their written informed consent, were given 18 point anonymous questionnaire comprising items about their learning experience and procedures. Two focus group discussions of 12 internees, who were grouped into girls and boys group, was conducted. The data was analyzed using Fischer exact test at 5% significance level. All the responses of FGD were transcribed, coded, grouped together into different themes and analyzed. Results: Female interns conducted more number of deliveries compared to males. Patients’ refusal to give history was statistically significant for males than females. Male interns were significantly less confident with managing gynecological problems compared to females. FGD revealed that patient factors like religion, better educational status, higher socio-economic level & people around the interns like postgraduates and nurses, sought female preference and also refusal from patients’ side. Conclusion: All these factors led to discrimination for male interns to learn and choose OBG as career. Keywords: Gender bias, Impact, Learning experience, Undergraduates

Introduction: Every year about 800 000 people take their own life and there are many more people who attempt suicide. The second leading cause of death was suicide among 15–29 year olds globally in 2015 although it occurred in most of the ages. Suicide does not just occur in high income countries, but is a global phenomenon in all regions of the world. In fact, over 78% of global suicides occurred in low and middle income countries in 2015. Materials and Methods: Present study is carried out among attempted suicide cases admitted in last 3years between Jan 2015 to Dec 2017 at Rama Medical College Hospital and Research Centre (RMCH&RC) Kanpur (U.P). Retrospective hospital record based study carried out after obtaining ethical clearance from institutional ethical committee. Data was collected from medical record section. Inclusion Criteria: Patients admitted in the hospital and classified as ICD10 (X60-84) code for suicide under international coding of disease for whom, all necessary information were available, have been included in the study. Study Sample: Total (N=102) who were admitted at RMCH&RC and fulfilled the necessary information criteria included in study. Subjects aged Results and Discussion: Most of the suicide cases 47(46.1%) were aged between 15-25 years with mean age of suicide cases being 30.53 ±12.12, with M/F ratio (1.1:1). The data shows that most common method of suicide is the poisoning in 52.9% cases just literate were 62.7% and only 11.8%were illiterate. Hospital care determinants like duration of hospital stay was 3weeks for 4.9% cases only with mean duration of hospital stay was 7.60±6.24. Complications among survivors 27.5% Hepatic, 26.5% Physical disability, 17.6% Respiratory, 8.8% neurological and only 6.9?rdiacwith overall mortality (10.8%).The results are comparable with most of the hospital based studies. Conclusion: Mental health bill decriminalizing suicide passed by Parliament in India on March 27, 2017 that a person who attempts

Introduction: Population ageing is a global phenomenon. Ageing is a physiological process that starts from birth, continues throughout life and ends with death. In India, according the census 2011, there are nearly 104 million elderly persons. 53 million are females and 51 million are males. Assessment of falls and the determining factors leading to falls gives us the corrective measures to be taken to avoid falls among elderly. Objective: To study the determinants of falls, fractures and frailty among elderly visiting OPD/IPD in a tertiary care HSK hospital in Bagalkot. Materials and Methods: An observational study conducted in HSK hospital, among 60 Elderly on falls, fractures and frailty visiting IPD/OPD. Information on socio-demographic data, history of falls, fractures and the determinants of falls, fractures and frailty details were collected with a pre-designed, pre-tested, structured questionnaire. Chi square test was applied to look for the association between the determinants and age and gender. Results: Among 60 elderly populations 50 (83.33%) were between 60-74 years age and 10 (16.66%) were above 75 years age. Among 50, 38 (63.33%) were females and 22(36.66%) males. Hypertension, vertigo, giddiness, use of walker, showed statistically significant association between age and the determinants of falls. Also, other determinants like, falls during transferring; falls due to imbalance, slips also had association. Conclusion: Falls are very common among the elderly. The findings provide us with an opportunity to understand the risk factors still better, and need for rehabilitation, implement policies to reduce the risk of falls leading to fractures and frailty. Keywords: Elderly, Determinants, Falls & Fractures, Frailty.

Introduction: Reducing the preventable mortality and morbidity among children is one of the core indicators of sustainable development goals. This study was conducted with the objective of assessing the epidemiology, pattern, and outcome of physical injury and medico-legal case reports among pediatric population. Materials and Methods: We conducted a cross-sectional study in the three districts of Madhya Pradesh. All children less than fifteen years of age brought with physical injuries to the nine selected public hospitals were included in the present studies. The data were analysed for gender, age group, mode & type of injury. Results: A total of 2,533 children under fifteen years of age were included in this study. Of the total children, medico-legal reports were filed for 368 (14.5%) study participants and 82 (3.23%) children died because of their injuries. Road traffic accidents (RTA) were the most common cause of physical injury closely followed by fall from height and recreational activities. Conclusion: It is our firm conclusion that most cases of physical injuries among children could have been easily prevented. We identified several epidemiological factors which can be manipulated by various interventions to reduce the incidence of physical injuries among children. Keywords: Child, Trauma, Injury, Medicolegal.