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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.

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.

This is a scoping review protocol.

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.

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...

Revisão integrativa sobre características reproduzidas em mulheres vítimas de violência.

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.

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.

HIV infection is known to have established in India since year 1986 and three decades are over since then. A lot of activities have been since then going on by the government of India sponsored NACP under the aegis of NACO. The endemicity of this infection in populations is known to be inversely proportional to the level of awareness about HIV/AIDS. As per the data available, there are variations in level of awareness about the HIV/AIDS and it’s prevention among the general populations as well as the at risk populations. So it is always prudent to assess the level of awareness among the general population. For this reason survey of awareness level among the high school students can give a reliable indication as they represent the level of awareness of their families. Hence a study was conducted among the adolescent students in age group of 14-19 years ie. Class 9-12 years. Study Design: Cross sectional study. Study Subjects: adolescent students in age group of 14-19 years ie. Class 9-12 years. Study Period: Dec 2015 Materials and Methods: The study was conducted in village Maralian of Block RS Pura (rural field practice area of Department of Community medicine, GMC Jammu). The schools chosen were High and Higher secondary standards where the students of age group >14 years could be contacted. Study Instrument: A pre tested schedule containing (47) questions related to Knowledge, attitudes and practices of adolescents about modes of transmission and prevention of HIV infection, attitudes and beliefs about it and their related practices was used to interview. It was seen that the students in age group of 14-18 years were much aware about the HIV/AIDS, it’s causes, routes of transmission, risk factors, preventive measures and facilities for diagnosis and drugs. Students of this age group can be taken as proxy to the families they belong to and hence the general population of the area under study. But still, a large proportion is having wrong concepts or no ideas a

Fire, since ancient times have kept amusing mankind in various ways. Perhaps it is one of the greatest inventions in the history of all times. It has helped humans to evolve but if mishandled can lead to serious consequences. It is commonly encountered as medical emergencies in any hospital in India. It has continuously effected population resulting in form of prolonged morbidity, disability and even as death of the individual ultimately leading to loss to individual’s family, society and to the state. The present prospective study was carried out in the Department of Forensic Medicine & Toxicology, M.G.M. Medical College & M.Y. Hospital, Indore during the period from 1st August 2017 to 31st July 2018 which includes a total of 277 cases of death due to burn injuries, brought to the mortuary of the hospital for medico-legal postmortem examination. During the study period burn in female victims was more evident with accounting 178 (64.3%) cases as compared to males 99 (35.7%). 31-40 years age group in males i.e. 24 (8.6%) was most effected and minimum in the age group of 0-10 years i.e. 5 (1.8%) whereas in females maximum incidence was noted in the age group of 21-30 years i.e. 80 (28.8%) and minimum 5 cases were reported in age group of above 61 years. The minimum age to suffer burns was 1 year which was a male child and maximum age was 80 years which was a male patient. Various other demographic aspects of deaths due to burns were included as objective in the study and ultimately provided some remedial measures in order to cope up with current scenario. Keywords: Burn, Autopsy, Demography, Body surface area, Manner of death.

In republic of Benin, rape is a crime for which the law provides harsh penalties. The perpetrators of that form of crime are tried in the courts of appeal by special jurisdictions: the criminal courts. We conducted a case control study on 127 cases of rape investigated and judged by the court of appeal of Cotonou from 2005 to 2015. This research work points out that victims are exclusively women and girls and that 62.2% of them are children under 13 years of age. As regards offenders, all of them are male subjects and young adults in 63.8% of cases. They were acquaintances of the victims in 68.5% of the cases; and they all confessed to the criminal action with which they were charged. The victims were subject to medical examination 7 times out of 10 without police requisition. Those medical consultations confirmed the presence of injuries caused by extra-genital violence in .9 of victims. Defloration signs were noted in 79.7% of the girls less than 13 years old. The populations and health professionals should be sensitized about victims’ identification and sociocultural conditions that may facilitate the commission of those crimes; it is an important action to be carried so as to ensure an efficient fight against sexual violence. Keywords: Sexual assault, Rape, Genital injuries, Forensic-medicine, Benin republic.

Child abuse is a reality in all cultural, ethnic, and income groups. Our comprehensive review provides a feedback that it is still a global problem of considerable extent. Child abuse can be physical, emotional - verbal, sexual or through neglect. Keeping in mind the sensitivity of the issue an attempt was made to assess the different forms and magnitude of child abuse across the country by reviewing articles published on this topic in the past 25 years. It was found that child abuse is still an unfortunate problem in Saudi Arabia and its prevalence is a cause of concern both for the government and the healthcare agencies. Also, the incidents are reported much less than actual occurrence mostly due to either the innocence of the victim or the callousness and insensitivity of investigating agencies. The government initiated the National Family Safety Program (NFSP) in 2005 with the intention to prevent child abuse and provide preventive education to the population. Keywords: Child abuse, Emotional abuse, Physical abuse, Sexual abuse, Saudi Arabia.

Amongst all form of asphyxial death, hanging is most frequently encountered by forensic experts. Easy availability and presence of wide range of ligature materials at home itself makes hanging a preferred method of committing suicide over other methods. Findings over neck vary from case to case depending upon various factors like position of knot over neck, composition of ligature material, duration of suspension etc. The present prospective study was carried out in the Department of Forensic Medicine & Toxicology, M.G.M. Medical College & M.Y. Hospital, Indore, during the period from 1st August 2017 to 31st July 2018 and includes a total of 203 cases of death due to Hanging, brought to the mortuary of the hospital for medico-legal postmortem examination. Male victims were 137 (67.5%) and females were 66 (32.5%). The majority of victims belonged to 3rd decade among males were 49 (24.1%), followed by 4th decade were 44 (21.7%) while 2nd decade was most common among females were 25 (12.3%), followed by 3rd decade were 24 (11.8%). The objective of the study was to understand various demographic profile and various aspects of deaths due to hanging so as to suggest some remedial measures. Keywords: Hanging, Ligature Material, Position of knot, Suicide, Place of hanging.

Introduction: Substance use patterns are notorious for their ability to change over time. Both licit and illicit substance use cause serious public health problems. While lack of a comprehensive policy has been repeatedly highlighted and various suggestions made to address the range of problems caused by substance use. Objectives: To study the socio-demographic profile and the reasons for substance use among patients admitted at De-addiction centre in Belagavi, North Karnataka. Materials and Methods: In this cross-sectional study, all the patients admitted at the De-addiction centres during the study period were interviewed. The data was analyzed using Microsoft excel and proportions were used. Result: A total of 43 substance abusers were interviewed. Majority of the substance abusers (39.6%) were in the age group of 31 to 40 years. Most of the abusers had primary education (41.8%).81.4% of abusers were married and 76.7% were having nuclear type of family. Most of abusers were from lower socio economic status III to V (90.8%). History of substance abuse was observed in 58.1% of the family. Most of the abusers started using substance within 20 years (60.4%), 39.5% people used substance for Recommendation: Our observations point towards the vulnerability of younger age towards substance use and hence, it is proposed that the preventive health policies in this regard should be targeted specifically during teenage years. Keywords: Alcohol, substance use, De-addiction centre, Family background.

The term ‘Autopsy’ originates from ancient ‘Autopsia’ which is derived from ‘Autos’ i.e. ‘Oneself’ and ‘Opsis’ i.e. ‘to see for oneself’. Medico-legal postmortem examinations are performed as mandatory legal procedures for establishing the cause of death for people dying in circumstances where multiple causes of death could be ascribed. The present prospective study was carried out in the Department of Forensic Medicine & Toxicology, M.G.M. Medical College & M.Y. Hospital, Indore during the period from 1st August 2017 to 31st July 2018 which includes a total 2197 cases of death, brought to the mortuary of the hospital for medico-legal postmortem examination. The main objectives of the study were: to ascertain the various aspects of unnatural deaths, to analyze the probable reasons for the same & to find remedial measures to bring down the incidence. During the study period 2197 cases were analyzed in which 609 (27.8%) were females and 1588 (72.2%) were males. Major causes of death comprises trauma 818 (37.2%) burn 277 (12.6%) poisoning 238 (10.8%) asphyxia 237 (10.7%) and multiple pathology 146 (6.6%). Opinion about the cause of death was reserved in 310 (14.1%). This study was conducted to determine and evaluate the socio-demographic profile of different types of cases and to assess the nature and cause of their death. Keywords: Autopsy, Demography, Alleged manner of death.