The “Magnificent Seven Errors” in Forensic Autopsy Practice: The Italian Context

2021 ◽  
pp. 192536212110561
Author(s):  
Roberto Scendoni ◽  
Piergiorgio Fedeli ◽  
Nunzia Cannovo ◽  
Mariano Cingolani

According to the Italian legal system, forensic autopsies are performed by a medical doctor specialized in legal medicine, otherwise known as a medicolegal expert (MLE), who has a range of very complex responsibilities. Indeed, the quality of forensic autopsy activity is always questioned in courts of law; incorrect assessments are dangerous because they can jeopardize the validity of a criminal investigation and thus affect the outcome so that a real culprit may be acquitted or an innocent person convicted. Nonconformities also discredit the professionalism of the specialist who performs the autopsy. The work of a MLE implies a series of assignments and duties that should be given constant consideration, but when certain aspects of this activity are underestimated or overlooked, this can lead the expert to make mistakes with irreparable consequences for the judicial investigation. In this article, for the first time, we present a summary of seven known errors related to autopsy activity following death by unnatural causes, with the purpose of alerting MLEs who work under the Italian judicial system to the potential dangers of such errors. These relate to: oversights in autopsy technique, incorrect collection of photographic and video material, unauthorized attendance at the autopsy, missing/mistaken reporting at any stage of the forensic activity, failure to notify the party forensic consultant, using histological or toxicological nonaccredited laboratories for forensic activities, and lack of observance of the chain of custody.

2015 ◽  
Vol 21 (5) ◽  
pp. 1091-1116 ◽  
Author(s):  
Maria Crema ◽  
Chiara Verbano

Purpose – The purpose of this paper is to describe the Italian state of art of Health Lean Management (HLM) and to analyze the Italian projects that connect this approach with clinical risk management (CRM). Design/methodology/approach – After introducing Italian healthcare system and its main challenges, relevant Italian experiences have been searched investigating regional health plans (RHPs), managerial reports, books, workshops, conference proceedings and hospital web sites. The degree of experience of each Italian region has been first studied. Further, field of applicability, objectives, tools, practices and results of the projects with first signs of HLM and CRM integration have been analyzed. Findings – Although interest in new managerial approaches is spreading in almost all the territory and new managerial solutions are fostered in many RHPs, HLM projects are implemented patchy in Italy. For what regards HLM projects with CRM connections, the Italian context seems aligned with the international one, apart from few features. First indications for the implementation of HLM projects with CRM connections emerged. Originality/value – Healthcare systems are facing multiple challenges in a context where public funds decrease but quality of care must be guaranteed. Combining different managerial approaches could solve these issues. In this research, for the first time, a map about Italian HLM adoption has been drawn, and Italian HLM projects with CRM connections have been analyzed. The results constitute one of the first contributions useful to develop guidelines for the implementation of projects pursuing efficiency, quality and safety objectives.


Author(s):  
Marco Dettori ◽  
Antonio Azara ◽  
Erika Loria ◽  
Andrea Piana ◽  
Maria Masia ◽  
...  

The aim of the work is to evaluate the effectiveness of the risk communication strategies in cases of unsafe drinking water supply in Sardinia, the Italian context with the highest population distrust in drinking water safety. During the period 2010–2015, the ordinances published on the institutional websites were analyzed, and the population risk perception was evaluated by applying, for the first time in public health threats, the “OUTRAGE Prediction & Management” software released by Sandman. Overall, 417 ordinances issued by the Sardinian Municipalities were found. Only 1.5% of the ordinances reported information about parameters, concentrations, and risks to health, whereas 4.8% indicated only the parameters and non-standard levels. By contrast, 53.2% specified only the non-standard parameter, and 40.5% indicated a generic non-drinking motivation. The outrage assessment showed values exceeding the threshold of risk acceptance, attributable to the lack and low clarity of the information reported by the ordinances. The present study allowed us to highlight critical issues in risk communication of the quality of drinking water.


2020 ◽  
Vol 5 (2) ◽  
pp. 463-478
Author(s):  
Elizabeth Crais ◽  
Melody Harrison Savage

Purpose The shortage of doctor of philosophy (PhD)–level applicants to fill academic and research positions in communication sciences and disorders (CSD) programs calls for a detailed examination of current CSD PhD educational practices and the generation of creative solutions. The intended purposes of the article are to encourage CSD faculty to examine their own PhD program practices and consider the perspectives of recent CSD PhD graduates in determining the need for possible modifications. Method The article describes the results of a survey of 240 CSD PhD graduates and their perceptions of the challenges and facilitators to completing a PhD degree; the quality of their preparation in research, teaching, and job readiness; and ways to improve PhD education. Results Two primary themes emerged from the data highlighting the need for “matchmaking.” The first time point of needed matchmaking is prior to entry among students, mentors, and expectations as well as between aspects of the program that can lead to students' success and graduation. The second important matchmaking need is between the actual PhD preparation and the realities of the graduates' career expectations, and those placed on graduates by their employers. Conclusions Within both themes, graduate's perspectives and suggestions to help guide future doctoral preparation are highlighted. The graduates' recommendations could be used by CSD PhD program faculty to enhance the quality of their program and the likelihood of student success and completion. Supplemental Material https://doi.org/10.23641/asha.11991480


Author(s):  
Mohamad Hossein Pourhanifeh ◽  
Kazem Abbaszadeh-Goudarzi ◽  
Mohammad Goodarzi ◽  
Sara G.M. Piccirillo ◽  
Alimohammad Shafiee ◽  
...  

: Melanoma is the most life-threatening and aggressive class of skin malignancies. The incidence of melanoma has steadily increased. Metastatic melanoma is greatly resistant to standard anti-melanomatreatments such as chemotherapy, and 5-year survival rate of cases with melanoma who have metastatic form of disease is less than 10%. The contributing role of apoptosis, angiogenesis and autophagy in the pathophysiology of melanoma has been previously demonstrated. Thus, it is extremely urgent to search for complementary therapeutic approachesthat couldenhance the quality of life of subjects and reduce treatment resistance and adverse effects. Resveratrol, known as a polyphenol component present in grapes and some plants, has anti-cancer properties due to its function as an apoptosis inducer in tumor cells, and anti-angiogenic agent to prevent metastasis. However, more clinical trials should be conducted to prove resveratrol efficacy. : Herein, for first time, we summarize current knowledge of anti-cancerous activities of resveratrol in melanoma.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Domenico Cuda ◽  
Sara Ghiselli ◽  
Alessandra Murri

Abstract Background Prevalence of hearing loss increases with age. Its estimated prevalence is 40–50 % in people over 75 years of age. Recent studies agree that declinein hearing threshold contribute to deterioration in sociality, sensitivity, cognition, and quality of life for elderly subjects. The aim of the study presented in this paper is to verify whether or not rehabilitation using first time applied Hearing Aids (HA) in a cohort of old people with hearing impairment improves both speech perception in a noisy environment over time and the overall health-related quality of life. Methods The monocentric, prospective, repeated measurements, single-subject, clinical observational study is to recruit 100 older adults, first-time HA recipients (≥ 65 years).The evaluation protocol is designed to analyze changes in specific measurement tools a year after the first HA usage in comparison with the evaluation before HA fitting. Evaluations will consist of multiparametric details collected through self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in speech perception in noise to be used is the Italian version of Oldenburg Satz (OLSA) test whereas the indicator of changes in overall quality of life will be the Assessment of Quality of Life (AQoL) and Hearing Handicap Inventory for the Elderly (HHIE) questionnaires. The Montreal Cognitive Assessment (MoCA) will help in screening the cognitive state of the subjects. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare the effects of HA rehabilitation in the older adults immediately before first HA usage (Pre) and after 1 year of experience (Post). This broad approach will lead to a greater understanding of how useful hearing influences the quality of life in older individuals, and therefore improves potentials for healthy aging. The data is to be analyzed by using an intrasubject endpoint comparison. Outcomes will be described and analyzed in detail. Trial registration This research was retrospectively registered underno. NCT04333043at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.


1995 ◽  
Vol 12 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Simon J Taylor

AbstractObjective: In recent years a number of articles have highlighted deficiencies in drinking histories taken by junior doctors. This study examines whether standards have improved as a result. It also examines for the first time: 1. the quality of drinking histories taken from patients following parasuicide; and 2. the quality of illicit drug usage histories.Method: An audit of case notes was undertaken of 114 patients admitted to a district hospital's acute psychiatric wards or assessed following overdose. Two periods were considered; one preceding many of the articles, and the second four years later.Results: There was an overall improvement from 58% of histories in 1988 having no mention of alcohol usage to 25% in 1992. (X2MH=10.57, p<0.01). There was, however, insufficient improvement of quantitative histories to reach statistical significance. Histories taken as part of an overdose assessment were not significantly different from those taken for inpatient admission. In 1992, 27% of patients had any illicit drug usage history recorded which represented a statistically significant improvement (X2MH=5.91, p<0.02) compared with four years earlier.Conclusions: Although improvements have been noted, alcohol and drug histories remain inadequate.


2021 ◽  
pp. 003072702110242
Author(s):  
Max Rünzel ◽  
Paolo Sarfatti ◽  
Svetlana Negroustoueva

When evaluating Quality of Science (QoS) in the context of development initiatives, it is essential to define adequate criteria. The objective of this perspective paper is to show how altmetric and bibliometric indicators have been used to support the evaluation of QoS in the 2020 Review of the Phase 2-CGIAR Research Programs (CRPs, 2017–2022), where, for the first time, the Quality of Research for Development (QoR4D) frame of reference has been utilized across the entire CGIAR CRP portfolio. Overall, the CRP review showed a significant output of scientific publications during the period 2017–2020, with 4,872 articles, 220,101 references, and 7.1 citations per article. Additionally, wider interest in scientific publications is demonstrated by good to high altmetrics, with average attention scores ranging from 70.8 to 806.9 with an average of 425.1. The use of selected bibliometrics was shown to be an adequate tool, for use together with other qualitative indicators to evaluate the QoS in the 12 CRPs. The CRP review process clearly demonstrated that standardized, harmonized and consistent data on research output is paramount to provide high-quality quantitative instruments and should be a priority throughout the transition toward One CGIAR. Therefore, we conclude that the QoR4D framework should be augmented by standardized bibliometric indicators embedded in measurement frameworks within the new One CGIAR. Finally, its practical utilization in monitoring and evaluation should be supported with clear guidelines.


2021 ◽  
pp. 146247452198980
Author(s):  
Vicky Heap ◽  
Alex Black ◽  
Zoe Rodgers

Community Protection Notices (CPNs) are civil preventive orders used in England and Wales to prevent and/or require specific behaviour by an individual or organisation, where existing conduct has a ‘detrimental impact on the quality of life of those in the locality’. Breach of the notice results in a £100 fine under a Fixed Penalty Notice or a possible criminal conviction. To date, CPNs have tackled an array of perceived anti-social behaviours, ranging from rough sleeping to overgrown gardens. Using Ashworth and Zedner’s preventive justice as an analytical framework, our research qualitatively explores recipients’ experiences of this new tool for the first time. The findings highlight how the operationalisation of CPNs extends the coercive power of the state, with a range of negative consequences relating to the concepts of disproportionality, due process and accountability. We also offer three empirically-grounded recommendations for reforming CPN practices.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Wdowiak-Okrojek ◽  
P Wejner-Mik ◽  
Z Bednarkiewicz ◽  
P Lipiec ◽  
J D Kasprzak

Abstract Background Stress echocardiography (SE) plays an important role among methods of noninvasive diagnosis of ischemic disease. Despite the advantages of physical exercise as the most physiologic stressor, it is difficult (bicycle ergometer) or impossible (treadmill) to obtain and maintain the acoustic window during the exercise. Recently, an innovative probe fixation device was introduced and a research plan was developed to assess the feasibility of external probe fixation during exercise echocardiography on a supine bicycle and upright treadmill exercise for the first time. Methods 37 subjects (36 men, mean age 39 ± 16 years, 21 healthy volunteers, 16 patients with suspected coronary artery disease) were included in this study. This preliminary testing stage included mostly men due to more problematic probe fixation in women. All subjects underwent a submaximal exercise stress test on a treadmill (17/37) or bicycle ergometer (11/37). Both sector and matrix probes were used. We assessed semi-quantitatively the quality of acquired apical views at each stage – the four-point grading system was used (0-no view, 1-suboptimal quality, 2-optimal quality, 3-very good quality), 2-3 sufficient for diagnosis. Results The mean time required for careful positioning of the probe and image optimization was 12 ± 3 min and shortened from 13,7 to 11,1 minutes (mean) in first vs second half of the cohort documenting learning curve. At baseline, 9 patients had at least one apical view of quality precluding reliable analysis. Those patients were excluded from further assessment. During stress, 17 patients maintained the optimal or very good quality of all apical views, whereas in 11 patients the quality significantly decreased during the stress test and required probe repositioning. The mean image quality score at baseline was 2,61 ± 0,48 and 2,25 ± 0,6 after exercise. Expectedly, good image quality was easier to obtain and maintain in the supine position (score 2,74 ± 0,44) points as compared with upright position (score 2,25 ± 0,57). Conclusion This preliminary, unique experience with external probe fixation device indicates that continuous acquisition and monitoring of echocardiographic images is feasible during physical exercise, and for the first time ever - also on the treadmill. This feasibility data stem from almost exclusively male patients and the estimated rate of sufficient image quality throughout the entire test is currently around 60%. We are hoping, that gaining more experience with the product could increase the success rate on exercise tests. Abstract P1398 Figure. Treadmill and ergometer stress test


Sign in / Sign up

Export Citation Format

Share Document