A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2020

We analyzed the manner and cause of death in 945 forensic autopsies from the Jungbu province (Central part of South Korea) conducted by the National Forensic Service Daejeon institute in 2020. Analysis of the manner of death revealed that 43.6% (412/945 cases) were natural deaths, 41.6% (393/945 cases) were unnatural deaths, and 14.8% (140/945 cases) deaths were unknown. Among the unnatural deaths, the major manner of death (40.7%, 160/393 cases) were by accidents, 29.5% (116/393 cases) were by suicide, 21.6% (85/393 cases) were undetermined, and 8.1% (32/393 cases) were by homicide. Among the unnatural deaths, the major cause of death (42.7%, 168/393 cases) were by trauma, 19.3% (76/393 cases) were by poisoning, and 16.5% (65/393 cases) were by asphyxia. Falling was the major cause of death by trauma (42.9%, 72/168 cases) and strangulation was the major cause of death by asphyxia (72.3%, 47/65 cases). Among natural deaths, heart disease was the major cause (43.7%, 180/412 cases), followed by vascular disease (18.9%, 78/412 cases). This study is the first statistical analysis of the manner and cause of deaths in the Jungbu province. A time-series statistical analysis of the manner and cause of deaths in this province might allow more advanced interpretations about both public safety and healthcare in the future.

Handcuff use on forensic psychiatry wards

AimsThis project aimed to assess the use of handcuffs in a secure forensic mental health hospital.BackgroundHandcuffs are used by secure forensic psychiatric wards where patients need to leave the ward and require added restrictive measures for their own or other's safety. The decision to use handcuffs is made by the multi-disciplinary team, with the input of the unit's clinical security team and is assessed based on individual risk and need. This study investigated the frequency, duration and purpose of handcuff use in one secure forensic mental health unit, encompassing 8 male medium secure wards, 5 male low secure wards, 1 adolescent secure ward,1 female low secure ward and 5 female medium secure wards.MethodHandcuff use was recorded contemporaneously by ward staff in a specialised handcuff proforma. This data were then compiled to assess the number of instances of use, the mental health section applicable to the patient, the reason the patient needed to leave the unit, and the duration of use (including the time period for which the handcuffs were removed during the visit, if applicable.) Data from these forms over an 18 month period were analysed.ResultOver the 18 months, there were a total of 347 uses of handcuffs, with an average of 18.3 occurrences per month. In 55 cases, the patients were detained under a civil section, with the remaining instances occurring in patients detained under forensic section. 47% were unsentenced prisoners.The most common destination for patients was the general medical hospital, which accounted for 49% of all visits. Court was the second most common destination, with 39% of uses.The average duration spent in handcuffs was 3.3 hours. The average time that the handcuffs were taken off during the transfer was 1.2 hours.ConclusionThrough ongoing education and supervision by the clinical security team, handcuff use in this forensic service was limited to essential situations, most often to allow treatment of physical health issues off-site. A large proportion of instances involved unsentenced prisoners and court attendances, where the risk of absconsion might be particularly high. Duration spent in handcuffs was kept to a minimum, with cuffs being removed where possible. The service strives to continue such good practices and to identify further ways to reduce handcuff use, such as using video-conferencing as an alternative court attendance.

Evaluating adult forensic staff knowledge of olanzapine long-acting injection post injection syndrome: a service improvement project

AimsPost injection syndrome (PIS) is a serious complication that can occur after Olanzapine Long Acting Injection (LAI). It can occur without any derangement in physical observations. It is important that patients are monitored appropriately following administration of Olanzapine LAI to ensure that symptoms of PIS are appropriately identified and managed. This project aimed to evaluate the current level of knowledge about PIS in two staff groups within an Adult Forensic Service – in-patient nursing staff and junior doctors and advanced practitioners (APs) providing medical cover to inpatient wards.MethodElectronic surveys evaluating knowledge about the symptoms of PIS, monitoring requirements and management of possible PIS were circulated to inpatient nursing staff, junior doctors and APs working within an Adult Forensic Service in the North West of England.Result1) Nursing staff knowledge – 26 nursing staff completed the survey. 4.5% of nurses correctly identified all symptoms of PIS and 72.7% believed that tachycardia or hypotension occur in PIS. 22.7% of nurses identified the correct management plan if a patient feels unwell following Olanzapine LAI. 40.9% would only request a medical review if physical observations were abnormal. 2) Junior doctor and AP knowledge – 6 doctors and 6 advanced practitioners completed the survey. 17% of doctors and APs correctly identified all symptoms of PIS. 50% believed hypotension or tachycardia were symptoms of PIS. 25% of doctors and APs identified correct management of PIS and 16.7% believed that the patient should be managed on the psychiatric ward unless physical observations became abnormal.ConclusionLevels of knowledge about the symptoms and management of PIS are low within this Adult Forensic Service. Knowledge of PIS and management of suspected PIS needs to be improved in nursing staff, junior doctors and advanced practitioners to ensure correct identification and safe management. In response to these findings, a care plan for monitoring of patients after Olanzapine LAI was developed. This included a structured monitoring proforma for completion post depot administration and instructions for managing suspected PIS. This care plan is kept in the front of the drug chart of all patients prescribed Olanzapine LAI. One-page educational summaries on PIS were written and circulated to nursing staff, junior doctors and APs. Information on Olanzapine LAI use and PIS were included in junior doctor induction materials and on-call handbook, to improve trainee awareness and knowledge.

Age estimation based on 3D post-mortem computed tomography images of mandible and femur using convolutional neural networks

Age assessment has attracted increasing attention in the field of forensics. However, most existing works are laborious and requires domain-specific knowledge. Modern computing power makes it is possible to leverage massive amounts of data to produce more reliable results. Therefore, it is logical to use automated age estimation approaches to handle large datasets. In this study, a fully automated age prediction approach was proposed by assessing 3D mandible and femur scans using deep learning. A total of 814 post-mortem computed tomography scans from 619 men and 195 women, within the age range of 20–70, were collected from the National Forensic Service in South Korea. Multiple preprocessing steps were applied for each scan to normalize the image and perform intensity correction to create 3D voxels that represent these parts accurately. The accuracy of the proposed method was evaluated by 10-fold cross-validation. The initial cross-validation results illustrated the potential of the proposed method as it achieved a mean absolute error of 5.15 years with a concordance correlation coefficient of 0.80. The proposed approach is likely to be faster and potentially more reliable, which could be used for age assessment in the future.

How do forensic inpatients’ interpersonal sensitivity to dominance and perceptions of staff coercion impact upon anger and rates of aggression?

Purpose Coercive practices – which are used as means to manage violent/aggressive behaviour in secure forensic settings – have come under scrutiny in recent years due to their paradoxical effects on provoking further service user aggression and violence. Previous research has found relationships between increased service user aggression with both service users’ interpersonal styles and perceptions of staff coercion (i.e. staff limit setting). This paper aims to investigate whether forensic service users’ levels of interpersonal sensitivity to dominance increase levels of self-reported anger and rates of aggression towards staff through perceptions of staff coercion. Design/methodology/approach In a cross-sectional quantitative study design, 70 service users were recruited from one high and two medium secure forensic hospitals. Standardised measures were completed by service users and recorded incident data was collected within the past year. Correlation and mediation analyses were run to investigate the relationship between study variables. Findings A significant relationship was found between service users’ interpersonal sensitivity to dominance and self-reported rates of anger, where forensic service users’ who had higher levels of interpersonal sensitivity to others’ dominance were likely to report higher rates of anger. No significant relationships were found between all other study variables. Practical implications The findings from this study contradict previous research where coercive practices may not necessarily increase rates of aggression towards staff but, in the context of service users’ interpersonal sensitivities to dominance, it may be more useful to consider the way in which coercive practices are implemented. Originality/value There is a gap in the literature, which looks at the way in which forensic service users perceive coercive practices in relation to their interpersonal sensitivities and whether this too has an impact upon service user aggression.

Standar Fasilitas Pelayanan Forensik dan Kamar Jenazah di Era Pandemi COVID-19

Mortuary is one of the mandatory parts of a hospital. During the COVID-19 pandemic, the standard of morgue facilities must be a concern to prevent transmission from the corpse. The morgue needs to be designed so that it has the right placement, room design as well as equipment, so as to create a service flow that protects hospital staff and families/communities who come to mourn the corpse. Hospital management must prepare an appropriate standard of facilities, therefore, the funeral services can be carried out properly. This article aims to discuss good standards for forensic and mortuary services, and explores important options to provide mortuaries of type C and D hospitals or mobile hospitals.Keywords: mortuary, forensic service, facility standard Abstrak: Kamar jenazah merupakan salah satu bagian wajib ada di sebuah rumah sakit. Pada masa pandemi COVID-19, standar fasilitas kamar jenazah harus menjadi perhatian agar tidak terjadi penularan dari jenazah. Kamar jenazah perlu didesain agar memiliki penempatan, serta desain ruangan dan alat yang tepat, agar dapat tercipta alur layanan yang melindungi staf rumah sakit dan keluarga/masyarakat yang datang untuk melayat jenazah. Standar fasilitas yang tepat harus disiapkan oleh manajemen rumah sakit agar pelayanan jenazah dapat terlaksana dengan baik. Artikel ini bertujuan untuk membahas tentang standar pelayanan forensik dan kamar jenazah yang baik, dan mengeksplorasi pilihan penyediaan kamar jenazah bagi rumah sakit tipe C dan D ataupun rumah sakit bergerak.Kata kunci: kamar jenazah, pelayanan forensik, standar fasilitas

Evaluation of the operational viability of forensic units in Brazil: A hybrid approach based on the BWM and R-TOPSIS

Public security is an area of increasing importance in Brazil, as society requires that public resources are managed more efficiently and effectively. Criminalistics is an integral and vital part of the Brazilian public security system and requires new management tools to optimize human resources, equipment, and facilities allocation. Faced with a challenging scenario of budgetary constraints in several areas in public administration, the search for innovative methods should be a priority for the forensic service sector managers. The current article presents a multicriteria decision model to evaluate the operational viability of 23 forensic units within the Federal Police of Brazil (PF). The framework used the hybrid approach BWM and R-TOPSIS. The proposed model led to the complete ranking of 23 local forensic units. Amongst the last positions in the ranking, it was possible to recommend merging or shutting down some units. The sensitivity analysis performed did not show abrupt variations in the original positions, confirming the robustness of the proposed solution. It was concluded that the model allowed resources optimization whilst not compromising the quality of the services provided to society.