Another Perspective of the Miller Forensic Assessment of Symptoms Test – Part II: A Quantitative Review

Reference [1] presented pooled data for the specificity of the M-FAST cut-off, but ignored or excluded data based on poor justifications and used questionable analytic methods. The analyses here corrected the problems associated with [1]. No moderator substantively influenced sensitivity values. Therefore, sensitivity values were pooled across all studies (k = 25) to provide an overall estimate. Overall, the average sensitivity of the M-FAST cut-off was estimated to be 0.87, 95% CI [0.80, 0.91], and 80% of true sensitivity values were estimated to range from 0.63 to 0.96. Thus, there could be methodological scenarios when the M-FAST cut-off may not operate efficiently. Average specificity values for the M-FAST cut-off were moderated by one variable: the comparison group. On average, specificity values for clinical comparison (k = 15) groups (i.e., 0.80, 95% CI [0.73, 0.85]) were lower than specificity values for non-clinical comparison (k = 11) groups (i.e., 0.96, 95% CI [0.89, 0.99]). Unlike the CIs, the estimated distributions of true specificity values for the two subgroups overlapped, which suggests there could be scenarios when these subgroups share the same true specificity value. The M-FAST was designed to be a screener to detect potential feigning of psychiatric symptoms. An examinee is never to be designating as feigning or malingering psychiatric symptoms based on only a positive M-FAST result. As a screening instrument, the results here show that the M-FAST cut-off is operating adequately overall and negate the conclusions of [1].

Another Perspective of the Miller Forensic Assessment of Symptoms Test – Part I: A Narrative Review

Reference [1] presented a skewed perspective of the M-FAST literature base and provided the flawed conclusion that the M-FAST should no longer be used in practice. In an attempt to correct the many issues with [1], this article provides a narrative review of the strengths and weaknesses of research findings for the M-FAST interpretation as well as reviews methodological concepts underlying feigning research. The M-FAST was designed to screen for potential feigning of psychiatric symptoms. It was not designed to conclude that an examinee is feigning or malingering psychiatric symptoms. A positive result on the M-FAST only indicates that additional data needs to be collected to make the aforementioned conclusions. Applying the M-FAST in any other way is a serious error on the part of the user. The research literature thus far generally supports the use of the M-FAST cut-off as a screening measure for possible feigning of psychiatric symptoms. However, there are scenarios when the M-FAST may not operate as efficiently, and these scenarios are discussed. Reference [1] misrepresented the purpose of the M-FAST as well as research findings on the M-FAST. Therefore, [1] should be read with great caution.

How Hurricane Katrina influenced the design of hurricane protection and risk reduction systems and national approaches to risk and resilience: Part 1. Hurricane Katrina and New Orleans: A forensic assessment, risk and reliability analysis, and key lessons learned

A systems perspective is presented of what happened during and after Hurricane Katrina (2005) and the potential for reducing the likelihood of large losses in the future. This work was the basis for the rapid repair of the damage resulting from Katrina and ultimately the development and construction of a new risk reduction system for the region and a major shift in engineering guidance and practice related to public water infrastructure. The work was primarily accomplished through the Interagency Performance Evaluation Task Force (IPET) established by the Chief of Engineers, US Army Corps of Engineers, to conduct a comprehensive forensic analysis of what happened and why, and to an engineering risk and reliability assessment of the hurricane protection system in place when Katrina struck.

Main factors that cause negative complications of foot function after receiving mechanical traumatic injuries

The article is devoted to an important and relevant area of ​​forensic and clinical research to clarify and implement in medical theory and practice the main factors that cause negative complications of lower extremity function after fractures and other injuries due to mechanical trauma during traffic accidents ( further - road accident) and lead to permanent disability of more than 33%. Therefore, the aim of the study was to identify the criteria that indicate the occurrence of severe consequences of mechanical injury in the form of permanent disability of more than 33%, and to determine the value of these prognostic criteria. The material of the study was 180 forensic examinations and tests and medical records of victims of road accidents. Of these, 120 examinations and research - the main group, and 60 - control. A number of current legal documents describing the concepts and types of disability have also been studied. The methods were scientific analysis of legal sources and methods of descriptive statistics of medical and forensic documentation. The results of the study allowed us to identify 8 groups of symptoms that cause the negative consequences of post-traumatic changes in the form of permanent disability of more than 33%. Based on the study of these signs, prognostic criteria for modern forensic assessment of the severity of injuries burdened with loss of general ability to work in the above range were developed. The ranking of these prognostic criteria in the main group (voters) was carried out. A number of clinical and forensic features of modern forms and types of mechanical trauma of the lower extremities during an accident and the consequences of such injuries have been identified. A number of inconsistencies of by-laws regulating forensic medical examination in the field of glossary on permanent disability are shown. Conclusions and recommendations for improving the theory and practice of forensic determination of the degree of disability are given.

Clinical case of special legal liability which is the result of a doctor when combination of specialties

We analyzed a forensic case related to an unfavorable outcome of medical care by a pediatrician. One of the reasons for the unfavorable outcome of medical care was the combination of pediatric and pediatric neurology specialties by the doctor, which, according to experts, contributed to an incorrect assessment of the severity of the childs condition and incorrect assessment of general cerebral symptoms and neurological disorders, without proper differentiation. As a result, the diagnostic was not fully provided, and more serious diseases at the time were not excluded. We determined the objective and subjective aspects of liability for combination several specialties. A medical-legal and forensic assessment of a specific unfavorable outcome of medical practice is given. It is concluded that any combination of different specialties by a doctor not only requires additional professional duties but, at the same time, creates additional legal risks in term of criminal law, which should be taken into account by each specialist who has assumed additional obligations.

Forensic Determination of the Worth of Cultural Property

Forensic determination of the worth of various objects involved in legal proceedings is essential for ensuring a fair trial. Determining the worth of mass-produced goods does not usually pose any difficulties. The situation is different for unique cultural values and items that are in particular demand among collectors, history buffs, and others, but are withdrawn from civil circulation for moral reasons.The article analyzes the most significant aspects of the current market of cultural values, considers the methodological foundations of the forensic assessment of the worth of cultural values, mainly works of fine and applied art. The authors substantiate the necessity for a comprehensive forensic examination of cultural values due to the requirement for preliminary identification of the authenticity of items, their author, circumstances, and time of creation. The types of research necessary for this have been identified, such as traceological, documentary, materials analysis, historical, art, and others.The paper shows that forensic assessment of the worth of the items withdrawn from civil circulation based on the data on their worth on the black (illegal) market or on the legal markets of countries where the circulation of such items is not legally prohibited is inadmissible. The prohibition on using information about events that occurred after assessing the worth of cultural property is substantiated.

The profile of suspected criminal offenders referred for psychiatric evaluation on an outpatient basis at Ngwelezana Hospital

Background: Some suspected criminal offenders in South Africa are required to undergo forensic psychiatry assessments before or during the trial, which can be delayed as a result of the shortage of psychiatrists and inpatient forensic psychiatry beds. In KwaZulu-Natal (KZN) province, only one hospital (Fort Napier Hospital [FNH]) is designated for the 30-day inpatient forensic psychiatry assessments and there is a long waiting list for suspected criminal offenders awaiting assessment. There is a need to find ways of alleviating the backlog in the waiting list, with the use of outpatient forensic assessments being a possible adjunctive method.Aim: To determine the demographic, clinical and forensic profile of suspected criminal offenders referred for outpatient preliminary assessment to Ngwelezana Hospital, and identify the profile of those who most likely require referral to FNH for a 30-day inpatient assessment.Setting: The study was conducted at Ngwelezana Tertiary Hospital, in KZN, South Africa.Methods: We conducted a retrospective chart review of 207 suspected criminal offenders referred for outpatient forensic assessment from January 2009 to June 2015.Results: The majority of the participants were males (94.2%), with a diagnosis of substance use disorder (28.2%), intellectual disability (23.4%) or psychotic disorders (21.8%). Forty three per cent were charged with sexual crimes and 10.7% with murder. Fifty seven per cent were recommended for referral to FNH for a 30-day inpatient forensic assessment, whilst 43% were not recommended for referral. Those recommended for inpatient assessment were significantly more likely to have a lower level of education (p = 0.02), to be on a disability grant (p 0.01), and to have been diagnosed with intellectual disability (p 0.01), than those not recommended for referral.Conclusion: Identifying the characteristics of suspected criminal offenders who are most likely to be recommended for referral to FNH will potentially reduce the number of unnecessary referrals.