ABSTRACT
In forensic investigation, determining the time and cause of death becomes challenging, especially in cases where the remains are found in advanced decomposition, rendering traditional toxicological samples unavailable or unreliable. Entomotoxicology, an emerging methodology within forensic science, leverages insect specimens collected from cadavers as alternative toxicological samples. Several laboratory and field research studies have highlighted the efficacy in detecting various drugs, toxins, and elements absorbed by insects feeding on cadaveric tissues, even at low concentrations. However, correlation studies between drug concentrations in conventional matrices and insects remain controversial due to unknown factors influencing drug metabolism and larval feeding activity. This paper presents four real cases in which human cadavers were discovered in advanced stages of decomposition, and toxicological analyses were performed on both insect samples and available matrices. The results presented complement the scant literature currently available on the application of entomotoxicology in real cases, providing insights into the correlation between larvae and human specimen results. Furthermore, guidelines to collect and preserve entomological evidence at the crime scene and during the autopsy for use in entomotoxicological analyses are provided. This advancement holds promise in aiding forensic investigations, particularly in cases where traditional methods cannot be applied or require supporting data for further validation.
ABSTRACT
AIM: To assess the frequency, intensity and level of moral distress perceived by nurses working in medical, surgical and intensive care units. BACKGROUND: Moral distress among nurses compromises their ability to provide optimal patient care and may cause them to leave their job. METHODS: A cross-sectional questionnaire survey of 283 registered nurses was conducted to evaluate the frequency, intensity and levels of moral distress. A revised version of the Moral Distress Scale (MDS-R) was used. RESULTS: The highest level of moral distress was associated with the provision of treatments and aggressive care that were not expected to benefit the patients and the competency of the health-care providers. Multivariate regression showed that nurses working in medical settings, nurses with lower levels of experience working in medical, surgical or intensive care settings, and nurses who intend to leave their job experienced the highest levels of moral distress. CONCLUSIONS: The present study indicates that nurses experience an overall moderate level of moral distress. IMPLICATIONS FOR NURSING MANAGEMENT: Gaining further insight into the issue of moral distress among nurses and the clinical situations that most frequently cause this distress will enable development of strategies to reduce moral distress and to improve nurse satisfaction and, consequently, patient care.
