Lead toxicity in Lucilia cuprina and electrochemical analysis: a simple and low-cost alternative for forensic investigation.

Entomotoxicology allows the detection and analysis of substances such as poisons, drugs, and metals in necrophagous insects using analytical protocols. In a forensic situation related to death by gunshot, the gunshot residue (GSR) is dispersed at the crime scene and may be consumed by necrophagous insects. Lead (Pb) is the most abundant metal in GSR samples and it can be determined using non-portable methods. However, the toxicity effects of GSR samples on Lucilia cuprina (Diptera: Calliphoridae) and the detection of Pb via portable electrochemical methods have not been investigated. This study describes for the first time the toxicity analysis of Pb on immature L. cuprina through their survival rate and influence of Pb on immature development. In addition, the bioaccumulation of Pb in the larvae samples was determined based on square wave anodic stripping voltammetry (SWASV) measurements. The results revealed a low limit of detection to Pb (6.5 µg L-1) and the analytical performance was satisfactory because it measures Pb levels in larvae exposed to a diet containing 50 µg Pb g-1. Furthermore, the levels of Pb influenced the survival rate and development time of the immature L. cuprina. Larvae exposed to a high concentration of the metal (50 µg Pb g -1) showed statistically significant changes (p < 0.05). The presence of Pb in immature L. cuprina can be used to estimate the post-mortem interval; thus, the present study provides important information in forensic entomology.

Fast and efficient analyses of the post-mortem human blood and bone marrow using DI-SPME/LC-TOFMS method for forensic medicine purposes.

For the first time the method DI-SPME/LC-TOFMS was used and developed in order to determine the large antidepressant drugs in real forensic cases. The aim of the study was to optimize the new DI-SPME/LC-TOFMS method for the quantification of the large group of psychotropic drugs such as benzodiazepines, selective serotonin reuptake inhibitors, selective serotonin and noradrenaline reuptake inhibitors, tricyclic antidepressants and sleeping pills "Z". The volume of the sample, adsorption time, post-adsorption purification and desorption time were precisely optimized. The validation parameters such as limit of detection and quantification, linearity, precision during and between days and the matrix effect were determined. All obtained values are within the acceptable range for toxicological analyses. The usefulness of the method was confirmed by analyzing the post-mortem samples. Drug concentrations were determined in real samples with high precision, which gives perspectives for the DI-SPME/LC-TOFMS routine application in toxicological and forensic analyses in the future.

[An assessment of the direct costs of healthcare for victims of sexual assaults in hospital emergency units]. / Évaluation des coûts directs de la prise en charge en urgence d'une victime de violences sexuelles.

BACKGROUND: The Forensic medicine reform in 2011 enabled the development of forensic units specialized in multidisciplinary care of victims of criminal offences. Thanks to an annual budgetary allocation, the Ministry of Justice handles the financing of judicial acts, while the health care facilities assume the medical, psychological and social aspects. The objective of this study was to determine the direct costs of medical care provided to rape victims (such as defined in the article 222-23 of the Penal Code) in order to see how its funding could be reconsidered to prevent any additional cost that could be caused by non-sufficient medical, psychological and social care. Furthermore, this first assessment may serve as a basis for further reflection on creating other medical judicial units but also for reviewing existing structures. METHODS: The direct costs for medical care of a recent rape victim (<48hours) was quantified by including staff and consumables costs, treatments, biological tests and other expenses. RESULTS: The overall time for the entire medical care procedure was approximately three hours, for an overall cost of 673.92€, of which 41.5 % (279.90€) was paid by the Ministry of Justice. The medical, psychological and social aspects stood for the major expenditure items (394.02€), attributable mainly to the biological screening tests for sexually transmissible infections (STIs). CONCLUSION: These frequent situations require the convergence of human and material needs with a financial burden shared between the Ministry of Justice and health establishments. Authors suggest that in the annual hospital budgetary allocation allotted by the Ministry of Justice, the care of victims of sexual assault be based on the rate of day hospitalization "Medicine, medical specialties part time day or night common regime", allowing to provide optimal multidisciplinary care, which lessens the risks of complications and reduces the global cost created by these situations.

Conforming STOP Violence Against Women Formula Grant Program Regulations to Statutory Change; Definitions and Confidentiality Requirements Applicable to All OVW Grant Programs. Final rule.

This rule amends the regulations for the STOP (ServicesTrainingOfficersProsecutors) Violence Against Women Formula Grant Program (STOP Program) and the general provisions governing Office on Violence Against Women (OVW) programs to comply with statutory changes and reduce repetition of statutory language. Also, this rule implements statutory requirements for nondisclosure of confidential or private information relating to all OVW grant programs.

Influence of Criminal Justice Involvement and Psychiatric Diagnoses on Treatment Costs Among Adults With Serious Mental Illness.

The impact of criminal justice involvement and clinical characteristics on the cost of public treatment services for adults with serious mental illnesses is unknown. The authors examined differential effects of justice involvement on behavioral health treatment costs by primary psychiatric diagnosis (schizophrenia or bipolar disorder) and also by substance use diagnosis among 25,133 adult clients of Connecticut's public behavioral health system in fiscal years 2006 and 2007. Justice-involved adults with schizophrenia had the highest costs, strongly driven by forensic hospitalizations. Addressing the cross-system burdens of forensic hospitalizations may be a sensible starting point in the effort to reduce costs in both the public behavioral health and justice systems.

[The medico-economic approach to the evaluation of non-violent death among the population of the elder age group (based on the materials of the Nizhni Novgorod Regional Bureau of Forensic Medical Expertise)].

The objective of the present study was the comparative analysis of the deaths among the elderly and senile subjects taking into consideration the growing costs of forensic medical expertise at the Nizhni Novgorod Regional Bureau of Forensic Medical Expertise.

[The mathematical methods for the estimation of the workload on the personnel of the Bureau of Forensic Medical Expertise].

The objective of the present study was to analyse the financial support of forensic medical research with the application of mathematical methods based at the Nizhni Novgorod Regional Bureau of Forensic Medical Expertise. The authors elaborated the prognosis of the expenses for the forensic medical expertise of the corpses of the elderly and senile subjects.

Avoiding (or fixing) problems with lawyers and courts.

Clinicians who do work for attorneys and courts sometimes encounter problems in defining their roles, with access to records or litigants, with unexpected changes or additions to their tasks, or with being compensated for their work. Understanding the context of the forensic consultation and the processes commonly employed by lawyers and the judiciary can prevent many problems. Be cautious about "informal" requests from attorneys, particularly if they involve your own patients. Maintain solid business practices and make sure your role, relationship, and financial agreement with the person or entity retaining you are clear, ethical, and well documented before you begin work on a case.

[The QR code in society, economy and medicine--fields of application, options and chances]. / Der QR Code in Gesellschaft, Wirtschaft und Medizin--Anwendungsbeispiele, Möglichkeiten und Chancen.

2D codes like the QR Code ("Quick Response") are becoming more and more common in society and medicine. The application spectrum and benefits in medicine and other fields are described. 2D codes can be created free of charge on any computer with internet access without any previous knowledge. The codes can be easily used in publications, presentations, on business cards and posters. Editors choose between contact details, text or a hyperlink as information behind the code. At expert conferences, linkage by QR Code allows the audience to download presentations and posters quickly. The documents obtained can then be saved, printed, processed etc. Fast access to stored data in the internet makes it possible to integrate additional and explanatory multilingual videos into medical posters. In this context, a combination of different technologies (printed handout, QR Code and screen) may be reasonable.

[On the state of the budgetary funding of government forensic medical expert institutions in the Russian Federation].

The data on the budgetary funding of state-owned forensic medical bureaus in the Russian Federation for the period from 2005 to 2008 were collected and analysed. The results of the overall estimation and parameters characterizing the level of funding of these expert facilities are presented. Selected state forensic medical bureaus have been ranked based on the level of their financial support.

The development of mini pentameric STR loci for rapid analysis of forensic DNA samples on a microfluidic system.

There is increasing interest in developing methods for portable DNA analysis in mass disasters and criminal identification. Currently most forensic STR DNA analysis is performed by CE; however, these instruments are not portable and require long sample run times. One potential solution is the development of microfluidic systems for DNA typing. Unfortunately, fairly long (ca. 20 cm) separation channels are usually required for the proper resolution of multiplexed STR loci used in human identification. Commercially available systems like the Agilent 2100 Bioanalyzer have a small footprint and utilize chips with shorter channels and reduced resolution. Such portable systems might be valuable for evidence screening in remote locations. However, due to their lower resolution, most standard 4 base STR loci and their inherent 2 base variants will not resolve on such systems. In this paper, we discuss the development of reduced length pentameric (5 base) STR amplicons. Pentameric STRs have fewer variant alleles and are easier to separate due to the wider spacing between alleles. By incorporating novel denaturing sieving polymers in a short microfluidic channel, we demonstrate efficient separations on these chips. Such an approach can serve as a useful tool for rapid microfluidic DNA typing.

[Dynamics of main characteristics of activities of forensic biological departments of forensic medical bureaus of the Russian Federation for the period from 1980 till 2008].

Voluminous materials characterizing activities of forensic biological units of forensic medical bureaus of the Russian Federation for the period from 1980 till 2008 have been collected, summarized, and systematized. The study is the first attempt to analyse the entire scope of work performed by forensic biologists during a large period of time and to estimate the proportion of its constituent components. It revealed long-term dynamics (increase and decrease) of the number of forensic biological studies.

Provision of forensic medical services to police custody suites in England and Wales: current practice.

INTRODUCTION: Police services within England and Wales are required under the Police and Criminal Evidence Act 1984 to ensure appropriate healthcare to those detained in police custody (forensic medical services). Traditionally doctors have been used by police services to provide an appropriate level of care. Changes within the Act allowed other healthcare professionals (nurses and paramedics and emergency care practitioners) to be included in the provision of such services. The aim of this appears at least in part to have been to reduce the costs of providing such a service. In recent years police services within England and Wales have been outsourced to assorted commercial providers. There are now several different modes of delivery of forensic medical services, which are determined locally by separate police services. AIMS: This study aimed (a) to determine the different modes of delivery of forensic medical services in England and Wales; (b) to determine the healthcare workload caused by Police and Criminal Evidence Act 1984 Codes of Practice; (c) to determine the relative costs of different service models and (d) to determine availability of such information from the police services. METHODS: The study was undertaken in two parts--(a) a telephone survey of all police services, and (b) an application to each police service utilising the Freedom of Information Act 2000. RESULTS: All police services (n=43) in England and Wales were contacted. Of the 41 forces that furnished detailed information; 13/41 had a doctor only service; 20/41 had a doctor/nurse service; 6/41 had a doctor/nurse/paramedic service; 1/41 had a doctor/emergency care practitioner service (who may be nurses or paramedic); 1/41 had a doctor/paramedic service. 23/43 services were outsourced to private commercial providers. Mean cost per patient contact (in 17/43 services which supplied data) was GBP 97.25. The cheapest cost per patient contact was the Metropolitan Police Service - a doctor only service (GBP 56.4), the highest Lincolnshire--a doctor only service (GBP 151.1). Mean cost for a doctor only service was GBP 97.1; for a doctor/nurse service--GBP 91.56 and for a doctor/nurse/paramedic service--GBP 115.76. There was no significant difference in costs per patient contact between a doctor only versus mixed HCP delivery of service. Relative costs and 95% confidence intervals expressed as a percentage show that a doctor only model was on average 3.4% lower than a mixed HCP provision, and that a non-outsourced service was on average 9.9% less than an outsourced service. No outsourced service in this study uses a doctor only model. CONCLUSIONS: The study shows that there was a complete lack of consistency in the recording and availability of information regarding forensic medical services for police services in England and Wales. The information that was obtained suggested that usage of such services varied greatly between police services and that costs of forensic medical services appear to be increased by the use of mixed healthcare professional service delivery and by using external commercial providers.

[The possibility of medico-legal opinionating on medical error in cases of waived postmortem examination]. / Konsekwencje decyzji o zwolnieniu z sekcji zwlok w przypadkach opiniowania o bledzie lekarskim.

For several years now, with the introduction of the health care sector reform we have been observing a considerable drop in the number of postmortem examinations performed in patients who died in hospitals. The decrease amounts to as much as 50 to 70%. This is undoubtedly a consequence of financial restrictions imposed on the management of these inpatient facilities. On the other hand, Departments of Forensic Medicine established to evaluate the so-called medical errors are swamped with an increasing avalanche of complaints concerning the appropriateness of therapeutic management. This leads to a growing number of orders from penal prosecution and jurisdiction agencies with requests for assessment whether a medical error has been committed in a particular case. The result of a postmortem examination is practically the only basis for a factual evaluation of a given case. When no autopsy has been performed, the experts are virtually helpless, and in the majority of such instances, they are forced to refuse passing an expert opinion. The report presents basic principles of medico-legal opinionating in criminal cases (including proceedings pertaining to medical errors), the rules governing the medical error assessment, as well as problems encountered in evaluating the appropriate course of treatment when a post mortem examination has been waived.

Valoración medicoforense del esguince cervical. Réplica / Medico legal evaluation of whyplash injury. Reply

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[Efficiency of hardware-assisted tools in forensic expertise].

The authors analyze the efficiency of special-purpose hardware-assisted tools (SHT) in forensic expertise. Unlike clinical medicine, in which the methods of quantitative and qualitative analysis are comprehensively used in choosing drugs, issues related with providing the state forensic-expertise facilities with specialized equipment have not been virtually elaborated up to now. The qualitative analysis based on the subjective evaluation of experts is used presently for the purposes. Therefore, development of objective criteria of evaluation of SHT for forensic expertise is an important and topical issue.