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| 2. |
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| 3. |
- Olsson, Helen, et al.
(författare)
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Violence risk assessment in clinical practice: How forensic nurses experience violence risk assessment in daily work -A qualitative interview study
- 2017
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Ingår i: Global Journal of Health Science. - Canada : Canadian Center of Science and Education. - 1916-9736 .- 1916-9744. ; 9:12, s. 56-63
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Tidskriftsartikel (refereegranskat)abstract
- Background: The legislation of Swedish forensic psychiatric care states that the risk of further violence must be assessed before a patient is granted release from a forensic psychiatric hospital. The aim of the study was to describe the experiences of forensic nurses with in-patient risk assessment processes, and their implication for daily clinical forensic praxis.Method: Semi-structured interviews with staff who were involved in the patients risk assessment process. The interview texts were analyzed using qualitative latent content analysis.Discussion: The forensic nursing staff has to deal with many contradictory realities. The description was about being able to balance between supporting their work with an EBP approach of risk assessment while trying to establish interpersonal relationships and to allow for positive meetings with the patient. The study indicated that staff used a multiple sources of knowledge in order to make credible and accurate risk assessments.Conclusions: If the risk assessment process are to be used in a legally secure manner, the staff must receive regular support from team leadership that can provide both guidance and training. Based on a holistic approach, the link between the instinct of staff and their work with structured risk assessment must be founded on routines and solid platforms.
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| 4. |
- Tillmar, Andreas O., et al.
(författare)
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Choosing supplementary markers in forensic casework
- 2014
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Ingår i: Forensic Science International-Genetics. - : Elsevier BV. - 1872-4973 .- 1878-0326. ; 13, s. 128-133
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Tidskriftsartikel (refereegranskat)abstract
- The vast majority of human familial identifications based on DNA end up with a well founded conclusion, normally using a standard set of genetic short tandem repeat (STR) loci. There are, however, a proportion of cases that show ambiguous results. For such occasions a number of different supplementary markers could be typed in order to gain further information. There are numerous markers available for such supplementary DNA typing, including STRs, deletion and insertion polymorphisms (DIPs), and single nucleotide polymorphisms (SNPs). The purpose of this work was to describe a precise method for decision making, aiming to aid the comparison of different sets of markers for different case scenarios in order to find the most efficient set for routine casework. Comparisons are based on a particular function relating the expected additional value of information from new data to the amount of information already obtained from initial data. The function can be computed approximately by approximating likelihood-based error rates using simulation. In this paper we focused on paternity investigations, more specifically the use of supplementary markers in cases where a smaller number of genetic inconsistencies make the matter inconclusive. We applied the method to a comparison of three different kits: Investigator HDplex (STRs), Investigator DIPplex (DIPs), and the SNPforID-plex (SNPs) to study their efficiencies in gaining information in different case scenarios involving various alternative relationships between the tested man and the tested child. We show that the Investigator HDplex was the most efficient set of supplementary markers for the standard paternity case. However, for paternity cases with a close relative being the alternative father, the Investigator HDplex and the SNPforID-plex showed similar patterns in their ability to deliver a well-founded conclusion. The Investigator DIPplex was the least efficient set.
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| 5. |
- Trägårdh, Karin, et al.
(författare)
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Risk Profiles of Female Perpetrators of Severe Violence
- 2019
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Ingår i: 13th Nordic Symposium on Forensic Psychiatry. August 20-22, Gothenburg, Sweden.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Female offenders without a severe mental disorder show more criminogenic factors than those with. Both groups are characterized by mental health problems. We need to further characterize female offenders. Background Offenders of lethal/severe violence are in a majority of cases male, about 90% (Falk et al., 2014), and research has to a considerable extent focused on male violent offenders. Although less is known about female violent offenders than male offenders, previous research has indicated significant differences between male and female offenders of lethal/severe violence (Trägårdh et al., 2016; Yourstone et al., 2008). Since a majority of female perpetrators of lethal violence undergo a forensic psychiatric investigation (RPU/FPI), these documents contains important information about this group. Purpose The aim of this ongoing study is to characterize female perpetrators of severe violent crimes, and to compare female perpetrators sentenced to forensic psychiatric compulsory care with those sentenced to correctional treatment. Method This is an exploratory and descriptive study with a cross-sectional design. All forensic evaluations (FPI) made in Sweden between 2000-2014 (from The National Board of Forensic Medicine/RMV), and the subsequent court verdicts, in cases where women had used lethal/severe violence (n≈180) where used as the basis for data collection in this study. The present preliminary analyses (2-tests and ANOVA) contains approx. 26% (n=47) of the total group. Group differences were investigated regarding: Mental health (FPI) Risk factors (HCR-20 and PCL-R) Victim relation (FPI) Criminal behavior (FPI) Results Female offenders with and without a Severe mental disorder (SMD) seems to differ in some respects. For female offenders with a SMD, the crime was more likely to have been conducted in a less criminal context (see Table). For female offenders without a SMD, the following characteristics were more frequently present: Victim gender – male Substance abuse + Under the influence of substance (offender and victim) Previous violence between victim and offender Previous registered criminality Also, several common features between the SMD and non-SMD group of female offenders were found. The majority of all female offenders had: Previous psychiatric contact and diagnoses Previously attempted suicide No previously registered criminality Conclusions Preliminary results of the female perpetrators who had underwent a FPI seems to identify both substantial differences and similarities between those with versus without a SMD, where those without show more criminogenic factors. Both groups were also characterized by a high amount of mental illness. Also, these results supports previous research that female and male offenders of severe violence differ in important ways. Since a majority of female perpetrators of lethal violence undergo a forensic psychiatric investigation, these results should be generalizable to this group as a whole in Sweden. Based on these results, a great need to further characterize female offenders of severe/lethal violence remain.
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| 6. |
- Kjeldgård, Linnea, 1985-, et al.
(författare)
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Diagnosis-specific sickness absence among injured working-aged pedestrians: a sequence analysis
- 2023
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1, s. 367-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian. METHODS: A nationwide register-based study, including all individuals aged 20-59 and living in Sweden, who in 2014-2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression. RESULTS: In total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster "No SA", all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters "Immediate SA", "Episodic SA" and "Both SA due to injury and other diagnoses" were also associated with higher odds of pedestrians who sustained a fracture. CONCLUSIONS: This nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.
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| 7. |
- Aarts, B., et al.
(författare)
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DNActivity: International cooperation in activity level interpretation of forensic DNA evidence.
- 2015
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Ingår i: Abstract book, 7<sup>th</sup> European Academy of Forensic Science, EAFS, Prag, Tjeckien, 2015.. ; , s. 555-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Questions posed to expert witnesses by the legal community and the courts are expanding to include not just those relating to source level (i.e. ‘who is the donor of the trace?’) but also those relating to activitity level (i.e. ‘how did the DNA get there?’). The answers to these questions are usually formulated as the probability of the evidence under alternative scenarios. As activity level questions are part of investigative and legal considerations it is of paramount importance that expert witnesses are provided with knowledge and tools to address these questions.To answer such questions within a probabilistic framework, empirical data is needed to estimate probabilities of transfer, persistence and recovery of DNA as well as background levels of DNA on everyday objects. There is a paucity of empirical data on these topics, but the number of studies is increasing both through in-house experiments and experimental data published in international scientific journals.Laboratories that conduct such studies all use different experimental setups, trace recovery strategies and techniques and DNA analysis systems and equipment. It is essential for the forensic genetics community in general to establish whether the data generated by different labs are in concordance, and can therefore be readily used by the forensic community.Moreover, if existing data and data generated from future experiments are made available to the (forensic) community, knowledge is needed on the key factors that underlie potential interlaboratory variation.The aims and objectives of this ENFSI Monopoly 2013 project are to conduct a study of methodologies and data from different laboratories and to assess the comparability of the scientific data on transfer, persistence and recovery of DNA. This comparison will allow us to identify key factors that underlie potential variation. This information will be used to setup guidelines to enable sharing and database-storage of relevant scientificdata. This will improve the ability of forensic scientists and other professionals of the Criminal Justice System to give evidence-based answers to questions that relate to the activity level of the crime under investigation.
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| 8. |
- Abdaljaleel, Maram, et al.
(författare)
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Postmortem lung and heart examination of COVID-19 patients in a case series from Jordan
- 2023
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Ingår i: Journal of Pathology and Translational Medicine. - : The Korean Society of Pathologists and The Korean Society for Cytopathology. - 2383-7837 .- 2383-7845. ; 57:2, s. 102-112
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Tidskriftsartikel (refereegranskat)abstract
- Background: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19-positive autopsies performed in Jordan. Methods: The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples. Results: Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings. Conclusions: The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.
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| 9. |
- Acosta, S., et al.
(författare)
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Drugs in fall versus non-fall accidents with major trauma – A population-based clinical and medico-legal autopsy study
- 2019
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Ingår i: Forensic Science International. - : Elsevier BV. - 0379-0738. ; 296, s. 80-84
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Tidskriftsartikel (refereegranskat)abstract
- Background: The main aim of the present population-based study was to compare drugs in fall versus non-fall accidents causing major trauma, including both clinical and medico-legal autopsy data. Methods: All individuals with accidents resulting in major trauma, a new injury severity score (NISS) > 15 or lethal outcome was identified at hospital and/or the Department of Forensic Medicine between 2011 and 2013. Modified Downton Fall Risk Index ranged from 0 to 7, and was based on specific pharmaceuticals (max 5 points), previous fall (1 point) and cognitive impairment (1 point). Results: One hundred and four individuals with major traumatic accidents were identified, 38 (36.5%) died. The median modified Downton Fall Risk Index was 2 for fall accidents and 0 for non-fall accidents (p < 0.001). Modified Downton Fall Risk Index was an age-independent factor associated with fall accident (p < 0.001). The medico-legal autopsy rate for in-hospital patients was 50% (6/12) for fatal fall accidents in comparison with 92.3% (12/13) for fatal non-fall accidents (p = 0.03). In individuals undergoing medico-legal autopsy, the proportion of individuals with any detected drug was 77% in fall accidents compared to 39% in non-fall accidents (p = 0.036). The presence of sedatives (p = 0.002) and bensodiazepines (p = 0.023) were higher for fall accidents compared to non-fall accidents. Conclusion: This population-based study on accidents with major trauma showed that drugs had high impact on fall accidents with major trauma. It seems warranted from a public health perspective to study if implementation of medication review guidelines at hospital managing polypharmacy issues may prevent fall accident recidivism.
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| 10. |
- Ahlm, Kristin, et al.
(författare)
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Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden
- 2009
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Ingår i: Accident Analysis and Prevention. - : Elsevier. - 0001-4575 .- 1879-2057. ; 41:1, s. 129-136
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol and drugs are important risk factors for traffic injuries, a major health problem worldwide. This prospective study investigated the epidemiology and the presence of alcohol and drugs in fatally and hospitalized non-fatally injured drivers of motor vehicles in northern Sweden. During a 2-year study period, blood from fatally and hospitalized non-fatally injured drivers was tested for alcohol and drugs. The study subjects were recruited from well-defined geographical areas with known demographics. Autopsy reports, medical journals, police reports, and toxicological analyses were evaluated. Of the fatally injured, 38% tested positive for alcohol and of the non-fatally 21% tested positive; 7% and 13%, respectively, tested positive for pharmaceuticals with a warning for impaired driving; 9% and 4%, respectively, tested positive for illicit drugs. The most frequently detected pharmaceuticals were benzodiazepines, opiates, and antidepressants. Tetrahydrocannabinol was the most frequently detected illicit substance. No fatally injured women had illegal blood alcohol concentration. The relative proportion of positively tested drivers has increased and was higher than in a similar study 14 years earlier. This finding indicates that alcohol and drugs merit more attention in future traffic safety work.
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| 11. |
- Ahlm, Kristin, et al.
(författare)
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Blood loss in exsanguination deaths
- 2011
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Ingår i: Indian Journal of Forensic Medicine & Toxicology. - 0973-9122. ; 5:2, s. 5-8
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Tidskriftsartikel (refereegranskat)abstract
- Deaths by exsanguination among various underlying causes of death were analyzed in order to expand the knowledge on the relation of extravasated blood volume to other documented parameters. A consecutive series of 193 cases of ruptured thoracic aortic aneurysm (n=13), gunshot wounds (n=63), stab wounds (n=28), rib fractures (n=5), and blunt injury to thoracic aorta (n=84) were investigated. The amount of internal bleeding into pleural cavities only varied greatly (200-3,400 ml) with a mean value of 1,174 ml, slightly higher among males. Age, body weight, cause and manner of death, external bleeding, alcohol inebriation, multiplicity of injuries, and degree of coronary heart disease did not significantly affect the amount of internal (pleural) bleeding. Also, post-mortem delay to autopsy did not correlated to the amount of extravasated blood, indicating that post-mortem bleeding is of no importance in these days.
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| 12. |
- Ahlm, Kristin, et al.
(författare)
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Driver's alcohol and passenger's death in motor vehicle crashes
- 2006
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Ingår i: Traffic Injury Prevention. - : Taylor & Francis. - 1538-9588 .- 1538-957X. ; 7:3, s. 219-223
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Previous studies on alcohol involvement associated with fatal injury in traffic crashes have focused on the drivers, but the passenger's view is not well known. This study (1) analyzes the relationship between passenger's death and alcohol inebriation of the driver and (2) estimates the role of alcohol as the cause of a crash by examining who was at fault, sober, or inebriated.METHOD: The study includes all motor vehicle passengers (n = 420) who died in crashes in Sweden 1993 through 1996 and were medicolegally autopsied. Autopsy reports from the Departments of Forensic Medicine, including toxicological analyses, and police reports were studied. Presence of alcohol among drivers was based on blood and breath tests.RESULTS: One-fifth of the fatally injured passengers and one-fifth of the tested drivers were under the influence of alcohol. The youngest drivers had the highest prevalence of drunken driving. Drivers at fault were alcohol positive in 21% of these crashes and drivers were not at fault in 2% of these crashes. In 53% of the crashes where both the passenger and driver were alcohol positive, the passenger had a lower alcohol concentration than the driver. Children (<16 years) comprised 15% of the killed passengers. Notably, the children were riding with a driver who was under influence of alcohol in 13% of these crashes. Alcohol involvement was not tested in half of the surviving drivers.CONCLUSIONS: The data show that 20% of both passengers and drivers were under the influence of alcohol. Increased testing of surviving drivers regarding alcohol and other drugs is recommended.
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| 13. |
- Ahlm, Kristin, et al.
(författare)
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Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs : a retrospective study, 1992-2009
- 2013
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 13, s. 216-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.
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| 14. |
- Ahlm, Kristin, et al.
(författare)
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Suicidal drowning deaths in northern Sweden 1992-2009 : the role of mental disorder and intoxication
- 2015
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Ingår i: Journal of Forensic and Legal Medicine. - : Elsevier. - 1752-928X .- 1878-7487. ; 34, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- Suicides by drowning have received limited attention by researchers. A recent finding that almost onethird of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.
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| 15. |
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| 16. |
- Ahlm, Kristin, 1956-
(författare)
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Traffic and drowning incidents with emphasis on the presence of alcohol and drugs
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Worldwide, fatal traffic injuries and drowning deaths are important problems. The aim of this thesis was to investigate the cirumstances of fatal and non-fatal traffic injuries and drowning deaths in Sweden including analysis of the presence of alcohol and drugs, which are considered to be major risk factors for these events. Data where obtained from the database of National Board of Forensic Medicine.In the first study, we investigated 420 passenger deaths from 372 crashes during 1993-1996. There were 594 drivers involved. In total, 21% of the drivers at fault were alcohol positive compared to 2% of drivers not at fault (p<0.001) (Paper I). During 2004-2007, crashes involving 56 fatally and 144 non-fatally injured drivers were investigated in a prospective study from Northern Sweden (Paper II). The drivers were alcohol positive in 38% and 21%, respectively. Psychoactive drugs were found in 7% and 13%, respectively. Benzodiazepines, opiates and antidepressants were the most frequent drugs found in drivers. Illict drugs were found 9% and 4% respectively, with tetrahydrocannabinol being the most frequent of these drugs (Paper II).We investigated 5,125 drowning deaths in Sweden during 1992-2009 (Paper III). The incidence decreased on average by about 2% each year (p<0.001). Unintentional drowning was most common (50%). Alcohol was found in 44% of unintentional, 24% of intentional, and 45% of undetermined drowning deaths. Psychoactive substances were detected in 40% and benzodiazepines were the most common substance. Illicit drugs were detected in 10%. Of all drowning deaths, a significantly higher proportion females commited suicide compared with males (55% vs. 21%, p<0.001). Suicidal drowning deaths (n=129) in Northern Sweden were studied further in detail (Paper IV). of these, 53% had been hospitalized due to a psychiatric diagnosis within five years prior to the suicide. Affective and psychotic disorders were the most common psychiatric diagnoses. Almost one third had performed a previous suicide attempt. One fourth had committed suicide after less than one week of discharge from hospital. Alochol was found in 16% and psychoactive drugs in 62% of these cases, respectively. In conclusion, alcohol and psychoactive drugs are commonly detected among injured drivers and drowning victims, and probably play a role in these events. Most of the individuals that tested positive for alcohol and high blood concentrations, indicating alochol dependence or abuse. This association warrants futher attention when planning future prevention.
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| 17. |
- Ahlm, Kristin, et al.
(författare)
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Unnatural deaths in reindeer-herding Sami families in Sweden, 1961-2001
- 2010
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 69:2, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Unnatural deaths among Indigenous populations, including the Swedish Sami, occur more often than among the general population. To find prevention strategies, we explored the circumstances of the unnatural deaths of members of reindeer-herding Sami families.STUDY DESIGN: The number of deaths from among a cohort of 7,482 members of reindeer-herding Sami families were retrieved from the National Board of Health and Welfare for the years 1961- 2001.METHODS: An evaluation of the information from autopsy records at the National Board of Forensic Medicine, police reports, and available medical records identified 158 unnatural deaths. These were then analysed in detail.RESULTS: Transport-related deaths and suicides were the most common unnatural deaths among Swedish reindeer-herding Sami family members. Suicides contributed to 23% of all deaths, road traffic accidents to 16%, and snowmobile fatalities to 11%. The accidents generally reflected an "outdoor lifestyle" and the working conditions were characterized by the use of off-road vehicles such as snowmobiles. Half of the number of victims tested positive for alcohol and alcohol abuse was documented in 15% of all victims.CONCLUSIONS: The results indicate that alcohol is an important factor in preventing unnatural deaths among reindeer-herding Sami, together with increased safety of both on-road and off-road transportation.
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| 18. |
- Ahlner, Johan, et al.
(författare)
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Demographics and post-mortem toxicology findings in deaths among people arrested multiple times for use of illicit drugs and/or impaired driving
- 2016
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Ingår i: Forensic Science International. - : ELSEVIER IRELAND LTD. - 0379-0738 .- 1872-6283. ; 265, s. 138-143
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multiple arrests for use of illicit drugs and/or impaired driving strongly suggests the existence of a personality disorder and/or a substance abuse problem. Methods: This retrospective study (1993-2010) used a national forensic toxicology database (TOXBASE), and we identified 3943 individuals with two or more arrests for use of illicit drugs and/or impaired driving. These individuals had subsequently died from a fatal drug poisoning or some other cause of death, such as trauma. Results: Of the 3943 repeat offenders 1807 (46%) died from a fatal drug overdose and 2136 (54%) died from other causes (p amp;lt; 0.001). The repeat offenders were predominantly male (90% vs 10%) and mean age of drug poisoning deaths was 5 y younger (mean 35 y) than other causes of death (mean 40 y). Significantly more repeat offenders (46%) died from drug overdose compared with all other forensic autopsies (14%) (p amp;lt; 0.001). Four or more drugs were identified in femoral blood in 44% of deaths from poisoning (drug overdose) compared with 18% of deaths by other causes (p amp;lt; 0.001). The manner of death was considered accidental in 54% of deaths among repeat offenders compared with 28% for other suspicious deaths (p amp;lt; 0.001). The psychoactive substances most commonly identified in autopsy blood from repeat offenders were ethanol, morphine (from heroin), diazepam, amphetamines, cannabis, and various opioids. Conclusions: This study shows that people arrested multiple times for use of illicit drugs and/or impaired driving are more likely to die by accidentally overdosing with drugs. Lives might be saved if repeat offenders were sentenced to treatment and rehabilitation for their drug abuse problem instead of conventional penalties for drug-related crimes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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| 19. |
- Ahlström, Stina, et al.
(författare)
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Characteristics of post-mortem beta-hydroxybutyrate-positivet cases : A retrospective study on age, sex and BMI in 1407 forensic autopsies
- 2021
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Ingår i: Forensic Science International. - : Elsevier BV. - 0379-0738 .- 1872-6283. ; 325
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPost-mortem biochemistry, including the analysis of beta-hydroxybutyrate (BHB), is increasingly employed in forensic medicine, especially in conditions such as diabetes and chronic alcoholism. However, not much is known about the associations between age, body mass index (BMI), and sex and BHB concentrations in ketoacidotic conditions.AimTo retrospectively study the association between age, BMI and sex in several conditions, such as diabetic ketoacidosis (DKA), alcoholic ketoacidosis (AKA), and elevated post-mortem BHB concentrations.Methods1407 forensic autopsy cases analysed for BHB were grouped by diagnosis: DKA, AKA, HHS [hyperosmolar hyperglycaemic state], acidosis NOS [not otherwise specified], or hypothermia. Age, sex, BMI and the concentrations of blood alcohol, vitreous glucose and blood BHB were recorded.ResultsCases of AKA and DKA were most numerous (184 and 156, respectively). In DKA and in its male subgroup, cases with severe ketosis (BHB>1000 µg/g) were younger and had a lower BMI than those with moderate ketosis (BHB 250–1000 µg/g) and controls (P<0.001). In DKA and in its female subgroup, cases with moderate ketosis cases were older (P = 0.0218 and P = 0.0083) than controls. In AKA and in its male subgroup, cases with severe ketosis had a lower BMI than those with moderate ketosis (P = 0.0391 and P = 0.0469) and controls (P<0.001). Cases with moderate ketosis had a lower BMI than controls (P<0.001).ConclusionsBHB concentration is associated with BMI in DKA and AKA, and with both BMI and age in DKA. Constitutional factors should, therefore, be considered in potential AKA and DKA cases.
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| 20. |
- Albinsson, L., et al.
(författare)
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Mixed DNA profiles from single-donors
- 2015
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Ingår i: Abstract book, 7<sup>th</sup> European Academy of Forensic Science, EAFS, Prag, Tjeckien, 2015. ; , s. 538-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Mosaicism and chimerism in individuals can complicate the interpretation and even lead to misinterpretation of DNA profiles in forensic casework. If a person has different DNA profiles in different tissue types, i.e. a true chimaera, wrongful exclusions can be made. Additionally, mixed chimaeras can have DNA profiles that may be mistaken for mixtures. We have set-up automatic DNA databasing processes to handle atypical single-donor DNA profiles, i.e. profiles having one or several “extra” alleles.Studying all reference samples analysed at NFC from 2006 until spring 2014, 2‰ of the samples showed atypical DNA profiles. To be able to set routines for handling these DNA profiles, each one was manually searched in CODIS with adjusted settings, to evaluate the frequency of false-positive hits. To tag these profiles in LIMS a new result status was implemented. Additionally, all such DNA profiles must be confirmed by analysing at least two discrete samples. In LIMS, the results are manually recorded to compose of all alleles from the samples from a suspect, i.e. containing most possible genetic information. LIMS automatically categorises the atypical DNA profiles with a special CODIS index, called “Multi-allelic offender”. The first time an atypical profile is searched, the matches are manually investigated. If a match is false, its disposition will be set to “no match” to prevent this from occurring in future searches. Automatic searches will then be performed in every day routine with moderate stringency, allowing the atypical DNA profile to match either a genotype or a mixture. If the match is true, a match-report will be created and sent to the police from the LIMS.
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| 21. |
- Alfsdotter, Clara, 1988-
(författare)
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Forensic archaeology and forensic anthropology within Swedish law enforcement : current state and suggestions for future developments
- 2021
-
Ingår i: Forensic Science International: Reports. - : Elsevier. - 2665-9107. ; 3
-
Tidskriftsartikel (refereegranskat)abstract
- Archaeological theories and methods are developed to reconstruct past human behavior from fragmentary material remains. The interrelated discipline of physical anthropology addresses questions related to skeletal remains while acknowledging taphonomic parameters. The benefit of integrating these disciplines in forensic investigations has gained increasing acknowledgement over the last decades, but the use of forensic archaeology and anthropology (FAA) remains limited in Sweden. The aim of this study is to analyze the field of FAA in Sweden in relation to outdoor and fire crime scenes where human remains are encountered. Based on qualitative interviews, the state and potential developments of FAA within the Swedish police and the National Board of Forensic Medicine are discussed. The results show that for ensic investigations and analysis of human fragmentary remains are not standardized in Sweden. A great responsibility is placed on the individual crime scene investigator who elects how to investigate these sites and who to contract for the analysis of osteological remains. This can endanger evidence collection and interpretation. This study shows that investigations of buried or fragmentary human remains in Sweden could be aided by a development of FAA. Key steps to further development of FAA within Swedish police involve 1) quantifying cases that could benefit from FAA, 2) establish FAA as an independent subject, 3) develop a national infrastructure, 4) offer professional education in the subject(s), and 4) develop best practice to advance evidence collection and legal security in investigations involving fragmentary human remains. An ongoing ISO accreditation of outdoor crime scene investigations within the Swedish police will hopefully benefit FAA development and collaborations with external partners.
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| 22. |
- Alfsdotter, Clara, 1988-, et al.
(författare)
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Outdoor human decomposition in Sweden : A retrospective quantitative study of forensic-taphonomic changes and postmortem interval in terrestrial and aquatic settings
- 2021
-
Ingår i: Journal of Forensic Sciences. - : John Wiley & Sons. - 0022-1198 .- 1556-4029. ; 66:4, s. 1348-1363
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a quantitative retrospective study of gross human decomposition in central and southeastern Sweden. The applicability of methods developed abroad for postmortem interval (PMI) estimation from decomposition morphology and temperature are is evaluated. Ninety‐four cases were analyzed (43 terrestrial and 51 aquatic) with a median PMI of 48 days. The results revealed differences in decomposition patterns between aquatic, surface, hanging, and buried remains. While partial saponification and desiccation occurred in cases of surface remains, complete skeletonization was observed in all cases with a PMI over two years. Aquatic skeletonization was slower due to extensive saponification in cases with PMI higher than one year. Formulae for assessing accumulated degree‐days (ADD) from the original methods did not fit the study material. However, a regression analysis demonstrated that 80% of decomposition variance in surface remains could be explained by ADD, suggesting that a geographically adapted equation holds promise for assessing PMI. In contrast, the model fit was poor for aquatic cases (43%). While this may be explained by problems in obtaining reliant aquatic temperature data or an insufficient scoring system, aquatic decomposition may be highly dependent on factors other than ADD alone. This study evaluates the applicability of current PMI methods on an outdoor sample from a previously unpublished region, and represents the first scientific publication of human outdoor decomposition patterns in Sweden. Suggestions for future research are provided, including that scoring methods should incorporate saponification to fit forensic taphonomy in Swedish environments.
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| 23. |
- Allen, Marie, et al.
(författare)
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Universal tag arrays in forensic SNP analysis.
- 2005
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Ingår i: Methods in Molecular Biology. - 1064-3745 .- 1940-6029. ; 297, s. 141-154
-
Tidskriftsartikel (refereegranskat)abstract
- Microarray-based single nucleotide polymorphism (SNP) genotyping enables simultaneous and rapid detection of a large number of markers and is thus an attractive method for forensic individual acid identification. This assay relies on a one-color detection system and minisequencing in solution before hybridization to universal tag arrays. The minisequencing reaction is based on incorporation of a fluorescent dideoxynucleotide to a primer containing a tag-sequence flanking the position to be interrogated. This one-color system detects C and T polymorphisms in separate reactions on multiple polymerase chain reaction targets with the fluorophore TAMRA coupled to the respective dideoxynucleotide. After incorporation, tagged primer sequences are hybridized through their complementary sequence on the array, and positive signals are detected by a confocal laser-scanner.
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| 24. |
- Andersson, Elin Möller, et al.
(författare)
-
Clinicopathological concordance in cognitive disease diagnostics
- 2020
-
Ingår i: Clinical Neuropathology. - 0722-5091. ; 39:3, s. 99-104
-
Tidskriftsartikel (refereegranskat)abstract
- Neurocognitive disorder encompasses many separate diagnoses, such as frontotemporal dementia (FTD), Alzheimer's disease (AD), Lewy body dementia (LBD), vascular dementia (VaD), and mixed dementia (MD). Because of the many variations between and within each subtype, it may be a challenge to clinically diagnose each condition. In a previous study on 176 dementia patients in a university hospital cohort between the years 1996 and 2006, a full diagnostic concordance of 49% was demonstrated between clinical diagnoses and pathological morphology [1]. The aims of this study were to do a follow-up on diagnostic concordance from the subsequent 10 years (2007 - 2016) and to compare the results with the previous study from 2009. In all cases of neuropathologically diagnosed dementia disorders (n = 324), the clinical records were searched for information on the clinical diagnosis of dementia, including on subtype. All individuals who had been diagnosed by a specialist were selected (n = 210). In this study, a full concordance between clinical diagnoses and neuropathological morphology was found in 61% of individuals, with marked variations between subgroups, including the lowest (31%) in the group of VaD. Vigilance in clinicopathological concordance is important for quality maintenance as well as the improvement of skills in diagnostic work. In light of the previous study, VaD one decade later remains elusive. The unmasking of this complicated and multifaceted disorder may be beneficial to the overall diagnostic accuracy in cognitive disease investigations.
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| 25. |
- Andersson, M.G., et al.
(författare)
-
Application of the Bayesian framework for forensic interpretation to casework involving postmortem interval estimates of decomposed human remains
- 2019
-
Ingår i: Forensic Science International. - : Elsevier BV. - 1872-6283 .- 0379-0738. ; 301, s. 402-414
-
Tidskriftsartikel (refereegranskat)abstract
- © 2019 Elsevier B.V. We demonstrate how the Bayesian framework for forensic interpretation can be adapted for casework involving postmortem intervals (PMI) utilizing taphonomic data as well as how to overcome some of the limitations of current approaches for estimating and communicating uncertainty. A model is implemented for indoor cases based on partial body scores from three different anatomical regions as correlated functions of accumulated temperature (AT). The multivariate model enables estimation of PMI for human remains also when one or two local body scores are missing or undetermined, e.g. as a result of burns, scars or covered body parts. The model was trained using the expectation maximization algorithm, enabling us to account for uncertainty of PMI and/or ambient temperature in the training data. Alternative approaches reporting the results are presented, including the likelihood curve, likelihood ratios for competing hypotheses and posterior probability distributions and credibility intervals for PMI. The applicability or the approaches in different forensic scenarios is discussed.
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| 26. |
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| 27. |
- Ansell, Ricky, et al.
(författare)
-
Swedish Legislation Regarding Forensic DNA Elimination Databases
- 2016
-
Ingår i: Forensic Science Policy & Management: An International Journal . - : Taylor & Francis Group. - 1940-9044 .- 1940-9036. ; 7:1-2, s. 20-36
-
Tidskriftsartikel (refereegranskat)abstract
- Evidence contaminated with DNA from staff, police, and other individuals can have a dramaticimpact on an investigation and can mislead police inquiries. Forensic DNA elimination databases(EDB) are used to minimize the risks associated with DNA contamination. Central issues withmaintaining such databases include the basis for sample collection, sample, and profile integrity, aswell as retention times, database access, and procedures when a database match occurs. Followingyears of discussion, debate, and the use of an “in house” EDB at the Swedish National ForensicCentre (NFC), these issues have now been resolved by passing legislation on DNA EDB. According tothe legislation, sampling for EDB purposes is mandatory for certain forensic professionals, as well asfor other individuals who need access to the premises handling DNA evidence. In the event of adatabase match, the match can only be reviewed and evaluated for quality purposes and the nameof the donor cannot be disclosed to the crime inquiry. Thus, as a consequence, if a contaminationevent is not the probable cause the legal limitation opens for impunity for individuals included inthe database.KEYWORDSContamination; DNA;elimination database;forensic science; legislationIntroduction
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| 28. |
- Antona-Makoshi, Jacobo, et al.
(författare)
-
Accident analysis to support the development of strategies for the prevention of brain injuries in car crashes
- 2018
-
Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 117, s. 98-105
-
Tidskriftsartikel (refereegranskat)abstract
- This study estimated the frequency and risk of Moderate-to-Maximal traumatic brain injuries sustained by occupants in motor vehicle crashes in the US. National Automotive Sampling System - Crashworthiness Data System crashes that occurred in years 2001–2015 with light vehicles produced 2001 or later were incorporated in the study. Crash type, crash severity, car model year, belt usage and occupant age and sex were controlled for in the analysis. The results showed that Moderate concussions account for 79% of all MAIS brain 2+ injuries. Belted occupants were at lower risks than unbelted occupants for most brain injury categories, including concussions. After controlling for the effects of age and crash severity, belted female occupants involved in frontal crashes were estimated to be 1.5 times more likely to sustain a concussion than male occupants in similar conditions. Belted elderly occupants were found to be at 10.5 and 8 times higher risks for sub-dural haemorrhages than non-elderly belted occupants in frontal and side crashes, respectively. Adopted occupant protection strategies appear to be insufficient to achieve significant decreases in risk of both life-threatening brain injuries and concussions for all car occupants. Further effort to develop occupant and injury specific strategies for the prevention of brain injuries are needed. This study suggests that these strategies may consider prioritization of life-threatening brain vasculature injuries, particularly in elderly occupants, and concussion injuries, particularly in female occupants.
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| 29. |
- Antona-Makoshi, Jacobo, et al.
(författare)
-
Analysis of Traumatic Brain Injuries Sustained by Occupants in Japanese Brand Car Crashes in the US
- 2018
-
Ingår i: International Journal of Automotive Engineering. - : Society of Automotive Engineers of Japan. - 2185-0992 .- 2185-0984. ; 9:3, s. 145-450
-
Tidskriftsartikel (refereegranskat)abstract
- This study estimates, by means of an analysis of accident data from the US, the incidence and risk of car crash related traumatic brain injuries for occupants in Japanese brand cars. The study incorporated crash type, crash severity, car model year, belt use and the victim's age and sex. Concussion risk was the highest among all brain injury categories for all crash types and severities; females were at higher risks than males. When concussions were excluded, Subdural Haemorrhages, Intracranial Haemorrhages and Sub-Arachnoid Haemorrhages comprised the most frequent injury categories. Elderly occupants were at considerably higher risks than non-elderly for these bleeding injuries.
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| 30. |
- Arnes, Marit, et al.
(författare)
-
Rate of elimination of gamma-hydroxybutyrate from blood determined by analysis of two consecutive samples from apprehended drivers in Norway
- 2020
-
Ingår i: Forensic Science International. - : ELSEVIER IRELAND LTD. - 0379-0738 .- 1872-6283. ; 314
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: Gamma-hydroxybutyrate (GHB) is a common drug of abuse with an elimination half-life of 20-45 min. However, there is some evidence that GHB might exhibit saturation kinetics after ingesting high recreational doses. The aim of this study was to investigate the elimination kinetics of GHB from blood in people apprehended by the police for impaired driving and secondary to describe concentrations in all GHB-positive drivers. Methods: Two consecutive blood samples were taken about 30-40 min apart from N =16 apprehended drivers in Norway. GHB was determined in blood by an Ultra High-Performance Liquid ChromatographyTandem Mass Spectrometry (UHPLC-MS/MS) method. The changes in GHB between the two consecutive blood samples allowed estimating GHBs elimination half-life, assuming first-order and zero-order elimination kinetics. GHB concentrations are also reported for N =1276 apprehended drivers with GHB in blood. Results: The median time interval between collecting the two blood samples was 36 min (range 20 56 min). The median concentration of GHB in the first blood sample was 56.5 mg/L (range 14.1 142 mg/L) compared with 47.8 mg/L in the second sample (range 9.75 113 mg/L). The median elimination half-life was 103 min (range 21 187 min), and GHBs median zero-order elimination rate constant was 21.0 mg/L/h (range 6.71-45A mg/L/h). Back-calculation to the time of driving resulted in GHB concentrations up to 820 mg/L assuming first-order kinetics and up to 242 ma assuming zeroorder kinetics. In all drivers (N 1276), the median GHB concentration was 73.7 ma and highest was 484 mg/L. Conclusion: The elimination half-life of GHB in blood samples from apprehended drivers was longer than expected compared with results of controlled dosing studies. Zero-order kinetics seems a more appropriate model for GHB when concentrations are back-calculated. and the median elimination rate was 21 mg/L/h. (C) 2020 The Authors. Published by Elsevier B.V.
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| 31. |
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| 32. |
- Ballantyne, Kaye N., et al.
(författare)
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Toward Male Individualization with Rapidly Mutating Y-Chromosomal Short Tandem Repeats
- 2014
-
Ingår i: Human Mutation. - : John Wiley & Sons. - 1059-7794 .- 1098-1004. ; 35:8, s. 1021-1032
-
Tidskriftsartikel (refereegranskat)abstract
- Relevant for various areas of human genetics, Y-chromosomal short tandem repeats (Y-STRs) are commonly used for testing close paternal relationships among individuals and populations, and for male lineage identification. However, even the widely used 17-loci Yfiler set cannot resolve individuals and populations completely. Here, 52 centers generated quality-controlled data of 13 rapidly mutating (RM) Y-STRs in 14,644 related and unrelated males from 111 worldwide populations. Strikingly, greater than99% of the 12,272 unrelated males were completely individualized. Haplotype diversity was extremely high (global: 0.9999985, regional: 0.99836-0.9999988). Haplotype sharing between populations was almost absent except for six (0.05%) of the 12,156 haplotypes. Haplotype sharing within populations was generally rare (0.8% nonunique haplotypes), significantly lower in urban (0.9%) than rural (2.1%) and highest in endogamous groups (14.3%). Analysis of molecular variance revealed 99.98% of variation within populations, 0.018% among populations within groups, and 0.002% among groups. Of the 2,372 newly and 156 previously typed male relative pairs, 29% were differentiated including 27% of the 2,378 father-son pairs. Relative to Yfiler, haplotype diversity was increased in 86% of the populations tested and overall male relative differentiation was raised by 23.5%. Our study demonstrates the value of RMY-STRs in identifying and separating unrelated and related males and provides a reference database.
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| 33. |
- Bartelink, Eric J., et al.
(författare)
-
A Case of Contested Cremains Analyzed Through Metric and Chemical Comparison
- 2015
-
Ingår i: Journal of Forensic Sciences. - : Wiley. - 0022-1198 .- 1556-4029. ; 60:4, s. 1068-1073
-
Tidskriftsartikel (refereegranskat)abstract
- Since the 1980s, cremation has become the fastest growing area of the U.S. funeral industry. At the same time, the number of litigations against funeral homes and cremation facilities has increased. Forensic anthropologists are often asked to determine whether the contents of an urn are actually cremated bone, and to address questions regarding the identity of the remains. This study uses both metric and chemical analyses for resolving a case of contested cremains. A cremains weight of 2021.8 g was predicted based on the decedent's reported stature and weight. However, the urn contents weighed 4173.5 g. The urn contents also contained material inconsistent with cremains (e.g., moist sediment, stones, ferrous metal). Analysis using XRD and SEM demonstrated that the urn contained thermally altered bone as well as inorganic material consistent with glass fiber cement. Although forensically challenging, cremains cases such as this one can be resolved using a multidisciplinary approach.
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| 34. |
- Baudin, Christian, 1985, et al.
(författare)
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A Static-99R Validation Study on Individuals With Mental Disorders: 5 to 20 Years of Fixed Follow-Up After Sexual Offenses
- 2021
-
Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- 'The Static-99R is one of the most commonly used risk assessment instruments for individuals convicted of sexual offenses. It has been validated for use on many populations, but few studies specifically target and describe individuals with mental disorders. Additionally, research on the discriminative properties (how well the instrument separates recidivists from non-recidivists) of the instrument over longer follow-up periods is scarce. This article evaluated the validity of the Static-99R using a cohort of individuals with mental disorders convicted of sexual offenses in Sweden (N = 146) with fixed 5-year (n = 100), 10-year (n = 91), 15-year (n = 79), and 20-year (n = 36) follow-up periods. A Static-99R cut score of 6 demonstrated the highest Youden index, maximizing sensitivity (72.7%) and specificity (74.2%), with 25.8% of recidivists correctly assumed to reoffend sexually and 95.7% of non-recidivists correctly assumed not to. The Static-99R instrument demonstrated adequate discrimination (AUC = 0.79, CI 95% = 0.70-0.87, and OR = 1.45, CI 95% = 1.14-1.84, p < 0.001, 5-year fixed follow-up), with only marginal differences for 10-, 15-, and 20-year fixed follow-up (AUC = 0.73, 0.74, and 0.74 and OR = 1.31, 1.36, and 1.40, respectively). Calibration (quantifying risk and correspondence with the instrument's norms) was acceptable (Brier = 0.088, P/E = 0.70, E/O = 1.43), with the routine sample norms displaying a decisively better fit to the study cohort compared to the high-risk/high-need sample norms. The results affirm the recommendation that, when in doubt and where there is no recent local norm group large enough available, the Static-99R routine sample found in the evaluators' workbook should be used.
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| 35. |
- Beck, Olof, et al.
(författare)
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First evaluation of the possibility of testing for drugged driving using exhaled breath sampling
- 2019
-
Ingår i: Traffic Injury Prevention. - : TAYLOR & FRANCIS INC. - 1538-9588 .- 1538-957X. ; 20:3, s. 238-243
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Driving under the influence of psychoactive drugs causes an increased risk for accidents. In combating this, sobriety tests at the roadside are common practice in most countries. Sampling of blood and urine for forensic investigation cannot be done at the roadside and poses practical problems associated with costs and time. An alternative specimen for roadside testing is therefore warranted and the aerosol particles in exhaled breath are one such alternative.Methods: The present study investigated how the exhaled breath sample compared with the routine legal investigations of blood and urine collected from suspects of drugged driving at 2 locations in Sweden. Exhaled breath was collected using a simple filter collection device and analyzed with state-of-the-art mass spectrometry technique.Results: The total number of cases used for this investigation was 67. In 54 of these cases (81%) the results regarding a positive or negative drug test result agreed and in 13 they disagreed. Out of these, the report from the forensic investigation of blood/urine was negative in 21 cases. In 6 of these, analytical findings were made in exhaled breath and these cases were dominated by the detection of amphetamine. In 7 cases a positive drug test from the forensic investigation was not observed in the breath sample and these cases were dominated by detection of tetrahydrocannabinol in blood. In total, 45 samples were positive with breath testing and the number of positives with established forensic methods was 46.Conclusion: The promising results from this study provide support to exhaled breath as a viable specimen for testing of drugged driving. The rapid, easy, and convenient sampling procedure offers the possibility to collect a drug test specimen at the roadside. The analytical investigation must be done in a laboratory at present because of the need for a highly sensitive instrument, which is already in use in forensic laboratories. The analytical work is not more challenging than for blood or oral fluid and should not cause an increase in cost. However, more studies need to be done before exhaled breath drug testing can be applied routinely for drugged driving investigation.
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| 36. |
- Beer, Torfinn, 1992-
(författare)
-
An epidemiological perspective on heart and lung weight in cardiac and intoxication deaths
- 2022
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main purpose of a medico-legal autopsy is to determine the cause and manner of death. A forensic pathologist makes assessments of this using several sources of information, one of which is the discrepancy between measured organ weight and reference values. Of particular interest is the heart weight in heart disease and the weight of the lungs in fatal intoxications. In this thesis, a linear model of lung weight was created, but the model could at best explain only 13% of the variation in combined lung weight (Paper I). Unsurprisingly, this meant that the model was a poor definition of “normal” lung weight and could not be used to identify intoxication cases (Paper II). A ratio of lung weight to heart weight (LWHW ratio) also failed to differentiate intoxication cases from controls. The poor performance of these methods could plausibly have been due to fatal intoxications with only some substances being associated with increased lung weight, but an analysis showed that many common intoxicants were associated with heavier lungs than hanging deaths (Paper III). To establish heart weight references more applicable in a medico-legal autopsy population, a model of heart weight accounting for undiagnosed cardiac hypertrophy was created (Paper IV). The model showed that for a decedent of average the evidence that a was hypertrophic reached, substantial support at around 470 g.In conclusion, a definition of “heavy lungs” remains elusive. However, it seems to be a finding compatible with fatal intoxications with many substances and the low predictive value found may be due to study design. The heart weight model presented allows pathologists to assess the evidence of cardiac hypertrophy more easily than previously published models.
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| 37. |
- Beer, Torfinn, et al.
(författare)
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Cardiac enlargement in a medicolegal autopsy setting
- 2023
-
Ingår i: American Journal of Forensic Medicine and Pathology. - : Wolters Kluwer. - 0195-7910 .- 1533-404X. ; 44:4, s. 267-272
-
Tidskriftsartikel (refereegranskat)abstract
- A key element for diagnosing cardiac enlargement in an autopsy setting is relevant heart weight references. However, most available references are to a large extent not representative of a medicolegal autopsy population, implying that reference weights are likely lower than those in the relevant population.To establish more applicable heart weight references in a medicolegal autopsy population, we designed a heart weight model that accounts for undiagnosed cardiac enlargement using data from 11,897 nontraumatic Swedish medicolegal autopsy cases autopsied between 2010 and 2019. The model was validated in 296 nonobese young adult suicidal hanging cases.For a decedent of average height (174 cm), the evidence that a heart weight was enlarged reached weak support at approximately 430 g, substantial support at approximately 480 g, and strong support at 520 g. The modeled prevalence of cardiac enlargement was very high among elderly and obese decedents.We believe that our model is more applicable in a medicolegal setting than those previously published. The presented quantification of the degree of uncertainty regarding diagnosis can help the pathologist in diagnosing cardiac enlargement. To facilitate the use of this model, we also made it available through a simple online tool (https://formedum.shinyapps.io/HeartWeightCalc/).
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| 38. |
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| 39. |
- Beer, Torfinn, et al.
(författare)
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Increased lung weight in fatal intoxications is not unique to opioid drugs
- 2023
-
Ingår i: Journal of Forensic Sciences. - : John Wiley & Sons. - 0022-1198 .- 1556-4029. ; 68:2, s. 518-523
-
Tidskriftsartikel (refereegranskat)abstract
- Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a single substance, we created models of combined lung weight and brain weight. The models used age and sex as predictors as well as nested varying effects for the specific intoxicant and category of intoxicant. Suicidal hanging with negative toxicology cases served as controls. The population majority was male among both intoxications (68%) and controls (83%). The most common single substance group was opioids. All tested substances were associated with heavier lungs than controls, with the largest effect in the opioid group. Our findings show that several substances are associated with increased lung weight and that among intoxication deaths there is no difference in expected brain weight between substances. Hence, heavy lungs, without a reasonable explanation, should prompt a broad toxicological screening.
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| 40. |
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| 41. |
- Bendroth, Peter, et al.
(författare)
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Comparison of ethyl glucuronide in hair with phosphatidylethanol in whole blood as post-mortem markers of alcohol abuse
- 2008
-
Ingår i: Forensic Science International. - : Elsevier BV. - 0379-0738 .- 1872-6283. ; 176:1, s. 76-81
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Tidskriftsartikel (refereegranskat)abstract
- Ethyl glucuronide (EtG) is a direct metabolite of ethanol and has been used as a marker of alcohol abuse in both urine and hair. This study investigated the value of EtG testing in post-mortem hair for diagnostic improvement of alcohol abuse in forensic medicine. Material from 70 consecutive medico-legal autopsies was collected in accordance with the recommendations on ethics by the Swedish National Board of Forensic Medicine. A method for determination of EtG in hair samples was developed using ultra performance liquid chromatography/electrospray tandem mass spectrometry (UPLC/ESI-MS/MS; LOQ, 2.5 pg/mg). The result of the EtG analysis was compared with the findings of phosphatidylethanol (PEth) in femoral whole blood, as measured by high performance liquid chromatography with an evaporative light-scattering detector (HPLC–ELSD; LOQ, 0.22 μmol/l). Evaluation of liver histology and anamnestic evidence of alcohol abuse of the deceased were taken in consideration for the interpretation. Measurable levels of EtG were present in 49 of the 70 autopsy cases whereas PEth was present in 36. Thirty-nine cases had EtG levels above the cutoff limit (≥30 pg/mg) compared with 29 for PEth (≥0.7 μmol/l). Fifteen cases had EtG as exclusive indicator for alcohol abuse compared with four cases for PEth. These findings suggest that measurements of EtG in hair may provide improved diagnostic information on alcohol abuse, due to a long retrospective time-window for detection and stability of EtG in hair in the decaying cadaver. However, an EtG level below the cutoff does not completely exclude previous alcohol abuse.
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| 42. |
- Benschop, Corina C G, et al.
(författare)
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Results of an inter and intra laboratory exercise on the assessment of complex autosomal DNA profiles.
- 2017
-
Ingår i: Science & justice. - : Elsevier. - 1355-0306 .- 1876-4452. ; 57:1, s. 21-27
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Tidskriftsartikel (refereegranskat)abstract
- The interpretation of complex DNA profiles may differ between laboratories and reporting officers, which can lead to discrepancies in the final reports. In this study, we assessed the intra and inter laboratory variation in DNA mixture interpretation for three European ISO17025-accredited laboratories. To this aim, 26 reporting officers analyzed five sets of DNA profiles. Three main aspects were considered: 1) whether the mixed DNA profiles met the criteria for comparison to a reference profile, 2) the actual result of the comparison between references and DNA profiling data and 3) whether the weight of the DNA evidence could be assessed. Similarity in answers depended mostly on the complexity of the tasks. This study showed less variation within laboratories than between laboratories which could be the result of differences between internal laboratory guidelines and methods and tools available. Results show the profile types for which the three laboratories report differently, which informs indirectly on the complexity threshold the laboratories employ. Largest differences between laboratories were caused by the methods available to assess the weight of the DNA evidence. This exercise aids in training forensic scientists, refining laboratory guidelines and explaining differences between laboratories in court. Undertaking more collaborative exercises in future may stimulate dialog and consensus regarding interpretation. For training purposes, DNA profiles of the mixed stains and questioned references are made available.
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| 43. |
- Berg von Linde, Maria, et al.
(författare)
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A Swedish nationwide forensic study of the manner of death in single stab injuries to the trunk
- 2024
-
Ingår i: Forensic Science International. - 0379-0738. ; 354
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Forensic pathologists are frequently confronted with questions about whether an injury is likely to have been inflicted by an assault or be self-inflicted. However, little is known of the epidemiological variables that might be applicable to differentiate between homicides and suicides in deaths caused by single stab injuries to the trunk. Method Using the Swedish forensic autopsy register, we identified 94 homicides and 45 suicides between 2010 and 2021 in which death followed a single stab injury to the trunk. We extracted characteristics from the cases and performed statistical analyses using the Mann-Whitney U test, Chi-square test and logistic regression model. Results Victims of homicides were younger than suicide victims (median age 33 years vs. 52 years, p
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| 45. |
- Berg von Linde, Maria, et al.
(författare)
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Forensic assessment of single stab injuries to the trunk
- 2023
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionForensic pathologists are frequently confronted with questions about the likelihood that an injury is inflicted by an assault or is self-inflicted. However, little is known of epidemiological variables applicable to differentiate between homicides and suicides in deaths caused by single stab injuries to the trunk. MethodUsing the Swedish forensic autopsy register we identified 94 homicides and 45 suicides between 2010 and 2021 that died following a single stab injury to the trunk. We extracted characteristics from the cases and performed statistical analyses using Mann-Whitney U and Chi-square test.ResultVictims of homicides were younger than suicide victims (median age 33 years vs. 52 years, p < 0.05), and males were in majority in both groups (93% vs. 82%). Some homicidal stab wounds were placed on the posterior (12%) and axillar trunk (11%) unlike the suicidal stabs which were all placed on the anterior trunk. Most stab wounds of all examinations were placed on the left side of the anterior thorax (60%). In suicides, single stab injuries to the heart were more common than in homicides (67% vs. 48%, p < 0.05). Vasculature injuries were more common in homicides (51% vs. 9%, p < 0.05).DiscussionThe epidemiological variables could be used as a tool when assessing the manner of death in single stabs. Further research on variables associated with manner of death are needed and we suggest also including surviving victims in such analyses.
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| 46. |
- Berg von Linde, Maria, et al.
(författare)
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Lethal injuries in single stabs to the trunk – A study on homicides and suicides in Sweden
- 2024
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Ingår i: Injury. - 0020-1383. ; 55:8, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionHomicides using knives or other sharp objects are the most common type of homicide in Europe, and the second most common type of homicide worldwide. In contrast, suicides using sharp objects are rarer, constituting only a few per cent of all suicides in western countries. We investigated single stab injuries to the trunk in both homicides and suicides to assess differences in extent of injuries and in medical care, which could be of value for trauma management, public health and forensic assessment.MethodsWe identified all cases in Sweden between 2010 and 2021 that died of a single stab to the trunk, in either a homicide (n = 94) or a suicide (n = 45), and that were the subject of a forensic autopsy. We obtained data on demographics, hospital care and injured structures. To assess the severity of injuries, we applied AIS (Abbreviated Injury Score) and NISS (New Injury Severity Score). The inter-rater reliability of NISS between two raters was evaluated with intra-class correlation (ICC), with 95 % confidence intervals (CI). The data was analysed using Fisher's exact test, Mann-Whitney U test and logistic regression models.ResultsThe inter-rater reliability between the two NISS raters showed an ICC of 0.87 (95 % CI 0.68−0.95). We observed a larger variation of injuries in suicides, with a higher proportion of both unsurvivable (NISS 75) and minor injuries (NISS ≤ 8) (66.7 % and 8.9 % respectively) compared to in homicides (46.8 % and 0 % respectively). We observed a larger proportion of injuries to the heart in suicides (68.9% vs. 46.8 %, p = 0.018). In homicides, injuries involving vessels (52.1% vs. 13.3 %, p < 0.001) and hospital care (56.4 % vs. 8.9 %, p < 0.001) were significantly more common compared to suicides.Discussion and conclusionCausation (self-inflicted or assaults) seems to be associated with characteristics of injury and the likelihood of receiving hospital care. These findings could potentially be valuable for trauma management and forensic assessment of manner of death, however, determining the mortality of the injuries would require a comparison group comprising injured survivors.
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| 48. |
- Berlin, Johan, 1975, et al.
(författare)
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Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample
- 2023
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings. Methods Here, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximumsecurity forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses. Results The ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting a and. values = 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity. Conclusion Despite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.
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| 49. |
- Björnstig, Ulf, et al.
(författare)
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Passenger car collision fatalities - with special emphasis on collisions with heavy vehicles
- 2008
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Ingår i: Accident Analysis and Prevention. - : Elsevier. - 0001-4575 .- 1879-2057. ; 40:1, s. 158-166
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Tidskriftsartikel (refereegranskat)abstract
- Between 1995 and 2004, 293 passenger car occupants died in collisions with other vehicles in northern Sweden (annual incidence: 3.3 per 100,000 inhabitants, 6.9 per 100,000 cars, or 4.8 per 109 km driven); half of these deaths involved heavy vehicles. The annual number of passenger car occupant death per 100,000 cars in var-truck/bus collisions has remained unchanged since the 1980s, , but in car-car collisions it has decreased to one third of its former level. As crash objects, trucks and buses killed five times as many car occupants per truck/bus kilometer driven as did cars.The collisions were characterized by crashes in the oncoming vehicle´s lane, under icy, snowy, or wet conditions; crashes into heavy vehicles generally occurred in daylight, on workdays, in winter, and on 90 and 70 km/h two-lane roads. Head and chest injuries accouted for most of the fatal injuries. multiple fatal injuries and critical and deadly head injuries characterized the deaths in collisions with heavy vehicles.An indication of suicide was present in 4% of the deaths; for thos who crashed into trucks, this percentage was doubled. Among the driver victims, 4% had blood alcohol levels above the legal limit of 0.2 g/L.Frontal collision risks might be reduced by a mid-barrier, by building less injurious fronts on trucks and buses, by efficient skid prevention, and by use of flexible speed limits varying with road and light conditions.
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