Emotional and Psychosocial Problems Encountered by Children Who Have Been Sexually Abused.

The current descriptive analysis sought to identify the emotional and psychosocial problems experienced by children who have been sexually abused. Of 518 children with a history of sexual abuse who applied to the Child Protection Center, 443 were included in the study. Approximately 71.6% of children were subject to sexual abuse entailing penetration, whereas 69% were subject to sexual abuse not entailing penetration. After-effects reported included despair (46.5%), fear of reoccurrence of the incident (52.8%), distrust of others (36.8%), difficulty sleeping (32.7%), negative expectations about the future (32.1%), and self-blame (31.1%). Nurses have crucial roles and functions in the protection, improvement, treatment, and rehabilitation of the health of children who have been sexually abused. [Journal of Psychosocial Nursing and Mental Health Services, 56(2), 37-43.].

[Secondary victimization of traffic accident victims: getting buried without the declaration of forensic case and without having performed autopsy]. / Trafik kazasina maruz kalan olgularda ikincil magduriyet: Adli olgu bildirimi yapilmadan veya otopsi uygulanmadan defnedilme.

BACKGROUND: In this study, it was aimed to analyze the cases of traffic accident related deaths, buried without performing autopsy, in order to increase awareness of the physicians about declaration liability of forensic cases and also emphasize the declaration of the forensic case and autopsy importance. METHODS: In the First Specialization Board of Council of Forensic Medicine, 542 cases of death, reported between the years 2004-2008, who were involved in traffic accidents and buried without an autopsy performed, were evaluated retrospectively. RESULTS: It was found that 69.4% of the cases (n=376) were males, whereas %30.6 (n=166) were females; mean age was 58.5±20.9 (range, 3-98 years). Age 61 and above was the most frequent age group with 301 cases (55.5%). Of the cases, 336 (62.0%) had died in hospital, 241 (44.5%) had died in 1-12 months following the accident and medico-legal corpse examination was performed only in 123 (22.9%) cases. Three hundred fourty-four (63.5%) of the cases were not reported as forensic cases and death certificate was signed by any physician other than medical examiner without being declared as a legal case. According to the decisions of Board, since an autopsy was not duly performed, the cause of death could not be determined for 95 cases (17.5%) and for 57 cases (10.5%), it was not possible to determine whether there was causality between the accident and death. DISCUSSION: Our findings emphasize the importance of declaration of forensic cases and performing autopsy in time in traffic accident victims.

Traumatic asphyxia: An autopsy case.

Traumatic asphyxia is a form of asphyxia where respiration is prevented by external pressure on the body. A 19-year-old man was found by relatives compressed by motorboat in the garage. The death was investigated by the prosecutor; body was taken to the Morgue Department for performing autopsy. On gross physical examination; the face, neck and upper part of the chest were congested and many petechiae were observed on the conjunctivae, but not in low extremities. Autopsy macroscopic examination of lungs revealed congestion, sub pleural superficial bleeding areas. In the presented case death was reported as traumatic asphyxia by thorax compression without other lethal factors.

Analysis and comparison of domestic femicide cases in the cities of Diyarbakir & Tekirdag, Turkey: A preliminary study.

Court decision files from 2007 to 2012 were examined retrospectively in the Criminal High Courts of Diyarbakir and Tekirdag to analyse and compare domestic femicides in Diyarbakir and Tekirdag, Turkey, according to different fundamental characteristics. In total, 58 assailants were convicted of 50 femicides during this period. There were no so-called 'honour killings' in Tekirdag, while 16 (37.2%) of the homicides were honour killings in Diyarbakir. Policies to prevent violence against women, extending the means of access to post-violence services and reinforcing the law, policies and action plans to end this type of violence could be effective in decreasing cases of domestic femicide.

Customary Homicides in Diyarbakir Province.

This study presents an analysis of the causes of so-called honor killings in the context of "customary homicide" and a discussion of preventive measures. Finalized case files of customary homicide between January 1, 2007 and December 31, 2012 were retrospectively examined in Diyarbakir Province, Turkey. Of a total of 28 case victims, 17 (60.7%) were females and 11 (39.3%) were males. All perpetrators were male. There was a significant difference between male and female victims in terms of economic independence (p=0.000). A direct blood relationship or relationship by marriage (such as brother-in-law) was found to have a significant association with the gender of the victim (p<0.001). Multilevel educational activities targeting a transformation of the perception of women by society, replacement of patriarchal models with more modern attitudes, and encouragement of individuality may represent effective strategies that may help reduce the number of customary homicide, which represents a multifaceted problem.

Evaluation of shotgun suicides in Konya, Turkey between 2000 and 2007.

The number of the suicides is increasing all around the world. In this study, the cases autopsied between 2000 and 2007 in The Konya Branch of Forensic Medicine Council were retrospectively investigated. Fifty-seven shotgun suicides were determined. The cases were evaluated in terms of their demographic characters, site of entrance wound, the type of the cartridge used, shooting distance, the place of incident, the place of death, motive for suicide, and the presence of previous suicide attempts. The most preferred site of entrance wound was the head with 34 cases (59.7%). Of 34 cases in which the entrance wound was on the head, there was indirect mandibular fracture in 16 cases (47.1%). In 11 cases (19.3%), there observed small ecchymosed abrasions on the finger surfaces, which are thought to have resulted from the trigger kicking back during triggering or the finger having been stuck between the trigger and the trigger guard. It is concluded that there is a need for a legal regulation that makes obtaining of shotguns more difficult and the people who have them are to be educated not to keep them in easily accessible places.

Analysis of tractor-related deaths.

The aim of the study was to evaluate the properties of tractor-related death cases and discuss the precautions in order to prevent such events. For this aim, reports made between 2006 and 2009 by the First Specialty Board of Council of Forensic Medicine (FSBCFM), Turkey, were evaluated retrospectively. Forty-one tractor-related death cases were included in this study. Thirty-five (85.4%) of the cases were male. The mean age was 42.52 ± 25.1 (with a range between 1 and 84 years old). The average time interval between the incident and death was 13.76 ± 33.53 days (range: 0-176 days) and 20 (48.8%) cases died on the incident spot or during transportation to the hospital. Among the cases, 34.1% (n = 14) were drivers, whereas 39.0% (n = 16) were passengers and the remaining were pedestrians (26.9%, n = 11). The accident was caused by the tractor rolling over in 34.1%, the victim being run over in 22.0%, and the victim falling from the tractor or trailer in 22.0% of the cases. Most of the events (56.1%) occurred on the road. In conclusion, tractors must not be used as a transportation vehicle for passengers. Periodic training of drivers can be useful for reducing tractor-related accidents.

Bilateral long styloid process detected at autopsy (case report).

The aim of the article was to reveal the significance of prolonged styloid process detected at forensic autopsy. A-61-year-old man was found dead in his home. The crime scene investigation exposed suicide by hanging. On internal autopsy examination pulmonary edema and congestion of all internal organs were identified. Dissection of the neck structures revealed 90 mm in length on the right side, 70 mm in length on the left side, bilateral long styloid process. Distal parts of the prolonged styloid process were situated between external and internal carotid artery. Our aim was to discuss the significance of prolonged styloid process detected at forensic autopsy.

Air bag-mediated fatal craniocervical trauma: a case report.

This case report describes a four-year-old girl (102 cm, 17 kg) who sustained fatal craniocerebral injuries as a result of an inflating automobile air bag. The car struck the lid of the sewer system, which was 15 cm above the ground level, at a low speed, and both the driver and passenger air bags inflated. Despite the fact that air bag usage has lessened both the possibility and severity of occupant injuries in frontal collisions, case reports of serious injuries and even deaths especially in children due to air bag deployment, particularly during low speed impacts, highlight the need for changes in both system design and possibly the threshold speed of air bag deployment.

Accidental hanging deaths in children in Konya, Turkey between 1998 and 2007.

In general, hanging cases are the result of suicide, and accidental and homicidal hanging cases are rarely seen. This study retrospectively investigated 4571 death examinations and autopsies that were performed at The Konya Branch of the Forensic Medicine Council (Turkey) between 1998 and 2007; hanging was involved in 201 (6.5%) of the cases. There were a total of 13 accidental hanging cases, where 12 of these involved children. In seven of the cases, the accidental hanging involved a scarf that wraps around swing-like cradles and is intended to prevent infants from falling down. It was concluded that accidental hanging deaths can be reduced by replacing swing-like cradles with cribs that are designed for children, removing ropes in and around the house, and preventing children from reaching and/or playing with rope-like objects.

Dead bodies found in wells.

Corpses found in wells or lime pits must be identified and the cause and manner of death must be determined. There are several circumstances that may lead to the presence of corpses in wells. In this study, 3940 death examinations and autopsies, performed at the Konya Branch of Forensic Medicine Council (Turkey) between 2000 and 2007, were retrospectively investigated, and it was found that 18 (0.46%) of the bodies had been recovered from wells. The cases were evaluated in terms of their demographic features, manner of death (accidental, suicidal, or homicidal), autopsy findings, cause of death, and the characteristics of the wells in which they were found. The ages of the victims ranged from 4 to 74 years, and the average age was 40. 4 +/- 20.6 years. Of total, 16 cases were males and 2 were females. The manner of death was determined to be accidental in 10 of the cases, suicide in 6 of the cases, and homicide in the remaining 2 cases. In 7 of the cases, death had occurred as a result of drowning in water. A comprehensive scene investigation and autopsy must be performed for corpses recovered from wells and pits for both identification and determination of the cause and manner of death. Wells should be covered and kept closed at all times to reduce the number of accidental deaths resulting from falls into wells.

Decapitation and dismemberment of the corpse: a matricide case.

Dismemberment of a corpse has always been viewed by society to be a more hideous crime than the homicide itself. In this study, we present a case of a 57-year-old woman who was decapitated and her right arm and both hands were dismembered. It was determined that the victim was murdered and dismembered by her 33-year-old daughter, who had been receiving treatment for schizophrenia for 15 years. On the victim's head and back there were 71 incised and stab wounds in total. They were superficial, except the five stab wounds which were connected to the right chest cavity and which incapacitated the victim. Although there is not a regulation for the act of dismembering the corpse in the Turkish Penal Code, since this type of case is rare, the crime scene and the autopsy findings were evaluated together with other pertinent data available in the literature.

Postmortem findings after anaphylactic reactions to drugs in Turkey.

AIMS: To determine the frequency of anaphylactic deaths at autopsies performed in Turkey between January 2001 and June 2006 and to review the circumstances of death and autopsy findings. METHODS: The Council of Forensic Medicine database in Istanbul was searched for anaphylactic deaths. Postmortem reports and medical records were reviewed to determine the circumstances of death. Data about basic demographics, medical history, drugs responsible for allergic reactions, and pathologic findings at autopsy were collected. RESULTS: A total of 36 anaphylactic deaths from drugs were identified for the study period. Death was due to antibiotics in 26 cases, analgesics in 7 cases, an intraoperative drug in 1 case, an H2 receptor in 1 case, and intravenous contrast medium in 1 case. Out of 36 cases, 19 were male and 17 female. They were aged between 1 and 74 years with the median age of 26.7 years. Death occurred within 1 hour of the onset of anaphylaxis in 27 cases. Findings at autopsy included nonspecific pulmonary edema and congestion, upper airway edema, cerebral hypoxia, and cutaneous edema. Serum tryptase levels were not measured in all cases. CONCLUSION: Anaphylactic reaction is an uncommon cause of sudden death. In many cases, no specific macroscopic or microscopic findings were detected at autopsy. When serum tryptase levels cannot be determined, in the presence of typical clinical records, eye witness reports and autopsy findings can be useful diagnostic aids.

Suicide by ligature strangulation: three case reports.

Suicide by ligature strangulation, which gives the initial impression of a homicide, is very rare. In this article, 3 suicidal death cases caused by ligature strangulation in Konya between 2001 and 2006 are presented. The first victim was a 68-year-old man who suffered from depression and lived alone in a cottage house. He terminated his life by applying a tourniquet to his neck after leaving a suicide note. The second victim was a 70-year-old woman who was found dead on the floor of the living room in her house. After she cut the vessels in her wrist, she tied pantyhose with 3 knots around her neck. It was reported that she had been intermittently receiving treatment for bronchial asthma and depression for 20 years. The third victim was a 30-year-old woman who suffered from schizophrenia for 6 years. She tied a scarf around her neck with 3 knots and died in the hospital after 1 day due to "hypoxic brain syndrome." As a result of the death scene investigations, autopsies, and judicial inquiries, it was concluded that death was by suicide in all 3 cases. Because the use of the ligature strangulation method, and particularly the tourniquet method, in suicidal cases is extremely rare in the literature, our aim is to present and discuss these cases.

Autopsy findings of suicidal deaths committed by firearms in Ankara, Turkey.

The purpose of this study was to examine autopsy findings from suicidal deaths using firearms in Ankara, Turkey, and to compare the results with those reported from other studies. We retrospectively evaluated suicidal deaths by firearms referred for autopsy to the Morgue Department, Institute of Forensic Medicine, between 2002 and 2004. Results were subjected to discriminant analyses using SPSS 11.5 package program. One hundred and fifteen cases (83.3%) were male, the ratio of male to female was 5 to 1 and the mean age was 31.96 years (range:12-85 years). Forty cases were aged between 12 years and 20 years, 28 were aged between 0 and 18 (20.29%). One hundred and thirty-three cases (96.4%) had one bullet entry and five cases (3.6%) had two bullet entries. Out of 143 bullet entries, 116 (81.12%) were caused by gunshots fired from contact or near contact range. Regarding bullet entry sites, 103 (72.03%) were on the head with 56 (54.37%) located on the right temporal region. Gunshot related crimes are an increasing cause for concern in Turkey. However, a simple preventive measure may prevent the suicidal deaths of many young people.

[The effect of firearms in inducing stress in high school students in the city of Düzce (Turkey)]. / Atesli Silahlarin Adolesans Döneminde Stres Yapici Faktör Olarak Etkisi.

OBJECTIVE: This study aimed to examine the behaviors of high school students exposed to firearms and firearms- related violence, which they had perpetrated or witnessed, and whether or not these events were related to stress. METHOD: The study was conducted in Düzce province, which is characterised by the widespread use of firearms. A questionnaire was prepared to ascertain students' attitudes and behaviors towards owning firearms, their thoughts about firearms- related violence, and whether or not they had been a victim or witness to firearms- related violence. After a stress level scale was added to the questionnaire, it was administered to 791 students randomly chosen from the 8304 students that were attending all high schools in Düzce. The results were evaluated with using SPSS v.11.0 software. RESULTS: The level of stress in students that had contact with firearms, whether or not they were faced with a violent act, may be reached the adaptation difficulty level. Aggressive behaviors like hectoring occurred between coequal groups and brothers/sisters, affectedstress levels. Exposure to and witnessing violent acts had important roles on level of stress. Gender, income level, and lack of a private room at home for adolescents affected stress levels. Contrary to expectations, the presence of firearms at home or in their surroundings did not have an effect on stress levels. Hearing the sound of gunfire was one of the most important factors related to stress levels. CONCLUSION: Because of its ability to induce stress in adolescents, they must be protected form exposure firearms and their use, which is widespread in Düzce.

Accidental decapitation: a case report.

We report a case of an accidental decapitation of an agriculture worker in a field. The scene investigation revealed that the worker had loosely tied a scarf tied over his face in an attempt to diminish his exposure to barley dust, to which he was allergic, while distributing the barley loads with a shovel upon a trailer. The trailer was simultaneously being loaded by a helix elevator machine and its rotating shaft suddenly caught the victim's scarf and pulled it down to the victim's neck. The rotating motion immediately tightened the scarf around the neck resulting in hanging/strangulation noose that, by continued tightening, caused decapitation of the victim. The victim's body was found on the ground by the trailer and the victim's head was discovered in the barley load in the trailer. Examination revealed that the neck was severed at the level of the second and third cervical vertebrae.

Unusual suicide note written on the body: two case reports.

Suicide notes are commonly written on some materials, such as notebooks, papers, and mirrors. Additionally, suicide plans have been communicated in face-to-face conversations, by speaking on the telephone, recording on CDs or video cassettes, and sending messages through text messaging. In this article, 2 suicide death cases are presented in which suicide notes were written on the bodies of the victims. The first case, a 32-year-old man, was a university graduate and had been unemployed for years; he committed suicide in his house by hanging. On the external examination, it was seen that there were some words on the body written with a pen; specifically "DONKEY" was written on the forehead; coursing up-and-down along the chest, "HODJA" was on the right, "DO NOT" was on the sternal region, and "WASH" was on the left; and undecipherable handwritings were on both zygomatic regions. The second case, a 39-year-old woman, was a housewife who was being physically abused by her husband and committed suicide by ingesting an insecticide. It was observed that on the left leg, a note was written with a pen saying that she could not stand being beaten by her husband on account of the inheritance dispute between him and her elder brother; there was purple ecchymoses in the periphery of the right eye and in the right gluteal area. Since we have not found any reports of suicide notes written on the body in the literature, we present and discuss our cases herein.

Fatalities caused by spherical bullets fired from blank cartridge guns in Istanbul, Turkey.

Blank cartridge guns are generally regarded as being harmless and are not considered to be firearms in the legal sense in most countries. To show the danger of these guns upon simple modifications, we report 59 fatalities resulting from these simply modified blank cartridge guns in Istanbul, Turkey. The great majority of the victims were males and the age of those ranged from 11 to 61 years. In 55.9% of these cases, homicide was the origin followed by suicide (39%). The right temporal region was detected to be the preferred region in suicidal shots by blank cartridge guns with a frequency of 56.5%. In trial shots, all these guns were detected to discharge steel or lead spherical objects, generally 4 or 5 mm in diameter, successfully. Our findings strongly suggest that these guns should also be considered as handguns in the legal sense.