Is This Broken Bone Because of Abuse? Characteristics and Comorbid Diagnoses in Older Adults with Fractures

Gironda, Melanie W.; Nguyen, Annie; Mosqueda, Laura

doi:10.1111/jgs.14246

Cited by 22 publications

(19 citation statements)

References 28 publications

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“…Comparing the cases of fatal trauma in this study with those of nonfatal trauma to understand which of these fracture patterns and morphologies, if any, may directly contribute to the fatality would further inform forensic practitioners with their interpretations of the circumstances of a fatal low free fall. Furthermore, comparing and contrasting these fractures with the skeletal BFT resulting from other types of falls and other BFT mechanisms such as physical assaults (e.g., ) would allow forensic anthropologists and pathologists to begin to address those complex BFT questions pertaining to the mechanism of injury.…”

Section: Resultsmentioning

confidence: 99%

Skeletal Trauma Resulting From Fatal Low (≤3 m) Free Falls: An Analysis of Fracture Patterns and Morphologies

Rowbotham

Blau

Hislop-Jambrich³

et al. 2017

Journal of Forensic Sciences

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The skeletal trauma resulting from fatal low (≤3 m) free falls is poorly researched and understood by forensic practitioners. The aim of this study was to identify the types of skeletal trauma resulting from low falls through investigating fracture patterns and morphologies. Skeletal trauma was analyzed using full-body postmortem computed tomography scans of 145 individuals who died from a low free fall. Trauma was then contextualized to the variables that influence how a person falls using multiple logistic regression. Results showed fracture patterning primarily involved the axial skeleton and that there were a number of patterns significantly associated with the height fallen, pre-existing health conditions, and age. Analysis of fracture morphologies showed 108 possible fracture types, six of which were significantly associated with the height fallen. Understanding the skeletal trauma characteristic of low free falls will further inform anthropological interpretations of trauma in cases where a fall may be considered the possible mechanism.

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Section: Resultsmentioning

confidence: 99%

Skeletal Trauma Resulting From Fatal Low (≤3 m) Free Falls: An Analysis of Fracture Patterns and Morphologies

Rowbotham

Blau

Hislop-Jambrich³

et al. 2017

Journal of Forensic Sciences

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“…In the latter case, it is really difficult to discern between an elder's proneness to falling and a caregiver's intentional lack of vigilance. These differences explain why the substantiation rate of referrals and calls for EN is very low (Gironda, Nguyen, & Mosqueda, ).…”

Section: Elder Neglect a Relatively Recent Conditionmentioning

confidence: 99%

Elder neglect—Oral diseases and injuries

Petti¹

2018

Oral Diseases

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Elder neglect (EN) is the failure of a designated caregiver to meet the needs of a dependent older person. World EN prevalence, meta-analyzed in this study, is 1.0% or 1.8% according to different statistical methods. Referring alleged EN cases to Adult Protective Services (APSs) by healthcare workers (HCWs) is mandatory in many countries. However, only few claims are substantiated, as EN could be confused with SelfNeglect, and neglect could be unintentional or due to caregiver unawareness.Screening tools are inaccurate, and their use is discouraged by public health organizations, because they lead to too many false positives, which engulf the already overwhelmed APSs. HCWs need effective tools with objective judgments, which do not hamper the HCW-caregiver-patient rapport and prevent lawsuits when allegations are unfounded. Orofacial EN manifestations (poor oral/denture hygiene, lack of needed/improper dentures, dry mouth, skin/mucosal rashes) are essential Forensic Markers of EN. I classified EN-associated oral diseases according to the unmet needs into four groups: (1) traumatic injuries due to lack of caregiver vigilance (e.g., maxillofacial fractures); (2) diseases due to oral hygiene deficiency (e.g., root caries); (3) diseases typical of the elderly with late/no diagnosis (e.g., oral cancer); and (4) diseases typical of the elderly exacerbated by psychological distress (e.g., oral lichen planus). K E Y W O R D Selder neglect, oral and maxillofacial injuries, oral diseases

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“…[3] Despite this, studies in the field are estimated to be 20 years behind those for domestic violence and child abuse. [4] To date, Indonesia is yet to conduct a national review for the prevalence of nonfatal elder abuse. [5] Prior studies have identified 13 individual forensic markers linked to elder abuse and neglect.…”

Section: Introductionmentioning

confidence: 99%

“…It was concluded that finding a risk factor of abuse with forensic markers prompts for further investigation. [4] Another research on community-dwelling elders discovered individual level risks to be psychiatric illness, cognitive impairment, psychological problems, behavioural problems, functional dependency, poor physical health and frailty. [6] This study is aimed at building on existing research in the field of forensic markers of elder abuse and attempt to prescreen elder abuse and neglect within Sanglah General Hospital, Bali.…”

Section: Introductionmentioning

confidence: 99%

PRE-Screening for Elder Abuse in Sanglah General Hospital, Denpasar, Bali

2019

IJITEE

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Objectives : To identify clinically elderly individuals with elevated risk of being abused based on risk factors and potential forensic markers present. Methods : The design was a cross-sectional analysis of deidentified data taken from the medical database of Sanglah General Hospital, Denpasar. Participants were individuals aged 60 and above with specific ICD-10 coding indicating potential correlates of abuse reported in Sanglah General Hospital over a 6 year period (N = 898). Measured were participant characteristics include demographic characteristics, management and method of payment. The presence of four risk factors and seven potential forensic markers identified using ICD-10 codes were taken and summed. Analytic statistics was used for analysis.Results : Approximately two-thirds of participants were between ages 60-74, 51% were male, 87% received out-patient treatment and 85% used state insurance. 13% had multiple potential correlates of abuse. Five elders were coded with history of assault, with a further 5 coded for abuse. In logistic regression, four predictors, cognitive impairment, functional dependency, fracture and multiple injuries were identified. However only multiple injuries (P=0.008) was significantly associated with multiple risk factors and potential forensic markers of elder abuse. Conclusion : Given the ability of forensic markers to identify elder abuse strongly, it is important to further screen elderly patients who present with multiple injuries. More research is needed to further identify forensic markers of elder abuse valid within the Indonesian clinical context.

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Is This Broken Bone Because of Abuse? Characteristics and Comorbid Diagnoses in Older Adults with Fractures

Cited by 22 publications

References 28 publications

Skeletal Trauma Resulting From Fatal Low (≤3 m) Free Falls: An Analysis of Fracture Patterns and Morphologies

Skeletal Trauma Resulting From Fatal Low (≤3 m) Free Falls: An Analysis of Fracture Patterns and Morphologies

Elder neglect—Oral diseases and injuries

PRE-Screening for Elder Abuse in Sanglah General Hospital, Denpasar, Bali

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