Relationship between Child Abuse and Delinquent Behavior in Male Adolescents Deprived of Liberty

The objective is to identify the prevalence of child abuse and criminal behavior among young male prisoners in Ecuador. Method: A total of 425 young people between 12 and 18 years of age, deprived of liberty from different centers for adolescent offenders in Ecuador, were used. The level of abuse to which they had been subjected in childhood was evaluated, as well as the risk factors present in their history. The relationship between abuse, risk factors, and criminal behavior was analyzed. Results: A high prevalence of the different types of abuse was found in the mean age of 15.03 years standard deviation (SD = 1.34). Conclusion: In addition, a relationship was discovered between the abuse suffered during childhood and the risk factors present in criminal behavior during adolescence, which was demonstrated in this article. The practical implications of these results are discussed, taking into consideration their relevance for prevention

Adequacy and study of skeletal remains in forensic anthropology

Demostrada la importancia de la antropología forense en la identificación positiva de restos óseos humanos, consideramos relevante el aprendizaje de un manejo básico de las técnicas por los estudiantes del Grado de Medicina, en el contexto de la asignatura “Medicina Legal y Ética”. El objetivo principal era aplicar conocimientos teóricos y técnicas de antropología física y forense para identificación de casos reales mediante dinámicas de trabajo en grupo, concluyendo con una toma de decisiones justificada. Se organizaron 16 talleres de 2 horas de duración para grupos de 8 alumnos, utilizando restos esqueléticos de 4 individuos mezclados con huesos animales. Distribuidos por parejas, y una vez identificados los restos humanos, aislaron los 4 esqueletos realizando un inventario de los huesos disponibles, y una estimación básica del perfil biológico de cada uno de ellos: sexo, edad y estatura. Dichos datos fueron consignados en un formulario protocolizado de trabajo, que entregaron al finalizar la práctica. Posteriormente, realizaron un cuestionario anónimo de 10 preguntas, sobre el grado de satisfacción acerca de contenidos, metodología, y utilidad en su formación. Con una tasa de respuesta del 78,4% (n=125) las puntuaciones medias más elevadas fueron otorgadas a los ítems relacionados con: profesor y materia (χ 4,98; Dt. 0,14), claridad expositiva (χ 4,94; Dt. 0,24) y adecuación de metodología (χ 4,92; Dt. 0,28). Además de los resultados favorables obtenidos, se objetivó mediante los formularios protocolizados, la adecuada resolución de casos prácticos reales, basada en una toma de decisiones conjunta y justificada en base a los conocimientos teóricos aprendidos.Having demonstrated the importance of forensic anthropology in the positive identification of human skeletal remains, we consider it relevant to learn a basic management of the techniques by the students of the Medical Degree, in the context of the subject "Legal Medicine and Ethics". The main objective was to apply theoretical and technical knowledge on physical and forensic anthropology to identify real cases through group work dynamics, concluding with justified decision making. Sixteen 2-hour workshops were organized for groups of 8 students, using skeletal remains of 4 individuals mixed with animal bones. After the human remains were identified, the four skeletons were isolated and an inventory of the available bones was made. The basic biological profile of each of them was analyzed: sex, age and height. These data were entered in a protocol form, which they delivered at the end of the practice. Subsequently, they conducted an anonymous questionnaire of 10 items about the degree of satisfaction on contents, methodology, and utility in their training. With a response rate of 78.4% (n = 125), the highest mean scores were given to items related to: teacher and subject (χ 4,98; Dt. 0.14), expository clarity (χ 4, 94, Dt. 0.24) and adequacy of methodology (χ 4,92, Dt. 0,28). In addition to the favorable results obtained, it was objectified through the protocolized forms, the adequate resolution of real practical cases, based on a joint decision making and justified on the theoretical contents learned

Secreto profesional médico: estudio de las debilidades en la práctica clínica

Introducción: Respetar la confidencialidad es esencial para salvaguardar el bienestar de los pacientes y garantizar el buen funcionamiento de la sociedad. Material y Métodos: Mediante la observación directa, nuestro estudio evidenció situaciones reales en las que se produjo una violación de la confidencialidad en un hospital de tercer nivel (HURS). Para observar y recopilar datos sobre estas situaciones, reclutamos a estudiantes de últimos cursos matriculados en el grado de Medicina en la Universidad de Córdoba. Los observadores anotaron sus observaciones en plantillas estandarizadas durante sus prácticas clínicas en diferentes Unidades de Gestión Clínica: Medicina Interna; Ginecología y Obstetricia; Pediatría; Urgencias; Cirugía General y Digestiva; Cirugía Maxilofacial; Cirugía Plástica; Ortopedia y Traumatología; Digestivo; Dermatología; Reumatología; Salud Mental; Nefrología; Neumología; Neurología; y Oftalmología. Resultados: Después de 7138 días y 33157 horas de observación, calculamos un índice de frecuentación de una falta cada 22.22 horas de observación. En cuanto a la tipología de las faltas observadas, las más frecuentes (54,6%) estaban relacionados con la consulta y / o divulgación de los datos clínicos y / o personales a personal médico que no participan en la atención clínica del paciente, así como las personas externas al hospital. En cuanto a su gravedad, las faltas graves fueron las más frecuentes, que representan el 46,7% de todas las incidencias. La mayoría de los situaciones descritas se observaron en las zonas comunes del centro (37,9%), tales como pasillos, ascensores, cafetería, escaleras y vestuarios. Conclusiones: Además de los aspectos relacionados con la organización o infraestructura del hospital, se demuestra que todo el personal sanitario está implicado en situaciones que vulneran la confidencialidad, especialmente los médicos. Si bien la mayoría son cometidas de forma no intencionada, hay un número nada despreciable de faltas graves cometidas de forma reiterada (9,5%), lo que sugiere cierto descuido, quizá por desconocimiento de ciertos comportamientos que pueden poner en peligro la confidencialidad de los pacientes.Background: Respect for confidentiality is essential to safeguard the well-being of patients and ensure the proper functioning of society. Methods: By means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology. Results: Following 7138 days and 33157 hours of observation, we found an estimated Frequency Index of one breach per 22.22 hours. As regards the typology of the observed breaches, the most frequent (54,6%) were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7% of all incidents. Most of the reported incidents were observed in public areas (37.9%), such as corridors, elevators, the cafeteria, stairs, and locker rooms. Conclusions: In addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel is involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches (9.5%), thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality

ADECUACIÓN Y ESTUDIO DE RESTOS ÓSEOS EN ANTROPOLOGÍA FORENSE

Having demonstrated the importance of forensic anthropology in the positive identification of human skeletal remains, we consider it relevant to learn a basic management of the techniques by the students of the Medical Degree, in the context of the subject "Legal Medicine and Ethics". The main objective was to apply theoretical and technical knowledge on physical and forensic anthropology to identify real cases through group work dynamics, concluding with justified decision making. Sixteen 2-hour workshops were organized for groups of 8 students, using skeletal remains of 4 individuals mixed with animal bones. After the human remains were identified, the four skeletons were isolated and an inventory of the available bones was made. The basic biological profile of each of them was analyzed: sex, age and height. These data were entered in a protocol form, which they delivered at the end of the practice. Subsequently, they conducted an anonymous questionnaire of 10 items about the degree of satisfaction on contents, methodology, and utility in their training. With a response rate of 78.4% (n = 125), the highest mean scores were given to items related to: teacher and subject (χ 4,98; Dt. 0.14), expository clarity (χ 4, 94, Dt. 0.24) and adequacy of methodology (χ 4,92, Dt. 0,28). In addition to the favorable results obtained, it was objectified through the protocolized forms, the adequate resolution of real practical cases, based on a joint decision making and justified on the theoretical contents learned.Demostrada la importancia de la antropología forense en la identificación positiva de restos óseos humanos, consideramos relevante el aprendizaje de un manejo básico de las técnicas por los estudiantes del Grado de Medicina, en el contexto de la asignatura “Medicina Legal y Ética”. El objetivo principal era aplicar conocimientos teóricos y técnicas de antropología física y forense para identificación de casos reales mediante dinámicas de trabajo en grupo, concluyendo con una toma de decisiones justificada. Se organizaron 16 talleres de 2 horas de duración para grupos de 8 alumnos, utilizando restos esqueléticos de 4 individuos mezclados con huesos animales. Distribuidos por parejas, y una vez identificados los restos humanos, aislaron los 4 esqueletos realizando un inventario de los huesos disponibles, y una estimación básica del perfil biológico de cada uno de ellos: sexo, edad y estatura. Dichos datos fueron consignados en un formulario protocolizado de trabajo, que entregaron al finalizar la práctica. Posteriormente, realizaron un cuestionario anónimo de 10 preguntas, sobre el grado de satisfacción acerca de contenidos, metodología, y utilidad en su formación. Con una tasa de respuesta del 78,4% (n=125) las puntuaciones medias más elevadas fueron otorgadas a los ítems relacionados con: profesor y materia (χ 4,98; Dt. 0,14), claridad expositiva (χ 4,94; Dt. 0,24) y adecuación de metodología (χ 4,92; Dt. 0,28). Además de los resultados favorables obtenidos, se objetivó mediante los formularios protocolizados, la adecuada resolución de casos prácticos reales, basada en una toma de decisiones conjunta y justificada en base a los conocimientos teóricos aprendidos

Physicians' and Nurses' Knowledge in Palliative Care: Multidimensional Regression Models

The increase in life expectancy has led to a growth in the number of people in need of palliative care. Health professionals must possess appropriate knowledge and skills. This study aimed to assess knowledge in palliative care through the Palliative Care Knowledge Test Spanish Version (PCKT-SV)®. A cross-sectional analytical study was conducted in 40 primary care health services. A total of 600 PCKT-SV questionnaires were distributed among health professionals; 561 of them (226 nurses and 335 physicians) were properly filled up. Sociodemographic information, education, and work experience were also recorded. A total of 34.41% of the nurses and 67.40% of the physicians showed good or excellent knowledge of palliative care. Physicians' scores for pain, dyspnea, and psychiatric disorders were higher than those of the nurses. Nurses scored significantly better in philosophy. Professionals with continuous training in palliative care showed a higher level of knowledge. Age and work experience of physicians and undergraduate training in nurses had significant weight in knowledge. Developing continuous training and enhancing undergraduate training in palliative care will lead to improved patient care at the end of life.Ye