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Article: Importancia de la autorregulación: análisis de la actividad de la comisión de ética y deontología médica en Córdoba.

Beltran-Aroca, Cristina M / Girela-López, Eloy / Sáez-Rodríguez, José / Pérez-Cárceles, María Dolores

Cuadernos de bioetica : revista oficial de la Asociacion Espanola de Bioetica y Etica Medica

2023 Volume 34, Issue 110, Page(s) 37–50

Abstract: Objective: to analyse the activity of the Medical Ethics and Deontology Commission (MEDC) of the College of Physicians of Cordoba regarding conflictive situations in the profession from 2013 through 2021.: Material and methods: cross-sectional ... ...

Title translation	The importance of self-regulation: Analysis of the activity of the medical ethics and deontology commission in Cordoba.
Abstract	Objective: to analyse the activity of the Medical Ethics and Deontology Commission (MEDC) of the College of Physicians of Cordoba regarding conflictive situations in the profession from 2013 through 2021. Material and methods: cross-sectional observational study, in which 83 cases of complaints submitted to the College were collected. Results: the incidence was 2.6 complaints‰ members/year, with a total of 92 doctors reported. 61.4% were submitted by the patient, 92.8% of which were addressed to a single doctor. 30.1% were in the speciality of family medicine, 50.6% in the public sector and 72% in outpatient care. In 37.7% the chapter of the Code of Medical Ethics concerned was chapter IV (quality of medical care). In 89.2% of cases the parties came to make a statement, with a higher risk of disciplinary proceedings being observed when the statement was both, oral and written (OR:4.61; p=0.026). The median resolution time was 63 days, significantly longer in cases proposed for disciplinary proceedings (146 days vs. 58.50 days; OR:1.01; p=0.008). The MEDC found 15.7% (n=13) to be in breach of ethics, with 15 doctors being disciplined (16.3%) and 4 sanctioned (26.7%) with a warning and temporary suspension from practice. Conclusions: The role of the MEDC is fundamental in the self-regulation of professional practice. Inappropriate behaviour during patient care or between colleagues has serious ethical implications, disciplinary repercussions for the physician, and it particularly undermines patients' trust in the medical profession.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Ethics, Medical ; Physicians ; Self-Control
Language	Spanish
Publishing date	2023-05-10
Publishing country	Spain
Document type	Observational Study ; English Abstract ; Journal Article
ZDB-ID	2546303-2
ISSN	1132-1989
ISSN	1132-1989
DOI	10.30444/CB.141
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Relationship between Child Abuse and Delinquent Behavior in Male Adolescents Deprived of Liberty.

Vallejo Valdivieso, Patricio Alfredo / Zambrano Pincay, Graciela Hernestina / Beltran-Aroca, Cristina M / Girela-Lopez, Eloy

International journal of environmental research and public health

2022 Volume 19, Issue 24

Abstract: 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 ... ...

Abstract	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.
MeSH term(s)	Humans ; Adolescent ; Male ; Child ; Child Abuse, Sexual ; Child Abuse ; Criminal Behavior ; Risk Factors ; Surveys and Questionnaires ; Freedom
Language	English
Publishing date	2022-12-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph192416666
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Article ; Online: Forensic age estimation: comparison and validation of the Iscan method in 3D reconstructions using a surface scanner in a Spanish population.

Beltran-Aroca, Cristina M / Lopez-Alcaraz, Manuel / Perez-Jorge, Pablo / Velazquez-Gomez, Jose L / Font-Ugalde, Pilar / Girela-Lopez, Eloy

International journal of legal medicine

2023 Volume 137, Issue 3, Page(s) 773–785

Abstract: When investigating a death, post-mortem identification provides with results of great legal and humanitarian significance. The effectiveness of the methods used to estimate age depends on the reference population, considering variables such as sex and ... ...

Abstract	When investigating a death, post-mortem identification provides with results of great legal and humanitarian significance. The effectiveness of the methods used to estimate age depends on the reference population, considering variables such as sex and ancestry. The aim of this study was to validate the Iscan method to estimate age in a Spanish forensic population, comparing the estimates obtained in dry bones and 3D reconstructions created with a surface scanner. We carried out a cross-sectional study on 109 autopsied corpses (67% male), scanning the sternal end of the right fourth rib in a 3D mesh, using an EinScan-Pro® surface scanner (precision: 0.05 mm). Two observers estimated the phases in dry bones and 3D images according to the Iscan method and to the sex of the subject. The mean age was 57.73 years (SD = 19.12 years;18-93 years). The intra-observer agreement was almost perfect in bones (κ = 0.877-0.960) and 3D images (κ = 0.954), while the inter-observer agreement was almost perfect in bones (κ = 0.813) and substantial in 3D images (κ = 0.727). The correlation with the Iscan phases was very strong in bones (Rho = 0.794-0.820; p < 0.001) and strong in 3D images (Rho = 0.690-0.691; p < 0.001). Both sex-adjusted linear regression models were significant (dry bones: R
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Imaging, Three-Dimensional ; Cross-Sectional Studies ; Age Determination by Skeleton/methods ; Forensic Anthropology/methods ; Ribs/diagnostic imaging ; Ribs/anatomy & histology
Language	English
Publishing date	2023-03-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1055109-8
ISSN	1437-1596 ; 0937-9827
ISSN (online)	1437-1596
ISSN	0937-9827
DOI	10.1007/s00414-023-02983-6
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Article ; Online: Measuring moral distress in health professionals using the MMD-HP-SPA scale.

Girela-Lopez, Eloy / Beltran-Aroca, Cristina M / Boceta-Osuna, Jaime / Aguilera-Lopez, Dolores / Gomez-Carranza, Alejandro / Lopez-Valero, Manuel / Romero-Saldaña, Manuel

BMC medical ethics

2024 Volume 25, Issue 1, Page(s) 41

Abstract: Background: Moral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors ... ...

Abstract	Background: Moral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors associated with MD among health professionals during the pandemic and to determine its causes. Methods: A regional, observational and cross-sectional study in a sample of 566 professionals from the Public Health Service of Andalusia (68.7% female; 66.9% physicians) who completed the MMD-HP-SPA scale to determine the level of MD (0-432 points). Five dimensions were used: i) Health care; ii) Therapeutic obstinacy-futility, iii) Interpersonal relations of the Healthcare Team, iv) External pressure; v) Covering up of medical malpractice. Results: The mean level of MD was 127.3 (SD=66.7; 95% CI 121.8-132.8), being higher in female (135 vs. 110.3; p<0.01), in nursing professionals (137.8 vs. 122; p<0.01) and in the community setting (136.2 vs. 118.3; p<0.001), with these variables showing statistical significance in the multiple linear regression model (p<0.001; r Conclusions: Female, nursing professionals, and those from the community setting presented a higher risk of MD. The healthcare model needs to implement an ethical approach to public health issues to alleviate MD among its professionals.
MeSH term(s)	Humans ; Female ; Male ; Cross-Sectional Studies ; Stress, Psychological ; Health Personnel/psychology ; Physicians ; Morals ; Surveys and Questionnaires
Language	English
Publishing date	2024-04-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2041552-7
ISSN	1472-6939 ; 1472-6939
ISSN (online)	1472-6939
ISSN	1472-6939
DOI	10.1186/s12910-024-01041-z
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Article ; Online: The role of undergraduate medical students training in respect for patient confidentiality.

Beltran-Aroca, Cristina M / Ruiz-Montero, Rafael / Labella, Fernando / Girela-López, Eloy

BMC medical education

2021 Volume 21, Issue 1, Page(s) 273

Abstract: Background: Encouraging professional integrity is vital for providing a standard of excellence in quality medical care and education and in promoting a culture of respect and responsibility. The primary objective of this work consisted of studying the ... ...

Abstract	Background: Encouraging professional integrity is vital for providing a standard of excellence in quality medical care and education and in promoting a culture of respect and responsibility. The primary objective of this work consisted of studying the relationship of medical students to the right to patient privacy in Spain, specifically by analysing the conditions for accessing patient clinical histories (CHs). Methods: A cross-sectional study was conducted based on a questionnaire sent by e-mail to final-year students at 41 Spanish universities. It had 14 multiple choice and closed questions framed in 3 large blocks. The first question addressed basic general knowledge issues on the right to privacy and the obligation for confidentiality. The two remaining blocks were made up of questions directed towards evaluating the frequency with which certain requirements and action steps related to students attending patients were performed and regarding the guarantees associated with accessing and handling patient CHs both on paper and in the Electronic Medical Record. Results: A total of 245 valid replies were considered. A total of 67.8 % of participants were women, with an average age of 24.05 ± 3.49 years. Up to 90.6 % were aware that confidentiality affected the data in CHs, although 43.3 % possessed non-anonymized photocopies of patient clinical reports outside the healthcare context, and only 49.8 % of the students were always adequately identified. A total of 59.2 % accessed patient CHs on some occasions by using passwords belonging to healthcare professionals, 77.2 % of them did not have the patients' express consent, and 71.9 % accessed a CH that was not anonymised. Conclusions: The role of healthcare institutions and universities is considered to be fundamental in implementing educational measures regarding the risks and ethical and legal problems arising from the use of CHs among professionals and students. A thorough study of medical ethics is needed through the analysis of clinical cases and direct exposure to situations in which the patient's confidentiality is questioned.
MeSH term(s)	Adult ; Confidentiality ; Cross-Sectional Studies ; Ethics, Medical ; Female ; Humans ; Male ; Spain ; Students, Medical ; Young Adult
Language	English
Publishing date	2021-05-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-021-02689-6
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Article ; Online: Epidemiology and autopsy findings of 500 drowning deaths.

Girela-López, Eloy / Beltran-Aroca, Cristina M / Dye, Amanda / Gill, James R

Forensic science international

2021 Volume 330, Page(s) 111137

Abstract: Introduction: Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global ... ...

Abstract	Introduction: Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global drowning deaths. In addition, the postmortem diagnosis of drowning is challenging and the physiological mechanisms of death by drowning are complex and not very well understood. Purpose: To analyze a large series of bodies retrieved from the water in Connecticut (U.S.) in order to compare epidemiologic and toxicological data with those of the literature, as well as to examine the weights of the lungs and brains in drowning deaths. Material and method: We conducted a descriptive, retrospective, population-based analysis of all bodies retrieved from the water and subjected to a forensic autopsy at the Office of the Chief Medical Examiner in Connecticut (2008-2020, n = 500). Variables collected were sex, age, date of death, location of drowning, season, type of water, cause of death, manner of death, circumstances of death, signs of decomposition, BMI, brain weight, lung weight, presence of pulmonary edema, stomach contents, and toxicological analysis. Results: The death rates of drownings in Connecticut ranges from 0.75 to 1.28/100,000/year. They occurred predominantly in males (73.4%) and most were accidents (75.6%), though this gender difference diminishes in suicides (55.4% of males). Sex distribution is also different in bathtub drownings, where women drown more frequently (67.3%). Weights of the brains (p = 0.013) and lungs (p < 0.001) were higher in saltwater drownings. Conclusions: Drowning is more frequently an accident involving men, except for suicides where there is only a slight difference among sex. Heavy lungs and cerebral edema continue to be identified in numerous drowning deaths. These anatomic findings, however, must still be interpreted in the context of the entire case investigation. Weights of the brains and lungs are higher in salt water, although these organs' weights are mostly dependent on other variables such as BMI and decomposition.
MeSH term(s)	Autopsy ; Drowning/epidemiology ; Female ; Humans ; Male ; Retrospective Studies ; Suicide ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2021-12-03
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	424042-x
ISSN	1872-6283 ; 0379-0738
ISSN (online)	1872-6283
ISSN	0379-0738
DOI	10.1016/j.forsciint.2021.111137
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Article: Epidemiology and autopsy findings of 500 drowning deaths

Girela-López, Eloy / Beltran-Aroca, Cristina M. / Dye, Amanda / Gill, James R.

Forensic science international. 2022 Jan., v. 330

2022

Abstract: Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world’s third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global drowning deaths. In ... ...

Abstract	Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world’s third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global drowning deaths. In addition, the postmortem diagnosis of drowning is challenging and the physiological mechanisms of death by drowning are complex and not very well understood.To analyze a large series of bodies retrieved from the water in Connecticut (U.S.) in order to compare epidemiologic and toxicological data with those of the literature, as well as to examine the weights of the lungs and brains in drowning deaths.We conducted a descriptive, retrospective, population-based analysis of all bodies retrieved from the water and subjected to a forensic autopsy at the Office of the Chief Medical Examiner in Connecticut (2008–2020, n = 500). Variables collected were sex, age, date of death, location of drowning, season, type of water, cause of death, manner of death, circumstances of death, signs of decomposition, BMI, brain weight, lung weight, presence of pulmonary edema, stomach contents, and toxicological analysis.The death rates of drownings in Connecticut ranges from 0.75 to 1.28/100,000/year. They occurred predominantly in males (73.4%) and most were accidents (75.6%), though this gender difference diminishes in suicides (55.4% of males). Sex distribution is also different in bathtub drownings, where women drown more frequently (67.3%). Weights of the brains (p = 0.013) and lungs (p < 0.001) were higher in saltwater drownings.Drowning is more frequently an accident involving men, except for suicides where there is only a slight difference among sex. Heavy lungs and cerebral edema continue to be identified in numerous drowning deaths. These anatomic findings, however, must still be interpreted in the context of the entire case investigation. Weights of the brains and lungs are higher in salt water, although these organs’ weights are mostly dependent on other variables such as BMI and decomposition.
Keywords	accidents ; brain ; death ; edema ; epidemiology ; forensic sciences ; gender differences ; lungs ; necropsy ; public health ; saline water ; stomach ; toxicology ; uncertainty ; Connecticut
Language	English
Dates of publication	2022-01
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	424042-x
ISSN	1872-6283 ; 0379-0738
ISSN (online)	1872-6283
ISSN	0379-0738
DOI	10.1016/j.forsciint.2021.111137
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Impact of the COVID-19 Pandemic on Palliative Care in Cancer Patients in Spain.

Beltran-Aroca, Cristina M / Ruiz-Montero, Rafael / Llergo-Muñoz, Antonio / Rubio, Leticia / Girela-López, Eloy

International journal of environmental research and public health

2021 Volume 18, Issue 22

Abstract: Background: The COVID-19 pandemic outbreak has severely affected healthcare organizations worldwide, and the provision of palliative care (PC) to cancer patients has been no exception. The aim of this paper was to analyse the levels of health care ... ...

Abstract	Background: The COVID-19 pandemic outbreak has severely affected healthcare organizations worldwide, and the provision of palliative care (PC) to cancer patients has been no exception. The aim of this paper was to analyse the levels of health care provided by the Clinical Management Unit for PC in Córdoba (Spain) for cancer patients. Method: a retrospective cohort study was conducted. It analyzed the PC internal management database including all cancer patients treated in the period of 2018-2021. Results: 1967 cases were studied. There was a drop in cancer cases ( Conclusion: The COVID-19 pandemic has presented a challenge in the management of patients requiring PC and has highlighted the urgent needs of the healthcare system if it is to continue providing a level of care which meets the needs of patients and their families.
MeSH term(s)	COVID-19 ; Female ; Humans ; Neoplasms/epidemiology ; Neoplasms/therapy ; Palliative Care ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; Spain/epidemiology
Language	English
Publishing date	2021-11-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph182211992
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Article ; Online: Assessment of Doctors' Knowledge and Attitudes Towards Confidentiality in Hospital Care.

Beltran-Aroca, Cristina M / Labella, Fernando / Font-Ugalde, Pilar / Girela-Lopez, Eloy

Science and engineering ethics

2019 Volume 25, Issue 5, Page(s) 1531–1548

Abstract: The physician's duty of confidentiality is based on the observance of the patient's privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. ... ...

Abstract	The physician's duty of confidentiality is based on the observance of the patient's privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients' data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents (37.5%) with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital (74%). The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups (≤ 30 vs. ≥ 51 years) and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Confidentiality ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Medical Records/legislation & jurisprudence ; Middle Aged ; Physicians/psychology ; Spain ; Surveys and Questionnaires ; Tertiary Care Centers
Language	English
Publishing date	2019-01-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2136491-6
ISSN	1471-5546 ; 1353-3452
ISSN (online)	1471-5546
ISSN	1353-3452
DOI	10.1007/s11948-018-0078-5
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Article ; Online: Study of the Psychometric Properties of the Spanish Version of the Measure of Moral Distress for Health Care Professionals (MMD-HP-SPA).

Girela-López, Eloy / Beltran-Aroca, Cristina M / Boceta-Osuna, Jaime / Aguilera-Lopez, Dolores / Gomez-Carranza, Alejandro / García-Linares, Miguel / Llergo-Muñoz, Antonio / Romero-Saldaña, Manuel

International journal of environmental research and public health

2022 Volume 19, Issue 23

Abstract: Background: The early detection of moral distress requires a validated and reliable instrument. The aim of this study was to carry out an advanced analysis of the psychometric properties of the moral distress scale for health professionals (MMD-HP-SPA) ... ...

Abstract	Background: The early detection of moral distress requires a validated and reliable instrument. The aim of this study was to carry out an advanced analysis of the psychometric properties of the moral distress scale for health professionals (MMD-HP-SPA) by performing a validation of the construct and its internal and external reliability. Methods: We performed a multicentre cross-sectional study in health professionals belonging to the Andalusian public health system. Construct validity was performed by exploratory ( Results: 384 doctors and 191 nurses took part in the survey. The overall mean for moral distress was 128.5 (SD = 70.9), 95% CI [122.7-134.3], and it was higher in nurses at 140.5 (SD = 74.9) than in doctors at 122.5 (SD = 68.1), F = 8.37 Conclusions: The MMD-HP-SPA scale has solid construct validity, excellent internal consistency, optimal temporal reliability, and underlying dimensions which effectively explore the causes of moral distress in health professionals, thus guaranteeing its use in hospital and community settings.
MeSH term(s)	Humans ; Reproducibility of Results ; Cross-Sectional Studies ; Psychometrics/methods ; Factor Analysis, Statistical ; Surveys and Questionnaires ; Health Personnel
Language	English
Publishing date	2022-11-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph192315649
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