Developing process and term analysis of WFAS standard: General Requirements for the Risk Control in the Safe Use of Acupuncture / 中国针灸

In order to promote the application of WFAS standard, General Requirements for the Risk Control in the Safe Use of Acupuncture and the safe practice of acupuncture technology worldwide, the paper introduces the developing process and main contents of this standard, explains the developing purpose, scope, ideas, methods and basis, and analyzes the definition of the relevant terms. Through strictly complied with the development procedure of standard, the terms related to acupuncture risk in this standard are defined. The connotations of 5 special terms are clarified, i.e. "acupuncture risks" "adverse events of acupuncture" "adverse reactions of acupuncture" "acupuncture accidents" and "acupuncture negligence". The range, rank, control flow and source of risk, as well as the control measures are determined. The standard extracts the underlying common problems and basic requirement of the safe practice of acupuncture so as to lay a framework for the development of the relevant technical standards of acupuncture.

Healthcare Professionals’ Standard Of Care During COVID-19 Pandemic (Piawaian Penjagaan dan Rawatan Kesihatan Semasa Pandemik COVID-19) / Jurnal Sains Kesihatan Malaysia

@#Since the beginning of the year 2020, Malaysia has been gravely affected by the COVID-19 pandemic where to date over four million of its population have been infected with the virus. At the time of writing this paper, the number of infections is still alarming. This situation undoubtedly places a strain on the healthcare system, particularly on healthcare professionals who have been entrusted to treat COVID-19 patients. Treating a high number of patients in an unprecedented situation may pose a challenge for doctors to fulfil their legal duties that arise from the usual doctor-patient relationship particularly in discharging the established standard of care imposed by the law. This is the main issue that this paper seeks to explore. In addition, this paper also examines doctors’ duty of care towards non-COVID-19 patients amidst limited medical resources and policy consideration that inevitably causes a delay in giving medical treatments and elective surgeries. In answering these questions, the method employed in this paper is qualitative analysis. In conclusion, it is suggested that keeping up to the established standard of care is crucial in maintaining public confidence in the medical profession and also to protect public health and welfare.

Responsabilidad médica profesional, guías para la práctica clínica y lex artis. La importancia de seguir las recomendaciones de las guías clínicas / Professional medical liability, clinical practice guidelines and Lex Artis. The importance of following clinical practice guidelines recommendations

Resumen La responsabilidad médica profesional es el resultado de mala praxis médica, la cual puede deberse a negligencia, impericia o imprudencia. Se conoce como lex artis al conjunto de conocimientos y habilidades que han sido universalmente aceptados por los pares, los cuales deben ser diligentemente aplicados en la situación específica de un paciente determinado. Entonces, lex artis es fundamentalmente todo lo contenido en las guías para la práctica clínica. Judicialmente hablando, en México el ejercicio de la medicina es una obligación de medios, mas no de resultados. Por consiguiente, apegarse a las recomendaciones de las guías para la práctica clínica es más efectivo para defenderse de una demanda legal por mala praxis.

Abstract Professional medical liability is the result of medical malpractice, which may be due to negligence, incompetence or carelessness. Lex Artis is the set of skills and knowledge that have been universally accepted by peers, which must be diligently applied in the specific situation of a given patient. Thus, Lex Artis is essentially everything contained in clinical practice guidelines. Judicially speaking, the practice of medicine in Mexico is an obligation of means, but not of results. Therefore, adherence to clinical practice guidelines recommendations is the most effective way to defend oneself against a malpractice lawsuit.

Uma leitura crítica das emergências em saúde global: o caso da epidemia de zika de 2016 / A critical view of the global health emergencies: the 2016 zika epidemic case

Resumo O estudo da definição de agendas e prioridades da saúde global tem sido, nos últimos anos, uma das prioridades de uma literatura crítica que visa identificar as dimensões políticas da governança global em saúde, e que enfatiza os pontos de tensão, exclusão e desigualdade. O presente ensaio se posiciona nesta leitura crítica da saúde global, focando a construção da categoria de emergência de importância internacional. Considerando em específico o caso do surto de zika e de síndromes congênitas no Brasil, em 2016, explora as condições que possibilitam a construção de uma emergência. Questionamos os fatores e condições em torno desse evento de saúde pública que eventualmente foram considerados no processo decisório, e que vão além dos dados materiais mais objetivos relativos à epidemiologia do zika, à sua morbi-mortalidade ou à sua associação com as malformações congênitas. Concluímos que o contexto securitário e a crescente importância do risco na saúde global são condições importantes para entender as declarações de emergência.

Abstract The study of global health agenda-setting and issue-prioritization has been one of the key aspects of a critical literature that, in recent years, has aimed to identify the political dimensions of global health governance and to shed light on points of tension, exclusion, and inequality. This essay speaks to this critical global health literature, focusing on the construction of the category of emergencies of international concern. Considering the case of the outbreak of zika and congenital syndrome in Brazil in 2016, it explores the conditions enabling the construction of an emergency. We question the factors and conditions around this public health event that were considered during the decision-making process and that transcended material, more objective data regarding zika's epidemiology, its morbimortality, or its association with congenital malformations. We conclude that the securitized context and the growing relevance of risk to global health are important conditions for understanding emergency declarations.

¿Quién juzga la actuación médica? / Who judges medical practice?

Resumen Las demandas judiciales por la percepción del paciente de una actuación médica inadecuada son una realidad creciente en la práctica médica, la cual entraña una preocupación extendida en el gremio médico. Las demandas judiciales frecuentemente conllevan circunstancias adicionales a la primaria preocupación de prevenir o sancionar actos de negligencia médica. CETREMI emite algunas recomendaciones a los profesionales jurídicos y médicos para mejorar esta situación y evitar daños en la relación médico-paciente.

Abstract Lawsuits due to patient perception of inappropriate medical actions are a growing reality in medical practice, which entails widespread concern in the medical community. Lawsuits often entail additional circumstances beyond the primary concern of preventing or sanctioning acts of medical negligence. CETREMI proposes various recommendations aimed at legal and medical professionals to improve this circumstance and avoid harming the doctor-patient relationship.

Perfil da Violência contra o Idoso em uma Cidade do Sul de Santa Catarina / Profile of Violence against the Elderly in a City in Southern Santa Catarina

Introdução: De acordo com a OMS (Organização Mundial de Saúde), os maus-tratos na terceira idade podem ser caracterizados como ato único ou repetido, ou, ainda, ausência de ação apropriada que cause dano, sofrimento ou angústia e que ocorram dentro de um relacionamento de confiança. A violência contra o idoso costuma ser categorizada em 5 tipos, sendo eles: violência física, psicológica, sexual, abuso financeiro e negligência. O presente estudo objetivou caracterizar o perfil epidemiológico da violência contra o idoso na cidade de Tubarão/SC. Métodos: A presente pesquisa trata-se de um estudo epidemiológico com delineamento transversal. A população em estudo consiste em idosos, vítimas de violência que realizaram o registro do caso de abuso na Delegacia de Prote- ção à Criança, Adolescente, Mulher e Idoso durante o período de janeiro de 2013 a dezembro de 2019. Resultados: Foi encontrada uma prevalência de 31,7% de casos de violência sendo classificados como negligência. As principais vítimas eram do sexo feminino (58,7%), e 51% das vítimas apresentavam algum tipo de limitação física ou cognitiva. Os principais agressores foram os familiares das vítimas, em 87,3% dos casos, sendo o domicílio o principal local de ocorrência da violência (83,7%). Conclusão: Foi possível caracterizar os idosos vítimas de violência na cidade de Tubarão/SC, em um período de 6 anos, com foco no perfil epidemiológico da vítima e de seus agressores, identificando variáveis como sexo, faixa etária, estado civil, além dos tipos de violência praticados e o local de ocorrência das mesmas.

Introduction: According to the WHO (World Health Organization), elder abuse can be a single or repeated act or even lack of appropriate action that causes harm, suffering, or distress and that occurs within a relationship of trust. Violence against the elderly usually classifies into five types, namely: physical, psychological, sexual, financial abuse, and neglect. The present study aimed to characterize the epidemiological profile of violence against the elderly in Tubarão/SC. Methods: This research is an epidemiological study with a cross-sectional design. The study population consists of elderly victims of violence who made the registration of the case of abuse at the Police Station for the Protection of Children, Adolescents, Women, and the Elderly during the period from January 2013 to December 2019. Results: A prevalence of 31.7% of cases of violence classified as neglect was found. Predominantly, the victims were female (58.7%), and 51% had some physical or cognitive limitation. The main aggressors were the victims' relatives in 87.3% of the cases, and the home was the most frequent place where the violence occurred (83.7%). Conclusion: It was possible to characterize the elderly victims of violence in the city of Tubarão/SC over six years, focusing on the epidemiological profile of the victim and their aggressors, identifying variables such as gender, age group, marital status, in addition to the types of violence committed and the place of their occurrence.

Analyzing the Role and Liability of Paramedics in the Indian Healthcare System

The Nursing and staff serves as backbone of a healthcare system. Despite being central to any healthcare system, not much has been written about them, especially on the issue of their regulations and legal liabilities emanating from their professional activities. Though they are governed by National and State councils, the implications of their acts are different in Civil Law, Criminal Law and under their respective regulations. These differences are primarily the subject matter of this paper.

Las negligencias más comunes en la práctica odontológica / The most common negligence in dental practice

Para el adecuado ejercicio de la odontología, los procedimientos realizados deben ejecutarse apegándose en todo momento a las normas y principios éticos propios de la profesión. Cuando un odontólogo decide, por voluntad propia, ejercer la profesión sin apegarse a dichos principios, se considera que actúa con negligencia. La negligencia se caracteriza por ser un acto indebido, en el cual el profesional ejecuta por voluntad propia acciones injustificables capaces de producir daños en la salud de los pacientes o en el pronóstico de un tratamiento. Los actos negligentes, además de atentar contra la integridad del paciente, ponen en riesgo a los profesionales de la salud que los cometen de sufrir consecuencias legales derivadas de dichos actos. El objetivo del presente artículo consiste en definir el concepto de negligencia, describir las formas más comunes en las que ésta se comete durante la consulta odontológica así como sus posibles consecuencias legales, ilustrándolas a su vez con la breve presentación de algunos casos (AU)

For the proper practice of dentistry, the procedures performed must be carried out adhering at all times to the standards and ethical principles of the profession. When a dentist voluntarily decides to practice the profession without adhering to these principles, he is considered to be acting negligently. Negligence is characterized as an improper act, in which the professional voluntarily executes unjustifiable actions capable of causing damage to the health of patients or the prognosis of a treatment. Negligent acts, in addition to threatening the integrity of the patient, put health professionals at risk who commit legal consequences derived from these acts. The aim of this article is to define the concept of negligence, to describe the most common ways in which it is committed during the dental practice as well as its legal consequences, illustrating them in turn with a brief presentation of some cases (AU)

Medical errors, medical negligence and defensive medicine: A narrative review

Abstract Error in medicine and medical liability has a long history dating back to Antiquity. During the 19th Century, most lawsuits related to errors in treating surgical problems were settled. However, in the first half of the 20th Century, lawsuits claimed that mistakes were related to the doctor's action: the doctor made something wrong (errors of commission). In Brazil, medical error is defined as inappropriate conduct, including negligence and recklessness, that causes harm to the patient. The physician's fear of being suited is the reason for some practice named defensive Medicine (D.M.), defined as ordering unnecessary tests and procedures or avoiding treatments for patients considered at high-risk. Thus, this narrative review aims to analyze and describe the relationship between medical errors, medical negligence, and the practice of D.M. So, the authors propose procedures and attitudes to avoid medical errors and the approach of D.M.: a national focus to create leadership and research tools to enhance the knowledge base about patient safety; a reporting system that would help to identify and learn from errors; the use of a computer-based protocol reminder; some technological devices to help the medical practice (electronic prescribing and information technology systems); creating risk management programs in hospitals. Therefore, the authors conclude that the most critical attitude to avoid medical liability is a good and ethical medical practice with the proper use of technology, based on knowledge of scientific evidence and ethical principles of medicine - for the benefit of patients. HIGHLIGHTS This article defines medical errors and medical responsibility from a Brazilian perspective. This article calls attention to the risks of medical liability and the unethical use of defensive medicine. The authors propose some procedures and attitudes to avoid medical errors like the use of technology at the bedside and computer-based protocols. The authors state that a good and ethical medical practice can avoid medical liability.

Dento-Legal Issues in Malaysia: A General Guide for Dental Practitioners (Isu-Isu Dento-Legal di Malaysia: Panduan Umum untuk Pengamal Pergigian) / Jurnal Sains Kesihatan Malaysia

@#Dentistry is a noble profession where dentists often manage to bring smiles and create confidence in patients. Nonetheless, as with other medical professionals, dentists too often encounter legal suits brought against them by their patients. Legal actions against dentists are not new in Malaysia, where several actions have been litigated in court. The rise in legal actions against medical professionals including dentists is associated with the increased awareness of patient’s rights and autonomy. Legal actions can cause several repercussions on dentists such as loss of reputation, shame and anxiety. As such, it is imperative for dentists to have the basic legal knowledge on the potential legal liability that they may face should something go wrong during the course of dental treatment. This is the main crux of this paper where several dento-legal cases that have been reported in Malaysian law journals are identified and analysed. This is followed with a brief discussion on the legal issues surrounding those cases. Legal principles governing the issues identified are provided in brief so as to provide dentists with basic legal knowledge on the legal aspect of dentistry.

Sufficient informed consent to medical treatment of adults legal and ethical perspectives from Malawi

This special communication discusses the current legal and ethical requirements for informed consent to medical treatment of adults in Malawi. It analyzes the scope of the laws and code of ethics on professional discipline, including criminal privilege for surgeries and clarifies when insufficient disclosures entitle patients to compensation under civil law. Inconsistencies and uncertainties in the law are made apparent. It evaluates to which degree disclosure standards of other Commonwealth jurisdictions (e.g. the case of Montgomery) would be suitable for the health care setting of a country like Malawi that is characterized by shortages of resources, high illiteracy rates and a communitarian cultural context. Doctor-patient communication is not alien to African culture and part of sufficient informed consent. In order to balance the need for efficiency in health care delivery, accountability for quality care, fairness and effective patient-doctor communication the authors suggest to adopt the reasonable patient test only, if a defence of heavy workload on case-to-case basis is introduced at the same time. This does not dispense the need for organisational diligence on part of the institutional health care provider within its capacity

Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis

Objectives: Medical malpractice complaints are apparently on the rise in Ghana. Though it has been suggested that medico-legal training programmes should emphasise the kinds of legal problems that healthcare staff encounter most frequently in practice, no comprehensive study currently analyses the pattern and outcomes of existing case laws. Design: Systematic content analysisData sources: Medical malpractice case laws sourced from Ghanaian legal repositories, media platforms and other grey literature sources. Results: Nine case laws were retained. Most of the cases (n=7) involved negligence. Emerging patterns of cases are complex, including patients' access to their medical records, practising without a license/ out of scope, refusal to treat, and the development of complications following surgical interventions. Obstetrics & Gynaecology, Surgery, and Paediatrics were the main clinical specialties involved in the malpractice cases identified. Conclusions: The pattern of the cases suggests that all medical specialties are potentially at risk, although most of the cases emerged from Obstetrics & Gynaecology, Surgery, and Paediatrics. Medico-legal training for healthcare staff should emphasise the duty of care and adherence to the Ghana Health Service Patient Charter

Relationship between Hemineglect and Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials / Relación entre heminegligencia y dolor: Una revisión sistemática y metanálisis de ensayos controlados aleatorizados

ABSTRACT Objective: To identify the relationship between hemineglect and pain. Methods: We conducted a systematic review with meta-analysis, examining the relationship between hemineglect and pain. The PRISMA criteria and the Covidence platform were used to select articles and extract data. Methodological quality was evaluated, a comparison was made using pain as an outcome measure, assessed with the visual analog scale (VAS). Results: Out of a total of 340 studies, 4 were selected, 2 of which made it possible to unify pain measured through VAS; the effects were summarized using standardized mean differences (SMD), yielding -0.65, with values of [-1.02, -0.29], with statistical significance. Conclusions: There is moderate evidence of the relationship between negligence and pain. Despite the fact that from the clinical care processes it is presented regularly, and even the little scientific information available, it was established that there are specific pathologies that carry negligence and pain.

RESUMEN Objetivo: Identificar la relación entre heminegligencia y dolor. Métodos: Realizamos una revisión sistemática con metanálisis que examina la relación entre heminegligencia y dolor. Se utilizaron los criterios PRISMA y la plataforma Covidence para seleccionar artículos y extraer datos. Se evaluó la calidad metodológica, se realizó una comparación utilizando el dolor como medida de resultado, evaluado con la escala visual analógica (EVA). Resultados: De un total de 340 estudios, se seleccionaron 4, de los cuales 2 permitieron unificar el dolor medido mediante EVA; los efectos se resumieron utilizando diferencias de medias estandarizadas (DME), obteniendo -0,65 con valores de [-1,02, -0,29] con significancia estadística. Conclusiones: Existe evidencia moderada de la relación entre negligencia y dolor. A pesar de que a partir de los procesos de atención clínica se presenta con regularidad y aún con la poca información científica disponible, se estableció que existen patologías específicas que conllevan negligencia y dolor.

Vítimas de maus-tratos, negligência ou abandono em estado do Nordeste Brasileiro / Victims of bad treatment, negligence or abandonment in a Northeast Brazilian state / Víctimas de malos tratos, descuido o abandono en un estado del Noreste del Brasil

Objetivo: descrever a situação epidemiológica de pessoas que foram vítimas de maus-tratos, negligência ou abandono em um estado do nordeste brasileiro. Método: Trata-se de estudo exploratório e descritivo, com abordagem quantitativa e dados retrospectivos, desenvolvido com dados obtidos do Sistema de Informação de Agravos de Notificação. Resultados: A população compreendeu pessoas atendidas e notificadas nos serviços próprios e conveniados ao Sistema Único de Saúde, por causas de maus-tratos, negligência ou abandono, entre 2015 e 2018. Observou-se que a maior parte era do sexo feminino (59,6%), na faixa etária de até 9 anos (56,4%) e residentes da zona urbana (79,1%). Quanto as pessoas que cometeram maus-tratos, negligência ou abandono, a maioria era do sexo feminino, não havia ingerido bebida alcóolica e a violência foi motivada por conflito geracional (20%). Conclusão: Evidenciou-se a necessidade de políticas públicas que proteja as crianças e as pessoas que estão em situação de vulnerabilidade.(AU)

Objective: describes an epidemiological situation of people who have been victims of abuse, neglect or abandonment in a state in northeastern Brazil. Method: This is an exploratory and descriptive study, with a quantitative approach and retrospective data, developed with data obtained from the Notifiable Diseases Information System. Results: The population comprised people attended and notified in the services themselves and under the Unified Health System, due to maltreatment, neglect or abandonment, between 2015 and 2018. It was observed that the majority were female (59, 6%), aged up to 9 years (56.4%) and residents of the urban area (79.1%). As for people who committed abuse, neglect or abandonment, the majority were female, had not drunk alcohol and violence was motivated by generational conflict (20%). Conclusion: The need for public policies to protect children and people who are in a situation of vulnerability was highlighted.(AU)

Objetivo: describe una situación epidemiológica de personas que han sido víctimas de abuso, negligencia o abandono en un estado del noreste de Brasil. Método: Se trata de un estudio exploratorio y descriptivo, con enfoque cuantitativo y datos retrospectivos, desarrollado con datos obtenidos del Sistema de Información de Enfermedades Notificables. Resultados: La población estuvo conformada por personas atendidas y notificadas en los propios servicios y en el Sistema Único de Salud, por maltrato, negligencia o abandono, entre 2015 y 2018. Se observó que la mayoría eran mujeres (59, 6%), de hasta 9 años (56,4%) y residentes del casco urbano (79,1%). En cuanto a las personas que cometieron maltrato, abandono o abandono, la mayoría eran mujeres, no habían bebido alcohol y la violencia estuvo motivada por conflicto generacional (20%). Conclusión: Se destacó la necesidad de políticas públicas para proteger a la niñez y a las personas en situación de vulnerabilidad.(AU)

Negligência Familiar: Implicações na Aprendizagem Escolar de Estudantes com Deficiência Visual / Family Neglect: Implications on the School Learning of Visually Impaired Students

Resumo: No âmbito da Educação Especial, o presente artigo procurou compreender as interferências da negligência familiar no que se refere aos processos de aprendizagem de estudantes com deficiência visual. Para tanto, foi realizada uma pesquisa de natureza básica, com abordagem qualitativa. Quanto aos objetivos, o estudo caracterizou-se como exploratório descritivo. O delineamento adotado foi o estudo de caso. Foram empregados, na pesquisa, como instrumentos de produção de dados, sete atas de ocorrências escolares referentes a duas estudantes com deficiência visual e cinco entrevistas focalizadas, a saber: duas entrevistas com as estudantes, duas entrevistas com os professores de classe e uma entrevista com a educadora especial da instituição onde ocorreu a pesquisa. Estes constituíram-se o público-alvo do estudo, que aconteceu no espaço de uma escola pública do interior do Rio Grande do Sul. A análise de conteúdo foi adotada para a interpretação dos dados, apontando a existência de três categorias de análise, quais sejam: negligência familiar, aprendizagem de estudantes com Deficiência Visual e troca de guarda. Como resultado, a negligência familiar destaca-se como um fator que interfere negativa e substancialmente, não só na aprendizagem, mas, sobremaneira, nas atitudes, nas relações interpessoais e nos sentimentos dos que vivem sob essa realidade, especialmente os estudantes com deficiência visual.

Abstract: In the context of Special Education, this article sought to comprehend the family neglect interference regarding the learning processes of students with visual impairment. For that, a basic research, with a qualitative approach was, carried out. Concerning the objectives, the study was characterized as exploratory descriptive. The adopted design was the case study. In the research, seven school occurrence records regarding two visually impaired students and five focused interviews, namely: two interviews with the students, two interviews with the classroom teacher and one interview with the special educator from the institution where the research took place. These subjects constituted the target audience of this study, which occurred in the space of a public school in the hinterlands of Rio Grande do Sul, Brazil. The content analysis was adopted for data interpretation, pointing out the existence of three categories of analysis, namely: family neglect, learning of visually impaired students and changing custody. As a result, family neglect is highlighted as a factor which interferes negatively and substantially not only in learning but also in attitudes, interpersonal relationship, and feeling of those who live under this reality, especially visually impaired students.

As (novas) tecnologias e o (velho) problema da determinação da responsabilidade penal nas equipas médicas / The (new) technologies and the (old) problem of the determination of criminal liability in medical teamwork / Las (nuevas) tecnologías y el (antiguo) problema de determinar la responsabilidad penal en equipos médicos

Objetivo: discutir a determinação da responsabilidade penal dos profissionais de saúde que atuam em equipa, convocando o princípio da divisão do trabalho e o princípio da confiança. Metodologia: utilizou-se o método dedutivo, em que se avaliou a validade do princípio da confiança no âmbito da divisão do trabalho nas equipas de saúde, analisando a seu enquadramento dogmático no Direito Penal. Resultados: a doutrina penal divide-se quanto ao modo de determinação da responsabilidade por negligência, em caso de pluralidade de agentes, sobretudo no âmbito da divisão de trabalho vertical. Conclusão: a partir do princípio da divisão do trabalho e do princípio da confiança, é possível determinar a responsabilidade penal de cada membro de uma equipa de saúde quando da atuação negligente resultar uma ofensa à integridade física ou mesmo a morte do paciente.

Objective: to discuss the determination of criminal liability of health professionals who work in teams, based on the principle of division of labor and the principle of trust. Methodology: the deductive method was used, in which the validity of the principle of trust in the scope of the division of labor in the health teams was evaluated, correlating it with the criminal aspects. Results: the penal doctrine is divided as to the way of determining liability for negligence in the case of plurality of agents, especially within the scope of the vertical division of labor. Conclusion: from the principle of division of labor and the principle of trust, it is possible to determine the criminal responsibility of each member of a health team when negligent performance results in an injury to the physical integrity or even the death of the patient.

Objetivo: este documento tiene como objetivo discutir la determinación de la responsabilidad penal de los profesionales de la salud que trabajan en equipo, con base en el principio de división del trabajo y el principio de confianza. Metodología: se utilizó el método deductivo, en el cual se evaluó la validez del principio de confianza en el alcance de la división del trabajo en los equipos de salud, analizando su marco dogmático en Derecho Penal. Resultados: la doctrina penal se divide en cuanto a la forma de determinar la responsabilidad por negligencia en el caso de la pluralidad de agentes, especialmente dentro del alcance de la división vertical del trabajo. Conclusión: desde el principio de división del trabajo y el principio de confianza, es posible determinar la responsabilidad penal de cada miembro de un equipo de salud cuando el desempeño negligente resulta en una lesión a la integridad física o incluso la muerte del paciente.

Unintended Formalin Injection instead of Local Anesthetic Agent: Its Causes & Management

Mistakes do happen in every profession instead of properprecautions. Mishaps are those unfortunate accidents thatoccur during treatment, some owing to inattention to detail,others being very unpredictable and some are due to thenegligence of the employee. Dental negligence may lead tosevere complications and may threaten one's life. This casereport presents an unconventional case of administeringformalin in lieu of local anesthesia in a dental clinic leading tochemical cellulitis and its management.

Cuidados inconsistentes durante a infância e relações de apego na adolescência: um estudo de caso / Inconsistent childhood care and adolescent attachment relationships: a case study

O presente trabalho consiste em um estudo de caso clínico de uma adolescente, realizado em um serviço de atendimento psicológico. Ao longo da terapia sistêmica individual foram abordados aspectos da história da paciente, como negligência, perdas, adoção intrafamiliar e apego inseguro. O processo terapêutico considerou a paciente no contexto da sua história, rede de relacionamentos e experiências, enfatizando os significados que ela atribuía a esses eventos. Assim, dentro das particularidades do caso, trabalhou-se para compreender o impacto na relação entre o tipo de cuidado recebido na infância e o apego na adolescência e construção de self. Entende-se que esse estudo pode contribuir para se pensar em estratégias de intervenção sistêmica que auxiliem a mudança na visão de pais ou cuidadores com relação ao apego de adolescentes.

This work consists in a clinical case study of a female teenager, held in a psychological service. Throughout the individual systemic therapy aspects of the patient's history were addressed, such as negligence, losings, intra-family adoption and insecure attachment. The therapeutic process considered the patient in the context of her history, relationships' network and experiences, emphasizing the meanings that she attributed to these events. Thus, within the particularities of the case, the clinical work aimed to understand the impact on the relationship between the type of care received in childhood, attachment in adolescence and self-construction. This study may contribute to elaborate strategies of strategies of systemic intervention that help change the vision of parents or caregivers with regard to attachment of adolescents.

Congenital Chagas disease: alert of research negligence

Abstract INTRODUCTION: Chagas disease (CD), a neglected endemic disease in Latin America, has acquired new epidemiological characteristics with an increase in the importance of alternative transmission routes such as congenital transmission. We evaluated the scientific research on this subject. METHODS: We searched the Scielo, BVS, and PubMed databases from 2006 to 2017. RESULTS: We identified a small number of published articles, mostly in journals with an impact factor less than 3.0. Studies on human congenital transmission of CD were carried out in only seven different countries. CONCLUSIONS: Our data highlight the lack of research on congenital CD.