Asistencia sanitaria y servicios sociales: enseñanza y aprendizaje significativo en talleres técnicos por el método de proyecto / Healthcare and social services: meaningful teaching and learning in technical workshops by the project method

Los derechos humanos, incluyendo la concreción del derecho a la salud, en Perú, contempla el mandato dirigido a los poderes públicos para que organicen la asistencia sanitaria, como elemento causal, específico y adopten el conjunto de medidas necesarias para lograr la prevención de las enfermedades o la mejora de las condiciones sanitarias generales, mediante el método de proyecto en el proceso enseñanza-aprendizaje se abordan los principios rectores de la política social y económica, contenidos del Estado social, y los mecanismos de justiciabilidad y exigibilidad. Se estudió el proceso enseñanza y aprendizaje significativo sobre asistencia sanitaria y servicios sociales en los talleres técnicos, en la Facultad de Derecho y Ciencias Políticas, de la Universidad Peruana Los Andes, durante el periodo lectivo 2019-II. En el egresado conlleva la interacción entre los conocimientos y la información nueva que recibe, en este proceso se construye un nuevo conocimiento o profundiza en los ya existentes. Este conocimiento es organizado y sistemático con conexiones interdisciplinarias entre ideas, se promueve desde el trabajo en equipo y colaborativo, capaz de vencer ambigüedades, complejidades y a lo impredecible; y aprovecha los recursos o herramientas de la vida real, por lo que el método de proyecto es una herramienta pedagógica aplicable a la formación del abogado(AU)

Human rights, including the realization of the right to health, in Peru, contemplates the mandate directed to the public powers to organize health care, as a causal, specific element and adopt the set of measures necessary to achieve the prevention of diseases or the improvement of general sanitary conditions, through the project method in the teaching-learning process, the guiding principles of social and economic policy, contents of the social State, and the mechanisms of justiciability and enforceability are addressed. The teaching and meaningful learning process on health care and social services was studied in technical workshops at the Faculty of Law and Political Sciences, Universidad Peruana Los Andes, during the 2019-II school period. In the graduate, it involves the interaction between knowledge and the new information received, in this process a new knowledge is built or deepens existing ones. This knowledge is organized and systematic with interdisciplinary connections between ideas, it is promoted from team and collaborative work, capable of overcoming ambiguities, complexities and the unpredictable; and it takes advantage of the resources or tools of the real life, reason why the project method is a pedagogical tool applicable to the training of the lawyer(AU)

Assédio moral: uma análise a partir da percepção de advogados que defenderam trabalhadores assediados / Moral harassment: an analysis based on the perception of lawyers who defended harassed workers

O assédio moral tem reverberado em pedidos indenizatórios junto ao poder judiciário trabalhista, e muitos deles têm sido negados. Dentre os motivos, estão as inconsistências apresentadas pelos advogados nos processos judiciais. Desse modo, o objetivo desta pesquisa é analisar a compreensão dos advogados em relação ao assédio moral no trabalho, por meio de um estudo qualitativo com 16 advogados, que defenderam ao menos um processo de assédio moral. Os dados oriundos de entrevistas foram tratados por análise de conteúdo, gerando categorias temáticas a posteriori. Os principais achados indicaram compreensões sobre o assédio moral divergentes do embasamento jurídico e psicológico, em termos de definição e caracterização, bem como quanto à distinção entre assédio e dano moral. Ademais, os advogados informaram os principais meios de prova utilizados, as dificuldades no estabelecimento do nexo causal entre assédio e adoecimento e relataram condutas enganosas que contribuem para fragilizar a noção de assédio moral. Os resultados geram preocupações quanto ao enfrentamento do assédio moral no trabalho, indicando a necessidade de qualificar a compreensão dos advogados.

Moral harassment has reverberated in claims for damages to the labor justice system, and many of them have been denied. Among the reasons are the inconsistencies presented by lawyers in lawsuits. Thus, the objective of this research is to analyze the understanding of lawyers in relation to bullying at work, through a qualitative study with 16 lawyers, who defended at least one case of moral harassment. Data from interviews were treated using content analysis, generating thematic categories a posteriori. The main findings indicated understandings of moral harassment that differed from the legal and psychological basis, in terms of definition and characterization, as well as the distinction between moral harassment and moral damage. Furthermore, the lawyers informed the main means of evidence used, the difficulties in establishing the causal link between harassment and illness, and reported misleading conduct that contributes to weakening the concept of moral harassment. The results raise concerns about coping with bullying at work, indicating the need to improve lawyers' understanding on the subject.

Assessment of the relationship between stress and performance in candidates for the Brazilian Bar Association examination

Abstract Objective: This study investigated stress and performance levels in candidates for the Brazilian Bar Association examination (Exame da Ordem dos Advogados do Brasil) in Rio Grande do Sul, Southern Brazil. Methods: The following instruments were used: A sociodemographic data sheet, Lipp's Stress Symptom Inventory for Adults, the Ways of Coping Scale, the Adult Self-Report Scale, and the Self-Report Questionnaire. The final sample comprised 117 candidates, aged from 18 to 59 years (mean = 29.7, standard deviation = 7.8), 76 women (65%) and 41 men (35%). Results: In the first phase of the examination, 67 candidates were approved (57.3%), but there was no significant difference in terms of stress: stress symptoms were present in 76.1% of the successful candidates and 62% of the unsuccessful candidates; (χ2 (1) = 2.09; p = 0.148). In terms of stress phases, 70.6% of the successful candidates (n = 36) were in the resistance phase and 78.4% of these had psychological symptoms. The mean age of successful candidates (28.2 years) was lower than that of unsuccessful candidates (31.7 years); (t (115) = −2.48; p = 0.015). Attention deficit/hyperactivity disorder symptoms were detected in 18 successful candidates (26.9%) and 6 unsuccessful candidates (12.2%); (χ2 (1) = 2.85; p = 0.091). Conclusions: Candidates who were successful in the first phase of the Brazilian Bar Association examination tended to be younger and scored higher for attention deficit/hyperactivity disorder symptoms, but their stress levels did not differ from those of unsuccessful candidates.

Abogacía de salud, la partaqe olvidada de la promoción de salud en medicina familiar / Health Advocacy, the forgotten part of health promotion in family medicine

Introducción: La abogacía de salud es una estrategia de la promoción de salud y un componente esencial y fundamental de ella, mas no siempre se ve así, a veces se confunde o se intercambia con la promoción de salud misma. Objetivo: Realizar una revisión bibliográfica sobre el término abogacía de salud y su relación con la promoción de salud y la medicina familiar. Métodos: Análisis documental de la literatura encontrada en bases de datos y análisis y síntesis de estos documentos desde un enfoque socio-histórico y lógico. Conclusiones: A pesar de que es un tema sugerido para su inclusión en los programas de formación de medicina familiar según los estándares globales de la Organización Mundial de Médicos de Familia y Generales (2013), existen muy escasas referencias en la literatura hispana y latinoamericana de medicina familiar. La abogacía de salud es habitualmente subestimada y obviada como parte de la promoción de salud en medicina familiar, es una actitud, una competencia y una responsabilidad social del médico en general(AU)

Introduction: Health advocacy is a health promotion strategy and an essential and fundamental component of it, but it does not always looks like this, sometimes it is confused or exchanged with the promotion of health itself. Objective: To carry out a bibliographical review on the term health advocacy and its relationship with the promotion of health and family medicine. Methods: Documentary analysis of the literature found in data and analysis bases, and summary of these documents from a socio-historical and logical approach. Conclusions: Although it is a suggested topic for inclusion in family medicine training programs according to global standards of the World Organization of Family and General Physicians (2013), there are very few references in the Hispanic and Latin American literature on Family Medicine. Health advocacy is usually underestimated and ignored as part of health promotion in family medicine, it is an attitude, a competence and a social responsibility of the general practitioners(AU)

Coalizões de advocacia e estratégias de negociação na revisão do Código Florestal / Coaliciones de causa y estrategias de negociación en la revisión del Código Forestal Brasileño / Advocacy coalitions and negotiation strategies in the revision of the forest code

Resumo Este artigo analisa as coalizões de advocacia (meio ambiente e agricultura) estabelecidas durante a revisão do Código Florestal brasileiro e as principais estratégias de negociação adotadas. Entrevistas, análise de documentos e notícias de jornais de grande circulação possibilitaram captar como os gestores do Ministério do Meio Ambiente (MMA) e do Ministério da Agricultura, Pecuária e Abastecimento (Mapa) lideraram tais coalizões. A teoria do Advocacy Coalition Framework (ACF) foi utilizada na análise das coalizões. Os resultados demonstram que esses ministérios recorreram à negociação como estratégia principal. A coalizão agricultura também investiu em informação científica, ao passo que a coalizão meio ambiente investiu em mobilização social.

Resumen El trabajo tiene como objetivo analizar las coaliciones de causa (medio ambiente y agricultura) establecidas durante la revisión del Código Forestal Brasileño y las estrategias de negociación principales que se utilizan. Entrevistas, análisis de documentos y de los principales periódicos de noticias permiten captar como gestores de los ministerios de Medio Ambiente (MMA) y de Agricultura, Ganadería y Abastecimiento (Mapa) lideraron estas coaliciones. La teoría de advocacy coalition framework (ACF) se utiliza para el análisis de las coaliciones. Los resultados mostraron que ambos ministerios utilizan la negociación como estrategia principal. La coalición agricultura invirtió en información científica, mientras que la coalición medio ambiente invirtió en movilización social.

Abstract This study aims to analyze the advocacy coalitions (classified as 'environment' and 'agriculture') established during the revision of the Brazilian Forest Code and the main negotiation strategies used. Interviews, analysis of documents and newspaper' reports allowed capturing how the managers of the Ministries of Environment (MMA) and Agriculture, Livestock and Supply (Mapa) led these coalitions. Coalition analysis used the Advocacy Coalition Framework (ACF). Results showed both ministries used negotiation as their main strategy. The agriculture coalition invested in scientific information, while environment coalition carried out social mobilization.

Os efeitos da coprodução nos resultados da conciliação judicial: a percepção da sociedade sobre um serviço inovador / Los efectos de la coproducción en los resultados de la conciliación judicial: la percepción de la sociedad de un servicio innovador / The effects of coproduction on judicial conciliation results: society's perception of an innovative service

Resumo Este estudo examinou os efeitos da coprodução e das competências do prestador de serviços nos resultados da conciliação judicial no Tribunal de Justiça do Distrito Federal e Territórios (TJDFT), a partir da percepção de satisfação das partes litigantes e dos advogados usuários do serviço. A conciliação judicial é uma inovação do Poder Judiciário que visa a aumentar a eficiência e o valor gerado pelos serviços de Justiça e trata-se de um processo coproduzido, no qual os usuários participam da prestação dos serviços públicos. Para alcançar o objetivo proposto, utilizaram-se dados secundários provenientes da pesquisa de satisfação do usuário elaborada e aplicada pela equipe técnica do TJDFT e a amostra final, após o tratamento dos dados, consistiu em 1.735 partes litigantes e 764 advogados. Para análise dos dados, aplicaram-se as técnicas de análise fatorial exploratória e de regressão logística e os resultados sugerem que a coprodução é a variável com maior poder preditivo dos resultados do serviço, tanto para o cidadão como para a imagem do Poder Judiciário, na perspectiva das partes. Por fim, os resultados do serviço para o cidadão, se positivos, aumentam a probabilidade da imagem do Poder Judiciário também ser positiva, na percepção dos dois grupos investigados.

Resumen Este estudio examinó los efectos de la coproducción y las competencias del prestador de servicios en los resultados de la conciliación judicial en el Tribunal de Justicia del Distrito Federal y Territorios (TJDFT), a partir de la percepción de satisfacción de las partes litigantes y de los abogados usuarios del servicio. La conciliación judicial es una innovación cuyo propósito es aumentar la eficiencia y el valor generado por los servicios de justicia y se trata de un proceso coproducido, en que los usuarios tienen un papel esencial en la prestación de los servicios públicos. Para alcanzar el objetivo propuesto, se utilizaron datos secundarios provenientes de la encuesta de satisfacción del usuario, elaborada y aplicada por el equipo técnico del TJDFT y la muestra final, después del tratamiento de los datos, consistió en 1.735 partes litigantes y 764 abogados. Para el análisis de los datos, se aplicaron las técnicas de análisis factorial exploratorio y de regresión logística, y los resultados sugieren que la coproducción es la variable con mayor poder predictivo de los resultados del servicio, tanto para el ciudadano como para la imagen del Poder Judicial, desde la perspectiva de las partes. Por último, los resultados del servicio para el ciudadano, si fueran positivos, aumentan la probabilidad de que la imagen del Poder Judicial también sea positiva, según la percepción de los dos grupos investigados.

Abstract This study examined the effects of coproduction and the competencies of the service provider on the results of the Judicial Conciliation at the State Courthouse of Distrito Federal, based on the satisfaction of the litigants and lawyers who used the service. The Judicial Conciliation is an innovation to increase efficiency and results for the general public and is a coproduced process, in which the users play an essential role in the provision of public services. The study used secondary data obtained from a customer satisfaction survey designed by the TJDFT. The final research sample consisted of 1,735 litigants and 764 lawyers. For the data analysis, exploratory factor analysis and logistic regression were used, and the results of the regressions suggest that coproduction is the variable that best explains the results of the service for the customers as well as for the reputation of the Judiciary, from the perception of the litigants. Finally, the perception that the service was beneficial to citizens increases the likelihood of the customer to develop a positive image of the Judiciary, according to the results obtained both in the litigants' and lawyers' samples.

Responsabilidad médica frente a casos de violencia al interior de las familias. Una mirada desde una perspectiva ética y legal / Medical responsibility in cases of violence within families. A look from an ethical and legal perspective

La violencia al interior de las familias (VIF), en sus distintas formas y con distintas víctimas, es un problema que nos toca en forma transversal a las distintas disciplinas médicas.En Chile, una de cada tres mujeres reporta haber experimentado VIF, y cerca de 45 mueren cada año por esta causa. Como país hemos optado por hacernos cargo de esta situación y nos hemos trazado como meta reducir la morbilidad, discapacidad y mortalidad prematura asociada a violencia, y, específicamente, a reducir los femicidios en un 33 por ciento. La denuncia es un instrumento legal que puede ayudar a este propósito.Este artículo reflexiona sobre conceptos médicos, legales y éticos involucrados en el abordaje inicial de una víctima de VIF, con especial foco en la denuncia. Se discute sobre los alcances de la nueva legislación vigente en Chile en materia de VIF, sobre la responsabilidad legal y ética del médico en Chile frente a este problema de salud, y sobre la postura de la Organización Mundial de la Salud al respecto. (AU)

Domestic violence (DV), in its different forms and with different victims, is a problem that affects us across several medical disciplines. In Chile, one out of three women reports being subject of domestic violence, and approximately 45 die each year for this reason. As a country, we have decided to deal with this situation, and we have self-imposed the goal of reducing morbidity, disability and premature mortality associated with violence, and to reduce femicide in 33 percent. Making a legal complaint is a tool that can help to achieve this purpose. The current article reflects on medical, legal and ethical concepts involved in the initial approach to a victim of domestic violence, with a focus in the act of make a legal complaint. We discuss the scope of the current legislation in Chile, about the legal and ethical responsibility of physicians confronted with this health problem, and about the position of the World Health Organization on this matter.(AU)

Analysis of Penalties Imposed on Organisations for Breaching Safety and Health Regulations in the United Kingdom

BACKGROUND: The study analyzes penalties imposed on organizations for breaching safety and health regulations. The research questions are as follows: what are the commonly breached safety and health regulations? How proportional are penalties imposed on organizations for breaching health and safety regulations in the United Kingdom? METHODS: The study employed sequential explanatory mixed research strategies for better understanding of health and safety penalties imposed on organizations. Actual health and safety convictions and penalties data for 10 years (2006 to 2016) were obtained through the United Kingdom Health and Safety Executive (HSE) public register for convictions. Overall, 2,217 health and safety cases were analyzed amounting to total fines of £37,179,916, in addition to other wide-ranging penalties. For thorough understanding, eight interviews were conducted with industry practitioners, lawyers, and HSE officials as part of the study qualitative data. RESULTS: Findings show that the Health and Safety at Work (HSW) Act accounted for 46% of all HSE prosecution cases in the last decade. This is nearly half of the total safety and health at work prosecutions. Moreover, there is widespread desire for organizations to comply with the HSW Act, but route fines are seen as burdensome and inimical to business growth. CONCLUSION: A key deduction from the study reveal significant disproportionality concerning penalties imposed on organizations for breaching safety and health regulations. On aggregate, small companies tend to pay more for health and safety offenses in a ratio of 1:2 compared to large companies. The study also reveals that the HSW Act accounted for nearly half of the total safety and health at work prosecutions in the last decade.

No fault compensation in perinatal medicine in Japan-from results for 8 years

No fault compensation in perinatal medicine has been established to provide aid to patients in the event of disability due to a medical accident during delivery and to strive to resolve disputes quickly that contributes to reduce medical malpractice suit in the field of perinatal medicine. Furthermore, this system is aimed to establish a mechanism that achieves higher quality of obstetric care by analyzing the causes of accidents. This system is operated by Japan Council for Quality Health Care and 99.9% of childbirth facilities in Japan registered with this compensation system. Compensation system has two major functions including compensation and cause analysis and recurrence prevention based on cases. Compensation eligibility is reviewed in the Review Committee at the organization in Japan Council for Quality Health Care and currently 1,717 cases are judged as eligible cases out of 2,250 since 2009. The cause of each eligible case is analyzed in the Cause Analysis Committee one by one. The Cause Analysis Committee has 7 independent subcommittee and each subcommittee members are consistent of obstetricians, neonatologists, pediatricians, midwives and lawyers. Original cause analysis report is sent to childbirth facility and patient's family. Questionnaire survey demonstrated that 73% of childbirth facilities and 65% of patient family were satisfied with the cause analysis report. The number of medical lawsuit in obstetrics and gynecology is significantly decreased compared to those in all medical departments since the compensation system was introduced suggesting that these cause analysis reports may contribute the decrease in medical lawsuits. The major purpose of the Recurrence Prevention Committee is striving to prevent future cases of cerebral palsy and to improve the quality of obstetric care. To accomplish the purpose, the committee routinely collect information from individual cases and analyze quantitatively and epidemiologically. Furthermore the committee choose subject from cases to discuss for future prevention and provide wide public disclosure of the information with recommendation. The committee issued 6 reports until now and these reports have been distributed to childbirth facilities, perinatal medicine-related scientific society and administrative agencies.

Autoavaliação da comunicação em promotores de justiça em um estado do nordeste, Brasil / Communication self-assessment by public prosecutors in a north-eastern Brazilian state

RESUMO Objetivo Descrever a autoavaliação do promotor de justiça quanto à sua comunicação e reação do ouvinte e analisar a relação com o gênero, idade e anos de trabalho. Método Desenho descritivo, transversal. Foi elaborado um questionário e enviado aos 126 promotores, sendo devolvidos 33 questionários preenchidos. As variáveis independentes foram o gênero, idade e anos do exercício profissional. As variáveis dependentes foram a autoavaliação da comunicação ao longo dos anos de trabalho, os parâmetros de comunicação utilizados e a reação do ouvinte. Foi realizada análise descritiva e o Teste Exato de Fisher. Resultados A amostra foi constituída por ambos os gêneros, mediana de 43 anos de idade e 20 anos de trabalho. A maioria dos respondentes referiu que ao falar em público sente desmotivação, insegurança, tensão e dificuldade de persuadir o ouvinte. Houve maior proporção em mulheres de piora da comunicação ao longo dos anos de trabalho que em homens. Todas as mulheres relataram insegurança ao falar em público. Um terço dos promotores referiu alteração de voz. Os respondentes com mais de 43 anos de idade tiveram maior proporção de voz alterada que aqueles com idade menor. A maioria dos promotores com mais de 20 anos de trabalho revelou insegurança ao falar em público comparado com aqueles com idade menor. Conclusão Os promotores identificam seus parâmetros fortes e fracos da comunicação. O gênero, idade e tempo de profissão influenciam o desempenho comunicativo.

ABSTRACT Purpose To describe how public prosecutors self-assess their communication approaches and how listeners react to them; to analyze how this relates to gender, age, and work experience. Methods Descriptive, transversal study. A questionnaire was developed and sent to 126 public prosecutors for completion. Thirty-three completed questionnaires were sent back. The independent variables were gender, age, and number of years of professional experience. The dependent variables were communication self-assessment throughout the years of work, communication parameters used, and listeners’ reactions. A descriptive analyzis and Fisher’s Exact Test was carried out. Results the sample contained both male and female participants with a median age of 43 years and an average of 20 years of professional experience. Most of the respondents claimed they had experienced demotivation, insecurity, tension, and difficulty when trying to convince listeners. More women than men reported they felt that their communication had worsened throughout their careers. All the women reported they experienced insecurity when speaking in public. One third of the public prosecutors stated they suffered from disorders on their voice. Those respondents aged over 43, experienced greater proportion on voice change than younger ones. In contrast to their younger colleagues, the majority of public prosecutors with more than 20 years of professional experience revealed that they felt insecure when speaking in public. Conclusion the public prosecutors identified their strong and weak communication parameters. Gender, age, and work experience affect communicative performance.

Reflexões sobre práticas psi-jurídicas na triagem da Defensoria Pública Paulista / Reflections on psycho-legal practices in the triage of the Public Defender's Office of São Paulo / Reflexiones acerca de las prácticas psi-jurídicas en la selección de la Defensoría Pública Paulista

Neste artigo, apresentamos alguns desdobramentos da pesquisa de doutorado na qual estudamos encontros psi-jurídicos na Defensoria Pública do Estado de São Paulo, tomando a experiência dos Centros de Atendimento Multidisciplinar (CAMs) como objeto. Por meio da metodologia qualitativa da pesquisa-intervenção que contou com a elaboração de diários e de narrativas, empreendemos o acompanhamento das práticas profissionais que envolviam o trabalho conjunto de defensores, assistentes sociais e psicólogos na Defensoria Pública, entre 2011 e 2013. Aqui, privilegiamos mostrar a triagem, espaço no qual é feito o primeiro atendimento às pessoas que buscam assistência jurídica, que nos possibilitou nos aproximar da gestão dos pedidos e de como eles se transformam em demandas jurídicas, não jurídicas e psicossociais. Para tanto, utilizamos informações das fichas dos encaminhamentos feitos a um CAM nos anos de 2010 e 2011, com situações vivenciadas no percurso da pesquisa. Os operadores conceituais do estudo se apoiam no pensamento foucaultiano e na Análise Institucional francesa. A triagem mostrou que se privilegia a partilha tradicional entre os saberes, tendendo-se a (re)produzir uma assistência jurídica "desintegrada" e disciplinarizada, oferecendo-se um modo familialista de resposta às problemáticas apresentadas pela população. No entanto as questões de saúde mental emergem como algo que escapa às divisões, produzindo desvios no processo de trabalho. Acreditamos que esses modos de saber-fazer engendram uma assistência jurídica que tende à atenção integral, constituindo-se numa experiência de pensar-saber-fazer entre profissões que não se submete aos protocolos e divisões já instituídos.

In this article, we presented some developments of the doctoral research in which were studied psycho-legal encounters at the Defensoria Pública do Estado de São Paulo (Public Defender's Office of the State of São Paulo), taking the experience of the Centros de Atendimento Multidisciplinar (Multidisciplinary Assistance Centers­CAMs, acronym in Portuguese) as subject. Through a qualitative intervention-research methodology based on diaries and narrative construction, we have monitored professional practices involving the joint work of defenders, social workers and psychologists at the Public Defender's Office, between 2011 and 2013. Here, we decided to focus on the triage, space where the first assistance to people who look for legal help is performed, which allowed us to get in contact with the management of requests and the way they become legal, non-legal and psycho-social demands. In order to do that, we used information from referral forms sent to a CAM in the years 2010 and 2011, along with situations experienced in the course of this research. The theoretical references of this study are Foucault's thought and French Institutional Analysis. The triage showed that a traditional division between knowledges is utilized, which tends to (re)produce an "unintegrated" and disciplined legal assistance, providing a familialist mode of response to the problems presented by the population. However, mental health issues emerge as something that escapes divisions, producing shifts in the work process. We believe these ways of knowing-how-to-do generate a legal assistance that tends to be more oriented to comprehensive care, constituting anexperience of thinking-knowing-doing between professions that does not submit to protocols and divisions already established.

En este artículo, presentamos algunas evoluciones de la investigación de Doctorado de en la que estudiamos los encuentros psi-jurídicos en la Defensoría Pública del Estado de São Paulo, teniendo la experiencia de los Centros de Atendimiento Multidisciplinar (CAMs) como objeto. Por intermedio de la metodología cualitativa de la investigación-intervención que incluyó la elaboración de diarios y narrativas, se llevó a cabo el estudio de prácticas profesionales en la Defensoría Pública, entre 2011 y 2013. Aquí, centramos en la que muestra el espacio de selección, en el que se hace la primera atención a las personas que buscan asistencia jurídica, lo que hizo posible acercarse a la gestión de pedidos y respecto a cómo ellos se convierten en exigencias jurídicas, no jurídicas y psicosociales. Para eso, utilizamos informaciones de los registros de derivaciones al CAM, locus de la investigación en 2010 y 2011 y del informe elaborado por la Asesoría Técnica Psicosocial (ATP), cuyos datos presentan el trabajo de equipos de CAM en 2011, además de las situaciones vividas en el camino de la investigación. Los operadores conceptuales del estudio se basan en el pensamiento de Foucault y en el Análisis Institucional francesa. La selección mostró favorecer la división tradicional entre los saberes, tendiendo a (re)producir una asistencia jurídica "desintegrada", disciplinarizada y despolitizada, que ofrece una forma familialista de la respuesta a los problemas presentados por la población. Sin embargo, las cuestiones de salud mental emergen como algo que escapa a las divisiones, produciendo desvíos en el proceso de trabajo. Creemos que estos modos de conocimientos engendran una asistencia jurídica que tiende a la atención integral, constituyéndose en una experiencia de pensar-saber-hacer entre profesiones que no está sujeta a los protocolos y las divisiones ya establecidos.

Análisis epistemológico de la película Philadelphia / Epistemological analysis of the film Philadelphia

La película Philadelphia, filmada en 1993, basada en la lucha de un brillante abogado homosexual con síndrome de inmunodeficiencia adquirida, quien forma parte de una renombrada firma de abogados de la ciudad de Philadelphia, Estados Unidos. Durante el ejercicio de su profesión mantiene en reserva su sexualidad y enfermedad hasta que esta comienza a deteriorar su salud y se hace notoria por las lesiones cutáneas del sarcoma de Kaposi. A partir de allí la firma de abogados sospecha de su padecimiento y lo despide alegando negligencia. Durante el juicio los personajes principales, el Dr. Andrew Beckett, representado por el actor Tom Hanks, quien es el discriminado y el Dr. Joe Miller representado por el actor Denzel Washington, su abogado defensor ante el juicio contra el bufete; van estableciendo una relación y un cambio de perspectiva, sobre todo del abogado defensor, esa intersubjetividad, que está ligada al encuentro, la lucha entre el reconocimiento reciproco, se analiza desde la escuela epistemológica social-humanista de Hegel-Marx y desde el Relativismo de Fleck.

Informed Consent as a Litigation Strategy in the Field of Aesthetic Surgery: An Analysis Based on Court Precedents

BACKGROUND: In an increasing number of lawsuits doctors lose, despite providing preoperative patient education, because of failure to prove informed consent. We analyzed judicial precedents associated with insufficient informed consent to identify judicial factors and trends related to aesthetic surgery medical litigation. METHODS: We collected data from civil trials between 1995 and 2015 that were related to aesthetic surgery and resulted in findings of insufficient informed consent. Based on these data, we analyzed the lawsuits, including the distribution of surgeries, dissatisfactions, litigation expenses, and relationship to informed consent. RESULTS: Cases were found involving the following types of surgery: facial rejuvenation (38 cases), facial contouring surgery (27 cases), mammoplasty (16 cases), blepharoplasty (29 cases), rhinoplasty (21 cases), body-contouring surgery (15 cases), and breast reconstruction (2 cases). Common reasons for postoperative dissatisfaction were deformities (22%), scars (17%), asymmetry (14%), and infections (6%). Most of the malpractice lawsuits occurred in Seoul (population 10 million people; 54% of total plastic surgeons) and in primary-level local clinics (113 cases, 82.5%). In cases in which only invalid informed consent was recognized, the average amount of consolation money was KRW 9,107,143 (USD 8438). In cases in which both violation of non-malfeasance and invalid informed consent were recognized, the average amount of consolation money was KRW 12,741,857 (USD 11,806), corresponding to 38.6% of the amount of the judgment. CONCLUSIONS: Surgeons should pay special attention to obtaining informed consent, because it is a double-edged sword; it has clinical purposes for doctors and patients but may also be a litigation strategy for lawyers.

The Korean Medical Association and self-regulation

According to the World Medical Association Declaration of Madrid on Professionally-led Regulation, physicians have been granted a high degree of professional autonomy, which is an essential component of high quality medical care. As a result, physicians have a continuing responsibility to be self-regulating. Historically, credible self-regulation has required maintaining professional competence, identifying problem physicians and conflicts of interest, and taking appropriate action. Recently, our society had two incidents that gave patients strong doubts about the professional expertise of physicians. The Korean Medical Association should consider the following in promoting its self-regulatory policies. First, if the structure of the self-regulation of lawyers is instructive, self-regulation completely independent from the government is unlikely to be realized. KMA or independent bodies should exercise primary authority and responsibility for self-regulation, and if this is not implemented well, it is reasonable that the Department of Health and Human Services should intervene. Second, the Ethics Committee of KMA should avoid political disputes between members and devote itself solely to establishing the core ethics of the medical profession. Third, KMA should inform its members that the ultimate beneficiaries of self-regulation are physicians and patients. KMA must determine the objectives it has in common with the Department of Health and Human Services and create a model of self-regulation.

The Korean Medical Association and self-regulation

According to the World Medical Association Declaration of Madrid on Professionally-led Regulation, physicians have been granted a high degree of professional autonomy, which is an essential component of high quality medical care. As a result, physicians have a continuing responsibility to be self-regulating. Historically, credible self-regulation has required maintaining professional competence, identifying problem physicians and conflicts of interest, and taking appropriate action. Recently, our society had two incidents that gave patients strong doubts about the professional expertise of physicians. The Korean Medical Association should consider the following in promoting its self-regulatory policies. First, if the structure of the self-regulation of lawyers is instructive, self-regulation completely independent from the government is unlikely to be realized. KMA or independent bodies should exercise primary authority and responsibility for self-regulation, and if this is not implemented well, it is reasonable that the Department of Health and Human Services should intervene. Second, the Ethics Committee of KMA should avoid political disputes between members and devote itself solely to establishing the core ethics of the medical profession. Third, KMA should inform its members that the ultimate beneficiaries of self-regulation are physicians and patients. KMA must determine the objectives it has in common with the Department of Health and Human Services and create a model of self-regulation.

A Provincial Population-Based Survey on Attitudes towards Wills of Individuals with Dementia and Related Issues / 신경정신의학

OBJECTIVES: This study investigated the attitudes of a provincial population towards wills of individuals with dementia and related concerns to prevent civil disputes related to dementia in an aging society. METHODS: The target population was registered residents in a province aged 19 years or older. The population forming the sampling frame was 1478821 (as of May 31, 2013). With a confidence interval of 2% and significance level of 5%, 2540 participants were sampled. This survey used a structured questionnaire composed of two main parts : seven items of general information (sex, age, residence, marital status, education, occupation, and income) and Testamentary Capacity-Related Questionnaire-12 items (TCRQ-12) comprising four items of basic knowledge and eight items of specific situational questions, using a five point Likert scale. RESULTS: The respondents were favorable toward the guarantee of will-making capacity of individuals with dementia. Self-relatedness, disadvantageousness and undue influence are significantly associated with objection to the will of individuals with dementia. In the pre-evaluation of testamentary capacity of individuals with dementia, the respondents responded strongly and with more favorable attitudes for evaluation by medical specialists than by lawyers. Last, in acceptance of the denial of self-related will due to dementia, negative response was dominant over positive response. CONCLUSION: Although it would be desirable that the will or testamentary capacity of individuals with dementia should be guaranteed for maximum, institutional and professional approaches are necessary to prevent civil disputes related to dementia.

A profissão de advogado conforme apresentada em jornais paraibanos / La profesión de abogado como aparecen en los periódicos paraibanos / The profession of the lawyer as presented in the newspapers of Paraíba

A pesquisa teve o objetivo de identificar a imagem da profissão de advogado disseminada por um jornal da Paraíba. Seus fundamentos focalizam os conceitos de grupo funcional e identidade coletiva. Desenvolvemos pesquisa documental com análise de conteúdo categórica para tratar o material selecionado: 382 reportagens dos anos de 2001 e 2003. Identificamos duas amplas categorias: (a) ações político-associativas e (b) exercício profissional. Os resultados empíricos nos permitiram identificar aspectos centrais na construção da identidade profissional, como: a influência do exercício profissional e do órgão de representação na sociedade; a atribuição de importância ao poder; e a capacitação entre as preocupações dos profissionais. Em síntese, encontramos uma identidade coletiva refletindo as tradições históricas no país...

El estudio tuvo como objetivo identificar la imagen de la profesión de abogado difundida por un periódico de Paraíba. Sus fundamentos se centran en los conceptos de grupo funcional y de identidad colectiva. Se ha llevado a cabo una investigación documental mediante el análisis de contenido categorial para tratar el material seleccionado: 382 ocurrencias correspondientes a los años 2001 y 2003. Se ha identificado dos grandes categorías: (a) acciones políticas y asociativas y (b) práctica profesional. Los resultados empíricos nos permitieron identificar los aspectos llave en la construcción de la identidad profesional, como: la influencia de la práctica profesional y del órgano de su representación en la sociedad; la atribución de la importancia al poder y la capacitación entre las preocupaciones de los profesionales. En resumen, se ha encontrado una identidad colectiva que refleja las tradiciones históricas del país...

The research aimed to identify the image of lawyer profession as disseminated in a newspaper in Paraíba. It grounded in concepts of functional group, and collective identity. We developed documental research with categorical content analysis to treat the selected material: 382 reports of the years 2001 and 2003. We identified two wide categories: (a) associative and political actions, and (b) professional exercise. The empirical results allowed us to identify core aspects concerning the professional identity formation, such as: the influence of profession exercise and the representative entity in the society; the attribution of importance to power, and professional's preoccupations. In sum, we found a collective identity reflecting the historical traditions in the country...

Family victim advocates: the importance of critical job duties / Conselheiros de proteção às famílias em situação de violação: a importância das funções críticas do trabalho

Child advocacy centers across the United States intervened in more than 250,000 child abuse cases in 2011(National Children's Alliance, 2012). Understanding the work of family victim advocates is imperative to helping children and families in child abuse cases. In this exploratory study, we surveyed advocates and program directors from child advocacy centers (CACs) across the United States to compare their perceptions of the critical job duties of family victim advocates. Data analysis revealed that CAC directors rated the importance of these duties significantly higher than family victim advocates. Results suggest the need for additional training to ensure that family victim advocates understand the importance of critical job duties to meet the needs of children and families in child abuse cases...

Os centros de proteção e defesa da criança interviram em mais de 250 mil casos de abuso infantil em todos os Estados Unidos em 2011 (National Children's Alliance, 2012). Compreender o trabalho de profissionais de proteção e defesa de famílias em situação de violação é imprescindível para ajudar crianças e famílias em casos de abuso infantil. Neste estudo exploratório, realizamos uma pesquisa com os profissionais de proteção e defesa e com os diretores de programa dos centros de proteção e defesa da criança (CPDC) nos Estados Unidos para comparar suas percepções sobre as atividades fundamentais dos profissionais que realizam ações de proteção e defesa de famílias em situação de violação. A análise dos dados revelou que os diretores dos CPDC avaliaram de forma significativamente mais alta a importância do trabalho do que os próprios profissionais de defesa e proteção das famílias em situação de violência. Os resultados sugerem a necessidade melhorar a formação para garantir que os profissionais de defesa e proteção das famílias em situação de violência possam compreender a importância das funções de trabalho que são críticas e essenciais para atender às necessidades de crianças e famílias em casos de abuso infantil...