The Present Legal Status Regarding the Utilization of Mechanical or Pharmacological Restraints in Psychiatric and Social-Health Settings.

No abstract present.

Physical restraints in nursing homes: A qualitative study with multiple stakeholders.

AIM: This study aims to understand the perceptions regarding physical restraints of the elder-care professional's stakeholders. DESIGN: A qualitative methodology was employed. METHODS: Semi-structured interviews were conducted with a convenient sample of 19 participants, which included nursing homes' managers, nurses and physicians; law, ethics, quality or patient rights' protection experts in care and public servers with responsibilities in the field. The data were collected, recorded and verbatim transcribed. A thematic analysis approach was used to analyse the data. RESULTS: Three main themes emerged: the use of restraints, organizational issues and regulation. Although professionals involved in nursing care agree that improvements have been made, they highlight the negative impact of restraints and the need for a change in culture about their use. Yet, they have concerns about the 'zero restraints' feasibility, with divergent views on the need for a stronger regulatory framework.

Nonconsensual Condom-Use Deception: An Empirically Based Conceptualization of Stealthing.

In recent years, the act of stealthing, also termed nonconsensual condom removal (NCCR), has become an emerging important topic related to nonconsensual sexual experiences. We performed a rapid review by searches in Web of Science (245 articles), Medline (157 articles), and PsycINFO (72 articles). The studies, in English, French, Italian, or Spanish, that reported empirical data on stealthing were included, except for those focusing on the legal response to the phenomenon. The final sample of 16 articles of various design is analyzed. According to this review, more than 10% of women experience stealthing in their lifetime, and men having sex with men also experience stealthing. The article describes the empirical research literature in the field, explores terminological and conceptual challenges, and proposes a new and more comprehensive term (nonconsensual condom-use deception), and a revised definition and categorization of the behavior, according to the concrete manifestation of consent breach, the associated practices, or the underlying motivation. We argue that research, as well as policy and practice responses to this growing problem need to be guided by a conceptual framework that uses information gathered directly from those who experienced it.

Professional Liability in Plastic Surgery: A Change of Scenario in Medical Professional Liability in Spain.

The epidemic of complaints and/or litigation, both in and out of court, for cases of alleged malpractice has increased dramatically. In Spain, claims related to plastic surgery are gaining more and more interest. Methods: The Council of Medical Associations of Catalonia database was used to analyze claims related to plastic surgery from 1986 to 2021. Results: 1039 claims (9.8% over 10,567 total claims) were studied. Both the total number of claims (P = 0.016; R2=0.16) and the number of claims for plastic surgery (P < 0.0005; R2=0.732) showed an upward trend during the period of study. In the period from 2000 to 2021, the behavior was different; while the number of total claims stabilized (P = 0.352; R2 = 0.043), plastic surgery claims continued to show a time-related tendency to increase (P < 0.0005; R2=0.484). The distribution was 50.12% out of court. Ten unique procedures accounted for 84.5% of the total number of claims. Liability was observed in 21.46% of the closed claims, with differences between civil (20.34%), criminal (6.89%), and out-of-court (25.53%) procedures. Regarding compensation amounts, out-of-court cases had an average of 33,169.44 euros paid; civil cases, 29,153.37 euros; and criminal cases, 37,186.88 euros. Conclusions: The increase in the number of cases can only be related to an increase in the activity carried out by plastic surgeons. There has been a change in Spain in terms of the most sought-after medical specialty, with plastic surgery having displaced the perennially most sought-after specialty, orthopedic surgery and traumatology.

Clinical Safety Recommendations for Testicular Torsion: Analysis of 101 Claims Settled with Compensation in Spain and France.

INTRODUCTION: The study aimed to analyze testicular torsion (TT) claims settled with compensation to have data available as the basis for making recommendations to decrease clinical risk and prevent claims. TT is a urological emergency with a high rate of orchiectomy, representing one of the main reasons for urological claims. METHODS: Data were analyzed from personal majority policy and from the public sector of Catalonia (Spain), as well as data from the main medical civil liability insurance firm at healthcare centers in France in the period from January 1, 2000 to December 31, 2018. RESULTS: Fifty Spanish and 51 French cases were analyzed. Statistical differences were logged in the two settings analyzed in performing ultrasounds, in the area where primary care was provided and with regard to settlement amounts. Diagnosis was late in 76.2% of cases. DISCUSSION: The medical action time from the onset of symptoms and Doppler testicular ultrasound in cases of questionable differential diagnoses is key to prognoses to save the testicles. Properly filling out the emergency report and the rest of medical records are essential for receiving correct medical care and defending possible claims.

On-call-related sleep deprivation and hypomania in healthcare workers.

OBJECTIVE: Acute sleep deprivation can induce antidepressant effects. We hypothesized that overnight calls can trigger symptoms of hypomania during the post-on-call period. METHODS: Online anonymous cross-sectional survey among Spanish-speaking healthcare professionals, including the Hypomania Symptom Checklist-32 (HCL-32). RESULTS: 2099 respondents. Most of them reported that they usually feel worse on their post-on-call period (91,3%), but the 51,6% acknowledged having felt better at least once and 33,4% reported it happened in at least at 50% of their calls. Up to 4,9% reached the cut-off at HCL-32. Males, younger professionals, those with less years of practice and residents were more likely to full fit hypomania criteria. Participants and their environment correctly identified the symptoms and their negative consequences. CONCLUSIONS: On-calls with sleep deprivation may trigger hypomanic symptoms with reported negative consequences among healthcare professionals, showing how working conditions' impact in professionals' wellbeing and raising concerns about decision-making performance after long-lasting working shifts.

Can routine Primary Care Records Help in Detecting Suicide Risk? A Population-Based Case-Control Study in Barcelona.

OBJECTIVES: To characterize people who died by suicide after having previous contacts with public health system using the data available in a primary care setting. METHOD: A retrospective, population-based case-control study identified through autopsy reports subjects who died from suicide between 2010 and 2015 in Barcelona province. Those who had previous interaction with primary healthcare services were selected, and 20 controls per case with similar age, sex and residence area were randomly sampled from a primary healthcare medical database; the available medical data derived from routine primary care records were anonymised and retrieved for analysis in all subjects. RESULTS: Of 2109 people deceased by suicide, 971 had previous primary healthcare interactions; 33.8% aged over 65 and 74% men. Of those with previous contact, 33% died during the week after and 58.5% within one month. A multivariable analysis identified several significant risk factors in the database, including previous suicide attempts, psychiatric diagnosis, number of primary healthcare visits, referrals to mental health, number of drugs prescribed, recent psychoactive drug prescriptions, and being on sick leave due to mental conditions in the previous year. CONCLUSIONS: Nearly half of suicide subjects contacted primary healthcare before dying but remained either undetected or not effectively managed for prevention. In cases who interacted, available data on risk factors included high frequentation and being on sick leave due to mental health disorders, in addition to other well-known factors. Routine electronic medical records represent an opportunity to provide clinical-decision support tools that could be implemented through automatized risk calculation.HIGHLIGHTSMost of suicide patients had a recent interaction with the healthcare systemWell known risk factors were available in the routine electronic medical recordsAdditional alerting tools could be implemented through automatized risk calculation.