Peer review to ensure quality in forensic mental health publication.

Peer reviewers have been called the gatekeepers of science. For journal publications in forensic psychiatry, as well as other disciplines, the purposes of peer review are to assist in the selection of manuscripts to publish, improve the quality of manuscripts before their publication, and promote the fairness of the process. In this article, we examine, in particular, characteristics of high-quality peer reviewers, selection of peer reviewers, recruitment and retention of peer reviewers, desired quality of peer-reviewer ratings, and the value of peer review. We conclude with specific, albeit largely untested, recommendations for improvements in peer review of forensic mental health publications.

Legal controls of the medical profession.

PURPOSE OF REVIEW: The authors, after a brief historical review of the theme, review the articles published in the last year. The purpose is to verify how the field has moved on during this period, as a constant increase of legal and social controls on the medical profession is perceived. RECENT FINDINGS: Surprisingly, very few articles treating directly the theme reviewed were found. The better part of the articles examined legal aspects of the medical profession in a nonsystematic way. Among the ones selected those that dealt with internal controls (produced by the professional categories such as the Clinical Practice Guidelines) and those that dealt with external controls (produced by other social groups) could be identified. SUMMARY: The authors conclude that the existence of limits and internal and external controls is fundamental for a professional medical practice of quality. However, the excess of controls, which causes a defensive attitude, may negatively interfere in the quality of the care offered to patients.

[Training and research in forensic medicine: present situation and future challenges for medical schools in Chile]. / Docencia e investigación en Medicina Legal: situación actual y desafíos para las Facultades de Medicina de Chile.

BACKGROUND: Lawyers need some medical knowledge and physicians must know about forensics. AIM: To explore training and research programs in forensic medicine in Chilean universities. MATERIAL AND METHODS: Deans of all Medicine Faculties in Chile were contacted by e-mail and invited to answer a questionnaire containing 21 questions. A survey of Chilean publications on forensic medicine was performed in Medline, Lilacs and SciELO databases. RESULTS: Fourteen deans answered the questionnaire. In all the responding faculties, forensic medicine is an obligatory course, generally during the fifth year and mostly combining theory with practice. In seven faculties, forensic medicine concepts are included in other courses. Forensics is taught in only two of 10 dental schools, two of 17 nursing schools, one of nine midwives schools and one of nine medical technology schools. It is not taught in phonoaudiology, kinesiology and nutrition schools. There are 74 physicians that teach the specialty but only 10 are certified by the National Board of Medical Specialty Certification (CONACEM). Treatment of most topics on forensics is insufficient. Thanatology is the strongest topic and forensic dentistry is the weakest. There are 52 publications in the area, mostly on "medical law". CONCLUSIONS: Forensic medicine is taught in medical schools mostly as thanatology. The knowledge of forensics among medical students is limited and must be improved.

Docencia e investigación en Medicina Legal: Situación actual y desafíos para las Facultades de Medicina de Chile / Training and research in Forensic Medicine: Present situation and future challenges

Background:Lawyers need some medical knowledge and physicians must know about forensics. Aim: To explore training and research programs in forensic medicine in Chilean universities. Material and methods: Deans of all Medicine Faculties in Chile were contacted by e-mail and invited to answer a questionnaire containing 21 questions. A survey of Chilean publications on forensic medicine was performed in Medline, Lilacs and SciELO databases. Results: Fourteen deans answered the questionnaire. In all the responding faculties, forensic medicine is an obligatory course, generally during the fifth year and mostly combining theory with practice. In seven faculties, forensic medicine concepts are included in other courses. Forensics is taught in only two of 10 dental schools, two of 17 nursing schools, one of nine midwives schools and one of nine medical technology schools. It is not taught in phonoaudiology, kinesiology and nutrition schools. There are 74 physicians that teach the specialty but only 10 are certified by the National Board of Medical Specialty Certification (CONACEM). Treatment of most topics on forensics is insufficient. Thanatology is the strongest topic and forensic dentistry is the weakest. There are 52 publications in the area, mostly on "medical law". Conclusions: Forensic medicine is taught in medical schools mostly as thanatology. The knowledge of forensics among medical students is limited and must be improved.

Proficiency test for the analysis of hair for drugs of abuse, organized by the Society of Hair Testing.

Eighteen laboratories interested in the analysis of human hair for drugs of abuse participated in a proficiency test (PT) organized by the Society of Hair Testing (SoHT) in 2001. Samples sent to the participants included one drug-free hair sample and two samples from drug users, sent in the form of short segments previously checked for homogeneity by three reference laboratories. Participants were requested to analyze the samples following the standard procedure used routinely in their laboratories.The compounds present in the samples included opiates, cocaine and metabolite, cannabinoids and amphetamines. All the laboratories analyzed opiates, cocaine and benzoylecgonine (BE); only 10 analyzed amphetamines, and 9 cannabinoids. Various methods were used to extract drugs from the hair-enzyme treatment, acidic, basic and methanol extractions. All the laboratories employed GC-MS, with the exception of two which used GC-MS/MS and LC-MS/MS, respectively. Six laboratories performed initial screening tests by RIA, ELISA or EMIT. Results show that the laboratories performed well qualitatively, since they successfully identified all the analytes that they tested, with the exception of eight false results. However, the scatter of quantitative results was high.

Guía de atención legal para la práctica de atención primaria de salud / En

Esta guía esta dirigida a médicos,estudiantes y personal de salud en atención primaria de salud,para desarrollar habilidades y destrezas a fin de responder a temas prácticos de medicina forence.Se ha tratado de incluir todos los problemas de índole medico-legal en los que se ven inmersos los médicos que están en la Atención Primaria de Salud,tanto hospitalarios,asi como domiciliarios,tiene como propósito fundamental recoger los principales básicos de actuación,documentación médico legal básica y las principales situaciones de este tipo con las que se encuentran en su practica diaria.

El secreto médico: apuntes sobre el secreto profesional del médico forense en Costa Rica / Medical secret: notes on the proffesional secret of the forense physician in Costa Rica

La determinación de lo que puede reputarse como secreto no puede depender exclusivamente de la revelación del confidente sino que es un dato objetivo derivado de la misma pericia, donde se establezca que todo lo que exceda del objeto peritaje deberá mantenerse en secreto por irrelevante que parezca. Lo que es secreto es el conocimiento adquirido, no importa de qué forma, si por revelación del sujeto o por descubrimiento intencional o accidental. El divulgar información profesional que puede causar daño de cualquier tipo: físico, patrimonial, móvil, etc., es delito aún cuando ocurriere otro daño distinto al previsto (dolo eventual) En pericia sólo se debe consignar lo que se peticione. Palabras clave: Secreto, revelación, dictámenes, médico, dolo, información, pericia perseguible

Conocimientos y actitudes de profesionales médicos en tres Hospitales de Arequipa acerca del aborto, año 1994

OBJETIVO DEL ESTUDIO: Determinar el nivel de conocimientos y actitudes de los médicos acerca del aborto. DISEÑO: Descriptivo y transversal. UBICACION: Distrito de Arequipa (Cercado). MUESTRA: Se encuestaron a 263 médicos que trabajaban en el Ministerio de Salud y en el Instituto Peruano de Seguridad Social. METODOS: Se aplicó una ficha encuesta anónima a cada médico que consta de 5 preguntas de conocimientos de aborto, y 11 reactivos de actitudes (según la escala de Likert). RESULTADOS PRINCIPAlES Y CONCLUSIONES: El 60.2 por ciento conoce la definición de aborto y el 42.7 por ciento su frecuencia. Asimismo el 20.8 por ciento conoce lo enunciado en la Constitución Política del Perú, y el 10 por ciento lo prescrito en el Código Sanitario sobre la prohibición de aborto terapéutico de dicho código. Finalmente con respecto a las actitudes aproximadamente el 50 por ciento de entrevistados están de acuerdo con el aborto en caso de malformación congénita fetal. Así mismo lo aprueban el 54.3 por ciento y el 51.3 por ciento en caso de enfermedad física y mental de la gestante respectivamente. De igual forma lo aceptan el 78 por ciento en caso de teratogenecidad farmacológica, el 45 por ciento si hay violación y el 54.3 por ciento en caso de incesto. Mientras que casi la totalidad de médicos lo rechaza en caso de multiparidad y gestante universitaria en su último año de estudios. Se evidencia en general que del 30 a 40 por ciento de entrevistados muestran desinformación y ausencia de criterio unificado acerca del aborto por tanto, actitudes y conocimientos son discordantes al adoptar posturas en contra y a favor del aborto