Esperanza L. Gómez-Durán

Bio: Esperanza L. Gómez-Durán is an academic researcher from International University Of Catalonia. The author has contributed to research in topics: Malpractice & Medicine. The author has an hindex of 14, co-authored 121 publications receiving 781 citations. Previous affiliations of Esperanza L. Gómez-Durán include Autonomous University of Barcelona & American Board of Legal Medicine.

The impact of the COVID-19 pandemic on the mental health of healthcare professionals.

Abstract: Introduction Healthcare professionals (HPs) have been confronted by unprecedented traumatic experiences during the COVID-19 pandemic, especially in countries that had not experienced similar epidemic outbreaks in recent years Aim To analyze the impact of the COVID-19 pandemic on the mental health of HPs Method We comprehensively reviewed the studies published in MEDLINE (PubMed), Web of Science and Google Scholar between December 2019 and May 2020 Results Most studies report a high prevalence of anxiety and depressive symptoms among HPs that can be associated with: a) COVID-19 exposure; b) epidemiological issues; c) material resources; d) human resources; and e) personal factors The role of certain variables, before, during and after the pandemic, remains unexplored Longitudinal studies will help elucidate which factors are associated with a higher risk of developing long-lasting negative effects Qualitative studies may contribute to understanding the influence of individual and social narratives in HPs' distress Conclusion A deeper analysis on the individual, institutional, political and socio-cultural factors, meanings and values influencing HPs distress and resilience during the COVID-19 pandemic is needed

Sexting: research criteria of a globalized social phenomenon.

Abstract: We read with great interest the study on sexting by high school students reported by Strassberg, McKinnon, Sustaita, and Rullo (2012).Theyaccuratelyhighlightedmethodological limitations ofpreviousstudies, someof thempublished in thepopularpress. Sexting definitional problems were also pointed out. We agree that most studies used vague definitional terms and heterogeneous descriptions. As noted by Lounsbury, Mitchell, and Finkelhor (2011), reporting very different sexting rates can lead to public misperception. Representativeness of samples also seems doubtful. Table 1 summarizes a review of main research findings, including our own unpublished data. We conducted a survey among university students, using a self-administeredquestionnaire.Wemostlyreplicatedtheonline questionnaire designed for the study on sexting conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy (2008). However, in our study, participants were present at the time of the survey. Percentages reported for our sample were higher than those previously described. This finding could be related to an older age of the sample (M, 20.4 years, SD = 3.0). Strassberg et al. (2012) emphasized that age effect and parents’ next-room presence during the interview may lead to an underestimation of the overall prevalence of sexting among minors. Therefore, we would like to vindicate the benefits of direct surveys of young adults, as asking adults retrospectively may diminish reluctance to answer about their teen-experiences (assuming that there would be other biases). Sexting is a social phenomenon; thus, cross-cultural differences may occur. Spanish media do not pay substantial attention to this phenomenon; yet, public policies are limited and scientific information in this area comes almost entirely from the U.S. Mitchell, Wolak, and Finkelhor (2007) reported a higher percentage of unwanted exposure to pornography among Hispanic participantsandFerguson(2012)studiedyoungHispanicwomen, reporting similar percentages to the results of previous studies with non-Hispanic samples. If country-specific features apply for our situation, the interpretations of epidemiological data from outside our borders may create inaccurate impressions that can be misleading and thus may hinder public health and educational interventions. Nevertheless, our results were similar or somewhat higher to those internationally reported, notwithstanding the lack of awareness of public opinion of this silent problem. Despite sample differences among studies, our results and literature review point to a globalized presence of sexting. Potentially serious legal and psychological consequences for teens have been reported (Strassberg et al., 2012) and developmentally appropriate prevention strategies that target youths directly are needed (World Health Organization, 2011). The World Health Organization (2011) states that ‘‘the most polarizing public health threat presented by the Internet may be as a means to intentionally or unwittingly jeopardize the safety of children and adolescents.’’ However, less than a quarter of responding countries legally require the use of safety tools and security technologies inpublicInternetfacilitiesusedbychildren (the United States being the most progressive region in implementing these measures). In an increasing digitalized world, child usage of new technologies presents both enormous possibilities and challenges. Current scientific data, such as reported by Strassberg et al. (2012), point to the importance of countries and international J. R. Agustina E. L. Gomez-Duran Department of Criminal Law and Criminology, Universitat Internacional de Catalunya, Barcelona, Spain

Legal medicine contributions to patient safety. From ascertainment and evaluation to research in medical liability

Abstract: We would like to congratulate Ferrara et al. for their thoughtful Guidelines on Methods of Ascertainment and Criteria of Evaluation in cases of suspected subjective medical liability [1]. Medical errors, patient safety and professional liability are worldwide concerns nowadays [2, 3]. Regulatory frameworks and national operative systems are certainly different from one country to another [2], but the scientific approach to cases ascertainment should not differ substantially across borders and this Guidelines will help favour the desired harmonisation of European legal medicine [4]. This homogenization of methods of ascertainment will definitively contribute to strengthen the guarantees in professional liability procedures, but this first step should be followed by a shift to prevention and patient safety. Claims data analysis could be the pathway to that new scenario. Interference of the liability system with the clinical practice cannot be denied—being defensive medicine one of its main reported consequences [2]—but the core aims of the liability system are to deter harm and compensate those who sustain negligent injury [5]. The liability system should foster access to and the quality of all health services and medical malpractice policies should be guided by the best evidence available [5]. Evidence comes from research and although only a small proportion of negligent injuries lead to a claim, still data from litigation claims represent a potentially rich source of learning from failure and is clearly underexploited [3]. Claims are the visible manifestation of adverse outcomes of care and some of them could be potentially avoidable. Detailed examination of claims can be used to identify a number of recurrent problems or types of error. A better method of cases ascertainment will result in more reliable and richer data and the participation of medico-legal experts in both the assessment and the data analysis will guarantee the results usefulness. Different publications regarding claim analysis can be found in the USA from different sources [6]. Regarding medicolegal issues, the nucleus with the greatest scientific productivity in Europe lies in Germany, Great Britain, France, Italy and Spain. “Malpractice branch” of medicolegal publishing is especially important in Great Britain, Switzerland and Spain [7]. In the UK, illustrative case histories are published by the Medical Defence Union and Medical Protection Society (which provide cover against negligence for individual practitioners in primary care and in private practice) as an aid to learning among their members [8]. In Spain, the Professional Liability Service (PLS) of the Catalonian Colleges of Physicians (CCP) manages the main professional liability insurance in the region of Catalonia and holds its own historical database of over 7,000 claims since 1986. This model of liability coverage is managed by the PLS of the CCP, assuring the best interests of professionals and patients, but relies on one of the main insurers in the country, which guarantees sustainability and stability [9]. The PLS publishes analyses of its data to maximise the opportunities for collective learning. Highlighting its usefulness, this research is supported by a grant from the Instituto de Salud Carlos III, which manages the Health Research and Development Strategy in our country. We strongly believe that a model of liability insurance, such as the Catalonian Model, that includes research in the field of negligence litigation enhances those policies considered as the most promising ones [10]. First, the identification of specific areas of substandard care trough claims analysis can guide the development of quality improvement (QI) programs. Second, the model is run by the PLS of the CCP, with long years of experience and the potential to head QI plans and foster E. L. Gómez-Durán (*) : J. Arimany-Manso Professional Liability Service, Collegi Oficial de Metges de Barcelona, Passeig de la Bonanova, 47, 08017 Barcelona, Spain e-mail: elgomezduran@gmail.com

Psychological impact of quarantine on healthcare workers

Abstract: Objectives Exposure to infection is an inherent occupational risk for healthcare workers and may lead them to undergo quarantine during disease outbreaks. Both front-line battle and quarantine are stressful experiences that may make psychological support for healthcare workers necessary. Psychological support measures based on the best available evidence should be included in emergency plans worldwide. We summarise the research evidence on the psychological impact of quarantine on healthcare workers. Methods We retrieved 470 articles on the psychological impact of quarantine on healthcare workers from the Web of Science and included in this review all 12 articles that met our inclusion criteria. Results The reviewed studies reported acute stress during quarantine and long-lasting depressive, post-traumatic stress and alcohol dependency and abuse symptoms. Healthcare workers fear infection for themselves, but more so for their loved ones, and are also concerned about the stigma that may affect their families, most especially their children. Conclusions The safety of healthcare workers and their families during disease outbreaks needs to be ensured. Suitable alternative accommodation and personalised monitoring during quarantine are useful intervention measures to prevent adverse effects in healthcare workers. Clear public health communication will help reduce uncertainty, guilt and stigma. Financial aid should be considered for the more severely affected workers. Finally, mental healthcare for healthcare workers should be a priority, as quarantines can be a mental distress trigger. The development of efficient referral paths and the provision of counselling or psychotherapy during the confinement period are an opportunity for early mental health interventions.

Epidemiology of Suicide and the Psychiatric Perspective.

Abstract: Suicide is a worldwide phenomenon. This review is based on a literature search of the World Health Organization (WHO) databases and PubMed. According to the WHO, in 2015, about 800,000 suicides were documented worldwide, and globally 78% of all completed suicides occur in low- and middle-income countries. Overall, suicides account for 1.4% of premature deaths worldwide. Differences arise between regions and countries with respect to the age, gender, and socioeconomic status of the individual and the respective country, method of suicide, and access to health care. During the second and third decades of life, suicide is the second leading cause of death. Completed suicides are three times more common in males than females; for suicide attempts, an inverse ratio can be found. Suicide attempts are up to 30 times more common compared to suicides; they are however important predictors of repeated attempts as well as completed suicides. Overall, suicide rates vary among the sexes and across lifetimes, whereas methods differ according to countries. The most commonly used methods are hanging, self-poisoning with pesticides, and use of firearms. The majority of suicides worldwide are related to psychiatric diseases. Among those, depression, substance use, and psychosis constitute the most relevant risk factors, but also anxiety, personality-, eating- and trauma-related disorders as well as organic mental disorders significantly add to unnatural causes of death compared to the general population. Overall, the matter at hand is relatively complex and a significant amount of underreporting is likely to be present. Nevertheless, suicides can, at least partially, be prevented by restricting access to means of suicide, by training primary care physicians and health workers to identify people at risk as well as to assess and manage respective crises, provide adequate follow-up care and address the way this is reported by the media. Suicidality represents a major societal and health care problem; it thus should be given a high priority in many realms.

Sudden infant death syndrome

Abstract: The term: SID syndrome applies to sudden and unexpected death of the infant for which no diagnostic fetal factor has been found. It is also applied to sudden death of a less than one year old baby, the cause is not recognizable after complete post mortem study, and review of disease records. Such a death will be a very bitter and sorrowful experience for the family, therefor the nurses are bound to support the family both mentally and spiritually.

Consensual sexting among adolescents: Risk prevention through abstinence education or safer sexting?

Abstract: Sexting – that is, the private exchange of self-produced sexual images via cell phone or the internet – has been widely discussed in public and academic discourses as a new high-risk behavior among youths (especially girls) that should be prevented through better education about the various and severe risks it poses. This paper summarizes existing data on sexting prevalence (17 studies), which reveal that sexting is much more common among adults than among youths, with increasing prevalence among adolescents as they grow older. The paper then looks at the current state of sexting research by reviewing all 50 sexting papers in the PsycINFO and PubMed databases published between 2009 and 2013 regarding their coverage of the risks and/or opportunities associated with sexting. Most of the papers (79%) address adolescent sexting as risky behavior and link it to sexual objectification and violence, to risky sexual behavior, and to negative consequences like bullying by peers and criminal prosecution under child pornography laws. In opposition to this deviance discourse, a normalcy discourse is appearing in the literature that interprets sexting as normal intimate communication within romantic and sexual relationships, both among adults and adolescents who are exploring and growing into adult relationships. Next, the paper analyzes the sexting risk prevention messages of 10 online educational campaigns. Such campaigns typically rely on scare scenarios, emphasize the risk of bullying and criminal prosecution, engage in female victim blaming, and recommend complete abstinence from sexting. The paper closes by questioning the abstinence approach in sexting education, and makes suggestions on how to move towards an evidence-based approach to sexting risk prevention that acknowledges both adolescents' vulnerability and sexual agency.

International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder.

Abstract: OBJECTIVES: Bipolar disorder is associated with a high risk of suicide attempts and suicide death The main objective of the present study was to identify and quantify the demographic and clinical correlates of attempted and completed suicide in people with bipolar disorder METHODS: Within the framework of the International Society for Bipolar Disorders Task Force on Suicide, a systematic review of articles published since 1980, characterized by the key terms bipolar disorder and 'suicide attempts' or 'suicide', was conducted, and data extracted for analysis from all eligible articles Demographic and clinical variables for which ≥ 3 studies with usable data were available were meta-analyzed using fixed or random-effects models for association with suicide attempts and suicide deaths There was considerable heterogeneity in the methods employed by the included studies RESULTS: Variables significantly associated with suicide attempts were: female gender, younger age at illness onset, depressive polarity of first illness episode, depressive polarity of current or most recent episode, comorbid anxiety disorder, any comorbid substance use disorder, alcohol use disorder, any illicit substance use, comorbid cluster B/borderline personality disorder, and first-degree family history of suicide Suicide deaths were significantly associated with male gender and first-degree family history of suicide CONCLUSIONS: This paper reports on the presence and magnitude of the correlates of suicide attempts and suicide deaths in bipolar disorder These findings do not address causation, and the heterogeneity of data sources should limit the direct clinical ranking of correlates Our results nonetheless support the notion of incorporating diagnosis-specific data in the development of models of understanding suicide in bipolar disorder Language: en