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Search Results: 1 - 10 of 44 matches for " Grettchen; "
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El médico en procesos judiciales
Flores-Sandí,Grettchen;
Acta Médica Costarricense , 2008,
Abstract: medical expert opinion is commonly required by courts as evidence, and one of the most important fundamentals of effective expert testimony is to understand the process, and to maintain an ethical behavior. also, physicians who provide expert testimony should have recent and substantive experience and knowledge in the area in which they testify. there are several basic rules the expert witness should consider when testifying.
Importancia de la entrevista médico forense en la evaluación del abuso sexual en el paciente pediátrico
Flores-Sandí,Grettchen;
Acta Médica Costarricense , 2007,
Abstract: abstract justification: even in confirmed cases of childhood sexual abuse, the child?s interview is often the most important element in its determination. during the pediatric sexual forensic analysis there are clinical differences and rules that must be followed and that can influence the outcome of the assessment objective: to analyze the importance of forensic interview in the evaluation of sexual abuse in pediatric patients. methodology: a randomized prospective study was conducted during the first semester of 2006, at the forensic clinic of the legal medicine department in costa rica. the variables analyzed were: cause of consultation, age, nationality, years of school, accompanying person during the evaluation, source of information (direct or indirect), type of abuse or contact, willingness or unwillingness to collaborate, the presence of obvious lesions and physical disabilities found. result: the sample was of 53 children. the reason of consultation in 40 cases was sexual abuse, in 12 it was rape and in 1 it was corruption of minors, 79% of the individuals were female. only 1 person was not costa rican and in 4 cases the source of information was indirect. the ages were between 2 and 12 years old, 47 % were below 6 years of age and 40 children were accompanied with their mothers. in 36 cases there was hand/finger contact and only in 7 cases there was important previous medical record. genital injuries were found only in 2 cases, contusions in an extra genital área in 2 cases too, and nonspecific erythema was found in 3 cases. all the patients collaborated with the physical examination and none had a physical disability as a consequence. conclusion: the most important aspect in a forensic legal evaluation is the expertise of the medical examiner who should be able to transmit this to stimulate the cooperation of the children to be evaluated.
Síndrome de Cronos
Flores-Sandí,Grettchen;
Acta Médica Costarricense , 2011,
Abstract: occupational health aims to promote and maintain the highest degree of physical, mental and social wellness of the workers. in recent years a new type of occupational hazards that are related to psychosocial factors are becoming important issues in the workplace for the illnesses associated. in general terms, the cronos syndrome refers to the pathological fear of the person who occupies a superior position to promote their subordinates for fear of being displaced or replaced. diagnosis is based on performance characteristics, fear of delegating, pathological social relationships, egocentrism, self-deception and limited development. this condition may have comorbidity with other disorders associated to organizational culture as in mobbing, workaholism and presenteeism. treatment may require an approach in two ways, in addition to providing treatment for the psychophysical symptoms, aid workers to develop effective response mechanisms at work, including proper management of organizational culture, work climate diagnosis, promoting communication and risk prevention.
Serendipia médica en un error de prescripción: Un caso de denuncia por mala práctica médica
Flores-Sandí,Grettchen;
Acta Médica Costarricense , 2006,
Abstract: a 22 year old female, student, prosecute her doctor of mal praxis. although a prescription error was demonstrated by the authorities, the really important reason to judge the case in court, was the absence of damage. because in this particular case the drug cured the patient. the medicolegal analysis was based on: the absence of sequelae secondary of this mistake; the indications of the utilized medication; the illness and the terapeutical effect of the prescribed medication; and iatrogenesis and serendipity.
Consideraciones sobre el consentimiento del paciente en la prueba pericial médica
Flores-Sandí,Grettchen;
Acta Médica Costarricense , 2011,
Abstract: the aim of the expert medical evaluation is to collaborate with judges and court in the evaluation of medical aspects of a person undergoing a judicial process, in order to facilitate reaching a correct justice administration. regardless of the reported incident, in the context of clinical forensic medicine, the patient’s consent has some ethical, informative and particular aspects to be considered by the medical expert, in order to full fill the legal requirements.
Presentismo: potencialidad en accidentes de salud
Flores-Sandí,Grettchen;
Acta Médica Costarricense , 2006,
Abstract: el concepto de salud ha sobrepasado el entorno propiamente sanitario y cada vez más, tiene otras implicaciones sociales, la institución de salud es hoy en día una actividad compleja donde no solamente se gestiona la prevención y tratamiento de las enfermedades de los usuarios sino al recurso humano encargado de su atención. asimismo en la actualidad se reconoce la importancia del recurso humano para la organización y surge el concepto de "presentismo", referido a aquellos trabajadores que sufren enfermedades que los obligarían a ausentarse del trabajo pero que se presentan a trabajar sin cumplir eficazmente sus funciones. al respecto y en relación con el presentismo, se debe tomar en cuenta que los efectos adversos o accidentes durante la atención de servicios de salud se encuentran asociados a factores fisiológicos, psicológicos y ambientales e implican desde el punto de vista administrativo, una falla en la productividad, que afecta tanto al usuario del servicio como al trabajador. se debe considerar que este grupo profesional se ubica entre los grupos de riesgo del presentismo y que con el fin de administrar y reducir el presentismo se requieren estrategias preventivas por parte de la gerencia de salud.
Perspectivas futuras de las actividades de educación medica continua en Costa Rica
Flores Sandí,Grettchen;
Medicina Legal de Costa Rica , 2004,
Abstract: the process of continued medical education would be favored if the people in charge of this activities consider the academic quality of the teachers, because is important have in mind the comprehension, interests, motivations and attitudes of the doctors and the aspects of the educative process, such as the theories and teaching and evaluation methods that allow them to accomplish their pedagogical objectives. it is possible to identify elements of the educative projects that need to be included in the programs of continued medical education, for instance: define learning objectives, methodological techniques and evaluation techniques of the acquired knowledge, the required time to complete the contents and define the proper profile of the assistants and of the teacher who participates in this types of programs, always trying to improve the learning / teaching process. both have to be qualified - the people in charge and the teachers of these activities - to carry out the processes that make the development of the educational action possible: analysis of the needs, programming, design and elaboration of methodologies, technique execution, evaluation, and follow up of the acquired knowledge. moreover, the people in charge must be aware that the learning - teaching process involves the student, the teacher, and a learning situation, and in this way this triad becomes the subject of evaluation. the capacitating process to the people in charge must be oriented, among others, to empower their abilities to improve the quality of the teaching - learning process, enhance efficient communication, increase critical and investigative attitudes, and develop the evaluation abilities of the acquired knowledge.
El suicidio en la población femenina en Costa Rica. 1983-1993
Flores Sandí,Grettchen;
Medicina Legal de Costa Rica , 1995,
Abstract: a total of 170 autopsy records dealing with female suicide in costa rica for a ten year period were studied. the greatest suicide frequency was in the group of women that were; aged 15-20 years, single, costa ricans, from the urban metroplitan area and housewives. the most frequent method was poisoning, the cause is still unknown in many cass and the higher counts correspond to april-october. albeit poisoning has long been the main method, hanging, jumping and self-shooting with fire arm have increased slightly in frequency during this period.
Indicadores de calidad en la pericia forense
Flores Sandí,Grettchen;
Medicina Legal de Costa Rica , 2004,
Abstract: if the legal-medical determinations are an instrument of quality in the attention to the patient in clinical services, we must ask ourselves if they reach high quality standards and if they are being elaborated in accordance with the established protocols laid down for such purpose. the quality of the forensic evaluation made by the medic is of great importance, because it is this report, be it oral or written, initial or definitive, that the judicial authority will use as element of proof to consider and to dictate sentences. the elaboration of quality requirements constitute an instrument to evaluate the medical services and the health centers, by making use of objectives and standards previously established. in the medical-forensic clinic, until 1999, the internal control quality of the legal-medical dictaminations was based on the final inspection made by the head of section and the head department, when they had to review them and/or legalize them. the evaluation that makes use of quality indicators of medical attention were nor defined until the year 2000 in the section of medical forensic clinic. the quality of the attention must be verified in the structure, the process and in the result of the attention, therefore, this essay will be used to present a series of process indicators.
Alternativa terapéutico administrativa para El "homicidio moral"
Flores Sandí,Grettchen;
Medicina Legal de Costa Rica , 2005,
Abstract: leadership, as a gift of service, supposes that working skills in directing human resources requires specialized training. nevertheless, there are situational, organizational and individual factors that favor some kind of authoritarism, such as moral harassment by those who occupy authoritative places. preventing and treating this organizational pathology must be a priority in modern day organizations, given the loss of positive economic results and the diminishment of the competitivity that this generates. some therapeutical alternatives stated are: construction of a shared vision and common genuine values, reflexive openness, training and transparency of working relations.
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