ETHICS: THE JOURNEY IN SEARCH OF A SATISFYING LIFE.

Background: Health professionals must change the ethics of the "third person", where moral actions carried out by other people are judged as correct / incorrect, for the ethics of the first person oriented to personal excellence, vocation to good and to dignity of a person. Objective: To explore the knowledge and ethical training of health professionals working in the field of Nephrology. Method: A survey of 37 items on the basic notions of ethics was applied to the participants of the annual IMIN Meeting. Results: 85 surveys were obtained, 79% think that the laws enacted today respond to economic interests; 82% express that we cannot accept moral absolutes, however, 89% think that practical reason that directs our behavior recognizes human good in search of plenitude. 44% feel that it is not possible to act according to justice on a regular basis, and 94% express that virtue ethics look to the integral good of the person. Conclusions: The philosophical reflection, so typical of the human being, constitutes an ethical requirement in search of the truth of the good that must be chosen to achieve fullness, in the work of health agents in the field of Nephrology. Keywords: bioethics, nephrology, personal autonomy

La profesión docente ¿elección o inducción?

En este trabajo se reportan los resultados de una investigación sobre los factores que determinan la elección de la profesión docente en el ámbito específico del nivel básico. El estudio se orientó al análisis de las razones que llevaron a los docentes a abrazar la profesión. La investigación se desarrolló a partir de entrevistas a profundidad centradas en las trayectorias conceptuales de categorías relacionadas con las razones de la elección y la satisfacción en el desarrollo de su quehacer docente. El estudio resalta las motivaciones, expectativas, resistencias, adaptaciones y negociaciones que se han producido en el ejercicio mismo de la elección de la profesión docente. La investigación se realizó en la Universidad Pedagógica Nacional Unidad 271 de Tabasco. Las reflexiones finales están referidas al análisis del origen y las distintas razones por las que los sujetos eligieron la docencia como profesión en el nivel de educación básic

La Ley de voluntad anticipada del Distrito Federal en México. Trasplantes e ideología

Background: The law on advance directives (LAD) in Mexico City regulates the will or intent of any person not to undergo unnecessarily life-prolonging treatment. Article 8 of the law stipulates the donation of organs for transplant must be manifest. Objective: The aim of this paper is to document knowledge of LAD.  Materials and methods: A qualitative study was conducted using a previously validated semi-structured interview.  Results: In all, 278 interviews were carried out and 64% of those surveyed were unfamiliar with LAD.    Among those who are familiar with LAD (n = 100), only 43% know what it stipulates regarding organ donation.   Conclusion: There is an evident lack of knowledge about LAD, because the public has not been duly informed.A Lei da Vontade Antecipada (LVA) da Cidade do México regula a vontade de qualquer pessoa para não se submeter a tratamentos que prolonguem sua vida desnecessariamente. A Lei pede, no artigo 8º, a manifestação a respeito da doação de órgãos para transplantes. O objetivo deste trabalho é documentar o conhecimento da LVA. Para isso, realizou-se uma pesquisa qualitativa com uma entrevista semiestruturada, previamente validada. Como resultado, realizaram-se 278 entrevistas. 64% dos entrevistados não conhecem a LVA. Da população entrevistada que tem conhecimento da LVA (n = 100) somente 43% sabem sobre a doação de órgãos. Conclui-se que é evidente o desconhecimento por falta de difusão da LVA.La Ley de voluntad anticipada (LVA) de la Ciudad de México regula la voluntad de cualquier persona para no someterse a tratamientos que prolonguen su vida innecesariamente. La Ley pide, en el artículo 8°, la manifestación respecto de la donación de órganos para trasplante. El objetivo de este trabajo es documentar el conocimiento de la LVA. Para estose realizó una investigación cualitativa con una entrevista semiestructurada, previamente validada. Como resultado se realizaron 278 entrevistas. El 64% de los encuestados no conocen la LVA. De la población encuestada que sí tiene conocimiento de la LVA (n=100) solamente el 43% saben lo referente a la donación de órganos. Se concluye que es evidente el desconocimiento por falta de difusión de la LVA.

Trasplantes en América Latina y el Caribe: difusión del documento de Aguascalientes

The Aguascalientes Document was drafted during the first 2010 Bioethics Forum of the Transplantation Society in Latin America and the Caribbean. The object of the document is to safeguard the integrity of the living donor. This article aims to investigate the Aguascalientes Document among the participants to the 2012 SLANH Congress. A questionnaire was applied, with 21 questions on topics covered by said document. The results show that 36.3% of the respondents accepts the unrelated living donor; 36.3% believes there is a margin of growth in the rate of deceased donors; 57.9% guarantees health with quality immunosuppressive drugs; 61.5% does not know the document. In view of the above, it is concluded that the Aguascalientes Document contains useful recommendations for monitoring the bioethical aspects of transplants.Durante o primeiro Fórum de Bioética da Sociedade de Transplantes da América Latina e do Caribe 2010, redigiu-se o Documento de Aguascalientes, que pretende assegurar a integridade do doador vivo. O artigo tem por objetivo indagar sobre o Documento de Aguascalientes entre os participantes do Congresso da SLANH 2012. Aplicou-se um questionário com 21 perguntas sobre temas abordados por tal documento. Os resultados mostram que 36,3% aceitam o doador vivo não relacionado; 36,3% consideram que há margem de crescimento na taxa de doadores falecidos; 57,9% garantem a saúde com medicamentos imunossupressores de qualidade; 61,5% não conhecem o documento. Conclui-se que o Documento de Aguascalientes tem recomendações úteis para vigiar aspectos bioéticos de transplantes.Durante el primer Foro de Bioética de la Sociedad de Trasplantes de Latinoamérica y el Caribe 2010 se redactó el Documento de Aguascalientes que busca salvaguardar la integridad del donante vivo. El artículo tiene por objeto indagar sobre el Documento de Aguascalientes entre los participantes del Congreso de la SLANH 2012. Se aplicó un cuestionario con 21 preguntas sobre temas abordados por el dicho documento. Los resultados muestran que el 36,3 % acepta al donante vivo no relacionado; 36,3 % considera que hay margen de crecimiento en la tasa de donantes fallecidos; 57,9 % garantiza la salud con medicamentos inmunosupresores de calidad; 61,5 % no conoce el documento. Se concluye que el Documento de Aguascalientes tiene recomendaciones útiles para vigilar aspectos bioéticos de trasplantes. DOI: 10.5294/pebi.2014.18.2.1

A Lei da Vontade Antecipada do Distrito Federal no México: transplante e ideologia

Background: The law on advance directives (LAD) in Mexico City regulates the will or intent of any person not to undergo unnecessarily life-prolonging treatment. Article 8 of the law stipulates the donation of organs for transplant must be manifest. Objective: The aim of this paper is to document knowledge of LAD.  Materials and methods: A qualitative study was conducted using a previously validated semi-structured interview.  Results: In all, 278 interviews were carried out and 64% of those surveyed were unfamiliar with LAD.    Among those who are familiar with LAD (n = 100), only 43% know what it stipulates regarding organ donation.   Conclusion: There is an evident lack of knowledge about LAD, because the public has not been duly informed.La Ley de voluntad anticipada (LVA) de la Ciudad de México regula la voluntad de cualquier persona para no someterse a tratamientos que prolonguen su vida innecesariamente. La Ley pide, en el artículo 8°, la manifestación respecto de la donación de órganos para trasplante. El objetivo de este trabajo es documentar el conocimiento de la LVA. Para estose realizó una investigación cualitativa con una entrevista semiestructurada, previamente validada. Como resultado se realizaron 278 entrevistas. El 64% de los encuestados no conocen la LVA. De la población encuestada que sí tiene conocimiento de la LVA (n=100) solamente el 43% saben lo referente a la donación de órganos. Se concluye que es evidente el desconocimiento por falta de difusión de la LVA. A Lei da Vontade Antecipada (LVA) da Cidade do México regula a vontade de qualquer pessoa para não se submeter a tratamentos que prolonguem sua vida desnecessariamente. A Lei pede, no artigo 8º, a manifestação a respeito da doação de órgãos para transplantes. O objetivo deste trabalho é documentar o conhecimento da LVA. Para isso, realizou-se uma pesquisa qualitativa com uma entrevista semiestruturada, previamente validada. Como resultado, realizaram-se 278 entrevistas. 64% dos entrevistados não conhecem a LVA. Da população entrevistada que tem conhecimento da LVA (n = 100) somente 43% sabem sobre a doação de órgãos. Conclui-se que é evidente o desconhecimento por falta de difusão da LVA

TRANSPLANTES NA AMÉRICA LATINA E NO CARIBE: DIFUSÃO DO DOCUMENTO DE AGUASCALIENTES

The Aguascalientes Document was drafted during the first 2010 Bioethics Forum of the Transplantation Society in Latin America and the Caribbean. The object of the document is to safeguard the integrity of the living donor. This article aims to investigate the Aguascalientes Document among the participants to the 2012 SLANH Congress. A questionnaire was applied, with 21 questions on topics covered by said document. The results show that 36.3% of the respondents accepts the unrelated living donor; 36.3% believes there is a margin of growth in the rate of deceased donors; 57.9% guarantees health with quality immunosuppressive drugs; 61.5% does not know the document. In view of the above, it is concluded that the Aguascalientes Document contains useful recommendations for monitoring the bioethical aspects of transplants.Durante el primer Foro de Bioética de la Sociedad de Trasplantes de Latinoamérica y el Caribe 2010 se redactó el Documento de Aguascalientes que busca salvaguardar la integridad del donante vivo. El artículo tiene por objeto indagar sobre el Documento de Aguascalientes entre los participantes del Congreso de la SLANH 2012. Se aplicó un cuestionario con 21 preguntas sobre temas abordados por el dicho documento. Los resultados muestran que el 36,3 % acepta al donante vivo no relacionado; 36,3 % considera que hay margen de crecimiento en la tasa de donantes fallecidos; 57,9 % garantiza la salud con medicamentos inmunosupresores de calidad; 61,5 % no conoce el documento. Se concluye que el Documento de Aguascalientes tiene recomendaciones útiles para vigilar aspectos bioéticos de trasplantes. DOI: 10.5294/pebi.2014.18.2.11Durante o primeiro Fórum de Bioética da Sociedade de Transplantes da América Latina e do Caribe 2010, redigiu-se o Documento de Aguascalientes, que pretende assegurar a integridade do doador vivo. O artigo tem por objetivo indagar sobre o Documento de Aguascalientes entre os participantes do Congresso da SLANH 2012. Aplicou-se um questionário com 21 perguntas sobre temas abordados por tal documento. Os resultados mostram que 36,3% aceitam o doador vivo não relacionado; 36,3% consideram que há margem de crescimento na taxa de doadores falecidos; 57,9% garantem a saúde com medicamentos imunossupressores de qualidade; 61,5% não conhecem o documento. Conclui-se que o Documento de Aguascalientes tem recomendações úteis para vigiar aspectos bioéticos de transplantes

. 8 Año 3 (2004) julio-septiembre. Señales de humo

- Los o'oba en el Museo de Sonora por Alejandro Aguilar Zeleny y César A. Quijada. - Editorial por Carlos Villegas Ivich. - Nuevo personal se integra al Centro INAH Sonora por Difusión Centro INAH Sonora. - "Los indios de todo se maravillaban: la relación de Hernando de Alarcón" Primera exploración del Río Colorado, Año de 1540 por Colegio de Jalisco. - Alquimia por Guadalupe Piña Ortiz. - Museo "EL Milenio", Santa Bárbara, Chihuahua por Martha Olivia Solís Zataraín. - El banquete yaqui por Carmen Castillo Rocha. - Elecciones municipales en Sonora, 1900-1910 por Esperanza Donjuan Espinoza. - El desarrollismo por Juan José Gracida Romo. - XXVII Mesa redonda de la Sociedad Mexicana de Antropología por Elisa Villalpando Canchola. - El concepto "Patrimonio" por Jorge A. Morales Álvarez. - Participación del Centro INAH Sonora en las X jornadas internacionales sobre Misiones Jesuitas por Raquel Padilla Ramos. - Noticias arqueológicas por M. Elisa Villalpando Canchola. - ¿Sabías que... por Eréndira Contreras Barragán. - De bandas y bandidos en Nuri, Sonora. Un recorrido por los instrumentos musicales de antaño por Suhei Lara López. - Vida académica y editorial por Cristina García. - Los materiales perecederos de las casas en acantilado de la Sierra de Sonora por Cristina García M. - Talleres de Verano 2004 por Martha Olivia Solís Zataraín. - IV Encuentro Internacional de Patrimonio, Desarrollo y Turismo por Miriam Roldán González. - XIX aniversario de Museo de Sonora por Difusión Centro INAH Sonora

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used