Importancia de la medicina narrativa en la formación y en la vida profesional

La práctica efectiva de la medicina requiere competencia narrativa, que es la habilidad para reconocer, absorber, interpretar, y actuar en las historias y apuros de los demás. La medicina practicada con competencia narrativa, llamada Medicina Narrativa, es el modelo para una práctica médica humana y más efectiva. Adoptar métodos como la lectura de libros y la práctica de la escritura reflexiva permite a la medicina examinar e iluminar cuatro de las situaciones centrales de la medicina narrativa: relación médico y paciente, relación médico consigo mismo, relación médico y colegas, y relación médico y sociedad

Emocions i estratègies davant l'estrès

L'estat d'ànim amb què ens enfrontem a situacions d'estrès té una influència decisiva en les estratègies que preparem per superar-les i no és, tal com s'havia pensat fins ara, una conseqüència de les mateixes. Així ho ha determinat un grup d'investigadors de la UAB després de realitzar un seguiment d'estrès a més de 300 universitaris per a conèixer de quina forma feien front el seu primer examen de carrera.El estado de ánimo con que nos enfrentamos a situaciones de estrés tiene una influencia decisiva en las estrategias que preparamos para superarlas y no es, tal como se pensaba hasta ahora, una consecuencia de las mismas. Así lo ha determinado un grupo de investigadores tras realizar un seguimiento a más de 300 universitarios para conocer de qué forma afrontaban su primer examen de carrera

Comparing interpolation methods for rainfall maps elaboration in the Icod-Cañadas aquifer (Tenerife, Canary Islands)

Groundwater is the main water resource in Tenerife (Canary Islands) where it represents almost 90% of the consumption. For the Insular Hydrological Plan the most important aquifer in the future will be the one located in Las Cañadas which belongs to the III Hydrogeological Zone. For exploiting this aquifer in a rational way in the future it is necessary to know and assess carefully the recharge estimates. It is for this reason, that the choice of the rainfall interpolation method is so important. In this study three different interpolation methods have been used to compare their results with the real data of the gauges and to obtain doing that, the best precipitation estimate in the area. The results show the ordinary kriging to be the best interpolation method in the study area and that the use of the relationship between elevation and precipitation do not increase the accuracy of the interpolation even though the climatic characteristics of the island have been taken into accoun

Selección de áreas estratégicas para la conservación en proyectos de desarrollo

La selección de áreas estratégicas para la conservación en proyectos de desarrollo se realizó a partir de la formulación de una metodología que permite escoger zonas aptas para este fin, teniendo en cuenta sus localizaciones geográficas, condiciones ambientales y los costos de la tierra. Inicialmente, fue necesario definir aquellos criterios que como parte de las dimensiones ambientales tienen parámetros y variables que permiten identificar el estado actual de la zona que se desea analizar, en este caso la zona de estudio definida para llevar a cabo esta investigación académica es el área de amortiguación del Parque Nacional Natural Los Nevados, en donde se analizaron aspectos como el almacenamiento de carbono, el rendimiento hídrico y hábitat a partir de las coberturas de la tierra, previamente identificadas. El almacenamiento de carbono fue calculado teniendo en cuenta la información de biomasa de las coberturas de suelo de 1982 y 2016, por su parte el rendimiento hídrico fue estimado con base en la escorrentía obtenida de la relación de evapotranspiración real, la precipitación y la temperatura; finalmente el hábitat se definió a partir de la ponderación dada por expertos en temas ambientales coberturas y su importancia para la conservación. Adicionalmente, se estableció el costo por hectárea en la zona de estudio, relacionando el tipo de cobertura con la pendiente en la que se encuentra ubicada la misma, los precios de predios fueron establecidos mediante entrevistas realizadas a personas que viven o trabajan en el área. Finalmente, fue desarrollado un algoritmo que permite establecer el aporte a la conservación de cada hectárea, realizando un análisis multiobjetivo entre los criterios antes descritos y la conectividad, determinada por la proximidad entre píxeles en un radio de estudio previamente establecido, obteniendo como resultado la selección de tierras con importancia para la conservación, usando de este modo los recursos financieros de manera óptima.Abstract: the selection of strategic areas for conservation in development projects was made from the formulation of a methodology that allows to choose suitable areas for this purpose, taking into account their geographical locations, environmental conditions and land costs. Initially, it was necessary to define those criteria that, as part of the environmental dimensions, have parameters and variables that allow us to identify the current state of the area that we want to analyze, in this case the study area defined to carry out this academic research is the buffer area of the Los Nevados National Natural Park, where aspects such as carbon storage, water yield and habitat from land cover, previously identified, were analyzed. The carbon storage was calculated taking into account the biomass information of the soil cover of 1982 and 2016; the water yield was estimated based on the runoff obtained from the ratio of real evapotranspiration, precipitation and temperature; Finally, the habitat was defined based on the weights given by experts in environmental issues, land coverage and its importance for conservation. Additionally, the cost per hectare was established in the study area, relating the type of coverage with the slope in which it is located; properties prices were established through interviews with people who live or work in the area. Finally, an algorithm was developed that allows establishing the contribution to the conservation of each hectare, performing a multiobjective analysis among the previously described criteria and connectivity, determined by pixel proximity in a previously established study radius, obtaining as a result the purchase of lands of importance for conservation, using financial resources in an optimal way.Maestrí

A systematic review of the ecological and longitudinal methods to study daily stress

The objective was to review the methods used to assess daily stress, focusing on the types records used, as well as the methods used to describe daily stressors, the ways to operationally define stress, and the different research approaches. A search for quantitative research articles published between January 2008 and December 2017 was carried out on indexed entries of four electronic databases. Of the 254 publications found in the search after duplicates were removed, eft 57 articles were selected to analyse. A large diversity of recording methods was detected, a single daily record for a week being the most frequently used. The different ways to operationalize stress highlight the different implicit definitions of stress: the number or intensity of stressful event refers to stress as an external factor, negative feelings refer to the individual's responses, and reactivity or "pile-up" are related to the process by which stress develops over time. Such variation suggests that stress is not a precise concept that can be assessed by a single measure, stress is rather a generic label for the complex process of adaptation to specific situations. The first one is that it can be concluded that stress is a process that explains the short- and long-term effects of exposure to stressors on health and wellbeing through a complex chain of mediators and moderators. The second point is that although it is known that the changes produced in stressful situations are adaptive at first, studies of the negative side of stress prevail. And the third point is that the studies analysed were not reduced to the analysis of the stress process or of any particular aspect of stress but rather, the evaluation of daily stress served to study other processes with marked social and affective components

A brief version of the implicit positive and negative affect test (IPANAT-18)

As self-reports of affect are limited in several regards, an indirect measure of affect, the Implicit Positive and Negative Affect Test (IPANAT; ) has previously been developed and adapted to more than 10 languages (), showing adequate reliability and validity. Based on a sample of 242 Spanish adults (111 males), we evaluate a trimmed 18 items version of the IPANAT (IPANAT-18). Item reductive procedures consisted in a random selection of the stimuli words used in the IPANAT. Psychometric properties of the IPANAT-18 were evaluated via Confirmatory Factor Analysis. In addition, correlational analyses were used to determine the relationship between the brief and the full version of the IPANAT, and with explicit measures of affect. We replicated a two-factors structure of positive affect versus negative affect and found a good fit for the IPANAT-18 model (CFI = 1; TLI = 1; RMSEA =.00; SRMR =.03). Reliability was adequate (implicit PA, α =.86; implicit NA, α =.77) and the pattern of relationships with explicit affect measures were congruent and consistent with previous findings. Differences between the mean scores of implicit affect assessed with 18 items or 36 items were statistically non-significant, and showed strong correlations (PA, r =.92, p <.01; NA, r =.88, p <.01). In sum, the IPANAT-18 showed satisfactory psychometric properties and constitutes a useful tool for economically measuring affective processes such as in experimental and economical multiple assessment (e.g., daily diary) settings

Discurso Ceremonia de las Batas Blancas

Quisiera extender un saludo muy cordial a la mesa directiva, profesores, familiares, acudientes y estudiantes. Muy buenas noches. Nos encontramos aquí, aproximadamente tres años después de haber iniciado nuestro viaje para convertirnos en médicos javerianos. Un viaje de una dificultad de renombre, lleno de un sinfín de experiencias, conocimientos, sentimientos, simbolismo y anécdotas. ¿Y qué sería un médico sin todas estas

Microvascular free flap in a pregnant patient after resection ofahigh-grade neuroendocrine carcinoma

Free !ap reconstruction is seldom performed during pregnancy. Not only does the prolonged operative time pose a risk for the mother and the fetus, but also the hypercoagulable state of pregnancy predisposes the mother to a greater risk of complications in the transplanted tissue. We present a case of a 29-year-old patient in week 27 of gestation with a rapidly progressive neuroendocrine tumor in the left nasal fossa with involve-ment of the nasal sinus, pterygopalatine fossa, dura, and left orbit, associated with neurological symptoms and recurrent epistaxis. The aggressive and rapidly progressive character of the tumor made surgical excision by a multidisciplinary team as the "rst option. We performed immediate reconstruction with an anterolateral thigh free !ap. Free tissue transfer was performed successfully, with satisfactory results on the mother and later delivery without complications.Free !ap reconstruction is seldom performed during pregnancy. Not only does the prolonged operative time pose a risk for the mother and the fetus, but also the hypercoagulable state of pregnancy predisposes the mother to a greater risk of complications in the transplanted tissue. We present a case of a 29-year-old patient in week 27 of gestation with a rapidly progressive neuroendocrine tumor in the left nasal fossa with involve-ment of the nasal sinus, pterygopalatine fossa, dura, and left orbit, associated with neurological symptoms and recurrent epistaxis. The aggressive and rapidly progressive character of the tumor made surgical excision by a multidisciplinary team as the "rst option. We performed immediate reconstruction with an anterolateral thigh free !ap. Free tissue transfer was performed successfully, with satisfactory results on the mother and later delivery without complications.Revista Internacional - No indexad