The hidden curriculum in medical teaching

Indexación: Web of Science; ScieloBackground: Medical education must ascribe to a curriculum but clinical teaching poses special difficulties that go beyond any programming attempt. Attitudes and skills learned during tutored clinical practice are called the "hidden curriculum". The figure and personal features of the teacher, his environment and the atmosphere that projects every particular medical school, are essential to shape the characteristics of the student. Paradoxically, it is almost impossible to measure the impact of this hidden curriculum. This article is a reflection on an issue that is acquiring special relevance in medical education.http://ref.scielo.org/x49wb

Bioethics reflection about lung transplant

Indexación: ScieloA pesar de los avances que ha experimentado la técnica de los trasplantes de órganos y la mejora en manejo del rechazo, en nuestro país no se advierte un crecimiento adecuado a las necesidades de los trasplantes del sistema respiratorio requeridos. Si bien existen indicaciones precisas de trasplante pulmonar, el problema de la escasez de donantes es una dificultad concreta para los enfermos. Se revisa y compara nuestra situación con la de España y se analizan algunos aspectos bioéticos que surgen de este proceso.Despite a substantial improvement in organ transplant techniques and rejections methods, Chile still exhibits an apparent lack of adequate increase of lung transplants. In particular, despite the presence of precise indicactions of lung transplant, the problem of limited donors is a very difficult reality for the receptors. In this work, we offer a comparison amongst Chile and Spain, with special emphasis on bioethical aspects of this process.http://www.scielo.cl/pdf/rcher/v30n4/art05.pd

The Tadpole of \u3cem\u3eEupsophus queulensis\u3c/em\u3e (Anura, Cycloramphidae)

The genus Eupsophus is characterized by endotrophic larvae that inhabit water-filled cavities. The larvae feed from large yolk reserves during metamorphosis. The external morphology has been described for four of the ten known species and data on larval chondrocranial morphology are available only for one. We describe the extema1 morphology, oral disc and chondrocranial anatomy of the larvae of Eupsophus queulensis. The characteristics of E. queulensis tadpoles are compared with those of other Eupsophus larvae

Organizing health care: an ethical perspective

Indexación: Web of Science; Scielo.Health Care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize Human Dignity as an ethical corner stone of the Health Care System, along with other important values such as Justice and Humanization, under the scope of the Ends of Medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the Ends of Medicine and the good of persons, such a health care system is ethically adequate.http://ref.scielo.org/9bt3z

Algunas amenazas actuales a la confidencialidad en medicina

Social, technical and legal conditions of the current practice of medicine make it necessary to insist on certain actions and circumstances that may jeopardize the confidentiality of information, offered by patients to their health providers. Therefore, some effects of the current Chilean law are analyzed in this respect, regarding access to data from the clinical record of a patient. Also, the risks of putting certain data on social networking sites are analyzed, as well as some of its effects on clinical practice. The reasons because of mandatory reporting of diseases, meaning danger to public health, is allowed, are mentioned. We also discuss the difficulties involved in managing the results of preventative health screenings and its knowledge by third parties, as well as some possible violations of personal privacy, regarding dissemination of some people health information and its further mention or figuration in mass media. We conclude that it is a must for both physicians and other health team members, to safeguard confidentiality of data to which they have had access, as well as the need to know the relevant law, in order to respect human dignity of patients, each one as a person. We address the attention to the possibility that, practicing in a different way, it could endanger the reliability of clinical records, also impairing the quality of people’s health care. (Rev Med Chile 2015; 143: 358-366) Key words: Access to Information; Confidentiality; Information Dissemination; Medical Records; Social Networkin

Respecting patient intimacy

Indexación: Web of Science; Scielo.Transparency as a general rule for all our professional acts casts doubts about the statement of the Hippocratic Oath that says "Whatever I see or hear in the lives of my patients, I will keep secret, as considering all such things to be private". Medical secrecy protects the intimacy of patients, who reveal to their physicians their most hidden secrets aiming to recover their health. Therefore, physicians should receive those secrets with reverence and care, as servers and not as their owners. The values associated with the respect for personal intimacy are the anthropological basis of medical confidentiality. A medical act is performed by definition between two equally honorable individuals. Therefore, the professional honors the trust of his patient, maintaining strict confidence of what is revealed. Therefore, medical secrecy must be strengthened rather than weakened, pursuing common wealth and dignity.http://ref.scielo.org/cf3mx

An ethical and medical perspective on the voluntary termination of pregnancy

Indexación: Web of Science; Scielo.“Voluntary termination of pregnancy” can refer to actions intended to make a delivery easier, to provide medical care to the fetus, or to protect the life or health of the mother. All of these are proper medical actions and are by definition voluntary. In other cases, the expression denotes a termination of pregnancy before the embryo or fetus is viable, leading to the death of the latter. This action is constitutive of abortion under current Chilean law. The product of conception living being, who develops in the womb during pregnancy, is an individual, both in the sense that it is different from its mother and father, and in that it is a biological individual. For these reasons, such living being constitutes another patient in itself. The free and voluntary medical action of health care professionals is geared toward disease prevention or health recovery and medical terminations of pregnancy, as distinguished from abortion, are not criminalized in our country. Therefore, the idea of legalizing abortive terminations of pregnancy so that they become “legitimate health care services” is a call to the medical community, which should engage in a debate about the meaning and consequences of an eventual mandate of the State that would be at odds with the Hippocratic tradition. A woman can feel that her health is at risk due to her pregnancy, and she certainly has the right to request medical help. Health professionals should care both at the medical and emotional level for all those who require their services, especially when such persons are undergoing situations of vulnerability and distress. When requested to perform an abortion, the physician faces dilemmas that should be addressed in line with the present state of the medical art.http://ref.scielo.org/c4ypf

Critical Role of Electrical Resistivity in Magnetoionics

The utility of electrical resistivity as an indicator of magnetoionic performance in stoichiometrically and structurally similar thin-film systems is demonstrated. A series of highly nanocrystalline cobalt nitride (Co-N) thin films (85 nm thick) with a broad range of electrical properties exhibit markedly different magnetoionic behaviors. Semiconducting, near stoichiometric CoN films show the best performance, better than their metallic and insulating counterparts. Resistivity reflects the interplay between atomic bonding, carrier localization, and structural defects, and in turn determines the strength and distribution of applied electric fields inside the actuated films. This fact, generally overlooked, reveals that resistivity can be used to quickly evaluate the potential of a system to exhibit optimal magnetoionic effects, while also opening interesting challenges.Financial support by the European Research Council (SPIN-PORICS 2014-Consolidator Grant, Agreement No. 648454, and the MAGIC-SWITCH 2019-Proof of Concept Grant, Agreement No. 875018), the Spanish Government (MAT2017-86357-C3-1-R and PID2020- 116844RB-C21), the Generalitat de Catalunya (2017- SGR-292 and 2018-LLAV-00032) and the European Regional Development Fund (MAT2017-86357-C3-1-R and 2018-LLAV-00032) is acknowledged. This work was partially supported by the Impulse-und Net-working fund of the Helmholtz Association (FKZ VH-VI-442 Memriox), and the Helmholtz Energy Materials Characterization Platform (03ET7015). The PALS measurements were carried out at ELBE at the Helmholtz-Zentrum DresdenRossendorf e. V., a member of the Helmholtz Association. L.A. thanks MINECO for a Ramón y Cajal Contract (RYC-2013-12640). J.S. thanks the Spanish Fábrica Nacional de Moneda y Timbre for fruitful discussions. E.M. acknowledges support as a Serra Húnter Fellow. We acknowledge service from MiNa Laboratory at IMNCSIC

Magneto-ionics in single-layer transition metal nitrides

Altres ajuts: Acord transformatiu CRUE-CSICMagneto-ionics allows for tunable control of magnetism by voltage-driven transport of ions, traditionally oxygen or lithium and, more recently, hydrogen, fluorine, or nitrogen. Here, magneto-ionic effects in single-layer iron nitride films are demonstrated, and their performance is evaluated at room temperature and compared with previously studied cobalt nitrides. Iron nitrides require increased activation energy and, under high bias, exhibit more modest rates of magneto-ionic motion than cobalt nitrides. Ab initio calculations reveal that, based on the atomic bonding strength, the critical field required to induce nitrogen-ion motion is higher in iron nitrides (≈6.6 V nm -1) than in cobalt nitrides (≈5.3 V nm -1). Nonetheless, under large bias (i.e., well above the magneto-ionic onset and, thus, when magneto-ionics is fully activated), iron nitride films exhibit enhanced coercivity and larger generated saturation magnetization, surpassing many of the features of cobalt nitrides. The microstructural effects responsible for these enhanced magneto-ionic effects are discussed. These results open up the potential integration of magneto-ionics in existing nitride semiconductor materials in view of advanced memory system architectures