From informed assent to informed consent. Ontological, epistemological and axiological foundations

El asentimiento y el consentimiento informado médico son dos procesos e instrumentos ético-jurídicos del acto-médico, que permiten establecer empatía, comunicación, información, responsabilidad y reciprocidad en el cuidado, consejo y seguridad en la relación médico-paciente, con la familia, la institución prestadora de servicios y los patrocinadores. Constituyen medios de información aptos y adecuados al paciente, sobre la naturaleza de la enfermedad y del procedimiento diagnóstico o terapéutico que se propone utilizar, alternativas, riesgos y beneficios que éste conlleva. El asentimiento y consentimiento forman parte del proceso de relación médico-paciente y constituyen, al final, un documento de acuerdo y contractual, en forma escrita, sobre las responsabilidades mutuas. Pero se diferencian, en que el primero pertenece más a la voluntad y el segundo, representa un acto del entendimiento. Se han venido aplicando en la relación de niños y adolescentes, con enfermos crónicos y sus familiares-cuidadores u otros, con enfermedades neurológicas que pierdan momentáneamente su competencia mental.The Informed Assent and Informed Consent are two ethical and legal processes instruments of the act-doctor, which establish empathy, communication, information, responsibility and reciprocity in health care, advice and safety in the doctor-patient relationship with the family, servicing institution and sponsors. Media are suitable and appropriate to the patient, the nature of the disease and the diagnostic or therapeutic procedure proposed use, alternatives, risks and benefits it brings. Assent and consent form part of the doctor-patient relationship and are ultimately a contractual agreement document and in written form on the mutual responsibilities. But they differ in that the first belongs more to the will and the second, represents an act of understanding. They have been applied in the relationship of children and adolescents with chronically ill and their relatives-caregivers or others with neurological diseases that momentarily lose their mental competence

Propuesta para el desarrollo de un sistema de regulación y control técnico-social de la investigación Biomédica y Biotecnológica: Caso Venezuela

El presente artículo tiene como propósito ofrecer los resultados de una investigación que pueda ayudar al mejoramiento del sistema de regulación y control tecno-social de la investigación biomédica y biotecnológica en Venezuela. Ésta, es clave tanto para el sector de Ciencia y Tecnología como para el de Salud nacional. La percepción bioética integral en esta materia, garantiza el incremento de la efectividad y calidad en la investigación con seres humanos, ya que esta interdisciplina busca la protección integral de las personas involucradas

Fe, ciencia y bioética

La tríada fe-ciencia-bioética permite enfrentar la conciencia de la Modernidad; el acercamiento al diálogo entrefe y razón, al debate moral entre la Fe y la Ciencia mediante la convocatoria de Van Rensselaer Potter en su libro Bioética: Un puente hacia el futuro. Tres tópicos entreverados entre sí, en ámbitos como el ser humano, la vida y la verdad. El trinomio conlleva tres paradigmas que tienen que ser comprendidos mediante un diálogo desapasionado y sistemático. Motivo de ello, el binomio Fe-Ciencia pareciese incompatible, por los resultados de sus controversiales encuentros. A partir de los años 80 se hicieron esfuerzos importantes de encuentro, en pro del desarrollo social y el progreso tecnológico. El proceso epistemológico de la bioética ha permitido la búsqueda interdisciplinaria y, sobre todo, transdisciplinaria, de espacios de encuentro y un respeto a la condición humana de nuestra naturaleza

Pesquisa, prática curricular e virtualidade: experiências na Venezuela

With respect to the triad of research, curricular practice and virtuality, virtual education has become a more effective, by overcoming pitfalls of time and space through innovative methods, techniques and resources that make the teaching-learning process more effective and flexible. Therefore, this new educational modality validates the principles of, education for everyone, learning to learn, personalized teaching-learning, and lifelong education; in other words, permanent or continuous education. It also enables a particular relationship with the development of Latin American critical thinking, where a concern for the knowledge of the limits of the current society and the possibility of shaping a more humane and fair public order enriches the social and harmonious coexistence.Con respecto a la triada investigación, práctica curricular y virtualidad, la educación virtual ha evidenciado un emprendimiento más efectivo, al superar escollos de tiempo y espacio mediante innovadores métodos, técnicas y recursos que hacen más efectivo y flexible el proceso de enseñanza-aprendizaje. Esta nueva modalidad educativa da validez así a los principios de educación para todos, aprender a aprender, la enseñanza-aprendizaje personalizada, la educación para toda la vida, es decir, la educación permanente o continua. Además, permite una relación particular con el desarrollo de un pensamiento crítico latinoamericano, cuya preocupación por el conocimiento de los límites de la sociedad actual y las posibilidades de configurar un orden más humano y justo enriquece lo social y la convivencia armónica.No que se refere à tríade de pesquisa, prática curricular e virtualidade, a educação virtual tem evidenciado um empreendimento mais efetivo, com a superação de barreiras de tempo e espaço por meio de métodos, técnicas e recursos inovadores que tornam mais efetivo e flexível o processo de ensino-aprendizado. Esta nova modalidade educativa valida os princípios de educação para todos, aprender a aprender, o ensino-aprendizado personalizado, a educação para a vida toda, ou seja, a educação permanente ou contínua. Além do mais, permite uma relação particular com o desenvolvimento de um pensamento crítico latino-americano, cuja preocupação pelo conhecimento dos limites da sociedade atual e as possibilidades de configurar uma ordem mais humana e justa enriquece o social e a convivência harmônica

The photospheric solar oxygen project: III. Investigation of the centre-to-limb variation of the 630nm [OI]-NiI blend

The solar photospheric abundance of oxygen is still a matter of debate. For about ten years some determinations have favoured a low oxygen abundance which is at variance with the value inferred by helioseismology. Among the oxygen abundance indicators, the forbidden line at 630nm has often been considered the most reliable even though it is blended with a NiI line. In Papers I and Paper II of this series we reported a discrepancy in the oxygen abundance derived from the 630nm and the subordinate [OI] line at 636nm in dwarf stars, including the Sun. Here we analyse several, in part new, solar observations of the the centre-to-limb variation of the spectral region including the blend at 630nm in order to separate the individual contributions of oxygen and nickel. We analyse intensity spectra observed at different limb angles in comparison with line formation computations performed on a CO5BOLD 3D hydrodynamical simulation of the solar atmosphere. The oxygen abundances obtained from the forbidden line at different limb angles are inconsistent if the commonly adopted nickel abundance of 6.25 is assumed in our local thermodynamic equilibrium computations. With a slightly lower nickel abundance, A(Ni)~6.1, we obtain consistent fits indicating an oxygen abundance of A(O)=8.73+/-0.05. At this value the discrepancy with the subordinate oxygen line remains. The derived value of the oxygen abundance supports the notion of a rather low oxygen abundance in the solar hotosphere. However, it is disconcerting that the forbidden oxygen lines at 630 and 636nm give noticeably different results, and that the nickel abundance derived here from the 630nm blend is lower than expected from other nickel lines.Comment: to appear in A&

Optomechanical circuits for nanomechanical continuous variable quantum state processing

We propose and analyze a nanomechanical architecture where light is used to perform linear quantum operations on a set of many vibrational modes. Suitable amplitude modulation of a single laser beam is shown to generate squeezing, entanglement, and state-transfer between modes that are selected according to their mechanical oscillation frequency. Current optomechanical devices based on photonic crystals may provide a platform for realizing this scheme.Comment: 11 pages, 5 figure

Continuous mode cooling and phonon routers for phononic quantum networks

We study the implementation of quantum state transfer protocols in phonon networks, where in analogy to optical networks, quantum information is transmitted through propagating phonons in extended mechanical resonator arrays or phonon waveguides. We describe how the problem of a non-vanishing thermal occupation of the phononic quantum channel can be overcome by implementing optomechanical multi- and continuous mode cooling schemes to create a 'cold' frequency window for transmitting quantum states. In addition, we discuss the implementation of phonon circulators and switchable phonon routers, which rely on strong coherent optomechanical interactions only, and do not require strong magnetic fields or specific materials. Both techniques can be applied and adapted to various physical implementations, where phonons coupled to spin or charge based qubits are used for on-chip networking applications.Comment: 33 pages, 8 figures. Final version, a few minor changes and updated reference

Factors related to successful job reintegration of people with a lower limb amputation

Objective: To study demographically, amputation-, and employment-related factors that show a relationship to successful job reintegration of patients after lower limb amputation. Design: Cross-sectional study. Setting: University hospital. Patients: Subjects had an acquired unilateral major amputation of the lower limb at least 2 years before, were aged 18 to 60 years (mean, 46yr), and were living in the Netherlands. All 322 patients were working at the time of amputation and were recruited from orthopedic workshops. Intervention: Questionnaires sent to subjects to self-report (1) demographic and amputation information and (2) job characteristics and readjustment postamputation. Questionnaire sent to rehabilitation specialists to assess physical work load. Main Outcome Measures: Demographically related (age, gender); amputation-related (comorbidity; reason and level; problems with stump, pain, prosthesis use and problems, mobility, rehabilitation); and employment-related (education, physical workload) information about the success of job reintegration. Results: Job reintegration was successful in 79% and unsuccessful in 21% of the amputees. Age at the time of amputation, wearing comfort of the prosthesis, and education level were significant indicators of successful job reintegration. Subjects with physically demanding jobs who changed type of job before and after the amputation more often successfully returned to work than subjects who tried to stay at the same type of job. Conclusions: Older patients with a low education level and problems with the wearing comfort of the prosthesis are a population at risk who require special attention during the rehabilitation process in order to return to work. Lowering the physical workload by changing to another type of work enhances the chance of successful reintegration

A unipolar quantum dot diode structure for advanced quantum light sources

Triggered, indistinguishable, single photons play a central role in various quantum photonic implementations. Here, we realize a novel n$^+-$i$-$n$^{++}$ diode structure embedding semiconductor quantum dots: the gated device enables spectral tuning of the transitions and deterministic control of the observed charged states. Blinking-free single-photon emission and high two-photon indistinguishability is observed. The linewidth's temporal evolution is investigated for timescales spanning more than $6$ orders of magnitude, combining photon-correlation Fourier spectroscopy, high-resolution photoluminescence spectroscopy, and two-photon interference (visibility of $V_{\text{TPI, 2ns}}=\left(85.5\pm2.2\right){\%}$ and $V_{\text{TPI, 9ns}}=\left(78.3\pm3.0\right){\%}$). No spectral diffusion or decoherence on timescales above $\sim 9\,\text{ns}$ is observed for most of the dots, and the emitted photons' linewidth $\left(\left(420\pm30\right)\text{MHz}\right)$ deviates from the Fourier-transform limit only by a factor of $1.68$. Thus, for remote TPI experiments, visibilities above $74\%$ are anticipated. The presence of n-doping only signifies higher available carrier mobility, making the presented device highly attractive for future development of high-speed tunable, high-performance quantum light sources