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LA éTICA DEL DESARROLLO PROFESIONAL CONTINUADO EN LA PROMOCIóN DE LA CALIDAD ASISTENCIAL
Altisent,Rogelio;
Acta bioethica , 2010, DOI: 10.4067/S1726-569X2010000200008
Abstract: ethics has always being present in a more or less explicit way in health care quality; nevertheless, there has not been paid attention enough to the power of quality found in the ethical drive and attitudes of professionals who are leaders in improvement processes. the continuous professional development is a process which must accompany successive stages of professional life with different motivational moments and periods of crisis, for which understanding its ethical basis is convenient by reflecting about health care quality. professionals who care patients also need attention to diagnose and overcome inertia, lack of initiative, skepticism and lack of self criticism situations. health care quality can only be guarantee if professionals develop a satisfactory progress in their career, for which it is necessary that personal services and human resources of health care institutions devote their best energies in the promotion of their professionals.
LA éTICA DEL DESARROLLO PROFESIONAL CONTINUADO EN LA PROMOCIóN DE LA CALIDAD ASISTENCIAL A éTICA DO DESENVOLVIMENTO PROFISSIONAL CONTINUADO NA PROMO O DA QUALIDADE ASSISTENCIAL ETHICS OF CONTINUOUS PROFESSIONAL DEVELOPMENT IN THE PROMOTION OF HEALTH CARE QUALITY
Rogelio Altisent
Acta Bioethica , 2010,
Abstract: La ética siempre ha estado presente de forma más o menos explícita en la calidad asistencial; sin embargo, no se ha prestado la necesaria atención al motor de la calidad que se encuentra en las actitudes y en el impulso ético de los profesionales que han de liderar los procesos de mejora. El Desarrollo Profesional Continuado es un proceso que debe acompa ar las sucesivas etapas de la vida del profesional, con sus distintos momentos de motivación y crisis, y conviene entender su fundamentación ética, reflexionando sobre la calidad asistencial. Los profesionales que cuidan pacientes también necesitan recibir atención para diagnosticar y superar las situaciones de inercia, ausencia de iniciativa, escepticismo y falta de autocrítica. Sólo se puede garantizar la calidad asistencial si los profesionales desarrollan un satisfactorio progreso de su carrera, para lo cual es necesario que los servicios de personal y de recursos humanos de las instituciones sanitarias dediquen sus mejores energías a cuidar la promoción de sus profesionales. A ética sempre esteve presente de forma mais ou menos explícita na qualidade assistencial; entretanto, n o se tem prestado a necessária aten o ao motor da qualidade que se encontra nas atitudes e no impulso ético dos profissionais que v o liderar os processos de melhoria. O Desenvolvimento Profissional Continuado é um processo que deve acompanhar as sucessivas etapas de vida do profissional, com seus distintos momentos de motiva o e crises, e convém entender sua fundamenta o ética, refletindo sobre a qualidade assistencial. Os profissionais que cuidam de pacientes também necessitam receber aten o para diagnosticar e superar as situa es de inércia, ausência de iniciativa, ceticismo e falta de autocrítica. Somente poderá ser garantida a qualidade assistencial se os profissionais desenvolverem um satisfatório progresso de sua carreira, para o qual é necessário que os servi os de pessoal e de recursos humanos das institui es sanitárias dediquem as suas melhores energias para cuidar da promo o de seus profissionais. Ethics has always being present in a more or less explicit way in health care quality; nevertheless, there has not been paid attention enough to the power of quality found in the ethical drive and attitudes of professionals who are leaders in improvement processes. The continuous professional development is a process which must accompany successive stages of professional life with different motivational moments and periods of crisis, for which understanding its ethical basis is convenient by reflecting about healt
Experiencias metodológicas ante el reto de la ense anza de la ética
Rogelio Altisent Trota
Educación Médica , 2006,
Abstract:
Principios éticos y legales en la práctica pericial psiquiátrica
González,J.; Rapún,A.; Altisent,R.; Irigoyen,J.;
Cuadernos de Medicina Forense , 2005, DOI: 10.4321/S1135-76062005000400005
Abstract: an ethical analysis of psychiatric expert practice has been raised, carrying a critical thought out from classic references of bioethics and deontology, applied to conventional clinical relation. concluding with a selection of the ethical principles which, adapted to the specifity of forensic psychiatry, could make use of reference superbly to the practice of this subspeciality of legal medicine.
Principios éticos y legales en la práctica pericial psiquiátrica Ethical and legal principles at the psychiatric expert practice
J. González,A. Rapún,R. Altisent,J. Irigoyen
Cuadernos de Medicina Forense , 2005,
Abstract: Se plantea un análisis ético de la práctica pericial psiquiátrica, realizando una reflexión crítica a partir de las referencias clásicas de la bioética y la deontología, aplicadas a la relación clínica convencional. Se concluye con una selección de los principios éticos que, adaptados a la especificidad de la psiquiatría forense, podrían servir de referencia para la excelencia en la práctica de esta rama de la medicina legal. An ethical analysis of psychiatric expert practice has been raised, carrying a critical thought out from classic references of bioethics and deontology, applied to conventional clinical relation. Concluding with a selection of the ethical principles which, adapted to the specifity of forensic psychiatry, could make use of reference superbly to the practice of this subspeciality of legal medicine.
Atención médica al final de la vida: Conceptos Medical care at the end of life: Concepts
M. Gómez-Sancho,R. Altisent,J. Bátiz,L. Ciprés
Revista de la Sociedad Espa?ola del Dolor , 2010,
Abstract: Hay una gran confusión terminológica en cuanto se refiere al final de la vida de los pacientes. Como quiera que es un asunto de un permanente debate, con mucha frecuencia la discusión se ve entorpecida por la interpretación que los diversos interlocutores hacen de algunos conceptos. Por este motivo, desde la Organización Médica Colegial se ha elaborado un peque o documento en el que se clarifica el significado de las palabras que aluden a situaciones relacionadas con el final de la vida. There is great confusion as regards the therm "end of life" of patients. The subject is continuosly under debate, with the arguments often being obstructed by how various interlocutors interpret some concepts. For this reason the Medical Colleges Organisation has prepared a short document in which it clarifies the significance of these words that allude to situations associated with the end of life.
Declaración sobre la atención médica al final de la vida: Working group on Medical care at the end of life The Collegiate Medical Organization
M. Gómez Sancho,R. Altisent Trota,J. Bátiz Cantera,L. Ciprés Casasnovas
Revista de la Sociedad Espa?ola del Dolor , 2010,
Abstract:
Consideraciones de la Organización Médica Colegial para el desarrollo de los cuidados paliativos en Espa a Considerations by the organisation of medical colleges for the development of palliative care in Spain
M. Gómez Sancho,R. Altisent Trota,J. Bátiz Cantera,L. Ciprés Casasnovas
Revista de la Sociedad Espa?ola del Dolor , 2010,
Abstract: La Organización Médica Colegial ha elaborado una especia de Decálogo en el que se recogen 10 puntos esenciales que las autoridades sanitarias deben tener muy en cuenta para elaborar programas asistenciales que garanticen la adecuada atención a enfermos en situación avanzada o terminal y a sus familiares. Durante muchos a os los cuidados paliativos dependían fundamentalmente de la buena voluntad, la vocación y el interés de unos cuantos profesionales pero, según dice la OMS, la voluntad política es un elemento decisivo para garantizar la adecuada atención a las personas al final de la vida. The Organisation of Medical Colleges (OMC) has prepared a kind of "Decalogue", in which it sets out ten essential points that the Health Authorities have to seriously taken into account for introducing care programs that will ensure adequate health care for patients with advanced or terminal conditions, and their families. For many years, palliative care has basically depended on the goodwill, vocation and interests of many professionals, but, according to the World Health Organisation, political will is a decisive element in guaranteeing adequate care of people at the end of life.
Effective prophylaxis with rFVIIa in young haemophiliacs with inhibitors using a schedule similar to FVIII prophylaxis in non-inhibitor patients  [PDF]
María Fernanda López-Fernández, Carmen Altisent, Víctor Jiménez-Yuste, Faustino García-Candel, Carmen Sedano, Ana Cid, Eva Mingot, Ramiro Nú?ez, María José Paloma, Inmaculada Soto, Manuel Prieto
Health (Health) , 2013, DOI: 10.4236/health.2013.57155
Abstract:

Objective: To assess the role of early prophylaxis with recombinant activated factor VII (rFVIIa) in young haemophiliacs with inhibitors and to determine whether it can reduce bleeding episodes and prevent joint damage. Patients and Methods: Ten severe haemophiliacs, less of three years old, with up to four joint bleeds and inhibitors to FVIII who started early prophylaxis with rFVIIa, were included. A number of haemorrhages/year/patient and haemarthroses/ year/patient were compared before the start of prophylaxis, which include both the time before (initial period) and after inhibitor diagnosis (inhibitor period), with those during prophylaxis (prophylaxis period). Results: The mean time of inhibitor diagnosis was 15.6 months (range: 2.3-34.1). The mean time between inhibitor diagnosis and the start of prophylaxis was 7.1 months (range: 0-23.2), shorter than the time of rFVIIa prophylaxis (mean: 10.3 months; range: 4.1-32.0). Bleeding episodes for the three time periods were 45, 36 and 17, respectively, or 0.29 and 0.51 haemorrhages/year/patient in the two periods prior to prophylaxis compared to 0.17 during prophylaxis. Total haemarthroses for the three-time periods were 7, 5 and 5, respectively. The haemarthroses/year/patient in the pre-prophylaxis period were 0.032 and 0.070, compared to0.049 inthe prophylaxis period. rFVIIa schedules were either 90 μg/kg three times weekly or 90 μg/kg daily. Conclusions: Early prophylaxis with rFVIIa may be efficacious in young haemophiliacs with inhibitors, reducing joint bleeds. After the risky period of inhibitor presence, they are able to continue rFVIII prophylaxis with success assured to prevent arthropathy.

Evaluation of a Non-Destructive Impact Sensor to Determine On-Line Fruit Firmness
Homer,Ian; García-Ramos,Francisco Javier; Ortiz-Ca?avate,Jaime; Ruiz-Altisent,Margarita;
Chilean journal of agricultural research , 2010, DOI: 10.4067/S0718-58392010000100007
Abstract: a non-destructive impact sensor to measure on-line fruit firmness was evaluated. this sensor is an adaptation of a static model used in the laboratory to measure fruit quality and was installed in an experimental fruit packing line with a commercial sizer chain. the firmness index is related to the acceleration-time curve supplied by an accelerometer attached to an impacting arm. the main objective of this study was to evaluate sensor performance and sources of variation. we made classification trials on three fruits: peaches (prunus persica (l.) batsch), apples (malus domestica borkh.), and pears (pyrus communis l.), as well as working trials, such as placing the fruit, orientation, and others. the sensor works correctly at a speed of 7 fruits s-1 (0.63 m s-1) and allows fruit classification at three levels of firmness using specific software. good discrimination was obtained only for soft peaches. there were variations in results between different fruits and different parts of the same fruit mainly due to the non-uniformity of fruit shape and lack of ripeness homogeneity of each one.
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