Sobre la naturaleza del conocimiento médico y su enseñanza (Parte I) / About the nature of medical knowledge and teaching in the field (Part one)

Introducción: En la actualidad persiste una discusión de larga data en cuanto al grado de especificidad de la educación médica en relación con la educación general. Se han postulado una serie de supuestos educativos propios que confieren características distintivas a la enseñanza de esta profesión. Tales peculiaridades, en el ámbito de la docencia, tienen sus raíces en la propia naturaleza del conocimiento médico y su práctica. Objetivo: Exponer la naturaleza del conocimiento médico y las especificidades de su enseñanza. Posicionamiento del autor: La formación del docente de medicina, con una perspectiva filosófica basada en la crítica de la experiencia y con enfoques epistemológicos de fondo, es una de las áreas críticas que debe recibir atención. Los saberes de carácter metacognitivo, en relación con la naturaleza del conocimiento médico y su enseñanza, deben formar parte tanto del conocimiento de los profesores de medicina como de los propios estudiantes. Conclusiones: La atención clínica de pacientes individuales representa la actividad más característica de la profesión médica. El proceso de diagnóstico constituye la piedra angular del razonamiento clínico. La autoexplicación, la reflexión estructurada, y las oportunidades de actividad clínica constituyen los fundamentos de una eficiente educación médica(AU)

Introduction: A long-standing discussion is still held nowadays concerning the degree of specificity of medical education with respect to general education. A series of educational assumptions have been postulated that confer distinctive characteristics to the teaching of the medical profession. In the field of teaching, such peculiarities are rooted in the very nature of medical knowledge and its practice. Objective: To expose the nature of medical knowledge and the specificities of teaching in the field. Author's position: The training of medical professors, with a philosophical perspective based on the critique of experience and epistemological approaches, is one of the critical areas that should receive attention. Knowledge of a metacognitive nature, in relation to the nature of medical knowledge and teaching in the field, should be part of both the knowledge of medical professors and students themselves. Conclusions: Clinical care of individual patients is an activity inherent to the medical profession. The diagnostic process is the cornerstone of clinical reasoning. Self-explanation, structured reflection and opportunities for clinical activity, are the foundations of efficient medical education(AU)

Conocimientos y prácticas actuales sobre cáncer de mama, preservación de la fertilidad y embarazo. Encuesta a los miembros de la Sociedad Argentina de Mastología / Knowledge and current practices on breast cancer, fertility preservation and pregnancy. Survey to the members of the Argentine Society of Mastology

Introducción: debido al retraso de la maternidad, es probable que las mujeres jóvenes con diagnóstico de cáncer de mama (CM) no hayan completado su proyecto de maternidad al momento del diagnóstico y estén interesadas en su fertilidad futura y podrían enfrentarse también a un cáncer de mama asociado al embarazo. El objetivo del trabajo fue analizar la práctica actual, de los miembros de la Sociedad Argentina de Mastología (SAM), sobre preservación de la fertilidad y embarazo. Material y método: se realizó una encuesta por correo electrónico. Respondieron 213 miembros. Resultados: la frecuencia con la que abordan el impacto del tratamiento oncológico en la fertilidad de las pacientes jóvenes y las derivan, fue "siempre" y "casi siempre" en 84,4% y 74,5% respectivamente. El 73,6% afirmó que el embarazo luego del CM no empeora el pronóstico. El 70,1% consideró seguro el uso de radiocoloides para identificar el ganglio centinela durante el embarazo. Encontramos una diferencia significativa en las respuestas de los profesionales pertenecientes a una UM. Conclusiones: el nivel de conocimiento es similar al de otras encuestas. La pertenencia a una unidad de mastología se asoció a un mejor nivel de actualización. Es necesario seguir trabajando en la capacitación de los profesionales.

Introduction: due to delayed motherhood, Young women diagnosed with breast cancer (BC) are likely to have not competed their maternity Project at the time of diagnosis, are interested in future fertility and may also face pregnancy-associated breast cancer. The aim of this study was to analyze the current practice of the Argentine Society of Mastology (SAM) members, on fertility preservation and pregnancy. Material and method: an email survery was conducted 231 members responded. Results: the frequency with which respondentes discuss the impact of cancer treatment of fertility among Young patients and referral was "always" and "almost always", 84.4% and 74.5% respectively. 73.6% considered pregnancy after BC does not worsen the prognosis. 70.1% used radiocoloids to identify sentinel node during pregnancy. We found a significant difference in the responses of professionals belonging to a Breast Unit. Conclusions: the level of knowledge is similar to that of other surverys. Working within a Breast Unit was associated with a better level of knowledge. Further work is needed in the training of professionals.

Conocimientos de vías de transmisión, medidas de prevención y actitudes sobre COVID-19 en estudiantes de medicina de la Universidad Nacional del Nordeste / Knowledge Of Routes Of Transmission, Attitudes And Prevention Measures Of COVID-19 In Medical Students Of The Universidad Nacional Del Nordeste

Introducción: En 2020, surgió la pandemia del COVID-19, causada por el SARS-CoV-2, asociada a mayor morbi-mortalidad impactando las vidas de la población mundial. Objetivo: Determinar conocimientos de vías de transmisión, medidas de prevención y actitudes sobre COVID-19 en estudiantes de 5° y 6° año de la Facultad de Medicina de la Universidad Nacional del Nordeste en los meses de mayo a junio del 2020. Métodos: Se realizó un estudio descriptivo, transversal con los estudiantes de los últimos años de la Carrera de Medicina. El instrumento fue validado por juicio de expertos. Se utilizó un cuestionario prediseñado ad hoc a través de la plataforma Google Forms. Los datos fueron analizados mediante el software Epi Info versión 7. Resultados: Fueron analizadas un total de 153 encuestas (N=153). La edad media fue 24,8 años. El 42% de los estudiantes encuestados refiere informarse de charlas con médicos, el 15% mediante redes sociales, canales de televisión y blogs y un 13% restante lo hace a través de amigos y/o familiares. El 95,4% de la población estudiada tuvo cambios de actitud aumentó la forma de limpiar/desinfectar las superficies y ambientes. El 70% respondió que es a través del aire (Gotas de Flügge), mientras hablan, tosen o estornuda como la vía de contagio más frecuente. El 84,4% menciona encontrarse tranquilo, el 13% está nervioso y preocupado y el 2,6% cansado. Conclusión: Se encuentran conocimientos adecuados y actitudes positivas en la población estudiada.

Introduction: In 2020, the COVID-19 pandemic emerged, caused by SARS-CoV-2, associated with higher morbidity and mortality, impacting the lives of the world population. Objective: Determine knowledge of transmission routes, prevention measures and attitudes about COVID-19 in 5th and 6th year students of the Facultad de Medicina of the Universidad Nacional del Nordeste in the months of May to June 2020. Methods: A descriptive, cross-sectional study was carried out with the students of the last years of the Medicine career. The instrument was validated by expert judgment. A pre-designed ad hoc questionnaire was used through the Google Forms platform. The data were analyzed using Epi Info version 7 software. Results: A total of 153 surveys were analyzed (N = 153). The mean age was 24.8 years. 42% of the students surveyed refer to information about talks with doctors, 15% through social networks, television channels and blogs and the remaining 13% do so through friends and / or family. 95.4% of the population studied had changes in attitude, increasing the way of cleaning / disinfecting surfaces and environments. 70% responded that it is through the air (Flügge Drops), while talking, coughing or sneezing as the most frequent route of infection. 84.4% mention being calm, 13% are nervous and worried and 2.6% tired. Conclusion: Adequate knowledge and positive attitudes are found in the studied population.

Saberes médicos y reflexiones morales durante el período rosista: Buenos Aires, 1835-1847 / Medical knowledge and moral reflections during the Rosas era: Buenos Aires, 1835-1847

Resumen Este artículo analiza cómo el discurso médico incorpora una serie de reflexiones sobre las conductas morales en Buenos Aires en la primera parte del siglo XIX. A través del estudio de tres textos, cuyos autores son los médicos Diego Alcorta, Guillermo Rawson y Francisco Javier Muñiz se identifican una serie de registros argumentales que resaltan el funcionamiento de los órganos, la cuestión de la herencia y la gravitación del clima en función de reflexionar sobre la moralidad de los individuos y las poblaciones. Este fenómeno de transferencia de saberes se debe a la presencia de la tradición médica francesa sumándose a factores locales derivados del intenso proceso de politización de la sociedad bajo el segundo gobierno de Juan Manuel de Rosas.

Abstract This article analyzes how medical discourse incorporated a series of reflections on moral behaviors in Buenos Aires in the early nineteenth century. Based on the study of three texts authored by the physicians Diego Alcorta, Guillermo Rawson and Francisco Javier Muñiz, it identifies a series of discursive registers that stress the role of organ functions, the question of heredity and the influence of climate in reflections on the morality of individuals and populations. This phenomenon of knowledge transfer is due to the presence of the French medical tradition, in addition to local factors stemming from the intense process of politicization of society under the second administration of Juan Manuel de Rosas.

Baldomero Sommer (1857-1918). Contribución a la capacitación permanente en posgrado en medicina / Baldomero Sommer (1857-1918). Contribution to permanent postgraduate training in medicine

A finales del siglo XIX e inicios del siglo XX, Baldomero Sommer realizó una decisiva contribución al conocimiento médico nacional y a los procesos de enseñanza y aprendizaje de la medicina.

During the end of the XIX century and the beginning of XX century Baldomero Sommer provided a decisive contribution of the medical knowledge national, the teaching and learning processer of medicine.

Text and Practice in East Asian Medicine: The Structure of East Asian Medical Knowledge Examined by Donguibogam Currents in Contemporary South Korea / 의사학

How do classical texts, such as Hwangdi Neijing and Shanghanlun, continuously play significant roles in medical practices in the history of East Asian medicine? Although this is a significant question in interpreting the position of written texts in the medical history and even for understanding the structure of East Asian medical knowledge, it has been conspicuously underexamined in the studies of East Asian medicine. In order to explore this underrepresented question, this study focuses on currents of tradition in contemporary South Korea. Drawing on anthropological fieldwork at three Donguibogam (Treasured Mirror of Eastern Medicine) currents, it delves into the interaction of text and practice in East Asian medicine. Even though all three currents (Hyun-dong, Byeong-in, Hyung-sang) are based on Donguibogam, their ways of reading the text and organizing clinical practices are diverse. Each current sets up a keyword, such as pulse diagnosis, cause of disease, and appearance-image, and attempts to penetrate the entire Donguibogam through the keyword. This means that the classical medical text is open to plural approaches. This study found that there is a visible gap between a medical text and the reader of the text in East Asia. Masters and currents of tradition are the actors who fill up the gap, continuously interpreting and reinterpreting classical texts, and guiding medical practices of new readers. Adding the history of practice to the body of literature that have focused on the history of written texts, this study will contribute to the history of East Asian medicine.

Sanadores inesperados: medicina china en la era de migración global (Lima y California, 1850-1930) / Unexpected healers: Chinese medicine in the age of global migration (Lima and California, 1850-1930)

Resumen Las masivas olas de migrantes chinos que llegaron a California y Lima en la segunda mitad del siglo XIX jugaron un rol clave en la expansión de la medicina china en ambos contextos. Desde fines de la década de 1860, los herbolarios expandieron su sistema de sanación más allá de su comunidad étnica, transformando la medicina china en una de las prácticas de sanación más adoptada por la población local. Desde una perspectiva comparada, este artículo examina las divergentes trayectorias de los sanadores chinos en Perú y EEUU, así como los factores sociales y políticos que determinaron la adaptación de este conocimiento médico, foráneo, en su nuevo entorno.

Abstract The massive waves of Chinese migrants arriving in California and Lima in the second half of the nineteenth century played a crucial role in expanding Chinese medicine in both settings. From the late 1860s on, herbalists expanded their healing system beyond their ethnic community, transforming Chinese medicine into one of the healing practices most widely adopted by the local population. This article uses a comparative approach to examine the diverging trajectories of Chinese healers in Peru and the USA, as well as the social and political factors that determined how this foreign medical knowledge adapted to its new environments.

Comparative Analysis of Linguistic Features in Medical Knowledge Base / 医学信息学杂志

Taking Physician Data Query (PDQ(R)),which is provided for doctors and patients by National Cancer Institute (NCI),for example,the paper carries out comparative analysis on professional and public editions of PDQ from the perspective of vocabulary and syntax to make clear the significant statistical difference between the knowledge bases facing patients and doctors.

A medicina é uma piada: representações humorísticas sobre médicos no jornal Santuário da Trindade / Medicine is a joke: humorous depictions of physicians in the Santuário da Trindade newspaper

O artigo analisa a representação do saber médico em Goiás nas primeiras décadas do século XX por meio de anedotas e artigos presentes no jornal católico Santuário da Trindade, em circulação de 1922 a 1931. Refletindo certo estranhamento à modernização da medicina, as anedotas ridicularizavam a ciência médica, demonstrando aquilo que Bakhtin caracterizou como a irreverência da cultura popular em relação às instituições sérias. Por outro lado, os saberes médicos foram altamente valorizados nos artigos do periódico, servindo como legitimadores do discurso moralizador de seus editores. Assim, no jornal, esses saberes foram representados, simultaneamente, de modo respeitoso e debochado, revelando a complexidade da absorção das mudanças nas práticas médicas no período.(AU)

This article analyzes representations of medical knowledge in Goiás in the early decades of the twentieth century through anecdotes and articles in the Catholic newspaper Santuário da Trindade, which circulated from 1922 to 1931. The anecdotes reflect a certain distancing from the modernization of medicine and ridicule medical science, demonstrating what Bakhtin characterized as the irreverence of popular culture in relation to serious institutions. On the other hand, medical knowledge was greatly esteemed in the paper's articles, and served to legitimize the moralizing discourse of its editors. Therefore, in the same newspaper this knowledge was simultaneously represented respectfully and mocked, revealing the complexity of how changes in medical practices during the period were absorbed.(AU)

O saber médico e o jornalismo especializado em saúde: como uma epidemia se torna notícia / The medical knowledge and the health news: how an epidimic is reported / El conocimiento médico y el periodismo especializado en salud: como una epidemia se convierte en noticia

Neste artigo, analisamos como os casos de microcefalia no Brasil foram noticiados como uma epidemia. As notícias surgiram como alertas e buscaram explicações para o problema, além de discutirem eventuais soluções. A partir do conceito de saber médico e da delimitação de características do jornalismo especializado em saúde, observamos como o conhecimento produzido pelo jornalismo é útil para a disseminação e fortalecimento desse sistema. A cobertura mostrou como os conceitos de biopolítica e governamentalidade ganham dimensões próprias ao enxergarmos o jornalismo especializado em saúde como dispositivo e tecnologia de poder.

In this article, we analyze how cases of microcephaly in Brazil were reported as an epidemic. The news have came as alerts and sought explanations for the problem, as well as they have discussed possible solutions. From the concept of medical knowledge and from the delimitation of characteristics of health news, weobserve how the knowledge produced by journalism is useful for the dissemination and strengthening of this system. The coverage showed how the concepts of biopolitics and governmentality gain their own dimensions when we understand health news as a device and technology of power.

En este artículo, se analiza cómo se registraron los casos de microcefalia en Brasil como una epidemia.Las noticias surgieron como alertas y buscaron explicaciones para el problema, y tambien discutieron posibles soluciones. Desde el concepto de conocimiento médico y de la delimitación de las características de periodismo especializado en salud, observamos cómo el conocimiento producido por el periodismo es útil para la difusión y fortalecimiento de este sistema. La cobertura mostró cómo los conceptos de biopolítica y gubernamentalidad ganan dimensiones propias cuando vemos el periodismo especializado en salud como dispositivo y tecnología de poder.

Research of the medication rules of ankylosing spondylitis based on the famous doctors' medical records / 国际中医中药杂志

Objective Applyingthe traditional Chinese medical knowledge service and sharing system, to explore the medication rules of ankylosing spondylitis in the medical records.Methods The ankylosing spondylitis medical records in the traditional chinese medical knowledge service and sharing system has been searched and 149 prescriptions were identified. The medication frequency, association rules, herbal combination and the cluster analyses were explored.Results Among the 149 prescriptions with 210 drugs, the use of high frequency drugs wereGouji, Baishao, Danggui, Duzhong, Weilingxian, and other medication whose frequency was more than 20 times were good at tonifying liver and kidney, activating blood circulation, clearing heat and promoting diuresis, dispelling cold and removing dampness. The high frequency of drug combinations included Sangjisheng and Gouji, Duzhong and Gouji, Baishao and Gouji, Guizhi and Baishao, Gancao and Danggui.Conclusions The treatment of ankylosing spondylitis with Chinese medicine is mainly based on tonifying liver and kidney, supplemented with drugs for warming Kidney Yang, dispelling cold and dehumidification, promoting blood circulation and removing blood stasis, clearing heat and promoting diuresis, dispelling wind and cold.

Review on the Construction Methods of Ontology-based Medical Knowledge Base / 医学信息学杂志

Around the ontology construction,diagnosis rule construction,ontology inference mechanism and so on in the process of ontology-based construction of medical knowledge base,the paper states respectively the involved key technologies and methods in each link,lists the examples of the construction of the domain knowledge base through relevant technologies,explores the best method of constructing the medical domain knowledge base.

O paciente informado e os saberes médicos: um estudo de etnografia virtual em comunidades de doentes no Facebook / The informed patient and medical knowledge: a virtual ethnography study of Facebook communities of the infirm

Resumo O mundo presencia atualmente a emergência do “paciente informado”: indivíduo inteirado sobre sua condição de saúde, devido à pesquisa extensa e ao compartilhamento de informação que realiza na internet. Este artigo analisa a seguinte questão: “paciente informado” promove o empoderamento do cidadão ou amplia a dominação dos saberes biomédicos instituídos? Foi realizado estudo exploratório em três grupos on-line no Facebook que reúnem portadores de diabetes, hepatite C e Aids, utilizando a etnografia virtual. Os resultados indicam que há tensões pontuais entre frequentadores de grupoon-line e seus médicos assistentes. É possível que o empoderamento proporcionado pela internet e a validade dos saberes médicos na atualidade não sejam dimensões mutuamente excludentes.

Abstract Today’s world has brought the emergence of the “informed patient:” someone who becomes well-informed about his or her medical condition through extensive research and information-sharing on the Internet. The article explores the following question: Do informed patients foster citizen empowerment or do they expand the command of existing biomedical knowledge? Using virtual ethnography, an exploratory study was conducted on three online Facebook groups of people with diabetes, hepatitis C, and Aids. Findings suggest points of tension between Facebook members and their healthcare providers. It may be that the empowerment fostered by the Internet and the validity of current medical knowledge are not mutually exclusive.

UKM Students Global Mobility Programme to Niigata: Gaining New Experience, Medical Knowledge and Culture in Japan

In the middle of January 2014 during the winter season, three post graduate students from Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) were invited to have a taste of experience on public health practice in Niigata Graduate School of Medicine & Dental Sciences (NU) under Division of International Health (Public Health). This is the fourth group which was invited through the student exchange program between both universities. The journey took almost 7 hours from Kuala Lumpur International Airport to Narita International Airport by plane; and another 2 hours by bullet train (shinkansen) ride from Tokyo City to Niigata prefecture. The cold weather, which was below 2 degree Celsius, did not stop our burning desire to step into the country which was well known for its modernization and yet still upholding its ancient and renowned tradition. Not many would know that Niigata was known as the “Rice Capital of Japan”. The large variation of seasons and temperature between night and day, the fertile soil and the pristine melting snow that feeds into the rice paddies create a natural environment for nurturing Niigata’s exquisite rice. Niigata boasts Japan's biggest harvest of rice, which is essential to Japanese cuisine, crackers and sake production. During our visit, we were made known on the Japanese code of etiquette, which governs the expectations of social behaviour in the country and is considered very essential. Bowing for example, is considered extremely important in Japan, so much so that, although children normally begin learning how to bow from a very young age, companies commonly provide training to their employees in how to execute bows correctly. There are also certain etiquette applied during eating, drinking, exchanging gifts and visiting. Giving a personal business card is essentially important and therefore we were made the effort to prepare our own cards during the visit. Upon our arrival, we were welcomed by the Head of Public Health Division; Prof. Dr. Reiko Saito and her colleague, Dr. Yugo Shobugawa. The introduction to the division was given and we were introduced to the staff in the division. The division is currently prioritising on the research related to avian influenza as well as Norvovirus through genetic study and Geographical Information System (GIS). During the first day of the visit, we were astonished to know that Niigata city possess its own “public health hospital” which was developed to cater disease outbreak and disaster. Recently it has been used for influenza outbreak as well as providing healthcare services for the victims of earthquake. During the usual operating hours, the hospital will provide a specialist health clinic ranging from internal medicine, orthopedics, pediatrics and obstetrics speciality. It has its own disaster wards, complete with laboratory as well as radiological investigation equiptments.​

The perceptual differences in learning outcomes between education and achievement levels between faculty and students in medical schools / 한국의학교육

PURPOSE: The purpose of this study was to compare the perception of learning outcomes between faculty and students in medical schools. METHODS: A total of 1,766 medical students and 436 faculty members participated in the survey. They responded to the perception of four learning outcomes: medical knowledge and problem solving, clinical skills, medical ethics, and clinical communication. The participants responded to the education and achievement levels of the learning outcomes. RESULTS: In all four learning outcomes, the student's perception of education level differed by educational system, and the students in mixed systems had the highest scores. Students differed significantly in achievement level of medical ethics between genders, wherein male students perceived their achievement level to be higher than females. Students perceived their achievement level to be lower than the education level. The students' clinical skills were the highest in the education and achievement levels. The faculty perceived the education level to be higher than the student's achievement level. In particular, the faculty's perception of education level of medical knowledge and problem solving was the highest, whereas the students' achievement level of it was lower. The faculty assessed the education level to be higher than students. The students showed higher perception of achievement level than faculty. CONCLUSION: There were perceptual differences in learning outcomes between students and faculty. The results of this study are expected to be used to design outcome-based learning methods.

Notas sobre "Um Discurso sem Palavras": a psicanálise na instituição de saúde / Notes about "A Discourse without Words": the psychoanalysis on health institution / Notas sobre "Un Discurso sin Palabras": psicoanálisis en la institución de salud / Notes sur "Un Discours sans Paroles": le psychanalyse sur la sante l'établissemen

Ao exteriorizar seus anseios acerca do alcance da psicanálise para além dos limites do consultório particular, Freud já chamava nossa atenção para dirigirmos nosso olhar ao sujeito, ao seu sofrimento, não importando em que lugar ou condições ele pudesse se encontrar. Já indicava, assim, uma articulação possível entre a psicanálise e a instituição. Tratando-se, pois, do dispositivo analítico como aquele que não se restringe ao consultório, mas que se aplica a qualquer configuração analítica, o presente trabalho, fruto de questões articuladas no grupo de pesquisa "Psicanálise, sintoma e instituição", propõe discutir o fazer da psicanálise enquanto um saber fazer que propicia um lugar para o sujeito, a despeito do local onde ela opere. Por conseguinte, entendemos que, na instituição de saúde, isso não se dê de modo diverso, porquanto, ainda que o contexto seja outro, a ética psicanalítica é a mesma. Se o sujeito tende a ser excluído na instituição regida pelo saber médico, o discurso psicanalítico, por sua vez, o inclui, na medida em que favorece o bem-dizer do desejo, logo, de um dizer que remete ao inconsciente. Para tecer algumas considerações acerca dessa temática, tomamos por fio condutor uma curiosa expressão proferida por Lacan: "um discurso sem palavras". Com ela, podemos pensar na psicanálise enquanto um lugar discursivo onde cabe um fazer diferente: o de possibilitar o pronunciamento do sujeito do inconsciente através da palavra, oferecendo-lhe a escuta e permitindo que apareça aquilo que é da subjetividade, propiciando ao sujeito um lugar no e pelo discurso.

In externalizing their wishes about the scope of psychoanalysis beyond the limits of the private practice, Freud was calling our attention to direct our gaze to the subject and his suffering, no matter the places or conditions he could be found. At the time, Freud was already indicating a possible link between psychoanalysis and the institution. As the analytical device is one that is not restricted to the office, but that applies to any analytic setting, the present work is a result of issues articulated in the research group "Psychoanalysis, symptom and institution" and aims to discuss the doing of psychoanalysis as an expertise that provides a place for the subject, regardless of where it operates. Therefore, we believe that in health facilities it does not happen in a different way, because even though the context is different, the psychoanalytic ethics is the same. Else, if the subject tends to be excluded when in an institution governed by medical knowledge, the psychoanalytic discourse, in turn, includes the subject, as far as it favors the well-saying of desire, a discourse which refers to the unconscious. In addition, to make a few observations about this issue, we refer to a curious expression by Lacan: "a discourse without words". With it, we can think of psychoanalysis as a discursive place, that have a different doing which allows the pronouncement of the subject of the unconscious through the word, offering the listening and thus allowing the rise of the subjectivity, providing a place to the subject, on and by the discourse.

Al exteriorizar sus preocupaciones sobre el alcance del psicoanálisis más allá de los límites de la práctica privada, Freud ya llamaba nuestra atención a dirigir nuestra mirada al sujeto y su sufrimiento, no importando en qué lugar o condiciones él estuviese. Por lo tanto, Freud ya indicaba una posible relación entre el psicoanálisis y la institución. Por lo tanto, no siendo el dispositivo analítico limitado a la oficina, pero que se aplica a cualquier ámbito de análisis, el presente trabajo, resultado de las discusiones enunciadas en el grupo de investigación "Psicoanálisis, síntoma y institución" tiene como objetivo discutir la hacer del psicoanálisis como un saber hacer que proporciona un lugar para el sujeto, independientemente del lugar en que ella opera. Por lo tanto, entendemos que en lá institución de salud no ocurre de manera diferente, porque aunque el contexto sea otro, la ética psicoanalítica es la misma. Y si el sujeto tiende a ser excluido cuando en la institución gobernada por el conocimiento médico, el discurso psicoanalítico, a su vez, o incluye, en la medida en que favorece el bien-decir del deseo, por lo que un decir que se refiere al inconsciente. Y para hacer algunas observaciones sobre este tema, tomamos como direccíon una expresión curiosa pronunciada por Lacan: "un discurso sin palabras". Con ella, podemos pensar en el psicoanálisis como un lugar discursivo que tiene un hacer diferente: permitir el pronunciamiento del sujeto del inconsciente através de la palabra, ofreciendo a escucharlo y por lo tanto permitiendo que la subjetividad aparezca, proporcionando para el sujeto un lugar en el discurso.

En externalisant leurs préoccupations quant à la portée de la psychanalyse au-delà des limites de la pratique privée, Freud a appelé notre attention pour diriger notre regard vers le sujet, sa souffrance, peu importe ce place ou les conditions qui pourraient être trouvés. Il indique donc un lien possible entre la psychanalyse et l'institution. Par conséquent, si le dispositif analytique ne se limite pas au bureau, mais 'applique à toute situation analytique, le présent travail, résultat de problèmes articulés dans le groupe de recherche "Psychanalyse, symptôme et institution", a pour but de discuter de la faire de la psychanalyse comme un savoir-faire qui donne une place pour le sujet, indépendamment du lieu où elle opère. De sorte, nous croyons que en l'établissement de santé ne se produit pas différemment, parce que même si le contexte est un autre psychanalytique éthique est la même. Et si le sujet peut être supprimé l'institution régie par les connaissances médicales, le discours psychanalytique, à son tour, comprend le sujet, dans la mesure où elle favorise le bien dit du désir, donc un disent qui fait référence à l'inconscient. Et pour faire quelques observations sur cette question, nous nous référons une expression curieuse dit par Lacan: "un discours sans paroles". Avec elle, nous pouvons penser de la psychanalyse comme une place discursive, celle qui correspond à un faire différent: permettre le prononcé du sujet de l'inconscient à travers la parole, offrant une écoute et permettant ainsi la subjectivité apparaît, donnant le sujet une place dans le discours et par le discours.

'Medical Knowledge' and 'Tradition' of Colonial Korea: Focused on Kudo's "Gynecology"-based Knowledge / 의사학

This article attempts to illuminate the ways in which Kudo's medical knowledge based on 'gynecological science' constructed the cultural 'traditions' of colonial Korea. Kudo appears to have been quite an influential figure in colonial Korea in that his writings on the relationship between women's crime, gynecological science and the Choson society granted a significant amount of intellectual authority. Here, I examine Kudo's position within colonial Korea as a producer and propagator of medical knowledge, and then see how women's bodies were understood according to his gynecological knowledge. It also traces the ways in which Kudo's gynecological knowledge represents Choson society and in turn invents the 'traditions' of Chosn. Kudo's knowledge of "gynecology" which had been formed while it traveled the states such as Japan, Germany and France served as an important reference for his representation of colonial Korean society. Kudo was a proponent of biological evolution, particularly the rules of 'atavism' put forth by the criminal anthropologist Cesare Lombroso, and argued that an unique social environment caused 'alteration of sexual urges' and primitive cruelty in Choson women. According to Kudo, The social environment was none other than the practice of 'early marriage,' which went against the physiology of women. To Kudo, 'early marriage' was an old 'tradition' of Choson and the cause of heinous crimes, as well as an unmistakable indicator of both the primitiveness and savageness of Chosn. While Lombroso considered personal factors such as stress as the cause of women's crimes, Kudo saw Choson women's crimes as a national characteristic. Moreover, he compared the occurrence rate of husband murders by provinces, based on which he categorized the northern population of Choson as barbaric Manchurian and the southern population as the superior Japanese, a combination of racism and scientific knowledge. Kudo's writings provide an insight into the appropriation of Western medical theories and criminal anthropological knowledge by a non-Western colony as well as the ambivalence and contradictions underlying Japanese empire as in the use of concepts like 'difference' and 'unity.' According to today's standards, Kudo's physiological arguments can hardly avoid being called pseudo science, which confirms that the power and authority of science standing on 'objectivity' and 'universality' are actually dependent on social contexts that are constantly being readjusted. In the end, the cultural 'traditions' of a nation/state often taken for granted are social constructions born out of transnational crossing points of knowledges, and on the basis of these constructs are the concepts of differences between nations/states. And one of the core references for these differences in colonial Korea was Western science/medical knowledge.

Survey and research on basic medicine knowledge of non-medical students in university / 中华医学教育探索杂志

Objective To research into the current situation of basic medicine knowledge grasp of non-medical students in local comprehensive university and to discuss the significance and necessity of launching basic medicine knowledge education in comprehensive university.Methods Random sampling was used to survey non-medical students of 1-3 grades in three gorges university with questionnaire.SPSS 13.0 software was used to do statistical analysis.Results 89.1％ undergraduates had consciousness to deal with slight illness and slight wound by themselves and 95.4％ undergraduates would prepare some drug to use when necessary.But only 37.2％ undergraduates knew the medicine classification management method of our country and 94.2％ undergraduates might abuse common medicine.96.7％ undergraduates thought that popularizing basic medicine knowledge by selected courses in university was necessary.Conclusions Most undergraduates lack basic medicine knowledge and potential medicine safety hazard like abuse medicine is existed.Education on basic medicine knowledge in university is of great significance in improving the life quality and basic quality of undergraduates.

Conocimiento médico y su gestión / Medical knowledge and its management

Introducción: El conocimiento es el principal recurso del que se dispone en la Era de la Información y esta afirmación se hace extensiva para el campo de las Ciencias Médicas. Desarrollo: Con el objetivo de reflexionar sobre la importancia de una gestión adecuada, se hace una exposición sobre el tema con énfasis en las características de la práctica médica en la época actual y las controvertidas implicaciones del surgimiento de la Medicina, basada en evidencias, desde el punto de vista epistemológico y práctico. Se comentan las ventajas que ofrecen las tecnologías de la Información en este propósito. Conclusión: La adecuada gestión del conocimiento médico constituye una verdadera prioridad en nuestros tiempos y para ello se requiere del desarrollo de todos los elementos implicados en el proceso: recursos materiales, recursos humanos (especialmente alfabetización informacional) y voluntad política.

Introduction: In general, knowledge is the main resource in the Information Era but concerning Medical Sciences this issue is of particular interest. To call for attention about the importance of an adequate knowledge management is the essential purpose of this paper, focussing on the medical practice features in the XXI century and the evidence based medicine controversial implications from the epistemological and practical point of view. The advantages of information technologies are commented. Conclusion: As a real priority of these times, adequate medical knowledge management needs the development of all the elements related to the process: material resources, human resources (especially concerning informational literacy) and political strategies.