Beatriz Shand - Academia.edu (original) (raw)

Papers by Beatriz Shand

Rev Chil Med Intensiv, 2004

Headache-related healthcare system utilization. Number of consultations per year are categorizes ... more Headache-related healthcare system utilization. Number of consultations per year are categorizes into 4 groups, and shown as percentage of the student population. 1Missing data on 3 patients from Germany and 5 patients from Spain, respectively. (PDF 55 kb)

Medication overuse headache sub-diagnosis and duration of medication overuse. The table character... more Medication overuse headache sub-diagnosis and duration of medication overuse. The table characterizes the medication overuse headache (MOH) sub-diagnosis. Results are shown as percent of patients with a specific MOH sub-diagnosis. Numbers in brackets presents the proportion of the patient population that used a specific analgesics 30 days/month. p-values correspond to comparison of MOH sub-diagnosis between Europe and Latin America. *p

Multiple medication overuse headache sub-diagnoses and specific combination of medication overuse... more Multiple medication overuse headache sub-diagnoses and specific combination of medication overuse. The table characterizes the proportion of patients with multiple medication overuse headache (MOH) sub-diagnoses and the specific medication overuse profile. The data are shown as percentages. (PDF 66 kb)

Revista Colombiana de Filosofía de la Ciencia, 2016

Se presenta una comparación entre la descripción de la simpatía por Adam Smith en el libro La Teo... more Se presenta una comparación entre la descripción de la simpatía por Adam Smith en el libro La Teoría de los Sentimientos Morales (TSM) y la empatía comprendida como fenómeno psicológico en la perspectiva neurocientífica. Esta comparación se realiza en tres momentos: en la génesis de la empatía, en la conformación de la capacidad empática durante el desarrollo humano y en las implicancias sociales y morales de la empatía. A pesar de la distancia temporal y epistémica de ambas perspectivas, se aprecian como aspectos comunes: el reconocimiento de la empatía como fenómeno connatural a lo humano y la modulación o desarrollo de la empatía en la interacción social. Las perspectivas se distancian en las implicancias sociales y morales de la empatía. En la TSM se propone la empatía como la trama psicológica básica desde dónde surge la moralidad. La interpretación neurocientífica apunta hacia una reducción funcionalista de la moral.

This work presents a comparison between the Adam Smith’s description of sympathy in the book The ... more This work presents a comparison between the Adam Smith’s description of sympathy in the book The Theory of Moral Sentiments (TSM) and the empathy understood as a psychological phenomenon in Neuroscience. This comparison is developed in three moments: in that of the genesis of empathy, in the configuration of empathic capacity during human development and in the social and moral implications of empathy. Despite the temporary and epistemic distance of both perspectives, they have common views: the recognition of empathy as a connatural phenomenon to the human being and the modulation or development of empathy in social interaction. These perspectives have differences related to the social and moral implications of empathy. The TSM identifies empathy as a source of morality. Neuroscience understands empathy as part of a functionalistic moral system.

Headache: The Journal of Head and Face Pain, 2019

; the Comoestas Consortium Background.-The International Classification of Headache Disorders lis... more ; the Comoestas Consortium Background.-The International Classification of Headache Disorders lists different subtypes of medication overuse headache (MOH), according to the medication overused. The aim of this study is to evaluate whether the different subtypes correspond to clinically distinguishable phenotypes in a large population. Method.-This descriptive cross-sectional observational study included 660 patients with MOH referred to headache centers in Europe and Latin America as a part of the COMOESTAS project. Information about clinical features was collected with structured patient interviews and with self-administered questionnaires for measuring disability, anxiety, and depression. Results.-Female/male ratio, body mass index, marital status, and level of education were similar among in subjects enrolled in the 5 centers. The mean age was higher among subjects overusing triptans (T-MOH) with respect to subjects overusing simple analgesic (A-MOH). Duration of headache before chronification was longer in T-MOH (19.2 ± 11.9 years) and in subjects overusing ergotamines (E-MOH, 17.8 ± 11.7 years) with respect to the A-MOH group (13.1 ± 10.9; P < .001 and P = .017, respectively) and in T-MOH with respect multiple drug classes (M-MOH, 14.9 ± 11.7; P = .030). Migraine Disability Assessment (MIDAS) score was significantly lower in E-MOH group (33.6 ± 41.6), while T-MOH group (56.8 ± 40.6) had a significant lower MIDAS score with respect to M-MOH (67.2 ± 62.5; P = .016 and P = .037, respectively). Prevalence of depression and anxiety was lower in patients overusing T with respect to other groups of patients (χ 2 = 10.953, P = .027 and χ 2 = 25.725, P < .001, respectively). Conclusion.-In this study on a large and very well characterized population of MOH, we describe the distinctive clinical characteristics of MOH subtypes. These findings contribute to more clearly define the clinical picture of a poorly delineated headache disorder. They also provide some insights in the possible trajectories leading to this highly disabling chronic headache, that is classified as a secondary form, but whose occurrence is entirely dependent on an underlying primary headache.

Revista Colombiana de Filosofía de la Ciencia, 2017

Los artículos publicados en la revista The Kaizo giran en torno a la posibilidad de una ética cie... more Los artículos publicados en la revista The Kaizo giran en torno a la posibilidad de una ética científica para la humanidad. El autor reconoce el carácter preliminar de estos ensayos en el camino hacia una ética fundamental como una condición inevitable dado el estatus de desarrollo de la ciencia racional del espíritu (Husserl). No obstante, pueden reconocerse en ellos los elementos principales para una ética científica, a saber: el actuar libre, la lucha (o combate) ética, la responsabilidad y la idea-meta del hombre ético o de la auténtica humanidad.

The journal of headache and pain, 2015

Medication overuse headache (MOH) is a very disabling and costly disorder due to indirect costs, ... more Medication overuse headache (MOH) is a very disabling and costly disorder due to indirect costs, medication and healthcare utilization. The aim of the study was to describe general demographic and clinical characteristics of MOH, along with the national referral pathways and national painkillers distribution in several European and Latin American (LA) Countries. This descriptive cross-sectional observational study included 669 patients with MOH referred to headache-centers in Europe and LA as a part of the COMOESTAS project. Information about acute medication and healthcare utilization were collected by extensive questionnaires, supplemented with structured patient interviews. Triptans were overused by 31 % European patients and by 6 % in LA (p < 0.001), whereas ergotamines were overused by 4 % in Europe and 72 % in LA (p < 0.001). Simple analgesics were overused by 54 % in Europe and by 33 % in LA (p < 0.001), while combination-analgesics were more equally overused (24 % i...

There are two apparently irreconcilable positions in response to the question as to whether it is... more There are two apparently irreconcilable positions in response to the question as to whether it is morally permissible to suspend nutritional support to patients in a vegetative state. On the one hand, there is nutrition invariably understood as basic care and, therefore, mandatory. On the other, there is the idea that assisted nutrition is therapy and, consequently, is always optional. Two relevant questions become confused in this discussion: Is assisted nutrition a basic measure or is it a treatment? And, morally speaking, is assited nutrition optional or mandatory? To answer these questions adequately, one must consider the obligation to care each person has with respect to their own health and that of others who are entrusted to our care. Not all treatment under any circumstance should be regarded simply as �optional�. In each case, the most appropriate course, from an ethical standpoint, is to judge proportionality. This paper offers a critical review of current positions on th...

Internal Medicine Issues in Palliative Cancer Care, 2015

Nutrition and the Cancer Patient, 2010

Revista chilena de neuro-psiquiatría, 2007

Revista médica de Chile, 2009

Ethical problems in medical services from the patients' point of view Background: There is a pauc... more Ethical problems in medical services from the patients' point of view Background: There is a paucity of information on the perception of patients about ethical issues in medical practice. Aim: To determine the type and frequency of ethical problems perceived by patients hospitalized in public and private hospitals. Material and methods: Eighty eight subjects aged 65 years (48% women), admitted to a public hospital and 44 subjects aged 59 years (52% women) admitted to a private clinic answered a survey about ethical problems. The main issues covered were medical information management, participation in decision making and intimacy of patients. Results: Fifty three percent of patients perceived at least one ethical problem. Patients admitted to the public hospital perceived more communication and intimacy problems than their peers admitted to a private clinic. Conclusions: Approximately half of the interviewed patients acknowledged the presence of ethical problems, especially in the communication and intimacy areas (Rev Méd Chile 2009; 137: 759-65).

Revista médica de Chile, 2013

Survey on moral judgment criteria among medical students Background: The evaluation of moral judg... more Survey on moral judgment criteria among medical students Background: The evaluation of moral judgment criteria in medical students is important to develop effective educational programs in bioethics. Aim: To compare priority judgment criteria and moral judgment tendency in medical students of first and fifth grade. Material and Methods: The Moral Foundations Questionnaire (MFQ30), to identify moral criteria was applied to 259 students, 63.7% from first year and 50.2% women. Results: The dominant moral tendency both in first and fifth year students was liberal. Justice and compassion were the most important criteria in men and in women, respectively. Respect towards authority and sanctity were the least important criteria in women and men, respectively. Conclusions: The implications for moral psychology and medical education of these results are discussed.

Revista médica de Chile, 2010

Contribution of epigenetics to understand human development Epigenetics refers to the study of ho... more Contribution of epigenetics to understand human development Epigenetics refers to the study of how genes produce their effect on the phenotype of the organism. This article is a review on the scope and importance of recently discovered epigenetic mechanisms on human development and their relationship to perinatal epidemiological issues. It shows a general view and present concepts about epigenetics and its contribution to the comprehension of several physiologic and pathological conditions of human beings. Secondly, it analyzes the evidence coming from epidemiological and animal studies, about the influence of events that occur in the perinatal and early postnatal periods on adult life and the possible epigenetic mechanisms involved. Lastly, it underscores the implications of these results of future research and the design of public policies that take into account the importance of events in early life in the future development of individuals.

Psycho-Oncology, 2011

Background: Decrease in oral intake, weight loss, and muscular weakness in the last phases of a t... more Background: Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of patient, family, and health staff. Methods: The present literature review examines the emotional impact of reduced oral intake as well as perceptions and attitudes toward assisted nutrition and hydration for terminally ill patients 1 at the end of life, among patients, family, and health care staff. We have identified the ways in which emotional and cultural factors influence decision-making about assisted nutrition and hydration. Results: Lack of information and misperceptions of medically assisted nutrition and hydration can play a predominant role in the decision to begin or suspend nutritional or hydration support. Conclusions: Our literature review reveals that these social, emotional, and clinical misperception elements should be considered in the decision-making processes to help the triad develop functional forms of care at this final stage of life.