La calidad de vida oral en un grupo de adultos mayores de la ciudad de Medellín, Colombia

Antecedentes/Objetivos: La transición demográfica que se presenta en la última década implica un esfuerzo para los profesionales de la salud bucal en conocer como es el comportamiento de los pacientes mayores de 65 años y en especial la comprensión de los impactos que se generan a nivel de su Calidad de Vida Oral-CVO. Muchos estudios se plantean hoy para el análisis en estas dimensiones subjetivas que resumen el vínculo estrecho entre la salud oral y general del paciente mayor, sin embargo, nuestro objetivo es conocer el impacto de las condiciones bucales en la calidad de vida de un grupo de pacientes mayores que frecuentan la red pública hospitalaria en la ciudad de Medellín. Métodos: Estudio de corte trasversal con muestreo aleatorio de 2 etapas en unidades hospitalarias y centros de salud de la red de salud pública “METROSALUD”. La muestra incluyó 352 adultos ≥ 65 años quienes se sometieron a un examen bucal y una encuesta estructurada. Se analizaron las características socio-demográficas y se aplicó el Índice de Calidad de Vida Oral en Geriatría –GOHAI con análisis por separado para los hombres (H) y mujeres (M). Resultados: Siendo enfocada la atención pública de la red hospitalaria principalmente para usuarios de niveles socioeconómico medio-bajo, los hallazgos ratifican que el 84% de los mayores viven particularmente en este entorno. Los indicadores muestran un CAOD de 23,8; IC95%: 22,7-24,8 (H: 23,3; IC95% 21,8-24,8 y M: 24,3; IC95% 23,0-25,6) y una tendencia del GOHAI hacia niveles bajos en el 67,9% de los entrevistados (M: 68,9%, M: 67,3%) con diferencias estadísticamente significativas según el sexo. Un indicador GOHAI de 44,42 (IC95%) en CVO indica una interpretación negativa del índice, sin embargo, estudios realizados con una metodología similar en países como Brasil (GOHAI: 33,8-CAOD: 26,7) y Arabia Saudí (GOHAI: 32,1-CAOD: 20,7), reportan valores muy negativos respecto a los encontrados en nuestro estudio. La Calidad de Vida Oral de los pacientes mayores de la ciudad de Medellín, se aproxima a niveles de comunidades estudiadas en China (GOHAI: 48,9-CAOD: 18,8), Malasia (GOHAI: 46,2-CAOD: 20,2) e incluso Francia (GOHAI: 46). Conclusiones: La calidad de vida oral con niveles bajos en la población adulta mayor de la ESE Metrosalud de Medellín, se ve impactada negativamente según los resultados asociados al estado de la dentición. Se plantea el análisis de las dimensiones de malestar psicológico, dolor físico y limitación funcional y la oportunidad para priorizar con estrategias que fortalezcan la Atención Primaria

A Qualitative Study of the Health Perceptions in the Venezuelan Immigrant Population in Medellín (Colombia) and Its Conditioning Factors

This study explored the general and oral health perceptions in the Venezuelan immigrant population in Medellín (Colombia) and its conditioning factors. A qualitative study involving Venezuelan immigrants ≥18 years with a minimum stay of six months in Colombia was conducted. Dentists, dental students, and other health professionals also participated. Semi-structured interviews (n = 17), focus groups (n = 2), and key informants’ interviews (n = 4) were utilized. The interviews and focus groups were recorded and transcribed for later narrative content analysis. A high degree of vulnerability of participants was found due to the precarious living conditions from the premigratory moment and the lack of job placement possibilities at the time of settling in Colombia, where the migratory status played a fundamental role. Among the perceived needs, the mitigation of noncommunicable diseases stood out. Poor mental health symptoms (depression and anxiety) were perceived, and oral health was not a priority. Barriers to accessing health and dental care were found. The migrant condition was found to be a determinant that affected physical, mental, and oral health and the provision of health care. This situation is of interest to the construction of public health policies that guarantee access to fundamental rights

Regenerative Endodontics Success Factors and their Overall Effectiveness: An Umbrella Review

Introduction: Regenerative endodontics is a developing field of dentistry and aims to recover the physiological and anatomical functions of the tooth for cases of severe dental caries, pulpal pathologies and dental trauma. Materials and Methods: This umbrella review seeks to discover the scientific evidence on the effectiveness and the factors result in successful regenerative endodontic therapies in teeth with necrotic pulps and with incomplete root development. The study was conducted following the PRISMA Guidelines. There were no restrictions regarding search period. A comprehensive literature search was carried out in EMBASE, LILACS, PubMed, Cochrane, Scopus, and Google Scholar. A quality evaluation was conducted by using AMSTAR-2. A descriptive analysis of the included systematic reviews and meta-analysis were conducted. Results: Thirteen descriptive systematic reviews and 7 meta-analyses were included. Three articles evidenced low methodological quality according to AMSTAR-2 tool. Overall success rates for the endodontic regeneration procedures ranged from 50% to 98% and the survival rates were between 94% and 100%. Pulp regeneration had a high success rate, evidenced by factors such as the resolution of symptoms, healing, increased root length, dentin thickening and recovery of sensitivity. Follow-up varied from 1 to 48 months for the original studies included in the systematic reviews and meta-analyses. Conclusions: Endodontic practice offers the clinician a good treatment option in case of necrotic pulp with immature roots such as the endodontic regeneration, that is supported by high and moderate quality scientific literature

Conocimientos y prácticas sobre salud bucal en profesores de dos escuelas: Quito y San Cristóbal (Galápagos), Ecuador

Objective: To analyze the knowledge, attitudes and practices that oral health teachers have in primary schools in Quito and San Cristobal Island (Galapagos), Ecuador. Methods: The research began with the validation of the self-surveyed survey on knowledge, attitudes and practices on oral health in teachers (CAPS teachers). Subsequently, this instrument delivered to 61 teachers from the two schools selected for the study. The descriptive statistics of these data were obtained, including the absolute and relative frequencies of the responses obtained. Results: The average score obtained in the total evaluation of the 61 teachers was 11.97 ± 2.37 points. When the data were analyzed by schools, the Quito school obtained an average of 12.06 ± 2.29, while the Galapagos school obtained an average of 11.29 ± 3.04 points. Conclusions: The knowledge in oral health of the teachers of the two educational centers was acceptable; there was no difference in the score of the total evaluation due to their origin.Objetivo: Analizar los conocimientos, actitudes y prácticas que sobre salud oral tienen los profesores de educación primaria de centros escolares de Quito y de la Isla San Cristóbal (Galápagos), Ecuador. métodos: La investigación se inició con la validación de la encuesta autodiligenciada sobre conocimientos, actitudes y prácticas sobre salud bucal en docentes (CAPS docentes). Posteriormente este instrumento fue entregado a 61 docentes de los dos centros escolares seleccionados para el estudio. Se obtuvo la estadística descriptiva de estos datos, que incluyó las frecuencias absolutas y relativas de las respuestas obtenidas. Resultados: La media de la puntuación obtenida en evaluación total de los 61 docentes fue de 11,97 ± 2,37 puntos. Cuando se analizaron los datos por centros escolares, la escuela de Quito obtuvo una media de 12,06 ± 2,29, mientras que la de Galápagos obtuvo una media de 11,29 ± 3,04 puntos. Conclusiones: El conocimiento en salud bucal de los docentes de los dos centros educativos fue aceptable, no se observó una diferencia en la puntuación de la evaluación total debido a la procedencia de los mismos

Factors determining access to oral health services among children aged less than 12 years in Peru

ABSTRACT Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children’s access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by tutor or guardian, wealth level, caregivers’ educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers’ education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising strategies to mitigate against inequities in access to oral health services

Scoping Review About Working Conditions and Health of Immigrant Workers in Spain

Fundamentos: La relación entre inmigración, trabajo y salud constituye uno de los retos más importantes en salud laboral y más concretamente en España por el importante incremento de proporción inmigrante acontecido en el mercado laboral. El objetivo de esta investigación es conocer la relación entre las condiciones de trabajo y sus efectos en la salud de trabajadores inmigrantes en España. Métodos: Revisión bibliográfica de artículos científicos originales en español e inglés Medline y Medes (1998-2012). Se revisaron los textos completos de los artículos incluidos. Resultados: Se incluyeron 20 estudios, 13 con metodología de investigación cuantitativa y 7 cualitativa. Los temas tratados abordaban problemas específicos de salud relacionados con el trabajo (principalmente lesiones por accidente de trabajo), incapacidad laboral y diferencias en condiciones de trabajo y empleo. Los hallazgos de los estudios mostraron mayor incidencia de lesiones por accidentes de trabajo, menores tasas de incapacidad laboral, mayor prevalencia de presentismo laboral, exposición a factores psicosociales y precariedad laboral en la población inmigrante. Conclusiones: A pesar de la singularidad del proceso demográfico migratorio, los problemas de salud y determinantes identificados no difieren de los referenciados en otros países, en otros contextos y en otros momentos.Background:The relationship between immigration, work, and health is one of the most important challenges in occupational health at current, particularly in Spain, by the significant increase in the migrant workers in the labor market occurred. This investigation aims to know the relationship betwen working conditions and their effects on migrant workers. Methods: Scoping review of scientific papers on this topic at the Medline and Medes databases in Spanish and English (1998-2012). The articles included were full text reviewed. Results: 20 studies were included, 13 with quantitative methodology and 7 qualitative. The topics address specific health problems related to work (primarily occupational accidents), disability, and differences in working conditions and employment. The findings of the studies show a higher incidence of injury accidents, lower rates of disability, higher prevalence of work presenteeism, exposure to psychosocial factors, and precariousness. Conclusion: Despite the uniqueness of the demographic process migration happened in Spain, health problems and determinants identified no different from those referenced in other countries, in other contexts and in other times

Cárie dental e higiene bucal em crianças da zona rural do município de Jericó, Antioquia, 2013

Introduction: The objectives of this research were to determine the prevalence and experience of dental caries among school children in the rural area of the municipality of Jericó (Antioquia) and to analyze oral hygiene conditions in the study population. Methods: A descriptive study was carried out based on information from 534 clinical records of people between the ages of 6 and 22, with mixed and/or permanent dentitions located in the study area. We analyzed Socio-demographic, Simplified Oral Hygiene Index (ihos from the Spanish acronym), prevalence and experience of dental cavities in permanent dentition using the traditional and modified dmtf Index (dmtfT - dmtfM) and the Significant Caries Index (sic). Univariate and bivariate analyses were conducted and a Chi square test was performed to observe statistically significant differences between the variables. Results: the prevalence of dental caries including non-cavitated lesions is 39% among both genders; dental caries had been experienced by 47% of the men and 46% of the women. Taking into account the sic, the mean is 2.70 when based on the dtmfT and 4.36 on the dtmfM. These indicators are lower in women (2.56 and 3.36, respectively). The mean for the ihos is lower among women&nbsp;(1.25 95%ci 1.18-1.32), with statistically significant differences compared to men (p&lt; 0.001). Differences in frequencies were observed in the dental caries and oral hygiene indicators according to age and level of education. Conclusion: Although the indicators are in accordance with international goals, inequalities were found among certain population groups.Introducción: los objetivos de esta investigación fueron determinar la prevalencia y experiencia de caries dental en la población escolar rural del municipio de Jericó (Antioquia) y analizar las condiciones de higiene bucal de la población de estudio. Métodos: estudio descriptivo con la información de 534 historias clínicas de personas entre los 6 y 22 años, con dentición mixta o permanente del área de estudio. Se analizaron variables sociodemográficas, Índice de Higiene Oral Simplificado (ihos), prevalencia y experiencia con caries dental en dentición permanente mediante el índice cop tradicional y modificado (copdT y copdM) y el Índice de Caries Significativo (sic). Análisis uni y bivariado y cálculo de Chi2 para observar diferencias significativas entre las variables. Resultados: la prevalencia de caries dental en ambos sexos, incluyendo lesiones no cavitacionales, es del 39%, y la experiencia con caries es del 47% en hombres y el 46% en mujeres. Teniendo en cuenta el sic, el promedio en hombres es de 2,70 cuando se calcula a partir del copdT y del 4,36 para el caso del copdM. Estos indicadores son menores en mujeres (2,56 y 3,36, respectivamente). En cuanto al ihos, el promedio es mucho menor en mujeres (1,25 ic95% 1,18-1,32) y con diferencias estadísticamente significativas con respecto a los hombres (p &lt; 0,001). Se presentan diferencias en los indicadores de caries dental e higiene bucal, según escolaridad y edad. Conclusión: si bien los indicadores están de acuerdo con las metas internacionales, se encuentran algunos grupos poblacionales en situación de desigualdad. &nbsp;Introdução: os objetivos desta pesquisa foram determinar a prevalência e experiência de cárie dental na população escolar rural do município de Jericó (Antioquia) e analisar as condições de higiene bucal da população de estudo. Métodos: estudo descritivo com a informação de 534 prontuários de pessoas entre 6 e 22 anos, com dentição mista e/ou permanente da área de estudo. Analisaram-se variáveis sociodemo-gráficas, Índice de Higiene Oral Simplificado (ihos), prevalência e ex-periência com cárie dental em dentição permanente mediante o índice cop tradicional e modificado (copdT e copdM) e o Índice de Cárie Sig-nificativo (sic). Análises uni e bivariada e cálculo de Chi2 para observar diferenças significativas entre as variáveis. Resultados: a prevalência de cárie dental em ambos os sexos, o que inclui lesões não cavitacionais, é de 39%, e a experiência com cáries é de 47% em homens e 46% em mulheres. Ao considerar o sic, a média em homens é de 2,70 quando se calcula a partir do copdT e de 4,36 para o caso do copdM. Esses indica-dores são menores nas mulheres (2,56 e 3,36, respectivamente). Quanto ao ihos, a média é muito menor em mulheres (1,25 ic95% 1,18-1,32) e com diferenças estatisticamente significativas com relação aos homens&nbsp;(p &lt; 0,001). Apresentam-se diferenças nos indicadores de cárie dental e higiene bucal segundo a escolaridade e a idade. Conclusão: embora os indicadores estejam de acordo com as metas internacionais, constatam-se alguns grupos populacionais em situação de desigualdade

Perceptions of female immigrant domestic workers on the effects of the sector regulation in Spain

Objetivo: Explorar las percepciones de las mujeres inmigrantes trabajadoras del servicio doméstico sobre la puesta en vigor en España del Real Decreto 1620/2011, que regula la relación laboral del servicio del hogar familiar, y su efecto en sus condiciones de empleo. Métodos: Estudio exploratorio mediante análisis de contenido cualitativo. Se realizaron tres grupos de discusión con mujeres inmigrantes (colombianas, ecuatorianas y marroquíes). Resultados: A pesar de valorar positivamente los beneficios teóricos de la nueva normativa, las mujeres inmigrantes han identificado barreras legales y económicas para conseguir un contrato, ser dadas de alta en la seguridad social y que las personas empleadoras asuman su coste, en especial en el caso de las trabajadoras contratadas por horas. Estas dificultades influyen en la posibilidad de legalizar su situación. La confluencia con la crisis económica ha emergido como un problema que dificulta su cumplimiento. Conclusiones: Aunque el nuevo régimen ha favorecido la creación de puestos de trabajo con mayores derechos laborales en el sector, las mujeres inmigrantes perciben que su puesta en marcha en el actual contexto de crisis económica no ha contribuido a mejorar sus condiciones de empleo.Objective: To examine the perceptions of female immigrant domestic workers of the effect of Royal Decree 1620/2011, which regulates the relationship of domestic workers in the family home and their employment conditions in Spain. Methods: An exploratory study was performed using qualitative content analysis of three focus group discussions with immigrant women from Colombia, Ecuador and Morocco. Results: Immigrant women positively assessed the theoretical benefits of the new regulation, but identified legal and economic barriers to obtaining a contract and being registered in the social security system by their employers, and to employers accepting the cost of these measures, especially for workers hired by the hour. These difficulties affected their possibilities of legalizing their status. The economic crisis posed a serious challenge to compliance with the new regulation. Conclusions: Although the new regime encourages job creation with stronger working rights for these workers, immigrant women perceived that its implementation has been hampered by the current financial crisis and has not, therefore, improved their employment conditions.FIS (PI11/01192)

Longer Residence of Ecuadorian and Colombian Migrant Workers in Spain Associated with New Episodes of Common Mental Disorders

The healthy migrant effect and its impact on mental health has been reported in the general population of many countries. Information is limited about its impact on working populations. The aim of this study is to estimate the incidence of common mental disorders over a one-year follow-up period among a cohort of Colombian and Ecuadorian employees in Spain, taking into account the duration of residence and comparing with Spanish-born workers. Data was from the Longitudinal Studies on Immigrant Families Project (PELFI), a follow-up survey of immigrants and Spanish-born workers interviewed in 2015 and 2016. Mental health was assessed using the 12-item general health questionnaire (GHQ-12). Crude and adjusted odds ratios (ORas) for common mental disorders by sociodemographic and employment characteristics were created. There were differences for immigrants with time of residence less than or equal to 15 years (time of residence 11–15 years: ORa = 0.06, 95% CI = (0.26–0.01); time of residence 1–10 years: ORa = 0.06, 95% CI = (0.36–0.01)). There was evidence of a healthy immigrant worker effect, as newer arrivals from Ecuador and Columbia to Spain had a lower incidence of common mental disorders than either the Spanish-born or immigrant workers who had lived in Spain for more than 15 years.This study has been funded by the Instituto de Salud Carlos III [PI14/00146] (co-funded by European Regional Development Fund/European Social Fund “Investing in your future”)

El acceso a los servicios de salud bucodental para la población adulta mayor en la red hospitalaria pública de Medellín (Colombia)

Antecedentes/Objetivos: La población adulta mayor es un grupo poblacional significativo teniendo en cuenta los cambios demográficos de las últimas décadas. En el país y en la ciudad de Medellín, este grupo presenta alta vulnerabilidad social, así mismo se observan necesidades en salud bucal, descritas en los estudios nacionales y regionales en el tema. Aunque se han realizado investigaciones que tratan de identificar determinantes que afectan el acceso y la utilización de los servicios de salud, los estudios en salud bucal son más escasos y en especial en la población adulta mayor. Objetivo: identificar barreras y facilitadores de acceso a los servicios de salud bucal en población adulta mayor atendida en la red hospitalaria pública de Medellín desde la perspectiva del personal de salud. Métodos: Estudio cualitativo. Se realizaron 34 entrevistas semiestructuradas en personal que presta servicios de salud en la red Metrosalud de Medellín. Se identificaron barreras y facilitadores según el modelo de Tanahashi sobre cobertura en los servicios de salud a través de 4 categorías: disponibilidad (D), accesibilidad (A), aceptabilidad (P) y contacto con el servicio (C). Se utilizó la herramienta informática AtlasTi. Resultados: Se identificaron barreras relacionadas con: dificultades en la implementación de políticas sociales debido a que la salud bucal no es una prioridad; se han priorizado otras poblaciones para dar atención en salud bucal y existe insuficiente recurso humano para prestar los servicios de salud (D); la situación de discapacidad de los adultos mayores (A); aspectos educativos, culturales y de género (P); y la crisis del sector salud como una barrera estructural del sistema (C). En cuanto a los facilitadores se mencionan: la existencia de programas que facilitan la demanda inducida a programas de salud bucal y de mecanismos para hacer valer los derechos en salud a través de instancias gubernamentales y otras (D); la ubicación de las unidades y centros de salud en zonas de fácil acceso (A); la capacidad de los profesionales para atender esta población (P) y la articulación de la odontología con otras áreas (C). Conclusiones: Se identificaron determinantes que afectan el acceso a servicios sanitarios en la población adulta mayor, por lo que se requieren estrategias para mejorar la calidad de la atención en salud bucal en este grupo socialmente vulnerable.E.S.E Metrosalud. Medellín (Código: C02-E11-L3-01)