TRATAMENTO ENDODÔNTICO CONVENCIONAL DE UM SEGUNDO MOLAR INFERIOR EM FORMA DE C, UTILIZANDO LIMAS PRO-DESIGN M, ALIADO AO FECHAMENTO DE PERFURAÇÃO COM CIMENTO BIOATIVO: RELATO DE CASO

The pulp tissue is responsible for the vitality of the dental pulp, it is found inside the root canals system, and it can undergo changes, which may lead to the need for an endodontic intervention. These canals may have anatomical variations, which make the process of cleaning, formatting, and three-dimensional filling even more difficult. Among them, there is the so-called “C-shaped canal”, a connection between two or more canals, which creates great difficulty in the instrumentation process and provides a greater propensity for iatrogenic injuries. The aim of this study was to report the diagnosis and treatment of a lower molar #37 with asymptomatic apical periodontitis, which had a C-shaped root canal. Patient, female, 23 years old, attended the Teaching Clinic of the Instituto Nacional de Ensino Superior e Pós-Graduação Padre Gervásio – Inapós, complaining of sensitivity in the left mandibular region. On clinical examination, extensive restoration was observed on tooth 37. On radiographic examination, a periapical lesion could be observed around the apex of the element in question. Necropulpectomy was performed on the same, using pro-design M files, during which there was a lateral perforation, treated with bioactive cement mineral trioxide aggregate (MTA).   El tejido pulpar es el responsable de la vitalidad de la pulpa dentaria, se encuentra dentro del sistema de conductos radiculares y puede sufrir cambios, lo que puede llevar a la necesidad de una intervención endodóntica. Estos canales pueden tener variaciones anatómicas, lo que dificulta aún más el proceso de limpieza, formateo y obturación tridimensional. Entre ellos, se encuentra el denominado “canal en C”, conexión entre dos o más canales, lo que crea una gran dificultad en el proceso de instrumentación y proporciona una mayor propensión a lesiones iatrogénicas. El objetivo de este estudio fue informar el diagnóstico y tratamiento de un molar inferior #37 con periodontitis apical asintomática, que tenía un conducto radicular en forma de C. Paciente, sexo femenino, 23 años, acudió a la Clínica Docente del Instituto Nacional de Ensino Superior e Pós-Graduação Padre Gervásio – Inapós, quejándose de sensibilidad en la región mandibular izquierda. En el examen clínico se observó una extensa restauración en el diente 37. En el examen radiográfico se pudo observar una lesión periapical alrededor del ápice del elemento en cuestión. En el mismo se realizó necropulpectomía, utilizando limas pro-design M, durante la cual se produjo una perforación lateral, tratada con agregado de trióxido mineral de cemento bioactivo (MTA).   O tecido pulpar, responsável pela vitalidade da polpa dentária, é encontrado no interior dos canais radiculares, e pode sofrer alterações que levam à necessidade de uma intervenção endodôntica. Estes canais podem ter variações anatômicas, as quais dificultam ainda mais o processo de limpeza, formatação e preenchimento tridimensional. Dentre as variações, há o denominado “Canal em C”, ligação entre dois ou mais canais, que gera uma grande dificuldade no processo de instrumentação com maior propensão à iatrogenias. O objetivo deste trabalho foi relatar o diagnóstico e tratamento de um molar inferior #37 com uma periodontite apical assintomática, que possuía canal em C. Paciente J.P.R, sexo feminino, 23 anos, compareceu à Clínica escola do Instituto Nacional de Ensino Superior e Pós-Graduação Padre Gervásio – Inapós, com queixa de sensibilidade na região esquerda mandibular. Ao exame clínico observou-se extensa restauração no dente 37. Ao exame radiográfico, pôde-se observar lesão periapical ao redor do ápice do elemento em questão. Realizou-se uma necropulpecnomia no dente, utilizando limas pro-design M, durante a qual houve uma perfuração lateral, tratada através do cimento bioativo agregado trióxido mineral (MTA).O tecido pulpar, responsável pela vitalidade da polpa dentária, é encontrado no interior dos canais radiculares, e que pode sofrer alterações, as quais podem levar à necessidade de uma intervenção endodôntica. Estes canais podem ter variações anatômicas, as quais dificultam ainda mais o processo de limpeza, formatação e preenchimento tridimensional do mesmo. Dentre elas, há o denominado “Canal em C”, ligação entre dois ou mais canais, que gera uma grande dificuldade no processo de instrumentação e proporciona maior propensão à iatrogenias. O objetivo deste trabalho foi relatar o diagnóstico e tratamento de um molar inferior #37 com uma periodontite apical assintomática, que possuia canal em C. Paciente, sexo feminino, 23 anos, compareceu à Clínica escola do Instituto Nacional de Ensino Superior e Pós-Graduação Padre Gervásio – Inapós, com queixa de sensibilidade na região esquerda mandibular. Ao exame clínico observou-se extensa restauração no dente 37. Ao exame radiográfico, pôde-se observar lesão periapical ao redor do ápice do elemento em questão. Realizou-se uma necropulpecnomia no mesmo, utilizando limas pro-design M, durante a qual houve uma perfuração lateral, tratada através do cimento bioativo agregado trióxido mineral (MTA). 

Propiedades psicométricas de la Escala Breve de Resiliencia (BRS) en el contexto ecuatoriano

The aim of the present study was to evaluate the psychometric properties of the Brief Resilience Scale (BRS). The sample consisted of 657 Ecuadorian adults. We evaluated internal and construct validity, internal consistency, concurrent validity, and measurement invariance was tested across sex categories. The results show that the structure of two first-order correlated factors presents adequate psychometric properties. Concurrent validity analysis shows that resilience correlates significantly with self-esteem, social support and quality of life dimensions. Finally, psychometric equivalence is evidenced between the models of configural, metric, scalar and residual invariance. The BRS scale is a reliable and valid instrument for research and clinical practice purposes in the Ecuadorian context.Esta investigación evaluó las propiedades psicométricas de la Escala Breve de Resiliencia (BRS). La muestra estuvo conformada por 657 adultos ecuatorianos. Se evaluó la validez interna y de constructo, la consistencia interna, la validez concurrente y la invarianza entre sexos. Los resultados de la evaluación de ocho modelos muestran que la estructura de dos factores correlacionados de primer orden presenta buenas propiedades psicométricas. El análisis de validez concurrente muestra que la resiliencia correlaciona significativamente con autoestima, apoyo social y dimensiones de la calidad de vida. Finalmente, se evidencia equivalencia psicométrica entre los modelos de invarianza configural, métrica, escalar y residual. La escala BRS esun instrumento fiable y válido para fines de investigación y práctica clínica en el contexto ecuatoriano

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Bienestar subjetivo y formación de cuidadores de adultos mayores

The proportion of senior citizens grows in the whole world and will continue to do so in the coming decades. For this reason, it is necessary to delineate and implement state plans to meet their social needs. These include the founding and maintenance of specialized social services and training of appropriate care staff. In this sense, the purpose of the research has been to establish the levels of well-being and the parameters that constitute it according to the opinion of Ecuadorian senior citizens. Data were obtained by applying the General Self-efficacy, General Welfare and Social Welfare, Gratitude Questionnaire, and self-perception questions to a sample of 386 senior citizens who were contacted at social service centers or while waiting for a public service. The analysis shows that self-efficacy and gratitude are predictive of well-being and that those participating in social service centers have higher average values at all scales. The results demonstrate the need for older adults to participate in academic, social and recreational activities to strengthen their psychological resources, with emphasis on self-efficacy and gratitude. In the training of caregivers, it should be emphasized that the care of the older adult transcends medical and nursing issues and that his subjective state of well-being is as important as material quality of life.La proportion des personnes âgées augmente de plus en plus. Pour cette raison, il faut délimiter et mettre en oeuvre des plans d’état pour répondre à leurs besoins sociaux, notamment la création et la maintenance de services sociaux spécialisés et la formation du personnel d’assistance approprié. Le but de la recherche vise à établir les niveaux de bien-être des personnes âgées équatoriennes et les paramètres qui constituent cet objectif. Les données obtenues proviennent de l’application des échelles d’Auto-efficacité générale, de questions de perception de l’autoévaluation générale, de Bien-être général, de Bien-être Social, d’un questionnaire de gratitude avec de questions d’auto-perception appliqué sur un échantillon de 386 personnes âgées contactées dans les centres de services sociaux ou en attendant leur tour pour un service public. L’analyse montre que l’auto-efficacité et la gratitude prédisent le bien-être et que ceux qui participent aux centres de services sociaux ont des valeurs moyennes les plus élevées à toutes les échelles. Les résultats démontrent le besoin des personnes âgées de participer à des activités académiques, sociales et récréatives pour renforcer leurs ressources psychologiques en mettant l’accent sur l’auto-efficacité et la reconnaissance. Dans la formation des auxiliaires, il convient de souligner que les soins aux personnes âgées dépassent les problèmes médicaux et les services d’entretien, alors l’état de bien-être subjectif des personnes âgées est aussi important que la qualité de vie matérielle.La proporción de adultos mayores crece y continuará creciendo. Por esta razón, se hace necesario delinear y poner en ejecución planes de estado que permitan atender sus necesidades sociales; entre ellas, la fundación y mantenimiento de servicios sociales especializados y la formación del personal asistencial apropiado. Se presentan los resultados de una investigación orientada a establecer los niveles de bienestar de adultos mayores ecuatorianos y los parámetros que lo constituyen. Los datos fueron obtenidos por aplicación de las escalas de Autoeficacia General, Bienestar General y Bienestar Social, el Cuestionario de Gratitud y preguntas sobre autopercepción de salud a una muestra de 386 adultos mayores que fueron contactados en centros de servicio social o mientras esperaban turno por un servicio público. El análisis muestra que la autoeficacia y la gratitud resultan predictivas del bienestar y que quienes participan en centros de servicio social tiene valores promedio más altos en todas las escalas. Los resultados demuestran la necesidad de que los adultos mayores participen en actividades de tipo académico, social y recreativo para fortalecer sus recursos psicológicos, con énfasis en la autoeficacia y la gratitud. En la formación de los cuidadores hay que resaltar que el cuidado del adulto mayor trasciende los asuntos médicos y de manutención y que su estado subjetivo de bienestar tiene tanta importancia como la calidad de vida material