Las experiencias de los estudiantes de medicina LGBTQ+ durante su formación: Una revisión sistemática / Experiences of medical students belonging to sexual and gender diversity: a systematic review

Background: Students belonging to sexual and gender diversity experience chronic stress due to stigmatization and discrimination. Aim: To identify the experiences of lesbian, gay, bisexual, transgender/transsexual, and queer (LGBTQ+) medical students. Material and Methods: Systematic literature review using the PRISMA protocol in PubMed, ERIC, EMBASE, and LILACS databases. Articles published in Spanish or English were considered. Three authors independently reviewed and synthesized information from the selected articles, according to the PRISMA criteria. Results: Fifteen studies met the inclusion criteria. Forty-three experiences were reported, which were finally classified into four categories: i) Relationship between peers in the educational context (23%), ii) Relationship between students and teachers in the educational context (23%), iii) Relationship with the educational institution (34%), and iv) Curriculum and training experience (19%). The relationship with the educational institution was identified as the most relevant category. Students with a strong sense of belonging to their institution were more likely to be persistent and make an effort in learning. The second most relevant experiences, mainly negative, derive from interactions with peers and teachers. Conclusions: LGBTQ+ medical students still experience more discrimination than inclusion during their training. Therefore, medical schools should render medical education a more inclusive space for the LGBTQ+ population.

Los atributos de un tutor clínico de excelencia: una revisión sistemática

Knowing what characterizes an excellent teacher is relevant to guide training, evaluation, and continuous improvement of the clinical teacher. We performed a systematic review using the PRISMA protocol, aiming to identify the attributes of an excellent clinical teacher. MEDLINE, ERIC, ScienceDirect, and Scopus databases were searched for articles published in English and Spanish, between 2007 and 2019. Two independent reviewers extracted and synthesized data from articles that met the PRISMA pre-established criteria. Twelve studies met the inclusion criteria. Of the 106 attributes reported by the studies, 49 (46,2%) were generic. The most frequently mentioned attribute was respectfulness. Forty-six attributes (43,3%) were pedagogical. Feedback and planning were those most frequently mentioned. Eleven attributes (10,3%) were disciplinary and clinical skills was the most mentioned. We conclude that generic and pedagogical dimensions had a greater representation in the literature, in comparison with the disciplinary dimension. This could be explained, considering that having adequate clinical skills is the minimal necessary requisite to become a clinical teacher, but does not make a difference in how their performance is perceived, contrary to the generic and pedagogical dimensions.

Ameloplastia positiva en relación céntrica como método auxiliar durante la finalización en el tratamiento de ortodoncia en un paciente bruxista / Positive ameloplasty in centric relationship as an auxiliary method during finalization in the orthodontic treatment in a bruxist patient

A continuación se presenta un caso de un paciente de 12 años de edad, con antecedente de bruxismo, con biotipo mesofacial, tercio inferior dolicofacial, hipertonicidad muscular en maseteros, cierre labial forzado con incompetencia labial de 4 milímetros con dolor en sinoviales anteriores inferiores. Los objetivos de tratamiento consistieron en lograr relajación muscular y promover un posicionamiento condilar ortopédicamente funcional y estable, realizar control vertical para disminuir gap interlabial, alinear líneas medias, mantener clase I molar bilateral, clase I canina bilateral y clase I incisiva, crear overjet y overbite adecuados, con recuperación estética y función del segmento anterior. Debido a eventos adversos durante la etapa de cierre de espacios, la clase molar y canina I no se logró, pero se aseguró mediante ameloplastias positivas la función y estética adecuadas para tener un tratamiento de ortodoncia estable a largo plazo (AU)

The following is a case of a 12-year-old patient, with a history of bruxism, with a mesofacial biotype, lower third of the facial area, muscular hypertonicity in the masseters, a forced labial closure with a 4-millimeter labial incompetence with pain in inferior anterior synoviums. Treatment objectives consisted of achieving muscle relaxation and promoting orthopedically functional and stable condylar positioning, perform vertical control to decrease interlabial gap, align midlines, maintain bilateral molar class I, bilateral canine class I and incisive class I, create adequate overjet and overbite, with aesthetic recovery and function of the anterior segment. Due to adverse events during the closing phase of spaces, the molar and canine I class was not achieved, but positive function and aesthetics were ensured by positive ameloplasties in order to have a long-term stable orthodontic treatment (AU)

Competencias para la enfermera/o en el ámbito de gestión y administración: desafíos actuales de la profesión / Skills for Nurses in the Field of Management and Administration: Contemporary Challenges to the Profession / Competências para a enfermeira/o no âmbito de gestão e administração: desafios atuais da profissão

Las competencias laborales de enfermería permiten disminuir inequidades, acceso limitado a los servicios y favorecen una atención segura y de calidad. La formación de enfermeras/os es fundamental en la composición y dinámica de la fuerza de trabajo en enfermería, la calidad y pertinencia de los cuidados y el desarrollo de la capacidad institucional en salud. Objetivo: responder dos interrogantes: ¿Cuáles son los requerimientos actuales para el/la enfermero/a en el ámbito de la gestión y administración?, y ¿cuáles son las competencias de gestión de enfermería más importantes y su relación con la gestión de cuidado? Método: revisión de la literatura que parte con una exploración de campo desde los contextos y desafíos actuales de la profesión. La búsqueda bibliográfica se realizó en las bases de datos Cochrane Library, Lilacs, CINHAL, Dialnet, Universidad de la Rioja, ProQuest, Web of Science, Science Direct, PubMed, Business Source Premier, SciELO, Scopus. Se encontraron 4.697 artículos. Precisando la búsqueda se seleccionaron 51 artículos y documentos técnicos. Resultados: los estudios que priorizan las competencias de gestión coinciden en colocar entre las más importantes: comunicación, trabajo en equipo, resolución de conflictos y habilidades interpersonales y de liderazgo. En liderazgo priorizan dominio personal, efectividad interpersonal, gestión financiera y de recursos humanos. Conclusiones: las habilidades de gestión y liderazgo se deben basar en conocimientos sólidos y en la experiencia. Asimismo, la concepción de gestión y liderazgo ocupa un lugar complementario al rol de cuidado que tiene la enfermera/o. El liderazgo transformacional y relacional son necesarios para mejorar la satisfacción de las/os enfermeras/os.

The job skills involved in nursing make it possible to reduce inequalities and limited access to services, and to support safe and quality care. The training nurses receive is fundamental to the composition and dynamics of the nursing work force, the quality and appropriateness of nursing care, and the development of institutional capacity in the health sector. Objective: The study was designed to answer two questions: What are the current requirements for nurses in the field of management and administration; and what nursing management skills are most important and how do they relate to health care management? Method: The literature review began by exploring the field in terms of current contexts and challenges to the profession. The bibliographic search involved several the databases; namely, the Cochrane Library, Lilacs, CINAHL, Dialnet, the University of La Rioja, ProQuest, Web of Science, ScienceDirect, PubMed, Business Source Premier, SciELO and Scopus. In all, 4,697 articles were found. When the search was narrowed, 51 technical papers were selected. Results: The studies that prioritize management skills coincide in that the most important ones are: communication, teamwork, conflict resolution, and interpersonal and leadership skills. As for leadership, the priority is on personal mastery, interpersonal effectiveness, financial management and human resources. Conclusions: Management and leadership skills must be based on sound knowledge and experience. Moreover, the concept of management and leadership is complementary to the role of nurses in providing care. Transformational and relational leadership are needed to improve the satisfaction of nurses.

As competências laborais de enfermagem permitem diminuir inequidades, acesso limitado aos serviços e favorecem um atendimento seguro e de qualidade. A formação de enfermeiras/os é fundamental na composição e dinâmica da força de trabalho em enfermagem, na qualidade e pertinência dos cuidados e no desenvolvimento da capacidade institucional em saúde. Objetivo: responder a duas interrogantes: Quais são os requerimentos atuais para a/o enfermeira/o no âmbito da gestão e da administração? Quais são as competências de gestão de enfermagem mais importantes e sua relação com a gestão de cuidado? Método: revisão da literatura que parte com uma exploração de campo a partir dos contextos e desafios atuais da profissão. A busca bibliográfica foi realizada nas bases de dados Cochrane Library, Lilacs, CINHAL, Dialnet, Universidad de la Rioja, ProQuest, Web of Science, Science Direct, PubMed, Business Source Premier, SciELO, Scopus. Encontraram-se 4.697 artigos. Precisando a busca, selecionaram-se 51 artigos e documentos técnicos. Resultados: os estudos que priorizam as competências de gestão coincidem em colocar entre as mais importantes: comunicação, trabalho em equipe, resolução de conflitos e habilidades interpessoais e liderança. Em liderança, priorizam domínio pessoal, efetividade interpessoal, gestão financeira e de recursos humanos. Conclusões: as habilidades de gestão e liderança devem ser baseadas em conhecimentos sólidos e na experiência. Além disso, a concepção de gestão e liderança ocupa um lugar complementar ao papel de cuidado que a/o enfermeira/o tem. A liderança transformacional e relacional são necessárias para melhorar a satisfação das/os enfermeiras/os.

Profilaxis de la endocarditis infecciosa en el tratamiento quirúrgico odontológico: 1ra. parte / Prophylaxis of infective endocarditis in surgical dental treatment

En este trabajo se trata, en una forma simple y esquemática, de recordar que pequeños actos quirúrgicos, en determinados pacientes, sea en la cavidad bucal o en otras partes del organismo, son capaces de producir bacteriemia con consecuencias graves para el enfermo. Además, se señala cuáles son los principales factores de riesgo de la endocarditis bacteriana, los microorganismos más comunes causantes de lamisma, las maniobras que inducen a bacteriemias y, tomando en cuenta las últimas publicaciones, mostrar un esquema terapéutico actualizado en la prevención de la endocarditis