Educational Research and Scholarship in India: The Way Forward

Medical education research (MER) aims to improve the practice of medical education by applying the theory of educational research. Internationally, medical education research has grown exponentially and has established itself as a distinct field. In contrast, in India, the medical faculty is either bogged down by clinical responsibilities, or is busy with biomedical research. The recent initiatives such as implementation of competency-based medical education (CBME) for medical undergraduates, and push coming from regulatory agencies besides National Education Policy have become game changers. The emerging concept of scholarship, takes in to account all scholarly activities in a fair manner. The scholarship of teaching and learning (SoTL) is helpful in connecting teaching with better patient care outcomes through evidence based approach. It also promotes a community of practice to boost research and publication activities. Finally, there is a need to enlarge the scope of research from treating sick children to promoting total wellbeing, which requires interdisciplinary and interprofessional approach to research.

Salutogénesis, sanación y curación

Introducció n: En salud aún prevalece, a escala mundial, el modelo patogénico, el cual acentúa la etiopatogenia de la enfermedad, la curación o rehabilitación. Progresivamente se viene introduciendo el modelo de salutogénesis, que preconiza la importancia de la prevención primaria, el bienestar y la sanidad. El objetivo del artículo consiste en argumentar los nexos entre salutogénesis, curación y sanación, como categorías conectadas a la condición saludable de los sujetos, tomándose como fuente de sustentación el criterio de profesionales de la salud y la consulta de fuentes bibliográficas acreditadas acerca de la temática. Material y métodos: Se emplearon métodos y técnicas teóricos, empíricos y estadísticos. La sistematización teórica permitió caracterizar y relacionar los procesos de salutogénesis, curación y sanación. Se aplicó un cuestionario en línea a profesionales vinculados con el sector de la salud para indagar acerca de las categorías de sanación y curación, de los que se obtuvo respuesta de 35 especialistas. Los datos fueron procesados mediante la estadística descriptiva. Resultados: La exploración develó algunas diferencias y semejanzas entre los procesos curativo y sanador; destacándose el carácter más restringido del primero; en tanto la metodología más versátil y creativa, el carácter transformador y los efectos más duraderos del segundo. Se advierte que el nivel de dominio relativo a ambos procesos no es suficientemente extendido ni notorio, como se requeriría para una labor asistencial más efectiva.

Introduction: In health, the pathogenic model still prevails worldwide, which emphasizes the etiopathogenesis of the disease, cure or rehabilitation. The salutogenesis model has been progressively introduced, which advocates the importance of primary prevention, well-being and health. The objective of the article is to argue the links between salutogenesis, healing and curing, as categories connected to the healthy condition of the subjects, taking as a source of support the criteria of health professionals and the consultation of accredited bibliographic sources on the subject. Material and method: Theoretical, empirical and statistical methods and techniques were used. The theoretical systematization allowed to characterize and relate the processes of salutogenesis, healing and curing. An online questionnaire was applied to professionals linked to the health sector to inquire about the categories of healing and curing, from which responses were obtained from 35 specialists. The data was processed using descriptive statistics. Results: The exploration revealed some differences and similarities between the curative and healing processes; highlighting the more restricted character of the first; as the most versatile and creative methodology, the transformative character and the most lasting effects of the latter. It is noted that the level of mastery related to both processes is not sufficiently widespread or notorious, as would be required for a more effective care work.

Resources for health maintenance in persons deprived of liberty with arterial hypertension: a salutogenic approach / Recursos para el mantenimiento de la salud en prisioneros con hipertensión arterial: un enfoque saludgénico / Recursos para manutenção da saúde em pessoas presas com hipertensão arterial: uma abordagem salutogênica

ABSTRACT Objective: to know the generalized resistance resources of people deprived of liberty with systemic arterial hypertension in a triple border region. Method: a qualitative study based on the theoretical framework of Salutogenesis, in which 38 people deprived of liberty in Foz do Iguaçu, Paraná, Brazil, participated from February to July 2022. Guiding questions were used in the interviews which were submitted to thematic content analysis. Results: 12 generalized resistance resources emerged in the reports of people deprived of liberty with systemic arterial hypertension: health team; access to medications; work; lifestyle habits: food, physical activity and restriction of access to drugs/cigarettes/alcoholic beverages; stress/anxiety control; reading and games; religiosity; family; self-care; cellmates; and employees. Conclusion: people deprived of liberty with systemic arterial hypertension have generalized resistance resources to manage their life and health, which are related to personal care, the social group and the environment. It is noteworthy that once they are identified, the generalized resistance resources can be used by health professionals to manage SAH, other chronic diseases and aid in health promotion.

RESUMEN Objetivo: conocer los recursos generalizados de resistencia de las personas privadas de libertad con hipertensión arterial sistémica en una región de la triple frontera. Método: investigación cualitativa basada en el referencial teórico de la Salutogénesis, en la que participaron 38 personas privadas de libertad de Foz do Iguazú, Paraná, Brasil, de febrero a julio de 2022. Se utilizaron preguntas orientadoras en las entrevistas, que fueron sometidas al análisis de contenido en la modalidad temática. Resultados: 12 recursos generalizados de resistencia surgieron en los relatos de detenidos con hipertensión arterial sistémica: equipo de salud; acceso a medicamentos; trabajar; hábitos de vida: alimentación, actividad física y restricción de acceso a drogas/cigarrillos/bebidas alcohólicas; control del estrés/ansiedad; lectura y juegos; religiosidad; familia; cuidados personales; compañeros de cubículo y empleados. Conclusión: las personas privadas de libertad con hipertensión arterial sistémica poseen recursos generalizados de resistencia para el manejo de su vida y salud, los cuales están relacionados con el cuidado personal, el grupo social y el medio ambiente. Se destaca que, una vez identificados, los recursos generalizados de resistencia pueden ser utilizados por los profesionales de la salud en el manejo de la HAS, otras enfermedades crónicas y promoción de la salud.

RESUMO Objetivo: conhecer os recursos generalizados de resistência das pessoas privadas de liberdade com hipertensão arterial sistêmica de uma região de tríplice fronteira. Método: pesquisa qualitativa pautada no referencial teórico da Salutogênese, da qual participaram 38 pessoas privadas de Liberdade de Foz do Iguaçu, Paraná, Brasil, no período de fevereiro a julho de 2022. Utilizou-se de questões norteadoras nas entrevistas, as quais foram submetidas a análise de conteúdo na modalidade temática. Resultados: emergiram 12 recursos generalizados de resistência nos relatos das pessoas presas com hipertensão arterial sistêmica: equipe de saúde; acesso às medicações; trabalho; hábitos de vida: alimentação, atividade física e restrição ao acesso a drogas/cigarro/bebida alcóolica; controle do estresse/ansiedade; leitura e jogos; religiosidade; família; autocuidado; companheiros de cubículo e funcionários. Conclusão: as pessoas privadas de liberdade com hipertensão arterial sistêmica apresentam recursos generalizados de resistência para manejar sua vida e saúde, os quais se relacionam ao cuidado pessoal, ao grupo social e ao ambiente. Destaca-se que, uma vez identificados, os recursos generalizados de resistência podem ser utilizados pelos profissionais de saúde no gerenciamento da HAS, outras doenças crônicas e promoção da saúde.

Relationship between sense of coherence, OHRQoL, and dental caries among nursing students in South India

Background: Dental caries is one of the most common dental diseases that affect all population and is associated with the avoidance of care. Research has reported that sense of coherence (SOC) is related to many aspects of health including oral health. SOC determines the quality of health and might have a direct association with the development of subjective assessments of oral health. Objectives: To find the association between SOC, Oral Health?Related Quality of Life (OHRQoL) and caries status among nursing college students in southern state of India. Design: Cross?sectional design using questionnaire and assessment of caries status. Participants: Nursing students from south India. Methods: Convenience sampling method was followed and students who were present on the day of the study and consented to participate were included in the study. The total study sample consisted of 494 nursing students. SOC and OHRQoL were measured by a self?administered questionnaire; caries status was assessed using Decayed, Missing and Filled Tooth (DMFT) index. Results: Association between SOC and Oral Health Impact Profile (OHIP) and caries status and OHIP was found to be statistically significant. Correlation between dental caries and OHIP was found to be statistically significant, with R?value –0.251 shows that OHIP is negatively correlated with caries status. Conclusion: SOC as a psychosocial resource is capable of facilitating the motivation for positive oral health behaviours. These resources along with socio?economic and demographic factors can create an environment that is partially responsible for the individuals’ cognitive and physical functions that can express themselves as the individuals’ well?being and positive health behaviours.

Sentido Comunitario de la Coherencia en asentamientos informales: aprendizajes y reflexiones desde Medellín (Colombia) / Community Sense of Coherence in slums: learnings and reflections from Medellín (Colombia) / Sentido comunitário da coerência em assentamentos informais: aprendizagens e reflexão desde Medellín (Colômbia)

Resumen Introducción: el modelo de urbanización ha provocado un aumento de las inequidades sociales, transgrediendo los principios éticos de la justicia social y espacial. La Organización Mundial de la Salud ha identificado la urbanización como uno de los principales desafíos de salud pública del siglo XXI. Objetivo: comprender el sentido de la coherencia comunitario generado a través de los activos comunitarios para la salud en el asentamiento informal El Faro al nororiente de la ciudad de Medellín. Materiales y métodos: se realizó una investigación bajo una metodología de estudio de caso de alcance interpretativo, y un análisis narrativo de construcción de la explicación a partir de siete entrevistas semiestructuradas, dos talleres de fotovoz y un mapeo de activos comunitarios para la salud desarrollado entre 26 habitantes de Medellín. Resultados: desde el modelo salutogénico se reconoció el empoderamiento de la comunidad, porque les ha permitido enfrentar las resistencias del contexto, creando prácticas positivas y saludables. Estas prácticas han movilizado sus activos comunitarios, permitiendo el desarrollo de un importante Sentido Comunitario de la Coherencia, con el cual la comunidad enfrenta los desafíos de la vida y construye experiencias coherentes. Conclusiones: los habitantes han buscado encontrar soluciones que respondan a la situación de pobreza, en un proceso de abajo hacia arriba que ha buscado crear espacios significativos, un mayor sentido de pertenencia y una percepción de seguridad de habitar este territorio. Finalmente, cuanto mejor se conoce el entorno, mejor se conocen las comunidades entre sí y se preserva mejor la salud comunitaria y el bienestar social.

Abstract Introduction: The urbanization model has caused an increase in social inequities, transgressing the ethical principles of social and spatial justice. The World Health Organization has identified urbanization as one of the major public health challenges of the 21st century. Objective: To understand the Sense of Community Coherence generated through community assets for health in the informal settlement El Faro in the northeast of the city of Medellin. Materials and methods: This research was conducted under a case study methodology with an interpretive scope, and a narrative analysis of construction of the explanation from seven semi-structured interviews, two photo-voice workshops and a mapping of community assets for health developed between 26 inhabitants of Medellin. Results: From the salutogenic model, the empowerment of the community was recognized because it has allowed them to face the resistance of the context creating positive and healthy practices. These practices have mobilized their community assets, allowing the development of an important Community Sense of Coherence with which the community faces the challenges of life and builds coherent experiences. Conclusions: The inhabitants have sought to find solutions that respond to the situation of poverty in a bottom-up process that has search to create significant spaces, a greater sense of belonging and a perception of security in inhabiting this territory. Finally, the better the environment is known, the better the communities know each other and the better the community health and social well-being are preserved.

Resumo Introdução: o modelo de urbanização tem provocado um aumento das inequidades sociais, transgredindo os princípios éticos da justiça social e espacial. A Organização Mundial da Saúde já identificou a urbanização como um dos principais desafios da saúde pública do século XXI. Objetivo: compreender o sentido da coerência comunitária gerada a través dos ativos comunitários para a saúde no assentamento informal O Faro ao nordeste da cidade de Medellín. Materiais e métodos: realizou-se uma pesquisa baixo uma metodologia de estudo de caso de alcance interpretativo, e uma análise narrativa de construção da explicação a partir de sete entrevistas semi-estruturadas, das oficinas de foto voz e um mapeio de ativos comunitários para a saúde desenvolvendo entre 26 habitantes de Medellín. Resultados: desde o modelo salutogênico se reconheceu o empoderamento da comunidade, porque lhes permitiu enfrentar as resistências do contexto, criando práticas positivas e saudáveis. Estas práticas tem mobilizado seus ativos comunitários, permitindo o desenvolvimento de um importante Sentido Comunitário da Coerência, com o qual a comunidade enfrenta os desafios da vida e constrói experiencias coerentes. Conclusões: os habitantes procuraram encontrar soluções que respondam à situação de pobreza, em um processo de abaixo para arriba que tem buscado criar espaços significativos, um maior sentido de pertinência e uma percepção de segurança de habitar este território. Finalmente, quanto melhor se conhece o entorno, melhor se conhecem as comunidades entre si e se preserva melhor a saúde comunitária e o bem-estar social.

Bases teóricas para promoção da saúde e resistência camponesa: um novo horizonte metodológico / Theoretical bases for peasant health promotion and resistance: a new methodological horizon

RESUMO O agronegócio vem historicamente promovendo a submissão da produção, economia e vida das famílias camponesas, gerando graves danos sanitários a essa parcela da população brasileira. No entanto, a resistência do campesinato perante esse secular processo evidencia que a organização das famílias e comunidades camponesas e o resgate participativo dos conhecimentos agroecológicos locais podem fundamentar estratégias de promoção da saúde que busquem mudanças concretas nesse contexto sanitário vulnerável. O objetivo deste trabalho foi apresentar pilares que fundamentaram o processo capitalista de submissão camponesa no Brasil e abordagens teórico-prático-epistemológicas que permitem sua superação. Para isso, foram apresentados tanto referenciais para pesquisas e ações que subsidiem famílias e comunidades camponesas em um processo social de autorreconhecimento, autovalorização e utilização dos seus conhecimentos e suas práticas para uma transição agroecológica emancipatória, quanto a experiência ampliada de promoção da saúde desenvolvida por meio desses referenciais em Lavras-MG. A estrutura metodológica participativa apresentada permitiu o desenvolvimento, nesse município, dos passos iniciais e fundamentais de um processo social de organização camponesa em torno de seu modo de vida e economia, tendo a agroecologia como fator determinante para a saúde e para a construção de um contexto mais justo, favorável e promissor.

ABSTRACT Agribusiness has historically promoted the submission of production, economy, and life of peasant families, causing serious health damage to this portion of the Brazilian population. However, the peasantry's resistance to this secular process shows that the organization of families and communities and the participatory rescue of local agroecological knowledge can support health promotion strategies that seek concrete changes in this vulnerable health context. The objective of this work is to present bases that founded the capitalist process of peasant submission in Brazil and also theoretical-practical-epistemological approaches that allow its overcoming. For this, references for research and actions that subsidize peasant families and communities in a social process of self-recognition, self-valorization, and use of their knowledge and practices for an emancipatory agroecological transition are presented, as well as the health promotion expanded experience developed through these references in Lavras-MG, Brazil. The participatory methodological structure presented allowed the development of the initial and fundamental steps of a social process of peasant organization around their way of life and economy, with agroecology as a determining factor for health and for the construction of a fairer, more favorable, and more promising context.

Efectos en adultos mayores de su participación en un proyecto comunitario basado en activos para la salud / Effects on older adults of their participation in a community project based on health assets

Introducción: el envejecimiento poblacional y el incremento de las enfermedades crónicas no transmisibles están generando un gran impacto en los sistemas de salud a nivel mundial. Articular el sistema de salud con los recursos comunitarios es fundamental para poder coordinar la atención sociosanitaria, descomplejizar la atención de los adultos mayores y promover el envejecimiento activo. Nuestro objetivo fue analizar la relación entre la participación de adultos mayores en un proyecto de mapeo de activos para la salud y los efectos percibidos en esta experiencia. Métodos: la intervención consistió en un taller de seis encuentros semanales donde se aprendió a reconocer activos para la salud. Estos fueron volcados en un mapa virtual de acceso libre y gratuito para ser compartido con toda la sociedad. En el taller también se reforzó la importancia de la relación entre los participantes para mejorar los apoyos sociales. Utilizamos un diseño cualitativo de tipo interactivo con una estructura interconectada y flexible de los componentes de la investigación. Se observaron las interacciones y diálogos que se produjeron entre moderadoras-participantes y participantes entre sí, y se incluyeron los registros del cuaderno de campo de las moderadoras. Al finalizar el último encuentro, y cumplidos tres meses, se realizaron entrevistas en profundidad a quienes asistieron, al menos, a la mitad de los encuentros. Se utilizó una guía con preguntas abiertas, para conocer la perspectiva de los participantes acerca de eventuales cambios percibidos a partir de la experiencia vivida en el taller. Los datos se categorizaron y, posteriormente, se triangularon para garantizar la validez del análisis. Resultados: se identificaron las siguientes categorías que sitúan las experiencias de los participantes en relación con su paso por el proyecto: la generación de vínculos entre pares, los vínculos con las moderadoras, la dinámica de taller, la sustentabilidad del proyecto y la resignificación del barrio. Conclusión: es factible generar cambios positivos en la salud de los adultos mayores, potenciar los espacios de socialización y contribuir satisfactoriamente en la resignificación de los barrios a través del mapeo de activos para la salud. (AU)

Introduction: population ageing and the increase in chronic non-communicable diseases are having a major impact on health systems worldwide. Linking the health system with community resources is essential in order to coordinate social and health care, decomplexify the care of older adults and promote active ageing. Our objective was to analyse the relationship between the participation of older adults in a health asset mapping project and the perceived effects of this experience. Methods: the intervention consisted of a workshop of six weekly meetings where participants learned to recognise health assets from the perspective of each participant. These were then uploaded onto a virtual map that could be accessed free of charge and shared with the whole of society. The workshop also reinforced the importance of the relationship between participants to improve social support.We used an interactive qualitative design with an interconnected and flexible structure between the research components. The interactions and dialogues that took place between moderators-participants and participants with each other were observed, and the field notebook records of the moderators were included. At the end of the last meeting, and after three months, in-depth interviews were conducted with those who attended at least half of the meetings. A guide with open-ended questions was used to find out the participants perspective on possible changes perceived as a result of the workshop experience. The data were categorised and then triangulated to ensure the validity of the analysis. Results: the following categories were identified that situate the participants experiences in relation to their time in the project: the generation of links between peers, the links with the moderators, the workshop dynamics, the sustainability of the project and the re-signification of the neighbourhood. Conclusion: it is feasible to generate positive changes in the health of older adults, to strengthen the spaces for socialisation and to successfully contribute to the resignification of the neighbourhoods through the mapping of assets for health. (AU)

Social determinants of health and community assets: Their importance for context analysis / Determinantes sociales de la salud y activos comunitarios: importancia para el análisis de contexto

ABSTRACT Public health, from alternative perspectives on the approach to positive health, seeks to overcome the deficit in recognizing the resources possessed by people and their communities as proposed in the Salutogenesis assets model. Therefore, this paper aims to establish the relationship between the Social Determinants of Health (SDH) and community assets. A two-stage sequential transformative mixed methods design, quantitative and qualitative, was used. Family files, mapping techniques, interviews, and participant observation were used as instruments. Older adults, women, and leaders have a history that creates opportunities based on education, work, and potential, developed individually or by coexistence between the same families and in the neighborhood. The SDH and community assets converge in the understanding of the territory as a social, historical, and eco-environmental space. There, the macro-policies are reflected, sometimes isolated from people's perceived, conceived, and lived spaces. In the construction of a healthy life, the main elements are people and their relationships. It is in this context that their talents, skills, and abilities are discovered. The results show a bilateral relationship between community assets and the SDH to understand the health-disease process. While the determinants focus on external conditions, risk, and vulnerability, depending on the disease, the assets do so in a positive health perspective that strengthens the resources of people and their communities. In this sense, they complement each other.

RESUMEN La salud pública, desde miradas alternativas con acercamiento a la salud positiva, busca superar el déficit para reconocer los recursos que tienen las personas y sus comunidades, a partir de la Salutogénesis - Modelo de activos. Así, pues, el escrito establece la relación de los determinantes sociales de la salud (DSS) y los activos comunitarios. Se utilizó un diseño mixto transformativo recurrente con dos fases: cuantitativa y cualitativa. Como instrumentos, las fichas familiares, técnicas cartográficas, la entrevista y la observación participante. Los adultos mayores, mujeres y líderes poseen una historia que crea oportunidades basadas en la educación, el trabajo y sus potencialidades, desarrolladas individualmente o por la convivencia entre las mismas familias y el barrio. Los DSS y los activos comunitarios convergen en la comprensión del territorio, como un espacio social, histórico y ecoambiental. Allí, se reflejan las macro políticas, en ocasiones aisladas de los espacios percibidos, concebidos y vividos de las personas. En la construcción de una vida sana, los principales elementos son las personas y sus relaciones; en ese contexto, se descubren sus talentos, las habilidades y las capacidades. Los resultados evidenciaron relación bilateral entre los activos comunitarios y los DSS, para comprender el proceso salud-enfermedad; mientras los determinantes se centran en condiciones externas, de riesgo y de vulnerabilidad en función de la enfermedad, los activos lo hacen en una mirada de salud positiva, que fortalece los recursos de las personas y sus comunidades. En este sentido, se complementan de manera recíproca.

Propósito, Satisfacción y Proyecto de Vida: una relación dialéctica / Purpose, Satisfaction and Life Project: a dialectical relationship

En este artículo teórico se revisan tres constructos implicados en una perspectiva salutogénica del ser humano y en la relación particular que mantiene con su propia vida: propósito o sentido en la vida, satisfacción con la vida y proyecto de vida. En primer lugar, se presenta una breve descripción de cada variable, para luego llegar a una articulación e integración entre ellas. Asimismo, se destaca el impacto que estos tres constructos psicológicos tienen en el desarrollo y devenir de la vida de cada persona, ya sea desde una perspectiva retrospectiva, presente o prospectiva(AU)

In this theoretical article, three constructs implied in a salutogenic perspective of the human being and in the particular relationship that it maintains with its own life are reviewed: purpose or meaning in life, life satisfaction and life project. Firstly, a brief description of each variable is presented, to later arrive at an articulation and integration between them. Likewise, the impact that these three psychological constructs have on the development and becoming of the life of each person is highlighted, whether from a retrospective, present or prospective perspective(AU)

Saúde bucal na infância: um modelo orientado para a gênese da saúde / Oral health in childhood: a model oriented towards the genesis of health

Nas últimas décadas do século XX e início do século XXI, a prevalência de cárie dentária apresentou redução na maioria dos países desenvolvidos. Apesar disso, a cárie permanece como a doença crônica mais frequente na infância, com distribuição desigual entre os países e populações. O esforço da comunidade científica se concentrou, até o momento, em desenvolver pesquisas focadas na etiopatogenia e nos fatores de risco à cárie. Poucos estudos buscaram analisar os fatores positivos, considerados como ativos em saúde que contribuem para a saúde bucal na infância. Este ensaio teórico teve por objetivo propor um modelo teórico-conceitual, incorporando as abordagens da patogênese e salutogênese, com orientação para a gênese da saúde. A metodologia foi estruturada por meio de revisões de literatura que subsidiaram a elaboração do modelo proposto.

In the last decades of the 20th century and the beginning of the 21st century, the prevalence of dental caries decreased in most developed countries. Despite this, caries remains the most frequent chronic disease in childhood, with uneven distribution among countries and populations. So far, the scientific community's efforts have been focused on developing research regarding the etiopathogenesis and risk factors for caries. Few studies have sought to analyze the positive factors, considered to be active in health that contribute to oral health in childhood. This theoretical essay aims to propose a theoretical-conceptual model, incorporating approaches to pathogenesis and salutogenesis, with guidance for the genesis of health. The methodology was structured through literature reviews that support the development of the proposed model.

Relación entre sentido de coherencia y diabetes mellitus: una revisión sistemática / Relationship between sense of coherence and diabetes mellitus: a systematic review

Resumen El objetivo fue sintetizar las mejores evidencias científicas sobre el efecto del sentido de coherencia en el desarrollo de la enfermedad, tratamiento e indicadores biomédicos de control metabólico y desarrollo de complicaciones de personas en riesgo de desarrollar diabetes y en diabéticos. El método utilizado fue la revisión sistemática. Búsqueda y selección por dos revisores independientes en las bases de datos Scopus, Web of Science, PubMed, Ebsco, Science Direct y manuales, disponibles hasta 2017, en español e inglés, en población con edad superior a 18 años. De un total de 154 estudios, 20 artículos fueron incluidos en la revisión sistemática. Más de la mitad de los estudios utilizaron la versión SOC-13 para la verificación del sentido de coherencia y el indicador de control metabólico más frecuente fue la hemoglobina glucosilada. Además, 14, de los 20 estudios, encontraron una relación estadísticamente significativa entre el sentido de coherencia y la diabetes. Se concluye que el sentido de coherencia tiene una fuerte correlación con la diabetes en las diferentes fases de la enfermedad y está relacionado con la reducción del riesgo para el desarrollo de la enfermedad, la reducción de los valores de hemoglobina glucosilada y la aparición de complicaciones de la diabetes mellitus.

Abstract The aim was to synthesize the best scientific evidence on the effect of sense of coherence in disease development, treatment, and biomedical metabolic control indicators, as well as the complications involved for people at risk of developing diabetes and for diabetics. The systematic review method was implemented. Search and selection efforts of two independent reviewers on Scopus, Web of Science, PubMed, Ebsco, Science Direct, and manuals databases, available until 2017, in Spanish and English, of the population aged 18 and over. From a total of 154 studies, 20 articles were included in the systematic review. Over half of the studies used the SOC-13 version to verify the sense of coherence and the most frequent indicator of metabolic control was glycated hemoglobin. In addition to this, 14 of the 20 studies found a statistically significant relationship between sense of coherence and diabetes. It is concluded that the sense of coherence has a strong correlation with diabetes in the different phases of the disease and is related to the reduction of risk for the development of the disease, a reduction of glycated hemoglobin values, and the appearance of diabetes mellitus-related complications.

Escala Reducida Para Valorar El Sentido De Coherencia: Soc 15 / Scale Reduced To Value The Sense Of Coherence: Soc 15

Resumen Introducción: El sentido de coherencia es una constructo de la salud que permite al individuo enfrentar las dificultades y situaciones difíciles de la vida. Está configurado por tres factores: significado, comprensión y manejo. Se ha propuesto como método de valoración de este constructo a la escala SOC con 29 ítems. Objetivo: En esta investigación se plantea como objetivo, proponer una escala SOC reducida. Métodos: Se trabajó con una muestra de 445 participantes saludables de Quito-Ecuador, 145 hombres (32.5%) y 300 mujeres (67.4%). Resultados: Se obtuvo que la escala reducida en 15 ítems presenta adecuada consistencia interna en sus tres factores: comprensión α=.74, manejo α=.82 y significado α=.82. En el análisis factorial confirmatorio se encontró un ajuste aceptable del modelo reducido (SOC-15) x 2=317.90, GL=87, p=<.001, CFI=.92, RMSEA=.07 (.06-.08) y SRMR=.04. Conclusiones: Se discuten los datos en relación a los beneficios de contar con una escala reducida para su futuro aplicación en el contexto clínico sanitario y científico.

Abstract Introduction: The sense of coherence is a construct of health that allows the individual to face difficult situations of life. It is configured by three factors: meaning, understanding and management. As a method of assessment of this construct, has been proposed the SOC scale with 29 items in its original version. Objective: The objective of this study is to propose a reduced SOC scale. Methods: We worked with a sample of 445 healthy participants from Quito-Ecuador, 145 men (32.5%) and 300 women (67.4%). Results: It was obtained that the reduced scale of 15 items presents an adequate internal consistency in its three factors: understanding α = .74, management α = .82 and meaning α = .82. In the confirmatory factor analysis, an acceptable adjustment of the reduced model was found (SOC-15) x 2 = 317.90, DF = 87, p = <. 001, CFI = .92, RMSEA = .07 (.06-.08) and SRMR = .04. Conclusions: The data is discussed in relation to the benefits of counting with a reduced scale for its future application in the clinical and health scientific context.

Mobile Stalls Pulled by Family Physicians: A Community-based Salutogenic Project Using Mobile Stalls / 日本プライマリ・ケア連合学会誌

We introduced the "Health Cafe with Mobile Stalls Project" as an example of community-oriented care. The authors, two family physicians and a medical student held salutogenic dialogues at mobile stalls in the "Yanesen" area in Tokyo and Toyooka City in Hyogo Prefecture. Mobile stalls may be able to demonstrate "small scale multi-functional" roles to approach people who are indifferent to health, and serve as a place where multiple generations can connect.

Associação entre senso de coerência e qualidade de vida em indivíduos de 50 a 74 anos / Association between sense of coherence and quality of life in individuals among 50 to 74 years old

O Senso de Coerência (SOC) reflete a forma como o indivíduo percebe a sua saúde e enfrenta os agentes estressores. O SOC está associado à qualidade de vida, sendo considerado um importante preditor de saúde. Este estudo têm o objetivo de investigar a associação entre o senso de coerência e os diferentes domínios da qualidade de vida (físico, psicológico, relações sociais e meio ambiente) em indivíduos de 50 a 74 anos residentes em Porto Alegre, Brasil. Trata-se de um estudo transversal com uma amostra de 720 sujeitos, selecionados por processo de amostragem aleatória proporcional em múltiplos-estágios. Foram utilizados dois instrumentos: Sense of Coherence Scala (SOC 13) e o World Health Organization Abbreviated Instrument for Quality Of Life Assessment (qa21’WHOQOL-BREF). As análises univariada e multivariada foram realizadas por meio de regressão linear, observando-se associação significativa do escore senso de coerência com a qualidade de vida, mesmo quando ajustado para as variáveis sóciodemográficas (p<0,001). Para um aumento de 10 pontos no escore do senso de coerência, há um aumento médio de 6,8 pontos nos escores de qualidade de vida no domínio psicológico (b=6,80; IC 95%: 5,94 a 7,67); 6,45 pontos no domínio físico (b=6,45; IC95%: 5,38 a 7,53); 5,51 pontos no domínio de relações sociais (b=5,51; IC 95%: 4,53 a 6,49); e de 4,73 pontos nos escores do domínio meio ambiente (b=4,73; IC 95%: 3,84 a 5,61). O escore global de qualidade de vida aumenta, em média, 6,84 pontos a cada 10 pontos do escore do senso de coerência (b=6,84; IC 95%: 5,70 a 7,98). Os resultados deste estudo demostram que o constructo SOC associa-se positivamente a qualidade de vida; quanto mais elevado o senso de coerência, melhor será a qualidade de vida.

The Sense of Coherence (SOC) reflects how the individual perceives their health and face stressors. The SOC is associated with quality of life and is considered an important predictor of health. This study aims to investigate the association between the sense of coherence and the different domains of quality of life (physical, psychological, social relationships and environment) in subjects 50-74 years of age living in Porto Alegre, Brazil. It is a cross-sectional study with a sample of 720 individuals selected by proportional random sampling process in multiple-stage. Two instruments were used: Sense of Coherence Scale (SOC 13) and the World Health Organization Abbreviated Instrument for Quality Of Life Assessment (WHOQOL-BREF). The univariate and multivariate analyzes were performed by linear regression observing significant association between the sense of coherence score with quality of life, even when adjusted for sociodemographic variables (p <0.001). For a 10-point increase in the score of sense of coherence, there is an average increase of 6.8 points in scores for quality of life in the psychological domain (b = 6.80, 95% CI: 5.94 to 7.67); 6.45 points in the physical domain (b = 6.45, 95% CI: 5.38 to 7.53); 5.51 points in the field of social relations (b = 5.51, 95% CI: 4.53 to 6.49); and 4.73 points in the environment domain scores (b = 4.73, 95% CI: 3.84 to 5.61). The overall score for quality of life increases, on average, 6.84 points for each 10-point score of sense of coherence (b = 6.84, 95% CI: 5.70 to 7.98). The results of this study indicate that the SOC construct positively associates with quality of life, the higher the sense of coherence better the quality of life.

Study of sense of coherence health promoting behavior in north Indian students.

Background & objectives: With advances in knowledge about health promotion, public health professionals are in search for the determinants of personal health behaviours. This study was carried out to explore the level of engagement of north Indian students in health promoting behaviours; to determine their sense of coherence scores; and to ascertain the determinants of health promoting behaviours of these students. Methods: A cross-sectional study was done in four randomly selected colleges of Chandigarh during 2007-2008 in 200 students (100 male, 100 female). Their health promoting lifestyle profile (HPLP) and sense of coherence (SOC) scores were estimated using interviews. The data were analyzed using Pearson's product moment correlation, and also stepwise linear regression analysis. Results: Mean HPLP and SOC scores of the students were 138.69 and 130.87, respectively. Females cared more about their health than males. Male students were more involved in physical activities. There was a linear correlation between the total SOC and HPLP scores (r=0.3). Female students (63%) consulted doctors more than males (50%) and washed their hands more regularly (P<0.05). Only 13 per cent students practiced yoga regularly. Female students had more meaningful relationships with friends and had more faith in God. Regression equation revealed that the two independent variables (SOC and age) accounted for 10.8 per cent of the variance in HPLP. Interpretation & conclusion: Students with higher SOC scores had higher HPLP scores. Female students were more health conscious than male students. In general, college students in Chandigarh had a good health promoting lifestyle and good sense of coherence.

"Cancer and Acupuncture & Moxibustion"-The Effective Indications and the Limitations of Acupuncture Treatments as Primary and Secondary Preventions (Treating Patient before Disease Arises), Treatments, Palliative Cares of Cancer- / 全日本鍼灸学会雑誌

In recent years, we have been told that the western medicine has developed the techniques of treatments on cancer, but the truth is that very few practical accomplishments has been made, while death rate from cancer has been steadily increasing. Although acupuncture has been thought to be ineffective in the treatments of cancer, nowadays we find some reports concerning its effectiveness in palliative cares, improvements of quality of life (QOL) and cancer regressions. Thus, this symposium was planned to investigate this theme. There were reports from appointed speakers on the acupuncturists' feelings of swung back and forth between joy and despair when treating patients with cancer, the experiences in treating her parents who died of lung cancer, and the patients who failed or rejected to be treated in western medicine but successfully treated using acupuncture eventually.<BR>A panelist who practices acupuncture treatments in a hospital reported the effectiveness and indications on combined application of acupuncture and standard treatments for the patients in the terminal stage of cancer. He also reported that no correlation had been found between effective rates and duration (frequency) of treatments neither between stages (duration) of disorders and efficacy. Furthermore, if the environment of acupuncture treatment is well organized, he mentioned that acupuncture can produce a good deal of effect even in patients with terminal stage. He also reported that acupuncture will be able to influence on the physiology in autonomic nervous system, leading to the hyperactivity of parasympathetic nerve.<BR>A panelist who practices his acupuncture treatments based on the theory of Professor Abo reported the effectiveness of acupuncture in improving QOL and in prolonging one's life. He showed an actual situation of the patient with scirrhous carcinoma who had prolonged his life for a long period using acupuncture treatment. He also demonstrated that radiotherapy, one of the three major medical treatments for cancer, will deprive the resistance of the patients.<BR>A panelist who advocates salutogenesis demonstrated the possibility of the direct effectiveness of acupuncture treatment on cancer because acupuncture has significant effects in alleviating pains and enhancing the power of restoring human energy in patients with cancer. He mentioned the limitation of the treatments using “a theory of pathogenesis (modern medicine)” and the importance of the treatments using “a theory of salutogenesis (traditional medicine)”, and emphasized the necessity of acupuncture treatments as well as supplemental agents, and the importance of psychological approaches toward the mind of patients.<BR>In this symposium, the efficacy of acupuncture treatments as palliative cares was indicated. Although there are few convincing evidences, the efficacy of acupuncture treatments as one of treatment methods for cancer may be demonstrated. Further integrative researches on the efficacy of acupuncture in patients with cancer are needed.