Modelo para la toma de decisiones en atención odontologica: descripción y puesta a prueba de un modelo de intervención a nivel local / Modelo para a tomada de decissões na assistênciaodontológica: descrição e teste de um modelo deintervenção local / Model for decision making in dental care: description and testing of an intervention model at local level

Objetivo: Describir un modelo para analizar la atención odontológica de un área geográfica local para facilitar toma de decisiones en la atención basadas en la evidencia científica. Metodología: La metodología incorpora (a) el diseño del modelo (MI) y (b) su aplicación probatoria en un municipio (capital de provincia). (a) El modelo propuesto, construido desde un enfoque estratégico, incluye tres estadíos (MM). El MM1 (identificatorio) consiste en la identificación de los problemas mediante recopilación de datos primarios y secundarios. El MM2 (analítico) plantea el análisis cuanti-cualitativo de los datos relevados. El MM3 (propositivo) a partir de la información analizada y priorizada, formula recomendaciones en dimensiones social, jurídico administrativa, epidemiológica, perceptual e investigativa. (b) La aplicación probatoria del modelo incluyó la identificación, análisis y priorización de los ejes problemáticos surgidos de los datos censales, de estadísticas de servicios de salud y de los programas vigentes. Los datos fueron procesados mediante una matriz explicativa y la fórmula de Hanlon. Un análisis FODA (interno y externo) permitió realizar recomendaciones y su potencial traslación a decisiones educativo-sanitarias. Resultados: (1) La puesta a prueba del modelo en una base territorial local (municipio) permitió la identificación rápida de problemas de la atención odontológica y la integración de la información recogida. (2) El modelo facilitó la traduccióndel estado de salud buco-dental en actividades educativo-sanitarias de alcance local, con eventual impacto sobre la salud de la población cubierta. Conclusiones: El MI puede ser aplicado en tiempo corto y obtener información oportuna para la toma de decisiones en un área local.

Objective: To describe a model to analyze dental care in a local geographical location inorder to facilitate decision making related to care, based on scientific evidence.Methodology: The methodology includes (a) model design (MI) and (b) its testingapplication in a municipality (capital of the province). (a) The suggested model, builtfrom a strategic approach, includes three stages (MM). MM1 (identifying) consists in theidentification of problems through the collection of primary and secondary data. MM2(analytic) related to the quantitative and qualitative analysis of the collected data. From theanalyzed and prioritized information, the MM3 (propositive) makes recommendations inthe social, legal-administrative, epidemiologic, perceptual and investigative areas. (b) Thetesting application of the model included the identification, analysis and prioritization ofthe problematic focuses arising from census data, statistics from health services and currentprograms. Data were processed with an explicative matrix and Hanton´s formula. A SWOTanalysis (internal and external) made it possible to make suggestions and their potentialtransfer to health and education decisions.Results: (1) Testing the model in a local territory base (municipality) allowed the quickidentification of problems in dental care and the integration of the collected information. (2)The model facilitated the translation of dental status into local reach health and educationalactivities, with possible impact on the health of the covered population. Conclusions: TheMI can be applied in a short time and used to get timely information for decision makingin a local area.

Knowledge, behavior, and attitudes of adolescent university students towards HIV infection and AIDS

The aim of this study was to evaluate the knowledge, behavior, and attitudes of students entering the University of Buenos Aires (UBA) towards HIV/AIDS, as well as to determine the differences between genders and between groups with different behavior in terms of HIV/AIDS risk behavior, through the conduct of an ad hoc semi-structured questionnaire. This questionnaire was completed anonymously by 12,000 university students going in for compulsory medical check-up at the Health and Social Welfare Office of the UBA. Two thousand cases were selected by simple randomized sampling and statistically analyzed. Results revealed that: (1) 87.2

of the population under study was between 18 and 27 years old; (2) the students’ knowledge of the subject was acceptable; (3) the percentage of respondents who reported having sexual intercourse with more than one person decreased as the number of sexual partners in a year increased. Less than 1.5

explicitly stated being homosexual or bisexual; (4) 53.9

of the men and 46.7

of the women claimed they always used condoms; (5) analysis of the perception of their own risk showed that 75

considered they were not at risk; (6) between 95.8

were in favor of developing educational-preventive activities and 64.2

thought compulsory AIDS screening for job applicants or candidates for educational courses was discrimination. Conclusions: (a) Information available to admission course students is sufficient. However, there are contradictions in their responses about their own behaviors; (b) Most of the respondents are in favor of the corresponding Faculties implementing educational and preventive measures. The students would regard the University’s intervention as a way of fulfilling its social role.

Oral health of children from rural excluded villages (Trancas and Calchaqui valleys. Tucumán, Argentina)

The general hypothesis of the study was to evaluate strategically important rural areas to confirm their characteristics of [quot ]excluded population[quot ] and identify the priorities to allocate human and financial resources of the international co-operation project. The aim of this study was to establish the degree of development of villages in the Trancas and Calchaqui valleys, and the oral health of children living in areas involved in an integral study on excluded villages in the northwest of Argentina. These villages are considered a priority in the UNIR Project; they are thus strategically important as a link with countries of the MERCOSUR. Data on living conditions were obtained through direct inquiries (Project UNIR, W. K. Kellogg Foundation/University of Tucumán) and from data supplied by the Ministry of Economy, by the Ministry of Culture and Education and by the SIEMPRO project of the Secretariat of Social Development of the Ministry of Health. The Human Development Index (HDI) was calculated as World Bank criteria (1995), The studies on dental conditions were carried out in all the children between 12 and 14 years old, that is a total of 58 in the Trancas Valley and 212 in the Calchaqui Valley. RESULTS: (1) The HDI was 0.731 for the province, 0.56 for the Trancas Valley and 0.51 for Calchaqui valley. (2) The results are above the values for the country in the first case, and below the average country values for the valleys. (3) The percentage of BNN families reached 92

. The results for oral health show: (4) the DMFT were 6.34 +/- 0.07 in the Trancas Valley and 7.47 +/- 0.276 in the Calchaquí valley. (5) Carious teeth (CT) were the most important component of this index. (6) The absence of a specific and preventive assistance. CONCLUSIONS: (a) Children between 12 and 14 living in the Valleys of Trancas and Calchaqui (Tucumán, Argentina) are affected by severe levels of caries, with values above the national and province means. (b) The human development index is below that of the corresponding national and province levels. (c) Inhabitants of these valleys can be identified as socially and biologically highly vulnerable. (d) The indicators of cariogenic risk reveal the importance of introducing oral preventive care components to the health plan for the area focused on the excluded population.

Effect of self-brushing with acidulated phosphate fluoride (pH 5.6) on dental caries in children

The aim of this work was to study the effect of a preventive program on the dental plaque and on the caries incidence in school children. The program comprised weekly supervised self brushing with acidulated phosphate fluoride (APF) gel (pH 5.6; concentration: 4520 ppm of ion F-). The program involved 240 children of 1st., 3rd and 5th grade of a primary school in the City of Buenos Aires (Argentina). The population was divided in 2 groups: A (experimental) and B (control). Ninety children from both groups (45 experimental and 45 control) were submitted to baseline clinical examination (DMFT and plaque index) and microbiological analysis (total streptococci, St mutans and St. mutans and St. mutans percentage). Group A was then submitted to a preventive program which included self brushing with APF gel (4520 ppm of ion F-). The 90-children sample was monitored after 1 and 2 years of program. Results were statistically processed and they revealed the following: a--DMFT was significantly greater in the control group than in the experimental group after 1 and 2 years of program; b--an 81.43

reduction in caries increment rate at the end of the 2-years program in the experimental group as compared to the control group; c--a rise in the number of colonies of total streptococci and of St. Mutans; d--a reduction in the

of St. mutans in the total streptococci flora in the plaque of children in the experimental group; e--the presence of St. mutans colonies featuring a rough surface; f--the effectiveness of the program in the modifying the profile of the diagnosed dental pathology.