Frequency of symptoms and the associated factors of eating disorders in a group of dental students in Medellín, Colombia.

BACKGROUND: Eating disorders (EDs) are considered a public health problem. Scientific research has focused on teenagers due to their higher prevalence in this population. However, other groups, such as university students, may be exposed to suffering from EDs due to their academic, social and personal characteristics. Identifying the magnitude of EDs and the associated characteristics may impact the generation of prevention strategies. OBJECTIVES: The aim of the present study was to establish the prevalence of the risk of EDs (anorexia nervosa (AN) and bulimia nervosa (BN)) and the associated factors in dental students at the University of Antioquia, Medellín, Colombia.. MATERIAL AND METHODS: A cross-sectional study was conducted on 278 students (76 males, 202 females) with the use of a Google-Forms survey. The validated Spanish version of the Eating Attitudes Test-26 (EAT-26) and the Sick, Control, One Stone, Fat, Food (SCOFF) questionnaire were used. Other recorded variables included sociodemographic data, coronavirus disease 2019 (COVID-19)-related factors, health, and social support (the Duke-11 profile). The bivariate analysis of the risk of EDs was conducted according to different variables (95% confidence interval (CI)), followed by the logistic regression models adjusting for different variables (adjusted prevalence ratio (aPR) and 95% CI). RESULTS: According to EAT-26, the risk of EDs was 27.6% (18.8-38.6) for males and 28.7% (22.9-35.3) for females. However, differences between males and females were higher when the SCOFF questionnaire was applied (males: 6.6% (2.8-14.5); females: 22.3% (17.1-28.5); p < 0.01). According to the SCOFF instrument, after adjusting for sociodemographic and health variables, women were more likely to report the symptoms of EDs (aPR: 2.20; 95% CI: 1.06-4.57). Women receiving information from social networks were more likely to report the symptoms of EDs (aPR: 1.85; 95% CI: 1.19-2.88). Multivariate models showed that women reporting poor self-rated health and some symptoms during the mandatory confinement caused by the COVID-19 pandemic were more likely to report the symptoms of EDs. CONCLUSIONS: A higher risk of EDs was found in dental students. Healthcare, psychological and/or psychiatric interviews, and educational/early prevention strategies are required.

Impact of COVID-19 on the future career plans of dentists.

BACKGROUND: It is important to complement the scientific literature with the data regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on the social, work and health practices as well as on the daily life of dentists, and to promote adequate public policies. OBJECTIVES: The aim of the study was to explore the impact of the COVID-19 pandemic on the career plans of dentists in Colombia. MATERIAL AND METHODS: As part of global research on the impact of COVID-19 on dentistry, a crosssectional survey was administered via digital media to dentists in Colombia. The validated questionnaire included inquiries regarding sociodemographic variables, the perception of the risk of contagion with COVID-19 and the impact of COVID-19 on the dentists' career plans. The variables were summarized in absolute and relative frequencies, and a binomial logistic regression analysis was carried out to evaluate the impact of COVID-19 on career plans according to the independent variables. RESULTS: A total of 5,370 dentists answered the survey (women: 3,878; median age: 45 years; response rate: 16.85%). Most of the dentists (96%) believed that COVID-19 infection was a risk for them and 81.96% reported that the COVID-19 pandemic had some impact on their career plans, including reducing working hours (77.96%), retiring early (26.54%) and changing their career away from dentistry (18.15%). The regression model showed that older adults (OR = 1.62; 95% CI: 1.16, 2.26), general practitioners (OR = 1.21; 95% CI: 1.02, 1.44), private practice owners (OR = 2.33; 95% CI: 1.94, 2.79), private practice associates (OR = 2.20; 95% CI: 1.84, 2.63), and those with 'very probable' risk perception (OR = 4.29; 95% CI: 1.35, 13.60) had a significantly greater chance of the pandemic having an impact on their future career plans. CONCLUSIONS: The pandemic has had a great impact on dentists' career plans. Dentists who are most fearful of the risk of contagion, those who are older and those who have their private practice are thinking about reducing working hours, retiring early or changing their career.

Impact of the COVID-19 pandemic on the timing of dental care in Peruvian children.

BACKGROUND: Due to the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), governments adopted preventive measures, such as social distancing and obligatory social immobilization, which negatively affected access to health services, including oral health services. Similarly, dental care restraint arose in this context, with the aim of reducing the possibility of cross-infection caused by aerosols, which notably restricted dental care activity. OBJECTIVES: The aim of the study was to determine the impact of the COVID-19 pandemic on the timing of dental care in Peruvian children. MATERIAL AND METHODS: A cross-sectional study with a population of 42,115 respondents for 2019 and 20,510 for 2020 was conducted. The participants were children aged 0-11 years. The records of those who responded to the question on the time since their last dental care were considered, extracting a total of 22,166 (69.03%) subjects for 2019 and 9,945 (30.97%) subjects for 2020. The dependent variable consisted of the time since the last dental care measured in years; the variables of health, geographic and sociodemographic characteristics were grouped within 3 dimensions. Descriptive bivariate and multivariate analyses were applied by means of multiple linear regression in order to analyze the variables. RESULTS: The time since the last dental care during 2019 was 5.25 ±4.30 years, and it increased to 6.64 ±4.90 years in 2020. Within the multivariate analysis, the dimensions and their variables were ordered hierarchically for 2019 and 2020 separately, and as a whole. Each model was not significant when observed independently (p > 0.05); however, when evaluated as a whole, validity was observed only in model 1 of the year (p = 0.018), with R2 = 2.90, a constant equal to 3.852, the non-standardized regression coefficient (ß) of 1.653, and a 95% confidence interval (CI) of 0.289-3.018. CONCLUSIONS: The 2020 COVID-19 pandemic year had a negative impact on the timing of dental care in Peruvian children, increasing it by 1.39 years as compared to 2019.

Institutional practices in maternal health according to social class. Bogotá, Colombia, 2018 / Prácticas institucionales en salud en maternas según clase social. Bogotá, Colombia, 2018

RESUMEN Objetivo: Comprender las prácticas institucionales en salud que se realizan en las mujeres en embarazo parto y posparto, según la clase social, en Bogotá. Materiales y métodos: Estudio cualitativo, desde el paradigma de la hermenéutica crítica. Método de etnografía crítica, con muestreo teórico. Participaron 9 mujeres y 8 profesionales de la salud de la ciudad de Bogotá, que asistieron a instituciones públicas y privadas, pertenecientes a los regímenes subsidiado y contributivo del Sistema General de Seguridad Social en Salud (SGSS). Se realizaron 38 entrevistas a profundidad durante 13 meses y 62 acompañamientos a las maternas en las actividadesde control prenatal, vacunación, trabajo de parto, consulta posparto, exámenes de seguimiento, curso psicoprofiláctico, hospitalización y sala de espera, tanto en servicios públicos como privados. Análisis por triangulación en Atlas Ti. Resultados: Teniendo en cuenta los discursos de los actores, la observación participante y el contexto, se encontraron dos categorías que determinan estas inequidades, denominadas el mercado regula la salud, y la vigilancia y el control en los servicios de salud. Conclusiones: En la práctica médica es conveniente fortalecer las competencias ciudadanas para garantizar los derechos del personal de salud y de las mujeres. Estudiar desde la investigación cualitativa es una oportunidad para promover la transformación de las racionalidades médicas que afectan a las mujeres.

ABSTRACT Objective: To understand institutional practices in healthcare as relates to women during pregnancy, childbirth and the postpartum period according to social class in Bogota. Materials and methods: Qualitative study based on the critical hermeneutics paradigm. Critical ethnographic method with theoretical sampling. The participants included 9 women and 8 health-care professionals from the city of Bogotá, attending public and private healthcare institutions that serve populations under both the subsidized as well as the contributive regimes of the General Social Security System. Overall, 38 in-depth interviews were conducted during a 13 month period, with 62 instances of support to the mothers in terms of prenatal care, vaccination, labor, postpartum visits, follow-up tests, psychoprophylactic course, hospitalization and waiting room. Triangulation analysis on Atlas Ti. Results: Taking into account the discourse of the different players, observations and context, two categories were found to be determining factors of inequities: "Market-regulated health" and "Over- sight and control in health services". Conclusions: It is advisable in medical practice to build competencies in the population in order to ensure the realization of the rights of women and healthcare personnel. Qualitative research offers the opportunity to promote the transformation of medical rationale affecting women.

Salud bucal y determinantes sociales en escolares con limitación visual en Medellín / Oral health and social determinants in visually impaired schoolchildren from Medellín

RESUMEN Introducción: La salud bucal requiere un análisis contextual y social en poblaciones consideradas vulnerables. Objetivo: Describir la situación de salud bucal en un grupo de escolares con limitación visual y su relación con determinantes sociales, familiares e individual. Métodos: Estudio descriptivo en 21 escolares con limitación visual y 15 adultos significativos. Se realizó una encuesta que indagó por datos sociodemográficos, hábitos y utilización de servicios de salud bucal. Mediante examen clínico se aplicaron los siguientes indicadores: índice de O'Leary, índice gingival de Löe y Silness, índice COP-D de Klein y Palmer, tradicional y modificado, e índice significante de caries (SiC). Análisis descriptivo de frecuencias absolutas y relativas. Resultados: Los datos se agruparon bajo tres contextos: social, familiar e individual. En el contexto social se encontró que un 40 por ciento (n = 6) de los encuestados pertenecían al régimen subsidiado, además el 53,3 por ciento (n = 8) manifestó tener dificultades para acceder a los servicios de odontología. En cuanto al espacio familiar se detectó que el 53 por ciento (n = 8) de la población pertenece al estrato socioeconómico bajo y solo el 60 por ciento (n = 9) de los participantes en el estudio habían concluido la secundaria. Finalmente, el individual, el 100 por ciento de los escolares presentaban control de placa deficiente (73,3 por ciento ± 23,7). El índice significante de caries tradicional fue de 4,3 (± 2,4) y el modificado de 6,7 (± 1,7). Se encontró un índice gingival moderado en el 100 por ciento de los escolares con un promedio de 23,5 (± 24,5). Conclusiones: Las principales barreras se identifican en la posición social (ocupación, ingresos, educación), lo que repercute en la situación de salud bucal. Es necesario abordar este tipo de población desde un enfoque participativo, continuo e integral que empodere a sus cuidadores y transforme sus prácticas a través de la promoción de la salud(AU)

ABSTRACT Introduction: Oral health requires a contextual and social analysis in populations considered vulnerable. Objective: Establish the oral health status of a group of visually impaired schoolchildren and its relationship to social, family and individual determinants. Methods: A descriptive study was conducted of 21 visually impaired schoolchildren and 15 significant adults. A survey was applied to collect sociodemographic information and data about habits and use of oral health care services. Clinical examination was based on the following indicators: O'Leary's index, Löe and Silness's gingivitis index, Klein and Palmer's COP-D index, both traditional and modified, and significant caries index (SiC). Descriptive analysis was performed of absolute and relative frequencies. Results: The data were distributed into three categories: social, family and individual. Social analysis found that 40 percent (n = 6) of the respondents were in the subsidized sector, whereas 53.3 percent (n = 8) reported difficulties to access dental care services. With respect to the family environment, it was found that 53 percent (n = 8) of the study population were from a low socioeconomic stratum and only 60 percent (n = 9) of the participants in the study had completed secondary education. Individual analysis revealed that 100 percent of the schoolchildren showed evidence of poor plaque control (73.3 percent ± 23.7). The traditional significant caries index was 4.3 (± 2.4), whereas the modified significant caries index was 6.7 (± 1.7). A moderate gingivitis index was found in 100 percent of the schoolchildren with an average 23.5 (± 24.5). Conclusions: The main hurdles identified had to do with the social status (occupation, income, education), all of which has an impact on the oral health status. It is necessary to address this type of population with a participative, continuous, integral approach which empowers care givers and transforms their practices via health promotion(AU)

Institutional practices in maternal health according to social class. Bogotá, Colombia, 2018.

OBJECTIVE: To understand institutional practices in healthcare as relates to women during pregnancy, childbirth and the postpartum period according to social class in Bogota. METHODS: Qualitative study based on the critical hermeneutics paradigm. Critical ethnographic method with theoretical sampling. The participants included 9 women and 8 health-care professionals from the city of Bogotá, attending public and private healthcare institutions that serve populations under both the subsidized as well as the contributive regimes of the General Social Security System. Overall, 38 in-depth interviews were conducted during a 13 month period, with 62 instances of support to the mothers in terms of prenatal care, vaccination, labor, postpartum visits, follow-up tests, psychoprophylactic course, hospitalization and waiting room. Triangulation analysis on Atlas Ti. RESULTS: Taking into account the discourse of the different players, observations and context, two categories were found to be determining factors of inequities: "Market-regulated health" and "Over- sight and control in health services". CONCLUSIONS: It is advisable in medical practice to build competencies in the population in order to ensure the realization of the rights of women and healthcare personnel. Qualitative research offers the opportunity to promote the transformation of medical rationale affecting women.

TITULO: PRÁCTICAS INSTITUCIONALES EN SALUD EN MATERNAS SEGÚN CLASE SOCIAL. BOGOTÁ, COLOMBIA, 2018. OBJETIVO: Comprender las prácticas institucionales en salud que se realizan en las mujeres en embarazo parto y posparto, según la clase social, en Bogotá. METODOS: Estudio cualitativo, desde el paradigma de la hermenéutica crítica. Método de etnografía crítica, con muestreo teórico. Participaron 9 mujeres y 8 profesionales de la salud de la ciudad de Bogotá, que asistieron a instituciones públicas y privadas, pertenecientes a los regímenes subsidiado y contributivo del Sistema General de Seguridad Social en Salud (SGSS). Se realizaron 38 entrevistas a profundidad durante 13 meses y 62 acompañamientos a las maternas en las actividadesde control prenatal, vacunación, trabajo de parto, consulta posparto, exámenes de seguimiento, curso psicoprofiláctico, hospitalización y sala de espera, tanto en servicios públicos como privados. Análisis por triangulación en Atlas Ti. RESULTADOS: Teniendo en cuenta los discursos de los actores, la observación participante y el contexto, se encontraron dos categorías que determinan estas inequidades, denominadas el mercado regula la salud, y la vigilancia y el control en los servicios de salud. CONCLUSIONES: En la práctica médica es conveniente fortalecer las competencias ciudadanas para garantizar los derechos del personal de salud y de las mujeres. Estudiar desde la investigación cualitativa es una oportunidad para promover la transformación de las racionalidades médicas que afectan a las mujeres.

Characterization of unsafe acts in dentistry (uad) in a teaching-service institution, medellín (colombia), 2015-2017 / Caracterización de las acciones inseguras en odontología (aio) en una institución de docencia-servicio, medellín (colombia), 2015-2017

ABSTRACT. Introduction: the implementation of measures to improve the culture of patient safety in public and private institutions seems to require the development of epidemiological surveillance systems. This study aims to characterize unsafe acts in dentistry (UAD) according to several variables in a dental school of a public university in Medellín (Colombia). Methods: longitudinal descriptive study of the UADs reported at the Universidad de Antioquia School of Dentistry during the period 2015-2017. To this end, a form was designed using the Google Docs™ tool (available upon request to the authors). The sociodemographic variables were described using absolute and relative frequencies, and Χ-square statistical significance tests were used to identify differences among the variables. This study had institutional ethical approval. Results: during the study period (33 months), 541 UADs were reported, 65% of them during the year 2015. The highest frequency of UAD was reported at the Children's Clinic (84%). Also, 84% of these UADs were classified as healthcare failures. These failures were mostly reported by students, males, persons aged ≤ 24 years, and undergraduate students, and they generally occurred in male patients and persons aged ≤ 12 years. Significant differences were found (p < 0.05) between the various types of UADs and the variables included in the analysis on the one hand, and time when the services were provided and type of clinic on the other. Conclusions: differences in the reporting of UADs were found considering the variables included in the analysis.

RESUMEN Introducción: el establecimiento de acciones para mejorar la cultura de la seguridad del paciente en instituciones públicas y privadas parece requerir de sistemas de vigilancia epidemiológica. Este estudio pretende caracterizar las atenciones inseguras en odontología (AIO) según diferentes variables, en una institución pública que forma recursos humanos en salud bucal en Medellín (Colombia). Métodos: estudio descriptivo longitudinal de las AIO reportadas en la Facultad de Odontología de la Universidad de Antioquia durante el periodo 2015-2017. Para ello se diseñó un formulario mediante la herramienta Google Docs™ (disponible si se solicita a los autores). Se describieron las variables sociodemográficas mediante frecuencias absolutas y relativas y se realizaron pruebas de significancia estadística χ2 para observar diferencias entre las variables. Se contó con la aprobación ética de la institución. Resultados: durante el periodo de estudio (33 meses), se reportaron 541 AIO, el 65% durante el año 2015. La mayor frecuencia de AIO se reportó en la clínica del niño (84%). De igual manera, un 84% de estas AIO se clasificaron como fallas en la atención en salud. Estas fallas fueron reportadas mayormente por estudiantes, por hombres, por personas 24 años, por estudiantes de pregrado, y en pacientes del sexo masculino y personas 12 años. Se encontraron diferencias significativas (p < 0,05) entre los diferentes tipos de AIO y las variables consideradas en el análisis, y según el periodo de ocurrencia de las atenciones y el tipo de clínica. Conclusiones: se encontraron diferencias en el reporte de AIO según las variables consideradas en el análisis.

Caries dental en niños de 0-5 años del municipio de Andes, Colombia. Evaluación mediante el sistema internacional de detección y valoración de caries - ICDAS / Dental caries in children aged 0 to 5, from the Andes municipality, Colombia. An evaluation using the international caries detection and assessment system - ICDAS / Cárie dentária em crianças entre 0-5 anos do município de Andes, Colômbia. Avaliação utilizando o Sistema Internacional de Avaliação e Detecção de Cáries -ICDAS

Resumen La falta de información de la situación de caries dental en la primera infancia en Andes, limita las acciones en el marco de la Alianza por un Futuro libre de Caries. Objetivo: establecer la situación de caries dental de los niños y niñas de 0 a 5 años del Municipio de Andes (Colombia). Metodología: fueron examinados 623 niños y niñas para evaluar la presencia y severidad de las lesiones de caries, con base en criterios del Sistema Internacional para la detección y evaluación de caries - ICDAS. Se calcularon las proporciones de experiencia y prevalencia de caries dental, y los índices cICDAS 5-6 opd y cICDAS 1-6 opd. Resultados: el 38,2% tenía experiencia de caries dental severa, cuando se incluyen las lesiones iniciales y moderadas de caries dental la experiencia fue 88,4%. Al año de edad, el 4,9% tenía lesiones severas de caries dental, y a los 5 años el 53,6% presentó este tipo de lesiones. El índice cICDAS 5-6 opd fue 0,15±0,8 al año de edad y 2,79±3,6 a los 5 años; el valor del indicador aumenta a 1,97±2,9 y 9,61±4,6 respectivamente, cuando se incluyen lesiones iniciales y moderadas de caries dental, cICDAS 1-6 opd . Discusión: la enfermedad está presente desde el primer año en el 58,8%, el doble de lo reportado en el país a esta edad (29,3%). Conclusión: los hallazgos resaltan la necesidad de diseñar estrategias integrales para el control de la enfermedad, que involucren la salud bucal en políticas y programas de primera infancia.

Abstract The lack of information on dental caries limits the actions of the program called "Alliance for a Cavity Free Future" in the Andes municipality, Colombia. Objective: to establish a baseline for dental caries in primary dentition among children aged 0 to 5. Methods: a total of 623 children were examined in order to detect the presence of dental caries and its severity. This analysis was conducted using the criteria of the International Caries Detection and Assessment System, ICDAS. In addition, the experience and prevalence ratios were calculated along with the cICDAS 5-6, mft and cICDAS 1-6 mft indices. Results: 38.2% of the children had experienced severe caries (dICDAS 5-6 mft>0); the percentage of caries experienced increased to 88.4% when initial and moderate dental caries lesions were included (dICDAS 1-6 mft>0). The data showed that 4.9% of the one-year-olds had untreated severe carious lesions, and this percentage increased to 53.6% for five-year-olds. The dICDAS 5-6 mft index was 0.15±0.8 for one-year-olds and 2.79±3.6 for five-year-olds, increasing to 1.97±2.9 and 9.61±4.6, respectively when initial and moderate dental caries lesions were included - dICDAS 1-6 mft. Discussion: dental caries is present from the first year in 58.8% of children, this is twice the amount reported for Colombia and for the same age (29.3%). Conclusion: the findings highlight the need to design comprehensive strategies for controlling the disease. Such strategies should include oral health in the early policies and programs dealing with early childhood.

Resumo A falta de informação sobre a situação de cáries dentárias na primeira infância no município Andes limita as ações no âmbito da Aliança para um Futuro Livre de Cáries. Objetivo: estabelecer a situação das cáries dentárias nas crianças entre 0-5 anos do Município Andes, Colômbia. Metodologia: foram examinadas 623 crianças visando avaliar a presencia e severidade das lesões de cáries, com base nos critérios do Sistema Internacional de Avaliação e Detecção de Cáries -ICDAS. Calcularam-se as proporções de experiência e prevalência de cáries dentarias, e os índices cICDAS 5-6 opd e cICDAS 1-6 opd. Resultados: 38,2% tinha experiência de cárie dentária severa. Incluindo as lesões iniciais e moderadas de cárie dentária, a experiência foi de 88,4%. Com um ano de idade, 4,9% tinha lesões severas de cárie dentária, e com 5 anos 53,6% tinha este tipo de lesões. O índice de cICDAS 5-6 opd foi 0,15±0,8 com um ano de idade, e de 2,79±3,6 com 5 anos. O valor do indicador aumenta a 1,97±2,9 e 9,61±4,6 respectivamente, incluindo as lesões iniciais e moderadas de cárie dentária, cICDAS 1-6 opd. Discussão: a doença está presente desde o primeiro ano de idade em 58,8%, que é duas vezes o que se notifica no país para esta idade (29,3%). Conclusão: os resultados ressaltam a necessidade de conceber estratégias para controlar esta doença, incluindo a saúde bucal nas políticas e programas de primeira infância.

Present teeth in population of ages25, 35, 45, 55 and 65 years,Antioquia (Colombia) 2011 / Dientes presentes en población de 25, 35, 45, 55 y 65 años, Antioquia (Colombia) 2011

Introduction and objective:The global goals of oral health propose to establish own oral indexes in each country and region accordingto their achievements. The aim of this study was to estimate the baseline indicators of natural teethpresent in population aged 25, 35, 45, 55 and 65 years in Antioquia, Colombia.Materials and methods:Descriptive study from a consolidated database by the “Secretaria Seccional de Salud de Antioquia”,which contains records of people who attended the dental service for first time during 2010 and 2011 inthe municipalities of the department, and that were examined according the guidelines of the “Ministeriode la Protección Social” for the evaluation of dental status.Results:For people aged 25-years old, the 62.9% had all natural teeth present, percentage that decrease withincreasing age, for 65 years old was only 5.2%. The mean of present teeth in 25 and 65 years old groupswere 27.2±1.4 and 14.5±8.3 respectively. Missing teeth due to caries for 25 years old were on average0.56±1.2, index that increase with age, being 11±8.8 for 65 years old while the mean number of missingteeth due to other reasons was 0.7±2.6. The percentage of persons with less than 21 teeth was 17.7%.Conclusions:The number of natural teeth present for people aged 25-years is in agreement with the goal proposed bythe National Public Health for older than 18 years, but was only achieved for 25 years old.

Introducción y objetivo:Las metas globales en salud bucal proponen establecer indicadores propios en cada país y localidad de acuerdocon los logros alcanzados. El objetivo del estudio fue estimar los indicadores línea de base de dientes naturalespresentes en la población de 25, 35, 45, 55 y 65 años del departamento de Antioquia, Colombia.Materiales y métodos:Estudio descriptivo a partir de una base de datos consolidada por la Secretaría Seccional de Salud deAntioquia, con los registros de las personas que asistieron a consulta odontológica entre 2010 y 2011,y que fueron examinadas según lineamientos del Ministerio de la Protección Social, para el registro delestado de la dentición.Resultados:A los 25 años de edad el 62,9% tenía todos los dientes naturales presentes, porcentaje que disminuyea medida que aumenta la edad, siendo 5,2% a los 65 años. El promedio de dientes presentes a los 25y 65 años fue 27,2±1,4 y 14,5±8,3 respectivamente. Los dientes perdidos por caries dental a los 25años fueron en promedio 0,56±1,2 y el índice aumenta con la edad, llegando a 11±8,8 a los 65 años. Elpromedio total de dientes no presentes por otras razones fue 0,7±2,6. El 17,7% tenía 20 o menos dientes.Conclusión:El porcentaje de población con todos los dientes presentes a los 25 años, está en consonancia con lopropuesto por el Plan Nacional de Salud Pública para los mayores de 18 años, pero solo se alcanza lameta en esta edad.

La epidemiología para la gestión social del conocimiento, un trazador con sentido en la construcción de políticas públicas en salud / Epidemiologia para gestao social do conhecimento, um tracejador com sentido na construcao de políticas públicas em saúde / Epidemiology for the social management of knowledge

Esta reflexión, interesada en reconocer la interacción entre la ciencia política y la salud pública, reconoce en la epidemiología uno de los puentes para el abordaje de las políticas en salud, de modo que se pretende explorar cómo la ciencia política es responsable de apoyarse en otras ciencias como la salud pública, y a su vez, en disciplinas como la epidemiología, la demografía, la estadística, entre otras, para la construcción de políticas públicas en salud, a través de la gestión social del conocimiento y por medio de principios fundamentales como la transdisciplinariedad, la cual integra las neo-estructuras políticas, y la producción del conocimiento en relación con las ciencias de la vida, teniendo en cuenta cómo los tomadores de decisión hacen uso de los resultados de investigación y abordan las problemáticas multidimensionales de realidades sociales como la colombiana. De esta manera, la ciencia política se constituye en un elemento generador, por excelencia, de políticas públicas, así como para los sistemas de salud lo es la evidencia que arroja la epidemiología, gran insumo para comprender muchas de las decisiones en salud pública...

This reflection -interested in recognizing the interaction between public health and political science- acknowledges epidemiology as a bridge to approach the study of the policies in health, so as the objective of this paper is to explore the way political science has the responsibility to be supported in other sciences such as public health and disciplines like epidemiology, demography, statistics, among others likewise, considering public health policy making ,through social knowledge management based on some main principles: transdisciplinarity as integrator of political structures and the production of knowledge related to life sciences, in front of decision makers who use research results and improve their abilities addressing the multidimensional problems of social realities like the Colombian one. Political science is -per excellence- a generator element of public policies, in similar way that the evidence produced by epidemiology for the components of health system, as a constitutive ingredient for welfare and delivering of public health decisions...

Esta reflexão, interessada em reconhecer a interação entre ciência política e saúde pública, reconhece na epidemiologia uma das pontes para a abordagem das políticas de saúde, de modo tal que, a pretensão é a de descobrir o jeito como a ciência política é responsável de se apoiar em outras ciências como a saúde pública, e por sua vez, em disciplinas como epidemiologia, demografia, estadística, entre outras, para a construção de políticas públicas em saúde, através da gestão social do conhecimento e por médio de princípios fundamentais tais como a transdisciplinariedade, mesma que integra as neo-estruturas políticas e a produção do conhecimento no que diz respeito das ciências da vida, levando em conta a maneira como os tomadores de decisões fazem uso dos resultados de pesquisa e abordam problemáticas multidimensionais de realidades sociais como a colombiana. Desta forma, a ciência política constitui-se num elemento gerador por excelência, das políticas públicas, mesmo como para os sistemas de saúde é a evidência arrojada pela epistemologia, insumo grande para compreender muitas das decisões em saúde pública...

Caries dental y necesidades de tratamiento en el primer molar permanente en escolares de 12 años de las escuelas públicas del municipio de Rionegro (Antioquia, Colombia), 2010 / Dental Caries and Treatment Needs in the First P ermanent Mol ar in 12-year-old School children fr om P ublic Schools in the Municipal ity of Rionegro (Antioquia, Colombia), 2010

Antecedentes: es importante evaluar el primer molar permanente, ya que en edad escolares el diente permanente más afectado por caries. La prevalencia de caries en estos dientesse ha asociado con la actividad futura de caries. Objetivo: determinar la prevalencia decaries y las necesidades de tratamiento de los primeros molares permanentes en la poblaciónescolar de 12 años de las escuelas oficiales del municipio de Rionegro (Antioquia).Métodos: se realizó un estudio descriptivo transversal en 808 escolares de 12 años deescuelas públicas del municipio. Se analizó la prevalencia de caries dental en el primer molarpermanente por número y tipo de dientes afectados y de acuerdo con sexo, escolaridad,zona de residencia y afiliación al Sistema General de Seguridad Social en Salud (SGSSS).También se describieron las necesidades de tratamiento para cada primer molar permanente.Resultados: los molares inferiores presentaron la mayor prevalencia de cariesdental en relación con las variables de afiliación al SGSSS, sexo y zona de residencia;en estas dos últimas variables se evidenció más afectación en el primer molar inferiorderecho y concentración en este molar de las necesidades de tratamiento restaurativo.Conclusiones: aunque se cuenta con estudios previos sobre prevalencia de caries dentalen el municipio que muestran cumplimiento de metas de la Organización Mundial de laSalud, son más escasos los estudios que evalúen de manera individual los primeros molarespermanentes para orientar políticas de salud pública dirigidos a la preservación de estasimportantes estructuras dentales...

Background: Evaluation of the first permanent molar is important since it is the tooth thatis most affected from dental cavities in schoolers. Caries prevalence of this molar has beenassociated with future caries activity. Objective: Determine caries prevalence and treatmentneeds in the first permanent molar of a 12-year-old population from public schools in themunicipality of Rionegro (Antioquia). Methods: A descriptive study in 808 12-year-old schoolchildren from public schools in Rionegro was conducted. Caries prevalence in the first permanentmolar was analyzed regarding number and type of teeth affected and associationwith sex, grade, zone of residence, and type of affiliation to the social security system (SSS).Needs for dental treatment in this molar were also described. Results: Lower molars werethe most affected by dental caries in relationship with sex, SSS, and zone of residence; in thelatter two dental cavities were more prevalent in the right lower first molar, tooth in which theneed for restorative treatment is higher than the other first molars. Conclusions: Althoughthere are previous studies on the dental health status in Rionegro and indicators show thatthe goals of the World Health Organization are being met, evaluative research focused onthe first permanent molar is scarce and necessary given its importance for health publicpolicymaking intended to preserve this teeth...

Mobbing, un aspecto a vigilar en los profesionales en Colombia / Mobbing, um aspecto que deve ser vigiado nos profissionais colombianos / Mobbing, an aspect to keep guard over in Colombian professionals

En el presente ensayo se reconoce la importancia de fortalecer el conocimiento del ambiente laboral desde la dimensión y percepción de los trabajadores, identificando sus determinantes. De allí que el mobbing sea de interés en salud pública, puesto que facilita la generación de información de carácter institucional y social. Para su elaboración se realizó una revisión de la literatura y del marco legal vigente sobre el mobbing. Se destaca en la investigación un instrumento que define acciones de intervención y permite incorporar estrategias para lograr el acceso a la información y la toma de decisiones con relación a las políticas sociales sanitarias y todo lo que ello incluye en sus desarrollos. Se registra que para el abordaje del mobbing debe existir una estrecha relación con la equidad en salud y es posible intervenir las problemáticas que afectan el desarrollo económico, para mejorar la calidad de vida de los trabajadores y su relación con el ambiente laboral, a través del uso racional de la evidencia disponible.

This article recognizes the importance of strengthening the knowledge on the working environment -from the dimension and perspective of the workers--and the identification of its determiners. From there, mobbing has become a relevant public health issue, because it eases the generation of social and institutional information. Literature and current legislation reviews about mobbing were conducted for its elaboration. Within this research, the role of an instrument that defines intervention actions is highlighted for incorporating strategies to access information and make decisions in relation to social-sanitary policies and the aspects related to their development. It is consigned that mobbing has to be closely related to equity in health to be approached, and it is possible to intervene problems affecting economic development in order to improve the quality of life of workers and their relationship with the working environment, through the rational use of the evidence available.

Neste ensaio é reconhecida a importância de fortalecer o conhecimento do ambiente de trabalho desde a dimensão e percepção dos trabalhadores, identificando seus determinantes. Daí que o mobbing seja de interesse em saúde pública, já que facilita a geração de informação de caráter institucional e social. Para sua elaboração foi realizada a revisão da literatura e do entorno jurídico e legal vigente sobre o mobbing. Destaca-se na pesquisa um instrumento que define ações de intervenção e permite incorporar estratégias para obter acesso à informação e a tomada de decisões no que diz respeito às políticas sociais sanitárias e tudo o que elas incluem em seu desenvolvimento. Registra-se que para a abordagem do mobbing deve existir una estreita relação com a igualdade em saúde e é possível intervir as problemáticas que afetam o desenvolvimento econômico, para melhorar a qualidade de vida dos trabalhadores e sua relação com o ambiente de trabalho, através da utilização racional da evidência disponível.

La salud bucal colectiva y el contexto colombiano: un análisis crítico analysis / A saúde bucal coletiva e o contexto colombiano: uma analise crítica / Collective oral health and the colombian context: a critical

La práctica odontológica ha elaborado procesos de reflexión política con relación a otras disciplinas; una de estas propuestas es pensar la salud bucal desde la dimensión colectiva. Este escrito propone el desarrollo de un nuevo campo de acción para la agenda de salud bucal de Colombia mediante el análisis de algunos indicadores sociales y en salud. Además, se plantean unos principios en salud bucal colectiva: la salud bucal como derecho fundamental, la capacidad comunitaria para asumir el control de la salud y sus determinantes, y la participación de actores sociales, económicos, académicos y de servicios de salud. Se requiere un papel protagónico, con mayor conciencia colectiva, de los profesionales, tomadores de decisión y el sector salud en general...

The practice of dentistry has conducted reflexive process according the other academic disciplines. This paper proposes the implementation of a new political field in the oral health agenda in Colombia by means of exploring some social and health indicators. Furthermore, principles in collective oral health were raised: the oral health as a fundamental right, the community capacity for assuming the health control and their determinants, and the participation of social, economic, and academic actors and the health care services. A protagonist role in the society is required and a major collective consciousness concerning the professionals, the decision-makers and the health sector in general...

A prática odontológica tem elaborado processos de reflexão política com relação a outras disciplinas. Uma dessas propostas é pensar sobre a saúde bucal desde a dimensão coletiva. Este artigo propõe o desenvolvimento de um novo campo de ação para a agenda da saúde bucal na Colômbia mediante a análise de alguns dos indicadores sociais e de saúde. Além disso, apresentam-se princípios na saúde bucal coletiva: a saúde bucal como direito fundamental, a capacidade comunitária para assumir o controle da saúde e suas determinantes, e a participação de atores sociais, econômicos, acadêmicos e de serviços de saúde. Requere-se um papel protagonista com maior consciência coletiva dos profissionais, decisórios, e o setor de saúde em geral...

[Occupational health of immigrant workers in Spain [ITSAL Project]: key informants survey]. / Condiciones de trabajo y salud en inmigrantes (Proyecto ITSAL): entrevistas a informantes clave.

OBJECTIVE: To describe the characteristics, working conditions, and occupational health situation of immigrant workers in Spain through key informants. METHOD: We performed a qualitative, exploratory and descriptive study using indepth interviews carried out in 2006. Organizations and associations working with immigrant collectives in Alicante, Barcelona, Huelva, Madrid and Valencia were identified and the most representative and accessible entities in each location were selected. Fortythree interviews were performed with key informants from 34 different organisms. A narrative content analysis was performed. RESULTS: Informants described difficulties in having health problems recognized as workrelated, due to irregular and precarious employment, employers' and insurance companies' reluctance, and immigrants' lack of knowledge. Informants coincided in reporting that the occupational risks for immigrant workers did not differ from those affecting Spanish workers in the same occupations and circumstances. However, exposure to occupational risks was exacerbated in immigrants because of their greater presence in unqualified jobs and their economic need to prolong working hours. Immigrants had little knowledge of their occupational health and safetyrelated rights, although some informants detected an increase in empowerment in this area, mostly through greater participation in trade unions. CONCLUSIONS: This first step allowed us to identify some of the general factors influencing the health and safety of immigrant workers in Spain. This information will be used in a longterm, ongoing research project [Project Immigration, Work and Health (Proyecto Inmigración, Trabajo y Salud [ITSAL]), which aims to evaluate occupational health problems in inmigrants working in Spain through both qualitative and quantitative methods.

Condiciones de trabajo y salud en inmigrantes (Proyecto ITSAL): entrevistas a informantes clave / Occupational health of immigrant workers in Spain [ITSAL Project]: key informants survey

Objetivo: Caracterizar colectivos de inmigrantes trabajadores en España y conocer sus condiciones de salud laboral mediante informantes clave. Método: Estudio cualitativo exploratorio-descriptivo con entrevistas en profundidad realizado en 2006. Se identificaron organizaciones, asociaciones y colectivos relacionados con la población inmigrante en Alicante, Barcelona, Huelva, Madrid y Valencia, y se seleccionaron los más accesibles y representativos. Se entrevistó a 43 informantes clave procedentes de 34 asociaciones u organismos. Se realizó un análisis narrativo del contenido. Resultados: Se señalan dificultades para el reconocimiento de los daños a la salud derivados del trabajo por las situaciones de irregularidad y precariedad, por resistencia por parte de los contratadores o las entidades aseguradoras, y por desconocimiento de los inmigrantes. Los informantes coinciden en que los riesgos laborales en los inmigrantes no difieren de los riesgos de los trabajadores autóctonos en similares circunstancias, pero los inmigrantes padecerían exposiciones más frecuentes e intensas por el acceso mayoritario a puestos menos cualificados y por la necesidad de prolongar las jornadas de trabajo. También se destaca su desconocimiento general en relación con los derechos de protección y de salud en el trabajo, aunque algunos informantes detectan un crecimiento de su actividad reivindicativa a través de los sindicatos. Conclusiones: Este primer acercamiento ha permitido definir algunos condicionantes generales que influirán en la salud laboral de los inmigrantes. La información obtenida servirá de base para profundizar, mediante técnicas adicionales de carácter cualitativo y cuantitativo, en los problemas de salud laboral de los inmigrantes trabajadores en España dentro del marco del Proyecto Inmigración, Trabajo y Salud (ITSAL), actualmente en desarrollo (AU)

Objective: To describe the characteristics, working conditions, and occupational health situation of immigrant workers in Spain through key informants. Method: We performed a qualitative, exploratory and descriptive study using indepth interviews carried out in 2006. Organizations and associations working with immigrant collectives in Alicante, Barcelona, Huelva, Madrid and Valencia were identified and the most representative and accessible entities in each location were selected. Fortythree interviews were performed with key informants from 34 different organisms. A narrative content analysis was performed. Results: Informants described difficulties in having health problems recognized as workrelated, due to irregular and precarious employment, employers¿ and insurance companies¿ reluctance, and immigrants¿ lack of knowledge. Informants coincided in reporting that the occupational risks for immigrant workers did not differ from those affecting Spanish workers in the same occupations and circumstances. However, exposure to occupational risks was exacerbated in immigrants because of their greater presence in unqualified jobs and their economic need to prolong working hours. Immigrants had little knowledge of their occupational health and safetyrelated rights, although some informants detected an increase in empowerment in this area, mostly through greater participation in trade unions. Conclusions: This first step allowed us to identify some of the general factors influencing the health and safety of immigrant workers in Spain. This information will be used in a longterm, ongoing research project [Project Immigration, Work and Health (Proyecto Inmigración, Trabajo y Salud [ITSAL]), which aims to evaluate occupational health problems in inmigrants working in Spain through both qualitative and quantitative methods (AU)

Condiciones de trabajo y salud de los recicladores urbanos de Medellín (Colombia) / Working conditions and health among urban recycling workers in Medellín (Colombia)

Objetivos. Analizar la situación laboral, socio-económica, y las condiciones de salud y acceso a la seguridad social de los recicladores de basura de Medellín (Colombia). Métodos. Estudio descriptivo combinando técnicas cuantitativas (encuestas sociodemográficas y de salud, revisiones médicas) y cualitativas (la observación participante del recorrido del reciclador en la jornada de trabajo y entrevistas sobre los aspectos más relevantes de su oficio). Resultados. Los recicladores tienen una jornada laboral mucho más intensa que la población general (el 58% trabajan más de ocho horas), el 64% llevan trabajando en el oficio más de seis años, y el 74% de los familiares han trabajado en la misma ocupación. Están expuestos a factores de riesgo físicos, químicos, relacionados con el orden público, la seguridad y con el tránsito vehicular; la mayoría (87%) tiene un salario inferior a los 8 € diarios, insuficiente para cubrir necesidades básicas La cobertura en salud es deficiente. Presentan con frecuencia infecciones respiratorias y enfermedades de los órganos de los sentidos. Conclusiones. Este grupo cumple una función importante dentro del proceso social y ambiental de la ciudad, en un entorno laboral con numerosos factores de riesgo y unas condiciones sociales y de salud menoscabadas en comparación con los indicadores para la población general. Se requieren estrategias que contribuyan a la mejora de sus condiciones de trabajo a través de políticas públicas, educación, prevención de riesgos y de la institución formal de organizaciones de trabajo que agrupen a este colectivo como son las cooperativas o asociaciones

Objectives. To analyze socioeconomic, occupational and health conditions of recycling workers in the city of Medellín (Colombia). Methods. A descriptive study, examining risk factors by means of quantitative techniques such as sociodemographic and health surveys, and clinical examinations, and qualitative techniques such as field observations of recycling workers, coupled with in-depth interviews about relevant aspects of their jobs. Results. Results show that recycling workers labor longer hours than the general population (58% work more than 8 hours per day). Sixty-four per cent have been working as recyclers for more than six years and 74% of their relatives have worked in the same job. They are exposed to various physical and chemical risk factors, as well as to risks associated with traffic or assaults. The majority (87%) have low salaries (less than 8 € per day), insufficient to cover basic necessities, and they present various health disorders, including respiratory infections and disorders of the senses. Conclusions. Recycling workers fulfill an important social function related to social and environmental processes in the city. Their work is performed under highly deficient health and safety conditions, with high risk exposures and social conditions worse than in the general population. Strategies are required in order to improve their job situation, through public polices, risk education and prevention, and their formal organization through cooperatives or workers’ associations

Alcances y limitaciones del fluor dentro de la política pública en la salud bucal en Colombia / Limitations and capacities of the fluor in the oral health public in Colombia

Uno de los elementos controversiales con relación a la salud bucal de la población colombiana, es la adopción de estrategias que aseguren indicadores epidemiológicos en consonancia con las metas propuestas por La Organización Mundial de la Salud (OMS) y La Federación Dental Internacional (FDI). Con el tiempo algunas de ellas se transformarían en políticas. La utilización del flúor en vehículos masivos de fácil acceso como lo son el agua y la sal siguen siendo influyentes por la magnitud y el impacto que han tenido en Colombia y en otros países, Sin embargo, en algunos contextos se han presentado algunas discrepancias en su utilización. En el presente ensayo, producto de un foro de estudio permanente convocado con el apoyo de diversas instituciones académicas y gremiales, se presentan algunos de los puntos de discusión, retos y desafíos que la profesión odontológica colombiana debería asumir para una mejor salud bucal de sus colectivos.

One of the most points of view that conduce us to create controversy with the oral community health in Colombia have to be with the adoption of policies strategies that assure epidemiologicalmeasurements in relation with the goals of WHO and FDI. With time, some of them would be change into public policies in health. Fluoride usage in masive vehicles (water and salt)and easy access are being one of the most influences strategies due to magnitude and impact in health in Colombia and in other countries. Nevertheless, in some contexts, there are some controversial points in its use. This essay should have displayed some points of discussion, challenges and dares that colombian dental profesión will have to assume in order to find in itscollectives a healthy oral health. This essay procede from a study forus with the supportinf of several academic and guild institucions.

Condiciones de salud bucal de los recuperadores informales del sector de Guayaquil y sus familias. Médellín, Colombia, 2003 / Oral health conditions of the informal recyclers of Guayaquil and their families. Medellin, Colombia, 2003

Se realizó una investigación que caracteriza las condiciones socioeconómicas y de salud de los recuperadores del sector de Guayaquil, Medellín, Colombia, la cual muestra cómo las condiciones de vida definen en gran medida su situación de salud. Allí, en una población de 68 recuperadores y familiares se elabotó un estudio de carácter descriptivo, transversal, para conocer sus condiciones de salud bucal. Por medio de la anamnesis y de un examen odontológico completo, siguiendo los lineamientos del II Estudio Nacional de Salud Bucal de 1998, se reconocieron algunos aspectos relacionados con sus representaciones y prácticas en salud, hábitos y la situación de salud bucal de cada individuo. Los hallazgos nos indican cómno este grupo está en condiciones desfavorables con respecto a la población general y nos da pautas para establecer estrategias de intervención claras que permitan mejorar sus condiciones de salud tan precarias, ofreciendo bienestar