"Opportunities and responsibilities": how do pharmacists assess their professionalism?

INTRODUCTION: Professionalism is fundamental to the existence of professions. In pharmacy, interest in this theme improved with events that examined the resocialization of pharmacists in care. With this, evaluating professionalism can help the operationalization of the theme and, consequently, the development of strategies for pharmacy consolidation before its challenges. Therefore, this study aimed to evaluate the professionalism of Brazilian pharmacists. METHODS: To meet the objective, a cross-sectional study was conducted between March 2022 and August 2023. Data were collected using the Brazilian version of the "Modification of Hall's Professionalism Scale for Use with Pharmacists". The scale has 39 items grouped into the domains: autonomy, vocation, professional council, self-regulation, continuing education, and altruism. Data were analyzed using descriptive statistics and an ANOVA analysis of variance with post-hoc Hochberg or Games-Howell tests with Bootstrapping was conducted to verify differences between groups. RESULTS: 600 pharmacists participated in this study. The majority (69%) was female and carried out their professional activities in community pharmacies (50%). Professionalism scores ranged between 14 and 29 points, with an average of 22.8 points. Pharmacists working in outpatient clinics had higher scores in most factors, namely, altruism, continuing education, professional council, vocation, and autonomy. This indicates that the inclination of pharmacists to occupy areas focused on care can be significant to assess professionalism. CONCLUSIONS: The data obtained indicate that pharmacists working in outpatient clinics had higher professionalism scores compared to others. This corroborates the worldwide trend experienced by pharmacy in recent decades, which is the execution of increasingly patient-centered practice models.

Resident pharmacist participation in shared medical appointments in palliative care in São Paulo, Brazil: experience and contributions.

OBJECTIVE: To describe the resident pharmacist's participation in Shared Medical Appointments (SMA) in palliative care. METHODS: The resident pharmacist participated in face-to-face SMA with the attending physician, medical and gerontology students, and a nurse. KEY FINDINGS: The resident pharmacist supported interdisciplinary discussions and performed pharmaceutical interventions. He helped raise awareness about the effective, safe, and convenient use of medicines, helping improve the quality of life of patients and caregivers. CONCLUSIONS: Providing pharmaceutical care to patients in palliative care helped to improve the quality of clinical services offered to these patients, as well as adding value to resident pharmacists' interprofessional practice.

Assessment of the implementation of pharmacist prescribing: Challenges and pathways for ambulatory practice.

BACKGROUND: Prescribing by pharmacists is an increasingly common practice worldwide. In Brazil regulation of this practice began in 2013, and the practice remains unexplored as a research topic. OBJECTIVE: We aimed to explore and gain insights into pharmacist prescribing practices in Brazil and assessing pharmacist's perceptions of their training and preparedness to prescribe medications. METHODS: A cross-sectional survey was conducted between October 2022 and March 2023 via convenience sampling. Data were collected using an online questionnaire covering sociodemographic issues, academic training, prescribing practices, and perceptions regarding the provision of pharmacist prescribing in ambulatory care. Exploratory descriptive analysis and Poisson regression were performed to estimate the associations between pharmacist characteristics and their practices in prescribing medicines. RESULTS: Among the 305 valid responses, 58.7% of the outpatient pharmacists stated that they had not prescribed any medication in the previous three years. Over-the-counter medication prescriptions were most common (42.0%). Only 4.6% of respondents had prescribed prescription-only medicines provided through collaborative agreement, with 2.6% reporting that they had adjusted doses, and 2.3% played a role in prescription renewal. Pharmacists living in Northeast regions tended to be more active prescribers (PR = 1.42; 95%CI 1.03-2.18), whereas those in primary healthcare (PR = 0.61; 95%CI 0.39-0.96) and self-declared Black pharmacists (PR = 0.30; 95%CI 0.10-0.97) prescribed less. Respondents strongly believed in the pharmacist's role as a prescriber, although they remained ambivalent regarding their responsibility for patient outcomes. Progress barriers include infrastructure gaps and strained relationships with physicians. CONCLUSIONS: This study suggests that pharmacists in Brazil predominantly prescribe over-the-counter medications, and variations in setting, region, and race can influence prescribing by pharmacist in ambulatory care.

Toward inclusive health care: Pharmacists' perceptions on academic preparedness and health care provision for the LGBTQIA+ community.

BACKGROUND: The community of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identities (LGBTQIA+), comprising sexual and gender minorities, frequently encounters violence, discrimination, and numerous obstacles in accessing health care services. Pharmacists have the potential to significantly contribute to the health care provision for this community. OBJECTIVE: To assess pharmacists' perceptions regarding academic preparedness and health care provision for the LGBTQIA+ community in Brazil. METHODS: An online cross-sectional survey was conducted from August 2022 to February 2023, focusing on the academic training of pharmacists and the provision of health care to the LGBTQIA+ community in Brazil. Data collection was achieved through a 28-question online questionnaire, comprising both closed-ended questions, and Likert-type items. The study variables were subjected to an exploratory descriptive analysis. RESULTS: We received 261 complete and valid responses. A majority of pharmacists indicated that they provided health care to the LGBTQIA+ community (n = 161, 61.7%); however, they lacked formal education on LGBTQIA+ health care during their pharmacy program (n = 256, 98.1%). Most participants strongly agreed that pharmacists play a crucial role in promoting health care for this community (n = 213, 81.6%). However, only a small percentage felt confident in addressing issues related to the effectiveness and safety of hormone use for transgender patients (n = 38, 14.6%). Furthermore, less than a third believed that the health care provided by pharmacists should be differentiated for patients within and outside of the LGBTQIA+ community (n = 76, 29.1%). CONCLUSION: The results of this study underscore the necessity and significance of incorporating this topic both in pharmacy training and continuing education. This approach is crucial to enhance and bolster the clinical practice of pharmacists.

Profile, performance, and perception of pharmacist preparedness for the COVID-19 pandemic.

INTRODUCTION: The lack of human resources for disease prevention and control is evident in times of health crisis, such as the COVID-19 pandemic. In public health emergencies, the capacity for adequate assistance and guaranteed access to pharmacological treatment are fundamental and contribute to impact reduction. We aimed to analyze the profile, performance, and characteristics related to the self-perception of preparedness among pharmacists who responded to the COVID-19 pandemic in Brazil. METHOD: A cross-sectional study was conducted in two stages: content validation of a questionnaire and its application to a representative sample of pharmacists in Rio de Janeiro. The snowball technique was used to recruit participants. A logistic regression model was adjusted to determine the effects of the factors on the probability of a pharmacist feeling prepared to act during the pandemic. RESULTS: Six experts approved and validated the questionnaire, and 376 pharmacists were included in the study, 60.6 % of whom were in places specially designated by health authorities to diagnose and treat COVID-19. Professionals participated in various activities related to pandemic demands, including medication management and population guidance. Postgraduate degrees increased the odds of participants feeling prepared to act during the pandemic. Furthermore, pharmacists who worked in reference facilities were more likely to feel ready than those who worked in other places. Professionals who knew treatment guidelines were almost three times more likely to feel prepared than the ones without the knowledge of treatment guidelines. Training or guidance on how to act during the pandemic increased pharmacists' odds of feeling prepared by 2.58 times. CONCLUSION: Pharmacists actuated from diagnosis to treatment and participated in the health activities required during the pandemic. Factors contributing to the self-perception of preparedness were identified. Such factors can be targets for interventions to promote the preparedness of the workforce for future health emergencies.

Primary health care: Nurses' meanings in a Colombian municipality

Introduction: Primary health care is a strategy that involves the different health professionals and other agents in the system who can influence the social determinants that affect human wellbeing. Objective: To know the meanings about primary health care of nursing professionals practicing in this field in a municipality of Colombia. Materials and Methods: Qualitative, exploratory, descriptive study. The research was conducted in a State Social Company (ESE for its acronym in Spanish) that provides primary health care services. Data was collected through semi-structured interviews. The sample consisted of 13 professionals. IRaMuTeQ software was used to help data interpretation. Results: 'Nurse' was the most frequent word. The content analyzed was categorized into four classes: 'Meanings about primary health care', 'nursing activities in primary health care', 'barriers encountered in primary health care', 'primary health care organization and work team'. Conclusions: Primary health care meaning is understood as the entry point of users into the health system and the one responsible for coordinating their passage through other points of the healthcare network according to users' health needs. In addition, primary health care is understood as the level of care at which essential health actions focused on the early detection of health risks and complications are carried out, so that health interventions can be planned, implemented, and evaluated on that basis.

Health inequalities in the geographic distribution of dental practitioners in Costa Rica: An ecological study.

OBJECTIVE: The uneven distribution of dental health services in a territory can cause an imbalance in accessibility, increasing health inequalities. This study aimed to describe the geographical distribution of dental health practitioners according to urbanicity and area-level socio-economic status in Costa Rica. METHODS: A National Dentist Survey was developed to identify employment status, number of working hours, address and list of the working clinics. Data was completed using information from the national College of Surgeons, including all Costa Rican dentists. The Minimal Geographic Units (MGU) allowed for aggregating the population's individual level socio-economic position. Local Potential Accessibility (LPA) calculated the density of full-time hour's equivalents around each MGU using floating sectors. Clinics were geocoded using Geographic Information Systems, creating 2853 clinical points. Distance between each MGU and the nearest accessible clinics considering full-time working hours equivalents was estimated. MGU were divided into six categories: 'No accessibility', 'Very low accessibility', 'Low accessibility', 'Good accessibility' 'High accessibility' and 'Very high accessibility'. RESULTS: Mean national LPA was 6.5 full-time equivalents per 10 000 inhabitants, 3.4% of the Costa Rican population had no access to dentist; 12.9% had very low accessibility, 22.7% had low accessibility, 35.0% had good accessibility, 16.2% had high accessibility, and 9.8% had very high accessibility. Overall, 39% of the population has a rather low accessibility. LPA was higher in urban districts compared to rural districts and in wealthiest districts compared to most disadvantaged districts. Within districts, after adjustment for district's characteristics, LPA was higher in urban MGU compared to rural MGU and in wealthiest MGU compared to most disadvantaged MGU. CONCLUSIONS: This study found that despite having a high number of dentists, their numbers are small in many areas, increasing inequalities in access to health care. The dentist's free establishment, where they can decide to provide private services within a community, creates zones with very high densities, in particular in the wealthiest urban areas, and others with very low densities, in particular the poorest rural areas. The lack of territorial planning has been one of the reasons that has encouraged an imbalance in the availability of dental human resources. To achieve effective universal health coverage, public institutions should focus their efforts on improving access to dental services in underserved areas.

Oral manifestations of syphilis: Knowledge and skills of senior dental students and newly graduated dentists.

OBJECTIVES: To evaluate the knowledge of senior dental students and newly graduated dentists about the prevention, diagnosis and treatment of oral manifestations of syphilis. MATERIALS AND METHODS: A 32-question questionnaire was designed with three domains: (I) demographic, academic and professional data of the participants, (II) attitudes, practices and self-perception regarding training about syphilis and (III) knowledge about syphilis. All knowledge responses were classified as correct or incorrect. Scores ranging from 1 to 14 were calculated, and grades were assigned to each participant according to their level of knowledge. RESULTS: The sample comprised 408 dental students and 339 newly graduated dentists. The mean score was 7.70 ± 3.35 for undergraduates and 9.09 ± 3265 for dentists. The highest frequency of correct answers (>70%) was attributed to questions about the aetiology, transmission and treatment of syphilis. The questions with the lowest frequency of correct answers (<50%) were about the identification of oral manifestations and stages of syphilis. CONCLUSIONS: The knowledge of dental practitioners and academics about the oral manifestations of syphilis was unsatisfactory. The lack of understanding of these aspects can delay the diagnosis and treatment of patients with this disease, which is concerning given the steady increase in cases in recent years.

Ferenczi e a clínica psicanalítica contemporânea: uma revisão sobre suas contribuições ao papel do analista / Ferenczi and the contemporary psychoanalytic clinic: a review of his contributions to the role of the analyst / Ferenczi et la clinique psychanalytique contemporaine: une revue de ses contributions au rôle de l'analyste / Ferenczi y la clínica psicoanalítica contemporánea: Una revisión de sus contribuciones al papel del analista

Objetivou-se fazer uma revisão sistemática da produção científica nacional e internacional, no período de 2015 a 2020, sobre a obra de Sándor Ferenczi e suas contribuições à clínica psicanalítica na contemporaneidade, no que concerne ao papel do analista. Os seguintes descritores foram utilizados: "Ferenczi" "clínica psicanalítica" e "analista". As bases de dados pesquisadas foram: P@rthenon, SciELO e Pepsic. Foi utilizada a metodologia da Análise de Conteúdo. O processo de análise levou a leitura dos títulos, resumos e textos completos, e 52 artigos preencheram os critérios. A pesquisa compreendeu que a retomada dos trabalhos de Ferenczi quanto ao papel do analista evidenciam uma nova configuração de relação analítica baseada em uma ética do cuidado. O papel do analista apresenta-se como uma possibilidade de contorno e sustentação às experiências traumáticas, colaborando com o paciente, na produção de sentidos e elaborações dessas experiências

This is a systematic review of national and international scientific papers published between 2015 and 2020 on Sándor Ferenczi's work and his contributions to the contemporary psychoanalytic clinic, mainly regarding the role of the analyst. Search was conducted on the P@rthenon, Scielo and Pepsic databases using "Ferenczi," "psychoanalytic clinic" and "analyst" as search descriptors. After reading the titles, abstracts and full texts a total of 52 articles met the inclusion criteria. Resumption of Ferenczi's work on the role of the analyst reveals a new configuration of analytical relations based on an ethics of care. The analyst presents a possibility of shaping and underpinning traumatic experiences, collaborating with the patient to produce meanings and elaborations of these experiences

Il s'agit d'une revue systématique des articles scientifiques nationaux et internationaux publiés entre 2015 et 2020 sur l'œuvre de Sándor Ferenczi et ses contributions à la clinique psychanalytique contemporaine, notamment en ce qui concerne le rôle de l'analyste. La recherche a été effectuée sur les bases de données P@rthenon, Scielo et Pepsic en utilisant « Ferenczi ¼, « clinique psychanalytique ¼ et « analyste ¼ comme descripteurs. Après la lecture des titres, des résumés et des textes intégraux, 52 articles répondaient aux critères d'inclusion. La reprise des travaux de Ferenczi sur le rôle de l'analyste révèle une nouvelle configuration des relations analytiques fondées sur une éthique du soin. L'analyste offre la possibilité de concevoir et d'étayer les expériences traumatiques, en collaborant avec le patient pour produire de significations et d'élaborations de ces expériences

El objetivo fue realizar una revisión sistemática de la producción científica nacional e internacional, en forma de artículo científico, de 2015 a 2020, sobre la obra de Sándor Ferenczi y sus aportes a la clínica psicoanalítica en la contemporaneidad, en torno al papel del analista. Se utilizaron los siguientes descriptores: "Ferenczi", "clínica psicoanalítica" y "analista". Las bases de datos buscadas fueron: P@rthenon, Scielo y Pepsic. Se utilizó la metodología de Análisis de Contenido. El proceso de análisis condujo a la lectura de títulos, resúmenes y textos completos y 52 artículos cumplieron los criterios. La investigación entendió que la reanudación del trabajo de Ferenczi sobre el rol del analista revela una nueva configuración de relación analítica basada en una ética del cuidado. El rol del analista se presenta como una posibilidad de modelar y sostener experiencias traumáticas, colaborando con el paciente, en la producción de significados y elaboraciones de estas experiencias

Nursing technicians' professional training in patient safety: A mixed-methods study / Formação profissional do técnico de enfermagem em segurança do paciente: estudo misto / Formación profesional del técnico en enfermería en seguridad del paciente: estudio mixto

Abstract Objective: to analyze nursing technicians' training in patient safety. Method: a convergent parallel mixed-methods study, where qualitative and quantitative elements were concomitantly implemented and equally prioritized, carried out in three technical colleges linked to a federal public institution in the Brazilian Northeast region. In the qualitative phase, semi-structured interviews were conducted with 24 professors and thematic analysis was applied. In the quantitative study, of the survey type, an instrument was used to screen terms about patient safety with 84 students. The results were combined during the general data interpretation, which was based on the Patient Safety Curricular Guide. Results: two thematic categories emerged: The professors' understanding about the theme of patient safety in nursing technicians' training; and Application and projection of the teaching of patient safety in nursing technicians' training. In the quantitative study, among the 46 screening terms, their identification in the theoretical-practical context predominated in Courses A and C, totaling 36 (78.3%) and 25 (54.3%), respectively. Theoretical teaching stood out in Course B, with 26 terms (56.5%). Conclusion: professional training of Nursing Technician students has a technical focus and does not fully contemplate patient safety issues in the teaching-learning process and, thus, constitutes a challenge for training institutions and professors alike.

Resumo Objetivo: analisar a formação de técnicos de enfermagem em segurança do paciente. Método: estudo de método misto paralelo convergente, em que elementos qualitativos e quantitativos foram concomitantemente implementados e igualmente priorizados, realizado em três colégios técnicos vinculados a uma instituição pública federal do Nordeste brasileiro. No qualitativo, realizou-se entrevista semiestruturada com 24 docentes e aplicou-se a análise temática. No estudo quantitativo, survey, utilizou-se instrumento para rastrear termos sobre segurança do paciente com 84 discentes. A interpretação geral dos dados realizou a combinação dos resultados e balizou-se no Guia Curricular de Segurança do Paciente. Resultados: emergiram duas categorias temáticas: Compreensão dos docentes acerca do tema segurança do paciente na formação de técnicos de enfermagem e Aplicação e projeção do ensino da segurança do paciente na formação de técnicos de enfermagem. No estudo quantitativo, dos 46 termos rastreadores, predominou a identificação de termos no contexto teórico-prático, nos Cursos A e C, totalizando 36 (78,3%) e 25 (54,3%), respectivamente. No Curso B, destacou-se ensino teórico, com 26 termos (56,5%). Conclusão: a formação profissional do discente técnico de enfermagem apresenta foco tecnicista e não contempla, integralmente, no processo ensino-aprendizagem, questões de segurança do paciente e, assim, configura-se desafio para as instituições formadoras e docentes.

Resumen Objetivo: analizar la formación de los técnicos en enfermería en seguridad del paciente. Método: estudio de método mixto paralelo convergente, en el que los elementos cualitativos y cuantitativos fueron implementados simultáneamente y considerados con el mismo nivel de prioridad, realizado en tres escuelas técnicas vinculadas a una institución pública federal en el Nordeste brasileño. En el estudio cualitativo se realizó una entrevista semiestructurada a 24 profesores y se aplicó el análisis temático. En el estudio cuantitativo, survey, se utilizó un instrumento para detectar términos sobre seguridad del paciente con 84 estudiantes. Para la interpretación general de los datos se realizó la combinación de los resultados y se tomó como base la Guía Curricular de Seguridad del Paciente. Resultados: surgieron dos categorías temáticas: Comprensión de los docentes sobre la seguridad del paciente en la formación de técnicos en enfermería e Implementación y proyección de la enseñanza de la seguridad del paciente en la formación de técnicos en enfermería. En el estudio cuantitativo, en los 46 términos indicadores, predominó la identificación de términos en el contexto teórico-práctico, en las carreras A y C, con un total de 36 (78,3%) y 25 (54,3%), respectivamente. En la carrera B se destacó la enseñanza teórica, con 26 términos (56,5%). Conclusión: la formación profesional de los estudiantes de la carrera de técnico en enfermería tiene un enfoque técnico y no considera de forma integral los temas que tienen que ver con la seguridad del paciente en el proceso de enseñanza-aprendizaje, por lo que es un desafío para las instituciones formadoras y para los docentes.

El rol del factor humano en el éxito de la práctica clínica odontológica / The role of the human factor in the success of dental clinical practice

Los fracasos y complicaciones en el campo de la cirugía bucal son analizados generalmente desde un punto de vista técnico o biológico. En términos generales, a partir del es- píritu fragmentario del conocimiento, se tiende a enfocar la atención odontológica en la parte técnica y teórica. Actual- mente se están produciendo cambios socioculturales que están generando modificaciones en los paradigmas de la atención odontológica, considerando también la comunicación con el paciente y la situación psicológica tanto del paciente como del equipo profesional. En este editorial se busca reflexionar so- bre estos temas analizando perspectivas más integradas para lograr un mayor equilibrio en la atención profesional (AU)

Failures and complications in the field of oral surgery are generally analyzed from a technical or biological point of view. In general terms, based on the fragmentary spirit of knowledge, dental care tends to be focused on the technical and theoretical knowledge. We are currently witnessing so- ciocultural changes that are producing modifications in the paradigms of dental care, also considering communication with the patient and the psychological situation of both the patient and the professional team. This editorial seeks to re- flect on these issues, considering the most integrated visions to achieve greater balance in professional care (AU)

Seroprevalence, infection, and personal protective equipment use among Colombian healthcare workers during the COVID-19 pandemic.

Introduction: Healthcare workers (HCWs) are at the forefront of the COVID-19 response and frequently come into close contact with patients and their virus-contaminated body fluids. Recent studies have identified differential risks of infection and the use of personal protective equipment (PPE) among HCWs. However, available data might be interpreted with caution because of differences in the national health systems, local implementation issues, and adherence limitations to guidelines. A comprehensive description of infection, exposure at work, and biosafety habits during the COVID-19 pandemic has not been conducted among the HCW groups in Latin American populations. Objective: To describe SARS-CoV-2 seroprevalence, infections, and extent of PPE use during the COVID-19 pandemic among HCWs at three different times, including dental practitioners (DP), nursing assistants (NA), physicians (P), and respiratory therapists (RT), from Bogotá, Colombia. Methods: After IRB approval, this cross-sectional study included 307 HCWs. Participants provided nasopharyngeal swabs and blood samples to detect viral RNA (RT-qPCR) and IgM/IgG anti-SARS-CoV-2 (ELFA-ELISA) at baseline (BL) and two follow-ups. Infection prevalence was defined as the number of positive-tested participants (RT-qPCR and/or IgM). Data on clinical status and biosafety habits were collected each time. Results: Differential infection prevalence was found among HCWs through the study timeline (BL: RT-qPCR = 2.6%, IgM = 1.6%; follow-up 1 (45 days after BL): RT-qPCR = 4.5%, IgM = 3.9%; follow-up 2 (60 days after BL): RT-qPCR = 3.58%, IgM = 1.3%. Dental practitioners showed a higher infection frequency in BL and follow-up 1. IgG-positive tested HCWs percentage progressively increased from BL to follow-ups among the whole sample while index values decreased. Limitations in N95 availability and a high perception of occupational risk were reported. Conclusion: A low prevalence of active SARS-CoV-2 infections among HCWs groups was found. Over time, there was an increase in participants showing IgG antibodies, although the levels of these antibodies in the blood decreased. Additionally, HCWs reported limitations in the availability of PPE as well as a variation in their safety practices.

Dental anxiety and oral health-related quality of life before and after non-surgical periodontal treatment.

OBJECTIVES: To (1) investigate dental anxiety (DA) and oral health-related quality of life (OHRQOL) before and after non-surgical periodontal treatment (NSPT) and (2) determine correlations between these patient-reported measures. MATERIALS AND METHODS: Demographics, smoking habits, dental pain, Modified Corah's Dental Anxiety Scale (MDAS), and Oral Health Impact Profile (OHIP-14) were assessed in eighty-two participants. RESULTS: Mean age was 48.3 years ± 11.5. At baseline, 8.5% reported being active smokers. Of non-smokers, 11% reported being an ex-smoker. After NSPT, 11.0% reported smoking. Patients' maximal pain in the last month decreased after therapy. Before treatment, participants reported higher DA. Extreme DA was observed in 8.5% of participants before therapy. Afterwards, 2.4% of participants reported extreme DA. Fear of having a foreign object in the mouth decreased after NSPT. All OHIP-14 scores, except functional limitation, improved post-treatment. Higher DA was associated with worse OHRQoL before treatment. After treatment, total MDAS score was associated with OHIP-14 global score, physical pain, psychological disability, and social disability. Worse MDAS sub-scores were associated with a higher OHIP-14 global score. Individuals with "normal/slight anxiety" had a significant improvement in OHRQoL, whereas people in the "moderate and extreme anxiety" group did not report a significant improvement. Patients diagnosed with generalized periodontitis (GP) stage III grade B and GP stage IV grade B reported less anxiety after NSPT. CONCLUSIONS: Associations of MDAS subcategories with OHIP-14 domain scores were found before and after therapy. DA decreases and OHRQoL enhances after NSPT in patients with "normal/slight" anxiety to dental treatment. Dental practitioners should plan strategies to cope with anxiety to dental treatment and prevent decreases in OHRQoL. CLINICAL RELEVANCE: Within the limitations of this study, DA and OHRQoL were positively correlated in patients with periodontitis, before and after NSPT, using the MDAS and OHIP-14 questionnaires. The results of our study suggest that treatment is effective in terms of alleviating DA and improving oral health, along with quality of life, in patients that report "normal/slight" anxiety to dental treatment. Nonetheless, results must be interpreted with caution since patients are generally anxious before any type of dental treatment. DA may not just be confined to NSPT per se. According to our results, evaluation of both outcomes should be an integral part of routine periodontal clinical evaluation and periodontal reevaluation of initial therapy. It is important that clinicians learn to identify patients that suffer from anxiety and take time to explain the treatment procedures to the patient, to strive for patient's emotional well-being before, during, and after dental care services. The use of specific questionnaires for both DA and OHRQoL may be more appropriate to demonstrate the psychological and quality of life differences due to periodontal disease and NSPT.

Adaptarnos para sobrevivir. Requerimientos de un nuevo paradigma / Adapting to survive. Requirements for a new paradigm

A lo largo de la historia, el rol del bioquímico en el laboratorio clínico ha ido mutando, adaptándose a nuevos paradigmas, consecuencia del avance de la tecnología1 y la informática, de la presión externa ejercida por las empresas proveedoras de reactivos que reducen el tiempo útil de los equipos, aumentando su tasa de recambio, de una medicina más compleja que impone nuevos desafíos diagnósticos y de los cambios sociales que se ven reflejados en una alteración en el orden de los valores adoptado por las nuevas generaciones de profesionales que conviven con otras, provocando "turbulencia generacional" en los lugares de trabajo. Los laboratorios necesitan hoy someterse a una reingeniería de sus procesos, descartar aquellos que no agreguen valor, que causan fugas innecesarias de insumos, personas y tiempo e intervenir la cultura organizacional de manera integral, para adaptarse a las exigencias que la actualidad requiere, donde la calidad, la seguridad y la sostenibilidad son los principales protagonistas )AU)

Over time, the role of the biochemist in the clinical laboratory has been changing, adapting to new paradigms, as a consequence of the advance of technology and informatics, of the external pressure exerted by the companies supplying reagents that reduce the useful time of the equipment, increasing its replacement rate, of a more complex medicine that imposes new diagnostic challenges, and of social changes that are reflected in an alteration in the values adopted by the new generations of professionals who coexist with others, causing "generational turbulence" in the workplace. Laboratories today need to reengineer their processes, eliminate those that do not add value, that cause unnecessary waste of supplies, people and time, and intervene in the organizational culture in a comprehensive manner, in order to adapt to the demands of today's world, where quality, safety, and sustainability are the main drivers (AU)

Effect of staining layer on roughness after progressive wear of monolithic ceramics.

PURPOSE: The aim of this study was to evaluate staining layer behavior applied to high-translucency zirconia (YZHT), feldspathic ceramics (FD), and zirconia-reinforced lithium silicate (ZLS) surfaces against different antagonists. METHODS AND MATERIALS: Monolithic ceramic discs (n = 120) (ø 12 mm; thickness, 1.2 mm; ISO 6872) were obtained, 30 from YZHT and FD, and 60 from ZLS CAD/CAM blocks (staining layer applied before or after the crystallization procedure). The specimens were divided into 12 subgroups (n = 10) according to the antagonists: steatite, polymer-infiltrated ceramic, or zirconia. Mechanical cycling (1.5 × 104 cycles; 15 N; horizontal displacement, 6 mm; 1.7 Hz) and flexural strength tests (1 mm/min-1000 kg cell) were performed. The differences between final and initial roughnesses (Ra, Rz, and Rsm), the mass loss, and the flexural strength data were individually analyzed by two-way ANOVA and Tukey's test (α = 0.05). RESULTS: The roughnesses of all ceramics did not present a statistically significant difference before wear simulation: Ra (p = 0.3348), Rz (p = 0.5590), and Rsm (p = 0.5330). After the wear simulation, the Ra parameter was not affected by an interaction between ceramic and antagonist (p = 0.595). The Rz and Rsm parameters were affected only by the antagonist pistons (both, p = 0.000). The ceramics used in this study showed statistically significant differences in mass loss after the wear test (p < 0.0001). The additional firing (2 steps) of the ZLS2 led to a higher lost mass quantity. CONCLUSION: All ceramics presented similar initial roughnesses and similar roughnesses after the wear simulation. The zirconia antagonist showed better performance against ceramics with high crystalline content. CLINICAL SIGNIFICANCE: It is clear that restorative materials must be carefully selected by dental practitioners according to indications, properties, and antagonists. The steatite antagonist, that is, an enamel analog, showed better performance against vitreous ceramics, while the zirconia antagonist showed better performance against ceramics with high crystalline content. Wear affects the surface roughnesses of the ceramics. Additional firing for the staining of the zirconia-reinforced lithium silicate ceramic led to a greater loss of mass.

El papel de las tecnologías digitales en el envejecimiento y la salud / The role of digital technologies in aging and health

El Papel de las tecnologías digitales en el envejecimiento y la salud es parte de una serie de publicaciones titulada La Década del Envejecimiento Saludable en las Américas: situación y desafíos. Las publicaciones están concebidas para presentar información y datos actualizados sobre el envejecimiento y la salud, con el objetivo de favorecer la priorización de acciones eficaces a nivel local, así como el seguimiento y desarrollo de políticas de salud pública, para la implementación de la Década de las Naciones Unidas para el Envejecimiento Saludable (2021-2030) en las Américas. Este informe aborda las oportunidades que surgen cuándo se diseña y presenta la tecnología como una herramienta para el envejecimiento y cómo puede mejorar la vida de las personas mayores. Enfatiza la necesidad de desarrollar programas innovadores y enfoques inclusivos que alienten a la industria y los gobiernos a proporcionar soluciones tecnológicas aptas para las personas mayores y para todas y todos. La Década del Envejecimiento Saludable 2021-2030 es un período para dirigir la acción hacia la transformación de las sociedades ante el envejecimiento de la población y fomentar la inclusión de las personas mayores en cada decisión que se tome. Este trabajo aspira a contribuir a esa estrategia y a resaltar los próximos desafíos y oportunidades en torno al envejecimiento saludable asociados al uso de la tecnología

Tracing ΦX174 bacteriophage spreading during aerosol-generating procedures in a dental clinic.

OBJECTIVE: The aim of this study was to test the plausibility of using the ΦX174 bacteriophage as a tracer of viral aerosols spreading in a dental aerosol-generating procedure (AGP) model. METHODS: ΦX174 bacteriophage (~ 108 plaque-forming units (PFU)/mL) was added into instrument irrigation reservoirs and aerosolized during class-IV cavity preparations followed by composite fillings on natural upper-anterior teeth (n = 3) in a phantom head. Droplets/aerosols were sampled through a passive approach that consisted of Escherichia coli strain C600 cultures immersed in a LB top agar layer in Petri dishes (PDs) in a double-layer technique. In addition, an active approach consisted of E coli C600 on PDs sets mounted in a six-stage cascade Andersen impactor (AI) (simulating human inhalation). The AI was located at 30 cm from the mannequin during AGP and afterwards at 1.5 m. After collection PDs were incubated overnight (18 h at 37 °C) and bacterial lysis was quantified. RESULTS: The passive approach disclosed PFUs mainly concentrated over the dental practitioner, on the mannequin's chest and shoulder and up to 90 cm apart, facing the opposite side of the AGP's source (around the spittoon). The maximum aerosol spreading distance was 1.5 m in front of the mannequin's mouth. The active approach disclosed collection of PFUs corresponding to stages (and aerodynamic diameters) 5 (1.1-2.1 µm) and 6 (0.65-1.1 µm), mimicking access to the lower respiratory airways. CONCLUSION: The ΦX174 bacteriophage can be used as a traceable viral surrogate in simulated studies contributing to understand dental bioaerosol's behavior, its spreading, and its potential threat for upper and lower respiratory tract. CLINICAL RELEVANCE: The probability to find infectious virus during AGPs is high. This suggests the need to continue characterizing the spreading viral agents in different clinical settings through combination of passive and active approaches. In addition, subsequent identification and implementation of virus-related mitigation strategies is relevant to avoid occupational virus infections.

Interpreting the prevalence of musculoskeletal pain impacting Italian and Peruvian dentists likewise: A cross-sectional study.

Background: Musculoskeletal pain is a frequent condition among dental practitioners due to working in prolonged static isometric/eccentric contraction. The study aimed to describe musculoskeletal pain prevalence and the interplay between environmental conditions, lifestyle, and drugs consumed among Italian and Peruvian dentists. Methods: A 18 multiple choice questionnaire was administered to Peruvian and Italian dental care practitioners. A total of 187 questionnaires were submitted. One hundred sixty-seven questionnaires were selected for the analysis, including 86 questionnaires from Italy, and 81 from Perú. The study examined musculoskeletal pain presence in dental practitioners. The prevalence of musculoskeletal pain presence was analyzed considering different parameters: gender, age, type of dental practitioners, specialization in dentistry, hours of work per day, years of work, physical activity, localization of musculoskeletal pain and the influence of musculoskeletal pain on the performance on work. Results: The selected questionnaires for analysis were 167 (67 from Italy and 81 from Perú). Male and female participants were numerically equal. Most of the dental practitioners were dentists. The percentage of dentists who present musculoskeletal pain is 87.2% in Italy and 91.4% in Perú (p < 0.05). Conclusion: Musculoskeletal pain represents a very diffused condition in dental practitioners. The results about the prevalence of musculoskeletal pain show how the two populations (Italian and Peruvian) are very similar despite the geographical distance. Nevertheless, the high percentages of musculoskeletal pain in dental practitioners translate into the need to use solutions to reduce its onsets, such as improving ergonomics and physical activity.

Prevalence of retromolar foramen in nineteenth century Spanish population.

Among the non-metrical variants of the mandible that have been proven to be a key issue for dental practitioners, the retromolar foramen constitutes one of the most controversial details regarding its prevalence and associated variables. Thus, this study evaluated the prevalence of the retromolar foramen and the variables associated with its presence in a large Spanish collection of human dry mandibles from the nineteenth century. Six hundred Spanish human dry mandibles (1200 sides) belonging to an osteology collection were examined. The presence of teeth, the presence or absence of retromolar foramen, as well as its side, diameter, number, and location were evaluated. Descriptive analysis and analysis of the associations between the variables were performed. The retromolar foramen was observed in 184 mandibles (31%) and was predominantly present unilaterally (60.8%). Most mandibles (54.9%) had a single foramen. The most common location was the retromolar trigone region (84%). On analysis of the association of variables, it was observed a strong association (p < 0.001) between the presence or absence of the foramen and the presence of teeth. Moreover, a significant association was also found between sex vs. presence of teeth (p = 0.033), sex vs. presentation side of the foramen (p = 0.028), sex vs. number of foramina found (p = 0.004), and diameter vs. number of foramina found (p < 0.001). This study reveals that the retromolar foramen showed a high prevalence of 31% in nineteenth century Spaniards and was located primarily in the retromolar trigone, suggesting that dentists should be aware of and consider the relevant findings of this study.