Entrevista motivacional como estrategia de mejoramiento de la salud bucal de niños y cuidadores. Revisión en sombrilla / Motivational interviewing as a strategy to improve the oral health of children and caregivers. Umbrella review

Objetivo: demostrar la efectividad de la entrevista motivacional (EM) en el mejoramiento de algunos indicadores de salud bucal en niños de 0 a 12 años y sus cuidadores. Material y métodos: estudio de revisión en sombrilla (umbrella review). Se realizó búsqueda en bases de datos electrónicas (PubMed, MEDLINE, SCOPUS, EBSCO) y Google Scholar desde el año 2010 hasta el año 2020, con las siguientes palabras clave: ('motivational interviewing' OR 'motivational interview' OR 'motivational interviewing style' OR 'motivational intervention' OR 'motivational counseling' OR 'brief motivational counseling' OR 'maternal counseling' OR 'behavioral intervention') AND (“caries” OR 'dental caries' OR 'tooth decay' OR 'dental decay' OR 'carious lesions' OR 'DMFT index' OR “ICDAS”) AND ('gingival diseases' OR “gingivitis” OR “CPITN” OR 'gingival bleeding' OR 'dental calculus') AND (“children” OR “families” OR “caregivers”). Se incluyeron artículos originales sobre la efectividad de la entrevista motivacional en salud bucal (EMSB) en niños de hasta 12 años y cuidadores, tipo revisión sistemática de la literatura y metanálisis, desde el año 2010 hasta el 2020. Resultados: 69 artículos (2 revisiones sistemáticas y 4 metanálisis). Los indicadores encontrados fueron: cambios en la presentación de caries de la infancia temprana, higiene bucal, condiciones gingivales y frecuencia de visitas a la consulta odontológica, con resultados alentadores y, en otros, contradictorios. Conclusiones: la evidencia sobre la efectividad de la entrevista motivacional en comparación con la educación convencional muestra cambios positivos en indicadores de salud bucal, como mejoramiento de la higiene dental y de la presentación de la caries en la primera infancia. (AU)

Objective: to demonstrate, the effectiveness of motivational interviewing in improving oral health indicators in children aged 0 to 12 years and their caregivers. Material and method: an umbrella review design. Search in electronic databases (PubMed, MEDLINE, SCOPUS, EBSCO) and Google Scholar since 2010 to 2020, with the following keywords: ('Motivational interviewing' OR 'motivational interview' OR 'motivational interviewing style' OR 'motivational intervention' OR 'motivational counseling' OR 'brief motivational counseling' OR 'maternal counseling' OR 'behavioral intervention') AND (“caries” OR 'dental caries' OR 'tooth decay' OR 'dental decay' OR 'carious lesions' OR 'DMFT index' OR “ICDAS”) AND ('gingival diseases' OR “gingivitis” OR “CPITN” OR 'gingival bleeding' OR 'dental calculus') AND (“children” OR “families” OR “caregivers”), original articles on the effectiveness of motivational interviewing in oral health (EMSB) in children between 0 and 12 years of age and caregivers, type systematic review of the literature and metaanalysis. Results: 69 articles were found (2 systematic reviews and 4 metaanalysis). The indicators found: change in early childhood caries, oral hygiene, gingival conditions and frequency of visits to the dental office with promise results and others contradictories. Conclusion: the evidence on the effectiveness of motivational interviewing compared to conventional education shows positive changes in oral health indicators such as improvement in dental hygiene and the presentation of caries in early childhood, among others. (AU)

La Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP): una red de referencia e impulsora de la investigación en atención primaria / The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research

La Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP), una red de referencia e impulsora de la investigación en atención primaria fue creada en 2003 gracias al programa Redes Temáticas de Investigación Cooperativa en Salud (RETICS) del Instituto de Salud Carlos III (ISCIII). Su creación ha supuesto un cambio radical en la situación de la investigación en atención primaria. A lo largo de sus 19 años (2003-2021) han participado distintos grupos de investigación y comunidades autónomas, y se han desarrollado distintas líneas de investigación con numerosos proyectos y publicaciones. A pesar de las dificultades sufridas, ha creado una experiencia de investigación colaborativa entre distintas comunidades autónomas con gran vitalidad y con importantes resultados para la atención primaria. La redIAPP, por tanto, ha sido un gran referente para la investigación en atención primaria y para la profundización de su área de conocimiento. Se sugieren varias líneas de mejora para el futuro de la investigación en atención primaria.(AU)

The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.(AU)

[The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research]. / La Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP): una red de referencia e impulsora de la investigación en atención primaria.

The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.

Alzheimer's disease prevention: A way forward. / Prevención de la enfermedad de Alzheimer: un camino a seguir.

This review proposes a more optimistic view of Alzheimer's disease (AD), in contrast to that contributed by the ageing of the population and the failure of potentially curative therapies (vaccines and others). Treatment failure is likely due to the fact that AD gestates in the brain for decades but manifests in old age. This review updates the concept of AD and presents the results of recent studies that show that primary prevention can reduce the incidence and delay the onset of the disease. Half of all cases of AD are potentially preventable through education, the control of cardiovascular risk factors, the promotion of healthy lifestyles and specific drug treatments. These approaches could substantially reduce the future incidence rate of this disease.

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice.

INTRODUCTION AND OBJECTIVES: There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with moderate risk. METHODS: Participants (n=2310, 58% women) aged 40 to 65 years from a national population-based study (Di@bet.es Study) were identified. First, a priori high/very-high risk individuals were identified. Next, total cardiovascular risk (Systematic Coronary Risk Evaluation equation including high-density lipoprotein cholesterol) was used to assess risk of a priori non-high risk individuals. Variables independently associated with moderate versus low-risk were investigated by multiple logistic regression analysis. RESULTS: Age-and-sex standardized (direct method) percentages of high/very-high, moderate, and low-risk were 22.8%, 43.5%, and 33.7%, respectively. Most men were at moderate (56.2%), while 55.4% of women were at low risk. Low-density lipoprotein cholesterol (< 70,<100, < 115 mg/dL) and blood pressure (<140/90 mmHg) goals for very-high, high and moderate risk were met in 15%, 26% and 46%, and 77%, 68% and 85% of the individuals, respectively. Body mass index, high triglycerides concentrations, diastolic blood pressure, and low Mediterranean diet adherence (in women) were independently associated with moderate (versus low) risk. CONCLUSIONS: Cardiovascular risk in Spain is mainly moderate in men and low in women. Achievement of treatment goals in high-risk individuals should be improved. The prevalence of non-classical cardiovascular risk factors is elevated in subjects at moderate risk, an important aspect to consider in a population-based strategy to decrease cardiovascular disease in the most prevalent group.

Concepções dos profissionais da estratégia saúde da família sobre intervenção precoce em saúde mental / Concepts of professionals of family health strategy about early intervention in mental health / Conceptos de los profesionales de la estrategia de salud de la familia cerca de la intervención de la salud mental temprana

Um grupo multiprofissional de estudos interdisciplinares em Campina Grande (PB) promoveu debates os quais fundamentaram a implementação do Programa Municipal de Intervenção Precoce (PMIP) pelos Centros de Atenção Psicossocial Infantil (CAPS i) sendo expandido posteriormente para Atenção Básica (AB) a partir de cursos formação continuada de profissionais. Neste artigo discute-se um estudo que objetivou conhecer as concepções dos profissionais da Estratégia Saúde da Família (ESF) sobre a IP e em que medida eles utilizavam tais concepções em suas práticas profissionais. O estudo foi exploratório descritivo de abordagem qualitativa. Para coleta do material empírico, ocorrida de junho a agosto de 2009, utilizou-se entrevista semiestruturada com 10 profissionais. A avaliação dos dados fundamentou-se na técnica de análise de conteúdo categorial temática. Constatou-se profissionais sensíveis para desenvolver ações de IP nos serviços, tendo tal Programa favorecido a atuação dos profissionais da Estratégia Saúde da Família na identificação de psicopatologias de forma precoce, possibilitando uma assistência integral, proposta pelo modelo de cuidado que vem sendo buscado pela política de saúde mental.

A multidisciplinary group of interdisciplinary studies in Campina Grande (PB) promoted discussions which motivated the implementation of the Municipal Early Intervention Program (PMIP) for Psychosocial Care Centers Children (CAPS i) being expanded later to Primary Care (AB) from continuing education courses for professionals. This article discusses a study that aimed to identify the concepts of professional Family Health Strategy (FHS) on the IP and to what extent they used these concepts in their professional practices. The study was exploratory and descriptive qualitative approach. To collect empirical data that occurred from June to August 2009, we used semistructured interviews with 10 professionals. Data evaluation was based on the technique of content analysis categories and themes. It was found sensitive professionals to develop actions of IP services, such program having favored the work of professionals from the Family Health Strategy in identifying psychopathology so early, enabling a comprehensive care proposed by the model of care that is being sought by the policy mental health.

Un grupo multidisciplinario de estudios interdisciplinarios en Campina Grande (PB) promovió discusiones que motivaron la implementación del Programa Municipal de Intervención Temprana (PMIP) para Centros de Atención Psicosocial Infantil (CAPS i) se amplió más tarde a la Atención Primaria (AB) de cursos de educación continua para profesionales. En este artículo se analiza un estudio que tuvo como objetivo identificar los conceptos de la Estrategia Salud de la Familia profesional (FHS) en la IP y en qué medida se utilizan estos conceptos en sus prácticas profesionales. El estudio cualitativo exploratorio y descriptivo. Para recoger los datos empíricos que se produjeron entre junio y agosto de 2009, se utilizaron entrevistas semiestructuradas con 10 profesionales. Evaluación de los datos se basó en la técnica de las categorías y los temas de análisis de contenido. Se encontró profesionales sensibles a desarrollar acciones de servicios IP, como programa de haber favorecido el trabajo de los profesionales de la Estrategia Salud de la Familia en la identificación de la psicopatología tan temprano, lo que permite una atención integral que propone el modelo de atención que está siendo buscada por la política la salud mental.

La prevención de la enfermedad renal, un nuevo reto para la enfermera / Kidney disease prevention, a new challenge for nurses

En Colombia y en el mundo la transición demográfica ha traído cambios en el estado de salud. Es así como la enfermedad renal se ha ido incrementando debido al aumento de edad en la población, y a la presencia de hipertensión arterial y diabetes mellitus como enfermedades precursoras; en estas dos enfermedades la falta de detección temprana y de un tratamiento adecuado y oportuno conllevan a la aparición de la enfermedad renal, que sin un control adecuado, progresa llevando al usuario a terapias de soporte renal y su consecuente efecto negativo en la calidad de vida del usuario y su familia. Por lo anterior, las enfermeras tienen un gran reto desde la atención primaria en salud, reforzando el cuidado de enfermeria desde el empoderamiento de la salud, pasando por la promoción de la salud, la prevención de la enfermedad y la prevención de las complicaciones, y en unión con el equipo de salud, trabajar conjuntamente con el usuario y su familia, ya que de lo contrario, el cuidado de la salud será en vano.

In Colombia and the rest of the world demographic transitions have caused changes to the health of the population. Among these changes is an increase in kidney disease due to increased life expectancy; hypertension and diabetes are precursors of the disease and late or inadequate treatment of this conditions leads to kidney disease, which without proper control creates the need for renal support therapy that has a negative effect on patients and their families lifestyles.\r\nFor this reason, nurses have a great challenge in primary health care, reinforcing care with health empowerment, health promotion, disease prevention and prevention of complications. Nurses need to work together with the health care provider and the patient and family, otherwise health care services will be in vain.

Jamaica, the Caribbean and sickle cell disease / Jamaica, el Caribe y la enfermedad de células falciformes

The development of research interests in sickle cell disease has been traced from the first recorded case, the founding of the University Hospital of the West Indies and the Jamaican Sickle Cell Unit with its influence on clinical practice in this disease worldwide.

El presente trabajo sigue el desarrollo del interés en la investigación de la enfermedad de células falciformes - desde el registro del primer caso, la fundación del Hospital Universitario de West Indies, y la Unidad de Anemia Falciforme en Jamaica - con su influencia en la práctica clínica de esta enfermedad a nivel mundial.

Evaluation of oral health in a community of native Brazilians of the Umutina Reservation, Mato Grosso State / Evaluación de la salud oral en una comunidad de Brasileños nativos de la Reserva Umutina, Estado de Mato Grosso

The occurrence of diseases and variations from normality is very common in the maxillofacial complex,and this phenomenon is closely associated to peculiar genetic determinants and influenced by genetic isolation. Studies on the distribution of oral diseases and variations from normality in South American natives are generally directed mainly to thestudy of dental caries in the children and periodontal diseases in the adults, disregarding a wide range of other oral diseases. The aim of this study was to evaluate the distribution of lesions and anatomical variations from normality in eight ethnic groups living in the Umutina Indian Reservation, State of Mato Grosso, Brazil, through physical and oral examinations besides cytological evaluation and assessment of diet and habits, such as tobacco and alcohol consumption. A total of 291 Indians, of both genders, with ages ranging from 1 to 96 years, were examined, being identified 132 variations from normality,evidencing a high occurrence of ankyloglossia, which was present in 108 cases (37.1 percent), followed by benign migratory glossitis in 5 cases (1.7 percent); mandibular torus and candidiasis in 3 cases (1.0 percent). No malignant lesion was identified in thepopulation.

La ocurrencia de enfermedades y variaciones de normalidad son muy comunes en el complejo maxilofacial. Este fenómeno se asocia estrechamente a determinantes genéticos peculiares y son influenciados a través del aislamiento genético. Estudios sobre la distribución de enfermedad oral y variaciones de la normalidad en nativos Sudamericanos son generalmente dirigidos al estudio de la caries dental en niños y enfermedad periodontal en adultos, dejando de lado una amplia gama de otras enfermedades orales. El objetivo de este estudio fue evaluar la distribución de lesiones y las variaciones anatómicas de normalidad en ocho grupos étnicos indígenas pertenecientes a la reserva Umutina, Estado de Mato Grosso, Brasil, a través del examen físico y oral, además de la evaluación citológica y valoración de dieta y hábitos como tabaco y consumo de alcohol. Un total de 291 indígenas de ambos sexos, con edades que van de 1 a 96 años fueron examinados, identificándose 132 variaciones de normalidad, evidenciando una alta ocurrencia de anquiloglosia, la cual se presentó en 108 casos (37,1 por ciento), seguido por glositis migratoria benigna en 5 casos (1,7 por ciento); torus mandibular y candidiasis en 3 casos (1,0 por ciento). Ninguna lesión maligna se identificó en la población.

Autocuidado en recicladores-recuperadores informales de Medellín, Colombia, 2005 / Self-care in individuals who recycle garbage (recyclers) of Medellín, Colombia, 2005

OBJETIVO: comprender las concepciones, actitudes y prácticas sobre autocuidado en los recicladores informales de Medellín. METODOLOGÍA: se realizó un estudio cualitativo desde la perspectiva de los recuperadores no agremiados de Medellín en el 2005. Se aplicaron 52 entrevistas, con previo consentimiento informado, observación no participante y diario de campo. RESULTADOS: el autocuidado se concibe como la protección del cuerpo con el fin de evitar la ocurrencia de enfermedad; incluye aspectos de higiene, dieta, consulta médica, uso del tiempo libre y utilización de instrumentos de protección personal, como guantes, tapabocas, cachucha, tapaoídos y otros. DISCUSIÓ: la prevención de la enfermedad trasciende el plano biológico y se posiciona en una dimensión social para la persona, en que lo más importante son las consecuencias que puede generar para sí misma, su grupo de trabajo y su familia. Los recuperadores poseen saberes sobre la prevención y las prácticas que promueven la salud y el bienestar, pero estas últimas no son aplicadas porque disminuyen su rendimiento, no las consideran necesarias, no depende de ellos ejecutarlas o carecen de los recursos económicos. Las prácticas de autocuidado del recuperador se sustentan más por la primacía de la historia del grupo que por el saber científico.

OBJECTIVE: to understand the conceptions, attitudes and practices about self-care among informal recyclers in Medellín. METHODOLOGY: a qualitative study from the perspective of recyclers not belonging to any guild in Medellín in 2005 was developed. A total amount of 52 interviews with previous informed consent were applied, plus non-participant observation and field diary. RESULTS: self-care is understood as the constant protection of the body in order to avoid the occurrence of diseases. It includes aspects of hygiene, diet, medical consultation, proper use of leisure time and utilization of instruments for personal protection, such as gloves, face masks, caps, and ear plugs among other devices. DISCUSSION: disease prevention goes beyond biological aspects and becomes part of a social dimension for people in which the most important features are the consequences for themselves, their labor team and their families. Recyclers have knowledge on prevention and practices that promote health and well-being, but the latter are not applied because they diminish their job performance, or they do not consider them to be necessary, do not feel like executing them nor they lack the economic resources to assume them. Autocare practices of recyclers are mainly supported by the primacy of the team history than by the scientific knowledge concerning it.

Historia de la prevención / The history of care and prevention

Los cuidadores de la salud iniciaron su sendero histórico desde el momento en que los beneficios comunitarios sobrepasaron los intereses personales. El hombre primitivo con la observación y la imitación de los animales, comenzó toda una revolución en la atención al enfermo y al desvalido. Las civilizaciones antiguas desde sus diferentes perspectivas religiosas y filosóficas propendieron por el cuidado de las personas enfermas y de las sanas en condición de abandono. El cuidado a través de los periodos históricos ha sido constante en el mantenimiento de la salud y en la prevención de la enfermedad.

The caretakers of the health began their historical path from the moment inthat the community benefits surpassed the personal interests. The primitive man with the observation and the imitation of the animals, an entire revolutionbegan in the attention to the sick person and the destitute one. The old civilizations inclined from their different religious and philosophical perspectives,for the care of sick people and you heal in condition of abandonment. The care through the historical periods has been constant in the maintenance and prevention of the health.