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OBJECTIVE/AIM: The absence of a comprehensive understanding of potential anaphylactic reactions to local anesthetics (LAs) and management can result in grave consequences. For this reason we aim to assess Latin American dentists' knowledge, preparedness, and competency in managing anaphylactic reactions to LAs. MATERIALS AND METHODS: Design: A cross-sectional study was conducted from November 2021 to February 2022. Board-certified dentists answered a survey comprising 26 structured questions. Chi-square tests and logistic regression models were performed in Stata 17.0. SETTING: Argentina, Brazil, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Peru, Venezuela, and other Latin American countries. RESULTS: Of 507 respondents, lidocaine was the most frequently used LA (88.1%). While 85.2% could identify dyspnea as a symptom of anaphylaxis, only 50.1% knew the correct route for epinephrine administration, and just 43.5% had epinephrine in their emergency kits. Confidence in managing anaphylactic reactions was low (9.6%). Older age was inversely related to both knowledge of anaphylaxis management and the possession of epinephrine (P = 0.003 and P = 0.0001, respectively). DISCUSSION: Our study highlights a concerning discrepancy between the practical readiness of Latin American dentists in handling anaphylaxis. CONCLUSION: The study's findings underscore the need for educational interventions to improve the readiness to identify and handle anaphylactic emergencies in dental practice.
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BACKGROUND: ChatGPT was not intended for use in health care, but it has potential benefits that depend on end-user understanding and acceptability, which is where health care students become crucial. There is still a limited amount of research in this area. OBJECTIVE: The primary aim of our study was to assess the frequency of ChatGPT use, the perceived level of knowledge, the perceived risks associated with its use, and the ethical issues, as well as attitudes toward the use of ChatGPT in the context of education in the field of health. In addition, we aimed to examine whether there were differences across groups based on demographic variables. The second part of the study aimed to assess the association between the frequency of use, the level of perceived knowledge, the level of risk perception, and the level of perception of ethics as predictive factors for participants' attitudes toward the use of ChatGPT. METHODS: A cross-sectional survey was conducted from May to June 2023 encompassing students of medicine, nursing, dentistry, nutrition, and laboratory science across the Americas. The study used descriptive analysis, chi-square tests, and ANOVA to assess statistical significance across different categories. The study used several ordinal logistic regression models to analyze the impact of predictive factors (frequency of use, perception of knowledge, perception of risk, and ethics perception scores) on attitude as the dependent variable. The models were adjusted for gender, institution type, major, and country. Stata was used to conduct all the analyses. RESULTS: Of 2661 health care students, 42.99% (n=1144) were unaware of ChatGPT. The median score of knowledge was "minimal" (median 2.00, IQR 1.00-3.00). Most respondents (median 2.61, IQR 2.11-3.11) regarded ChatGPT as neither ethical nor unethical. Most participants (median 3.89, IQR 3.44-4.34) "somewhat agreed" that ChatGPT (1) benefits health care settings, (2) provides trustworthy data, (3) is a helpful tool for clinical and educational medical information access, and (4) makes the work easier. In total, 70% (7/10) of people used it for homework. As the perceived knowledge of ChatGPT increased, there was a stronger tendency with regard to having a favorable attitude toward ChatGPT. Higher ethical consideration perception ratings increased the likelihood of considering ChatGPT as a source of trustworthy health care information (odds ratio [OR] 1.620, 95% CI 1.498-1.752), beneficial in medical issues (OR 1.495, 95% CI 1.452-1.539), and useful for medical literature (OR 1.494, 95% CI 1.426-1.564; P<.001 for all results). CONCLUSIONS: Over 40% of American health care students (1144/2661, 42.99%) were unaware of ChatGPT despite its extensive use in the health field. Our data revealed the positive attitudes toward ChatGPT and the desire to learn more about it. Medical educators must explore how chatbots may be included in undergraduate health care education programs.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estudos Transversais , Feminino , Masculino , Adulto , Inquéritos e Questionários , Estudantes de Ciências da Saúde/psicologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Atitude do Pessoal de Saúde , Adulto Jovem , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricosRESUMO
The dialectical relationship between ecosystems and society is complex; therefore, holistic approaches are required to address this complexity. This view also stands out in the ecosystem services valuation field, where different scholars and global platforms have drawn attention to the need to incorporate plural valuation initiatives at decision-making. In this sense, through a comprehensive design, we conducted a multi-layered valuation of ecosystem services, and we highlighted multiple values in two areas of the province of Caldas, Colombia. We proposed a three-phase valuation process called Recognizing, Normalizing and Articulating values. Then, in cooperation with the regional environmental authority, we obtained different water-related ecosystem services values. Our results showed some warnings: first, we found mismatches between ecosystem services values; second, people assigned high values to ecosystems but the actual capacity of ecosystems to support ES is low. Finally, monetary values were marginal compared to social and ecological values. We conclude by saying that the more strata are assessed, the more values appear in the valuation scenarios, and those values could be conflicting. Our results have political implications, since they highlight the need to incorporate plural values as a fundamental tool for planning and land use in real scenarios where conflicts of interest and values are evident.
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La ambliopía es una patología que tiene una prevalencia de aproximadamente 0.5 a 7 por ciento, susceptible de recibir tratamiento exitoso si éste se instaura a tiempo (antes de los 12 años), obteniéndose mejor respuesta si se inicia a corta edad (2 a 3 años), y va disminuyendo su eficacia al aumentar la edad de inicio. Para su diagnóstico se utiliza tradicionalmente la toma de agudeza visual con la cartilla de Snellen, siendo ésta muy difícil de realizar en pacientes de corta edad. Se han utilizado otros métodos alternativos para agilizar su diagnóstico y el de sus factores de riesgo, los cuales pueden ser utilizados en pacientes que aun no son candidatos para una buena toma de agudeza visual con los métodos convencionales. Comprobamos la eficacia de dos de estos (la cartilla HOTV y el uso del autorrefractómetro) como métodos de screening para la detección de ambliopía...