Importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, Ucayali, Perú / Cultural importance of the flora used by the Asheninka Sheremashe native community, Ucayali, Peru

The cultural significance of the flora used by the native Asheninka Sheremashe community in Ucayali, Peru was determined. To do this, a fieldwork of over 4 months was conducted, involving semi-structured interviews with 106 residents through non-probabilistic convenience sampling. The community utilizes 139 plant species in their daily lives, belonging to 120 genera and 52 families, with the most abundant being Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae, and Rutaceae. Furthermore, 25.9% of the species are of significant importance to theinhabitants according to the Cultural Index (CI), such as Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, among others. It can be concluded that the flora plays a prominent role in the life of the community, with the categories reporting the highest number of species being: food (29.35%), medicine (28.36%), culture (9.95%), construction (9.45%), lumber (6.97%), commerce (3.48%), craftsmanship (2.49%), toxic (2.49%), and other uses (7.46%)

Se determinó la importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, en Ucayali, Perú. Para ello, se realizó un trabajo de campo de más de 4 meses, donde se aplicaron entrevistas semiestructuradas a 106 habitantes mediante un muestreo no probabilístico por conveniencia. La comunidad emplea 139 especies vegetales en su día a día, pertenecientes a 120 géneros y 52 familias; siendo las más abundantes las Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae y Rutaceae. Además, el 25.9% de las especies tiene gran importancia para los pobladores según el Índice Cultural (IC): Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, entre otras. Se concluye que la flora tiene un rol preponderante en la vida de la comunidad, siendo las categorías que presentaron mayor reporte de especies: alimentación (29.35%), medicina (28.36%), cultura (9.95%), construcción (9.45%), aserrío (6.97%), comercio (3.48%), artesanía (2.49%), tóxico (2.49%) y otros usos (7.46%)

Outcomes of a Community of Practice on Quebec Speech Language Pathologists' Voice Assessment Practices and Professional Identity

In a context where different protocols for recommended practices in clinical voice assessment exist, while there are gaps in the literature regarding the evidence base supporting assessment procedures and measures, clinicians from regions where a strong community holding expertise in clinical and scientific voice practices lack can struggle to confidently develop their voice assessment practices. In an effort to improve voice assessment practices and strengthen professional identity among speech-language pathologists in Quebec, Canada, a community of practice (CoP) was established, with the aim of promoting knowledge sharing, implementing change in clinical practice, and improving professional identity. Thirty-nine participants took part in the CoP activities conducted over a four-month period, including virtual meetings and in-person workshops. Participants had a high rate of attendance (> 74% participation rate in virtual meetings), and were highly satisfied with their participation and intended to remain involved after the project's end. Statistically significant changes in voice assessment practices were observed post-CoP, regarding probability of performing assessments (p < .001), and perceived importance of assessment for evaluative purposes (p <.001), as well as improvements in assessment specific confidence, specifically for procedure of auditory-perceptual assessment (p < .001) and purpose of aerodynamic assessment (p = .05). Moreover, there was an increase in professional identity post-CoP (p < .001) and participants felt they made significant learnings. The present study highlighted the need to involve SLPs in future research to identify assessments that are relevant to the specific evaluative objectives of SLPs working with voice, and suggests CoPs are an efficient tool for that purpose.

En un contexto en el que existen diferentes protocolos para las prácticas recomendadas en la evaluación vocal clínica, y en el que se presentan vacíos en la literatura respecto a la base de evidencia que respalda los procedimientos y medidas de evaluación, los profesionales de regiones donde no hay una comunidad sólida con experiencia en prácticas vocales clínicas y científicas pueden enfrentar dificultades para desarrollar con confianza sus prácticas de evaluación vocal. Con el propósito de mejorar las prácticas de evaluación vocal y fortalecer la identidad profesional entre los logopedas de Quebec, Canadá, se estableció una comunidad de práctica (CdP). Esta tenía como objetivo fomentar el intercambio de conocimientos, implementar cambios en la práctica clínica y mejorar la identidad profesional. Un total de treinta y nueve participantes se involucraron en las actividades de la CdP, llevadas a cabo durante un período de cuatro meses, que incluyeron reuniones virtuales y talleres presenciales. Los participantes tuvieron una alta tasa de asistencia (> 74% de participación en las reuniones virtuales) y expresaron un alto grado de satisfacción con su participación, manifestando su intención de continuar involucrados después de la finalización del proyecto. Se observaron cambios estadísticamente significativos en las prácticas de evaluación vocal posterior a la CdP, en lo que respecta a la probabilidad de llevar a cabo evaluaciones (p < .001) y la percepción de la importancia de la evaluación con fines evaluativos (p < .001), así como mejoras en la confianza específica en la evaluación, particularmente en el procedimiento de evaluación auditivo-perceptual (p < .001) y el propósito de la evaluación aerodinámica (p = .05). Además, se registró un aumento en la identidad profesional posterior a la CdP (p < .001) y los participantes sintieron que obtuvieron aprendizajes significativos. El presente estudio destacó la necesidad de involucrar a los logopedas en investigaciones futuras, para identificar evaluaciones pertinentes a los objetivos evaluativos específicos de los logopedas que trabajan con la voz, y sugiere que las CdP son una herramienta eficiente con ese propósito.

Modelos de preceptoria de residência em medicina de família e comunidade: um estudo Delphi / Models of preceptorship in family and community medicine residence: a Delphi study

Resumo Introdução: A preceptoria na atenção primária à saúde desempenha papel central na formação do residente, já que 70%-80% da carga horária dos programas de residência de medicina de família e comunidade (PRMFC) acontece na unidade de saúde da família. Como preceptor entende-se o professor que ensina na prática clínica. O cenário atual de expansão dos PRMFC, associado a poucos profissionais especializados em preceptoria, fez com que vários modelos fossem praticados. Uma revisão de literatura feita em estágio anterior a este trabalho, além das contribuições da Sociedade Brasileira de Medicina de Família e Comunidade, identificou quatro modelos de preceptoria em MFC: ombro a ombro, preceptor da equipe ao lado, preceptor de unidade e preceptor de campo. Objetivo: Este estudo teve como objetivos validar esses quatro modelos e identificar outros, determinar, sob a ótica da qualidade de formação dos residentes, a aceitabilidade e o grau de recomendação dos modelos, e reconhecer os pontos positivos e negativos. Método: Utilizou-se a técnica Delphi modificada por questionários on-line. O estudo começou com 24 participantes de todo o Brasil na primeira rodada e terminou com 18. Aplicaram-se a técnica de estatística descritiva e a análise de conteúdo. O estudo foi realizado entre fevereiro e abril de 2022. Resultado: Validaram-se os quatro modelos apresentados, e nenhum outro foi identificado. Os modelos ombro a ombro, preceptor da equipe ao lado e preceptor de unidade foram considerados aceitáveis; e o modelo preceptor de campo, inaceitável. Os modelos ombro a ombro e preceptor de unidade foram recomendados. Reconheceram-se 92 aspectos como pontos positivos e negativos, dos quais 81 atingiram consenso. Conclusão: Obteve-se a validação dos quatro tipos de modelos de preceptoria para PRMFC. Como os modelos ombro a ombro e preceptor de unidade foram elencados como aceitáveis e recomendáveis, é importante que sejam priorizados na implantação e manutenção dos PRMFC. Os modelos preceptor da equipe ao lado e preceptor de campo foram julgados como não recomendados e, portanto, devem ser evitados. O conhecimento das fortalezas e fraquezas de cada modelo prepara os PRMFC para as possíveis dificuldades e os auxilia na escolha do modelo adequado às diversas realidades existentes no país.

Abstract Introduction: Medical residency preceptorship in primary healthcare plays a major role in the professional qualification of medical residents, since 70-80% of the workload of the Family and Community Medical Residency Program (PRMFC) takes place in primary care clinics. A preceptor is understood as an experienced practitioner who teaches during clinical practice. The current scenario of expansion of PRMFCs in Brazil, associated with the limited number of professionals specialized in preceptorship, has resulted in the practice of different preceptorship models. A literature review performed in the previous stage of this study, added to the contributions of the Brazilian Society of Family and Community Medicine, pointed out four models of preceptorship in family practice: shoulder-to-shoulder, next-door team, clinic preceptor and field preceptor. Objective: To validate these four models of preceptorship and identify if there are others models; to determine, from the perspective of the quality of training residents, the acceptability and degree of recommendation of the models and recognize the positive and negative points. Method: The Delphi technique modified by online questionnaires was used. It was initiated with 24 participants from all over Brazil in the first round and ended with 18. Descriptive statistics and content analysis method was applied. The study was conducted between February and April 2022. Result: The four models presented were validated and no others were identified. The shoulder-to-shoulder, nextdoor team preceptor and clinic preceptor models were considered acceptable and the field preceptor model, unacceptable. The shoulder-to-shoulder and clinic preceptor models were recommended. Ninety-two aspects were recognized as positive and negative points. Of these, 81 achieved consensus. Conclusion: The shoulder-to-shoulder preceptor and clinic preceptor models were validated as acceptable and recommended, so it is important to prioritize these models in the implementation and maintenance of PRMFCs. The next-door team preceptor and field preceptor models were deemed as not recommended and, therefore, should be avoided. Information about the strengths and weaknesses of each model prepares the PRMFCs for possible implementation difficulties and helps them to select the appropriate model for the different realities existing in the country.

As redes vivas na produção do cuidado com o usuário na centralidade do tratamento para tuberculose multidroga resistente / Las redes vivas en la producción del cuidado con el usuario en la centralidad del tratamiento para la tuberculosis multidrogo resistente / Live networks in care production with the user at the center of the treatment for multidrugresistant tuberculosis

Vivenciamos a trajetória de uma usuária-guia no tratamento para tuberculose multidroga resistente (TB-MDR). As narrativas das redes vivas na produção de cuidado apontam para os seguintes itens: 1) cuidar no ato de viver: suplantar os estigmas e cultivar vínculos que ajudem a superar os discursos fomentados pelo medo, preconceitos, exclusão e invisibilidade dos sujeitos; 2) redes vivas de cuidado: os entremeios da norma; e 3) as interfaces de atenção usuário-trabalhador da saúde: como desmistificar o julgamento dos trabalhadores da saúde, que, subordinados a protocolos limitantes, muitas vezes estigmatizam o usuário como "abandonador de tratamento"?. A usuária-guia vislumbrou que cuidar é se desterritorializar, é colocar os desejos como potência para transformação, saindo do modus operandi rumo à criatividade, tendo o usuário no centro do processo. (AU)

Presenciamos la trayectoria de una usuaria-guía en el tratamiento para tuberculosis multidrogo resistente (TB-MDR). Las narrativas de las Redes Vivas en la producción de cuidado señalan: 1) cuidar en el acto de vivir: suplantar los estigmas y cultivar vínculos que ayuden a superar los discursos fomentados por el miedo, prejuicios, exclusión e invisibilidad de los sujetos. 2) Redes Vivas de cuidado: los entresijos de la norma y 3) las interfaces de atención usuario-trabajador de la salud: ¿cómo desmistificar el juicio de los trabajadores de la salud quienes, subordinados a protocolos limitantes, muchas veces estigmatizan al usuario como "abandonador de tratamiento"? La usuaria-guía vislumbró que cuidar es desterritorializarse, es colocar los deseos como potencia para trasformación, saliendo del modus operandi rumbo a la creatividad, colocando al usuario en el centro del proceso. (AU)

We followed the trajectory of a guiding user undergoing treatment for multidrug-resistant tuberculosis (MDR-TB). The narratives of Live Networks in care production showed: 1) Caring in the act of living: Overcoming stigmas and cultivating bonds that help overcome discourses fostered by fear, prejudice, exclusion and invisibility of subjects; 2) Live Networks of care: The in-betweens of the norm; and 3) Interfaces of user-health worker care: How can we demystify the judgment of health workers who, subordinated to limiting protocols, often stigmatize the user as someone who "abandons the treatment"? The guiding user perceived that caring means deterritorializing oneself, expressing one's desires as power for transformation, and leaving the modus operandi towards creativity, with the user at the center of the process. (AU)

O que os adolescentes do município do Rio de Janeiro, Brasil, têm feito para reduzir sua exposição à violência comunitária? / What have adolescents in Rio de Janeiro city, Brazil, done to reduce their community violence exposure?

Resumo O objetivo do estudo é conhecer as estratégias individuais mais utilizadas por adolescentes de escolas públicas e privadas da IX Região Administrativa do município do Rio de Janeiro para evitar a exposição à violência comunitária, bem como investigar o perfil de coocorrência e sua prevalência em subgrupos populacionais específicos. Trata-se de um estudo seccional com 693 indivíduos. As informações referentes às estratégias para evitar a exposição à violência comunitária foram coletadas por meio de questionário multidimensional autopreenchido em sala de aula. As estratégias mais utilizadas foram: evitar passar onde há pessoas armadas (55,5%), evitar andar sozinho (30,5%) e evitar voltar para casa de madrugada (24,7%). Observou-se que as meninas adotam mais todos (concomitantemente) os quatro tipos de comportamento limitantes para reduzir sua exposição à violência comunitária (53% vs. 32%). Ressalta-se que a adoção de tais estratégias diferiu segundo os indicadores socioeconômicos, sendo maior entre os adolescentes oriundos de família de estratos de renda mais baixos. Tais achados chamam a atenção para a alta frequência de utilização de tais estratégias por adolescentes, o que pode cercear e limitar o pleno desenvolvimento de suas habilidades sociais e culturais.

Abstract This study aims to identify the individual community strategies to avoid violence exposure most used by adolescents from public and private schools in the IX Administrative Region of Rio de Janeiro and investigate the profile of co-occurrence and its prevalence in specific population subgroups. This is a cross-sectional study with 693 individuals. A multidimensional questionnaire collected information regarding strategies to avoid community violence exposure and was self-completed in the classroom. The most used strategies were avoiding walking close to armed people (55.5%), avoiding walking alone (30.5%), and avoiding returning home at dawn (24.7%). Girls adopt more of all (concurrently) the four limiting behaviors to reduce their community violence exposure (53% vs. 32%). Notably, the adoption of such strategies differed by socioeconomic indicators and was higher among adolescents from lower-income households. These findings point to the high frequency of use of such strategies by adolescents, which may hinder and limit the full development of their social and cultural skills.

Fatores associados à internação de usuários encaminhados pela atenção primária para acompanhamento em Centros de Atenção Psicossociais do município de São Paulo, Brasil / Factors associated with the hospitalization of users referred from primary health care to follow-up in Psychosocial Care Centers in the city of São Paulo, Brazil

Resumo Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários.

Abstract This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users.

Construction and validation of the community health workers perception questionnaire on conditions amenable to physiotherapy in primary health care / Construção e validação do questionário de percepção dos Agentes Comunitários de Saúde sobre condições sensíveis à fisioterapia na Atenção Primária

Abstract Introduction Community health workers, like the physiotherapist, perform essential functions in primary health care, being an important element in the transformation of public policies. There are no reported studies investigating the knowledge of community health workers about health conditions amenable to physiotherapy intervention in primary health care. Objective To construct a questionnaire to investigate the perception of community health workers about health conditions that could be remedied by physiotherapy intervention in primary health care. Methods This was a methodological study in which it was initially an analysis matrix with the aim of encompassing the ideas contemplated in the questionnaire. To construct the instrument, a literature review was carried out, and health conditions treatable with physiotherapy in primary health care were chosen. To validate the content and appearance of the items, twelve physiotherapists specialized in primary health care judged the suitability of the items contained. The content validity index was used to determine the degree of agreement during the response analysis process. Subsequently, a semantic analysis was carried out through the understanding of the items by 15 community health workers. In the validation stage, two rounds of evaluation were carried out. Adjustments were made to 17 questions. Results The study investigated a questionnaire with 20 questions containing hypothetical situations of home visits, in which the resident's situation could or could not constitute a health risk amenable to physiotherapeutic intervention. Conclusion The community health workers perception instrument on health conditions amenable to physiotherapy intervention in primary health care proved to be valid for use in this context. The use of the instrument may contribute to the development of community health worker training programs, with the aim of facilitating team communication.

Resumo Introdução O Agente Comunitário de Saúde (ACS), assim como o fisioterapeuta, desencadeia funções fundamentais na Atenção Primária à Saúde (APS), sendo ele-mento importante na transformação de políticas públicas. Inexistem estudos que investiguem o conhecimento dos ACS sobre as condições de saúde sensíveis à inter-venção da fisioterapia na APS. Objetivo Construir um questionário de investigação da percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS. Métodos Trata-se de um estudo metodológico no qual, inicialmente, construiu-se uma matriz de análise com o intuito de englobar as ideias contempladas no questionário. Para a construção do instrumento, realizou-se uma revisão da literatura, sendo eleitas condições de saúde sensíveis à intervenção da fisioterapia na APS. Para a validação de conteúdo e aparente dos itens, 12 fisioterapeutas especialistas em APS julgaram a adequação dos itens contidos. Utilizou-se o índice de validade de conteúdo para verificar o grau de concordância durante o processo de análise das respos-tas. Posteriormente, realizou-se análise semântica por meio da compreensão dos itens por 15 ACS. Na etapa de validação, foram realizadas duas rodadas de avaliação. Foram feitos ajustes em 17 questões. Resultados O estudo resultou em um questionário com 20 questões contendo situações hipotéticas de visitas domiciliares, cuja situação do morador poderia ou não configurar um risco à saúde sensível à intervenção fisioterapêutica. Conclusão O instrumento de percepção dos ACS sobre as condições de saúde sensíveis à intervenção da fisioterapia na APS mostrou-se válido para ser utilizado no contexto da APS. A utilização do instrumento poderá contribuir na elaboração de programas de capacitação dos ACS, com o intuito de facilitar a comunicação da equipe.

Del vínculo a la praxis: Reflexiones sobre la posibilidad de una comunidad profesional prural / From kinship to praxis: Reflections on the possibilities of a plural professional community / Do vínculo à práxis: reflexões sobre as possibilidades de uma comunidade profissional plural

Este editorial destaca quince resultados de la iniciativa de foto-voz "ImpacTO comunitario". A través de este medio, terapeutas ocupacionales de Colombia compartieron la experiencia de su ejercicio profesional en la comunidad, en el marco de la celebración del Día Mundial de la Terapia Ocupacional de 2023, que tuvo por lema: "Unidad a través de la comunidad". Se reflexiona sobre el contexto histórico en el que se desarrolló la iniciativa, dado el recrudecimiento del conflicto israelí-palestino, alrededor del cual se generaron discusiones sobre el concepto de comunidad para el colectvo de terapeutas ocupacionales. Se explora la idea de comunidad profesional desde los vínculos, las afinidades y los haceres compartidos, así como su significado en medio de la guerra. Se destaca la necesidad de reconocer la coexistencia y la pluralidad en la profesión, subrayando la interdependencia entre individuos y contextos sociales. Se invita, finalmente, a reflexionar sobre la posibilidad de crear una comunidad profesional desde la pluralidad.

This editorial highlights fifteen results of the photo-voice initiative "ImpacTO comunitario" (Community Impact). Through this medium, occupational therapists from Colombia shared the impact of their professional exercise in the community as part of the celebration of World Occupational Therapy Day 2023, which had the theme: "Unity through the community." It reflects on the historical context in which the initiative was developed, given the escalation of the Israeli-Palestinian conflict, generating discussions on the concept of community for the occupational therapists' collective. What community means amid war is questioned, and the idea of the professional community is explored from the kinships, affinities, and shared doings. The need to recognize coexistence and pluralism in the profession is highlighted, stressing the interdependence between individuals and social contexts. Finally, the readers are invited to reflect on the possibility of creating a professional community from pluralism.

Este editorial destaca quinze resultados da iniciativa de foto-voz "ImpacTO comunitário". Através deste meio, terapeutas ocupacionais da Colômbia compartilharam a incidência de seu exercício profissional na comunidade, no âmbito da celebração do Dia Mundial da Terapia Ocupacional de 2023, que teve por lema: "Unidade através da comunidade". Reflexiona-se sobre o contexto histórico em que se desenvolveu a iniciativa, dado o recrudescimento do conflito israelense-palestino, ao redor do qual se geraram discussões sobre o conceito de comunidade para o coletivo de terapeutas ocupacionais. É questionado o que significa comunidade no meio da guerra e a ideia de comunidade profissional é explorada a partir de vínculos, afinidades e fazeres compartilhados. Destaca-se a necessidade de reconhecer a coexistência e a pluralidade na profissão, sublinhando a interdependência entre indivíduos e contextos sociais. Convida-se, finalmente, a refletir sobre a possibilidade de criar uma comunidade profissional a partir da pluralidade.

Serviço de convivência e fortalecimento de vínculos: reXistências por via do acontecimento / A public service for youth: community identity through resistance / Un service public pour la jeunesse: l'identité communautaire par la résistance / Un servicio público para los jóvenes: identidad comunitaria por vía de la resistencia

Este texto traz um relato de experiência advindo das atividades de uma orientadora social realizado no Serviço de Convivência e Fortalecimento de Vínculos (SCFV) de um Centro de Referência de Assistência Social (Cras) situado na Grande Florianópolis (SC). O serviço integrou 20 jovens com idade entre 12 e 18 anos no espaço de uma instituição de formação policial. Este trabalho analisará: (1) um acontecimento ocorrido na instituição policial; (2) quais foram os seus desdobramentos; e (3) como a orientadora social atuou na mediação do grupo. A análise da do relato de experiência e a mediação da orientadora social foram embasadas no conceito de acontecimento de Gilles Deleuze. No decorrer dos encontros, a instituição parceira do projeto adotou medidas disciplinares que desqualificavam a cultura proveniente dos cotidiano dos(as) jovens participantes, o que levou o grupo a constituir uma identidade coletiva a partir da resistência à violência simbólica. Assim, diante da situação-problema, tornou-se possível uma experiência de fortalecimentos de laços comunitários

This paper discusses a situation that occurred in a public youth service for young people living in vulnerable city areas. The service worked with 20 young people aged between 12 and 18 years and the meetings took place at a police training institution. Inspired by Gilles Deleuze's theory, this text analyzes 1) an event that occurred at the police institution, 2) their consequences and 3) how the professional responsible dealt with the event in a group context. At some point in the meetings, the police training institution adopted disciplinary measures that disqualified the participants' culture, leading the group to create a collective identity to resist symbolic violence. Thus, a community gathering experience emerged in the face of the conflicted situation

Le texte discute une situation survenue dans une fonction publique désignée pour accueillir des jeunes vivant dans des quartiers vulnérables. Le service comprenait 20 jeunes de 12 à 18 ans et les réunions se sont déroulées dans un établissement de formation policière. Inspirées par la théorie de Gilles Deleuze, ce texte analyse 1) un événement survenu dans l'institution policière, 2) qu'elles en ont été ses conséquences et 3) comment le professionnel responsable a agi pour faire face à l'événement dans un contexte de groupe. À un moment donné au cours des réunions, l'institution de formation a adopté des mesures disciplinaires qui disqualifiaient la culture des jeunes participants, ce qui a conduit le groupe à se forger une identité collective basée sur la résistance à la violence symbolique. Par conséquent, une expérience de rassemblement communautaire a émergé face à la situation conflictuelle

El texto se refiere a una situación ocurrida en un servicio público designado para trabajar con jóvenes que viven en zonas vulnerables de la ciudad. El servicio incluyó a 20 jóvenes de entre 12 y 18 años y las reuniones se ubicaron en una institución de capacitación policial. Este texto analiza 1) un suceso que ocurrió en la institución policial, 2) cuáles fueron sus consecuencias y 3) cómo actuó el profesional responsable del servicio para enfrentar el suceso en un contexto grupal. El análisis de esta situación y la referencia teórica que apoyó los actos profesionales se inspiraron en la teoría de Gilles Deleuze. En algún momento de los encuentros, la institución de capacitación policial adoptó medidas disciplinarias que descalificaron la cultura de los jóvenes participantes, lo que llevó al grupo a constituir una identidad colectiva basada en la resistencia contra la violencia simbólica. Por lo tanto, ante la situación conflictiva, fue posible una experiencia de reunión comunitaria

Risk factors for osteoporotic hip fracture among community-dwelling older adults: a real-world evidence study

Abstract Background Hip fractures in the older adults lead to increased morbidity and mortality. Although a low bone mineral density is considered the leading risk factor, it is essential to recognize other factors that could affect the risk of hip fractures. This study aims to evaluate the contribution of clinical characteristics, patient-reported outcomes, and muscle and aerobic capacity for hip fractures in community-dwelling older adults. Methods This is a retrospective cohort study with real world-data from subjects ≥ 60 years old attending an outpatient clinic in Minas Gerais, Brazil, from May 1, 2019, to August 22, 2022. Data about clinical characteristics (multimorbidity, medications of long-term use, sedative and or tricyclic medications, number of falls), patient-reported outcomes (self-perception of health, self-report of difficulty walking, self-report of vision problems, and self-report of falls) and muscle and aerobic capacity (calf circumference, body mass index, and gait speed) were retrieved from an electronic health record. The association of each potential risk factor and hip fracture was investigated by a multivariable logistic regression analysis adjusted for age and sex. Results A total of 7,836 older adults were included with a median age of 80 years (IQR 72-86) and 5,702 (72.7%) were female. Hip fractures occurred in 121 (1.54%) patients. Multimorbidity was associated with an increased risk of hip fracture (OR = 1.12, 95%CI 1.06-1.18) and each episode of fall increased the chance of hip fracture by 1.7-fold (OR = 1.69, 95%CI 1.52-1.80). Patient-reported outcomes associated with increased fracture risk were regular or poor self-perception of health (OR = 1.59, 95%CI 1.06-2.37), self-report of walking difficulty (OR = 3.06, 95%CI 1.93-4.84), and self-report of falls (OR = 2.23, 95%CI 1.47-3.40). Body mass index and calf circumference were inversely associated with hip fractures (OR = 0.91, 95%CI 0.87-0.96 and OR = 0.93, 95%CI 0.88-0.97, respectively), while slow gait speed increased the chance of hip fractures by almost two-fold (OR = 1.80, 95%CI 1.22-2.66). Conclusion Our study reinforces the importance of identified risk factors for hip fracture in community-dwelling older adults beyond bone mineral density and available fracture risk assessment tools. Data obtained in primary care can help physicians, other health professionals, and public health policies to identify patients at increased risk of hip fractures.

Effects of training Community Health Agents on dementia: a quasi-experimental study / Efectos de la capacitación de Agentes Comunitarios de Salud en la demencia: un estudio cuasi experimental / Efeitos da capacitação de Agentes Comunitários de Saúde na demência: um estudo quase experimental

ABSTRACT Objectives: to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. Methods: a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer's Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student's t-test for related samples was used, and the effect size was calculated. Results: while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. Conclusions: it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.

RESUMEN Objetivos: evaluar el conocimiento de los Agentes Comunitarios de Salud sobre la demencia antes y después de un taller de capacitación para la detección de signos de la enfermedad. Métodos: estudio cuasi experimental con 33 agentes comunitarios, en el que se recopilaron datos sociodemográficos y conocimiento sobre la demencia, evaluados mediante la Escala de Conocimiento de la Enfermedad de Alzheimer, antes y después del taller. Hubo 10 sesiones semanales en línea y sincrónicas. Se utilizó la prueba t de Student para muestras relacionadas y se calculó el tamaño del efecto. Resultados: mientras que la puntuación promedio en la evaluación inicial a través del instrumento de medición fue de 16,3, en la evaluación final fue de 21,24. Se observó un aumento en la puntuación de instrumento después de participar en el taller, con un valor de 4,94. Conclusiones: es urgente invertir en la educación continua de estos profesionales para aumentar la conciencia en la detección oportuna de casos de demencia en atención primaria y la concienciación sobre factores potencialmente modificables.

RESUMO Objetivos: avaliar o conhecimento dos Agentes Comunitários de Saúde sobre demência antes e após a oficina de capacitação para detecção de sinais da doença. Métodos: estudo quase-experimental com 33 agentes comunitários, no qual foram coletadas informações sociodemográficas e de conhecimento sobre demência, avaliadas pela Alzheimer's Disease Knowledge Scale, no pré e pós-oficina. Houve 10 encontros semanais, online e síncronos. Utilizou-se o teste t de Student para amostras relacionadas e calculou-se o tamanho do efeito. Resultados: enquanto a média de pontos na avaliação inicial, por meio do instrumento de medida, foi de 16,3, na avaliação final foi de 21,24. Observou-se aumento na pontuação na escala após a participação na oficina, com um valor de 4,94. Conclusões: é urgente investir na educação permanente desses profissionais para maior conscientização na detecção oportuna de casos de demência ainda na atenção básica e conscientização de fatores potencialmente modificáveis.

Fortalecimento da Rede Nacional de Atenção Integral à Saúde do Trabalhador pela mobilização social: relato de experiência / Strengthening the National Network for Comprehensive Occupational Healthcare through social mobilization: an experience report

Resumo Introdução: a participação social é o pilar da implementação da Política Nacional de Saúde do Trabalhador e da Trabalhadora que estabelece as ações de atenção à Saúde do Trabalhador no Sistema Único de Saúde, a partir da Rede Nacional de Atenção Integral à Saúde do Trabalhador (Renast). Objetivo: descrever a parceria ensino-serviço para fortalecer a atenção à Saúde do Trabalhador em um município, em consonância com os princípios da Renast, a partir da formação e mobilização social em saúde. Métodos: trata-se de um relato do projeto de extensão desenvolvido por demanda da Comissão Intersetorial de Saúde do Trabalhador e da Trabalhadora municipal. Foram realizadas três oficinas de trabalho que utilizaram o diálogo em grupos de discussão como método para produção de conhecimento associado a estratégias de ensino-aprendizagem. Resultados: profissionais de saúde, estudantes, trabalhadores e representantes de entidades participaram das oficinas, que versavam sobre: organização da Renast; a epidemiologia e papel dos diversos atores para fortalecimento da Renast; a articulação intra e intersetorial da Renast, suas fragilidades e potencialidades; e a relevância de cada ator no sentido de mobilizá-los para mudança de suas realidades. Conclusão: as oficinas apresentaram-se como estratégia possível de formação e ponto de partida, visando à mobilização social para fortalecer a Renast.

Abstract Introduction: social participation is a cornerstone in implementing the National Policy for Occupational Heath, which establishes care actions for worker's health within the Unified Health System, based on the National Network for Comprehensive Occupational Healthcare (Renast). Objective: to describe the educational-service partnership aimed at strengthening occupational care in a municipality according to Renast principles by education and social mobilization in health. Methods: This experience report focuses on the outreach project developed to answer the demands of the municipal Intersectoral Commission on Occupational Health. Three workshops were conducted using discussion groups as a method for knowledge production associated with teaching and learning strategies. Results: health professionals, students, workers, and representatives of entities participated in the workshops, which addressed Renast organization; epidemiology and the role of various actors in strengthening Renast; Renast intra and intersectoral articulation, its weaknesses and potentialities; and the relevance of each actor in changing their realities. Conclusion: the workshops proved to be a feasible strategy for education and social mobilization aimed at strengthening Renast.

Esquema para mejorar el aprendizaje sobre el Análisis de la Situación de Salud

Introducción: El análisis de la situación de salud es una investigación primordial que se realiza en el sistema de salud cubano, en el que se estudia la salud, los elementos que la determinan y las formas de mejorarla. Objetivo: Evaluar la propuesta de diseño de un esquema que contribuya a la mejora del aprendizaje del análisis de la situación de salud de la comunidad para los residentes de la especialidad Medicina General Integral, pertenecientes a la Universidad de Ciencias Médicas de Guantánamo. Método: Se realizó una investigación pedagógica de tipo descriptiva en la antes mencionada institución durante el período marzo-julio de 2022. De un universo de 67 profesores que aceptaron participar, se seleccionaron 26 por muestreo intencional. Para obtener los datos primarios fueron aplicados tres cuestionarios tipo Likert para evaluar el esquema, en consideración con la estructura, la funcionalidad y el aporte en el aprendizaje. Dichos cuestionarios incluyeron las respuestas: Totalmente en desacuerdo, En desacuerdo, Ni de acuerdo ni en desacuerdo, De acuerdo y Totalmente de acuerdo. Los datos se resumieron en números absolutos y porcentajes. Se presentaron en tablas de distribución de frecuencias. Resultados: Los subtotales de respuestas Totalmente de acuerdo y De acuerdo sobre la evaluación estructural y funcional, así como la influencia que se espera de este para mejorar el aprendizaje del análisis de situación de salud, se consideraron adecuados al superar el estándar. Conclusiones: El esquema propuesto es evaluado como adecuado en estructura y funcionalidad. Se considera positiva la influencia que se espera de este para mejorar el aprendizaje del análisis de situación de salud de la comunidad.

Introduction: The analysis of the health situation is a fundamental investigation carried out in the Cuban health system, in which health is studied, the elements that determine it and the ways to improve it. Objective: To evaluate the design proposal of a scheme that contributes to the improvement of learning of the analysis of the health situation of the community for the residents of the Comprehensive General Medicine specialty, belonging to the Universidad de Ciencias Médicas de Guantánamo. Method: A descriptive pedagogical research was carried out in the aforementioned institution during the period March-July 2022. From a universe of 67 teachers who agreed to participate, 26 were selected by intentional sampling. To obtain primary data, three Likert-type questionnaires were applied to evaluate the scheme, taking into consideration the structure, functionality and contribution to learning. These questionnaires included the responses: Totally disagree, Disagree, Neither agree nor disagree, Agree and Totally agree. Data were summarized in absolute numbers and percentages. They were presented in frequency distribution tables. Results: The subtotals of Completely Agree and Agree responses on the structural and functional evaluation, as well as the expected influence of this to improve the learning of health situation analysis, were considered adequate when exceeding the standard. Conclusions: The proposed scheme is evaluated as adequate in structure and functionality. The influence expected from this to improve learning about the analysis of the community's health situation is considered positive.

Introdução: A análise da situação sanitária é uma investigação fundamental realizada no sistema de saúde cubano, no qual se estuda a saúde, os elementos que a determinam e as formas de melhorá-la. Objetivo: Avaliar a proposta de desenho de um esquema que contribua para a melhoria da aprendizagem da análise da situação de saúde da comunidade para os residentes da especialidade Medicina Geral Integral, pertencente à Universidad de Ciencias Médicas de Guantánamo. Método: Foi realizada uma pesquisa pedagógica descritiva na referida instituição durante o período de março a julho de 2022. De um universo de 67 professores que aceitaram participar, 26 foram selecionados por amostragem intencional. Para obtenção dos dados primários, foram aplicados três questionários do tipo Likert para avaliação do esquema, levando em consideração a estrutura, funcionalidade e contribuição para a aprendizagem. Esses questionários incluíram as respostas: Discordo totalmente, Discordo, Nem concordo nem discordo, Concordo e Concordo totalmente. Os dados foram resumidos em números absolutos e porcentagens. Eles foram apresentados em tabelas de distribuição de frequência. Resultados: Os subtotais das respostas Concordo Totalmente e Concordo na avaliação estrutural e funcional, bem como a influência esperada desta para melhorar a aprendizagem da análise da situação de saúde, foram considerados adequados quando excedem o padrão. Conclusões: O esquema proposto é avaliado como adequado em estrutura e funcionalidade.A influência que se espera disto para melhorar a aprendizagem sobre a análise da situação de saúde da comunidade é considerada positiva.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy

Seasonal and epidemiological characteristics of community-acquired pneumonia in Chuzhou in 2010 - 2022 / 公共卫生与预防医学

Objective To analyze the seasonal and epidemiological characteristics of community-acquired pneumonia (CAP) in Chuzhou from 2010 to 2022. Methods The epidemiological data of CAP in Chuzhou from 2010 to 2022 were obtained from the center for diseases control and prevention of Chuzhou City, Anhui Province. After inclusion and exclusion, a total of 1 053 cases were enrolled. General data were collected. Then the characteristics of CAP patients in terms of gender, age, regional and seasonal distribution and pathogenic bacteria distribution were analyzed. Results A total of 316 patients with CAP, with a prevalence rate of 30.01%, including 152 males (48.10%) and 164 females (51.90%). Regarding age, 86 cases (27.22%) at 19-40 years, 106 cases (33.54%) at 41-60 years, and 124 cases (39.24%) at >60 years, suggesting a statistical difference in the CAP detection rate among different genders and ages (P<0.05). Seasonally, 118 cases (37.34%) were detected in spring, 13 cases (4.11%) in summer, 49 cases (15.51%) in autumn, and 136 cases (43.04%) in winter, with the highest CAP detection rate in winter, followed by spring. Pathogenic bacteria were positive in 198 of 316 patients, with a detection rate of 62.66%. A total of 125 strains of pathogenic bacteria were detected in sputum culture, of which 138 cases were Gram-negative, mainly Escherichia coli (24.24%, 48/198), and 60 cases were Gram-positive, mainly Streptococcus pneumoniae (14.14%, 28/198). Among 198 patients positive for pathogen detection, 41 cases were detected in spring, 37 cases in summer, 56 cases in autumn and 64 cases in winter. The drug sensitivity results showed that Escherichia coli had the highest resistance rate to ampicillin and cefazolin, and was sensitive to imipenem and other antibiotics; Streptococcus pneumoniae has the highest resistance rate to penicillin and erythromycin, and is sensitive to vancomycin. Conclusion CAP is quite common in elderly population in Chuzhou from 2010 to 2022, with a high prevalence rate in spring and winter, and the prevention work of high-risk groups should be strengthened.

Construction and application of the “school-enterprise-community”linkage community pharmaceutical care mode based on the WeChat mini program / 中国药房

OBJECTIVE To construct the “school-enterprise-community” linkage community pharmaceutical care mode based on the WeChat mini program， upgrade the content and mode of community pharmaceutical care， and improve the quality of healthy life of the residents. METHODS Focusing on the pharmaceutical care needs of community residents， by integrating school， enterprise and community pharmaceutical resources， the WeChat mini program of “drug enjoying health” was created and the “online+offline” community pharmaceutical care mode was built. Using classified random sampling， mini program users were randomly selected as the observation group， and offline pair-assisted community residents as the control group. The intervention effects of the two groups were compared around the three aspects of medication health knowledge mastery， medication compliance and medication behavior. RESULTS The “drug enjoying health” mini program consisted of four modules：“ drug for health”，“ drug for warmth”，“ drug for safety”， and “personal information”. The “school-enterprise-community” linkage community pharmaceutical care mode based on the “drug enjoying health” mini program began to be applied in July 2022， with 6 185 users， 2 732 recovery records of expired drugs， 941 times of pharmaceutical care， and 3 354 consultation orders. After the intervention， the qualified rate of medication health knowledge mastery， complete compliance rate， and the correct rate of medication behavior in the observation group increased from 33.53% to 76.87%， 20.23% to 46.26%， and 49.71% to 89.80%， respectively； the proportion of the increase after the intervention was higher than that of the control group （P＜0.05）. CONCLUSIONS This mode has effectively improved the quality of community pharmaceutical care， improves the health awareness of community residents in drug use， and promotes the standardization， rationalization and safety of residents’ drug use.

Application and evaluation of management mode for the use of antimicrobial drugs in county-level medical communities led by anti-infective clinical pharmacists / 中国药房

OBJECTIVE To provide reference for improving the rational use of antimicrobial drugs in primary township medical institutions. METHODS Based on the county prescription pre-review center， a team led by anti-infective clinical pharmacists constructed the management mode for the use of antimicrobial drugs in county-level medical communities with clinical pharmacists as the main team by finding out the main problems in the use of antimicrobial drugs in primary township medical institutions， providing feedback on the problems， organizing relevant training for the problems， improving the customization rules of the prescription pre-review software， implementing the automatic interception and pharmacist online prescription review and other measures. Data on the use of antimicrobial drugs were collected and compared in the 15 primary township medical institutions between January-June in 2022 （before the implementation of the mode） and January-June in 2023 （after the implementation of the mode）. RESULTS Compared with before the implementation of the mode， the utilization rate of antimicrobial drugs in outpatients of primary township medical institutions decreased from 24.97% before the implementation of the mode to 19.39% after the implementation of the mode； the utilization rate of antimicrobial injection in outpatients decreased from 66.10% to 46.80%； the utilization rate of intravenous drip of antimicrobial drugs in outpatients decreased from 52.33% to 40.35%； the rates of combined use of antimicrobial drugs in outpatients decreased from 12.70% to 8.19%； the reasonable rate of antimicrobial prescribing in outpatients increased from 55.28% to 73.93%. After the implementation of the mode， the proportion of antimicrobial prescriptions for each diagnosis was basically the same as before； the defined daily dose system （DDDs） and proportion of a few antimicrobial drugs changed compared with before according to the anatomical therapeutic chemical classification of drugs， among which DDDs of lincomycin， gentamicin and other drugs declined significantly； DDDs of antimicrobial drugs for each classification was basically the same as before according to AWaRe classification. CONCLUSIONS The management mode of the use of antimicrobial drugs led by anti-infective clinical pharmacists is constructed in the prescription pre-reviewing center of county-level medical communities， which can effectively improve the rational use of antimicrobial drugs in the primary township medical institutions.

A Scoping Review of Biobehavioural Interventions to Improve PrEP Continuum of Care in Latin America

According to the literature, biobehavioural interventions or combined strategies would reduce the risk of HIV infection by more than 7,000 new cases each day, which would contribute to the battle facing Latin America, where despite the high incidence and prevalence of HIV in the region, access to PrEP (pre-exposure prophylaxis) is very limited. The objective of this research was, consistent with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to conduct a scoping review to assess the evidence of available outcome data on biobehavioural interventions and programs to address gaps in the PrEP continuum of care in Latin America. The search was conducted in the databases EBSCOhost, WoS, Scopus, and ProQuest, and include all studies published from 2010 to 2021. One hundred eighty-six studies were identified and evaluated according to the eligibility criteria in six stages starting with the elimination of duplicates until the selection of studies that met the previously mentioned criteria; at the end five studies were chosen which were submitted to the methodological quality assessment including compliance with ethical guidelines. Results show that biobehavioural interventions promoting PrEP in Latin America are effective in increasing condom use, decreasing HIV risk, and increasing PrEP awareness, uptake, adherence, and retention. The limited number of interventions in the PrEP continuum of care indicates a need for the uptake of dissemination and implementation science (D&I) frameworks. D&I could help facilitate the translation of evidence-based practices, interventions, and policies to address the HIV crisis in Latin America.

Según la literatura, las intervenciones bioconductuales o estrategias combinadas reducirían el riesgo de infección por VIH en más de 7000 nuevos casos cada día, lo que contribuiría a la batalla que enfrenta América Latina, región en la que, a pesar de la alta incidencia y prevalencia del VIH, el acceso a la PrEP (profilaxis preexposición) es muy limitado. De acuerdo con las directrices de PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), el objetivo de esta investigación fue realizar una revisión de alcance para evaluar la evidencia de los datos de resultados disponibles sobre intervenciones bioconductuales y programas para abordar las brechas en el continuo de atención de PrEP en América Latina. La búsqueda se realizó en las bases de datos EBSCOhost, WoS, Scopus y ProQuest, e incluyó todos los estudios publicados de 2010 a 2021. Se identificaron ciento ochenta y seis estudios, y se evaluaron de acuerdo con los criterios de elegibilidad en seis etapas, iniciando por la eliminación de duplicados hasta la selección de estudios que cumplieran los criterios previamente mencionados; al final se eligieron cinco estudios, los cuales fueron sometidos a la evaluación de calidad metodológica, incluyendo el cumplimiento de los lineamientos éticos. Los resultados muestran que las intervenciones bioconductuales que promueven la PrEP en América Latina son efectivas para aumentar el uso del condón, disminuir el riesgo de VIH y aumentar la conciencia, la aceptación, la adherencia y la retención de la PrEP. El número limitado de intervenciones en el continuo de atención de la PrEP indica la necesidad de adoptar marcos científicos de difusión e implementación (D&I); marcos que podrían ayudar a facilitar la traducción de prácticas, intervenciones y políticas basadas en la evidencia para abordar la crisis del VIH en América Latina.

Salud bucal y factores de riesgo en campesinos de la comunidad rural La Picadora, Yaguajay, Sancti Spíritus

Fundamento: El panorama económico y epidemiológico ha repercutido en la salud bucal de las comunidades rurales. Objetivo: Describir el estado de salud bucal, así como identificar factores de riesgo en 16 campesinos de la comunidad rural La Picadora. Metodología: En 2022 se realizó un estudio transversal descriptivo en 16 campesinos de la comunidad rural La Picadora, Yaguajay, Sancti Spíritus. Se hicieron entrevistas y examen bucal. Se calcularon indicadores epidemiológicos estomatológicos en el SPSS 16 y se resumieron los factores de riesgo mediante estadística descriptiva. Resultados: El índice de COP-D fue de 10.7 con predominio de dientes perdidos, el índice gingival fue de 1.4 y el de placa bacteriana de 1.0. Fue frecuente el desgaste de incipiente a moderado en menores de 60 años y de moderado a severo en mayores de 60 años. El 75 % de la muestra presentó oclusión normal o maloclusión mínima y el 94 % necesitó rehabilitación protésica. El 81.2 % consumió bebidas alcohólicas en los últimos 30 días, el 62.5 % ha fumado o fuma actualmente, el 87.5 % refirió el cepillado diario menor de 3 veces y el 43.8 % no asistió al estomatólogo en los últimos 10 años. Conclusiones: Se identificó la necesidad de atención estomatológica, así como la urgencia de acciones de prevención y promoción en esta comunidad.

Background: The economic and epidemiological panorama has impacted on oral health in rural communities. Objective: To describe the oral health status, as well as to identify risk factors in 16 farmers from the La Picadora rural community. Methodology: In 2022, a descriptive cross-sectional study was conducted in 16 farmers in the La Picadora rural community, Yaguajay, Sancti Spíritus. Interviews and oral examination were performed. Stomatological epidemiological indicators in SPSS 16 were calculated and risk factors were summarized using descriptive statistics. Results: The COP-D index was 10.7 with a predominance of missing teeth, The COP-D index was 10.7 with a predominance of missing teeth, the gingival index was 1.4 and the bacterial plaque index was 1.0. Incipient to moderate wear was frequent in people under 60 years of age and moderate to severe in over 60 years of age. 75% of the sample presented normal occlusion or minimal malocclusion and 94% required prosthetic rehabilitation. 81.2% consumed alcoholic beverages in the last 30 days, 62.5% have smoked or currently smokes, 87.5% referred the daily brushing less than 3 times a day and 43.8% did not attend a stomatologist in the last 10 years. Conclusions: The need for stomatological attention, was identified, as well as the urgency for prevention and promotion actions in this community.