Psychometry and estimation of cutoff points of Jefferson Scale of empathy in dental students.

OBJECTIVE: The objective of this study was to determine the psychometric properties of the 3-dimensional latent model of empathy on the Jefferson Scale of Physician Empathy instrument (version S), and to verify the existence of cutoff points capable of differentiating empathy measures classified as: "high," "medium," and "low" using data collected from observations of students from 11 dental faculties of 5 Central American and Caribbean countries (n = 3082) between 2015 and 2019. METHODS: This is an exploratory, "a posteriori," and non-experimental study. Factor structure and factor invariance by country and gender were analyzed. Hierarchical cluster analysis and bifactorial analysis were applied, and the data were normalized by cluster and by percentiles within them. RESULTS: Confirmatory factor analysis showed that the original model was replicable and fit the data, while multigroup analysis allowed assuming an invariant factor structure by country and by gender. There is reliability in the measurement made by the scale and its dimensions. CONCLUSIONS: The instrument has adequate psychometric properties, and cutoff values obtained allow people with lower or higher levels of empathy and its components to be classified. Therefore, these results solve the problem of comparing the scores and observed levels of empathy between dental schools within and between countries and between genders. Such comparisons were only possible since the original data of each study were made available for traditional statistical methods.

Reconsidering the 'Decline' of Dental Student Empathy within the Course in Latin America.

INTRODUCTION: The controversy over the presence of empathic decline within the course in students of medicine, dentistry and health sciences in general, has not fully been studied. This controversy could be partially solved if massive studies of empathy levels are made in similar cultural, social and economic contexts. MATERIAL AND METHODS: Empathy levels within the course were studied in eighteen dental schools from six countries in Latin America (2013). The mean of the empathy levels were used to study the behavior between first and fifth academic years. The values of empathy levels within the course were observed by applying the Jefferson Scale of Physician Empathy, the Spanish version. All these studies were cross-sectional. The value of means observed, were subjected to regression studies and further adjustment curves were obtained and the coefficient of determination were calculated. RESULTS: Six different models of behavior were observed, which found that five of them suffer empathic decline within the course, but with different final results: in some the decline persists until the fifth academic year and in others, this decline 'recovers' persistently until the fifth academic year. The sixth model is characterized by a constant and persistent increase of levels of empathy within the course until the last academic year. DISCUSSION: There are six different models for the behavior of means of levels of empathy within the course evaluated by a common methodology in eighteen dental schools from six countries of Latin America. These findings support the existence of variability of empathic response and a comprehensive approach is needed to find the causes that give rise to this variability. CONCLUSION: In dental students of Latin America, there is variability in the behavior of the distribution in means between the academic years of the dentistry schools examined in this study.

Introdução: A controvérsia sobre o declínio da empatia relativamente ao curso em estudantes de Medicina, Odontologia e Ciências da Saúde em geral ainda não foi completamente elucidada. Esta controvérsia poderia ser parcialmente solucionada se fossem realizados estudos significativos sobre os níveis de empatia em contextos culturais, sociais e económicos similares. Material e Métodos: Foram estudados os níveis de empatia com o curso em dezoito escolas de Odontologia de seis países na América Latina (2013). As médias dos níveis de empatia foram usadas para estudar o comportamento entre académicos do primeiro e quinto anos. Os valores de níveis de empatia para com o curso foram observados aplicando a versão em espanhol da escala Jefferson de Empatia Médica. Todos estes estudos foram transversais. O valor das médias observadas sujeito a tratamento estatístico de regressão, obtendo-se as subsequentes curvas de ajustes e calculado o coeficiente de determinação. Resultados: Foram observados seis diferentes modelos de comportamento, sendo que em cinco deles se verificou declínio da empatia, com diferentes resultados finais: em alguns, o declínio persistiu até o quinto ano académico e, em outros, o declínio 'recuperou-se' persistentemente até ao quinto ano académico. O sexto modelo caracterizou-se por um constante e persistente aumento nos níveis de empatia com o curso até o último ano académico. Discussão: Existem seis modelos diferentes para o comportamento das médias dos níveis de empatia para com o curso, avaliados por uma metodologia comum em dezoito escolas de Odontologia de seis países na América Latina. Estes resultados suportam a existência de variabilidade de resposta empática, sendo necessária uma abordagem compreensiva para encontrar as suas causas. Conclusão: Em estudantes de Odontologia da América Latina verifica-se variabilidade no comportamento da distribuição de meios entre os anos acadêmicos das escolas de odontologia examinadas neste trabalho.

Polymerase Chain Reaction for detection of Streptococcus mutans and Streptococcus sobrinus in dental plaque of children from Cartagena, Colombia / Reacción en cadena de la polimerasa para la detección de Streptococcus mutans y Streptococcus sobrinus en placa dental de preescolares de Cartagena, Colombia

Objectives: To detect the presence of Streptococcus mutans and Streptococcus sobrinus in dental plaque of children from Cartagena and correlate it to dental caries precavity stages, applying a standardized PCR-based technique for epidemiological purposes. Methods: Descriptive study using a non-probabilistic sample of 50 children between 3 and 5 years of age, preschoolers from a Caribbean population in Colombia. Criteria for selection were that children should exhibit plaque accumulations on the surface of the cervical margins of the rearmost molars, and placed in one of two study groups: carious lesions and sound surfaces. Dental plaque samples from both groups were subjected to molecular analysis and statistical analysis was applied to determine the difference between the two groups using the frequencies of presence of S. mutans, S. sobrinus or both in the two groups applying Fisher's exact test for association between the presence of microorganisms and the state of the tooth surface from where the dental plaque was taken. Results: The frequency of S. mutans in carious lesions was 76% and 24% in healthy surfaces. The frequency of S. sobrinus in carious lesions was 81.9% and 18.1% in caries-free surfaces. There was statistical significance between the presence of S. mutans and the presence of caries (p=0.001) and between the presence of S. sobrinus (p=0.02) and the presence of caries. There was no statistical significance between the presence of caries and the simultaneous presence of both microorganisms (p=0.08). Conclusions: The presence of S. mutans and S. sobrinus in dental plaque samples is highly prevalent and associated to non cavitated carious lesions, being the molecular identification of these microorganisms by PCR a sensitive, fast, and easy to use detection method for the mutans group of oral bacteria.

Objetivos: Detectar la presencia de Streptococcus mutans y Streptococcus sobrinus en placa dental de niños de Cartagena y relacionarlo con la caries dental en estadíos precavitacionales, estandarizándose la técnica basada en PCR para detectar a nivel epidemiológico la presencia de estos microorganismos. Métodos: Estudio de tipo descriptivo, a partir de una muestra no probabilística de 50 niños entre 3 y 5 años de los hogares infantiles de una población del Caribe colombiano. Como criterios de selección se tuvo en cuenta que los niños presentaran acumulaciones de placa dental sobre la superficie de los márgenes cervicales de los últimos molares. El estudio se dividió en dos grupos: lesiones cariosas y superficies sanas. Las mediciones se realizaron a partir de muestras de placa dental, sometidas a análisis molecular. El análisis estadístico se realizó a partir de las frecuencias de presencia de S. mutans, S. sobrinus o ambos en las lesiones cariosas y superficies sanas, utilizando la prueba exacta de Fisher para la asociación entre la presencia de los microorganismos y el estado de la superficie dental donde se encontró la placa. Resultados: La frecuencia de S. mutans para las lesiones cariosas fue 76% y 24% en superficies sanas. Con respecto a S. sobrinus, la frecuencia en lesiones cariosas fue 81.9% y 18.1% en superficies sin caries. La presencia de caries estuvo asociada significativamente en forma individual con S. mutans (p=0.001) o con S. sobrinus (p=0.02), pero no fue significante con la presencia simultánea de los dos microorganismos (p=0.08). Conclusiones: La presencia de S. mutans y S. sobrinus en muestras de placa bacteriana se considera un factor de asociación con la presencia de lesiones de caries precavitacionales, siendo la identificación molecular por PCR un método sensible, rápido y de fácil uso para la detección de bacterias del grupo mutans.

Prevención de la enfermedad oral en familias desplazadas por la violencia de la comunidad de Nelson Mandela Cartagena- Colombia / Prevention of oral disease in a community, displaced by violence in Cartagena- Colombia

Introducción y Objetivo: Las intervenciones con programas de promoción de la salud y prevención de la enfermedad oral han sido utilizadas en las comunidades vulnerables con el fin de evitar tratamientos de operatoria dental. El propósito de este estudio fue analizar los conocimientos, manejo y aplicación de los conceptos de salud y enfermedad oral, en familias desplazadas por la violencia. Materiales y Métodos: Un enfoque metodológico cualitativo, apoyado en el método de investigación acción participativa, fue utilizado en 15 familias desplazadas por la violencia con niños escolarizados. Para la recolección de la información se utilizaron los talleres, la entrevista individual estructurada, la entrevista a grupos focales y la observación. Resultados: Los pobladores lograron construir un nuevo conocimiento en el cual se estableció la salud como un proceso constituido por diferentes componentes (bienestar físico, mental y social). De igual manera, el método de enseñanza (IAP) permitió a los pobladores ser parte activa de la solución de sus problemas y dificultades, modificando conceptos vagos de salud y enfermedad y convirtiéndolos en personas inquietas en la búsqueda de situaciones que mejoren su calidad de vida, autoestima, motivación y sentido de pertenencia en la comunidad. Conclusiones: Es fundamental la interacción directa con la comunidad, donde se pueda conocer a fondo todos sus aspectos sociales y tomar este análisis como punto de partida para diseñar estrategias que permitan la intervención directa de la comunidad y mejorar su calidad de vida.

Introduction and Objective: The interventions with health promotion and prevention programs had been used in vulnerable communities, in order to reduce operative dentistry. The aim of the present study was to analyze the knowledge and application of health and illness concepts, in families displaced by violence. Materials and Methods: This project is based on a qualitative methodological focus, supported in the participatory action investigation method, including constructive and hermeneutical tools. 15 lower-income families displaced by violence and whose children were scholarized, were selected. Data collection was done through educational workshops, individual structured interviews, focus groups and observation of people responsible for the care of the children. Categories analyzed included Health and general illness, health and oral illness, prevention, knowledge on treatment of oral illnesses, oral health habits and social practices. Results: The settlers managed to build a new knowledge in which health was established as a process constituted by different components such as social, mental, and physical welll-being. Similarly, this technique of teaching (IAP) allowed settlers to participate actively in the solution of their problems and difficulties, modifying vague concepts of health and illness and becoming involved in looking for solutions that improve their quality of life, self-esteem, motivation and sense of belonging to the community. Conclusions: It is fundamental to have a direct interaction with the community, in order to know all its social aspects in depth. This analysis will serve as a starting point in order to design educational strategies that will permit direct intervention of the community and improve their quality of life.

Representaciones sobre los escenarios de prácticas en salud oral de los habitantes de la Boquilla-Cartagena de Indias 2005 / Social representations concerning oral health practice scenaries of the inhabitant of the Boquilla Cartegena de Indias 2005

Introducción y Objetivos: Este estudio caracterizo los escenarios de prácticas de salud oral de los pobladores del corregimiento de la Boquilla Cartagena de Indias, 2005. Materiales y Métodos: Estudio cualitativo que utilizó una aproximación a la etnografía. Se seleccionaron 10 familias donde se empleó en primera instancia la observación no participativa, la entrevista individual estructurada, la observación participativa, y la entrevista a profundidad. Resultados: Se logró percibir como los habitantes del sector muestran cierta apatía hacia las actividades individuales o colectivas que se relacionen con la salud oral. Se resalta que existen otras prioridades entre ellas la alimentación, el trabajo, y la vivienda con condiciones sanitarias adecuadas, y por ultimo la salud general, incluyendo en algunas ocasiones a la salud oral. De esta forma, la población de La Boquilla tiene una concepción muy clara de las instituciones que prestan el servicio de salud oral en la población, además reconocen al centro de salud como la institución que se encarga de brindarles estos beneficios y de enseñarles a prevenir las enfermedades, siendo el principal motivo de consulta odontológica la extracción de órganos dentarios que presenten sintomatología dolorosa. Conclusión: En este sentido se propone que la instauración de conocimientos para la adquisición y aplicación de buenos hábitos de higiene oral debe hacerse bajo una negociación de saberes, en donde el profesional tenga en cuenta el pensamiento y opinión del paciente como una alternativa más de salud...

Síndrome de sjogren caso clínico / Sjogren's Syndrome clinical case

Los autores presentan un reporte actualizado de los criterios clínicos y terapéuticos indispensables para el manejo del síndrome de sjogren(SS), acompañado de un caso clínico con manifestaciones orales. Se describen aquellos signos síntomas más relevantes de esta patología, las pruebas diagnósticas más aceptadas en la actualidad, haciendo énfasis en la biopsia de las glándulas salivales menores labiales y exponiendo la técnica adecuada para realizarla. Por último se concluye que el manejo de pacientes con SS debe realizarse interdisciplinariamente ya que sus alteraciones no son únicamente del área estomatognática.