Comparison of the def index with Nyvad's caries diagnostic criteria in 3- and 4-year-old Colombian children.

PURPOSE: The aims of this research were to determine the epidemiological profile of dental caries in 3- and 4-year-old preschool children living in Bogotá, Colombia, and to compare two different caries indices--the standard def and Nyvad's new caries diagnostic criteria. METHODS: The children were screened by two calibrated examiners who first brushed the children's teeth and air dried them for 5 seconds before they were examined. The diagnostic criteria used were the standard def-t and def-s and the def-t and def-s of the new caries diagnostic system proposed by Nyvad. The chi-square test2 was used with a significance level of 5%. RESULTS: Prevalence of caries was 70% using the standard def-t criteria and 97% with the criteria proposed by Nyvad. The standard def-t and def-s were 3.3 and 5.7, respectively, and the def-t and def-s with the Nyvad citeria were 8.7 and 14.3, respectively. CONCLUSIONS: Prevalence of caries was high, indicating that the population studied had a high disease rate. The results obtained with the more detailed Nyvad new caries diagnostic criteria were higher than the ones obtained with the standard def-t index, both for teeth and surfaces.

La calidad asistencial y la competencia médica en la práctica clínica de emergencias, evaluada a travésde un sistema de valoración del desempeño en la escena / Health care quality and medical competencies in the practice of emergency medicine: on-scene job performance evaluation

Objetivo: Mostrar el sistema de valoración del desempeño médico de un servicio de emergencias extrahospitalario y detectar si existe asociación existente entre el tiempo de experiencia y la evolución en la competencia médica de los médicos de nueva incorporación, a través de un sistema de valoración del desempeño (VD) en la asistencia. Método: Estudio prospectivo observacional de cohortes con observación directa del proceso asistencial. Se establecen 4 grupos de médicos según los años de experiencia en emergencias extrahospitalarias: A (0-1 años), B (2-3 años), C (4-5 años) y D (> 5años), cuyos resultados en VD se comparan. Resultados: Se realizaron 6.450 observaciones asistenciales entre el año 2006 y el2010 que incluyeron 85 médicos: 22 del grupo A, 21 del grupo B, 16 del C y 26 del D, sin diferencias significativas en edad, sexo y media de observaciones entre grupos. El perfil en formación especializada en el grupo de médicos de nueva incorporación(grupos A, B y C) frente a los antiguos (grupo D) fue mucho mayor. 68,2% en el A vs11,5% en el D (p < 0,05) y 61,9% en el B vs 11,5% en el D (p < 0,05). Se encontraron diferencias estadísticamente significativas en la VD del grupo A (p < 0,001) y del grupo B (p = 0,049) frente al grupo D. La mayor tasa de VD suficiente está entre los 3y 4 años. Conclusiones: En nuestro estudio, sólo cuando el urgenciólogo tiene una experiencia de4-5 años presta una calidad asistencial comparable a la de los médicos más experimentados, según el sistema de VD in situ que se describe (AU)

Objective: To demonstrate a job performance evaluation system for an out-of-hospital emergency service. The specific aim was to study the association between length of experience and the demonstration of medical competencies by means of job performance evaluations of newly hired physicians. Methods: Prospective observational cohort study based on direct observation of the care process in the Madrid Emergency and Rescue Service (SAMUR). Four subgroups were identified according to years of experience in this out-of hospital emergency service: up to 1 year, up to 3 years, up to 5 years, and 5 years. The job performances of physicians in the different groups were compared to that of the most experienced physicians. Results: A total of 6450 care process observations were carried out between 2006 and 2010. Twenty-two had worked for up to 1 year, 21 for up to 3 years, 16 for up to 5 years, and 16 for 5 years. There were no significant differences between the groups in age, sex, or mean number of performance observations. Considerably more newly hired physicians had specialist training. Only 11.5% of the most experienced physicians had such training, whereas 68.2% of those with up to 1 year’s experience and 61.9% of those with up to 3 years’ experience had training (P<.05). In the job performance comparisons by years of out-of-hospital emergency practice experience, significant differences were found between the evaluations of the most experienced ( 5 years) and those with only up to 1 year on the job (P<.001) and also between the most experienced and those who had been on the job between 2 and 3 years (P=.049). The largest number of satisfactory ratings came in the group of physicians with 3 to 4 years of experience. Conclusions: On-scene job performance evaluations revealed that only physicians with between 4 and 5 years of experience were able to provide emergency care comparable to that given by physicians with more 5 years of experience (AU)

Violencia de género: detección precoz y abordaje integral desde los servicios extrahospitalarios de emergencias / No disponible

Introducción: la ciudad de Madrid dispone de un sistema integral de actuación contra la VG (Violencia de Género) en la que la petición de ayuda por parte de una víctima de violencia doméstica será codificada como 5.7, activándose una unidad de SAMUR-Protección Civil junto con otra de UAPF (Unidad de Atención y Protección a la Familia) e iniciándose la atención sanitaria y psicológica urgente y la protección a la víctima. El SAVD (Servicio de Atención de Violencia Doméstica) y el PMORVG (Punto Municipal del Observatorio Regional de Violencia de Género) serán los últimos eslabones para facilitar la reinserción al tejido social de la víctima. Según el 016, el 24,9% de las llamadas relacionadas con VG proceden deMadrid, el 80,2% las realiza la propia víctima. El perfil es el de una mujer casada en el 51% casos, con hijos en el 90,6% y su edad no supera los 40 años en el 59,3%. El nivel de estudios es primario y se dedican a las tareas del hogar mayoritariamente. Las lesiones presentes en las víctimas tienen el siguiente mecanismo lesional: arma blanca (46,8%), arma de fuego (16,1%), traumas contusos (13,6%), estrangulamiento (8,7%). Objetivos: obtener datos estadísticos de la actividad derivada del procedimiento de actuación (SAMURProtección Civil-UAPF-SAVD-PMORVG) ante la VG y estudio del perfil de las personas atendidas. Material y método: estudio observacional, descriptivo, transversal, retrospectivo de las asistencias realizadas por SAMUR-Protección Civil de código 5.7 VG desde diciembre de 2007-diciembre 2009, coincidiendo con la entrada en vigor de las medidas de prevención y protección integral contra VG en la Ley 13/2007. Consulta archivo de informes de asistencia, bases de datos del servicio, memoria de actividad y protocolo de SAVD, PMORVG, UAPF y 016. Resultados: SAMUR-Protección Civil realizó 2.102 intervenciones por VG, de las cuales 1.938 son resueltas en el lugar por una unidad SVA y derivadas al SAVD. De ellas 164 precisan traslado a centro sanitario, siendo los hospitales: 12 de Octubre (35), Gregorio Marañon (32), Clínico (26) los principales receptores. La demanda de asistencia sanitaria proviene de Policia Múnicipal (1.466), Policia Nacional (421) y Madrid 112 (166) y se realiza en la propia comisaría (1.140), vía pública (516) y en el domicilio o alrededores (446). Esta se produce los domingos (486), sábados (350) y viernes (269); en los meses de Diciembre (226), Junio (210), Mayo (207), Enero (197), Febrero (194) y Julio (178); en horario de tarde (916), mañana (597) y noche (589). La edad de las pacientes es de 31/40 años (873), 18/30 años (803) y de 41/50 años (277) y su distrito de residencia es: Villaverde (245), Tetúan (226), Puente Vallecas (184), Ciudad Lineal (168) y San Blas (153)...(AU)

Introduction: The city of Madrid has a comprehensive system of performance against VG in which the request for help from a victim of domestic violence will be coded as 5.7 SAMUR activating a unit, along with other Civil Protection of health care starting UAPF urgent psychological and protection to the victim. The PMORVG Savda and will be the final links in the social reintegration of the victim. According to 016, 24,9% of the calls regarding genderbased violence came from Madrid, 80,2% were phone calls the victim made and this average victim is married in the 51% of the cases and has children in the 90,6%, and her age was up to 40 y.o. in 59,3% of the cases. The victim’s studies level is Primary and they are mainly housewives. The violence was caused by: White weapons (46,8%), Guns (16,1%), Contusions (13,6%) or Strangulation (8,7%). Background: To obtain stadistic figures about act proceedure (SAMUR-Protección Civil-UAPF-SAVDPMORVG) and to study the patients that were attended. Methodology: Observation, description, transversal, retrospective from the assistances by SAMUR-Protección Civil 5.7 code (Domestic Violence) from December 2007 to December 2009, coinciding with the enforcement date of the prevention and fully protection measures against Domestic Violence that are part of the 13/2007 Spanish Law. Files seeking, memory and other sources (SAVD, PMORVG, UAPF and 016). Results: SAMUR-Protección Civil attended 2.102 situations caused by Domestic Violence, 1.938 were fixed in the place by a SVA unit and referred SAVD; regarding the other 164 cases, transfer to a medical center were needed, and the most frequently used Hospitals were: 12 de octubre (35), Gregorio Marañon(32), Clinico(26). The medical service requirement comes from Local Police (1466), National Police (421) and also from Madrid 112 Service (166) and this requirement is made from the Police Station (1140), from the street (516) or from a home address or nearby (446). The requirements are made on Sunday (486), Saturday (350) and Friday (269) during the months of December (226), June (210), May (207), January (197), February (194) and July (178), in the afternoon (916), morning (597) and evening/night (589). The patient’s average age is 31/40 y.o. (873), 18/30 y.o. (803) and 41/50 y.o. (277) and their neighborhood is: Villaverde (245), Tetúan (226), Puente Vallecas (184), Ciudad Lineal (168) and San Blas (153). They were Spanish in 1.352 of the situations and 750 were foreigners. The main reasons why assistance was needed were: injuries and minor contusions (1690), facial trauma (79), orthopedic trai,a (54), anxiety attack (53), (42) thoracic trauma (17) and neck trauma (12). Throughout the time the study took, 131 women were mortal victims by Domestic Violence: 21 of them died in Madrid region and 8 of them were in Madrid city. Half of these 8 victims were in Puente de Vallecas(AU)