A service-learning framework to address accreditation standards: Self-Assessment, communication skills, health literacy, and cultural competence.

OBJECTIVES: Pre-doctoral dental programs must provide opportunities for students to become proficient in self-assessment, communication skills, health literacy, and cultural competence, essential for independent unsupervised practice. This study aimed to assess how student learning through a classroom education service-learning program addresses the Commission on Dental Accreditation (CODA) standards 2-11 and 2-17; specifically through the examination of self-assessment, communication skills, health literacy, and cultural competence. METHODS: This 2022 retrospective mixed methods cohort study examined unstructured faculty comments on drafted lesson plans and structured evaluations of classroom education service-learning rehearsal sessions. A random sample of faculty comments from three academic years, 2018, 2019, and 2020, were deidentified and analyzed by five researchers for emerging themes using NVivo. Quantitative data from rehearsal presentations were analyzed with descriptive statistics to assess the concordance of self and faculty feedback on specific evaluation criteria. RESULTS: Six major themes from faculty lesson plan feedback emerged: knowledge, professionalism, communication, presentation skills, cultural competence, and program logistics. Concordance between faculty feedback and student self-assessment ranged from 83% to 92.4% across all evaluation criteria over the 3 years: spoke clearly and confidently at the right pace, provided accurate dental terminology and facts, used grade-appropriate language, provided clear instructions to follow, appeared enthusiastic throughout the rehearsal presentation, and designed a well thought out lesson plan that will engage children for the entire presentation. CONCLUSION: Findings support the classroom education service-learning program as a framework to provide opportunities for student self-assessment and feedback on communication skills, health literacy, and cultural competence aligned with CODA standards 2-11 and 2-17.

Promoting Children's Health Equity With Medical-Dental Integration.

BACKGROUND: Successful medical-dental integration is key to achieving children's health equity. In 2015, a community health center (CHC) in Boston, Massachusetts, implemented a model of interdisciplinary care in a nationwide pilot. Based on the Oral Health Delivery Framework, pediatricians were trained to assess dental caries risk and apply fluoride varnish. They were trained to offer education materials to patients, incorporate oral health assessment in pediatric practice, and document preventive dental care in the electronic health record. This study assessed the level of medical-dental integration achieved by the pilot and maintained over 2 years after program implementation. METHODS: Deidentified data were provided by the CHC on all well-child visits during 2014 to 2018 for children 72 months or younger, including appointment dates, age, ethnicity, race, insurance status, and outcomes of interest (ie, whether a dental assessment was performed and whether fluoride varnish was applied). Outcomes were stratified by visit year to allow pilot (2015-2016) outcomes to be compared to pre-pilot (2014) and post-pilot (2017-2018) outcomes. Descriptive statistics were used to summarize the data. RESULTS: Pediatricians performed fluoride varnish applications and dental assessments in 25% and 0% of visits, respectively, at baseline; in 50.2% and 49.4% of visits, respectively, at the pilot's end; and in 56.7% and 57.3% of visits, respectively, 2 years post-pilot. CONCLUSIONS: The proportion of well-child visits during which pediatricians integrated oral health preventive measures increased by roughly 25% to 50% from baseline (2014) to the end of the pilot (2016) and by at least 5% from 2016 to 2018. The success of this medical-dental integration pilot underscores the need for broader implementation of interprofessional education and practice to promote children's health equity.

Hidroxicloroquina para manejo de infección por SARS-CoV-2 Una revisión exploratoria / Hydroxychloroquine for treatment of SARS-CoV-2 infection An exploratory review

Resumen Introducción: la hidroxicloroquina se ha venido postulando en estos tiempos de pandemia como posible tratamiento eficaz frente a COVID-19. Esto ya que se ha demostrado por expertos chinos su capacidad para inhibir la replicación viral usando distintos mecanismos. En este momento es de vital importancia tener conocimiento acerca de las últimas investigaciones y ensayos clínicos en lo que respecta a un esquema de tratamiento efectivo que ayude a un mejor manejo de pacientes con infección por SARS-CoV-2. Objetivo: presentar la información disponible sobre el uso de hidroxicloroquina como opción de manejo para pacientes infectados por SARS-CoV-2. Material y métodos: se realizó una revisión siguiendo el marco metodológico sugerido por Arksey y O'Malley. Las bases de datos utilizadas fueron: PubMed, MedLine, Lilacs, Scopus, Clinical Trials, Cochrane y CNKI. Se incluyeron únicamente textos en español e inglés, finalmente se realizó una caracterización y resumen de los estudios pertinentes para esta revisión. Resultados: se incluyeron en la revisión 87 artículos académicos incluyendo estudios experimentales y no experimentales; todos con evidencia sobre el uso de hidroxicloroquina en COVID-19. Conclusiones: A la fecha no hay información científica disponible que sustente y tenga la suficiente evidencia para soportar el uso de la hidroxicloroquina como tratamiento farmacológico en la pandemia actual. Dos ensayos clínicos aleatorizados se contradicen en cuanto a la efectividad de la hidroxicloroquina; sin embargo, ambos comparten errores metodológicos y tamaños de muestra limitados; y un único ensayo no aleatorizado con los mismos errores demuestra efectividad de la hidroxicloroquina. En cuanto al perfil de seguridad se cuenta con información que evidencia una menor tasa de efectos adversos de la hidroxicloroquina frente a la cloroquina por lo que se preferiría su uso en caso de demostrar efectividad frente a COVID-19. Existen varios ensayos clínicos aleatorizados en curso que se espera esclarezcan las dudas que surgen al revisar la literatura.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1880).

Abstract Introduction: hydroxychloroquine has been recommended in this pandemic as a possible effective treatment for COVID-19. This is because Chinese experts have demonstrated its ability to inhibit viral replication through various mechanisms. At this juncture, it is vitally important to understand the latest research and clinical trials regarding an effective treatment regimen which would help improve the treatment of patients with SARS-CoV-2 infection. Objective: to present the available information regarding the use of hydroxychloroquine as a treatment option for patients infected with SARS-CoV-2. Material and methods: a review was carried out following the methodological framework proposed by Arksey and O'Malley. The data bases used were: PubMed, MedLine, Lilacs, Scopus, Clinical Trials, Cochrane and CNKI. Only texts in Spanish and English were included. Finally, the pertinent studies for this review were described and summarized. Results: a total of 87 academic articles were included in the review, including experimental and non-experimental studies, all containing evidence regarding the use of hydroxychloroquine in COVID-19. Conclusions: To date, there is no available substantiating scientific data with enough evidence to support the use of hydroxychloroquine as a pharmacological treatment for the current pandemic. Two randomized clinical trials contradict each other regarding the efficacy of hydroxychloroquine. However, they both share methodological errors and have small sample sizes. A single nonrandomized trial with the same errors shows efficacy of hydroxychloroquine. As far as the safety profile, there is data showing a lower rate of adverse effects for hydroxychloroquine compared with chloroquine, so its use would be preferred if it were to be proven effective against COVID-19. There are several randomized clinical trials underway which, it is hoped, will answer the questions raised by the literature review.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1880).

Asociación entre tamización de cáncer de próstata, vinculación al sistema de salud y factores asociados en adultos mayores: análisis secundario de la encuesta SABE Bogotá, Colombia / Relationship between prostate cancer screening, linkage to the health system and associated factors in older adults from Bogotá, Colombia: Secondary analysis of the SABE survey

Introducción y objetivos El cáncer de próstata es una enfermedad con alta prevalencia en nuestra población. Su diagnóstico temprano es importante para mejorar el pronóstico de esta enfermedad. El objetivo de este artículo es evidenciar los factores asociados a la oportunidad de tamización en adultos mayores de la ciudad de Bogotá, Colombia. Métodos Se analizaron los datos del estudio Salud, Bienestar y Envejecimiento (SABE) Bogotá 2012, que incluyó a 736 hombres de 60 años o más. Se utilizó como variable dependiente el autorreporte de examen de próstata en los 2 últimos años y se evaluó con respecto a factores sociodemográficos por medio de un análisis multivariado. Resultados Se encontró una prevalencia de cáncer de próstata del 3,15%. El 57,8% de los hombres se habían realizado al menos un examen de próstata. Aquellos afiliados al régimen contributivo tenían mayor oportunidad para ser tamizados con respecto a los vinculados/no asegurados (OR: 8,81) (IC95%: 2,92-26,63) (p < 0,001), al igual que los del régimen subsidiado (OR: 3,70) (IC95%; 1,20-11,41) (p = 0,023). Conclusión Existe una inequidad en cuanto a la oportunidad de tamización de cáncer de próstata según el tipo de seguridad social, por lo que se deben optimizar las estrategias de detección temprana que fortalezcan la inclusión de toda la población. Se necesitan más estudios que brinden mayor información sobre esta problemática.

Introduction Prostate cancer is a high prevalence disease in our male population. Early diagnosis is important in order to improve its prognosis. The aim of this article is to describe the factors associated with prostate cancer screening of older adults in Bogotá, Colombia. Materials and methods The study used data from the Bogotá 2012 Health, Well-Being, and Ageing (Salud, Bienestar y Envejecimiento [SABE]) survey, which included 736 men aged 60 years or older. The dependent variable used was self-reported prostate screening in the last 2 years. An analysis was performed to determine the between this variable and socio-demographic variables and comorbidities using multivariate analysis. Results There was a prevalence of prostate cancer of 3.15%, with 57.8% of the population having had at least one prostate examination. Those affiliated to a health insurance scheme were more likely to be screened than the uninsured with an OR: 8.81, 95% CI: 2.92-26.63, P < .001, as those affiliated to subsidized social security health scheme OR: 3.70, 95% CI: 1.20-11.41, P = .023, respectively). Conclusion There is inequity in the opportunity of screening for prostate cancer according to the type of health insurance scheme. Early detection strategies must be strengthened in order to include the entire population. Further studies are needed to provide more information on this issue.