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Indexación: Scopus. Background. Oral health plays a crucial role in general health, quality of life and well-being of pregnant women and their newborns. In Chile, pregnant women have dental care guaranteed by law. However, due to the lack of previous epidemiological studies on the benefits of this guarantee, it is necessary to describe this situation and evaluate the need to change the methods of providing dental services. Objectives. The objective of this study was to describe the pattern of providing dental benefits resulting from the Explicit Health Guarantee – Integral Oral Health in Pregnant Women (GES-SOIE) program to pregnant women attending the Juan Soto Fernández Family Health Center, Concepción, Chile, in 2014–2015. Material and methods. A cross-sectional study of the electronic dental records of patients admitted to GES-SOIE was conducted. The variables studied were sociodemographic data, dental chair hours, non-attendance, treatment completion, and the type of referral to secondary healthcare (SHC). Results. Of 233 pregnant women, 65.2% were registered for non-attendance, 21.2% required referral to SHC and 76.4% completed their treatment. When performing logistic regression, it was found that for each non-attendance the chance of not completing the treatment increased 1.4 times. Conclusions. The level of non-attendance and opting out of the treatment in pregnant women is high, which hinders the proper functioning and effectiveness of GES-SOIE. © 2018 by Wroclaw Medical University and Polish Dental Society. http://www.dmp.umed.wroc.pl/en/article/2018/55/2/179/

Objective To report the adaptation and cultural validation of the Oral Health Literacy Instrument (OHLI) for the adult Chilean population attending public and university health services. Study design The original OHLI in English was translated to Spanish and back-translated, then a preliminary version was obtained following review by four experts. A pilot study was carried out in 30 patients, who were asked to assess their understanding of the questionnaire. The following variables were included: sociodemographic factors (sex, age, average monthly income, education and marital status); oral health (history of caries, periodontal disease and oral hygiene); oral health-related quality of life; health literacy; oral health literacy; and psychometric properties (internal consistency, temporal stability, convergent validity and predictive validity). Clinical examination and questionnaire administration were carried out at the public health centres where the participants were receiving treatment. Results A total of 482 persons participated in the study. The internal consistency was high; Cronbach's alpha values were 0.864 for the first section, 0.739 for the second section and 0.887 for the entire instrument. The temporal stability was good, and the intraclass correlation coefficient was >0.6. Regarding convergent validity, the correlation of Chilean version of OHLI (OHLI-cl) with health literacy was positively moderate to strong (r > 0.5 and ρ > 0.5) and statistically significant (P < 0.01). Regarding predictive validity, the correlation of OHLI with oral health damage was negatively weak to moderate (r < −0.2 and ρ < −0.2) and statistically significant (P < 0.01). Conclusion The OHLI-cl demonstrates adequate psychometric properties for measuring the oral health literacy in Chilean populations attending public and university health services.

Este trabajo desarrolla el diseño y la implementación de Unidades Didácticas Integradas (UDI) en el marco de la educación superior siguiendo el enfoque AICLE (Aprendizaje Integrado de Contenidos y Lenguas Extranjeras). El diseño y la implementación de una metodología conjunta ha permitido poner en práctica dichas UDI durante el curso 2015/2016 en diferentes ámbitos de contenido. Ello ha ofrecido datos relevantes sobre el nivel de lengua y contenidos que el alumnado ha adquirido. La integración de diferentes áreas en las dos ramas de conocimiento (Ciencias Sociales e Ingeniería) ha constituido un marco interesante y especialmente adecuado para la puesta en práctica de estas UDI en el marco de la Educación Superior Europea. This paper addresses the design and implementation of Integrated Didactic Units (IDUs) within Higher Education following the CLIL (Content and Language Integrated Learning) approach. The design of a joint methodology for different content areas has allowed the teaching staff herein to implement different IDUs along the 2015/2016 academic year. The data collected on initial and final language level and contents from the joint and complementary work of two different content areas (Social Sciences and Engineering) has offered an interesting working framework which we consider suitable for an EHEA teaching innovation after the analysis and discussion of our results.

Objective: To evaluate the relationship between the social determinants of health and the quality of life of women with various types of cancer aged 60 and over. Methodology: Quantitative, transversal study, with descriptive - correlational approach. The QLQ-C30 quality of life scale and sociodemographic data sheet were applied to 70 women aged 60 years and over diagnosed with cancer, from a public hospital, Concepcion province, Biobio region, Chile. Result: The average age of the women was 69.9 years (SD = 6.8), the predominant cancer was the breast, more than 50% of them were with chemotherapy and 72% in the advanced stage of the cancer (III -IV). The quality of life in the scales of physical, role, emotional, cognitive and social functioning, obtained values ​​over 63/100 points and in the overall health over 65/100 points; the symptoms of pain and fatigue obtained high scores compared with others. There was a statistically significant relationship with 2 Structural Social Determinants (education and occupation), and with 3 Intermediaries (tenure and housing status, and income satisfaction). Conclusion: The scores on the quality of life scale indicate a trend towards a good quality of life. However, it is negatively impacted by education, occupation, housing status and satisfaction with income received. It is necessary to focus on these social determinants in the assessment and care of elderly women with cancer, to propose interdisciplinary strategies that effectively improve their well-being and quality of life.

17 páginas Objetivo: evaluar las actitudes hacia el cuidado al final de la vida de enfermeras/os de la región Bío Bío, de Chile, y determinar las variables que ejercen mayor influencia sobre estas. Materiales y método: estudio descriptivo-correlacional y predictivo en 308 enfermeras/os que trabajaban en cuidados paliativos en centros de salud públicos. Se utilizaron las escalas de Actitudes hacia el cuidado al final de la vida de Frommelt, Inteligencia emocional, Actitudes hacia la muerte, Trabajo emocional y variables bio-sociodemográficas de experiencia y formación profesional. Resultados: la actitud hacia el cuidado al final de la vida mostró una tendencia favorable, presentando una asociación directa y estadísticamente significativa con: edad, experiencia laboral, mayor vínculo en tiempo y número pacientes terminales atendidos, y con la comprensión y regulación emocional. También se presentó una mayor actitud en el sexo femenino. La preferencia por trabajar en cuidados paliativos y ser formador en el área influyeron favorablemente en la actitud; al contrario, el miedo a la muerte y el trabajo emocional fingido influyeron negativamente la actitud. Conclusiones: se requiere formación profesional que aporte al modelo empírico, oriente la educación de actitudes hacia la muerte y que ayude al afrontamiento emocional y actitudinal hacia el cuidado al final de la vida. Objective: Evaluate attitudes towards end-of-life care among nurses from the Bío Bío region of Chile and determine the variables that exert the most influence in that respect. Materials and methods: This is a descriptive-correlational and predictive study of 308 nurses who work in palliative care at public health centers. The Frommelt Attitudes Toward Care of the Dying Scale was used, as were scales on emotional intelligence, attitudes toward death, emotional work and bio-demographic variables of experience and professional training. Results: The trend in attitude toward end-of-life care was shown to be favorable, and a direct and statistically significant association was found with age, work experience, more attachment over time, the number of terminal patients served, and with understanding and emotional regulation. The attitude was more prevalent among the females in the study and was influenced favorably by the preference for working in palliative care and by being a trainer in the area. On the contrary, it was negatively influenced by fear of death and feigned emotional work. Conclusions: There is a need for professional training that contributes to the empirical model, orients education on attitudes toward death, and helps with emotional coping and attitudes toward end-of-life care.

Introduction Oral health education/promotion interventions have been identified as cost-efficient tools to improve the oral health of the population. These interventions are regularly made in contexts where the target population is captive, for example, in health centres. In Chile, there are no oral health interventions delivered at home. Methods and analysis This community trial covers two disadvantaged urban areas in the province of Concepcion. Both sectors have public preschool education coverage with a traditional programme (TP) to promote oral health. The intervention will comprise four to six visits by dental hygienists trained in the delivery of a standardised oral health promotion programme using motivational interviewing (MI) at home. The experimental group will receive TP and MI, while the control group will receive only TP. If a positive and significant effect of MI is found, this will be administered to the control group. For a 50% reduction in the incidence of caries, a sample size of 120 preschoolers per group is estimated. Data will be gathered on demographic and socioeconomic variables; oral health outcomes using WHO oral health indicators (the prevalence and severity of caries, periodontal disease, dentofacial anomalies and oral hygiene); the oral health literacy of caregivers, measured by the Rapid Estimation of Adult Literacy in Dentistry and the Oral Health Literacy Instrument, both validated for the Chilean population. Assessments will take place at baseline and at 12-month follow-up. Ethics and dissemination The university bioethics committee approved this study (EI/21/2014). We will submit the trial’s results for presentation at international scientific meetings and to peer-reviewed journals. Trial registration number ACTRN12615000450516.

Con el objetivo de determinar si la escala de adherencia a la medicación de Morisky de 8 ítems (MMAS-8) es un instrumento útil en adultos mayores hipertensos que acuden a un centro de atención primaria, se realizó un estudio de campo con abordaje cuantitativo de evaluación de pruebas diagnósticas, en ancianos hipertensos del Programa de Salud Cardiovascular de Cabrero, Chile. Los resultados de la escala fueron comparados con la presión arterial y el método de recuento de comprimidos. La evaluación diagnóstica de la escala utilizando los métodos de referencia presión arterial y recuento de comprimidos dio como resultado: sensibilidad: 86%, 85%; especificidad: 56%, 58%; valor predictivo positivo: 60%, 65%; valor predictivo negativo: 84%. 81%. En conclusión, la escala permite detectar de forma simple, y a bajo costo, a personas que no son adherentes a su régimen de tratamiento medicamentoso. In order to determine whether the Morisky 8-item medication adherence (MMAS-8) is a useful instrument in elderly hypertensive patients attending a primary care center, we conducted a field study with a quantitative approach of evaluation of diagnostic tests in elderly hypertensive patients from the Cardiovascular Health Program Health in Cabrero, Chile. The results of the scale were compared with the blood pressure and the pill-count method. The diagnostic evaluation of the scale using the reference methods of blood pressure and pill count resulted: Sensitivity: 86%, 85%; specificity: 56%, 58%; positive predictive value: 60%, 65%; negative predictive value: 84%. 81%. In conclusion, the scale allows to detect in a simple way, and at a low cost, to people who are not adherent to their regimen of drug treatment.

ResumenIntroducciónEl estudio de la enfermedad periodontal (EP) ha presentado resultados imprecisos y heterogéneos debido a diversos factores, entre ellos, los métodos usados en la medición, las diferencias en el momento de definir el grado de afectación y los valores desde los cuales se consideraría que un paciente presenta EP. Existen múltiples índices periodontales utilizados frecuentemente en estudios epidemiológicos, cada uno con sus criterios y protocolos de medición.ObjetivoDeterminar la concordancia del valor de la prevalencia de la EP dada por algunos índices periodontales utilizados.Material y métodoSe realizó un estudio observacional transversal descriptivo en una población de 58 pacientes adultos de 35-44 años pertenecientes al CESFAM Lorenzo Arenas, Concepción, en el año 2013. Los examinadores fueron calibrados. Se realizó un examen con registro de boca completa midiendo 6 sitios por diente, con exclusión de los terceros molares, para medir pérdida de inserción clínica, profundidad de sondaje y hemorragia al sondaje. Los resultados se analizaron mediante el programa estadístico EPIDAT 3.0.ResultadosSe determinaron unos valores de prevalencia de EP muy distintos entre los indicadores evaluados, obteniéndose una variación de incluso 31 puntos en una escala porcentual. El análisis de la concordancia de los índices periodontales con el indicador CDC/AAP mostró que tanto ICEP, como CPI y CPITN lograron un buen valor kappa.ConclusiónA pesar de la gran diversidad de los índices con respecto a su formulación, se observó cierta concordancia entre algunos de ellos.AbstractIntroductionThe study of periodontal disease (PD) has shown inaccurate and heterogeneous results due to various factors, among them: most used methods to measure the illness, differences at the time of deciding the level in which it affects patients and the values from which a patient would be considered to suffer from PD. There are numerous periodontal indexes frequently used in epidemiological studies, each one with different criteria and measurement protocols.ObjectiveTo establish the agreement in PD prevalence value given by some periodontal indexes used.Material and methodA descriptive cross-sectional observational study was conducted on 58 adult patients between 35-44 years old belonging to Lorenzo Arenas Primary Health Care Center in Concepcion during the year 2013. All examiners who participated in the study were calibrated. A full mouth registration exam was carried out, measuring 6 places per tooth, not including the third molars, in order to measure the clinical attachment loss, probing depth, and bleeding on probing. The results were analyzed using EPIDAT 3.0 statistical program.ResultsVery different PD prevalence values were obtained using the measured indicators, having a variation of up to 31 points in a percentage scale. The analysis of the agreement in periodontal indexes with the CDC/AAP indicator showed ICEP, CPI and CPITN scored a good kappa value.ConclusionDespite the great diversity of the indices with respect to their formulation, some correlation between them was observed.

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) del año 2014 y 2015 del Grupo NADYA-SENPE. Métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2014 y la mismas fechas de 2015, y se procedió al análisis descriptivo y analítico de los datos. Resultados: en el año 2014, se registraron 3.749 pacientes y en 2015, 4.202; la prevalencia fue de 80,58 pacientes/millón de habitantes en el año 2014 y de 90,51 en 2015. Por sexos, hubo un 49,9% de mujeres en 2014 y un 50,3% en 2015. La edad media fue de 73 años (IIQ 59-83) en ambos años. Finalizaron 684 episodios de NED en 2014 y 631 en 2015, la causa principal fue el fallecimiento en el 54,9% y 50,4% de los casos, respectivamente. Los portadores de sonda nasogástrica presentan una edad media superior a los pacientes con cualquier otra vía (p < 0,001). Se registraron 67 pacientes pediátricos en 2014 (56,7% niñas) y 77 en 2015 (55,8% niñas). La vía principal de administración fue la gastrostomía en el 52,0% de los casos de 2014 y sonda nasogástrica en el 50,8% de los casos de 2015. La causa principal de fi nalización de la nutrición fue el fallecimiento (57,1% en 2014 y 38,5% en 2015). Se observó que los niños más pequeños eran los que se alimentaban preferentemente por SNG (p 0,004 vs. 0,002).Tanto en pacientes pediátricos como en adultos el diagnóstico principal que motivó la necesidad de NED fue la enfermedad neurológica que cursa con afagia o disfagia severa. Conclusiones: se ha incrementado el número de pacientes del registro, así como el número de centros participantes y el número medio de pacientes comunicados por cada centro respecto a años anteriores, sin que se hayan modificado sustancialmente las características de los pacientes, salvo mayor duración de los episodios, Objective: To present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2014 and 2015. Methods: From January 1st 2014 to December 31st 2015 the HEN registry was recorded and afterwards a further descriptive and analytical analysis was done. Results: In 2014, 3749 patients were recorded, and 4202 in 2015; prevalence was 80.58 patients/one million inhabitants in Spain in 2014 and 90.51 in 2015. There were 49.9% females in 2014 and 50.3% in 2015. Median age was 73 years (IQI 59-83) in 2014 as well as in 2015. 684 episodes fi nished in 2014 and 631 in 2015, with death as the main cause, in 54.9% and 50.4%, respectively. The ones who were fed through nasogastric tube had a mean age higher than the ones fed by any other route (p-value < 0.001). Sisty-seven paediatric patients were recorded in 2014 (56.7% females) and 77 in 2015 (55.8% females). Median age at the beginning of HEN among children was 5 months in 2014 and 5 months in 2015. The main route of administration was gastrostomy, in 52.5% in 2014 and nasogastric tube in 50.8% in 2015. 7 episodes fi nished in 2014 and 13 in 2015, having death as the main cause (57.1% in 2014 and 38.5% in 2015). It was found that were younger children the ones who were mainly fed by nasogastric tubes (p-value 0.004 vs. 0.002). Among paediatric patients as well as adults, the main diagnosis leading to HEN was neurological disease which gives aphagia or severe dysphagia. Conclusions: There has been an increase in the number of patients in the registry as well as the participating centers and the number of patients per center, without any signifi cant change in the characteristics of the patients other than longer duration of the episodes

espanolEl objetivo de este estudio fue valorar la intensidad del dolor en los recien nacidos frente a procedimientos de enfermeria, que les fueron realizados con ocasion de los cuidados y tratamiento. Se sustento desde la vision humanista del cuidado de Jean Watson. Metodologia: Estudio descriptivo-correlacional, de corte transversal, cuya poblacion estuvo constituida por recien nacidos hospitalizados en la Unidad de Neonatologia del Hospital Clinico Herminda Martin de Chillan, en el periodo de junio a septiembre del ano 2015. Para Valorar el dolor se aplico la escala de valoracion del dolor de Susan Givens Bell y un cuestionario semiestructurado de variables sociodemograficas. Resultados: La muestra estuvo conformada por 52 Recien Nacidos en un porcentaje igual de hombres y mujeres El mayor numero de procedimientos realizados fueron instalacion de sonda orogastrica, puncion venosa y arterial, siendo esta ultima la causante de dolor moderado en el R.N. El nivel de dolor presentado por la muestra, fue en un 42,3% dolor intenso, el 23,1% dolor moderado y en un 34,6 % no presento dolor. El Instrumento presento una confiabilidad con un alfa de Crombach de 0,802. Conclusiones: Los prematuros menores de 37 semanas sintieron mayor dolor que los RN de termino.El peso de nacimiento se observo que a mayor peso mayor es el dolor. El APGAR de nacimiento en el estudio se observo que hay una relacion directa, pero debil, que a mayor APGAR al nacer, mayor es dolor. EnglishABSTRACT: This study was aimed to assess the intensity of pain in newborns against nursing treatments, which were performed during care and treatment. This was sustained from the humanist view of Jean Watson. Method: A cross-sectional descriptive-correlational study, whose population consisted of newborns hospitalized at the Neonatology Unit of the Herminda Martin Clinical Hospital of Chillan, Chile, in the period between June and September, 2015. In order to assess pain, Susan Givens Bell Assessment Scale was applied, as well as a semi-structured Questionnaire of sociodemographic variables. Results: The sample consisted of 52 newborns in an equal percentage of men and women. The greatest number of procedures was the nasogastric tube insetion, venipuncture and arterial puncture, being the latter the cause of moderate pain in newborns. The level of pain presented by the sample was 42.3% intense pain, 23.1% moderate pain and in 34.6% no pain was presented. The instrument presented reliability with a Cronbach’s alpha of 0.802. Conclusions: Premature infants under 37 weeks felt greater pain than full-term newborns. Regarding Barth weight, it was observed that the greater the weight, the grater the pain. Birth APGAR in the study indicated that there is a direct but weak relation and the higher APGAR at birth, the greater the pain.

A prospective, controlled, and randomized clinical study was carried out with the purpose of evaluating the influence of somatostatin in the evolution of acute pancreatitis. One hundred patients were randomly divided into two groups, a control group (n = 50 patients) and a somatostatin group (n = 50 patients to whom a dosage of 250 micrograms/h was administered for 48 h following a bolus of 250 micrograms at the beginning of therapy). The two groups were homogeneous in age, sex, etiology, and severity of clinical picture (on admission). The following parameters were compared in the two groups: 1. Evolution of the Computerized Axial Tomography (CT) findings on admission and after 48 h; 2. Length of hospital stay; 3. Need for surgery; and 4. Mortality. The results from the CT scans showed a significant statistical difference in favor of somatostatin regarding the evolution of pancreatic lesions and length of stay in the hospital. Another study using a larger sample would be required in order to evaluate the rest of the parameters.