RESUMO
El desarrollo de competencias transversales es un aspecto relevante en el currículum de pregrado de Odontología, sin embargo, existe escasa evidencia sobre su presencia en los planes de estudio nacionales. El objetivo de esta investigación fue conocer la presencia de asignaturas centradas en competencias transversales en la carrera de Odontología de las universidades chilenas. Se realizó un estudio descriptivo de diseño transversal, revisando las mallas curriculares publicadas en la web por cada universidad que dictó el pregrado de Odontología el año 2020, con proceso de admisión abierto. De las 19 universidades consultadas, todas exhibieron en sus mallas curriculares asignaturas asociadas a competencias transversales y distribuidas a lo largo de los seis años del plan de estudios. Al utilizar la agrupación de competencias transversales propuesta por el Proyecto Tuning América Latina, se observó que las asignaturas relacionadas con los procesos cognitivos asociados al aprendizaje eran las más numerosas y suponían el 41 % del total; las vinculadas con los valores sociales correspondieron al 34 %; las asociadas al contexto tecnológico e internacional representaron el 20 %; mientras que las relacionadas con las habilidades interpersonales, solo alcanzaron un 5 %. Debido a su escasa presencia, es posible concluir que gran parte de los aprendizajes relacionados con el entrenamiento en habilidades interpersonales se encuentren resguardados en el currículum oculto y que probablemente estén a cargo del modelaje docente que se realiza diariamente en la práctica clínica. Como propuesta de futuro, el estudio sugiere mejorar la formación en competencias transversales de los egresados de odontología de las universidades chilenas.
The development of transversal competencies is a relevant aspect in the dental undergraduate curriculum. However, there is insufficient evidence about its implementation in national curriculums. The aim of this research was to know whether or not the courses are focused on transversal competencies in dental programs of Chilean universities. To accomplish this, a descriptive, cross-sectional study was carried out. This research was based on the review of the curriculums published on the websites of each university that awarded undergraduate degrees in dentistry in 2020, and facilitated an open admission process. Of the 19 universities studied, all had courses associated with transversal competencies in their dental curriculum. These were distributed throughout the six years of the curriculum. Using the grouping of transversal competencies, as proposed by the Latin America Tuning Project, it was shown that courses related to cognitive learning processes were the most represented of the subjects, corresponding to 41 % of all courses studied. Those related to social values corresponded to 34 %; courses associated with informational technology and those within the international context represented 20 %; while the courses related to interpersonal skills only reached 5 %. Due to the fact that the courses related to interpersonal skills were scarce, it could be concluded that a large part of this learning is included in the hidden curriculum and is probably achieved via instructional modeling as part of the daily clinical practice. As a proposal for the future, this research suggests that we need to improve the training in transversal competencies for the dental graduates of Chilean universities.
Assuntos
Humanos , Faculdades de Odontologia/tendências , Educação em Odontologia/métodos , Estudantes de Odontologia/estatística & dados numéricos , Epidemiologia Descritiva , Competência Clínica , ProfissionalismoRESUMO
OBJECTIVES: To analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: Observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: The prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: Preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery.
Assuntos
Emoções , Procedimentos Ortopédicos , Dor Pós-Operatória/epidemiologia , Ferimentos e Lesões/cirurgia , Idoso , Feminino , Humanos , Masculino , Dor Pós-Operatória/psicologia , Período Pré-Operatório , Prevalência , Estudos RetrospectivosRESUMO
OBJECTIVES: to analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery. .
OBJETIVOS: analisar a relação entre o estado emocional pré-operatório e a prevalência e a intensidade da dor pós-operatória e explorar fatores preditivos de dor pós-operatória. MÉTODO: estudo retrospectivo observacional, realizado com 127 pacientes adultos submetidos a cirurgias ortopédicas e traumatológicas. A dor pós-operatória foi avaliada usando a escala numérica verbal e cinco variáveis do estado emocional: ansiedade, sudorese, estresse, medo e choro. Para a análise estatística, foram utilizados os testes do qui-quadrado, teste t de Student ou análise de variância e uma análise de regressão logística multivariada. RESULTADOS: a prevalência de dor pós-operatória imediata foi de 28%. A ansiedade foi o fator emocional mais comum (72%) e fator preditivo de risco para dor pós-operatória severa (OR: 4,60, IC 95%: 1,38 a 15,3, p<0,05, AUC: 0,72, IC 95%: 0,62 a 0,83). A idade exerceu efeito protetor (OR 0,96, IC 95%: 0,94-0,99, p<0,01). CONCLUSÃO: a ansiedade pré-operatória e a idade são fatores preditivos de dor pós-operatória em pacientes submetidos a cirurgias ortopédicas e traumatológicas. .
OBJETIVOS: analizar la relación entre el estado emocional preoperatorio y la prevalencia e intensidad de dolor postoperatorio inmediato y explorar los factores predictivos de dolor postoperatorio. MÉTODO: estudio observacional y retrospectivo realizado a 127 pacientes adultos de cirugía ortopédica y traumatológica. El dolor postoperatorio se evaluó con la escala verbal numérica y el estado emocional con 5 variables: ansiedad, sudor, tensión, miedo, lloros. Para el análisis estadístico se utilizaron las pruebas de χ2, t de Student o ANOVA y un análisis multivariado con regresión logística. RESULTADOS: la prevalencia de dolor postoperatorio inmediato fue del 28%. La ansiedad fue el factor emocional más frecuente (72%) y un factor de riesgo predictivo para el dolor postoperatorio moderado-intenso (OR: 4,60, IC95%: 1,38-15,3, p<0,05; AUC: 0,72, IC95%: 0,62-0,83). La edad ejercía un efecto protector (OR: 0,96; IC95%: 0,94-0,99, p<0.01). CONCLUSIÓN: la ansiedad prequirúrgica y la edad son factores predictivos del dolor postoperatorio en pacientes sometidos a cirugía ortopédica y traumatológica. .
Assuntos
Humanos , Masculino , Feminino , Idoso , Dor Pós-Operatória/epidemiologia , Ferimentos e Lesões/cirurgia , Procedimentos Ortopédicos , Emoções , Dor Pós-Operatória/psicologia , Prevalência , Estudos Retrospectivos , Período Pré-OperatórioRESUMO
Endoneurial nerve growth factor (30 ng) produced significant heat hyperalgesia in rats on postinjection days 3 and 5. The percentage of neuron profiles expressing the sensory neuropeptide substance P in the dorsal root ganglion (DRG), and the density and distribution of substance P immunoreactivity at the DRG and the dorsal horn remained essentially unchanged throughout the 10 days of study. NGF increased pain scores in the second phase of the formalin test on postinjection day 3, but not on days 5 and 10. Our results indicate that the observed heat hyperalgesia is not dependent on NGF-induced changes in SP content and release from primary sensory neurons.
Assuntos
Hiperalgesia/metabolismo , Fator de Crescimento Neural/metabolismo , Nociceptores/metabolismo , Células Receptoras Sensoriais/metabolismo , Substância P/metabolismo , Vias Aferentes/efeitos dos fármacos , Vias Aferentes/metabolismo , Animais , Gânglios Espinais/efeitos dos fármacos , Gânglios Espinais/metabolismo , Hiperalgesia/induzido quimicamente , Hiperalgesia/fisiopatologia , Imuno-Histoquímica , Masculino , Fator de Crescimento Neural/farmacologia , Nociceptores/efeitos dos fármacos , Medição da Dor , Limiar da Dor/efeitos dos fármacos , Limiar da Dor/fisiologia , Células do Corno Posterior/efeitos dos fármacos , Células do Corno Posterior/metabolismo , Ratos , Ratos Sprague-Dawley , Células Receptoras Sensoriais/efeitos dos fármacosRESUMO
Recent findings indicate that calcitonin gene-related peptide (CGRP) is involved in neuropathic pain, this peptide being up-regulated in a small population of large- and medium-sized primary sensory neurons after peripheral nerve injury. In adult animals, the expression of CGRP is regulated by nerve growth factor (NGF). After nerve injury, NGF is up-regulated at the injury site for several weeks, and this up-regulation contributes to the onset of neuropathic pain. Using immunohistochemistry, we investigated the time course of the effect of an endoneurial injection of NGF on the expression of CGRP in primary sensory neurons. NGF increased the percentage of medium- to large-sized DRG neuron profiles expressing CGRP, did not modify the percentage of small-sized neurons expressing CGRP, and increased CGRP expression in the laminae III and IV of the dorsal horn. The effects of NGF were evident as soon as 1 day after endoneurial injection, and lasted for 5 days. Ten days after the injection of NGF, the patterns of CGRP expression in the DRG were normal, whereas a slight decrease in CGRP content was observed in the dorsal horn. The injection of vehicle did not produce any change on CGRP expression in primary sensory neurons. These results suggest that endoneurial NGF is responsible for the increase in CGRP expression in some large-sized neurons and their central processes observed after nerve injury in animal models of neuropathic pain. Our findings contribute to the understanding of the role of NGF in neuropathic pain.