Marco Cornejo-Ovalle | Universidad de Chile (original) (raw)

Papers by Marco Cornejo-Ovalle

Research paper thumbnail of Factors influencing professionalism during dental training at the University of Chile: perception of students and patients

BMC Medical Education, May 17, 2023

Background The University should be considered a favourable space and agent for the training and ... more Background The University should be considered a favourable space and agent for the training and transmission of values and attitudes related to professionalism, such as responsibility, teamwork and ethical commitment. In addition, dentistry is a profession with a deep social sense that seeks to solve the oral health problems of the population to improve the quality of life. In this context, our aim was to explore the perception of students and patients about the contribution of the curriculum to the development of professionalism and to identify the factors that strengthen and weaken this perception. Methods A qualitative approach was carried out through focus groups and semi-structured interviews with students from the 4th, 5th and 6th year of training and patients treated at the Dental Clinic of our Faculty. Results In the opinion of patients and students, the factors that debilitate the training in professionalism are associated with weakened professional values/behaviours in the training, the lack of teacher training of the professors and factors of educational environment. On the contrary, factors strengthening the professionalism are mainly related to hallmark values/ professional behaviours trained in the institution and to the good evaluation by patients. The respondents also perceive the implementation of a new curriculum as a positive factor for the training in professionalism. Conclusion The patients and students interviewed believe that the main strength for the training in professionalism in the institution is the development of adaptability for the future professionals to any social context, especially to a vulnerable one, the ability to solve the problems they face and the responsibility towards the patients and their treatment.

Research paper thumbnail of Manifestaciones orales y recuento de linfocitos T CD4+ en pacientes adultos con infección por VIH atendidos en el Hospital San Juan de Dios. Santiago, Chile

Revista Chilena De Infectologia, 2022

Background: Oral lesions classified as strongly associated with HIV infection occur in cases of s... more Background: Oral lesions classified as strongly associated with HIV infection occur in cases of severe immunosuppression (CD4+ T lymphocyte count ≤ 200 cells/mm 3 of blood). Aim: To associate the presence of oral lesions strongly associated with HIV infection with CD4+ T lymphocytes count at the time of diagnosis. Methods: A cross-sectional study was carried out in PLHIV treated at the San Juan de Dios Hospital between 2013 and 2019. Oral lesions were diagnosed by the EC-Clearinghouse-OHARA criteria and immunosuppression was determined according to the CD4+ T lymphocyte count. Results: Of the 240 recruited patients, 35 had lesions strongly associated with HIV infection and 26 of them had severe immunosuppression. The probability of occurrence of a lesion strongly associated with HIV infection is 12.3 times higher in patients with severe immunosuppression. Conclusion: There is a statistically significant association between a severe immunosuppression and the presence of oral manifestations strongly associated with HIV/ AIDS infection, which has clinical relevance since it is presented as a clinical tool for initial diagnosis, disease progression and monitoring of antiretroviral therapy. Keywords: HIV/AIDS; T4 lymphocytes; CD4 count; oral manifestations; oral lesion oral candidiasis; oral Kaposi sarcoma; oral no Hodgkin lymphoma.

Research paper thumbnail of Knowledge, attitudes, and training in tobacco control among dental students in a public dental school in Catalonia

Tobacco Prevention and Cessation, Dec 10, 2021

is an open access, peer-reviewed online journal that encompasses all aspects of tobacco use, prev... more is an open access, peer-reviewed online journal that encompasses all aspects of tobacco use, prevention and cessation that can promote a tobacco free society. The aim of the journal is to foster, promote and disseminate research involving tobacco use, prevention, policy implementation at a regional, national or international level, disease development-progression related to tobacco use, tobacco use impact from the cellular to the international level and finally the treatment of tobacco attributable disease through smoking cessation.

Research paper thumbnail of Oral Health Policy in Latin America: Challenges for Better Implementation

European Journal of Dental and Oral Health

Background: Oral health is considered an important public policy. This study aimed to understand ... more Background: Oral health is considered an important public policy. This study aimed to understand which barriers and facilitator occurs during the implementation of oral health programs/policies. Methods: A qualitative study was conducted within personal interviews with decision-makers, at the political, technical, and academic levels. Data were transcribed and analyzed using Maxqda®. Results: The formation of dentists with an emphasis on the public service proved to be a critical knot, also the population´s lack of knowledge about their rights was mentioned. In Chile and Colombia, one of the main facilitators was the previous existence of oral health programs. As barrier, the lack of systematization of epidemiological data. In Brazil, the main facilitators were many dentists available and the political will of politicians to include oral health as public. Managers unprepared to work in public service was one of the main barriers. Conclusions: During the development and implementatio...

Research paper thumbnail of Barriers and facilitators to implement oral health policies on Brazil, Colombia, and Chile

European Journal of Public Health, 2020

Background Public health policies are important for the general population's well-being. Amon... more Background Public health policies are important for the general population's well-being. Among the policies, oral health is included in the context of integral health, so those responsible for creating oral health policies and programs are key elements for the programs focusing on improving the health of a country's population. Oral health is considered a right to the citizen in the countries of this study (Brazil, Colombia and Chile), although their health systems are different. The aim of this study was to understand which barriers and facilitator occurs during the implementation of oral health programs/policies. Methods A qualitative study was conducted within personal interviews with decision-makers, at the political, technical and academic levels. Data were transcribed and analyzed using Maxqda®. Results It was observed that, at the moment of the insertion of oral health into the Health System, the formation of dentists with an emphasis in the public service proved to b...

Research paper thumbnail of Mecanismos De Distribución Del Sistema De Pago

... (55) CatSalut. Informe d'avaluació sanitària del projecte per a la implantació d'un... more ... (55) CatSalut. Informe d'avaluació sanitària del projecte per a la implantació d'un sistema de compra en base poblacional. Barcelona: Servei Català de la Salut; 2004. (56) Martínez-García E. Catalonia: Paying providers for better quality. 2006. (57) CatSalut. ...

Research paper thumbnail of Oral health policies and decision-making process in Brazil, Colombia and Chile

Brazilian Oral Research

Public health policies are crucial for the well-being of the general population; however, the hea... more Public health policies are crucial for the well-being of the general population; however, the health systems of developed countries still do not include oral health in its system. Thus, it is necessary to understand the process of decision-making in oral health policies to create opportunities for countries to achieve an overall positive health outcome, including oral health. This study aimed to identify the factors influencing the inclusion of oral health on the political agenda in Brazil, Colombia, and Chile. The study sample involved decision-makers at political, technical, and academic levels. The extracted data were analyzed using the software Maxqda ® and Kingdon´s theoretical model; defining interactive variables that produce a "window of opportunity" to define the agenda and the insertion of theme in formulating public policies. The decision-making process regarding oral health is influenced by many factors like the need to improve the overall oral health of the population, identified through national epidemiological studies, and the importance of individuals in positions involving political decision-making, who advocate for oral health. Strategies were developed in partnership with the academy that focused on the health rights of the population provided by law; territorial and national programs were also developed. The inclusion and creation of oral health policies depend on actors who advocate for thematic and scientific evidence to support decision-making. A close relationship between academia and stakeholders and knowledge translation is important for the development of public policies that can be effective for health systems.

Research paper thumbnail of Adaptation, implementation, and evaluation of an online health sciences training program for brief smoking intervention: A pre-post study in four European countries

Research paper thumbnail of ¿Qué Nos Queda Por Recorrer Para Proveer Salud Oral De Calidad A Las Personas Adultas En Chile?

International journal of interdisciplinary dentistry

Research paper thumbnail of Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples

Nurse Education in Practice

Research paper thumbnail of Tool to monitor tobacco control policy implementation: the Tobacco Control Scale in Latin America. Adaptation process and pilot study

Tobacco Control, 2021

BackgroundMonitoring tobacco control policy implementation is one of the keys for tobacco consump... more BackgroundMonitoring tobacco control policy implementation is one of the keys for tobacco consumption reduction in Latin America (LA). This study reports on the adaptation of the Tobacco Control Scale (TCS) for use in LA countries and the level of tobacco control policy implementation in this region according to the scale.MethodsEcological cross-sectional survey. The questionnaire to measure tobacco control policies was a translated (into Spanish and Portuguese) and adapted version of the last TCS as used in Europe. The resulting TCS-LA maintains the same structure as the original TCS, with eight policy domains and 100 points (pts) as maximum score; however, four policy domains were adapted because the exact same rationale could not be applied. At least two non-governmental tobacco control experts were contacted per country to answer the TCS-LA.ResultsInformants from 17 out of 18 countries completed the questionnaire. Using the TCS-LA, Panama (70 pts), Uruguay (68 pts) and Ecuador (...

Research paper thumbnail of Procesos de determinación del derecho a la salud bucal de mujeres en post-parto y sus hijos. Bucaramanga y Medellín (Colombia), Santiago (Chile), 2017

Gerencia y Políticas de Salud, 2021

Introducción. Numerosos estudios abordan la situación de salud bucal y el acceso a la atención o... more Introducción. Numerosos estudios abordan la situación de salud bucal y el acceso a la atención odontológica de las gestantes, sin embargo pocos continúan la observación en el postparto y mucho menos la situación de sus hijos durante los primeros años de vida. Objetivo. Identificar y comprender los procesos generales, particulares y singulares que limitan o favorecen el ejercicio del derecho a la salud bucal de la mujer postparto y su hijo durante el primer año de vida. Método. El estudio parte del enfoque de la Determinación Social de la Salud en dos ciudades colombianas, Medellín y Bucaramanga, y en Santiago de Chile. En cada ciudad participaron 26 binomios previo consentimiento informado. Se usaron técnicas cualitativas (entrevistas y grupos de discusión) y cuantitativas (encuesta y exámenes bucales) para la recolección de los datos. Resultados. Procesos generales de orden económico, político, y de género, unidos a dinámicas laborales, de consumo y socioculturales, de los modos d...

Research paper thumbnail of Guías de práctica clínica: estudio cualitativo sobre su implementación en el sistema de salud de Chile

Revista Panamericana de Salud Pública, 2017

Objetivo. Caracterizar el proceso de implementación, barreras y facilitadores de recomendaciones ... more Objetivo. Caracterizar el proceso de implementación, barreras y facilitadores de recomendaciones basadas en evidencia en el contexto del desarrollo de guías prácticas clínicas (GPC) generadas por el Ministerio de Salud de Chile, a fin de brindar propuestas para la optimización del proceso. Métodos. Estudio cualitativo del tipo “investigación-acción”. Se realizaron 19 entrevistas semiestructuradas y se armaron nueve grupos de discusión a distintos niveles del sistema público de salud chileno. El análisis se realizó mediante el software Atlas ti® y en forma manual, desde un marco de análisis de contenido, mediante la categorización y codificación de la información según dimensiones preespecificadas y con la inclusión de categorías emergentes cuando fue pertinente. Resultados El principal desafío de implementación de recomendaciones mencionado es la falta de un proceso explícito y estructurado. Los actores del sistema de salud reconocen dificultades dependientes del contexto al momento...

Research paper thumbnail of Tumor odontogénico calcificante quístico: Presentación de dos casos clínicos

Biblioteca de la Universidad Complutense de Madrid, Base de datos de artículos de revistas, ...

Research paper thumbnail of Osteocondroma de apófisis coronoides

Research paper thumbnail of Herniation of buccal fat pad, report of a clinical case in a 5 year old patient

Research paper thumbnail of Instrumentos para medir la capacidad funcional intrínseca y la fragilidad de personas mayores en la Atención Primaria en Chile

Revista médica de Chile

Instruments to assess functional capacity and the presence of frailty in older people Background:... more Instruments to assess functional capacity and the presence of frailty in older people Background: The evaluation of functional capacity and the presence of frailty is an essential prognostic indicator in older people. Aim: To explore the instruments used to characterize the intrinsic functional capacity (CFI) and frailty in elderly people cared at Primary Health Care Centers (PHC) in Chile. Material and Methods: A narrative review of national and international scientific literature was carried out, including observational studies published in Pubmed (since 2015) and Scielo (since 2010) about tools to assess CFI or frailty. Studies in English or Spanish carried out in Chilean beneficiaries of PHC aged 60 years and over, were included. Results: After the first search, 110 articles were selected in Pubmed and 86 in Scielo. According to the relevance of the title and abstract, 36 articles were preliminarily screened, of which 25 were selected for full reading, 12 of which were finally included in this review. In Chile, the main instrument used to assess CFI is the Functional Examination of the Elderly (EFAM). There are few national studies to assess frailty and the instruments used are mainly based on the Fried criteria and the FTI (Frailty Tilburg Indicator). The reviewed studies suggest improving the coverage and reconsidering the predictive capacity of the measurements used for the assessment of CFI and frailty in older people, suggesting the incorporation of handgrip strength as a predictor of frailty. Conclusions: The main instruments to assess CFI and frailty in older people cared in PHC in Chile are the EFAM, and the Fried and FTI criteria, respectively.

Research paper thumbnail of Pay-for-performance: paying by results in oral health indicators

Journal Of Oral Research, 2015

Research paper thumbnail of Osteochondroma of the coronoid process

Egyptian Journal of Oral & Maxillofacial Surgery, 2015

Osteochondroma is the most common benign neoplasia of the skeleton. In the head it was been descr... more Osteochondroma is the most common benign neoplasia of the skeleton. In the head it was been described in cranial base, posterior maxillary surface, maxillary sinus, and different mandibular areas like condyle, ramus, body and symphysis. Osteochondroma of the coronoid process are rare. We present a review of the literature and the report of the cas of a 44 years old female patient presenting limited mouth opening and swelling of the left cheek, with diffuse limits, bony consistency, painless, and covered of normal skin. No temporomandibular joint disease was present. In panoramic radiographs was evident a coronoid tumor localized in the union of zigomatic arch and bone. Under general anaesthesia coronoidectomy was made, recovering mouth opening until 43 mm. The post-operative period was performed without complications. Histopatological examinations revealed normal trabecular bone covered with hyaline cartilage. The histopatological diagnosis was osteochondroma. Clinical and pathological aspects, treatment and differential diagnosis with other lesions are discussed.

Research paper thumbnail of Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009

International Journal of Environmental Research and Public Health, 2015

The study examines changes in the distribution and socioeconomic inequalities of dental care util... more The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004-2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20-39, 40-59, 60-63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for

Research paper thumbnail of Factors influencing professionalism during dental training at the University of Chile: perception of students and patients

BMC Medical Education, May 17, 2023

Background The University should be considered a favourable space and agent for the training and ... more Background The University should be considered a favourable space and agent for the training and transmission of values and attitudes related to professionalism, such as responsibility, teamwork and ethical commitment. In addition, dentistry is a profession with a deep social sense that seeks to solve the oral health problems of the population to improve the quality of life. In this context, our aim was to explore the perception of students and patients about the contribution of the curriculum to the development of professionalism and to identify the factors that strengthen and weaken this perception. Methods A qualitative approach was carried out through focus groups and semi-structured interviews with students from the 4th, 5th and 6th year of training and patients treated at the Dental Clinic of our Faculty. Results In the opinion of patients and students, the factors that debilitate the training in professionalism are associated with weakened professional values/behaviours in the training, the lack of teacher training of the professors and factors of educational environment. On the contrary, factors strengthening the professionalism are mainly related to hallmark values/ professional behaviours trained in the institution and to the good evaluation by patients. The respondents also perceive the implementation of a new curriculum as a positive factor for the training in professionalism. Conclusion The patients and students interviewed believe that the main strength for the training in professionalism in the institution is the development of adaptability for the future professionals to any social context, especially to a vulnerable one, the ability to solve the problems they face and the responsibility towards the patients and their treatment.

Research paper thumbnail of Manifestaciones orales y recuento de linfocitos T CD4+ en pacientes adultos con infección por VIH atendidos en el Hospital San Juan de Dios. Santiago, Chile

Revista Chilena De Infectologia, 2022

Background: Oral lesions classified as strongly associated with HIV infection occur in cases of s... more Background: Oral lesions classified as strongly associated with HIV infection occur in cases of severe immunosuppression (CD4+ T lymphocyte count ≤ 200 cells/mm 3 of blood). Aim: To associate the presence of oral lesions strongly associated with HIV infection with CD4+ T lymphocytes count at the time of diagnosis. Methods: A cross-sectional study was carried out in PLHIV treated at the San Juan de Dios Hospital between 2013 and 2019. Oral lesions were diagnosed by the EC-Clearinghouse-OHARA criteria and immunosuppression was determined according to the CD4+ T lymphocyte count. Results: Of the 240 recruited patients, 35 had lesions strongly associated with HIV infection and 26 of them had severe immunosuppression. The probability of occurrence of a lesion strongly associated with HIV infection is 12.3 times higher in patients with severe immunosuppression. Conclusion: There is a statistically significant association between a severe immunosuppression and the presence of oral manifestations strongly associated with HIV/ AIDS infection, which has clinical relevance since it is presented as a clinical tool for initial diagnosis, disease progression and monitoring of antiretroviral therapy. Keywords: HIV/AIDS; T4 lymphocytes; CD4 count; oral manifestations; oral lesion oral candidiasis; oral Kaposi sarcoma; oral no Hodgkin lymphoma.

Research paper thumbnail of Knowledge, attitudes, and training in tobacco control among dental students in a public dental school in Catalonia

Tobacco Prevention and Cessation, Dec 10, 2021

is an open access, peer-reviewed online journal that encompasses all aspects of tobacco use, prev... more is an open access, peer-reviewed online journal that encompasses all aspects of tobacco use, prevention and cessation that can promote a tobacco free society. The aim of the journal is to foster, promote and disseminate research involving tobacco use, prevention, policy implementation at a regional, national or international level, disease development-progression related to tobacco use, tobacco use impact from the cellular to the international level and finally the treatment of tobacco attributable disease through smoking cessation.

Research paper thumbnail of Oral Health Policy in Latin America: Challenges for Better Implementation

European Journal of Dental and Oral Health

Background: Oral health is considered an important public policy. This study aimed to understand ... more Background: Oral health is considered an important public policy. This study aimed to understand which barriers and facilitator occurs during the implementation of oral health programs/policies. Methods: A qualitative study was conducted within personal interviews with decision-makers, at the political, technical, and academic levels. Data were transcribed and analyzed using Maxqda®. Results: The formation of dentists with an emphasis on the public service proved to be a critical knot, also the population´s lack of knowledge about their rights was mentioned. In Chile and Colombia, one of the main facilitators was the previous existence of oral health programs. As barrier, the lack of systematization of epidemiological data. In Brazil, the main facilitators were many dentists available and the political will of politicians to include oral health as public. Managers unprepared to work in public service was one of the main barriers. Conclusions: During the development and implementatio...

Research paper thumbnail of Barriers and facilitators to implement oral health policies on Brazil, Colombia, and Chile

European Journal of Public Health, 2020

Background Public health policies are important for the general population's well-being. Amon... more Background Public health policies are important for the general population's well-being. Among the policies, oral health is included in the context of integral health, so those responsible for creating oral health policies and programs are key elements for the programs focusing on improving the health of a country's population. Oral health is considered a right to the citizen in the countries of this study (Brazil, Colombia and Chile), although their health systems are different. The aim of this study was to understand which barriers and facilitator occurs during the implementation of oral health programs/policies. Methods A qualitative study was conducted within personal interviews with decision-makers, at the political, technical and academic levels. Data were transcribed and analyzed using Maxqda®. Results It was observed that, at the moment of the insertion of oral health into the Health System, the formation of dentists with an emphasis in the public service proved to b...

Research paper thumbnail of Mecanismos De Distribución Del Sistema De Pago

... (55) CatSalut. Informe d'avaluació sanitària del projecte per a la implantació d'un... more ... (55) CatSalut. Informe d'avaluació sanitària del projecte per a la implantació d'un sistema de compra en base poblacional. Barcelona: Servei Català de la Salut; 2004. (56) Martínez-García E. Catalonia: Paying providers for better quality. 2006. (57) CatSalut. ...

Research paper thumbnail of Oral health policies and decision-making process in Brazil, Colombia and Chile

Brazilian Oral Research

Public health policies are crucial for the well-being of the general population; however, the hea... more Public health policies are crucial for the well-being of the general population; however, the health systems of developed countries still do not include oral health in its system. Thus, it is necessary to understand the process of decision-making in oral health policies to create opportunities for countries to achieve an overall positive health outcome, including oral health. This study aimed to identify the factors influencing the inclusion of oral health on the political agenda in Brazil, Colombia, and Chile. The study sample involved decision-makers at political, technical, and academic levels. The extracted data were analyzed using the software Maxqda ® and Kingdon´s theoretical model; defining interactive variables that produce a "window of opportunity" to define the agenda and the insertion of theme in formulating public policies. The decision-making process regarding oral health is influenced by many factors like the need to improve the overall oral health of the population, identified through national epidemiological studies, and the importance of individuals in positions involving political decision-making, who advocate for oral health. Strategies were developed in partnership with the academy that focused on the health rights of the population provided by law; territorial and national programs were also developed. The inclusion and creation of oral health policies depend on actors who advocate for thematic and scientific evidence to support decision-making. A close relationship between academia and stakeholders and knowledge translation is important for the development of public policies that can be effective for health systems.

Research paper thumbnail of Adaptation, implementation, and evaluation of an online health sciences training program for brief smoking intervention: A pre-post study in four European countries

Research paper thumbnail of ¿Qué Nos Queda Por Recorrer Para Proveer Salud Oral De Calidad A Las Personas Adultas En Chile?

International journal of interdisciplinary dentistry

Research paper thumbnail of Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples

Nurse Education in Practice

Research paper thumbnail of Tool to monitor tobacco control policy implementation: the Tobacco Control Scale in Latin America. Adaptation process and pilot study

Tobacco Control, 2021

BackgroundMonitoring tobacco control policy implementation is one of the keys for tobacco consump... more BackgroundMonitoring tobacco control policy implementation is one of the keys for tobacco consumption reduction in Latin America (LA). This study reports on the adaptation of the Tobacco Control Scale (TCS) for use in LA countries and the level of tobacco control policy implementation in this region according to the scale.MethodsEcological cross-sectional survey. The questionnaire to measure tobacco control policies was a translated (into Spanish and Portuguese) and adapted version of the last TCS as used in Europe. The resulting TCS-LA maintains the same structure as the original TCS, with eight policy domains and 100 points (pts) as maximum score; however, four policy domains were adapted because the exact same rationale could not be applied. At least two non-governmental tobacco control experts were contacted per country to answer the TCS-LA.ResultsInformants from 17 out of 18 countries completed the questionnaire. Using the TCS-LA, Panama (70 pts), Uruguay (68 pts) and Ecuador (...

Research paper thumbnail of Procesos de determinación del derecho a la salud bucal de mujeres en post-parto y sus hijos. Bucaramanga y Medellín (Colombia), Santiago (Chile), 2017

Gerencia y Políticas de Salud, 2021

Introducción. Numerosos estudios abordan la situación de salud bucal y el acceso a la atención o... more Introducción. Numerosos estudios abordan la situación de salud bucal y el acceso a la atención odontológica de las gestantes, sin embargo pocos continúan la observación en el postparto y mucho menos la situación de sus hijos durante los primeros años de vida. Objetivo. Identificar y comprender los procesos generales, particulares y singulares que limitan o favorecen el ejercicio del derecho a la salud bucal de la mujer postparto y su hijo durante el primer año de vida. Método. El estudio parte del enfoque de la Determinación Social de la Salud en dos ciudades colombianas, Medellín y Bucaramanga, y en Santiago de Chile. En cada ciudad participaron 26 binomios previo consentimiento informado. Se usaron técnicas cualitativas (entrevistas y grupos de discusión) y cuantitativas (encuesta y exámenes bucales) para la recolección de los datos. Resultados. Procesos generales de orden económico, político, y de género, unidos a dinámicas laborales, de consumo y socioculturales, de los modos d...

Research paper thumbnail of Guías de práctica clínica: estudio cualitativo sobre su implementación en el sistema de salud de Chile

Revista Panamericana de Salud Pública, 2017

Objetivo. Caracterizar el proceso de implementación, barreras y facilitadores de recomendaciones ... more Objetivo. Caracterizar el proceso de implementación, barreras y facilitadores de recomendaciones basadas en evidencia en el contexto del desarrollo de guías prácticas clínicas (GPC) generadas por el Ministerio de Salud de Chile, a fin de brindar propuestas para la optimización del proceso. Métodos. Estudio cualitativo del tipo “investigación-acción”. Se realizaron 19 entrevistas semiestructuradas y se armaron nueve grupos de discusión a distintos niveles del sistema público de salud chileno. El análisis se realizó mediante el software Atlas ti® y en forma manual, desde un marco de análisis de contenido, mediante la categorización y codificación de la información según dimensiones preespecificadas y con la inclusión de categorías emergentes cuando fue pertinente. Resultados El principal desafío de implementación de recomendaciones mencionado es la falta de un proceso explícito y estructurado. Los actores del sistema de salud reconocen dificultades dependientes del contexto al momento...

Research paper thumbnail of Tumor odontogénico calcificante quístico: Presentación de dos casos clínicos

Biblioteca de la Universidad Complutense de Madrid, Base de datos de artículos de revistas, ...

Research paper thumbnail of Osteocondroma de apófisis coronoides

Research paper thumbnail of Herniation of buccal fat pad, report of a clinical case in a 5 year old patient

Research paper thumbnail of Instrumentos para medir la capacidad funcional intrínseca y la fragilidad de personas mayores en la Atención Primaria en Chile

Revista médica de Chile

Instruments to assess functional capacity and the presence of frailty in older people Background:... more Instruments to assess functional capacity and the presence of frailty in older people Background: The evaluation of functional capacity and the presence of frailty is an essential prognostic indicator in older people. Aim: To explore the instruments used to characterize the intrinsic functional capacity (CFI) and frailty in elderly people cared at Primary Health Care Centers (PHC) in Chile. Material and Methods: A narrative review of national and international scientific literature was carried out, including observational studies published in Pubmed (since 2015) and Scielo (since 2010) about tools to assess CFI or frailty. Studies in English or Spanish carried out in Chilean beneficiaries of PHC aged 60 years and over, were included. Results: After the first search, 110 articles were selected in Pubmed and 86 in Scielo. According to the relevance of the title and abstract, 36 articles were preliminarily screened, of which 25 were selected for full reading, 12 of which were finally included in this review. In Chile, the main instrument used to assess CFI is the Functional Examination of the Elderly (EFAM). There are few national studies to assess frailty and the instruments used are mainly based on the Fried criteria and the FTI (Frailty Tilburg Indicator). The reviewed studies suggest improving the coverage and reconsidering the predictive capacity of the measurements used for the assessment of CFI and frailty in older people, suggesting the incorporation of handgrip strength as a predictor of frailty. Conclusions: The main instruments to assess CFI and frailty in older people cared in PHC in Chile are the EFAM, and the Fried and FTI criteria, respectively.

Research paper thumbnail of Pay-for-performance: paying by results in oral health indicators

Journal Of Oral Research, 2015

Research paper thumbnail of Osteochondroma of the coronoid process

Egyptian Journal of Oral & Maxillofacial Surgery, 2015

Osteochondroma is the most common benign neoplasia of the skeleton. In the head it was been descr... more Osteochondroma is the most common benign neoplasia of the skeleton. In the head it was been described in cranial base, posterior maxillary surface, maxillary sinus, and different mandibular areas like condyle, ramus, body and symphysis. Osteochondroma of the coronoid process are rare. We present a review of the literature and the report of the cas of a 44 years old female patient presenting limited mouth opening and swelling of the left cheek, with diffuse limits, bony consistency, painless, and covered of normal skin. No temporomandibular joint disease was present. In panoramic radiographs was evident a coronoid tumor localized in the union of zigomatic arch and bone. Under general anaesthesia coronoidectomy was made, recovering mouth opening until 43 mm. The post-operative period was performed without complications. Histopatological examinations revealed normal trabecular bone covered with hyaline cartilage. The histopatological diagnosis was osteochondroma. Clinical and pathological aspects, treatment and differential diagnosis with other lesions are discussed.

Research paper thumbnail of Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009

International Journal of Environmental Research and Public Health, 2015

The study examines changes in the distribution and socioeconomic inequalities of dental care util... more The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004-2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20-39, 40-59, 60-63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for