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In the Amazon floodplains, hydrological variability plays a crucial role by shaping the habitat, offering shelter and feeding or breeding areas. During the dry season, some fresh water turtles such as the yellow-spotted turtle (Podocnemis unifilis Troschel, 1848) use the sand banks at point bar areas as breeding sites, which must be available in time for the start of oviposition. In this study, we used altimetry-derived water level data from radar satellites combined with in-situ hydrological measurements to evaluate water level variations and relate them to oviposition starting dates (2003-2012) from Pacaya-Samiria National Reserve, Peru. Synchronous hydrological behavior was found between the major river stems (Ucayali and Marañon) and the inner rivers (Pacaya and Samiria), thus enabling the utilization of water level in the main river stem to correlate with oviposition in the inner rivers. Mean oviposition date was July 23nd with selection of a narrow water level range (92 masl ± 0.9 SD). Consistent shifts towards early/late oviposition were found for years with early/late dry season onset. Extreme biological shifts in terms of oviposition date onset, were identified for specific years (2004, 2010 and 2011) mainly for the extreme dry year of 2010.

INTRODUCTION: Clinical reasoning is a core competence in health professions that impacts the ability to solve patients' health problems. Due to its relevance, it is necessary to identify difficulties arising from different sources that affect clinical reasoning development in students. The aim of this study was to explore a comprehensive approach to identify challenges for clinical reasoning development in undergraduate dental students and their potential solutions.METHODS: Mixed methods were used in four stages: (1) students and clinical teachers focus groups to identify challenges to clinical reasoning development; (2) literature review to explore potential solutions for these challenges; (3) Delphi technique for teacher consensus on pertinence and feasibility of solutions (1-5 scale); (4) teachers' self-perception of their ability to implement the solutions.RESULTS: Three categories and seven subcategories of challenges were identified: (I) educational context factors influencing the clinical reasoning process; (II) teacher's role in clinical reasoning development; (III) student factors influencing the clinical reasoning process. From 134 publications identified, 53 were selected for review, resulting in 10 potential solutions. Through two Delphi rounds, teachers rated the potential solutions very highly in terms of relevance (4.50-4.85) and feasibility (3.50-4.29). Finally, a prioritization ranking of these solutions was generated using their scores for relevance, feasibility and teachers' self-perception of their ability to implement them.CONCLUSIONS: The present comprehensive approach identified challenges for clinical reasoning development in dental students and their potential solutions, perceived as relevant and feasible by teachers, requiring further research and follow-up actions to address them.

BACKGROUND Workplace-based assessment is a key component of dental-student clerkships, allowing students to demonstrate clinical proficiency. PURPOSE This study adapts the Mini-Clinical Evaluation Exercise (Mini-CEX) to a dentistry-program clerkship, analyzing the results and examining the psychometric properties of Mini-CEX. METHODS First, Delphi panel methodology was used to ensure content validity. Mini-CEX was then piloted in the dental-clerkship program, with each student assessed by at least 2 supervisors and a peer student. Subsequently, psychometric properties, acceptability, and observation time were analyzed. RESULTS The study was conducted between July and November 2019. Overall, 140 Mini-CEX evaluation exercises were carried out on 30 students by 84 supervisors and 56 peers. The adapted instrument was found to be unidimensional, obtaining an acceptable internal consistency (α = 0.74). As the assessor type changed, there were differences in observation time; the medians (Q1-Q3) were 10 minutes (5-15) for supervisors and 30 minutes (20-45) for peer students (P

Introducción: los procesos de enseñanza aprendizaje en odontología deben adaptarse permanentemente a los cambios sociales, demográficos, científicos y tecnológicos, con el fin de formar profesionales con un perfil de egreso basado en conocimientos, habilidades y actitudes integrales, conectados con la realidad y necesidades de la sociedad, que impacten positivamente en el sistema de salud. El propósito de esta revisión narrativa fue analizar los principales desafíos de la educación en odontología reportados en la literatura y proponer acciones concretas para abordarlos. Métodos: a través de un método de consenso, un panel de nueve expertos seleccionó las principales áreas donde se presentan estos desafíos, para luego realizar una búsqueda de información científica en inglés y español, consultando las bases de datos MEDLINE vía PubMed, ERIC (EBSCO), Scopus, SciELO y Google Scholar. Resultados: los cuatro desafíos para la educación en odontología analizados fueron: responsabilidad social de la educación, perfil de egreso de en diferentes contextos, metodologías de enseñanza aprendizaje y sistemas de evaluación, procesos de titulación y certificación. Conclusiones: las acciones que sustentan los principales cambios requeridos a nivel nacional e internacional en la educación en odontología necesitan el apoyo transversal de organizaciones gubernamentales, científicas, sociales y de las propias instituciones de educación superior, a través de un trabajo colaborativo. Este camino es vital para lograr la formación de cirujanos dentistas que serán reales agentes de cambio, preparados integralmente para insertarse en un sistema que garantice la calidad, seguridad, efectividad y equidad en salud bucal.

Objective This study aimed to compare the strength of association (i.e., explained variability) of the cumulative grade point average (GPA) with the grades obtained in the clerkship portfolio and the final structured oral exam by dental students. Methods A prospective longitudinal study was designed to analyze quantitative data from three cohorts of dental school students. Univariate and multivariate linear regression models were built to evaluate the association between the students' cumulative GPA with the grades obtained in their clerkship portfolio and the final structured oral exam. Results In total, 171 students in the last year of the undergraduate program were considered (76% women, age average 24.8 +/- 1.6 years). The dental students' grades of both portfolio and structured oral exam were significantly associated with the GPA score but with different strengths of association. The clerkship portfolio was more strongly associated with cumulative GPA than the structured oral exam (R-2 = 19.6% versus R-2 = 7.6%). On the opposite, the association between the structured oral exam and GPA can be interpreted as a lower precision in its practical significance and thus reflecting different concurrent validity. Conclusions Considering the results of this study, it could probably incline the balance toward the portfolio because it may be closer to a programmatic assessment model, with timely feedback, development of metacognition, and the achievement of formative process measurement rather than evidence of a single instance of examination.

Background Clinical dental evaluations are considered complex and costly measurements that epidemiological surveillance studies of multiple simultaneous chronic diseases currently require, for example National Health Surveys (ENS). Accordingly, simpler and more affordable methods need to be validated. The aim of this study was to assess the validity of the self-report on the total number of teeth in the general Chilean adult population. Methods A substudy was conducted on ENS 2016–2017 participants. A stratified random sample of 101 of them was subjected to a telephone questionnaire. This information was then compared with the results obtained from the oral examination performed by a trained nurse during a home visit. Spearman correlations, intraclass correlation coefficients and the Bland-Altman method were used to analyse the data. Results In men, the average number of teeth recorded during the oral examination coincided with the number of teeth in the self-report (22 teeth). In women, the total teeth average was 18 and 19 teeth according to the examination and self-report, respectively. For the total number of participants, a strong and significant Spearman correlation was obtained (ρ = 0.93); in men and women, the Spearman correlation observed was also strong and significant (ρ = 0.90 and ρ = 0.96 respectively). The value of the intraclass correlation coefficient indicated a significant concordance (CCI = 0.96) in both men and women (CCI = 0.93 and 0.98 respectively). A tendency to greater correlation was observed as the number of teeth decreased. Conclusions The number of teeth self-reported by the subjects in this study correlated with the number of teeth recorded in the clinical examination. Self-report is a valid method to determine the number of teeth in national health surveys.

Introduccion La enfermedad por coronavirus-19 (COVID-19) es un problema mundial de salud publica debido a su morbimortalidad, especialmente en grupos de riesgo El entorno odontologico tiene un alto riesgo de transmision viral, por ello el objetivo de este estudio fue identificar recomendaciones para la atencion odontologica durante esta pandemia Metodos Se realizo una busqueda de evidencia cientifica publicada desde 2002 hasta el 23 de marzo de 2020 en bases de datos electronicas (MEDLINE/PubMed, EMBASE, Cochrane y Epistemonikos) y en las paginas electronicas de la Asociacion Dental Americana, de Centers for Disease Control and Prevention Oral Health, del Ministerio de Salud de Chile y de sociedades cientificas Resultados Se incluyeron nueve articulos publicados, en los cuales se recomienda el uso irrestricto de elementos de proteccion personal, preferir tecnicas radiograficas extraorales, uso de enjuagues bucales con peroxido de hidrogeno al 1% o povidona yodada al 0,2%, tecnica a cuatro manos con aspiracion constante y uso de suturas reabsorbibles Ademas, existe consenso respecto a que durante los periodos de transmision comunitaria se deben posponer los tratamientos odontologicos no urgentes Conclusiones Debido al alto riesgo de infeccion cruzada que presentan los equipos odontologicos, deben implementarse recomendaciones basadas en la mejor evidencia disponible, con el fin de preservar la salud de los miembros del equipo y de la poblacion a su cuidado Introduction COVID-19 is a world public health problem due to its morbidity and mortality, especially in at-risk groups The dental environment has a high risk of viral transmission;accordingly, this study aimed to identify recommendations based on the best available evidence for dental care during this pandemic Methods We performed a search for scientific evidence published since 2002 to March 23th 2020 in electronic databases (MEDLINE/PubMed, EMBASE, Cochrane, and Epistemonikos) and the web pages of the American Dental Association, Centers for Disease Control and Prevention Oral Health, the Ministry of Health in Chile and scientific societies Results We included nine published studies The recommendations were the following: unrestricted use of personal protection elements, use of extraoral radiographic techniques, use of mouth rinses with 1% hydrogen peroxide or 0 2% iodine povidone, a four-hand technique with ongoing aspiration and the use of absorbable sutures Furthermore, there is a consensus that non-urgent treatments should be postponed during periods of community transmission Conclusions Dental practitioners are exposed to a high risk of cross-infection, meaning they must implement recommendations based on the best available evidence to preserve the health of team members and the population they are caring for

espanolIntroduccion. Para realizar una practica clinica basada en la evidencia es fundamental que los profesionales de la salud sepan reconocer sus brechas de conocimiento y posean las herramientas necesarias para realizar busquedas de informacion. Con el objetivo de mejorar la metodologia de ensenanza-aprendizaje para la busqueda eficiente, se disenaron tres capsulas de autoaprendizaje. Sujetos y metodos. Las capsulas se aplicaron en cursos del primer, quinto y octavo semestre de la carrera de odontologia y se analizaron sus resultados en los niveles 1 y 2 del modelo de evaluacion de programas Kirkpatrick. Cada capsula se evaluo en modalidad online mediante una tarea de aplicacion y un cuestionario de cumplimiento de objetivos. Resultados. Las capsulas se aplicaron el primer y segundo semestre de 2018 a un total de 218 alumnos. Tanto alumnos como profesores se manifestaron satisfechos con la metodologia y los contenidos, destacando la modalidad b-learning y la calidad del material instruccional. El 100% de los alumnos aprobo la evaluacion asociada a cada capsula. El promedio de percepcion de alcance de objetivos fue del 72% para la capsula 1, 80% para la capsula 2 y 84% para la capsula 3, con una mayor proporcion de diferencias positivas (p = 0,00). Conclusion. Las capsulas de autoinstruccion para la ensenanza de busqueda de evidencia son una metodologia efectiva, en terminos de reaccion y aprendizaje. EnglishIntroduction. To carry out an evidence-based clinical practice, health professionals must know how to recognize their knowledge gaps and have the necessary tools to search for information in order to improve their teaching methodology. Three self-learning capsules were designed to search efficiently for information. Subjects and methods. The capsules were applied in courses of the 1st, 5th and 8th semesters of the dentistry degree. The results were analyzed at levels 1 and 2 of the Kirkpatrick program evaluation model. Each capsule was evaluated in online mode through an application task and a and a fulfilling objectives questionnaire. Results. The self-instruction capsules were applied to a total of 218 students. The satisfaction survey showed high values for students and teachers considering the methodology and content, highlighting the b-learning modality and the quality of the instructional material. All of the students approved the evaluation associated with each capsule. The average perception of goal achievement was 72% for capsule 1, 80% for capsule 2 and 84% for capsule 3, with a higher proportion of positive differences (p = 0.00). Conclusion. In terms of reaction and learning, it is an effective methodology to use self-instruction capsules for teaching evidence seeking.

Se aplico la Ley de Taylor en dos conjuntos de datos correspondientes a poblaciones de taxa distintos, con el proposito de determinar sus patrones espacio-temporales segun la interpretacion biologica de dicha ley y senalar sus limitaciones en la descripcion de los cambios en la distribucion espacial de las abundancias. Los datos empleados fueron las abundancias de aves entre Febrero-1998 y Febrero-2001 y, las abundancias de coleopteros colectados con trampas pitfall entre Febrero-1998 y Diciembre-2001 en la Reserva Nacional de Lachay. A traves de la significacion estadistica de los valores de bs y bt, se establecio el patron de refugios para 8 especies de aves y 5 de coleopteros, aunque los valores de R2 revelaron que estos solo se cumplieron parcialmente. Estos resultados indican que ninguna de las especies de ambos taxa se adecuo absolutamente a los patrones planteados como interpretacion biologica de la Ley de Taylor y asimismo, que los valores de R2 deben tomarse en cuenta, como exigencia estadistica necesaria para definir los patrones.

Ante la perturbacion que constituyo el evento El Nino 97 -98 (ENSO), se evaluaron los cambios espacio - temporales en la diversidad de aves de las Lomas de Lachay como un paso previo al analisis del desarrollo de procesos de resiliencia. Se encontro que la diversidad de aves, describe un comportamiento post - ENSO, probablemente asociado a la baja productividad de la comunidad vegetal durante 1999. Los valores registrados para el ano 2000 presentan un comportamiento similar al esperado durante un ano normal. Por otro lado la diversidad muestra el paso de una distribucion espacial homogenea durante los meses bajo el efecto del ENSO, hacia una distribucion heterogenea durante los meses de la epoca seca de un ano que tiende a ser normal. Se puede afirmar que la avifauna mediante los valores de diversidad que genera y la distribucion espacial de la misma, desarrolla procesos de resiliencia que le han permitido mostrar el comportamiento que se espera ocurra bajo condiciones normales y un retorno a la estacionalidad caracteristica del ecosistema.

RESUMENSe propuso un protocolo consistente en educacion continua, dieta, ejercicio y metformina a pacientescon diagnostico de sindrome de ovario poliquistico. Se controlaron 55 mujeres en edad reproductiva, deabril de 2001 a mayo de 2004. Todas se controlaron al menos 3 veces, por un minimo de 9 meses deseguimiento. Se realizaron examenes de laboratorio y controles antropometricos. La edad promedio de laspacientes fue de 29 anos. Hubo cambios significativos en las variables estudiadas y logramos demostrarque el protocolo propuesto es capaz de disminuir los riesgos metabolicos de esta enfermedad.PALABRAS CLAVES: Sindrome de ovario poliquistico, hiperandrogenismo ovarico, resistencia a la insulina, hirsutismo, anovulacion cronicaSUMMARYIt was proposed a consistent protocol in sistematic education, diet, exercises and metformin to consultingpatients, who were diagnosticated of PCOS. Fifty five women in reproductive age were submited to controlssince April 2001 to May 2004. All the patients were submited at least three times, with a follow up of at leastnine months. Laboratory exams and antropometric controls were carried out. The patients' average age wastwenty nine years old, we found significant changes in the studied variables and we succeeded to prove thatthe treatment protocol that had been proposed can diminish the metabolic risks of this disease.KEY WORDS: Polycystic ovary syndrome, hyperandrogenism, insulin resistance,hirsutism, chronic anovulation