Affect and cognition as antecedents of patients' trust in the dentist: cross-sectional study

Aim: to evaluate the association of the patients' perception about dentist's affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients' adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (ß = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (ß = .41). The trust positively influences the patient's intention to return to that dentist (ß = .82). In addition, the intention to return to the dentist positively influences the patient's satisfaction with life (ß = .49). Conclusions: Affective and cognitive aspects positively influenced the patient's trust in the dentist. The greater the patient's trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient's satisfaction with life

Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability

Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach's alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach's alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

A perda dentária, o declínio cognitivo e a recuperação imediata do exercício mastigatório para, possivelmente, reduzir este problema mundial. Estamos perto de uma resposta? / Tooth loss, cognitive decline, and the immediate recovery of masticatory exercise to possibly reduce the burden of the disease. How close are we now?

Este artigo apresenta os achados mais recentes sobre a perda dentária, declínio cognitivo e o possível papel que a mastigação teria na prevenção deste problema mundial. A ausência de dentição funcional afeta » dos adultos no Brasil. Existem evidências anatômicas demonstrando a ligação neuronal entre os circuitos mastigatórios trigeminais e o hipocampo ­ área cerebral da cognição (memória, aprendizado) e primariamente afetada pela doença de Alzheimer. A eficiência manual é significativamente melhorada, quando feita simultaneamente à mastigação. Três estudos com populações humanas significativas mostraram que a deficiência cognitiva é aumentada pelas próteses mal adaptadas; a perda de 16 unidades dentárias é suficiente para ser associada ao impedimento cognitivo severo; e um tempo de edentulismo superior ou acima de 15 anos piora significativamente os escores de cognição. Um estudo mostra que o desenho das PPRs com e sem extensão distal gera atividades cerebrais diferentes, que podem reduzir a habilidade mastigatória. Como os experimentos em animais têm mostrado que a mastigação induz a neurogênese no hipocampo, que este fenômeno pode ser impedido pela troca de uma dieta sólida por uma dieta pastosa, e ainda que o exercício físico em idosos aumenta a área do hipocampo e a percepção espacial, por semelhança, a mastigação cada vez mais se consolidaria como o "exercício principal adicional mais simples" na manutenção dos níveis de cognição. Neste sentido, os profissionais da Odontologia que detectarem a necessidade de colocar adequadamente implantes e próteses o mais cedo possível tornarão seus pacientes edêntulos grandes mind trainers e, possivelmente, estarão contribuindo para reduzir esta patologia de um grande impacto mundial.

This article presents the most recent findings on tooth loss, cognitive decline, and the possible role of mastication to prevent this global problem. The lack of functional dentition affects over » of Brazilian adults. There are anatomical evidences demonstrating the neuronal circuitry relationship among the trigeminal and hippocampus pathways (the cerebral region responsible for long-term memory and learning, being affect by Alzheimer disease). Manual dexterity is significantly improved when combined with masticatory exercise. Three studies with large samples highlightened that cognitive impairment increases for those with maladjusted dentures; sixteen dental lost units are enough for severe cognitive deficit, and that people edentulous for more than 15 years had their cognition scores significantly reduced. Also, one study demonstrated that the partial removable prosthesis design (with and without distal extensions) modify brain activity that can influence on masticatory ability. Animal experiments have shown that masticatory leads to neurogenesis at the hippocampus, and that this phenomenon can be prevented and reversed by alternating hard-and soft-diets. In a similar way, since physical exercise in old persons increases the hippocampal area and spatial perception, mastication could have a more and more evolving paper as "the most simple supplementary exercise" to maintain cognition levels. In this sense, dental professionals detecting the need to and who adequately deliver dental implants and prostheses as soon as possible will turn their edentulous patients into great "mind trainers" and surely would be contributing to reduce the burden of this global disease.

Efeitos da atividade física sobre a memória e estresse oxidativo plasmático e hipocampal de ratas na senescência / Effects of physical activity on memory, plasma and hippocampal oxidative stress of rats on senescence

Há evidências que a prática regular de atividade física potencializa a memória, diminui o estresse oxidativo plasmático e hipocampal e a ansiedade na senescência. Neste trabalho foram utilizadas 40 ratas (Rattus norvegicus albinus, Wistar), com 13 meses de idade ao início do experimento, divididas em quatro grupos: um grupo controle (GC) e três grupos tratamento (GT1, GT2 e GT3), sendo 10 animais em cada grupo. O grupo controle foi mantido apenas sob observação. Aos grupos tratamento foram aplicados exercícios físicos e de memória, sendo que ao GT1, apenas exercícios de memória; ao GT2 escalada em escada, e ao GT3 ambos os exercícios. Os animais que foram submetidos à escalada em escada três vezes por semana durante três meses consecutivos e aos testes de memória, apresentaram melhor desempenho nas memórias de curto e longo prazo e de habituação, bem como menor ansiedade em teste de campo aberto. A baixa concentração de malonaldeído (MDA), o equilíbrio da superóxido dismutase (SOD) e o aumento da capacidade antioxidante total (Ferric Reducing Antioxidant Power- FRAP, foram observados nas amostras plasmáticas e hipocampais de ratas submetidas aos tratamentos. Concluiu-se que a prática de exercício físico regular associado a exercícios de memória melhorou as capacidades mnemônicas, diminuiu o estresse oxidativo e a ansiedade de ratas na senescência(AU)

There is evidence that regular physical activity enhances memory, decreases plasma and hippocampal oxidative stress, and anxiety in senescence. In this work, 40 rats (Rattus norvegicus albinus, Wistar), 13 months old at the start of the experiment, were divided into four groups: one control group (CG) and three treatment groups (GT1, GT2 and GT3), 10 animals in each group. The control group was kept under observation only. In the treatment groups, physical and memory exercises were applied, and to GT1, only memory exercises; to GT2 climbing stairs, and to GT3 both exercises. Animals that underwent ladder climbing three times a week for three consecutive months and memory tests showed better performance in short and long term memory and habituation as well as lower anxiety in the open field test. The low concentration of malonaldehyde (MDA), the balance of superoxide dismutase (SOD) and the increase in total antioxidant capacity (Ferric Reducing Antioxidant Power - FRAP) were observed in the plasma and hippocampal samples of rats submitted to treatments. Regular exercise practice associated with memory exercises improved mnemonic abilities, decreased oxidative stress and anxiety of rats in senescence(AU)

Relação entre compreensão leitora e habilidades cognitivas e linguísticas em escolares com distúrbio de aprendizagem / Relationship between reading comprehension and cognitive skills in children with learning disorder

O presente estudo verificou o perfil de desempenho de crianças com Distúrbio de Aprendizagem (DA) nas seguintes habilidades: cognitiva (memória de trabalho fonológica), metacognitiva (estratégias de leitura), linguística (vocabulário); e metalinguística (consciência sintática); comparou o desempenho nestas habilidades em crianças com DA que já estavam em processo de intervenção fonoaudiológica com aquelas não submetidas à intervenção; comparou o desempenho nas habilidades testadas de crianças com DA com aquelas sem dificuldades de aprendizagem; e verificou se há associação entre o desempenho obtido nas habilidades avaliadas com a compreensão de leitura. Sessenta crianças, de ambos os sexos, de 7 a 12 anos, foram divididas igualmente em 4 grupos: experimental 1 (GE1) composto por crianças com DA sem intervenção fonoaudiológica, experimental 2 (GE2) composto por crianças com DA em intervenção fonoaudiológica, controle 1 (GCE1) e controle 2 (GCE2), ambos compostos por crianças sem dificuldade na aprendizagem. Todas foram submetidas à avaliação fonoaudiológica por meio de procedimentos específicos. A análise dos resultados foi feita de forma descritiva, qualitativa e quantitativa. Para a análise comparativa entre os grupos foi utilizado do Teste de Mann-Whitney e para verificar o grau de correlação entre às variáveis de interesse foi aplicada a Análise de Correlação de Spearman. Adotou-se nível de significância de 5%. Os grupos experimentais evidenciaram déficits na compreensão leitora. Nas habilidades testadas a maioria das crianças dos grupos experimentais evidenciaram déficits na habilidade cognitiva e na habilidade metacognitiva, sendo adequado nas demais habilidades. Somente a habilidade cognitiva evidenciou diferença estatisticamente significante entre os grupos experimentais. As crianças...

The aim of this study was to assess the phonological working memory (PWM), the reading strategies (RS), the vocabulary (V) and syntactic awareness (SA) of children with Learning Disorder (LD). The performance of children with LD who were already under the process of speech-language intervention was compared to one’s not under intervention and both were compared to the performance of children without learning disorders. Also evaluated the relationship between the assessed skills (PWM, RS, V, SA) and reading comprehension skills. Sixty children of both genders (7 to 12 years old) were divided equally into 4 groups - experimental 1 (E1 - LD without intervention), experimental 2 (E2 - LD with intervention), Control 1 (C1) and control 2 (C2), both composed of children without difficulty in learning paired with children from the experimental groups. All children underwent specific evaluations (PWM, RS, V, SA) and 2 reading comprehension tests. A descriptive analysis of the results was performed as well as a quantitative and qualitative assessment. The results were analyzed by considering the score of each specific procedure. For a comparative analysis between groups, the Mann-Whitney test was used and to check the degree of correlation between the variables (skills and reading comprehension), the Spearman Correlation Analysis was applied. The significance level of 5% (0.050) was adopted. Both experimental groups showed deficits in reading comprehension. Most children of the experimental group showed deficits in PWM and RS. In the other skills most children showed performance classified as normal. Comparing both experimental groups, PWM was the only statistically significant test. LD children under intervention performed better than LD children without therapy, and children without LD presented significantly higher performance than both experimental groups. A positive correlation coefficient was found between the tests (PWM, RS, V, SA) and reading comprehension...

Motor, linguistic, personal and social aspects of children with Down syndrome

AbstractA global developmental delay is expected from Down syndrome, affecting motor, cognitive, linguistic and personal-social skills. However, not always these delays are proportional; different conditions occur due to several intrinsic and extrinsic variables that must be controlled to form groups of greater homogeneity.Objective To enhance personal-social, fine motor-adaptive, gross motor and linguistic skills among children with Down syndrome and compare them with typically developing children, matched for gender, socioeconomic status and mental age, while controlling some variables that interfere with the global development.Methods The ethical aspects were fulfilled (Case No. 040/2009). The following inclusion criteria were considered: participants without a history of prematurity, very low birth weight, congenital hypothyroidism, significant hearing and vision problems, and signs of Autism Spectrum Disorder. After the inclusion criteria were considered, 40 children participated in the study, of which 20 had Down syndrome (experimental group - EG), these being of both genders and with chronological ages ranging from 38 to 63 months, and the other 20 being typically developing children (control group - CG), matching the EG in terms of gender, socioeconomic status and mental age, with this age ranging from 13 to 50 months. The evaluation consisted in applying the Denver Developmental Screening Test II, a test that assesses areas such as personal-social, fine motor-adaptive, linguistic and gross motor development. The results were subjected to statistical analysis using Student’s t-test.Results A statistically significant difference was verified between the groups for the language and fine motor-adaptive areas.Conclusion Children with Down syndrome showed lower performance in language and fine motor skills when compared with typically developing children. There was no statistically significant difference in gross motor and personal-social areas. It is worth mentioning the importance of controlling the variables to deal with more homogeneous groups.

Desempenho em habilidades motoras, comunicativas e cognitivas de crianças com hipotireoidismo congênito tratadas desde o período neonatal / Performance motor, communication and cognitive skills of children with congenital hypothyroidism treated since the neonatal period

O hipotireoidismo congênito (HC) é um distúrbio do metabolismo, caracterizado pela produção deficiente dos hormônios tireoidianos. A literatura ressalta que crianças podem apresentar alterações cognitivas, linguísticas e problemas comportamentais, mesmo quando o diagnóstico e o tratamento iniciaram precocemente. O estudo teve como objetivo verificar desempenho em habilidades motoras, comunicativas e cognitivas de indivíduos com hipotireoidismo congênito, tratados desde o período neonatal e comparar esses achados com seus pares sem alterações da tireoide. Participaram deste estudo 15 indivíduos com o diagnóstico de hipotireoidismo congênito do gênero feminino, com idade cronológica variando entre36 a 71 meses, com Quociente de Inteligência superior a 70, denominado Grupo Experimental (GE); e 15 indivíduos típicos, sem alterações da tireoide, denominado Grupo Comparativo (GC). Os participantes dos dois grupos foram pareados quanto à idade cronológica e nível socioeconômico. Os instrumentos de avaliação utilizados foram: Entrevista com pais; Observação do Comportamento Comunicativo; Teste de Vocabulário por Imagem Peabody – TVIP; Teste de Screening de Desenvolvimento DenverII. Foi realizada avaliação psicológica, quanto ao nível intelectual, com a aplicação da Escala de Inteligência StanfordBinet. Os resultados mostraram que o desempenho das crianças do GE quanto às habilidades comunicativas, de linguagem, cognitiva e de linguagem receptiva apresentaram diferença estatística significante quando comparado com o GC. Os achados desse trabalho confirmam a interferência do HC no desenvolvimento infantil, ressaltando que indivíduos com HC, mesmo diagnosticados e tratados precocemente, podem apresentar alterações motoras, comunicativas e cognitivas e esses prejuízos poderão afetálos no decorrer da vida, inclusive nas habilidades escolares. Reitera se que estudos longitudinais são importantes para acompanhar e prevenir essas alterações.

Congenital hypothyroidism (CH) is a metabolic disorder characterized by deficiente production of thyroid hormones. The literature points out that children may have cognitive, language and behavioral problems changes even when the diagnosis and treatment started early. The study aimed to verify performance in motor, communication and cognitive abilities of individuals with congenital hypothyroidism treated from the neonatal period and to compare these findings with their peers without thyroid changes. The study included 15 subjects with a diagnosis of congenital hypothyroidism females with chronological age ranging from 36 to 71 months, with Intelligence Quotient greater than 70, called Experimental Group (GE); and 15 typical individuals without thyroid changes, called Comparative Group (GC). Participants in both groups were matched for chronological age and socioeconomic status. The assessment instruments used were: Interview with parents; Observationof Communicative Behavior; Vocabulary Test Peabody Picture TVIP; Screening Test Development DenverII. Psychological assessment was conducted, on theintellectual level, with the application of the Stanford Binet Intelligence Scale. The results showed that children's performance of GE regarding communication skills, language, cognitive and receptive language showed statistically significant differences when compared to the GC. The findings of this study confirm the interference of HC in child development, noting that individuals with HC, even if diagnosed and treated early, may have driven, communicative and cognitive changes and these losses may affect them throughout their lives, including in school skills. It is reiterated that longitudinal studies are important to monitor and prevent these changes.

Habilidades do desenvolvimento infantil em crianças com Doença Falciforme: enfoque na linguagem / Child development skills in sickle cell disease: focus on language

A Doença Falciforme é uma alteração hemolítica hereditária do tipo autossômica recessiva com grande variabilidade clínica e importância epidemiológica envolvendo afrodescendentes. As complicações agudas estão relacionadas geralmente a vaso-oclusão, acarretando dores osteomioarticulares e abdominais e comprometimento crônico de múltiplos órgãos e sistemas. Estas complicações envolvem o sistema nervoso central, provocando acidentes vasculares encefálicos ou infartos cerebrais silenciosos. Há evidências de que o efeito cumulativo destas complicações, associado à fatores socioambientais e ao genótipo interferem no desempenho cognitivo, linguístico, pessoal-social e motor, levando a diminuição do rendimento acadêmico em idade escolar e repercutindo na qualidade de vida destes indivíduos. Os objetivos deste trabalho foram: verificar as habilidades do desenvolvimento infantil, com enfoque na linguagem, em pré-escolares com Doença Falciforme sem AVE comprovado em comparação com crianças saudáveis para a doença; verificar a influência dos aspectos motores, pessoais-sociais e cognitivos no desenvolvimento da linguagem; e verificar a influência de fatores socioambientais no desenvolvimento infantil. Trinta e quatro crianças (17 com Doença Falciforme - GDF e 17 saudáveis para a doença - Grupo controle: GC) com idade entre um ano e cinco anos e 11 meses, submeteram-se à avaliação das habilidades motoras, cognitivas, pessoais-sociais, linguísticas e psicolinguísticas por meio da aplicação dos seguintes instrumentos, de acordo com sua faixa etária: Teste de Screening do Desenvolvimento de DENVER-II; Early Language Milestone Scale; ABFW Teste de Linguagem Infantil Parte A (fonologia); Teste de Vocabulário por Imagem Peabody; e Teste Illinóis de Habilidades Psicolinguísticas. As crianças foram pareadas quanto à idade em anos e meses, sexo, nível socioeconômico e afrodescendência. Para análise estatística utilizou-se os Teste de Correlação de Spearman...

The Sickle Cell Disease is an inherited autosomal recessive hemolytic alteration with great clinical variability and epidemiological importance involving african descent. Acute complications are usually related to vascular occlusion, causing musculoskeletal and abdominal pain and chronic involvement of multiple organs and systems. These complications involve the central nervous system, causing strokes or silent cerebral infarcts. There is evidence that the cumulative effect of these complications associated with environmental factors and genotype interfere with cognitive, language, personal-social and motor performance, leading to decreased academic performance at school age and reflecting on the quality of life of these individuals. The objectives of this study were to verify the child development skills, with a focus on language, in preschool children with sickle cell disease without proven stroke compared to healthy children for the disease; verify the influence of motor, personal-social and cognitive aspects on language development; and verify the influence of environmental factors on child development. Thirty-four children (17 with Sickle Cell Disease - SCDG and 17 without the disease - Control Group: CG) with chronological age between one and five years and 11 months, underwent assessment of motor, cognitive, personal-social, linguistic and psycholinguistic skills through the following instruments, according to their age: DENVER-II Developmental Screening Test; Early Language Milestone Scale; ABFW Teste de Linguagem Infantil- Part A (phonology); The Peabody Picture Vocabulary Test; and Illinois Test of Psycholinguistic Abilities. The children were matched for age in years and months, sex, socioeconomic status and african ancestry. It was used the Spearman correlation, Mann-Whitney and Fish tests for the statistical analysis. The SCDG, compared with the CG, showed significantly lower results in language and psycholinguistic skills...

A importância da mastigação na doença de alzheimer: [revisão] / The relationship between mastication and alzheimer's disease: [review]

Com o crescimento paulatino da longevidade da população, a incidência da doença de Alzheimer, que afeta, principalmente, a terceira idade, aumentou. A doença de Alzheimer afeta o cérebro, principalmente as áreas da memória e da linguagem, levando a um progressivo prejuízo dessas funções. Estudos relatam que a falta de uma mastigação eficiente pode ser um dos fatores de risco para a doença de Alzheimer. O objetivo deste estudo foi fazer uma revisão da literatura sobre a importância da mastigação e sua relação com a doença de Alzheimer.