Pedagogical monitoring as a tool to reduce dropout in distance learning in family health.

BACKGROUND: This paper presents the results of a study of the Monsys monitoring system, an educational support tool designed to prevent and control the dropout rate in a distance learning course in family health. Developed by UNA-SUS/UFMA, Monsys was created to enable data mining in the virtual learning environment known as Moodle. METHODS: This is an exploratory study using documentary and bibliographic research and analysis of the Monsys database. Two classes (2010 and 2011) were selected as research subjects, one with Monsys intervention and the other without. The samples were matched (using a ration of 1:1) by gender, age, marital status, graduation year, previous graduation status, location and profession. Statistical analysis was performed using the chi-square test and a multivariate logistic regression model with a 5 % significance level. RESULTS: The findings show that the dropout rate in the class in which Monsys was not employed (2010) was 43.2 %. However, the dropout rate in the class of 2011, in which the tool was employed as a pedagogical team aid, was 30.6 %. After statistical adjustment, the Monsys monitoring system remained in correlation with the course completion variable (adjusted OR = 1.74, IC95% = 1.17-2.59; p = 0.005), suggesting that the use of the Monsys tool, isolated to the adjusted variables, can enhance the likelihood that students will complete the course. Using the chi-square test, a profile analysis of students revealed a higher completion rate among women (67.7 %) than men (52.2 %). Analysis of age demonstrated that students between 40 and 49 years dropped out the least (32.1 %) and, with regard to professional training, nurses have the lowest dropout rates (36.3 %). CONCLUSIONS: The use of Monsys significantly reduced the dropout, with results showing greater association between the variables denoting presence of the monitoring system and female gender.

The influence of hormone replacement therapy on the salivary flow of post-menopausal women.

The aim of this study is to investigate the influence of hormone therapy on salivary flow in menopausal women. It is a case-control study involving 86 post-menopausal women. The case group consisted of 47 women undergoing estroprogestative or estrogen hormone replacement therapy (HRT), and the control group consisted of 39 women who did not receive any HRT. All patients were submitted to a standard questionnaire, followed by total stimulated sialometry and determination of body mass index (BMI). The salivary flow was classified as follows: normal (1.0-3.0 mL/min), low (0.7-1.0 mL/min), and hyposalivation (<0.7 mL/min). The results were analyzed statistically by the chi-square test, logistic regression model, and linear regression (p < 0.05). The HRT group presented an association of protection, even after adjusting the analysis, for low salivary flow (Adjusted OR = 0.22; 95% CI = 0.05-0.88; p = 0.034), and hyposalivation (Adjusted OR = 0.30; 95% CI = 0.10-0.92; p = 0.036). The results suggest that estroprogestative therapy (ß = + 0.53; p = 0.022) has greater influence on the increase of salivary flow than estrogen therapy (ß = +0.35; p = 0.137). The study concludes stating salivary flow was influenced by HRT on the post-menopausal women studied.

Educational Game as an Aid to Good Practices in Dentistry.

The use of games may constitute an innovative strategy for training. OBJECTIVE: Develop an educational quiz type game, construct 60 assessment items and validate this content. METHODOLOGY: Elaboration of the didactic-pedagogical project, development of the game, creation of the assessment items and validation of the content. RESULTS: the technical evaluation obtained a Content Validity Index (CVI) over 80%. CONCLUSIONS: The game can be used as a tool for making information available, thus contributing to the democratization of knowledge.

Serious game is an effective learning method for primary health care education of medical students: A randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the influence of a serious game dedicated to primary health care with traditional learning methods on knowledge of undergraduate medical students. METHODS: A randomized controlled trial was conducted with undergraduate medical students. The students (n = 27) attended to an expositive leveling lesson regard the theme "Screening on Primary Health Care", and answered to a baseline knowledge test, comprised by objective questions. Students were randomly allocated to the control and game groups, in which received a text-based material regarding "Screening on Primary Health Care" or were exposed to a serious game. An immediate knowledge test and a retention knowledge test, presenting the same questions of baseline test, were responded by students at the finish of exposure and four weeks later. The students also performed a survey evaluating the user experience on the serious game. Knowledge test scores were analysed by repeated measures ANOVA and paired sample t-test. User experience and expectation surveys were descriptively analyzed. RESULTS: For the control group, the mean scores and standard deviation were 7.85 ±â€¯0.99, 9.00 ±â€¯1.87 and 7.69 ±â€¯1.44 for baseline, immediate and retention knowledge tests, respectively; the score at immediate test was higher than for baseline and retention tests. The game group presented 7.07 ±â€¯1.98, 8.00 ±â€¯1.84 and 7.15 ±â€¯1.41 for baseline, immediate and retention knowledge tests, respectively. The comparison between groups did not show differences at any moment (p < 0.05). The majority of the participants consider that the serious game has understandable instructions, presented the contents clearly, and it favors the engagement on study. CONCLUSION: The serious game was effective to improve the students' knowledge on primary health care contents. Learning based on a serious game is as effective as learning based on printed text.

Prevalence of carotid artery calcifications detected on panoramic radiographs and confirmed by Doppler ultrasonography: Their relationship with systemic conditions.

CONTEXT: Atherosclerosis affects large and medium caliber arteries by forming calcific atheromas, precursors of cerebral vascular disease. Diabetes mellitus, obesity, and hypertension are considered as risk factors of atherosclerosis. Panoramic radiographs can display images suggestive of carotid artery calcifications (CACs). AIMS: To investigate the prevalence of images suggestive of CAC in panoramic radiographs of the jaws (PRJs) and confirm them by Doppler ultrasonography. To evaluate their anatomic locations and relationships between systemic conditions (diabetes, hypertension, and obesity) and the presence of unilateral or bilateral CAC detected on PRJ or by Doppler ultrasonography. MATERIALS AND METHODS: Of the 723 routinely performed PRJ in patients over 40 years at the Radiology Center in São Luís, Maranhão, Brazil, 21 PRJ containing images suggestive of CAC were selected in this cross-sectional study. The findings from the PRJ were confirmed by Doppler sonography. RESULTS: Images suggestive of CAC was detected in 21 (2.9%) of the PRJ evaluated, consisting of 11 (52.4%) hypertensive, 7 (33.3%) diabetics, and 9 (42.9%) obese. There was a higher prevalence of hypertensive patients in the unilateral CAC group (100%) and bilateral CAC (60%) compared to patients without CAC (25%). CONCLUSIONS: CACs can be detected in PRJs, and are more frequent in common carotid arteries. No significant associations were detected between the presence of unilateral or bilateral CAC in PRJ and hypertension, diabetes, or obesity.

Association between chronic apical periodontitis and low-birth-weight preterm births.

INTRODUCTION: The objective of this study was to investigate the association between chronic apical periodontitis (CAP) and low-birth-weight preterm births (LBWPB). METHODS: Sixty-three women in postpartum period were included in this case-control study. The case group consisted of mothers of LBWPB infants (n = 33), and the control group was represented by mothers of newborns at term (n = 30). The CAP diagnosis was performed by using periapical radiographs through the periapical index in postpartum period. The χ(2) test, Fisher exact test, and linear and logistic regression were used for statistical analysis. RESULTS: It was observed that CAP was present in 54.5% of mothers in the case group and 20.0% in the control group (P = .004); postpartum women with CAP had about 3.5 times greater odds of LBWPB newborns than women without CAP (adjusted odds ratio, 3.52; 95% confidence interval, 1.01-12.32). Postpartum women who reported 6 or more prenatal consultations reduced odds of LBWPB newborns in 80% (adjusted odds ratio, 0.20; 95% CI, 0.06-0.69). It can be estimated that the increase of 1 unit of periapical index had a significant association with the reduction of 1½ gestational weeks in the crude analysis (ß = -1.5, P = .010) and the reduction of 211 g in birth weight after the adjusted analysis (ß = -211, P = .058). CONCLUSIONS: Prematurity and low birth weight were associated with radiographically detected CAP. Women with CAP in postpartum period had greater odds of LBWPB.

Image quality in digital radiographic systems.

The aim of the present study was to evaluate the image quality of four direct digital radiographic systems. Radiographs were made of the maxillary central incisor and mandibular left molar regions of a dry skull, and an aluminum step-wedge. The X-ray generator operated at 10 mA. 60 and 70 kVp, and images were acquired with 3, 5, 8, 12, 24 and 48 exposure pulses. Six well-trained observers classified the images by means of scores from 1 to 3. Collected data were submitted to nonparametric statistical analysis using Fisher's exact test. Statistical analysis showed significant differences (p < 0.01) in image quality with the four systems. Based on the results, it was possible to conclude that: 1) all of the digital systems presented good performance in producing acceptable images for diagnosis, if the exposures of the step-wedge and the maxillary central incisor region were made at 5 pulses, as well as at 8 pulses for the mandibular left molar region, selecting 60 or 70kVp; 2) higher percentages of acceptable images were obtained with the administration of lower radiation doses in CCD-sensors (charge-coupled device); 3) the Storage Phosphor systems produced acceptable images at a large range of exposure settings, that included low, intermediate and high radiation doses.

Association between chronic apical periodontitis and coronary artery disease.

INTRODUCTION: Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease. METHODS: This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís-Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software. RESULTS: The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease. CONCLUSIONS: In these study patients, chronic apical periodontitis was independently associated with coronary artery disease.

[Periodontal disease in women in post-menopause and its relationship with osteoporosis]. / Doença periodontal em mulheres na pós-menopausa e sua relação com a osteoporose.

PURPOSE: To investigate the relationship between periodontitis and osteoporosis, using a case-control study about periodontal status of postmenopausal women. METHODS: A total of 99 postmenopausal women were divided into three groups: normal bone (Gn, n=45), osteopenia (Gpenia, n=31) and osteoporosis (Gporosis, n=23). The categorization of bone mass was measured by dual energy absorptiometry with X-rays in the lumbar spine (L2 - L4), by assessing bone mineral density. Clinical attachment level (CAL), gingival bleeding index (GI), plaque index (PI), and probing depth (PD) were determined in all participants by a single examiner. The data were submitted to BioEstat 2.0 software through parametric analysis of variance (ANOVA) and the Bonferroni test, with the level of significance set at 5%. RESULTS: Women with osteoporosis presented the highest percentage of periodontal disease, with higher average CAL (2.6±0.4 mm) and PD (2.8±0.6 mm), GI (72.8±25.9 mm) and PI (72.9±24.2 mm). Statistical analysis revealed a significant difference in periodontal situation between Gn and Gporosis (p=0,01) and between Gpenia and Gporosis (p=0,03). CONCLUSION: Osteoporosis may have an influence on periodontal condition, based on the relation between periodontitis and osteoporosis in postmenopausal women.

Fluoride oral retention after professional topical application in children with caries activity: effect of the immediate water consumption.

PURPOSE: Since there is no agreement about the time patients must refrain from drinking or eating after a professional application of acidulated phosphate fluoride (APF), the purpose of this study was to evaluate the effect of water consumption on fluoride in saliva. METHODS: This blind randomized crossover in vivo study involved children who received a professional APF gel application followed by either drinking a glass of water (experimental group) or without rinsing, drinking, or eating (control group) for 2 hours. The nonstimulated saliva was collected at 0, 5, 15, 30, 60, and 120 minutes following the professional APF application. After a 7-day washout period, the control and treatment groups were switched. RESULTS: There was a statistically significant difference in the fluoride retention between groups in the times 0 to 5 minutes (P<.05). CONCLUSIONS: The data suggest that the recommendation of asking patients to refrain from drinking water for 30 minutes following the professional APF application is excessive and can be reduced to 15 minutes.

Radiographic study of the prevalence of apical periodontitis and endodontic treatment in the adult population of São Luís, MA, Brazil.

This study investigated the prevalence of apical periodontitis (AP) and its association with endodontically treated teeth in residents of São Luís, MA, Brazil. Two-hundred complete series of periapical radiographs taken over a 10-year period (1993-2003) were retrieved from the files of four prosthesists and five periodontists. The Periapical Index (PAI) was used and the age range, sex, tooth groups, location and association with endodontic treatment (ET) were also analyzed. The Cohen Kappa and Chi-square tests were used for statistical analysis. Out of 200 patients, 135 presented at least one case of AP, which corresponds to a prevalence of 67.5%. Of the 5008 teeth examined, 296 had AP and 553 had ET. Therefore, considering the total number of teeth, AP and ET prevalences were 5.9% and 11%, respectively. Of the 553 endodontically treated teeth, 235 (42.5%) were associated with AP. Chi-square test showed a strong correlation between AP and ET (p<0.05). The 40-year-old age group was significantly the most prevalent (p<0.05). There was no association between AP and patient's sex (p>0.05). The maxillary incisors were the most affected group of teeth (p<0.05). AP had predilection for the maxilla and was strongly associated with endodontically treated teeth (p<0.05). The prevalence of apical periodontitis and endodontically treated teeth with AP was high and similar to the results of studies performed in other countries.