Association of clinical, social and environmental variables with dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water / Associação de variáveis clínicas, sociais e ambientais sobre a cárie dentária em adolescentes de um município brasileiro com água fluoretada

Abstract Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p<0.0001) in dental caries indexes was observed between 2012 and 2018. Conclusion Fluoridation of public water supply at unsuitable levels, as well as other social and clinical variables can influence the caries pattern in adolescents.

Resumo Introdução A tendência de redução da cárie dentária tem sido constatada, apesar de maiores investigações sobre seu padrão e desenvolvimento serem ainda necessárias. Objetivo investigar a influência de variáveis clínicas, sociais e ambientais sobre a cárie em adolescentes de um município brasileiro com água fluoretada, no ano de 2018. Método Empregou-se uma amostra não probabilística de 277 adolescentes de 12 anos, de escolas públicas de Nova Friburgo, Rio de Janeiro, Brasil. Exames clínicos foram realizados por examinadores calibrados, para avaliação de cárie, doença periodontal e fluorose, sob critérios da Organização Mundial da Saúde (OMS). Questionários semiestruturados foram aplicados para coletar informações socioambientais. Resultados Indivíduos residentes em regiões com flúor na água em subdoses (OR=3,60, p=0,0006), e aqueles com baixa renda (OR =1,90, p=0,0444), com presença de gengivite (OR = 3,36; p = 0,0016) e cuja razão para a visita ao dentista foi para tratamento dentário (OR=2,41; 0,0203), apresentaram mais chances de terem cárie. Uma redução significativa (p<0,0001) nos índices de cárie foi observada entre 2012 (primeiro levantamento epidemiológico) e 2018. Conclusão A fluoretação das águas de abastecimento público, quando em níveis não adequados, assim como outras variáveis sociais e clínicas, podem influenciar o padrão de cárie nos adolescentes.

First-year weight loss following gastric band surgery predicts long-term outcomes.

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) continues to be a valid surgical treatment option to address severe obesity. However, outcomes are varied and can be difficult to predict. Early prediction of suboptimal weight loss following LAGB may enable adjustments to postoperative care and consequently improve surgical outcomes. Therefore, our aim is to investigate the prognostic utility of using early weight loss following LAGB to predict long-term weight outcomes. METHODS: Clinical data from patients undergoing LAGB between 2001 and 2007 at a single institution were retrospectively collected and analysed. The data was used to inform a model for predicting long-term weight loss after LAGB surgery. Percent total weight loss (%TWL) greater than 20% 1 year after surgery was considered a measurement of success since it has been associated with the improvement of comorbidities and increased patient satisfaction. RESULTS: The average %TWL 1 year after LAGB surgery was 23.73% (n = 1524, SD = 8.68%). Weight loss of less than 10% in 1 year was a negative predictor of weight loss >20% in 8-12 years (OR = 0.449; p = 0.002; 95% CI = 0.272-0.742). Moreover, weight loss >20% in 1 year was a strong predictor of weight loss >20% in 8-12 years (OR = 5.33; p < 0.001; 95% CI = 3.17-8.97). CONCLUSION: Total body weight reduction of less than 10% 1 year after LAGB surgery suggests a lesser weight loss at 8-12 years. For these patients, targeted interventions would be appropriate to increase the chances of long-term success.

The Impact of CKD on Perioperative Risk and Mortality after Bariatric Surgery.

Background: Twenty percent of patients with CKD in the United States have a body mass index (BMI) ≥35 kg/m2. Bariatric surgery reduces progression of CKD to ESKD, but the risk of perioperative complications remains a concern. Methods: The 24-month data spanning 2017-2018 were obtained from the Metabolic and Bariatric Surgery Quality Improvement Program (MBSAQIP) database and analyzed. Surgical complications were assessed on the basis of the length of hospital stay, mortality, reoperation, readmission, surgical site infection (SSI), and worsening of kidney function during the first 30 days after surgery. Results: The 277,948 patients who had primary bariatric procedures were 44±11.9 (mean ± SD) years old, 79.6% were women, and 71.2% were White. Mean BMI was 45.7±7.6 kg/m2. Compared with patients with an eGFR≥90 ml/min per BSA, those with stage 5 CKD/ESKD were 1.91 times more likely to be readmitted within 30 days of a bariatric procedure (95% CI, 1.37 to 2.67; P<0.001). Similarly, length of hospital stay beyond 2 days was 2.05-fold (95% CI, 1.64 to 2.56; P<0.001) higher and risk of deep incisional SSI was 6.92-fold (95% CI, 1.62 to 29.52; P=0.009) higher for those with stage 5 CKD/ESKD. Risk of early postoperative mortality increased with declining preoperative eGFR, such that patients with stage 3b CKD were 3.27 (95% CI, 1.82 to 5.89; P<0.001) times more likely to die compared with those with normal kidney function. However, absolute mortality rates remained relatively low at 0.53% in those with stage 3b CKD. Furthermore, absolute mortality rates were <0.5% in those with stages 4 and 5 CKD, and these advanced CKD stages were not independently associated with an increased risk of early postoperative mortality. Conclusions: Increased severity of kidney disease was associated with increased complications after bariatric surgery. However, even for the population with advanced CKD, the absolute rates of postoperative complications were low. The mounting evidence for bariatric surgery as a renoprotective intervention in people with and without established kidney disease suggests that bariatric surgery should be considered a safe and effective option for patients with CKD.

The Effect of Laparoscopic Sleeve Gastrectomy on Gastroesophageal Reflux Disease.

BACKGROUND: The laparoscopic sleeve gastrectomy (LSG) has become one of the most popular surgical weight loss options. Since its inception as a procedure intended to promote durable weight loss, the association between LSG and gastroesophageal reflux disease (GERD) has been a point of debate. First and foremost, it is known that GERD occurs more frequently in the obese population. With the sleeve gastrectomy growing to be the predominant primary bariatric operation in the United States, it is imperative that we understand the impact of LSG on GERD. OBJECTIVE: To examine the effects of LSG on GERD symptoms. METHODS: One hundred and ninety-one bariatric surgery candidates completed a Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) questionnaire before and after undergoing elective LSG (mean follow-up time of 20.4 ± 2.7 months). Values were stratified by the presence or absence of preoperative GERD, GERD medications, age, gender, crural repair, patient satisfaction with present condition, and percent total weight loss (%TWL). RESULTS: For the entire group, mean weight loss, %TWL, and reduction in BMI were 79 pounds, 28.1%, and 12.7 kg/m2 respectively. Within the overall cohort, there was no significant change in GERD symptoms from before to after surgery (mean GERD-HRQL scores were 6.1 before and after surgery, p = 0.981). However, in a subgroup analysis, patients without GERD preoperatively demonstrated a worsening in mean GERD-HRQL scores after surgery (from 2.4 to 4.5, p = 0.0020). The percentage of change in the usage of medications to treat GERD was not statistically significant (from 37 to 32%, p = 0.233). The percent of patients satisfied with their condition postoperatively was significantly increased in those with preoperative GERD, older age, crural repair intraoperatively, and in those with the highest %TWL. CONCLUSION: These results suggest that while overall LSG does not significantly affect GERD symptoms, patients without GERD preoperatively may be at risk for developing new or worsening GERD symptoms after surgery. It is important to remark that this is a review of the patient's clinical symptoms of GERD, not related to any endoscopic, pathological, or manometry studies. Such studies are necessary to fully establish the effect of LSG on esophageal health.

Comparative study between the anti-P. falciparum activity of triazolopyrimidine, pyrazolopyrimidine and quinoline derivatives and the identification of new PfDHODH inhibitors.

In this work, we designed and synthesized 35 new triazolopyrimidine, pyrazolopyrimidine and quinoline derivatives as P. falciparum inhibitors (3D7 strain). Thirty compounds exhibited anti-P. falciparum activity, with IC50 values ranging from 0.030 to 9.1 µM. The [1,2,4]triazolo[1,5-a]pyrimidine derivatives were more potent than the pyrazolo[1,5-a]pyrimidine and quinoline analogues. Compounds 20, 21, 23 and 24 were the most potent inhibitors, with IC50 values in the range of 0.030-0.086 µM and were equipotent to chloroquine. In addition, the compounds were selective, showing no cytotoxic activity against the human hepatoma cell line HepG2. All [1,2,4]triazolo[1,5-a]pyrimidine derivatives inhibited PfDHODH activity in the low micromolar to low nanomolar range (IC50 values of 0.08-1.3 µM) and did not show significant inhibition against the HsDHODH homologue (0-30% at 50 µM). Molecular docking studies indicated the binding mode of [1,2,4]triazolo[1,5-a]pyrimidine derivatives to PfDHODH, and the highest interaction affinities for the PfDHODH enzyme were in agreement with the in vitro experimental evaluation. Thus, the most active compounds against P. falciparum parasites 20 (R = CF3, R1 = F; IC50 = 0.086 µM), 21 (R = CF3; R1 = CH3; IC50 = 0.032 µM), 23, (R = CF3, R1 = CF3; IC50 = 0.030 µM) and 24 (R = CF3, 2-naphthyl; IC50 = 0.050 µM) and the most active inhibitor against PfDHODH 19 (R = CF3, R1 = Cl; IC50 = 0.08 µM - PfDHODH) stood out as new lead compounds for antimalarial drug discovery. Their potent in vitro activity against P. falciparum and the selective inhibition of the PfDHODH enzyme strongly suggest that this is the mechanism of action underlying this series of new [1,2,4]triazolo[1,5-a]pyrimidine derivatives.

Clinical and Social Variables Association on the Frequency of Intellectual Disability Persons to Dental Care

ABSTRACT Objective: To evaluate the association of oral health indicators and social variables on the frequency of visit to the dentist by persons with intellectual disability (ID). Material and Methods: The study comprised a sample consisting of 149 participants with ID, aged from 11 to 29 years, from non-governmental institutions. Semi-structured interviews were held to collect sociodemographic and psychosocial information with their parents/guardians, followed by oral health evaluations in accordance with World Health Organization criteria. Crude analyses and multiple analysis were conducted to test whether oral health indicators and social data were predictors of the visit to dental care services. Results: In the multiple logistic regression model, individuals with lower DMF-t (OR=3.13; 95% CI=1.40-6.97) and those with less crowded housing (OR=2.33; 95% CI=1.06-5.12) presented less frequency of visits to oral health services. Conclusion: DMFT and crowded housing are associated to the frequency of persons with intellectual disability to dental care as well as this outcome measure affects the oral health of persons with ID. Therefore, identifying limiting factors to dental care of persons with intellectual disability is needed so that this group can receive adequate attention.

Cuidados de enfermagem ao paciente renal crônico em hemodiálise em uso de cateter duplo lúmen / Nursing care of the chronic renal patient on hemodialysis using double lumen catheter / Cuidados de enfermería al paciente renal crónico en hemodiálisis en uso de Catéter Doble Lumen

Objetivo: Avaliar o cuidado de Enfermagem prestado ao paciente renal crônico em hemodiálise durante o manuseio do Cateter Duplo Lúmen. Métodos: Trata-se de um estudo descritivo, transversal realizado em uma clínica de hemodiálise de uma cidade de médio porte do nordeste brasileiro. Participaram do estudo 14 profissionais de enfermagem. A coleta dos dados ocorreu em setembro de 2016 subsidiada em checklist de adequação as normas vigentes de manuseio do cateter. Resultados: A maioria dos cuidados foi executada pelos técnicos de enfermagem, com 88,9% a 92,0% de frequência. Houve algumas falhas nos cuidados, e a mais presente foi a falta de higienização das mãos, presente em menos de 30% das observações. Conclusão O estudo evidenciou que existem lacunas na assistência de enfermagem ao paciente em uso de cateter, e que é necessário do enfermeiro orientação e supervisão constante da equipe para evitá-las

Objective: To evaluate the nursing care provided to chronic renal patients on hemodialysis during the handling of the double lumen catheter. Methods: This is a descriptive cross-sectional study conducted in a hemodialysis clinic in a medium-sized city in northeastern Brazil. Fourteen nursing professionals participated in the study. Data collection took place in September 2016, supported by a checklist of compliance with current catheter handling standards. Results: Most care was performed by nursing technicians, with 88.9% to 92.0% frequency. There were some failures in care, and the most common was the lack of hand hygiene, present in less than 30% of the observations. Conclusion: The study showed that there are gaps in nursing care for patients using catheters, and that the nurse needs constant guidance and supervision of the team to avoid them

Objetivo: Evaluar la atención de enfermería brindada a pacientes renales crónicos en hemodiálisis durante el manejo del catéter de doble luz. Métodos: Este es un estudio descriptivo transversal realizado en una clínica de hemodiálisis en una ciudad mediana en el noreste de Brasil. Catorce profesionales de enfermería participaron en el estudio. La recopilación de datos tuvo lugar en septiembre de 2016, respaldada por una lista de verificación del cumplimiento de los estándares actuales de manejo de catéteres. Resultados: La mayoría de los cuidados fueron realizados por técnicos de enfermería, con una frecuencia del 88,9% al 92,0%. Hubo algunas fallas en la atención, y la más común fue la falta de higiene de las manos, presente en menos del 30% de las observaciones. Conclusión: El estudio mostró que existen vacíos en la atención de enfermería para pacientes que usan catéteres, y que la enfermera necesita orientación y supervisión constantes del equipo para evitarlos

Prevalência da Síndrome de Burnout entre médicos residentes / Prevalence of Burnout Syndrome among resident doctors / Prevalencia del Síndrome de Burnout entre médicos residentes

Resumo Médicos residentes estão expostos aos estressores relacionados ao ensino e ao exercício profissional. Nesta pesquisa, objetivamos identificar a prevalência da síndrome de burnout entre os médicos residentes do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG) e explorar sua relação com aspectos sociodemográficos e ocupacionais. Dos médicos residentes, 273 responderam uma ficha sociodemográfica e ocupacional e o Inventário de Burnout de Maslach (MBI), desses, entrevistamos 13. Submetemos as respostas dos questionários à análise estatística e das entrevistas à análise de conteúdo. Encontramos alta exaustão emocional (68,1%), moderado ou alto cinismo (41,7%) e moderada ou alta ineficácia profissional (40,6%). Identificamos a presença de síndrome de burnout em 25,64% dos médicos residentes, além disso, encontramos relações de baixo poder explicativo com as variáveis sociodemográficas e ocupacionais. Os resultados fortaleceram a necessidade de questionarmos as condições de trabalho dos médicos residentes, o papel das variáveis sociodemográficas e ocupacionais, da religiosidade e do processo de socialização organizacional no desenvolvimento da síndrome de burnout. (AU)

Abstract Resident doctors are exposed to stressors related to both the education and the professional practice. This research aimed to identify the prevalence of burnout syndrome among the resident doctors of the Hospital das Clínicas of the Universidade Federal de Minas Gerais (HC-UFMG), exploring its association with sociodemographic and occupational aspects. Of the resident doctors, 273 answered a sociodemographic and occupational form and the Maslach Burnout Inventory (MBI), and we interviewed 13 of them. We submitted the answers of the questionnaires to statistical analysis, whereas we applied content analysis to answers of interviews. The participants showed high emotional exhaustion (68.1%), moderate or high cynicism (41.7%), and moderate or high professional ineffectiveness (40.6%). We found that 25.64% the resident doctors presented with burnout syndrome. Besides, sociodemographic and occupational variables presented low explanatory power to prevalence of the syndrome. These results strengthen the need to question the working conditions of resident doctors, as well as the role of sociodemographic and occupational variables, religiosity, and the process of organizational socialization in the development of burnout syndrome. (AU)

Resumen Los médicos residentes están expuestos a los estresores relacionados con la enseñanza y el ejercicio profesional. En esta investigación, el objetivo es identificar la prevalencia del síndrome de quemarse por el trabajo entre los médicos residentes del Hospital das Clínicas de la Universidade Federal de Minas Gerais (HC-UFMG), así como explorar su relación con aspectos sociodemográficos y ocupacionales. De los médicos residentes, 273 respondieron a una ficha sociodemográfica y ocupacional y al Cuestionario de Burnout de Maslach (MBI); de los cuales entrevistamos a 13 de ellos. Sometemos sus respuestas de los cuestionarios al análisis estadístico; y de las entrevistas, al análisis de contenido. Encontramos un alto agotamiento emocional (68,1%), moderado o alto cinismo (41,7%) y moderada o alta ineficacia profesional (40,6%). Identificamos la presencia de síndrome de quemarse en el 25,64% de los médicos residentes y encontramos relaciones de bajo poder explicativo con las variables sociodemográficas y ocupacionales. Los resultados fortalecieron la necesidad de cuestionar las condiciones de trabajo de los médicos residentes, el papel de las variables sociodemográficas y ocupacionales, de la religiosidad y del proceso de socialización organizacional en el desarrollo del síndrome de quemarse por el trabajo. (AU)

Early Post-operative Weight Change After Roux-en-Y Gastric Bypass Predicts Weight Loss at 12-Month Follow-up.

INTRODUCTION: Sub-optimal weight loss following Roux-en-Y gastric bypass (RYGB) represents an important clinical challenge in a significant number of patients. Early identification of such patients would be advantageous, as it could aid in the selective implementation of targeted adjunct interventions during the first post-operative year. METHODS: Clinical audit data from 1137 patients undergoing RYGB between 2013 and 2016 at the Instituto Sallet in Brazil were prospectively registered in an online database (BOLD) and analyzed. RESULTS: Forty-eight percent of patients achieving less than 5% total weight loss after the first post-operative month achieved a 20% total weight loss at 1 year (n = 626; OR = 0.6 CI = 95%). Eighty-three percent of patients losing between 5 and 10% at 1 month and 95% of patients losing greater than 10% at 1 month had lost at least 20% of total body weight after the first post-operative year. Forty-four percent of patients achieving less than 10% total weight loss after the third post-operative month achieved 20% total weight loss at 1 year (n = 494; OR = 0.3 CI = 95%). CONCLUSION: Total bodyweight reduction after RYGB of < 5% at 1 month and < 10% at 3 months is associated with suboptimal weight loss at 1 year. These results reinforce findings from other studies reporting that patients tend to follow a common weight loss trajectory. Identifying the patients with weight trajectory requiring adjunct therapies early on is crucial so appropriate adjustments can be made to post-operative care.

Acolhimento do enfermeiro na admissão do paciente renal crônico para tratamento hemodialitico / Nursing reception in the admission of chronic renal patient for hemodialitic treatment / Acogida del enfermero en la admisión del paciente renal crónico para tratamiento hemodialitico

Objetivos: analisar de que forma ocorre o acolhimento do paciente renal crônico para o tratamento hemodialitico pelo enfermeiro na admissão em uma clínica de Hemodiálise. Método: Estudo descritivo exploratório de abordagem qualitativa, realizada nos meses de setembro e outubro de 2018. Os participantes do estudo foram 16 enfermeiros que atuavam há pelo menos seis meses na área de hemodiálise, e excluídos os que não realizam assistência direta ao paciente. Resultados: As falas evidenciam que os enfermeiros executam procedimentos burocráticos rotineiros na admissão, identificam as necessidades de cuidado relacionados principalmente ao acesso, orientam para o autocuidado e que tem muitos pacientes sob sua supervisão dificultando a realização de uma assistência completa. Conclusão: o ato de acolher é executado, na busca da construção do vínculo profissional-paciente, orientando ao auto cuidado, mostrando formas de adaptação ao novo tratamento e o seu reflexo na qualidade de vida do paciente

Objectives: to analyze how the chronic renal patient receives for the hemodialytic treatment by the nurse on admission to a Hemodialysis clinic. Method: Exploratory descriptive study with a qualitative approach, carried out in September and October 2018. The study participants were 16 nurses who had been working for at least six months in the area of hemodialysis, and excluded those who did not provide direct assistance to the patient. Results: The nurses show that nurses perform routine bureaucratic procedures at admission, identify care needs related mainly to access, guide self-care, and have many patients under their supervision, making it difficult to perform complete care. Conclusion: the act of welcoming is performed in the search for the construction of the professional-patient bond, orienting to self-care, showing ways of adapting to the new treatment and its reflection on the patient's quality of life

Objetivos: analizar de qué forma ocurre la acogida del paciente renal crónico para el tratamiento hemodialitico por el enfermero en la admisión en una clínica de Hemodiálisis. Método: estudio descriptivo exploratorio de abordaje cualitativo, realizado en los meses de septiembre y octubre de 2018. Los participantes del estudio fueron 16 enfermeros que actuaban hace al menos seis meses en el área de hemodiálisis, y excluidos los que no realizan asistencia directa al paciente. Resultados: las declaraciones evidencian que los enfermeros realizan procedimientos burocráticos rutinarios en la admisión, identifican las necesidades de cuidado relacionadas principalmente con el acceso, orientan al autocuidado y que tiene muchos pacientes bajo su supervisión dificultando la realización de una asistencia completa. Conclusión: el acto de acoger es ejecutado, en la búsqueda de la construcción del vínculo profesional-paciente, orientando al auto cuidado, mostrando formas de adaptación al nuevo tratamiento y su reflejo en la calidad de vida del paciente

The influence of the Brazilian school health program on the oral-health-related quality of life of adolescents

Abstract The aim of this study was to evaluate the influence of the Brazilian School Health Program (SHP) on dental clinical disorders such as caries, gingivitis, and dental trauma as well as on the oral-health-related quality of life (OHRQoL) of adolescents in Nova Friburgo, RJ, Brazil. The study consisted of a non-probabilistic (convenience) sample comprising 319 12-year-old adolescents, both participants and non-participants of the SHP, for at least two years. Socio-demographic and OHRQoL questionnaires (CPQ11-14, the Child Perceptions Questionnaire) were applied as well as clinical examinations for caries, periodontal disease, and dental trauma following the World Health Organization (WHO) criteria by calibrated researchers. Mann-Whitney, chi-square tests, and multiple logistic regression models were used for the data analysis. Statistically significant differences were observed between the groups covered and not covered by the SHP for gingivitis (p = 0.0373) and OHRQoL on the social welfare subscale (p = 0.0265) and total scale (p = 0.0449) of CPQ11-14. Multivariate analysis showed that female adolescents were 1.74 times more likely to present a lower OHRQoL (OR = 1.74, 95%IC = 1.10-2.77, p = 0.0183) than males. In addition, non-SHP subjects were 1.56 times more likely to have poor OHRQoL (OR = 1.56, 95%IC = 0.94-2.59, p = 0.0873) than program participants. In conclusion, SHP positively influenced the OHRQoL of adolescents. However, follow-up studies are needed to verify the continued effectiveness of this Brazilian SHP in improving the oral health levels and quality of life of adolescents.

Teoria da mente e leitura: estudo qualitativo na educação infantil / Theory of mind and reading: qualitative study in early childhood education / Teoría de la mente y lectura: estudio cualitativo en la educación infantil

Tendo em vista as interfaces entre teoria da mente e linguagem e os benefícios da leitura mediada para o desenvolvimento sociocognitivo infantil, apresenta-se a vertente qualitativa de um estudo mais amplo sobre teoria da mente, que, de forma complementar, investigou as experiências vivenciadas por pré-escolares em relação à atividade leitora no contexto familiar e escolar. Participaram da pesquisa 178 crianças e 17 docentes de escolas públicas e privadas de educação infantil. As crianças responderam a um questionário que buscou avaliar o contexto familiar das atividades diárias de leitura; já as professoras foram entrevistadas para avaliar as concepções e práticas sobre as atividades leitoras em sala de aula, sendo os relatos submetidos à análise de conteúdo. Os resultados indicam que os contextos de leitura tanto familiar quanto escolar são potencialmente favoráveis ao desenvolvimento sociocognitivo e tendem a contribuir para o aprimoramento da compreensão infantil dos estados mentais.

Considering the interfaces between theory of mind and language and the benefits of mediated reading for children's sociocognitive development, the qualitative aspect of a broader study of mind theory is presented, which, in a complementary way, investigated the experiences experienced by preschool children in relation to the reading activity in the family and school context. The participants were 178 children and 17 teachers from public and private early childhood schools. The children answered a questionnaire that sought to evaluate the family context of the daily reading activities and the teachers were interviewed to evaluate the conceptions and practices about the reading activities in the classroom, and the reports were submitted to content analysis. The results indicate that both the family reading context and the school context are potentially favorable contexts for sociocognitive development and tend to contribute to the improvement of children's understanding of mental states.

Teniendo en vista las interfaces entre teoría de la mente y lenguaje y los beneficios de la lectura mediada para el desarrollo socio-cognitivo infantil, se presenta la vertiente cualitativa de un estudio más amplio sobre teoría de la mente que, de forma complementar, se investigó las experiencias vivenciadas por pre-escolares en relación a la actividad lectora en el contexto familiar y escolar. Participaron 178 niños y 17 docentes de escuelas públicas y privadas de educación infantil. Los niños contestaron un cuestionario que buscó evaluar el contexto familiar de las actividades diarias de lectura y las profesoras se entrevistaron para evaluar las concepciones y prácticas sobre las actividades lectoras en sala de clase, los relatos se sometieron al análisis de contenido. Los resultados indican que tanto el contexto familiar de lectura como el alumno constituyen contextos potencialmente favorables al desarrollo socio-cognitivo y tienden a contribuir para la mejora de la comprensión infantil de los estados mentales.

The preventive effects of ascorbic acid supplementation on locomotor and acetylcholinesterase activity in an animal model of schizophrenia induced by ketamine

ABSTRACT Studies have shown that schizophrenic patients seem to have nutritional deficiencies. Ascorbic acid (AA) has an important antioxidant effect and neuromodulatory properties. The aim of this study was to evaluate the effects of AA on locomotor activity and the acetylcholinesterase activity (AChE) in an animal model of schizophrenia (SZ). Rats were supplemented with AA (0.1, 1, or 10 mg/kg), or water for 14 days (gavage). Between the 9th and 15th days, the animals received Ketamine (Ket) (25 mg/kg) or saline (i.p). After the last administration (30 min) rats were subjected to the behavioral test. Brain structures were dissected for biochemical analysis. There was a significant increase in the locomotor activity in Ket treated. AA prevented the hyperlocomotion induced by ket. Ket also showed an increase of AChE activity within the prefrontal cortex and striatum prevented by AA. Our data indicates an effect for AA in preventing alterations induced by Ket in an animal model of SZ, suggesting that it may be an adjuvant approach for the development of new therapeutic strategies within this psychiatric disorder.

Dental Care for an adolescent with chromosome pentasomy: rare case report with a two year follow-up / Atenção Odontológica a jovem com pentassomia cromossômica: relato de caso raro com acompanhamento de 2 anos

Pentasomy of the x chromosome is a rare syndrome of unknown incidence and there are few reports in the scientific literature, especially in terms of dental care for patients with this syndrome. The aim of this study was to report the dental care given to an adolescent with pentasomy of the X chromosome. The patient presented a cleft palate, impacted teeth, malocclusion, high caries activity, gingivitis and multiple tooth loss due to caries. Despite the difficulties of carrying out the dental work due to involuntary movements and the initial lack of collaboration from the patient the overall dental care was completed on an outpatient basis. The therapeutic success of the treatment was strongly supported by the significant cooperation and relationship that grew up along the period of the treatment, as well as the desire to have the treatment done by both the patient and her parents.

A pentassomia do cromossomo x é uma síndrome rara, de incidência desconhecida e com poucos relatos na literatura científica, especialmente no que diz respeito à atenção odontológica para pacientes portadores da mesma. O objetivo deste estudo foi relatar um caso de atenção odontológica a uma jovem com pentassomia do cromossomo x, que apresentava fenda palatina, dentes inclusos, má-oclusão, alta atividade de cárie, gengivite e múltiplas perdas dentárias devido à cárie. Apesar das dificuldades de se realizar o tratamento dentário devido aos movimentos involuntários e a não colaboração inicial da paciente, houve total viabilidade da atenção odontológica em âmbito ambulatorial, observando-se significativa cooperação, formação de vínculo e adesão ao tratamento pela mesma e seus responsáveis, o que gerou sucesso terapêutico.

Interfaces entre teoria da mente, linguagem e faz de conta / Interfaces between theory of mind, language and make-believe

Gradualmente, as crianças tornam-se capazes de compreenderem os estados mentais próprios e alheios e de expressá-los por meio da linguagem. Neste domínio sociocognitivo, a brincadeira de faz de conta é uma atividade que pode favorecer a atribuição dos estados mentais na infância. O presente artigo pretende discutir algumas interfaces entre teoria da mente, linguagem e faz de conta. A importância da brincadeira de faz de conta e das conversações como recursos para promover o desenvolvimento sociocognitivo é destacada, pois ambas fomentam a atribuição dos estados mentais. Família e escola são apresentadas como contextos de desenvolvimento potenciais para tal estimulação, uma vez que constituem instâncias favorecedoras de conversações, leituras interativas e brincadeiras.

Gradually, children become able to understand their own and others' mental states and express them through language. In this socio-cognitive domain, playing at make-believe is an activity that may favor the attribution of mental states in childhood. This article discusses the interfaces among theory of mind, language and make-believe. The importance of playing at make-believe and of conversations as resources to promote socio-cognitive development is highlighted, because both encourage the attribution of mental states. Family and school are presented as potential development contexts for this stimulation, since they constitute favorable instances of conversations, interactive readings and games.

Evaluation of theory of mind: a study with students from public and private schools / Avaliação da teoria da mente: estudo com alunos de escolas públicas e particulares mineiras

This study assessed the development of the theory of mind in preschool children aged 4 and 5 years old, along with potential interactions among gender, age and whether children were from private or public schools. A total of 178 children (91 students from public schools and 87 from private schools) participated in the study. After securing ethical compliance with applicable guidelines, we applied the Theory-of-Mind-Scale. There was no evidence of differences regarding gender (p < 0.38). Differences were found in regard to age (p < 0.001) and whether students were from private or public schools (p < 0.008). Five-year-old children performed better on the scale and children from private schools also performed better than those from public schools. The results show that the scale was sufficiently sensitive to capture the evolutionary sequence of the theory of mind and the relevance of socio-cultural factors. Because research in this field is still incipient, we emphasize the importance of further studies conducted with larger samples.

Este estudo avalia o desenvolvimento da teoria da mente em pré-escolares de 4 e 5 anos de idade, bem como as possíveis interações entre as variáveis sexo, idade e rede de ensino. Participaram da pesquisa 178 crianças, das quais 91 alunos de escolas públicas e 87 de escolas particulares. Após procedimentos éticos, aplicou-se a Escala de Teoria da Mente. Não foi evidenciada distinção quanto ao sexo (p < 0,38). Foram verificadas diferenças quanto à idade (p < 0,001) e rede de ensino (p < 0,008). Crianças de 5 anos obtiveram melhor desempenho na escala. As crianças oriundas de escolas particulares apresentaram um desempenho superior às das escolas públicas. Resultados indicam que a escala foi sensível para captar a sequência evolutiva da teoria da mente e a relevância dos fatores socioculturais. Por ser uma área ainda em fase emergente de investigação no Brasil, ressalta-se a importância de estudos com amostras maiores.

Determinantes Sociais e sua Relação com a Experiência de Cárie em Adolescentes: um Estudo Transversal / Social Determinants and Their Relationship with the Dental Caries in Adolescents: a Cross Sectional Study

Recursos materiais e não materiais têm sido investigados para o entendimento do processo saúde-doença. Entretanto, o papel do suporte social na proteção/desenvolvimento de doenças bucais, como a cárie dentária, ainda parece obscuro. O objetivo deste estudo foi avaliar a influência dos recursos socioeconômicos e psicossociais na experiência de cárie em adolescentes residentes em duas regiões de Nova Friburgo, Lumiar e Olaria. A amostra não probabilística compreendeu 45 adolescentes de Lumiar e 75 de Olaria de 12 anos de idade de escolas públicas deambas regiões. Os resultados foram avaliados através de análise descritiva e mostraram uma baixa prevalência de cárie (CPO-D 1,13), para os adolescentes de Lumiar, e CPO-D= 3,27 para grupo de polarização da doença. Em Olaria, observou-se um valor médio de CPO-D dosadolescentes de 1,84. O grupo de polarização da cárie nos residentes do bairro de Olaria apresentou CPO-D= 4,21. Houve tendência à maiorescolaridade estar relacionada aos responsáveis dos adolescentes livres de cáries. Concluiu-se que a escolaridade dos responsáveis parece ser um possível fator relacionado à experiência de cárie e que o capital social pode ter influenciado a experiência de cárie.

Material and non-material resources have been investigated to understand the health-disease process. However, the role of social support in the protection/development of oral diseases such as dental caries still seems unclear. This study evaluated the effect of socio-economic and psychosocial resources on caries experience in adolescents in two regions of Nova Friburgo, Lumiar and Olaria. The non-probabilistic sample comprised of 45 and 75 12 year old students of public schools, living in Lumiar and Olaria, respectively. The evaluation involved an examination of dental caries on the adolescents, according to WHO criteria, besides a semi-structured interview with each tutor of the adolescents, in home environments, in order to record information about the different material and non-material resources. The descriptive results showed a low prevalence of caries (D3 MFT 1.13) and a polarization group- SIC Index (Significant Caries Index) - with a D3 MFT mean of 3.27 for the adolescents living in Lumiar. The D3 MFT mean was 1.84 and SIC Index was 4.21 in the adolescent group in Olaria. Thus,education of the tutor seemed to lead to protection against the disease and social capital may have influenced the caries experience by behavingnegatively as a detrimental factor to oral health in adolescents.

Fluoretação da Água e seu Heterocontrole no Município de Nova Friburgo, Rio de Janeiro - Brasil / Water Fluoridation and its external control in the municipality of Nova Friburgo, Rio de Janeiro - Brazil

A fluoretação da água, apoiada pela Política Nacional de Saúde Bucal, tem sido um desafio no Brasil, devido a algumas insuficiências atuais na gestão pública para a implantação e controle desta medida. Este estudo objetivou vigiar, de forma periódica e sistemática, os níveis de fluoretos na água para consumo humano, em Nova Friburgo - RJ- Brasil (NF), por um período de 12 meses, como medida de heterocontrole, realizada por uma universidade pública. As amostras de água foram coletadas mensalmente, em duplicata, em 26 localidades em todo o município e em datas estabelecidas por sorteio. O método para medir a concentração de fluoretos nas amostras de água foi o eletrométrico, utilizando-se um potenciômetro digital com eletrodo específico para o íon flúor. A concentração de fluoretos nas amostras foi analisada de acordo com padrões fornecidos pelo Cecol/USP (2011). Os dados mostraram grande variação na concentração de fluoretos nas amostras, variando entre um mínimo de 0,00 ppmF e um máximo de 0,98 ppmF, com algumas dentro do intervalo de 0,65 e 0,94 ppmF, considerado o de melhor benefício para prevenir a cárie dentária. A concentração de fluoretos na água de abastecimento público do município foi considerada abaixo dos níveis mínimos exigidos, na maioria das amostras avaliadas, mesmo naquelas pertencentes às Estações de Tratamento de Água (ETA), cuja medida de fluoretação fora previamente implantada. Desta forma, a fluoretação da água e seu respectivo heterocontrole deveriam ser estabelecidos de forma contínua em NF, já que são medidas públicas relevantes para a promoção de saúde bucal.

Water fluoridation, supported by the Brazilian Oral Health Policy, has been a challenge as a public measure to protect Oral Health, due to some current insufficiencies in public management for the implantation of this measure in most Brazilian cities. The present study aimed to monitor, the levels of fluoride in drinking water in Nova Friburgo - RJ-Brazil (NF), on a regular and a systematic manner for a 12 months period, as an external control measurement performed by a public university. Water samples were collected, in duplicate, from 26 localities throughout the city, on a monthly basis, on randomly established dates. The fluoride concentration in the water samples was measured by using an ion-specific electrode coupled to a potentiometer, according to standards supplied by Cecol/USP (2011). Data showed a large variation of fluoride concentration in water samples, ranging from minimum 0.00 ppmF and maximum 0.98 ppmF, with few samples into the interval between 0.65 and 0.94 ppmF, which had the best benefit to prevent dental caries. Fluoride concentration in public water in this city can be considered under the minimum required levels in most of the evaluated samples, even in those from the Water Treatment System (WTS), which has water fluoridation. Thus, water fluoridation and its external control should be established on a regular basis in Nova Friburgo-RJ, Brazil because they are relevant public measures to promote oral health.

Dental caries in inland Brazilian adolescents and its relationship with social determinants

AIM: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience. METHODS: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semi-structured questionnaire applied to the adolescents' parents. RESULTS: The D3MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435). CONCLUSIONS: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries...

Teoria da Mente e Desenvolvimento Social na Infância / Theory of Mind and Social Development in Childhood

A capacidade de compreender os estados mentais, que permite predizer e explicar as ações humanas por meio da linguagem desenvolve-se gradualmente na infância. A aquisição dessa capacidade tem um impacto direto sobre o desenvolvimento social das crianças, em especial nas relações com seus pares. Nesta direção, destacam-se aspectos como as relações de amizade, o comportamento pró-social, a empatia e a aceitação social. O presente artigo apresenta e discute estudos nacionais e internacionais que investigaram as possíveis relações entre o desenvolvimento social e a compreensão dos estados mentais, tais como desejos, crenças e emoções.

The ability to understand mental states that enables us to predict and explain human actions through language develops gradually during childhood. The acquisition of this ability has a direct impact on the social development of children, especially in their peer relations. In this sense, such aspects like friendship, pro-social behavior, empathy and social acceptance are discussed. This article presents and analyzes some national and international studies that have investigated the possible relationship between social development and the understanding of mental states such as desires, beliefs and emotions.