Microencapsulation of Limosilactobacillus reuteri (DSM 23878) for application in infant formula: Heat resistance and bacterial viability during long-time storage.

This study aimed to evaluate the survival capacity of the probiotic culture Limosilactobacillus reuteri (DSM 23878) to microencapsulation by spray drying, and its potential as component of an infant formula. Preliminary tests were performed between skim milk (SM) and infant formula (IF) as wall material and two inlet temperatures, evaluating the encapsulation efficiency, moisture content, water activity and stability, to choose the drying parameters. After drying in optimized conditions, the powder of microencapsulated L. reuteri was characterized and the viability after dilution in an infant formula at 70 °C was determined. In addition, the survival rate throughout 360 days of storage was assessed. As results, encapsulation efficiency was superior to 90 % in both wall materials. However, the use of IF as for microencapsulation produced microparticles with lower water activity (Aw) and moisture, as compared with the SM. Final microparticles produced with IF as wall material presented values of Aw, moisture content, and particle diameter averaged 0.11 ± 0.02, 2.10 ± 0.35 % and 10.30 ± 0.12 µm, respectively. The viability of microencapsulated L.reuteri decreased 1 Log CFU/mL after dilution at 70 °C and the powder maintained a survivor of 73.5 % after 365 days of storage at 4 °C. Thus, the microencapsulation by spray drying under the conditions of this study proved to be an effective technique to protect the probiotic L. reuteri for application in infant formulas, obtaining an adequate number of viable cells after reconstitution at 70 °C and during long time the storage.

Sustainability Competencies in Higher Education Research: An Analysis of Doctoral Theses in Portugal.

Educational research has been highlighting the importance of defining key competencies and learning outcomes related to education for sustainability as a reference for the transparent evaluation of students' learning in this domain. Drawing on a reference framework that identifies five key competencies in sustainability (i.e., systems-thinking competency, anticipatory competency, normative competency, strategic competency, and interpersonal competency), the study reported in this paper aims to understand whether, how, and to what extent these competencies are present in doctoral theses in Higher Education published in Portugal in the past ten years. To address this objective, a qualitative study framed in an interpretative paradigm was conducted, and a literature review was used as a preferential research method to elicit meaning, gain understanding, and develop empirical knowledge. The retrieved documents were treated using deductive content analysis, which was performed using WebQDA software. Results of the analysis show that the competencies considered in the reference framework are present in research on education for sustainability carried out in recent years in Portugal, with a greater emphasis on strategic and anticipatory competencies. Findings suggest that it is important to continue to conduct research on these competencies to successfully integrate them into educational curricula and teacher education programs.

Effect of calcium hydroxide on ph changes of the external medium after intracoronal bleaching.

AIM: This in vitro study evaluated the effect of calcium hydroxide on pH changes of the external medium after intracoronal bleaching. MATERIALS AND METHODS: A total of 50 extracted human premolars were prepared and filled with gutta-percha and endodontic sealer. The teeth were randomly divided into five groups according to the bleaching agents employed: (a) Sterile cotton pellet with distilled water (control group); (b) sodium perborate and distilled water; (c) sodium perborate and 10% carbamide peroxide; (d) sodium perborate and 35% hydrogen peroxide; (e) 35% hydrogen peroxide. The teeth were stored in vials containing distilled water and the pH values of the medium surrounding the teeth were analyzed. After 7-day storage, the bleaching agent was removed and replaced by calcium hydroxide, and the distilled water was changed, in which the teeth were kept stored for further 14 days. Measurement of pH of the external medium (distilled water) was performed 7 days after insertion of the bleaching agents, immediately, 7 and 14 days after insertion of the calcium hydroxide. Data were submitted to statistical analysis by the two-way ANOVA and Tukey,s test. RESULTS: There were pH changes of the external medium at 7- day period after bleaching procedures. These results confirmed the diffusion of bleaching agents to the external medium. CONCLUSION: Calcium hydroxide increased the external medium pH and was effective for pH alkalinization after intracoronal bleaching. CLINICAL SIGNIFICANCE: Intracoronal bleaching of endodontically treated teeth may cause cervical root resorption. A possible explanation for this process is the passage of bleaching agents to the periodontal tissues yielding an inflammatory process. In an attempt to keep the neutrality of the periodontal pH, the calcium hydroxide has been recommended.Results of this study showed that this material should be always used after intracoronal bleaching.

Characterization of a novel broad-spectrum antifungal protein from virus-infected Helminthosporium (Cochliobolus) victoriae.

A broad-spectrum anti-fungal protein of approximately 10 kDa, designated victoriocin, was purified from culture filtrates of a virus-infected isolate of the plant-pathogenic fungus Helminthosporium victoriae (teleomorph: Cochliobolus victoriae) by a multistep procedure involving ultrafiltration and reverse-phase high-performance liquid chromatography (RP-HPLC). Amino acid sequences, obtained by automated Edman degradation sequencing of RP-HPLC-purified victoriocin-derived peptides, were used to design primers for degenerate oligonucleotide-primed polymerase chain reaction (DOP-PCR) amplification from H. victoriae DNA and cDNA templates. An open reading frame coding for a victoriocin precursor of 183 amino acids with calculated molecular mass of approximately 20 kDa was amplified by PCR from H. victoriae genomic DNA but not from the control fungus Penicillium chrysogenum. Southern hybridization analysis confirmed the presence of the victoriocin gene in all H. victoriae strains tested. Sequence analysis indicated that victoriocin has a sequence motif similar to that found in scorpion short toxin/charybdotoxin and a consensus sequence similar to that found in defensins. Victoriocin, like some other antifungal proteins, including the totivirus-encoded killer proteins, is predicted to be expressed in vivo as a preprotoxin precursor consisting of a hydrophobic N-terminal secretion signal followed by a pro-region and terminating in a classical Kex2p endopeptidase cleavage site that generates the N terminus of the mature victoriocin. A putative cell wall protein of approximately 30 kDa (P30) co-purified with victoriocin from cultural filtrates. The potential role of P30 in the antifungal activity of H. victoriae culture filtrates is discussed.

Overexpression of the victoriocin gene in Helminthosporium (Cochliobolus) victoriae enhances the antifungal activity of culture filtrates.

We have previously reported the isolation and characterization of the broad-spectrum antifungal protein, victoriocin, from culture filtrates of a virus-infected isolate of the plant-pathogenic fungus Helminthosporium (teleomorph: Cochliobolus) victoriae. We predicted that the 10-kDa mature victoriocin is derived in vivo from a preprotoxin precursor that is processed by a signal peptidase and kexin-like endopeptidase. We also presented evidence that the victoriocin precursor is encoded by a host gene, designated the victoriocin (vin) gene. In the present study, an H. victoriae genomic DNA library was constructed in the cosmid vector pMLF-2, and a cosmid clone carrying the vin gene and flanking sequences was isolated and used to generate constructs for transformation of virus-free and virus-infected H. victoriae isolates with the vin gene. Culture filtrates of the virus-free vin transformants exhibited high levels of antifungal activity compared with that revealed by the nontransformed virus-free wild-type strain, which exhibited little or no antifungal activity. Moreover, transformation of the wild-type virus-infected H. victoriae strain with the vin gene resulted in still higher production of victoriocin and higher antifungal activity in the culture filtrates of the vin transformants compared with the virus-infected wild-type strain. As previously predicted, the presence in the vin transformants of the preprovictoriocin and its post-translationally generated products, the provictoriocin and the mature victoriocin, was clearly demonstrated. Processing of the victoriocin preprotoxin requires eukaryotic host factors because no processing occurred in an in vitro translation system or in bacteria. It is of interest that some of the virus-free isolates transformed with the vin gene exhibited some features of the virus-induced disease phenotype, including moderate stunting and sectoring. Present data suggests that victoriocin may play an indirect role in disease development. Taken together, these results indicate that victoriocin is the primary protein responsible for the antifungal activity in culture filtrates of virus-infected H. victoriae isolates and that virus infection upregulates the expression of victoriocin. Overproduction of victoriocin may give the slower-growing virus-infected fungal strains some competitive advantage by inhibiting the growth of other fungi.

An assessment of a municipal physical activity programme for seniors based on the EFQM model: Integrating the views of internal and external stakeholders.

The growing proportion of senior citizens and the importance of encouraging active well-ageing behaviours explain the increasing efforts carried out by governments to develop exercise programmes particularly targeted to this group. The complexity associated with the running of these programmes and the resources committed make their quality assessment essential. The aim of the current paper is to validate and refine the use of the EFQM model in this context. A programme of a medium-sized municipality of the Centre region of Portugal was used as a case study to evaluate the adequacy and relevance of the EFQM model and to identify the strengths and weaknesses of the current programme based on the data collected from service users, instructors, municipal leaders and programme partners. High levels of customer satisfaction and loyalty, together with the clarity of programme mission and strategy emerged as main areas of strength. On the other hand, insufficient attention to the measurement of people satisfaction, as well as the leaders' failure of to show appreciation for the efforts developed by the programme instructors are key areas for improvement.

Evaluation of Probiotic Potential of Bacteriocinogenic Lactic Acid Bacteria Strains Isolated from Meat Products.

In this study, the probiotic potential of five bacteriocin-producing lactic acid bacteria (LAB) strains, isolated from meat products, was investigated. They were presumptively identified as Lactococcus lactis subsp. cremoris CTC 204 and CTC 483, L. lactis subsp. hordinae CTC 484, and Lactobacillus plantarum CTC 368 and CTC 469 according to morphological, biochemical, and physiological characteristics. Analysis of genetic variability (random amplified polymorphic (RAPD)-PCR) and whole-cell proteins (SDS-PAGE) revealed similarity between Lactobacillus strains and variability among Lactococcus strains. The evaluation of the probiotic potential showed that the five LAB strains were tolerant to pH 2.0, and only strain CTC 469 was tolerant to the lowest concentration of the bile salts evaluated (0.1%). All strains showed survival or growth ability at 4, 25, and 37 °C, and tolerance at - 20 °C. Although strain CTC 204 in TSB Broth supplemented with MgSO4 showed the highest intensity of biofilm production, this compound was produced by all of them. The safety assessment showed that no thermonuclease, hemolytic, or gelatinase activities were detected. All strains were resistant to erythromycin and sensitive to amoxicillin and phenoxymethylpenicillin; furthermore, CTC 204 was resistant to chloramphenicol, CTC 368 and CTC 469 to chloramphenicol and vancomycin, CTC 483 to tetracycline and vancomycin, and CTC 484 to clindamycin and chloramphenicol. The evaluated strains showed biogenic amine production; the lowest levels were produced by CTC 204 and CTC 368 strains. It was concluded that CTC 204 and CTC 368 strains have the greatest potential for becoming probiotics.

Factors associated with dental pain in toddlers detected using the dental discomfort questionnaire.

BACKGROUND: Dental pain is one of the most common symptoms of untreated oral problems and exerts a strong impact on the well-being of children. AIMS: The aim of this study was to evaluate the associated factors with dental pain in children aged 1-3 years using the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B). METHODS: A cross-sectional study was conducted in the city of Diamantina, Brazil. A total of 318 randomly selected children were submitted to an oral clinical examination for the evaluation of tooth injuries and dental caries (International Caries Detection and Assessment System, [ICDAS]). The caregivers of the children were asked to answer the DDQ-B as well as a questionnaire addressing demographic and socioeconomic aspects of the family. Statistical analysis was performed and involved the description of frequencies as well as Poisson hierarchical regression analysis. RESULTS: Dental pain was associated with a household income less than the Brazilian minimum monthly wage (Prevalence ratios [PRs] = 1.33, 95% confidence interval [CI]: 1.07-1.66, P = 0.011) and dental caries in dentin - ICDAS codes 5 and 6 (PR = 1.48, 95% CI: 1.13-1.94, P = 0.004). CONCLUSIONS: Greater frequencies of dental pain were found in 1-3-year-old children from families with a low monthly income and dental caries with visible dentin with or without pulp involvement.

Effect of time interval between bleaching and bonding on tag formation.

The objective of this study was to assess penetration of adhesive material in enamel bleached with 35% hydrogen peroxide using optical polarized light microscopy. Extracted human teeth were randomly assigned to 5 groups, each representing a specific time interval between bleaching and the application of an adhesive material. They were designated as: (TC) the control group-restorations in unbleached teeth; (T0) comprising restorations carried out immediately after bleaching; (T7) comprising restorations 7 days after bleaching; (T14) comprising restorations 14 days after bleaching; and (T21) comprising restorations 21 days after bleaching. Length of resin tags was measured with an Axiophot photomicroscope at a x 400 magnification, and the results subjected to an ANOVA for a comparison between groups, with a p value of < 0.05. Differences between the groups were verified using a Tukey test at a confidence level of 5%. The specimens in the control group (TC) and experimental groups T7, T14 and T21 showed better penetration of adhesive material into enamel in comparison with experimental group T0. This suggests that a gap of at least 7 days should be left between bleaching enamel with 35% hydrogen peroxide and placing adhesive bonding agents and undertaking resin composite restoration work.

Reflexiones en torno a la investigación con métodos mixtos / Reflexão sobre pesquisa com métodos mistos / Reflections on research with mixed methods

Objetivo Se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.

Objetivo se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.

Objective this study presents a theoretical reflection based on the experience of the authors as researchers and professors of curricular units of research methodologies. Method theoretical-philosophical reflection. Results the dichotomy between qualitative and quantitative approaches originated the discussion on the need to think about the possibility of combining these methods aiming to answer the new and complex research problems currently facing us. This discussion was transformed into a dispute that some authors nicknamed "Science War", due to the methodological and epistemological challenges of this combination, which, in its turn, originated the Mixed Methods. The proposed reflection focuses on some of the main issues that arise in the scope of the current discussions between researchers and reflecting/translating some of their concerns.

"Horário do Soninho": uma estratégia para reduzir os níveis de pressão sonora em uma unidade de terapia intensiva neonatal / Quiet time: a strategy to reduce sound pressure levels in a neonatal intensive care unit

Introdução: Estudos mostram que o ambiente muito estimulante, com altos níveis sonoros, interfere negativamente no desenvolvimento e crescimento de recém-nascidos. Objetivo: verificar se o "horário do soninho" é capaz de reduzir os níveis de pressão sonora em uma unidade de cuidados neonatais. Método: Trata-se de uma pesquisa transversal. A medida do nível de pressão sonora foi realizada durante 15 dias não consecutivos, com tempo de avaliação de 30 minutos antes, 1 hora durante e 30 minutos após o "horário do soninho" Resultado: Observamos uma redução dos níveis de pressão sonora durante o "horário do soninho" (p = 0,00). Essa redução permaneceu no período dos 30 minutos subsequentes, com diferença estatisticamente significante quando comparada ao período antes do "horário do soninho" (p = 0,00). Conclusão: O "horário do soninho" é uma ferramenta capaz de reduzir o nível de pressão sonora em uma unidade de terapia intensiva neonatal. (AU)

Objective: Verify if the "quiet time" is able to reduce the sound pressure levels in a neonatal care unit. Method: It is a cross-sectional research. The measurement of the sound pressure level was performed during 15 non-consecutive days with an evaluation time of 30 minutes before, 1 hour during and 30 minutes after the "quiet time" Result: We observed a reduction of the sound pressure levels during the hours of quiet time (p = 0.00). This reduction remained in the period of the subsequent 30 minutes, with a statistically significant difference when compared to the period before sleep time (p = 0.00). Conclusion: The "quiet time is a tool capable of reducing sound pressure level in a neonatal intensive care unit. (AU)

Objectivo: Verificar si el "tiempo de silencio" puede reducir los niveles de presión acústica en una unidad de cuidados neonatales. Método: Investigación transversal. La medición del nivel de presión sonora se realizó durante 15 días no consecutivos con un tiempo de evaluación de 30 minutos antes, 1 hora durante y 30 minutos después del "tiempo de silencio". Resultado: Observamos una reducción de los niveles de presión sonora durante las horas de tiempo de silencio (p = 0.00). Esta reducción se mantuvo en el período de los siguientes 30 minutos, con una diferencia estadísticamente significativa en comparación con el período anterior al tiempo de sueño (p = 0,00). Conclusión: el "tiempo de silencio es una herramienta capaz de reducir el nivel de presión acústica en una unidad de cuidados intensivos neonatales. (AU)

Febre Amarela / Yellow Fever

A Febre Amarela é uma doença infecciosa aguda, caracterizada por febre. Não é transmissível e tem duração de no máximo 12 dias. As manifestações clínicas revelam as fases evolutivas da doença. Este trabalho consiste em um artigo de atualização, no qual foi realizado um estudo bibliográfico interpretativo e descritivo baseado na literatura atual sobre a Febre Amarela no Brasil. Esta doença é causada por um arbovírus que pertence à família Flaviviridae. A expansão da área de vacinação é muito discutida atualmente. Segundo o Ministério da Saúde, em 2016, foram confirmados seis casos de Febre Amarela no Brasil. Conforme a Sociedade Brasileira de Infectologia, a fisiopatologia desta doença é a mesma no ciclo urbano e no silvestre. O seu diagnóstico pode ser dividido em clínico e laboratorial, pois são as duas formas de confirmar a doença em indivíduos. As medidas preventivas consistem, principalmente, na imunização, medidas de proteção e no controle do vetor. Esta pesquisa fornece dados atuais em bases confiáveis, podendo ser utilizada para futuros trabalhos.

Yellow Fever is an acute infectious disease, characterized by fever. It is not transferable and lasts for a maximum of 12 days. The clinical manifestations reveal the evolutionary phases of the disease. This work consists of an update article, where an interpretative and descriptive bibliographic study was carried out based on the current literature on Yellow Fever in Brazil. This disease is caused by an arbovirus belonging to the family Flaviviridae. The expansion of the vaccination area is much discussed today. According to the Ministry of Health, in 2016, six cases of yellow fever were confirmed in Brazil. According to the Brazilian Society of Infectology, the pathophysiology of Yellow Fever is the same in the urban and wild cycle. The diagnosis of yellow fever can be divided into clinical and laboratory, as they are the two ways to confirm the disease in individuals. Preventive measures consist mainly of immunization, protective measures and vector control. This research provides current data on a reliable basis and can be used for future work

Prevalência e fatores sociodemográficos associados à utilização das PICS no Brasil nos anos de 2013 e 2019 / Prevalence and sociodemographic factors associated with the use of ICPs in Brazil in 2013 and 2019

As Práticas Integrativas e Complementares (PICs) consistem em práticas que buscam estimular os mecanismos naturais de prevenção de agravos e recuperação da saúde por meio de ações seguras e com o emprego de recursos naturais no cuidado à saúde, recusando o uso de substâncias que não existem na natureza, diferenciando do modelo biomédico e da medicalização, como por exemplo as plantas medicinais e fitoterapia, acupuntura e homeopatia. Consequentemente, em 2006, com o objetivo de prevenir agravos, promover e recuperar a saúde e orientado ao cuidado mais humanizado e integral, foi criada a Política Nacional de Práticas Integrativas e Complementares (PNPIC) que, atualmente, engloba 29 práticas. Este estudo propõe descrever a prevalência e os fatores sociodemográficos associados ao uso das Práticas Integrativas e Complementares em Saúde no Brasil. Trata-se de um estudo transversal, utilizando dados das Pesquisas Nacional de Saúde com amostra total de 64.348 e 108.525 domicílios, em 2013 e 2019, respectivamente. O desfecho do estudo foi o uso das Práticas Integrativas e Complementares nos anos de 2013 e 2019. As variáveis explicativas foram: macrorregiões de residência do país (Norte, Nordeste, Centro-oeste, Sul, Sudeste), sexo (feminino e masculino), zona (urbana ou rural), idade (18-19, 20-24, 25-59 e 60 anos ou mais), cor de pele/raça auto-referida (branca, preto, amarela ou indígena), estado civil (casado, divorciado, viúvo ou solteiro), escolaridade (ensino fundamental, ensino médio ou ensino superior), possuidor de plano de saúde (sim ou não). Também foram descritas nas variáveis se o tratamento foi no SUS (sim ou não) e os tipos de PICs utilizadas. Para avaliação das possíveis associações, foi utilizado o teste de qui-quadrado de Pearson, considerando um nível de significância de 5%. Para caracterizar o uso das PICS nos anos de 2013 e 2019, de acordo com os diferentes perfis dos entrevistados, foi utilizado o método de árvore de decisão pelo algoritmo CART. Os resultados demonstraram que, em 2013, a maior parcela de praticantes concentrava-se na região norte do Brasil e, no ano de 2019, além dessa região, houve a inclusão da região nordeste. Quanto às variáveis explicativas, os praticantes possuíam como perfil: sexo feminino para ambos anos (2013: 5,29%) (2019: 6,95%); idade acima dos 60 anos para ambos anos (2013: 5,37%) (2019: 6,61%); área rural (2013: 6,82%) e área urbana (2019 :5,66%); nível de escolaridade com ensino superior para ambos os anos (2013: 14,68%) (2019:11,56%); estado civil ­ viúvo (2013: 5,51%) e estado civil ­ divorciado (2019: 7,42%); e raça indígena para ambos anos (2013: 10,14%) (2019: 8,50%). Em 2013, 6,40% indivíduos receberam tratamento pelo SUS e, em 2019, 6,52%. Os tipos de PICS mais utilizadas foram: Acupuntura (2013: 22,23%) (2019: 27,96%); Homeopatia (2013: 13,02%) (2019: 17,94%); Plantas Medicinais e Fitoterapia (2013: 59,04%) (2019: 56,53%); e outros (2013: 5,7%) (2019: 5,3%). Evidenciou-se que, apesar do acréscimo do número de praticantes, na comparação entre 2013 e 2019, é indubitável a necessidade de maior participação dos gestores públicos nas políticas públicas de saúde orientadas a ampla divulgação, legitimação, implantação e acompanhamento da Política Nacional de Práticas Integrativas e Complementares (PNPIC). Ademais, similarmente, é fundamental que o Ministério da Saúde e o Ministério da Educação impulsionem investigações, pesquisas e reflexões acerca das Práticas Integrativas e Complementares e seus possíveis benefícios à saúde da população brasileira.

Integrative and Complementary Practices (ICPs) consist of practices that seek to stimulate natural mechanisms to prevent illnesses and recover health through safe actions and the use of natural resources in health care, refusing to use substances that do not exist in nature, differentiating them from the biomedical model and medicalization, such as medicinal plants and herbal medicine, acupuncture, and homeopathy. Consequently, in 2006, the National Policy for Integrative and Complementary Practices (NPICP) was created with the aim of preventing illnesses, promoting and recovering health, and aimed at providing more humanized and comprehensive care, which currently encompasses 29 practices. This study aims to describe the prevalence and sociodemographic factors associated with the use of Integrative and Complementary Health Practices in Brazil. This is a cross-sectional study, using data from the National Health Surveys with a total sample of 64,348 and 108,525 households, in 2013 and 2019, respectively. The outcome of the study was the use of Integrative and Complementary Practices in 2013 and 2019. The explanatory variables were: macroregions of residence in the country (North, Northeast, Midwest, South, Southeast), gender (female or male), area (urban or rural), age (18-19, 20-24, 25-59 and 60 years or older), self-reported skin color/race (white, black, yellow or indigenous), marital status (married, divorced, widowed or single), education (elementary school, high school or higher education), and having health insurance (yes or no). The variables were also described as to whether the treatment was provided by the UHS (yes or no) and the types of ICPs used. Pearson's chi-squared test was used to assess possible associations, considering a significance level of 5%. To characterize the use of ICPs in 2013 and 2019, according to the different profiles of the interviewees, the decision tree method using the CART algorithm was used. The results showed that, in 2013, the largest proportion of practitioners was concentrated in the northern region of Brazil, and in 2019, in addition to this region, the northeast region was included. As for the explanatory variables, the profile of practitioners was as follows: female for both years (2013: 5.29%) (2019: 6.95%); age over 60 for both years (2013: 5.37%) (2019: 6.61%); rural area (2013: 6.82%), and urban area (2019: 5.66%); higher education level for both years (2013: 14.68%) (2019: 11.56%); marital status - widowed (2013: 5.51%), and marital status - divorced (2019: 7.42%); and indigenous ethnicity for both years (2013: 10.14%) (2019: 8.50%). In 2013, 6.40% of individuals received treatment through the UHS, and, in 2019, 6.52%. The most commonly used types of ICPs were: Acupuncture (2013: 22.23%) (2019: 27.96%); Homeopathy (2013: 13.02%) (2019: 17.94%); Medicinal Plants and Phytotherapy (2013: 59.04%) (2019: 56.53%); and others (2013: 5.7%) (2019: 5.3%). Despite the increase in the number of practitioners between 2013 and 2019, there is an undoubted need for greater participation by public managers in public health policies aimed at broad dissemination, legitimization, implementation, and monitoring of the National Policy for Integrative and Complementary Practices (NPICP). Similarly, it is essential that the Ministry of Health and the Ministry of Education promote research, investigation, and reflection on Integrative and Complementary Practices and their possible benefits to the Brazilian population's health.

COnciliação trabalho/família em organizações de excelência / Work-family balance in organizations of excellence / Conciliación entre trabajo y familia en las organizaciones de excelencia

O presente trabalho identifica as práticas de conciliação trabalho/família adotadas por organizações de excelência e analisa o potencial papel impulsionador da Qualidade Total, enquanto filosofia de gestão que valoriza o envolvimento dos colaboradores. O estudo baseia-se num inquérito por questionário aplicado a uma amostra de organizações distinguidas como as "melhores para trabalhar" em Portugal. Os resultados mostram que, mesmo neste nicho, algumas medidas de conciliação são ainda pouco utilizadas, nomeadamente aquelas que implicam maiores recursos financeiros. Embora as organizações reconheçam a importância da conciliação, poderão estar a desvalorizar o impacto de algumas disfunções organizacionais que a sua ausência provoca. A implementação de referenciais da Qualidade, em especial das normas ISO, parece estar moderadamente associada com níveis mais elevados de conciliação.

The current study identifies the work/family balance (WFB) practices adopted by organizations committed to excellence and analyses the role of Total Quality Management as a potential driver, given the importance it gives to people involvement. The study is based on a questionnaire survey administered to a sample of organizations distinguished as "best for work" in Portugal. Findings show that, even among this group, some measures of WFB are still rare, in particular those that involve greater financial resources. Although the organizations recognize the importance of WFB, they undervalue the impact of some organizational dysfunctions caused by high levels of work/ family conflict. The implementation of quality frameworks, in particular ISO standards, seems to be moderately associated with higher levels of WFB.

En el presente trabajo se identifican las prácticas de conciliación entre trabajo y familia adoptadas por organizaciones de excelencia y se analiza el papel facilitador de la Calidad Total, como filosofía de gestión que valora la implicación de los colaboradores. El estudio se basa en un cuestionario aplicado a una muestra de organizaciones distinguidas como "mejores para trabajar" en Portugal. Los resultados muestran que, inclusive en este segmento de organizaciones, algunas medidas de conciliación aún son poco utilizadas, en particular aquellas que exigen un mayor volumen de recursos financieros. Aunque las organizaciones reconocen la importancia de la conciliación, pueden estar desconsiderando el impacto de algunas disfunciones organizacionales que su ausencia provoca. La utilización de referencias de calidad, en particular las normas ISO, parece estar moderadamente asociada a niveles de conciliación más elevados.

Evaluation of extraradicular pH after intracoronal bleaching using fourbleaching agents / Avaliação do pH externo após clareamento intracoronário utilizando quatro agentes clareadores

o objetivo deste estudo foi avaliar in vitro os valores de pH do meio externo após a realização do clareamento interno utilizando o peróxido de hidrogênio a 30% e diferentes associações de perborato de sódio. Foram utilizados 50 prémolares humanos, distribuídos aleatoriamente em cinco grupos, de acordo com o agente clareador utilizado para o clareamento interno desses dentes: a) água destilada; b) perborato de sódio com água destilada (2g/ml); c) perborato de sódio com peróxido de carbamida 10% (2g/ml); d) perborato de sódio com peróxido de hidrogênio 30% (2g/ml); e) peróxido de hidrogênio 30%. Foi realizada a abertura coronária, obturação do canal radicular, confecção de um tampão cervical com cimento de ionômero de vidro modificado por resina (Vitremer-3M/ESPE), e, posteriormente, a inserção do agente clareador. Os dentes foram armazenados em potes plásticos com água destilada, utilizando um dispositivo mecânico. A mensuração do pH do meio (água destilada) foi realizada imediatamente e 7 dias após a inserção dos agentes clareadores. Os dados obtidos foram submetidos a ANOVA – dois fatores e Teste de Tukey a 5%. Os resultados deste estudo confirmaram a alcalinidade das associações de perborato de sódio e a acidez do peróxido de hidrogênio a 30% no período inicial. Considerando os resultados obtidos, pode-se concluir que os agentes clareadores utilizados modificaram o pH do meio externo em um período de 7 dias.

The present in vitro study evaluated the pH values of extraradicular medium after intracoronal bleaching with 30%hydrogen peroxide or 10% carbamide peroxide and different associations of sodium perborate. The study was composed of 50 extracted human premolars, randomly divided into five groups, according to the bleaching agent employed for intracoronal bleaching of these teeth: a) distilled water; b) sodium perborate with distilled water (2g/ml); c) sodium perborate with 10% carbamide peroxide (2g/ml); d) sodium perborate with 30% hydrogen peroxide (2g/ml); e) 30% hydrogen peroxide. Coronal access was performed, followed by root canal filling, confection of a cervical intermediate base with resin-modified glass ionomer cement (Vitremer-3M/ESPE) and application of the bleaching agents. The teeth were stored in plastic flasks containing distilled water, using a mechanical device. Measurement of pH of the extraradicular medium (distilled water) was performed immediately and 7 days after insertion of the bleaching agents. The pH values were analysed using the two-way ANOVA and Tukey,s test at significance level of 5%. The results of the present study confirmed the alkalinity of associations of sodium perborate and the acidity of 30% hydrogen peroxide at the immediateperiod. Considering the results achieved, it can be concluded that the bleaching agents employed changed the pH of theextraradicular medium at 7-day period.

Evaluation of extraradicular pH after intracoronal bleaching using four bleaching agents

The present in vitro study evaluated the pH values of extraradicular medium after intracoronal bleaching with 30% hydrogen peroxide or 10% carbamide peroxide and different associations of sodium perborate. The study was composed of 50 extracted human premolars, randomly divided into five groups, according to the bleaching agent employed for intracoronal bleaching of these teeth: a) distilled water; b) sodium perborate with distilled water (2g/ml); c) sodium perborate with 10% carbamide peroxide (2g/ml); d) sodium perborate with 30% hydrogen peroxide (2g/ml); e) 30% hydrogen peroxide. Coronal access was performed, followed by root canal filling, confection of a cervical intermediate base with resin-modified glass ionomer cement (Vitremer-3M/ESPE) and application of the bleaching agents. The teeth were stored in plastic flasks containing distilled water, using a mechanical device. Measurement of pH of the extraradicular medium (distilled water) was performed immediately and 7 days after insertion of the bleaching agents. The pH values were analysed using the two-way ANOVA and Tukey's test at significance level of 5%. The results of the present study confirmed the alkalinity of associations of sodium perborate and the acidity of 30% hydrogen peroxide at the immediateperiod. Considering the results achieved, it can be concluded that the bleaching agents employed changed the pH of the extraradicular medium at 7-day period.

O objetivo deste estudo foi avaliar in vitro os valores de pH do meio externo após a realização do clareamento interno utilizando o peróxido de hidrogênio a 30% e diferentes associações de perborato de sódio. Foram utilizados 50 prémolares humanos, distribuídos aleatoriamente em cinco grupos, de acordo com o agente clareador utilizado para o clareamento interno desses dentes: a) água destilada; b) perborato de sódio com água destilada (2g/ml); c) perborato de sódio com peróxido de carbamida 10% (2g/ml); d) perborato de sódio com peróxido de hidrogênio 30% (2g/ml); e) peróxido de hidrogênio 30%. Foi realizada a abertura coronária, obturação do canal radicular, confecção de um tampão cervical com cimento de ionômero de vidro modificado por resina (Vitremer-3M/ESPE), e, posteriormente, a inserção do agente clareador. Os dentes foram armazenados em potes plásticos com água destilada, utilizando um dispositivo mecânico. A mensuração do pH do meio (água destilada) foi realizada imediatamente e 7 dias após a inserção dos agentes clareadores. Os dados obtidos foram submetidos a ANOVA – dois fatores e Teste de Tukey a 5%. Os resultados deste estudo confirmaram a alcalinidade das associações de perborato de sódio e a acidez do peróxido de hidrogênio a 30% no período inicial. Considerando os resultados obtidos, pode-se concluir que os agentes clareadores utilizados modificaram o pH do meio externo em um período de 7 dias.

Avaliação do Ph de várias substâncias utilizadas no clareamento intracoronário / Ph evaluation of several agents used for intracoronal bleaching

O objetivo desta pesquisa foi avaliar, in vitro, dentro de um período de 7 dias, os valores do pH de 4 substâncias utilizadasno clareamento intracoronário. O pH foi avaliado em cinco amostras (quatro soluções clareadoras e uma soluçãocontrole). As amostras de cada grupo foram assim constituídas: a) Grupo 1: 15ml de água destilada; b) Grupo 2: 10g deperborato de sódio (Byofórmula – Farmácia de manipulação) com 5ml de água destilada; c) Grupo 3: 10g de perboratode sódio com 5ml de peróxido de carbamida 10% (Byofórmula – Farmácia de manipulação); d) Grupo 4: 10g de perboratode sódio com 5ml de peróxido de hidrogênio 30% (Byofórmula – Farmácia de manipulação); e) Grupo 5: 15mlde peróxido de hidrogênio 30%. Os materiais foram acondicionados em frascos plásticos (FujiFilm) e o valor do pHfoi estabelecido com um aparelho pH-metro (Digimed DM-20), logo após a manipulação e também após 1h, 24h e 7dias. Os resultados mostraram que os valores do pH das associações do perborato de sódio mantiveram-se praticamenteconstantes, com exceção da associação com o peróxido de hidrogênio, onde ocorreu um aumento gradativo do pH nodecorrer dos períodos avaliados. O pH do peróxido de hidrogênio também apresentou-se constante, mantendo-se ácidodurante todo o experimento. Das quatro soluções analisadas, apenas o peróxido de hidrogênio apresentou um pH ácido,que assim se manteve em todos os períodos avaliados.

Tratamento precoce da classe 111 de angle com protração da maxila sem disjunção prévia: apresentação de caso clínico / Early treatment of angle class III malocclusion with maxillary protraction without previous palatal expansion: case report

A protração da maxila seguida da disjunção palatina como parte do tratamento ortodôntico precoce da maloclusão Classe III de Angle é bastante frequente na clínica ortodôntica. O presente trabalho tem como objetivo apresentar e discutir um caso clínico de uma paciente de 6 anos e 7 meses de idade com maloclusão de CIIII de Angle com protração da maxila sem realizar a disjunção palatina. Os resultados apresentados foram bastante satisfatórios em relação aos dados cefalométricos, perfil facial e principalmente, com a oclusão da paciente. Assim sendo, a protração maxilar sem disjunção prévia pode ser aplicada neste caso com bons resultados.

The maxillary protraction followed by rapid palatal expansion as part of the early orthodontic treatment of the Angle Classlll malocclusion is frequent in orthodontic clinic. This work objective to present and argue a clinical case of a patient of 6y and 7m age with Angle Class III malocclusion where we used maxillary protraction without carrying through the rapid palatal expansion. The presented results had been sufficiently satisfactory in regard of cefalometrics data and mainly in patient's occlusion and profile. Thus maxillary protraction without previous palatal expansion can be applied in growing patients with good results.

Influência do etanol e do ácido cítrico na microdureza de resinas compostas / Influence of ethanol and citric acid on microhardness of composite restorative

O objetivo desta pesquisa foi avaliar a influência do etanol a 50 por cento e do ácido cítrico 0,02M na superfície de resinas compostas para restaurações diretas e indiretas. Foram confeccionados 36 cilindros de resina Esthet X (Dentsply) (D) e 36 de resina Epricord (Kuraray) (I), dividos em 3 grupos de acordo com o meio de estocagem: água destilada (A), etanol a 50 por cento (E) e ácido cítrico 0,02 M (C) e em 3 subgrupos, de acordo com o tempo de estocagem: 1,7 e 14 dias. Os cílindros foram submetidos à leitura de microdureza com carga de 50 gf e tempo de permanência de 10s, utilizando-se o microdurômetro digital (modelo FM 700, Futuretch - Tókio - Japão). Os dados obtidos foram submetdos à análise estatística ANOVA 1 e 2 fatores e ao teste de Tukey (p = 5 por cento). Os resultados foram: DA1(69,38); DA7(68,57); DA14(68,21); DE1(41,67); DE7(50,97); DE14(47,08); DC1(67,12); DC7(52,82); DC14(48,20); IA1(39,42); IA7(40,46); IA14(39,36); IE1(41,67); IE7(33,84); IE14(28,15); IC1(41,88); IC7(37,06); IC14(30,44) e permitiram concluir que o etanol e o ácido cítrico exercem influência significativa na microdureza da resina composta para técnica direta e indireta, sendo influenciada pelo fator tempo, e que houve diferença significativa entre a microdureza da resina composta direta que apresentou-se superior à resina indireta