Descriptive study of COVID-19 mortality according to sex, schooling, age, health region and historical series: State of Rio de Janeiro, January 2020 to August 2021 / Estudo descritivo da mortalidade por COVID-19 segundo sexo, escolaridade, faixa etária, região de saúde e série histórica: Estado do Rio de Janeiro, janeiro de 2020 a agosto de 2021

 Introduction: the first COVID-19 case in the state of Rio de Janeiro was registered on march 6 2020 and SARS-Cov-2 has been impacting population's lives on biopsychosocial aspects since, being characterized as a syndemic and overwhelming the Brazilian public Unified Health System. Objectives: describe the COVID-19 pandemic through demographic stratification of deaths occurring from january 2020 to august 2021 and on Rio de Janeiro state's health service regions.  Methods: this is an aggregate transversional study, which used data available from the Health Ministry, producing a descriptive epidemiology. Measures of absolute prevalence and standardized mortality ratio (SMR) were calculated; population size used was the one estimated to 2020. Associations between variables were checked by Pearson's test. Results: statistically significant associations were observed between scholarity, sex, age and health service region in relation to COVID-19 deaths and by other causes. About COVID-19 mortality, there was an association between scholarity and sex, highlighting more deaths than expected on higher educated males and on no educated females.  The health regions Metropolitana I and II had SMR over 100%, and the other regions had low SMR, specially Baía da Ilha Grande and Baixada Litorânea regions which had less deaths than expected. Conclusions: the results showed demographic, geographic and historic patterns of the pandemic on Rio de Janeiro state, which may represent socioeconomic vulnerabilities, allowing to characterize COVID-19 as a syndemic.

Introdução. O primeiro caso de COVID-19 no Estado do Rio de Janeiro ocorreu em 6 de março de 2020 e o SARS-Cov-2 vem impactando a vida da população nos aspectos biopsicossociais, apresentando características de sindemia, e sobrecarregando o Sistema Único de Saúde. Objetivo: Descrever a pandemia de COVID-19 pela estratificação demográfica dos óbitos ocorridos no período de janeiro de 2020 a agosto de 2021 e nas Regiões de Saúde do Estado do Rio de Janeiro. Metodologia. Trata-se de estudo transversal de agregados, que utilizou dados disponibilizados pelo Ministério da Saúde, visando produzir uma epidemiologia descritiva. Foram calculadas medidas de prevalência absoluta, coeficiente de prevalência e razão padronizada de mortalidade (RPM); foram considerados os tamanhos populacionais estimados para 2020. Foram verificadas associações entre variáveis pelo teste de Pearson. Resultados. Foram observadas associações estatisticamente significativas  entre escolaridade, sexo, faixa etária e regiões de saúde em relação aos número de óbitos por COVID-19 e outras causas. Dentre os óbitos por COVID-19, houve associação entre escolaridade e sexo, destacando mais óbitos que o esperado entre pessoas do sexo masculino com ensino superior e do sexo feminino sem escolaridade. As Regiões de Saúde Metropolitana I e II apresentaram RPM acima de 100% e as demais abaixo, destacando as regiões Baía da Ilha Grande e Baixada Litorânea por apresentarem menos óbitos que o esperado. Conclusão. Os resultados mostraram padrões demográficos, geográficos e históricos da pandemia no Estado do Rio de Janeiro, que podem representar vulnerabilidades socioeconômicas, permitindo caracterizar a COVID-19 como sindemia.

Socio-demographic and psychological features associated with smoking in pregnancy.

OBJECTIVE: To investigate how social and psychological characteristics differ between pregnant women who smoke and do not smoke. To explore associations between social and psychological features with changes of smoking habits by the end of pregnancy. METHODS: A case-control study was set up. Smokers cases were never-smokers and ex-smokers controls. Pregnant women (n=328) from public prenatal services were interviewed. Socio-demographic data and psychological variables - personality traits, anxiety, depression, perceived stress, maternal fetal-attachment - were measured. Saliva samples were collected to measure cotinine and to check self-informed smoking status. In addition, 66 smokers were also assessed regarding smoking habits by late pregnancy. Smoking status was defined as a dependent variable. Exposure factors were analyzed through odds ratios. Logistic models and contingency tables were employed according to the nature of variables. "Qualitative change in smoking" was defined as a dependent variable for the last evaluation, and a logistic regression model was built. RESULTS: Lower schooling, higher age, use of alcohol and drugs, living without a partner, and passive smoking showed associations with smoking. Anxiety, depression and perceived stress also exhibited positive association with smoking. Among personality traits, only Neuroticism was associated with smoking. None of the variables were associated with qualitative change in smoking by the end of pregnancy. CONCLUSION: Smoking during pregnancy is associated with more unfavorable social conditions. Pregnant women who smoke exhibit more negative psychological states than nonsmokers, including a profile of accentuated Neuroticism. None of the investigated variables could predict changes in smoking during pregnancy.

History of maternal mortality in the city of ribeirão preto, in its regional health department, and in the state of são paulo after the establishment of the maternal committees from 1998 to 2017 / Recorte histórico da mortalidade materna no município de Ribeirão Preto, no seu Departamento Regional de Saúde, e no estado de São Paulo após a instituição dos comitês de mortalidade materna de 1998 a 2017

Abstract Objective To describe the evolution of maternal mortality right after the establishment of maternal death committees in the region of the city of Ribeirão Preto, state of São Paulo, Brazil. Methods The present study describes the spatial and temporal distribution of maternal mortality frequencies and rates, using data from the state of São Paulo, the municipality of Ribeirão Preto, and its Regional Health Department (DRS-XIII) from 1998 to 2017. The present ecological study considered the maternal mortality and live birth frequencies made available by the Computer Science Department of the Brazilian Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS, in the Portuguese acronym)/Ministry of Health, which were grouped by year and political-administrative division (the state of São Paulo, the DRS-XIII, and the city of Ribeirão Preto). The maternal mortality rate (MMR) was calculated and presented through descriptive measures, graphs, and cartograms. Results The overall MMR observed for the city of Ribeirão Preto was of 39.1; for the DRS-XIII, it was of of 40.4; and for the state of São Paulo, it was of 43.8 for every 100 thousand live birhts. During this period, the MMR for the city of Ribeirão Preto ranged from 0% to 80% of the total maternal mortalities, and from 40.7% to 47.2% of live births in the DRS-XIII. The city of Ribeirao Preto had an MMR of 76.5 in 1998and 1999, which decreased progressively to 12.1 until the years of 2012 and 2013, and increased to 54.3 for every 100 thousand live births over the past 4 years. The state of São Paulo State had an MMR of 54.0 in 1998-1999, which varied throughout the study period, with values pregnancy of 48.0 in 2008-2009, and 54.1 for every 100 thousand live births in 2016-2017. Several times before 2015, the city of Ribeirão Preto and the DRS-XIII reached the Millennium Goals. Recently, however, the MMR increased, which can be explained by the improvement in the surveillance of maternal mortality. Conclusion The present study describes a sharp decline in maternal death in the region of Ribeirão Preto by the end of 2012-2013, and a subsequent and distressing increase in recent years that needs to be fully faced.

Resumo Objetivo Descrever a evolução da mortalidade materna após a instituição dos comitês de morte materna na região de Ribeirão Preto. Métodos Este estudo descreveu a distribuição espacial e temporal das frequências e da razão demortalidadematerna, utilizando dados do estado de São Paulo, do Departamento Regional de Saúde de Ribeirão Preto (DRS-XIII), e domunicípio de Ribeirão Preto, no período de 1998 a 2017. O estudo ecológico considerou frequências de mortes maternas e de nascidos vivos disponibilizadas pelo Departamento de Informática do Sistema Único de Saúde (DATASUS)/Ministério da Saúde, que foramagrupadas por ano e pela referida divisão político-administrativa. A taxa de mortalidade materna (TMM) foi calculada e apresentada por medidas descritivas, gráficos e cartogramas. Resultados O total observado para o município de Ribeirão Preto foi uma TMM de 39,1; para o DRS-XIII, TMM de 40,4; e, para o estado de São Paulo, uma TMM de 43,8 por 100 mil habitantes. No período do estudo, a RMM do município de Ribeirão Preto variou de 0% até 80,0% do total de mortes maternas, e de 40,7% a 47,2% dos nascidos vivos no DRS-XIII. O município de Ribeirão Preto apresentou TMM de 76,5 no biênio 1998-1999, que progressivamente diminuiu para 12,1 em 2012-2013, e aumentou para 54,3 por 100mil habitantes nos últimos 4 anos. O estado de São Paulo apresentou TMM de 54,0 em 1998-1999, tendo variado ao longo do período com valores de 48,0 no período 2008-2009, e 54,1 no período 2016-2017. Várias vezes antes de 2015, o município de Ribeirão Preto e o DRS-XIII atingiramas Metas domilênio. Recentemente, porém, a TMM aumentou, o que pode ser explicado pela melhoria da vigilância da mortalidade materna. Conclusão O estudo descreveu um acentuado declínio da morte materna na região de Ribeirão Preto até o final do biênio 2012-2013, e um subsequente e aflitivo aumento em anos recentes, que precisa ser enfrentado.

History of Maternal Mortality in the City of Ribeirão Preto, in its Regional Health Department, and in the State of São Paulo after the Establishment of the Maternal Committees from 1998 to 2017.

OBJECTIVE: To describe the evolution of maternal mortality right after the establishment of maternal death committees in the region of the city of Ribeirão Preto, state of São Paulo, Brazil. METHODS: The present study describes the spatial and temporal distribution of maternal mortality frequencies and rates, using data from the state of São Paulo, the municipality of Ribeirão Preto, and its Regional Health Department (DRS-XIII) from 1998 to 2017. The present ecological study considered the maternal mortality and live birth frequencies made available by the Computer Science Department of the Brazilian Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS, in the Portuguese acronym)/Ministry of Health, which were grouped by year and political-administrative division (the state of São Paulo, the DRS-XIII, and the city of Ribeirão Preto). The maternal mortality rate (MMR) was calculated and presented through descriptive measures, graphs, and cartograms. RESULTS: The overall MMR observed for the city of Ribeirão Preto was of 39.1; for the DRS-XIII, it was of of 40.4; and for the state of São Paulo, it was of 43.8 for every 100 thousand live birhts. During this period, the MMR for the city of Ribeirão Preto ranged from 0% to 80% of the total maternal mortalities, and from 40.7% to 47.2% of live births in the DRS-XIII. The city of Ribeirao Preto had an MMR of 76.5 in 1998and 1999, which decreased progressively to 12.1 until the years of 2012 and 2013, and increased to 54.3 for every 100 thousand live births over the past 4 years. The state of São Paulo State had an MMR of 54.0 in 1998-1999, which varied throughout the study period, with values of 48.0 in 2008-2009, and 54.1 for every 100 thousand live births in 2016-2017. Several times before 2015, the city of Ribeirão Preto and the DRS-XIII reached the Millennium Goals. Recently, however, the MMR increased, which can be explained by the improvement in the surveillance of maternal mortality. CONCLUSION: The present study describes a sharp decline in maternal death in the region of Ribeirão Preto by the end of 2012-2013, and a subsequent and distressing increase in recent years that needs to be fully faced.

OBJETIVO: Descrever a evolução da mortalidade materna após a instituição dos comitês de morte materna na região de Ribeirão Preto. MéTODOS: Este estudo descreveu a distribuição espacial e temporal das frequências e da razão de mortalidade materna, utilizando dados do estado de São Paulo, do Departamento Regional de Saúde de Ribeirão Preto (DRS-XIII), e do município de Ribeirão Preto, no período de 1998 a 2017. O estudo ecológico considerou frequências de mortes maternas e de nascidos vivos disponibilizadas pelo Departamento de Informática do Sistema Único de Saúde (DATASUS)/Ministério da Saúde, que foram agrupadas por ano e pela referida divisão político-administrativa. A taxa de mortalidade materna (TMM) foi calculada e apresentada por medidas descritivas, gráficos e cartogramas. RESULTADOS: O total observado para o município de Ribeirão Preto foi uma TMM de 39,1; para o DRS-XIII, TMM de 40,4; e, para o estado de São Paulo, uma TMM de 43,8 por 100 mil habitantes. No período do estudo, a RMM do município de Ribeirão Preto variou de 0% até 80,0% do total de mortes maternas, e de 40,7% a 47,2% dos nascidos vivos no DRS-XIII. O município de Ribeirão Preto apresentou TMM de 76,5 no biênio 1998­1999, que progressivamente diminuiu para 12,1 em 2012­2013, e aumentou para 54,3 por 100 mil habitantes nos últimos 4 anos. O estado de São Paulo apresentou TMM de 54,0 em 1998­1999, tendo variado ao longo do período com valores de 48,0 no período 2008­2009, e 54,1 no período 2016­2017. Várias vezes antes de 2015, o município de Ribeirão Preto e o DRS-XIII atingiram as Metas do milênio. Recentemente, porém, a TMM aumentou, o que pode ser explicado pela melhoria da vigilância da mortalidade materna. CONCLUSãO: O estudo descreveu um acentuado declínio da morte materna na região de Ribeirão Preto até o final do biênio 2012­2013, e um subsequente e aflitivo aumento em anos recentes, que precisa ser enfrentado.

The Impact of CO2 Laser Treatment and Acidulated Phosphate Fluoride on Enamel Demineralization and Biofilm Formation.

Introduction: This study evaluated the impact of CO2 laser treatment and acidulated phosphate fluoride (APF) on enamel demineralization and biofilm formation, using in vitro and in situ designs. Methods: Demineralized enamel slabs were distributed among 8 groups: placebo, placebo + continuous CO2 laser, placebo + repeated CO2 laser, placebo + ultrapulsed CO2 laser, 1.23% APF, APF + continuous CO2 laser, APF + repeated CO2 laser and APF + ultrapulsed CO2 laser. In the in vitro study, 15 enamel slabs from each group were subjected to a pH-cycling regimen for 14 days. In the cross over in situ design, 11 volunteers wore palatal appliances with demineralized enamel slabs for 2 periods of 14 days each. Drops of sucrose solution were dripped onto enamel slabs 8×/day. Biofilms formed on slabs were collected and the colony-forming units (CFU) of Streptococcus mutans and Lactobacillus were determined. Results: For both in vitro and in situ studies, there was no significant difference between treatments (P>0.05). However, all treatments increased microhardness of demineralized enamel (P<0.05). After a further in situ cariogenic challenge, with the exception of the placebo, all treatments maintained microhardness values (P<0.05). Microbiological analysis showed no difference in Streptococcus mutans (P>0.05) or Lactobacillus (P>0.05) counts between groups. Conclusion: The results suggest that APF gel combined with the CO2 laser, regardless of the pulse emission mode used, was effective in controlling enamel demineralization, but none of the tested treatments was able to prevent bacterial colonization.

Significados da dengue para enfermeiros da atenção primária à saúde / Meanings assigned to dengue by primary health care nurses / Significados del dengue para los enfermeros de atención primaria de salud

INTRODUÇÃO: a dengue permanece como um importante problema de saúde pública e segue impactando o contexto econômico, social e de saúde da população. OBJETIVO: o objetivo desta pesquisa foi de conhecer os significados da dengue para enfermeiros da Atenção Primária à Saúde de um município sul mineiro. MÉTODO: trata-se de um estudo qualitativo fundamentado na Teoria das Representações Sociais. O trabalho de campo contemplou entrevistas individuais aos 17 Enfermeiros das Equipes de Saúde da Família e Unidades Básicas de Saúde de um município de Minas Gerais, entre junho e julho de 2015. Os depoimentos foram gravados, transcritos e, posteriormente, analisados e apresentados por meio do método do Discurso do Sujeito Coletivo. RESULTADOS: os sign ificados da dengue emersos foram: desconforto enorme, problema de saúde pública, descuido das pessoas, consequência da falta de educação, doença viral, preocupação e medo, doença grave, doença causada pela picada do mosquito, epidemia, e outros significados. O significado que apresentou maior grau de compartilhamento das ideias foi o da dengue como um problema de saúde pública. DISCUSSÃO: os achados simbólicos e figurativos emersos evidenciam o quão polissêmico e multifacetado é o tema dengue. Foi uma oportunidade importante para o eu coletivo, constituído pelos enfermeiros da Atenção Primária à Saúde do referido Município se manifestar e representar o que a dengue significa para ele. CONCLUSÃO: conhecer os significados desta doença para os profissionais ora abordados é importante para a compreensão da sua causalidade e para o seu enfrentamento como problema de saúde pública/saúde coletiva na atualidade.(AU)

Introduction: dengue remains an important public health problem and continues to impact the population's economic, social and health contexts. Objective: this study's objective was to identify the meanings of dengue from the perspective of primary health care nurses from a town in the south of Minas Gerais, Brazil. Method: this qualitative study is based on the Theory of Social Representations. The fieldwork included individual interviews held with 17 nurses working in Unidades Básicas de Saúde (UBS) [Primary Health Care Units] and Equipes da Estratégia Saúde na Família (ESF) [Family Health Strategy] from a town in Minas Gerais, Brazil, between June and July 2015. The reports were recorded, transcribed and later analyzed and presented using the Discourse of the Collective Subject (DCS). Results: the following meanings regarding dengue emerged: immense discomfort, public health problem, carelessness people, consequence of lack of education, viral disease, concern and fear, severe disease, disease caused by a mosquito bite, epidemics, and other meanings. The meaning that was most frequently reported was dengue as a public health problem. Discussion: the symbolic and figurative results reveal how polysemic and multifaceted the topic of dengue is. It was an important opportunity for the collective subject, composed of Primary Health Care nurses, to express and represent the meaning it assigns to dengue. Conclusion: identifying the meanings health workers assign to dengue is important to understanding its causality and combat it as a current public health/collective health problem. (AU)

Introducción: el dengue sigue siendo un importante problema de salud pública y continúa impactando el contexto económico, social y de salud de la población. Objetivo: el objetivo de esta investigación fue conocer el significado del dengue para los enfermeros de atención primaria de salud de una ciudad del sur del estado de Minas Gerais. Método: estudio cualitativo basado en la teoría de las representaciones sociales. El trabajo de campo incluyó entrevistas individuales con 17 enfermeros de los equipos de salud familiar y de las unidades básicas de salud de una ciudad de Minas Gerais, entre junio y julio de 2015. Las declaraciones fueron grabadas, transcritas y luego analizadas y presentadas a través del método del discurso del sujeto colectivo. Resultados: los significados del dengue que surgieron fueron: gran incomodidad, problemas de salud pública, descuido de las personas, consecuencia de la falta de educación, enfermedad viral, preocupación y miedo, enfermedades graves, enfermedad causada por la picadura del mosquito, epidemia, entre otros. El significado que más ideas permitió compartir fue el dengue como un problema de salud pública. Discusión: los hallazgos simbólicos y figurativos que surgen muestran cuán polisémico y multifacético es el tema del dengue. Fue una oportunidad importante para el yo colectivo, formado por los mencionados enfermeros, para expresarse y representar lo que el dengue significa para ellos. Conclusión: es importante conocer los significados de la enfermedad para estos profesionales para entender su causalidad y enfrentarla como un problema de salud pública/salud colectiva en la actualidad. (AU)

Impact of different approaches of primary care mental health on the prevalence of mental disorders.

AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders. BACKGROUND: Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment. METHODS: Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.

Effect of Er:Yag laser on dentin demineralization around restorations.

The aim of this study was to evaluate the effect of cavity preparation with Er:YAG laser on dentin adjacent to restorations submitted to cariogenic challenge in situ, by subsuperficial microhardness analysis. Bovine incisors were sectioned, flattened, and polished, resulting in 40 dentin slabs. The slabs were randomly assigned to four groups (n = 10), according to the cavity preparation method: I-high-speed handpiece (control); II-Er:YAG laser (160 mJ; 3 Hz); III-Er:YAG laser (260 mJ; 3 Hz); IV-Er:YAG laser (300 mJ; 3Hz). Cavities were restored with composite resin, and the specimens were fixed in intra-oral appliances, which were worn by 10 volunteers for 14 days for simulating cariogenic challenge in situ. During the experimental period, 20% sucrose solution was dripped over each specimen 6 times a day. Samples were removed, sectioned, and examined for subsuperficial Knoop microhardness at 100, 200, and 300 µm from the restoration and at 30 µm from dentin surface. Split-plot analysis of variance showed no significant difference among the cavity preparation techniques (p = 0.1129), among distances (p = 0.9030), as well as no difference in the interaction between the main factors (p = 0.7338). It was concluded that the cavity preparation with Er:YAG laser did not influence on dentin microhardness submitted to cariogenic challenge in situ.

Impact of CO2 laser and stannous fluoride on primary tooth erosion.

This study evaluated in vitro the effect of input power of CO2 laser, either associated or not to stannous fluoride (SnF2) gel, for the control of intrinsic erosion in primary teeth. One hundred four enamel slabs (3 × 3 × 2 mm) from human primary molars were flattened and polished. Adhesive tapes were placed on their surface leaving a window of 3 × 1 mm. Slabs were then cycled four times in 0.01 M hydrochloric acid (pH 2, 2 min) and in artificial saliva (2 h) for creation of erosive lesions. Specimens were randomly assigned into eight groups (n = 13) according to fluoride application [absent (control) or 0.4% stannous fluoride gel (SnF2)] and input power of CO2 laser [unlased (control), 0.5, 1.0 or 1.5 W]. The CO2 laser irradiation was performed in an ultra-pulse mode (100 µs of pulse duration), 4-mm working distance, for 10 s. Specimens were then submitted to further erosive episodes for 5 days and evaluated for enamel relative permeability. Fluoride did not show any protective effect for any of the laser-treated groups or control (p = 0.185). However, a significant effect was detected for input power of CO2 laser (p = 0.037). Tukey's test showed that there was a significant statistically difference between specimens irradiated with 0.5 and 1.5 W (p = 0.028). The input power of 0.5 W showed lower permeability. Variation of input power CO2 laser can influence enamel permeability, at the power of 1.5 W which promoted greater permeability.

Dengue e intersetorialidade: representações sociais de enfermeiros da atenção primária à saúde / Dengue and intersectionality: social representations of nurses in primary health care

Tratou-se de uma Pesquisa de Representação Social sobre quem deveria fazer parte do enfrentamento da Dengue, segundo os Enfermeiros da Atenção Primária à Saúde de Alfenas-MG. As Representações Sociais foram: Todos; Educação; Saúde e a População; Saúde e outros Setores; Intra-Setor Saúde; Vigilância Epidemiológica; Empresas e Profissionais; Estratégia Saúde da Família e Agentes de Controle de Endemias; Setor Público e Privado; e, Gestores. O enfrentamento da Dengue foi representado como uma responsabilidade de todos, tanto do setor saúde como de diversos segmentos sociais...

This was a social representation research on people who should be coping with Dengue, from the perspective of primary health care nurses from Alfenas, in the state of Minas Gerais. The social representations identified were: Ali; Education; Health and population; Health and other sectors; Intra-Sector Health; Epidemiological surveillance; Companies and professionals; Family health strategy and endemic disease control agents; Public and private sectors; and, Managers. Coping with Dengue was represented as a responsibility of ali people, both in the health sector and in several social segments...

Se trató de una investigación de representación social sobre quién debería hacerse cargo del enfrentamiento del dengue, según la visión de los enfermeros de atención primaria de salud de Alfenas-MG. Las representaciones sociales identificadas fueron: Todos; Educación; Salud y la población, Salud y otros sectores; Intrasector de salud; Vigilancia epidemiológica; Empresas y profesionales; Estrategia Salud de la Familia Agentes de control de endemias; Sector público y privado; y Funcionarios. El enfrentamiento del dengue resultó representado como una responsabilidad de todos, tanto del sector salud como de diversos segmentos sociales...

Representações sociais sobre a dengue: uma revisão integrativa / Representaciones sociales sobre el dengue: una revisión integrativa / Social representations of dengue: an integrative review

Investigar e descrever os traços de representações sociais sobre a Dengue encontradas naliteratura científica. Métodos: Foi realizada uma revisão integrativa, baseada nas fontes de dadosPubMed/MEDLINE, LILACS e SciELO; as buscas foram feitas usando os descritores “socialrepresentations” e “Dengue”. Resultados: Foram encontrados oito trabalhos publicados entre 2004 e2014, dos quais sete foram mantidos para a análise final; em tais estudos, utilizaram entrevistas,questionários seguidos de entrevista, grupos focais e análise documental como técnica de coleta dedados. Os atores sociais entrevistados – informantes – eram moradores de áreas afetadas pela Dengue,profissionais da Estratégia Saúde da Família, e estudantes de curso de graduação; nas análisesdocumentais foram explorados materiais educativos impressos e reportagens sobre a doença de jornais ede revistas. Nos resultados observados, notou-se que o interesse na compreensão das representaçõessociais sobre a doença foi orientado por objetivos acadêmicos, mas também para fins operacionais e deplanejamento da práxis em saúde. Conclusão: Esta revisão forneceu um panorama do conhecimentopopular e profissional sobre o tema. Diante do número reduzido de contribuições científicas abordando atemática, se reitera a importância de investigar as representações sociais sobre a Dengue nos diversossegmentos da sociedade...

Given the importance of Dengue for public health, the aim of this study was to investigateand describe the research on social representations of Dengue found in the scientific literature.Methods: The method used was an integrative review, with search performed in the PubMed/MEDLINE,LILACS and SciELO databases, using the descriptors social representations and Dengue. Results: Eightstudies were found, published between 2004 and 2014, of which seven were selected for final analysis.The data collection instruments observed were interviews, questionnaires followed by interview, focusgroups and documentary analysis. The social actors interviewed consisted of residents from the areasaffected by Dengue, professionals from the Family Health Strategy, and undergraduate students from apublic institution. Documentary analyses included printed educative materials and clippings fromnewspapers and magazines about the disease. Considering the studies obtained as one, it was observedthat the interest in understanding social representations of the disease was oriented by academicobjectives, but also had strategic purposes and aimed at the health praxis planning. Conclusion: Thisreview provides an overview of popular and professional knowledge on the subject. A low number ofcontributions approaching the theme was found, which reiterates the importance of investigating socialrepresentations of Dengue in the various segments of the community...

Ante la importancia del Dengue para la salud pública, se objetivó investigar y describir quéinvestigaciones de representaciones sociales sobre Dengue pueden encontrarse en la literaturacientífica. Métodos: Se realizó revisión integrativa, inquiriéndose en las bases de datosPubMed/MEDLINE, LILACS y SciELO, utilizándose los descriptores "Social Representations" y "Dengue".Resultados: Fueron obtenidos ocho trabajos, publicados entre 2004 y 2014, seleccionándose siete para el análisis final. Se observó que las técnicas de recolección de datos utilizadas fueron entrevistas,cuestionarios seguidos de entrevista, grupos focales y análisis documental. Los actores socialesentrevistados fueron habitantes de áreas afectadas por el Dengue, profesionales de la Estrategia Saludde la Familia y estudiantes de un curso público de graduación. En los análisis documentales, fueronexplorados materiales educativos impresos y crónicas de periódicos y revistas sobre la enfermedad.Tomando a los artículos obtenidos como un todo, se evidenció que el interés en la comprensión de lasrepresentaciones sociales sobre la enfermedad estuvo orientada por objetivos académicos y por finesestratégicos y de planificación de la praxis en salud. Conclusión: Esta revisión ofrece una visión generaldel conocimiento popular y profesional sobre el tema. Se consideró escaso el número de publicacionessobre la temática, por lo cual se reitera la importancia de investigar las representaciones sociales delDengue en diversos segmentos de la comunidad...

Effect of foods and drinks on primary tooth enamel after erosive challenge with hydrochloric acid.

The aim of this study was to evaluate the effect of industrialised foods and drinks on primary tooth enamel previously eroded with hydrochloric acid (HCl). The crowns of one hundred two specimens were subjected to an erosive challenge with HCl and randomly divided into six groups (n = 17): Chocolate Milk (Toddynho® - Pepsico) - negative control; Petit Suisse Yogurt (Danoninho® - Danone); Strawberry Yogurt (Vigor); Apple puree (Nestlé); Fermented Milk (Yakult® - Yakult); and Home Squeezed Style Orange Juice (del Valle) - positive control. The 28-day immersion cycles for the test products were performed twice daily and were interspersed with exposure of the test substrate to artificial saliva. Measurements of enamel surface microhardness (SMH) were performed initially, after immersion in HCl and at 7, 14, 21 and 28 days of experimentation. A two-way ANOVA, according to a split-plot design, followed by the sum of squares decomposition and Tukey's test, revealed a significant effect for the interaction between Foods and Drinks and Length of Exposure (p < 0.00001). Orange juice resulted in greater mineral loss of enamel after 28 days. None of the test products was associated with recovery of tooth enamel microhardness.

Assessment of the relationship between entomologic indicators of Aedes aegypti and the epidemic occurrence of dengue virus 3 in a susceptible population, São José do Rio Preto, São Paulo, Brazil.

The aims of this study were to describe the occurrence of dengue in space and time and to assess the relationships between dengue incidence and entomologic indicators. We selected the dengue autochthonous cases that occurred between September 2005 and August 2007 in São José do Rio Preto to calculate incidence rates by month, year and census tracts. The monthly incidence rates of the city were compared to the monthly Breteau indices (BI) of the São José do Rio Region. Between December 2006 and February 2007, an entomological survey was conducted to collect immature forms of Aedes aegypti in Jaguaré, a São José do Rio Preto neighborhood, and to obtain entomological indices. These indices were represented using statistical interpolation. To represent the occurrence of dengue in the Jaguaré neighborhood in 2006 and 2007, we used the Kernel ratio and to evaluate the relationship between dengue and the entomological indices, we used a generalized additive model in a spatial case-control design. Between September 2005 and August 2007, the occurrence of dengue in São José do Rio Preto was almost entirely caused by DENV3, and the monthly incidence rates presented high correlation coefficients with the monthly BI. In Jaguaré neighborhood, the entomological indices calculated by hectare were better predictors of the spatial distribution of dengue than the indices calculated by properties, but the pupae quantification did not show better prediction qualities than the indices based on the container positivity, in relation to the risk of dengue occurrence. The fact that the municipality's population had a high susceptibility to the serotype DENV3 before the development of this research, along with the almost total predominance of the occurrence of this serotype between 2005 and 2007, facilitated the analysis of the epidemiological situation of the disease and allowed us to connect it to the entomological indicators.

Effect of foods and drinks on primary tooth enamel after erosive challenge with hydrochloric acid

The aim of this study was to evaluate the effect of industrialised foods and drinks on primary tooth enamel previously eroded with hydrochloric acid (HCl). The crowns of one hundred two specimens were subjected to an erosive challenge with HCl and randomly divided into six groups (n = 17): Chocolate Milk (Toddynho® - Pepsico) - negative control; Petit Suisse Yogurt (Danoninho® - Danone); Strawberry Yogurt (Vigor); Apple puree (Nestlé); Fermented Milk (Yakult® - Yakult); and Home Squeezed Style Orange Juice (del Valle) - positive control. The 28-day immersion cycles for the test products were performed twice daily and were interspersed with exposure of the test substrate to artificial saliva. Measurements of enamel surface microhardness (SMH) were performed initially, after immersion in HCl and at 7, 14, 21 and 28 days of experimentation. A two-way ANOVA, according to a split-plot design, followed by the sum of squares decomposition and Tukey’s test, revealed a significant effect for the interaction between Foods and Drinks and Length of Exposure (p < 0.00001). Orange juice resulted in greater mineral loss of enamel after 28 days. None of the test products was associated with recovery of tooth enamel microhardness.

Correlates of experimentation with smoking and current cigarette consumption among adolescents / Correlatos de experimentação e consumo atual de cigarros entre adolescentes

OBJECTIVE: The aim of this study was to analyze social characteristics and stress as correlates of cigarette smoking in adolescence. The main intent was to identify elements that distinguish adolescents who had experimented with smoking and did not progress to regular smoking from those who became current smokers. METHODS: Students at 10 high schools in the city of Ribeirão Preto, Brazil, completed a questionnaire based on an instrument employed in a similar large-scale study. The students were classified as never-smokers or experimenters. The experimenters were subcategorized as having become current smokers or nonprogressors. Analyses were performed using adjusted logistic models. RESULTS: A total of 2,014 students (mean age, 16.2 ± 1.1 years; females, 53%) completed the questionnaire. We categorized 1,283 students (63.7%) as never-smokers, 244 (12.1%) as current smokers, and 487 (24.2%) as nonprogressors. We found that experimentation with smoking was associated with being held back a grade in school (OR = 1.80), alcohol intake (low/occasional, OR = 8.92; high/regular, OR = 2.64), illicit drug use (OR = 9.32), having a sibling or cousin who smokes (OR = 1.39), having a friend who smokes (OR = 2.08), and high levels of stress (in females only, OR = 1.32). Factors associated with an increased risk of transitioning from experimenter to current smoker were alcohol intake (low/occasional, OR = 3.28; high/regular, OR = 2.16), illicit drug use (OR = 3.61), and having a friend who smokes (OR = 7.20). CONCLUSIONS: Current smoking was associated with a profile of socioeconomic correlates different from that associated with experimentation only. Our data (showing that current smoking was associated with having a friend who smokes, ...

OBJETIVO: Analisar características sociais e estresse como correlatos de consumo de cigarros na adolescência. O principal objetivo foi identificar elementos que distingam adolescentes que experimentaram cigarros e não progrediram para o tabagismo regular daqueles que se tornaram fumantes correntes. MÉTODOS: Estudantes de 10 escolas do ensino médio de Ribeirão Preto responderam um questionário baseado em instrumento empregado em um estudo com escala semelhante. Os estudantes foram classificados em indivíduos que nunca fumaram (NF) e experimentadores de cigarros (E). O grupo E foi subcategorizado em fumantes atuais e indivíduos que não progrediram para tabagismo corrente. As análises foram realizadas usando modelos logísticos ajustados. RESULTADOS: Um total de 2.014 estudantes (16,2 ± 1,1 anos; mulheres, 53%) responderam o questionário. Categorizamos 1.283 alunos (63,7%) em nunca fumantes, 244 (12,1%) como fumantes atuais e 487 (24,2%) como não progressores. A experimentação de cigarros foi associada a repetição de anos na escola (OR = 1,80), consumo de álcool (baixo/ocasional, OR = 8,92; intenso/frequente, OR = 2,64), uso de drogas ilícitas (OR = 9,32), fumantes entre irmãos ou primos (OR = 1,39), fumantes entre amigos (OR = 2,08) e níveis elevados de estresse (apenas em mulheres, OR = 1,32). Fatores associados com um risco maior de passar de experimentador de cigarros para fumante atual foram consumo de álcool (baixo/ocasional, OR = 3,28; regular/elevado, OR = 2,16), uso de drogas ilícitas (OR = 3,61) e amigos fumantes (OR = 7,20). CONCLUSÕES: O tabagismo atual associou-se com um perfil de correlatos soc...

Spatial distribution of the human development index, HIV infection and AIDS-Tuberculosis comorbidity: Brazil, 1982-2007.

INTRODUCTION: AIDS epidemic has given visibility to the incidence of tuberculosis, for being the most frequent opportunistic infection. It is known that individuals who are socially vulnerable are more susceptible to HIV transmission and tuberculosis as well. OBJECTIVE: This study aims to conduct a geoepidemiological study on HIV/AIDS, AIDS-Tuberculosis co-infection and social vulnerability. METHOD: This is an ecological study using incidence rates and the human development index to produce thematic maps and a descriptive analysis of epidemiology. The records of reported cases of HIV/AIDS from 1982 to 2007 were used, considering as cases of AIDS-Tuberculosis those records that were positively diagnosed with tuberculosis and those records with unknown diagnosis of tuberculosis, but showing compatible signs and symptoms with tuberculosis (fever, cough, cachexia and asthenia). RESULTS: The maps allowed the identification of areas with social differences and different patterns of incidence of HIV/AIDS and AIDS-Tuberculosis; regional differences were similar to those found by Josué de Castro, in 1940; regions with higher human development index values also showed higher incidence HIV/AIDS and AIDS-Tuberculosis. CONCLUSION: The prevention of HIV infection must be geographically specific, given socioeconomic and cultural differences. Although official records show decline in AIDS-TB co-infection, treatment of cases of HIV/AIDS should observe the occurrence of opportunistic diseases, which should be notified and/or updated.

Correlates of experimentation with smoking and current cigarette consumption among adolescents.

OBJECTIVE: The aim of this study was to analyze social characteristics and stress as correlates of cigarette smoking in adolescence. The main intent was to identify elements that distinguish adolescents who had experimented with smoking and did not progress to regular smoking from those who became current smokers. METHODS: Students at 10 high schools in the city of Ribeirão Preto, Brazil, completed a questionnaire based on an instrument employed in a similar large-scale study. The students were classified as never-smokers or experimenters. The experimenters were subcategorized as having become current smokers or nonprogressors. Analyses were performed using adjusted logistic models. RESULTS: A total of 2,014 students (mean age, 16.2 ± 1.1 years; females, 53%) completed the questionnaire. We categorized 1,283 students (63.7%) as never-smokers, 244 (12.1%) as current smokers, and 487 (24.2%) as nonprogressors. We found that experimentation with smoking was associated with being held back a grade in school (OR = 1.80), alcohol intake (low/occasional, OR = 8.92; high/regular, OR = 2.64), illicit drug use (OR = 9.32), having a sibling or cousin who smokes (OR = 1.39), having a friend who smokes (OR = 2.08), and high levels of stress (in females only, OR = 1.32). Factors associated with an increased risk of transitioning from experimenter to current smoker were alcohol intake (low/occasional, OR = 3.28; high/regular, OR = 2.16), illicit drug use (OR = 3.61), and having a friend who smokes (OR = 7.20). CONCLUSIONS: Current smoking was associated with a profile of socioeconomic correlates different from that associated with experimentation only. Our data (showing that current smoking was associated with having a friend who smokes, alcohol intake, and illicit drug use) suggest the need for comprehensive approaches to discourage substance use during adolescence.

OBJETIVO: Analisar características sociais e estresse como correlatos de consumo de cigarros na adolescência. O principal objetivo foi identificar elementos que distingam adolescentes que experimentaram cigarros e não progrediram para o tabagismo regular daqueles que se tornaram fumantes correntes. MÉTODOS: Estudantes de 10 escolas do ensino médio de Ribeirão Preto responderam um questionário baseado em instrumento empregado em um estudo com escala semelhante. Os estudantes foram classificados em indivíduos que nunca fumaram (NF) e experimentadores de cigarros (E). O grupo E foi subcategorizado em fumantes atuais e indivíduos que não progrediram para tabagismo corrente. As análises foram realizadas usando modelos logísticos ajustados. RESULTADOS: Um total de 2.014 estudantes (16,2 ± 1,1 anos; mulheres, 53%) responderam o questionário. Categorizamos 1.283 alunos (63,7%) em nunca fumantes, 244 (12,1%) como fumantes atuais e 487 (24,2%) como não progressores. A experimentação de cigarros foi associada a repetição de anos na escola (OR = 1,80), consumo de álcool (baixo/ocasional, OR = 8,92; intenso/frequente, OR = 2,64), uso de drogas ilícitas (OR = 9,32), fumantes entre irmãos ou primos (OR = 1,39), fumantes entre amigos (OR = 2,08) e níveis elevados de estresse (apenas em mulheres, OR = 1,32). Fatores associados com um risco maior de passar de experimentador de cigarros para fumante atual foram consumo de álcool (baixo/ocasional, OR = 3,28; regular/elevado, OR = 2,16), uso de drogas ilícitas (OR = 3,61) e amigos fumantes (OR = 7,20). CONCLUSÕES: O tabagismo atual associou-se com um perfil de correlatos socioeconômicos diferentes daqueles associados apenas à experimentação. Nossos achados (tabagismo atual associou-se a amigos fumantes, consumo de álcool e de drogas ilícitas) sugerem a necessidade de abordagens abrangentes para o desencorajamento do uso dessas substâncias na adolescência.

Long-term chlorhexidine effect on bond strength to Er:YAG laser irradiated-dentin.

This study evaluates the bond strength of dentin prepared with Er:YAG laser or bur, after rewetting with chlorhexidine on long-term artificial saliva storage and thermocycling. One hundred and twenty human third molars were sectioned in order to expose the dentin surface (n = 10). The specimens were randomly divided in 12 groups according to treatment and aging: Er:YAG laser rewetting with deionized water (LW) and 24 h storage in artificial saliva (WC); LW and 6 months of artificial saliva storage + 12.000 thermocycling (6M), LW and 12 months of artificial saliva storage + 24.000 thermocycling (12M), Er:YAG laser rewetting with 2% chlorhexidine (LC) and WC, LC and 6M, LC and 12M, bur on high-speed turbine rewetting with deionized water (TW) and WC, TW6M, TW12M, bur on high-speed turbine + 2% chlorhexidine (TC) and WC, TC and 6M, TC and 12M. The specimens were etched with 35% phosphoric acid, washed, and dried with air. Single Bond 2 adhesive was applied and the samples were restored with a composite. Each tooth was sectioned in order to obtain 4 sticks, which were submitted to microtensile bond strength test (µTBS). The two-way ANOVA, showed no significant differences for the interaction between the factors and for the aging factor. Tukey 5% showed that the LC group had the lowest µTBS. The rewetting with chlorhexidine negatively influenced the bond strength of the preparation with the Er:YAG laser. The artificial saliva aging and thermocycling did not interfere with dentin bond strength.