As campanhas contra o Influenza e seu caráter educacional: análise do material produzido em 2016 / Campaigns against Influenza and its educational character: analysis of the material produced in 2016 / Campañas contra la Influenza y su carácter educativo: análisis del material producido en 2016

O avanço das complicações desenvolvidas pelas doenças é notável, tanto no número crescente de mortes quanto no de internações, sendo o vírus Influenza um dos representantes dos causadores desses males. Dessa forma, buscam-se maneiras eficazes de prevenir doenças como a gripe; entre tais medidas estão lavar as mãos com frequência, não compartilhar determinados objetos e, como ação mais eficaz, a vacinação. Por tal motivo, o trabalho em que se baseia este artigo tem o objetivo de analisar os tipos de conteúdo presentes em materiais elaborados pelo Ministério da Saúde no Brasil para campanha de vacinação contra a gripe no ano de 2016. A pesquisa faz uso das categorias de análise prescritas por Antoni Zabala acerca das práticas de ensino e aprendizagem. No decorrer da análise foi observado que o modo como o material foi elaborado em 2016 e a forma como foram dispostos os conteúdos, imagéticos e textuais, podem influenciar a eficácia das campanhas de vacinação.

The advance on complications developed by diseases is notable, both in the growing number of deaths and in the number of hospitalizations, and the Influenza virus is one of the causes of these diseases. Thus, effective ways of preventing diseases such as the flu are sought; such measures include washing frequently the hands, do not sharing certain objects and, as the most effective action, vaccination. For this reason, the study on which this article is based aims to analyze the types of content found in materials prepared by the Ministry of Health in Brazil for the flu vaccination campaign developed in the year 2016. The research makes use of the analysis categories prescribed by Antoni Zabala about teaching and learning practices. During the analysis, it was observed that the way of preparing the material in 2016 and the way of arranging the contents, both imagery and text, can influence the effectiveness of vaccination campaigns.

Es notable el aumento de las complicaciones que las enfermedades provocan, tanto en el creciente número de muertes como en el número de casos que exigen hospitalización, siendo el virus de la Influenza una de las causas de esas enfermedades. Por eso se buscan formas eficaces de prevenir enfermedades como la gripe; tales medidas incluyen lavar las manos con frecuencia, no compartir ciertos objetos y, como acción más eficaz, la vacunación. Por esta razón, el estudio que fundamenta este artículo tiene como objetivo analizar los tipos de contenido presentes en los materiales preparados por el Ministerio de Salud en Brasil para la campaña de vacunación contra la influenza desarrollada en lo año 2016. La investigación hace uso de las categorías de análisis prescritas por Antoni Zabala sobre prácticas de enseñanza y aprendizaje. Durante el análisis, se observó que la forma en que se preparó el material en y la forma en que se organizaron los contenidos, tanto las imágenes como el texto, pueden influir en la efectividad de las campañas de vacunación.

Mechanical Fatigue Analysis of PEEK as Alternative to Zirconia for Definitive Hybrid Abutments Supporting All-Ceramic Crowns.

PURPOSE: The aim of this study was to inspect the mechanical fatigue behavior of an implant-supported restorative system using polyether ether ketone (PEEK) and yttria partially stabilized zirconia polycrystals (YZ) as materials for customized definitive implant-supported hybrid abutments, supporting two types of all-ceramic restorations: translucent zirconia (TZ) and lithium disilicate (LD) monolithic crowns. MATERIALS AND METHODS: Forty Morse taper implants were included in epoxy resin. Titanium intermediary abutments were placed, and the specimens were randomly allocated into four groups (n = 10) according to the customized hybrid abutment material (PEEK or YZ) and the monolithic crowns (TZ or LD) representing a maxillary central incisor crown. The specimens were subjected to a mechanical fatigue test (step-stress analysis) by means of an initial 200-N load for 5,000 cycles and subsequent increase of 50 N (step-size) at each 10,000 cycles, until failure occurred. The load at failure and number of cycles until failure were recorded; survival probabilities and specimen displacement were calculated for each step. The failure pattern was evaluated, and the Weibull modulus was obtained for each condition. RESULTS: Fatigue of both types of crowns was not influenced by the abutment material (LD-PEEK = LD-YZ; TZ-PEEK = TZ-YZ). In the PEEK abutment, the values obtained in the LD and TZ crowns showed no statistical difference; however, in the YZ abutment, the TZ crown presented a load at failure value that was statistically higher than that for LD. Failure pattern analysis revealed a higher prevalence of crown fracture for LD groups, while screw/implant platform fractures were shown for TZ groups. CONCLUSION: YZ and PEEK hybrid abutments promoted similar fatigue levels regardless of the crown materials, TZ crowns promoted a higher fatigue level than LD ones when associated with YZ abutments, and LD crowns promoted a similar fatigue level to TZ ones when associated with PEEK custom abutments. Higher prevalence of crown fractures was shown for LD and screw/implant platform fractures for TZ groups.

Implant Volume Loss, Misfit, Screw Loosening, and Stress In Custom Titanium and Zirconia Abutments.

The aim of this study was to verify the effect of the implant volume loss, vertical misfit between abutment and prosthetic platform, prosthetic screw loosening torque, and screw stress distribution in titanium and zirconia abutments. Ten CAD/CAM system custom abutments of each material were milled and attached to the titanium implants. The implant volume loss was evaluated by microtomography, the vertical misfit with optical microscopy, and digital torque wrench measured the prosthetic screw loosening. All experimental analyses were performed before and after mechanical cycle (1,000,000 cycles, 100 N/2 Hz). Virtual models of the structures were created for finite element analysis, and the stress on the screw obtained with von Mises procedure. Data were analyzed using an independent t-test, two-way ANOVA for repeated measures, and Tukey's HSD test (a=0.05). There was no significant difference in the implant volume loss for the two abutment materials (p=0.662). Titanium abutments provided higher loosening torque values after mechanical cycling (p<0.001). Lesser marginal misfit was obtained with titanium abutments before and after mechanical cycling (p<0.001). The stress distribution on the screw was similar between abutment materials. In conclusion, CAD/CAM custom titanium abutment reduced the marginal misfit and increased the torque maintenance of prosthetic screws when compared to CAD/CAM custom zirconia abutment.

Implant volume loss, misfit, screw loosening, and stress in custom titanium and zirconia abutments

Abstract The aim of this study was to verify the effect of the implant volume loss, vertical misfit between abutment and prosthetic platform, prosthetic screw loosening torque, and screw stress distribution in titanium and zirconia abutments. Ten CAD/CAM system custom abutments of each material were milled and attached to the titanium implants. The implant volume loss was evaluated by microtomography, the vertical misfit with optical microscopy, and digital torque wrench measured the prosthetic screw loosening. All experimental analyses were performed before and after mechanical cycle (1,000,000 cycles, 100 N/2 Hz). Virtual models of the structures were created for finite element analysis, and the stress on the screw obtained with von Mises procedure. Data were analyzed using an independent t-test, two-way ANOVA for repeated measures, and Tukey's HSD test (a=0.05). There was no significant difference in the implant volume loss for the two abutment materials (p=0.662). Titanium abutments provided higher loosening torque values after mechanical cycling (p<0.001). Lesser marginal misfit was obtained with titanium abutments before and after mechanical cycling (p<0.001). The stress distribution on the screw was similar between abutment materials. In conclusion, CAD/CAM custom titanium abutment reduced the marginal misfit and increased the torque maintenance of prosthetic screws when compared to CAD/CAM custom zirconia abutment.

Resumo O objetivo neste estudo foi verificar o efeito da diminuição de volume do implante, desajuste vertical entre o pilar e plataforma protética, torque de afrouxamento do parafuso protético e distribuição da tensão no parafuso em pilares de titânio e zircônia. Dez pilares personalizados de cada material foram fresados e conectados aos implantes de titânio. A diminuição de volume do implante foi avaliada com microtomografia, o desajuste vertical com microscopia óptica e o torque de afrouxamento do parafuso protético com chave de torque digital. Todas as análises experimentais foram realizadas antes e após aplicação do ciclo mecânico (1.000.000 ciclos, 100 N/2 Hz). Modelos virtuais das estruturas foram criados para análise por elementos finitos e a tensão no parafuso obtida com valores de von Mises. Os dados foram analisados usando teste t independente, análise de varância dois fatores para medidas repetidas e teste de Tukey HSD (a=0,05). Não houve diferença significativa na diminuição de volume do implante para os dois materiais do pilar (p= 0,662). Os pilares de titânio proporcionaram maiores valores de torque de afrouxamento após o ciclo mecânico (p<0,001). O menor desajuste marginal foi obtido com os pilares de titânio antes e após o ciclo mecânico (p<0,001). A distribuição da tensão no parafuso foi similar entre os materiais. Em conclusão, os pilares personalizados de titânio reduziram o desajuste marginal e aumentaram a manutenção do torque dos parafusos protéticos quando comparados aos pilares de zircônia.

Highly Electroconductive Nanopapers Based on Nanocellulose and Copper Nanowires: A New Generation of Flexible and Sustainable Electrical Materials.

Nowadays, the development of sustainable high-performance functional nanomaterials is in the spotlight. In this work, we report the preparation of a new generation of flexible and high electroconductive nanopapers based on nanofibrillated cellulose (NFC) and copper nanowires (CuNWs). Homogeneous red brick color nanopapers (thickness 30.2-36.4 µm) were obtained by mixing different amounts of NFC aqueous suspensions and CuNWs (1, 5, 10, 20, and 50 wt %), followed by vacuum filtration and drying. scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) analysis confirmed the incorporation of the different amounts of CuNWs, and their uniform and random distribution. All of the nanomaterials displayed good mechanical properties, viz., Young's modulus = 2.62-4.72 GPa, tensile strength = 30.2-70.6 MPa, and elongation at break = 2.3-4.1% for the nanopapers with 50 and 1 wt % of CuNWs mass fraction, respectively. The electrical conductivity of these materials strongly depends on the CuNW content, attaining a value of 5.43 × 104 S·m-1 for the nanopaper with a higher mass fraction. This is one of the highest values reported so far for nanocellulose-based conductive materials. Therefore, these nanopapers can be seen as an excellent inexpensive and green alternative to the current electroconductive materials for applications in electronic devices, energy storage, or sensors.

Nanocomposite Polymeric Materials Based on Eucalyptus Lignoboost® Kraft Lignin for Liquid Sensing Applications.

This study reports the synthesis of polyurethane-lignin copolymer blended with carbon multilayer nanotubes to be used in all-solid-state potentiometric chemical sensors. Known applicability of lignin-based polyurethanes doped with carbon nanotubes for chemical sensing was extended to eucalyptus LignoBoost® kraft lignin containing increased amounts of polyphenolic groups from concomitant tannins that were expected to impart specificity and sensitivity to the sensing material. Synthesized polymers were characterized using FT-MIR spectroscopy, electrical impedance spectroscopy, scanning electron microscopy, thermogravimetric analysis, and differential scanning calorimetry and are used for manufacturing of all solid-state potentiometric sensors. Potentiometric sensor with LignoBoost® kraft lignin-based polyurethane membrane displayed theoretical response and high selectivity to Cu (II) ions, as well as long-term stability.

Collagen vs expanded polytetrafluorethylene membranes during guided-bone regeneration simultaneous with implant placement: a systematic review / Membranas de colágeno vs politetrafluoretileno expandido para regeneração óssea guiada simultânea à colocação de implante: uma revisão sistemática

Purpose: This systematic review evaluated the influence of the membrane type (resorbable collagen or non-resorbable expanded polytetrafluorethylene; e-PTFE) on the guidedbone regeneration associated to implant placement. Methods: Any type of clinical study or literature review was searched at MEDLINE/PubMed and Cochrane databases. Two independent reviewers screened titles/abstracts of articles and the full-text of potentially eligible studies. When data was available, pairwise meta-analysis was performed using random statistical model. Results: Nine studies met the inclusion criteria, considering 685 implants in 360 patients. Vertical bone regeneration did not differ with the use of the two membranes in 8 of the 9 studies included. Meta-analysis did not show either greater vertical bone gain or vertical bone loss after regeneration with any of the membranes. The results have shown a tendency of higher bone gain in horizontal guided-bone regeneration with nonresorbable e-PTFE membranes (reported by 2 of 3 studies). All studies clearly showed that both membranes were effective in increase bone volume. There was no clear tendency of any of the two membranes in cause more complications. Conclusion: resorbable collagen and nonresorbable e-PTFE membranes are similarly effective in vertical guided-bone regeneration; however, horizontal guided-bone regeneration seems to benefit with the use of non-resorbable ones. Both membranes showed to be effective in guided-bone regeneration and similar in regards to complications(AU)

Objetivo: Esta revisão sistemática avaliou a influência do tipo de membrana (colágeno reabsorvível ou politetrafluoretileno expandido não reabsorvível; e-PTFE) na regeneração óssea guia associada à colocação do implante. Métodos: Qualquer tipo de estudo clínico ou revisão de literatura foi pesquisada nas bases de dados MEDLINE / PubMed e Cochrane. Dois revisores independentes examinaram títulos / resumos de artigos e o texto completo de estudos potencialmente elegíveis. Quando os dados estavam disponíveis, a meta-análise pareada foi realizada usando modelo estatístico aleatório. Resultados: Nove estudos preencheram os critérios de inclusão, considerando 685 implantes em 360 pacientes. A regeneração óssea vertical não diferiu com o uso das duas membranas em 8 dos 9 estudos incluídos. Meta-análise não mostrou maior ganho ósseo vertical ou perda óssea vertical após a regeneração com qualquer uma das membranas. Os resultados mostraram uma tendência de maior ganho ósseo na regeneração óssea guiada horizontal com membranas de e-PTFE não reabsorvíveis (relatadas por 2 de 3 estudos). Todos os estudos mostraram claramente que ambas as membranas foram eficazes no aumento do volume ósseo. Não houve uma tendência clara de qualquer uma das duas membranas em causar mais complicações. Conclusão: o colágeno reabsorvível e as membranas não-reabsorvíveis de PTFE-e são igualmente eficazes na regeneração óssea guiada vertical; no entanto, a regeneração óssea guiada horizontal parece se beneficiar com o uso das membranas não reabsorvíveis. Ambas as membranas mostraram-se eficazes na regeneração óssea guiada e similares em relação às complicações(AU)

A narrativa como alternativa na pesquisa em saúde / La narrativa como alternativa en la investigación de salud / Narratives as alternative in health research

O potencial das narrativas na compreensão dos significados que as pessoas atribuem ao ambiente e a si mesmas contribui para sua utilização em pesquisas qualitativas. Entretanto, são escassos os detalhes procedimentais dessas pesquisas, especialmente daquelas que integram os relatos em uma única história. Este trabalho descreve a produção de conhecimento na pesquisa qualitativa em saúde a partir do estudo sobre prazer, sofrimento e adoecimento em docentes do ensino superior. O conjunto das vivências relatadas em 25 entrevistas orientou, em análise interpretativa fundamentada na hermenêutica-dialética, a construção de uma nova narrativa pelos pesquisadores. O material elaborado foi discutido e revisado pelos participantes em oficina de validação. Os dados construídos coletivamente e a dinâmica observada na oficina corroboraram a potencialidade desse tipo de investigação como alternativa metodológica em pesquisas qualitativas em saúde.(AU)

El potencial de las narrativas en la comprensión de los significados que las personas atribuyen al ambiente y a sí mismas contribuye para su utilización en investigaciones cualitativas. No obstante, son escasos los detalles procedimentales de esas investigaciones, principalmente de aquellas que integran los relatos en una única historia. Este trabajo describe la producción de conocimiento en la investigación cualitativa en salud a partir del estudio sobre placer, sufrimiento y enfermedad en docentes de la enseñanza superior. El conjunto de las vivencias relatadas en 25 entrevistas orientó, en análisis hermenéutico-dialéctico, la construcción de una nueva narrativa por parte de los investigadores. El material elaborado fue discutido y validado por los participantes en taller de validación. Los datos construidos colectivamente y la dinámica observa en el taller corroboran el potencial de ese tipo de investigación como alternativa metodológica en investigaciones cualitativas de salud.(AU)

The potential of narratives in understanding the meanings people attach to the environment and to themselves contribute to their use in qualitative research. However, few procedural details of these surveys are found, especially those that integrate reports into a single story. This work describes the production of knowledge in qualitative health research coming from the study of pleasure, suffering and illness in higher education teachers. The experiences reported in 25 interviews were the guide of an interpretive analysis based on the hermeneutic-dialectic and the construction of a new narrative by the researchers. The material was discussed and reviewed by the participants in a validation workshop. The data that was collectively built and the dynamics observed in the workshop confirmed the potentiality offered by this kind of investigation as a methodological alternative in qualitative health research.(AU)

Aumento do rebordo alveolar maxilar usando osso autógeno associado ao osso heterógeno particulado ­ relato de caso / Maxillary alveolar ridge augmentation using autogenous and heterogeneous bone grafts ­ case report

O objetivo deste relato de caso foi demonstrar que o uso de osso autógeno associado ao enxerto alógeno e membranas de lenta reabsorção é uma alternativa confiável em procedimentos de regeneração óssea alveolar. Uma paciente do sexo feminino, com 47 anos de idade, foi encaminhada para reabilitação com implantes dentários em região anterior de maxila. A espessura de osso na região era delgada, com menos de 2 mm. O aumento de tecido foi realizado por meio de regeneração óssea tecidual. Os blocos de osso autógeno foram coletados do ângulo da mandíbula e modelados conforme o sítio receptor. Os blocos foram fixados com parafusos e os espaços foram preenchidos com osso autógeno particulado associado ao enxerto alógeno (Bio Oss®). Uma membrana de lenta reabsorção (Bio Guide®) foi utilizada para cobrir o leito receptor. A ferida foi coberta usando o tecido mucoperiosteal. Aos seis meses, um novo exame radiográfico foi solicitado para planejar os implantes a serem instalados e verificou-se aumento entre 7,53 mm até 10,73 mm. Nenhuma exposição foi observada. Após isso, os implantes foram instalados com auxílio de guia cirúrgico. Os acompanhamentos pós-cirúrgicos revelaram estabilidade dos implantes com excelente osseointegração e área satisfatoriamente reconstruída. O uso de enxertos autógenos continua sendo alternativa adequada de regenerações, especialmente quando associadas aos ossos alógenos e membranas de lenta reabsorção (AU).

The aim of this case report was to demonstrate that the use of autogenous bone graft associated with deproteinized bovine bone and slow absorption membrane is a reliable alternative for maxillary alveolar bone regeneration. Female patient, 47-year-old was referred for implant placement in the maxillary anterior region. The alveolar bone width at the region was thin, with less than 2 mm. The tissue augmentation was accomplished using bone regeneration. The autogenous bone blocks were collected from the mandible angle and shaped according to the receiving site. The blocks were fixed with screws and gaps filled with a mixture of particulate autogenous bone and deproteinized bovine bone (Bio-Oss®). A slow absorption membrane (Bio-Guide®) was used to cover all regenerated site. The wound was closed using a vestibular mucoperiosteal flap. At 6 months, a new radiographic exam was requested to plan the implants to be placed and it was verified new bone width, with measures between 7.53 mm and 10.73 mm. No exposure was observed. After that, the implants were placed by the aid of a surgical guide. The postoperative follow-up revealed that the implants were stable with excellent osseointegration and the surgical area was satisfactorily reconstructed. The use of autogenous bone grafts is still an adequate alternative to alveolar regeneration, especially when associated to deproteinized bovine bone graft and slow reabsorption membrane (AU).

Doar sangue é compartilhar vida: Análise de conteúdo de aprendizagem de um cartaz da campanha nacional e doação de sangue / Donate blood is to share life: Learning content analysis of a poster of the national blood donation campaign

No Brasil, os hemocentros têm encontrado dificuldades em manter um nível de estoque de bolsas de sangue que atendam às demandas da população. Assim, o Ministério da Saúde (MS) elabora anualmente a Campanha Nacional de Doação de Sangue. Sabendo-se que a comunicação na Campanha Nacional de Doação de Sangue são realizadas a partir de materiais educativos impressos, além de recursos audiovisuais, faz-se necessário conhecer o processo comunicativo realizado através destes. Objetivo: Realizar a análise do conteúdo de aprendizagem de um cartaz da Campanha Nacional de Doação de Sangue. Materiais e Método: Trata-se de uma pesquisa documental realizada a partir da análise de conteúdo de aprendizagem sob a perspectiva de Antoni Zabala de um material educativo impresso elaborado pelo Ministério da Saúde (MS) para a Campanha Nacional de Doação de Sangue do ano de 2015. Resultados: O material educativo impresso analisado buscou, através dos seus conteúdos, estimular a doação de sangue apresentando uma imagem que remete ao gesto de solidariedade e gratidão. Segundo a análise realizada, foram encontrados conteúdos atitudinal e conceitual, atitudinal e procedimental e conceitual, atitudinal e factual. Conclusão: o presente estudo possibilitou entender a importância da comunicação nos processos de ensino-aprendizagem demonstrando que não existe uma única corrente de interpretação e construção deste processo sendo necessário agregar à utilização do material educativo outras formas de sensibilização dos doadores para que a participação de todos possa ocorrer de maneira efetiva, doando sangue e compartilhando vidas num gesto de solidariedade.

In Brazil, blood centers have found it difficult to maintain a stock level of blood bags that meet the demands of the population. Thus, the health ministry shall draw up annually national blood donation campaigns. Knowing that communication in national blood donation campaigns are made from printed educational materials, and audio visual resources, it is necessary to know the communication process performed by these. Objective: The purpose of this article is perform analysis of learning content of a poster of the national donation campaign. Materials and Methods: It is a documentary research performed from the learning content analysis under Antoni Zabala perspective of an educational printed material prepared by the Ministry for 2015 national blood donation campaign. Results: The analyzed printed educational material sought, through its contents, stimulate blood donation presenting an image that refers to the gesture of solidarity and gratitude. According to the analysis carried out, attitudinal and conceptual, attitudinal and procedural and conceptual, attitudinal and factual contents were found. Conclusion: Thus, this study made it possible to understand the importance of communication in teaching and learning processes demonstrating that there is no single current interpretation and construction of this process it is necessary to add the use of educational material other forms of awareness of donors to the participation of all can effectively occur, donating blood and sharing lives in a solidarity gesture.

Direct costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.

BACKGROUND: Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed. METHODS AND RESULTS: To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO) guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002) in the group that received blood products (US $1,622.40) compared with the group that did not receive blood products (US $550.20). CONCLUSION: The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.