Insegurança alimentar, vínculo mãe-filho e desnutrição infantil em área de alta vulnerabilidade social

OBJETIVO: analisar a insegurança alimentar e o vínculo inadequado mãe-filho como dois potenciais determinantes da desnutrição em crianças de quatro a seis anos de idade. MÉTODOS: estudo de caso-controle desenvolvido em Escolas Municipais de Educação Infantil (EMEIs) no Jardim Jaqueline, área de alta vulnerabilidade social do município de São Paulo, Brasil. Foram aplicados a Escala Brasileira de Insegurança Alimentar e o Protocolo de Avaliação do Vínculo Mãe-filho, além de coletadas informações biológicas e socio-econômicas. Para verificação dos efeitos de cada variável independente e controle dos efeitos das demais variáveis incluídas no modelo, foi utilizado o modelo de regressão logística múltipla. RESULTADOS: verificou-se que tanto a insegurança alimentar familiar (OR=3,6) como o vínculo inadequado mãe-filho (OR=9,4) estiveram associados com a desnutrição infantil (p<0,05), mesmo após o controle para o peso ao nascimento da criança e idade, estado conjugal e trabalho maternos. CONCLUSÕES: tanto a insegurança alimentar familiar (OR=3,6) como o vínculo mãe-filho inadequado (OR=9,4) mostraram-se fatores determinantes da ocorrência da desnutrição na população estudada.

Working at night and work ability among nursing personnel: when precarious employment makes the diVerence

Purpose To test the association between night work and work ability, and verify whether the type of contractual employment has any inXuence over this association. Methods Permanent workers (N = 642) and workers with precarious jobs (temporary contract or outsourced; N = 552) were interviewed and Wlled out questionnaires concerning work hours and work ability index. They were classiWed into: never worked at night, ex-night workers, currently working up to Wve nights, and currently working at least six nights/2-week span. Results After adjusting for socio-demography and work variables, current night work was signiWcantly associated with inadequate WAI (vs. day work with no experience in night work) only for precarious workers (OR 2.00, CI 1.01- 3.95 and OR 1.85, CI 1.09-3.13 for those working up to Wve nights and those working at least six nights in 2 weeks, respectively). Conclusions Unequal opportunities at work and little experience in night work among precarious workers may explain their higher susceptibility to night work

Biofuels and Sustainable Energy Development in Brazil

Through the assessment of three decades of the Alcohol Program in Brazil, the paper shows that adequate public policies regarding biomass production can deliver direct benefits like energy security improvement, foreign exchange savings, and local employment generation, reduced urban air pollution and avoided CO(2) emissions. Moreover, the paper shows that Brazilian produced ethanol has faced economies of scale, technical progress and productivity gains and is no longer dependent on subsidies to be competitive. The paper also examines the potential in Brazil for fostering other biofuels, namely biodiesel obtained from vegetable oils, as well as their implications on sustainable energy development. (C) 2011 Elsevier Ltd. All rights reserved.

Tooth-wear patterns in adolescents with normal occlusion and Class II Division 2 malocclusion

Introduction: In this study, we investigated tooth-wear patterns in adolescents with either normal occlusion or Class II Division 2 malocclusion. Methods: The sample consisted of dental casts from 165 subjects that were divided into 2 groups: 115 normal occlusion subjects (mean age, 14.3 years) and 50 complete Class II Division 2 subjects (mean age, 13.9 years). Dental wear was assessed by using a modified version of the tooth wear index. The 2 groups were compared with the Mann-Whitney test for the frequency and severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. Results: The normal occlusion group statistically had greater tooth wear on the incisal surfaces of the maxillary lateral incisors and the incisal surfaces of the maxillary canines than did the Class II Division 2 malocclusion group. The malocclusion group showed statistically greater tooth wear on the labial surfaces of the mandibular lateral incisors, the occlusal surfaces of the maxillary premolars and first molars, the occlusal surfaces of the mandibular premolars, the palatal surfaces of the maxillary second premolars, and the buccal surfaces of the mandibular premolars and first molars than did the normal occlusion group. Conclusions: Subjects with normal occlusion and those with complete Class II Division 2 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but, rather, the consequence of different interocclusal arrangements. (Am J Orthod Dentofacial Orthop 2010;137:730.e1-730.e5)

Tooth-wear patterns in subjects with Class II Division 1 malocclusion and normal occlusion

Introduction: The aim of this study was to investigate the prevalence of tooth wear in adolescents with Class II malocclusion, compared with those with normal occlusion. Methods: The sample consisted of dental casts obtained from 310 subjects, divided into 3 groups: group 1, 110 subjects with normal occlusion (mean age, 13.51 years); group 2, 100 complete Class II Division 1 patients (mean age, 13.44 years); and group 3, 100 half-cusp Class II Division 1 patients (mean age, 13.17 years). Dental wear was assessed by using a modified version of the tooth-wear index. The 3 groups were compared by means of the Kruskal-Wallis and Dunn tests, considering the frequency and the severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. Results: The normal occlusion group had statistically greater tooth wear on the palatal surfaces of the maxillary central incisors and the incisal surfaces of the maxillary canines than the corresponding surfaces in both Class II malocclusion groups. The complete and half-cusp Class II Division 1 malocclusion groups had statistically greater tooth wear on the occlusal surfaces of the maxillary second premolar and first molar, the occlusal surfaces of the mandibular premolars, and the buccal surfaces of the mandibular posterior teeth compared with the normal occlusion group. The half-cusp Class II Division 1 malocclusion group had significantly greater tooth wear on the incisal surfaces of the mandibular incisors compared with the complete Class II Division 1 malocclusion group. Conclusions: Subjects with normal occlusion and complete or half-cusp Class II Division 1 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but rather consequent to the different interocclusal tooth arrangement. (Am J Orthod Dentofacial Orthop 2010; 137: 14. e1-14.e7)

Stability and relapse of maxillary anterior crowding treatment in Class I and Class II Division 1 malocclusions

Introduction: The maxillary anterior teeth are the most important to facial esthetics because they are the first to show on a smile. Therefore, stability of the maxillary anterior teeth alignment is an important issue. The objective of this study was to compare the stability of maxillary anterior tooth alignment in Class I and Class II Division 1 malocclusions. Methods: The sample comprised dental casts of 70 patients with Class I and Class II Division 1 malocclusions and a minimum of 3 mm of maxillary anterior crowding measured by an irregularity index. The patients were treated with extractions and evaluated at pretreatment and posttreatment and at least 5 years after treatment. The sample was divided into 3 groups: group 1, Class I malocclusion treated with 4 first premolar extractions comprising 30 subjects, with an initial age of 13.16 years and 8.59 mm of initial maxillary irregularity; group 2, Class II malocclusion treated with 4 first premolar extractions comprising 20 subjects, with an initial age of 12.95 years and 11.10 mm of maxillary irregularity; and group 3, Class II malocclusion treated with 2 first maxillary premolar extractions comprising 20 subjects, with an initial age of 13.09 years and 9.68 mm of maxillary irregularity. Results: The decrease in the maxillary irregularity index was significantly greater in group 2 than in group 1 during treatment. The stability of maxillary anterior alignment was 88.12% over the long term; 77% of the linear displacement of the anatomic contact points tended to return to their original positions. Conclusions: Stability of maxillary anterior alignment between the 3 groups was similar. The stability of maxillary anterior alignment was high over the long term, but a high percentage of teeth tended to return to their original positions. (Am J Orthod Dentofacial Orthop 2011; 139: 768-74)

Occlusal outcomes and efficiency of 1-and 2-phase protocols in the treatment of Class II Division 1 malocclusion

Introduction: The purpose of this study was to compare the occlusal outcomes and the efficiency of 1-phase and 2-phase treatment protocols in Class II Division 1 malocclusions. Treatment efficiency was defined as a change in the occlusal characteristics in a shorter treatment time. Methods: Class II Division 1 subjects ( n = 139) were divided into 2 groups according to the treatment protocol for Class II correction. Group 1 comprised 78 patients treated with a 1-phase treatment protocol at initial and final mean ages of 12.51 and 14.68 years. Group 2 comprised 61 patients treated with a 2-phase treatment protocol at initial and final mean ages of 11.21 and 14.70 years. Lateral cephalometric radiographs were taken at the pretreatment stage to evaluate morphological differences in the groups. The initial and final study models of the patients were evaluated by using the peer assessment rating index. Chi-square tests were used to test for differences between the 2 groups for categorical variables. Variables regarding occlusal results were compared by using independent t tests. A linear regression analysis was completed, with total treatment time as the dependent variable, to identify clinical factors that predict treatment length for patients with Class II malocclusions. Results: Similar occlusal outcomes were obtained between the 1-phase and the 2-phase treatment protocols, but the duration of treatment was significantly shorter in the 1-phase treatment protocol group. Conclusions: Treatment of Class II Division 1 malocclusions is more efficient with the 1-phase than the 2-phase treatment protocol.

A modified orthodontic protocol for advanced periodontal disease in Class II division 1 malocclusion

An interdisciplinary approach is often the best option for achieving a predictable outcome for an adult patient with complex clinical problems. This case report demonstrates the combined periodontal/orthodontic treatment for a 49-year-old woman presenting with a Class II Division 1 malocclusion with moderate maxillary anterior crowding, a 9-mm overjet, and moderate to severe bone loss as the main characteristics of the periodontal disease. The orthodontic treatment included 2 maxillary first premolar extractions through forced extrusion. Active orthodontic treatment was completed in 30 months. The treatment outcomes, including the periodontal condition, were stable 17 months after active orthodontic treatment. The advantages of this interdisciplinary approach are discussed. Periodontally compromised orthodontic patients can be satisfactorily treated, achieving most of the conventional orthodontic goals, if a combined orthodontic/periodontic approach is used. (Am J Orthod Dentofacial Orthop 2011; 139:S133-44)