152 resultados para Pinos de retenção dentária


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Nowadays, Brazil has both the greatest goat herd and the greatest goat milk production of South America. The state of Rio Grande do Norte, located in northeast of Brazil, has an average year production of three thousand cubic meters of goat milk in natura. Part of this milk production is homemade and it comes from small farms, which unite in rural cooperatives created to encourage the production and implementation of industrial processes for preservation and processing of milk. Results presented by literature and obtained from preliminary essays in this thesis show that non conventional dryer of spouted bed with inert particles is able to produce powder milk from in natura milk (cattle or goat), with the same quality of spray dryer, however, operating at low cost. The method of drying in spouted bed consists of injecting milk emulsion on the bed of inert particles gushed by hot air. This emulsion covers the particles with a thin film, which dries and is reduced to powder during the circulation of inerts inside the bed. The powder is dragged by exhaustion air and separated in the cyclone. The friction among particles resulted from the particles circulation, encourages high taxes of shear in the thin film of emulsion, breaking the cohesive forces and making this process possible. Studying the drying process and the powder goat milk production in one unit of spouted bed with inert particles, seeing the development of a low cost technological route for powder milk production is the aim of this thesis. The powder milk produced by this route must attend the local demand of food industries which need an intermediate product to be used as a food ingredient (ice-cream, milk candy). In order to reach this aim, this thesis approaches the aspects related to physical, thermodynamics and physic-chemicals characteristics of goat milk, whose complete data are still inexistent in the literature. The properties of materials are of great importance to the project of any process which involves the operations of transportation of movement, heat and mass quantity, such as the dryers which operate in fluid dynamically active regime, like the spouted bed. It was obtained new data related to the goat milk properties in function of concentration of solids and temperature. It is also important to mention the study developed about the kinetic of solids retention in the bed of inert particles during the drying of goat milk. It was found more adequate processes conditions to the proposed technological route to be implemented in small and micro-industries, with simplifications in the system of milk injection as well as in the form of operation of the dryer. Important data were obtained for a posterior stage of this research which involves the v modeling, simulation, control and optimization of the process. The results obtained in this thesis, in relation to process performance as well as to the quality of produced powder milk validate the proposal of using the spouted bed dryer in the production of powder goat milk

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In northeastern semiarid, seasonality on precipitation temporal distribution, high intensity storm events and inadequate management of native vegetation can promote soil erosion. Vegetation removal causes soil surface exposure, reduces soil water storage capacity and can be the source degradation processes. In this context, this approach aims to analyze water and soil erosion processes on a 250 m2 undisturbed experimental plot with native vegetation, slope 2.5% by using 2006 and 2007 monitoring data. The site was instrumented to monitor rainfall, overland flow runoff and erosion by using a 5 m³ tank downstream the plot. Soil erosion monitoring was made by transported sediment and organic matter collection after each event. Field infiltration experiments were made at 16 points randomly distributed within the plot area by using a constant head infiltrometer during drought and rainy seasons, respectively. Infiltration data revealed high spatial and temporal variability. It was observed that during the beginning of the rainy period, 77% of the events showed runoff coefficient less than 0.05. As the rainy season began, soil water increase produced annual species germination. High intensity storms resulted in runoff coefficients varying between 0.33 and 0.42. Once the annual species was established, it was observed that approximately 39% of the events produced no runoff, which reflects an increase on soil water retention capacity caused by the vegetation. A gradual runoff reduction during the rainy season emphasizes the effect of vegetative density increase. Soil erosion observed data allowed to fit an empirical relationship involving soil loss and precipitation height, which was used to analyze the plot installation impact on soil erosion. Observed soil loss in 2006 and 2007 was 230 Kg/ha and 54 Kg/ha, respectively

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The improper disposal of nitrogen in receiving water courses causes problems such as toxicity to living beings through the consumption of oxygen to meet the nitrogen demand, eutrophication and nitrate contamination of aquifers. For this reason it is often necessary to be carried out complementary treatment of wastewater to eliminate or reduce the concentration of this compound in the wastewater. The objective of this study is to evaluate the biological removal of nitrogen compounds using submerged aerated and anoxic filters as post-treatment of an anaerobic system, with low cost and innovative technology, which in previous studies has shown high removal efficiency of organic matter and great potential biological nitrogen compounds removal. The simple design with perforated hoses for air distribution and filling with plastic parts proved to be very efficient in relation to organic matter removal and nitrification. The system presented, in the best stage, efficiency in converting ammonia to nitrate by 71%, and produced a final effluent concentration below 10 mg / L of NH3-N. In addition, carbon concentration was removed by 77%, producing final effluent with 24 mg/L COD. However, denitrification in anoxic filter was not effective even with the addition of an external carbon source. There was a reduction of up to 56% of nitrogen caused by the process of simultaneous nitrification and denitrification (SND). The high voids space presented by this type of support material coupled with direct aeration of the sludge, allows the respiration of biomass retained between the endogenous phase, increased cell retention time and sludge retention capacity, producing a final effluent with turbidity less than 5 UT and total suspended solids around 5.0 mg/L

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In semiarid region of northeast Brazil, the majority of reservoirs used for public supply has suffered degradation of water quality affected by diffuse pollution from agricultural and livestock areas of the watershed and by hydrologic regime peculiar to the region, characterized by a rainy season with higher volumes stored in reservoirs and a dry season with a reduction in water level due to high evaporation and increase of eutrophication. The Dourado reservoir, located in Currais Novos city, semiarid region of Rio Grande do Norte state, is one example of a water supply reservoir that can have degradation of water quality and impracticability of their use, due to the high external input of nutrients from non-point sources of watershed during the rainy season and increasing of eutrophication due to decrease the stored volume during the dry period. This study aimed to investigate and quantify diffuse pollution and the hydrologic regime of semiarid region in order to establish standards regarding the water quality of Dourado reservoir. The study period was between the months of May 2011 to March 2012. The diffuse pollution was quantified in terms of watershed from the mass balance of phosphorus in the reservoir, as in relation to areas under different types of land use within the riparian zone of the reservoir from the assessment of soil chemical properties and losses of phosphorus in each area. The influence of hydrological regime on water quality of the reservoir was evaluated from the monthly monitoring of the morphometric, meteorological and limnological features throughout the study period. The results showed that the reservoir has received a high load of phosphorus coming from the drainage basin and presents itself as a system able to retain some of that load tributary, giving an upward trend of the eutrophication process. Diffuse pollution by nutrients from areas under different types of land use within the riparian zone of the reservoir was higher in areas under the influence of livestock, being this area considered a potential diffuse source of nutrients to the reservoir. Regarding the water regime during the rainy season the reservoir was characterized by high concentrations of nutrients and small algal biomass, while in the dry season the reduction of volume and increase of the water retention time of the reservoir, contributing to the excessive growth algal biomass, favoring an increase in eutrophication and deterioration of water quality. In synthesis the water quality of Dourado reservoir is directed by diffuse pollution coming from the drainage basin and the hydrological regime of the peculiar semiarid region, where the rainy season is characterized by high input of allochthonous compounds from the tributaries and erosion of the soil in the reservoir riparian zone, and the dry season characterized by reducing the storage volume due to high evaporation, high residence time of water and consequent degradation of water quality due to the increase of eutrophication process

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The potentially toxic cyanobacterial blooms in water bodies are spread across the globe, resulting in the loss of water quality and adverse effects on human health. In arid and semiarid regions, the hydrologic regime characterized by an annual cycle of drought and rain, change the volume and the retention time of the reservoir. Such changes affect the limnological characteristics and causing changes in composition and biomass community of cyanobacteria. The reservoir Cruzeta (Zmax = 8.7 m) is a eutrophic water supply source located in the semiarid tropical (Northeast Brazil). Raised the hypothesis that the hydrological regime of semi-arid tropical is a determining factor in the availability of resources in eutrophic water sources, which influences the composition of dominant species of cyanobacteria. The aim of this study was to analyze the changes in biomass and species composition of cyanobacteria for two annual hydrological cycles and evaluate factors drivers. The study was divided into five distinct periods (dry 2010, rain 2011, dry 2011, rain 2012, dry 2012). The dominant group found in all periods was Cyanobacteria (99% of total biomass), which contributed to the low diversity. The filamentous species Cylindrospermopsis raciborskii was present at both points in almost every study. The colonial species Microcystis panniformis and Sphaerocavum brasiliensis dominated only in periods with lower volumes of water. The diatoms contribute more to the biomass during the period of severe drought. The point near the dam (P1) had phytoplankton biomass larger than the point near the tributary (P2). The dominant species of colonial cyanobacteria lasted until the overflow in P1, and P2 this dominance was until the first rains. The redundancy analysis indicated that physical factors such as light availability and water level were the main factors driving the seasonal succession of phytoplankton. The composition of phytoplankton in spring was alternated by species of filamentous cyanobacteria in conditions of poor stability of the water column, such as Cylindrospermopsis raciborskii, and colonial species under conditions of high stability of the water column, such as Microcystis panniformis and Sphaerocavum brasiliensis. The extremes of torrential rains and severe droughts, governed by the hydrological regime of the semi-arid region led to the availability of resources in the watershed, directing the spatial and temporal dynamics of phytoplankton in the reservoir Cruzeta

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Este estudio trata de establecer relaciones sobre la importancia del fenómeno sociocultural que emerge de Doña Militana para la cultura potiguar. Para tanto tomamos sus recuerdos de los romances como parte de un contexto social, relacionados con el tiempo y el espacio, que afecten a la vida material y moral de su grupo social. Resaltamos, por lo tanto, el fenómeno de la memoria individual en su relación con la memoria colectiva. Proponemos, en este sentido, suponer que el mantenimiento y permanencia de estos romances en la memoria de la romancera revelan una dinámica de su grupo social para la formación de su identidad. En este sentido, nos servimos como referencial teórico de los estudios de Maurice Halbwachs, en lo que respecta a los debates sobre la memoria colectiva, en paralelo a los estudios de Paul Zunthor cuando se trata de las funciones de la oralidad para la formación de la identidad. Para llevar a cabo los trabajos es de fundamental importancia, por supuesto, el relato de vida de la propia Doña Militana en confronto con los simbolismo culturales contenidos en los romances, con el objetivo que flagremos las (co)incidencias que demarquen la identidad de sus vínculos de identidad con el universo cultural en que está insertado. Como resultado, se tomó como objeto de análisis desde la deposición presentadas en las entrevistas, hasta los romances en sus aspectos poéticos, lingüísticos y mitológicos, incluyendo los significados que el desempeño de la romancera muestra. Objetivamos, por lo tanto, una comprensión dialógica de la relación entre la memoria individual (el caso de Doña Militana) con la memoria colectiva, sobre la base de un hipotético concepto que subyace a la aparente singularidad de este fenómeno - un hecho aislado en cierta medida - una razón intrínseca y compleja que se revela como la punta de un iceberg, al que convergen motivos históricos inconscientes de un patrimonio cultural

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The increasing world population of older individuals has become a subject of growing research for prevention and reversibility of the frailty because it is a major risk factor for the occurrence of falls, especially when it involves everyday situations of dual task. Some rehabilitation programs have already used the methods of dual-task with general exercises for improving gait and postural control, but has been reported that these interventions have little specificity with limited success to improve certain aspects of static and dynamic position during the performance of functional tasks. This study aimed to verify the measures of postural control in a group of elderly women with fragility phenotype after physical therapy intervention program based on dual-task treadmill training. We selected six pre-frail elderly subjects, with a minimum age of 65, female, living in the community and randomly assigned to two groups. The survey was conducted twice a week for 45 minutes, for four weeks. The simple task intervention consisted only in training on a treadmill and the dual task consisted of in treadmill training associated with visual stimuli. The assessments were made with the use of the Berg Balance Scale (BBS) and the Balance Master® computerized posturography, static and dynamically. The effects of retention were observed after one month, using the same instruments earlier used. The results showed a tendency toward improvement or maintenance of the balance after training on a treadmill, especially with respect to static equilibrium. Both groups showed the most notable changes in the variables related to gait, as the length and speed. The BBS scores and the baropodometric variables showed that the experimental group could keep all values similar or better even one month after completion of training unlike the control group. We concluded that the dual-task performance had no additional value in relation to the improvement of balance in general, but we observed that the effectiveness of visual stimulation occurred in the maintenance of short term balancevariables

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It is known that sleep plays an important role in the process of motor learning. Recent studies have shown that the presence of sleep between training a motor task and retention test promotes a learning task so than the presence of only awake between training and testing. These findings also have been reported in stroke patients, however, there are few studies that investigate the results of this relationship on the functionality itself in this population. The objective of this study was to evaluate the relationship between functionality and sleep in patients in the chronic stage of stroke. A cross-sectional observational study was conducted. The sample was composed of 30 stroke individuals in chronic phase, between 6 and 60 months after injury and aged between 55 and 75 years. The volunteers were initially evaluated for clinical data of disease and personal history, severity of stroke, through the National Institute of Health Stroke Scale, and mental status, the Mini-Mental State Examination. Sleep assessment tools were Pittsburgh Sleep Quality Index, the Questionnaire of Horne and Ostberg, Epworth Sleepiness Scale, the Berlin questionnaire and actigraphy, which measures were: real time of sleep, waking after sleep onset, percentage of waking after sleep onset, sleep efficiency, sleep latency, sleep fragmentation index, mean activity score. Other actigraphy measures were intraday variability, stability interdiária, a 5-hour period with minimum level of activity (L5) and 10-hour period with maximum activity (M10), obtained to evaluate the activity-rest rhythm. The Functional Independence Measure (FIM) and the Berg Balance Scale (BBS) were the instruments used to evaluate the functional status of participants. The Spearman correlation coefficient and comparison tests (Student's t and Mann-Whitney) were used to analyze the relationship of sleep assessment tools and rest-activity rhythm to measures of functional assessment. The SPSS 16.0 was used for analysis, adopting a significance level of 5%. The main results observed were a negative correlation between sleepiness and balance and a negative correlation between the level of activity (M10) and sleep fragmentation. No measurement of sleep or rhythm was associated with functional independence measure. These findings suggest that there may be an association between sleepiness and xii balance in patients in the chronic stage of stroke, and that obtaining a higher level of activity may be associated with a better sleep pattern and rhythm more stable and less fragmented. Future studies should evaluate the cause-effect relationship between these parameters

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The purpose of this study was evaluate the effectiveness of the chitosan at 0.4 with high molecular weight and high deacetylation degree mouthrinse over the total decrease of the streptococci, Streptococcus mutans, lactobaci/li and over the perceptible bacterial film and gingival bleeding indices. For that, a total of 68 healthy students between 11 and 13 years old, not allergic to crustacean and not users of antibiotics or antimicrobial agent for the last three months or during the treatment, was selected. From those, thirty two individuaIs used the mouthrinse test, and thirty six, the control one. The participants rinsed 10 mL of the solutions twice a day, one during the moming (which was supervised), and another one during the aftemoon (which was not supervised), for fifteen days. The saliva collect for the microbiological analysis, as well as the perceptible bacterial film and gingival bleeding indices check, were made before the use ofthe mouthrinses (base line), immediately after the last mouthrinse on the day (zero time) and fifteen days after (fifteen time). These data were collected at school and the saliva was carried inside the ice to the laboratory. The samples were diluted, and 0.1 mL ofthe 10 -1 dilution was seeded in Rogosa SL agar, for further analysis of the total of lactobaci/lus~ 0.1 mL of the 10-4 dilution in Mitis Salivarius with bacitracin, for S. mutans analysis; and 0.1 mL of the 10-6 dilution in Mitis Salivarius for the analysis ofthe total of streptococcus. The Rogosa SL agar plates were incubated in aerobic at 37°C for 72 hours and the MSB and the MS were incubated in anaerobic in Gaspak@ jars at 37°C for 48 hours for further count ofColonies Former Units (CFUs). The assay was made in duplicate for each bacterial group analyzed. The number of CFUs transformed in LOGlO was analyzed according to the following tests: ANOV A, t of Paired and Not Paired Student, Friedman, Man-Whitney and square-qui test. On the base line, alI the variables analyzed were similar on both tested groups. On both groups, for the total of streptococcus there was no significant difference along the time and for S. mutans there was a statistic significant increase of the CFUs from the base line to the zero time. For the total of lactobaccilus there was no significant difference on the test group along the time, and on the control there was a significant increase ofthe CFUs ITom the base line to the zero time. For both groups, there was significant decrease ofthe perceptible bacterial film index along the time, and that can be explained by the mechanic effect of the mouthrinse over the bacterial film and by the participation of the students on the research which could have motivated him to a better toothbrushing (Hawthome effect). The gingival bleeding index also showed a decrease along the time, even though it was not significant. Therefore, the conclusion of this study was that the chitosan at 0.4 % mouthrinse was not effective on the CFUs reduction of the three bacterial groups analyzed, as well as on the reduction of the perceptible bacterial film and gingival bleeding indices

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The presence of fixed orthodontics appliances interfere on sanitation, allowing periodontal diseases to appear, despite the fact patients keep on visiting the dentist every month. This research aims to determine a protocol for the mechanical control of the dental biofilm performed by the professional. A protocol that was able to maintain the periodontal health of the patients under orthodontic treatment with fixed appliances, and in order to do so, it used a non-controlled, randomized and blind clinical essay. The sample involved 40 adolescents who were under the installation of fixed orthodontics appliances and it was divided in three groups, as follows: monthly controlled group (group 1) composed of 11 patients, the quarterly controlled group (group 2) with 16 patients and the semestrial controlled group (group 3) with 13 patients. For data collection, an interview and clinical exams with probing depth measurement, quantity of keratinized mucosa, Gingival Index and the Plaque Index were used. On the initial exam all patients received brushing guidelines as well as the professional control of dental biofilm, with periodontal scaler, Robinson s brush and prophylactic paste. However, Group 1 returned every month for control procedures; Group 2 every three months and Group 3 after six months. The intervention had a six-month duration (for all the three groups), when all the exams were repeated by another examiner who did not know which group each patient was inserted in. Finally, the research concluded that despite the fact there is no statistically significant difference among the three groups, clinically the patients from the monthly group presented a better response to professional control, with less accumulation of dental biofilm and less rate of gingival inflammation. Thus, the mechanical control of the dental biofilm performed by the professional could not avoid gingival increase, characterized by the raise of probing depth measurement, neither the quantity of keratinized mucosa

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The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

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This study tried to know the social representation of dentists surgeons about the Family Health Program (FHP). Where used as methodological instruments a semi-structured interview and direct observation of work process in tive towns that are part of the metropolis region ofNatal city. During the interview some aspects where broached, such as the reasons of dentists surgeons join the FHP, what are the implications ofthe introduction of this program in the everyday practice, what kind of activities are they practicing and what are those professional missing the most in the FHP. In the direct observation where take in account some aspects related to the physic structure of health units, its service organization and demand, relationship amongst dentist and other member of the team, and about patient receptiveness, when they arrives at health unit. This study also identifY the researches subject showing their age, sex, for how they are graduates, what are them specialty and for how long they work for the FHP. The data had been analyzed through the analysis of content of Bardin5. The dentists depict the FHP for the change in assistance model through the preventive proposal of social work that makes possible to work with an ample concept of health. However what makes the FHP more attractive to dentists is the salary questiono The creation of bonds whit the community and the work whit groups and in team had been the main occurred changes in the daily one of the pratices ones of these professionals. The principal activities executed for these professionals inside of the new strategy of assistance in oral health are the carried trough preventive activities achieved in health units and social area. To them, the absence of institutional support and the employment of only one dentist for each team it is one the main point of strangling. There is no doubt that FHP is new strategy and that it is need a better integration amongst the professional, the institution

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The hospitalization is an event that can attack any person, independent of gender, race, social and economical condition. Last year, the prevalence of hospitalization was 8.1 for 100 inhabitants and the average time of hospitalization was 8.5 days for each patient one in Natal city. Therefore, an important point is whether the attention to the patients during the permanence in these health establishments incorporates the health integral model suggested by the principles proposed by the National Health System in Brazil (SUS), with actions of promotion and protection by different kinds of professionals, beside those called convalescence. Then, the aim of this study was to evaluate the patient s oral health conditions hosted in public hospitals of the Natal city, looking for to establish its relationship with several risk factors by two dimensions: the characteristics of the hospitalization and the patient s general and economical conditions. We accomplished a cross-sectional study with 205 patients distributed among the hospitals Onofre Lopes, Giselda Trigueiro and Monsenhor Walfredo Gurgel, looking for to know the socio-demographic characteristics, the food habits and of oral hygiene and the conditions of oral health, through the Visible Plaque Index and Gingival Bleeding Index. We observed that the conditions of the patient s oral health interned at public hospitals of reference of the municipal district of Natal is bad, existing accumulation of dental plaque and, consequently, a great number of patients with gingival bleeding. However, the time of hospitalization and its reason, the type of medicine used in this time and the toothbrush frequency were not configured as risk factors for this oral health condition

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Many studies have been made to understand the process of tissular cicatrization, as well as the possible effects of laser therapy in the wound healing. However, the influence of low frequency laser irradiation in the repairing process is not completely understood. Our study has the purpose to assess clinically the effect of postoperative irradiation of the low frequency laser in humans, and the gingival repairing process postgingivoplasty performed with the extern bevel technique. Twenty-four patients with inflammatory gingival hyperplasia were enrolled in this study, which did not reduce with basic periodontal procedures, and patients with melanin pigmentation, with esthetic indications. After surgery the test group, randomly selected by a drawing, received laser application with energy density of 4 J/cm2, immediately after surgery and each 48 hours, during a week, with a total of 4 sections. The control group did not receive irradiation. The visual clinical analyses were performed by a single blind examiner, in the 2nd, 4th, 6th, 8th, 15th and 21st days post surgery. For statistic analyses of the data was used a Q-square test. Concerning the color, the results showed a better wound healing during days 6 to 8. when assessed the degree of progress of surgical wound, the results showed that the test group had a better cicatrization compared with the control group in the 2nd, 6th, 8th and 15th days post surgery, and at the 21st day both groups had the same results. Our results confirm that the laser had clinical influence in the repairing process after gingivoplasty surgery during days 2 to 15 post surgery

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This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health