Ethics in the provision of removable partial dentures

Aim: To investigate the construction of cobalt-chromium removable partial dentures by commercial private dental laboratories. Methods: Ninety master casts for fabrication of cobalt-chromium removable partial dentures were obtained from three commercial laboratories randomly selected. Casts were assessed for dental arch treated, Kennedy classification, cast surveying, denture design information provided by the dentist, and mouth preparation (rest seat, guiding plane and retentive area). Dental technicians answered a questionnaire regarding qualification of assisted dentists, monthly number of framework castings, and use of dental surveyor. Mouth preparation was compared among laboratories using Kruskal-Wallis test (α=0.05). Results: The percentage of Kennedy class I was 16%, class II 19%, class III 56%, and class IV 9%. The majority of master cats (51%) examined was sent to dental laboratories without any design information and did not comply with ethical guidelines in the provision of RPD. Approximately half of the casts were considered “inappropriate” for guiding planes and retentive areas. One of the laboratories presented all casts “inappropriate” for rest seat distribution (p<0.001). Conclusions: Mouth preparation frequently failed for guiding planes, retentive areas and distribution of rest seats. It is necessary to provide students with adequate clinical experience at the dental school environment, which will actually be carried into the practice of dentistry.

Ethics in the provision of removable partial dentures

Aim: To investigate the construction of cobalt-chromium removable partial dentures by commercial private dental laboratories. Methods: Ninety master casts for fabrication of cobalt-chromium removable partial dentures were obtained from three commercial laboratories randomly selected. Casts were assessed for dental arch treated, Kennedy classification, cast surveying, denture design information provided by the dentist, and mouth preparation (rest seat, guiding plane and retentive area). Dental technicians answered a questionnaire regarding qualification of assisted dentists, monthly number of framework castings, and use of dental surveyor. Mouth preparation was compared among laboratories using Kruskal-Wallis test (α=0.05). Results: The percentage of Kennedy class I was 16%, class II 19%, class III 56%, and class IV 9%. The majority of master cats (51%) examined was sent to dental laboratories without any design information and did not comply with ethical guidelines in the provision of RPD. Approximately half of the casts were considered “inappropriate” for guiding planes and retentive areas. One of the laboratories presented all casts “inappropriate” for rest seat distribution (p<0.001). Conclusions: Mouth preparation frequently failed for guiding planes, retentive areas and distribution of rest seats. It is necessary to provide students with adequate clinical experience at the dental school environment, which will actually be carried into the practice of dentistry.

Caracterização ambiental de bancos areno-lamosos nos campos petrolíferos de Macau e Serra (RN), como subsídio às medidas mitigadoras ao processo erosivo

On Rio Grande do Norte northern coast the process of sediment transport are intensely controlled by wind and sea (waves and currents) action, causing erosion and shoreline morphological instability. Due to the importance of such coastal zone it was realized the multi-spectral mapping and physical-chemical characterization of mudflats and mangroves aiming to support the mitigating actions related to the containment of the erosive process on the oil fields of Macau and Serra installed at the study area. The multi-spectral bands of 2000 and 2008 LANDSAT 5 TM images were submitted on the several digital processing steps and RGB color compositions integrating spectral bands and Principal Components. Such processing methodology was important to the mapping of different units on surface, together with field works. It was possible to make an analogy of the spectral characteristics of wetlands with vegetations areas (mangrove), showing the possibility to make a restoration of this area, contributing with the environmental monitoring of that ecosystem. The maps of several units were integrated in GIS environment at 1:60,000 scale, including the classification of features according to the presence or absence of vegetation cover. Thus, the strategy of methodology established that there are 10.13 km2 at least of sandy-muddy and of these approximately 0.89 km2 with the possibility to be used in a reforestation of typical flora of mangrove. The physical-chemical characterization showed areas with potential to introduce local species of mangrove and they had a pH above neutral with a mean of 8.4. The characteristic particle size is sand in the fine fractions, the high levels of carbonate, organic matter and major and trace element in general are concentrated where the sediment had the less particles size, showing the high correlation that those elements have with smaller particles of sediment. The application of that methodological strategy is relevant to the better understanding of features behavior and physical-chemical data of sediment samples collected on field allow the analysis of efficiency/capability of sandy-muddy to reforestation with local mangrove species for mitigation of the erosive action and coastal processes on the areas occupied by the oil industry

Distribuição regional da ventilação pulmonar em indivíduos com insuficiência cardíaca crônica após serem submetidos a um programa de treinamento da musculatura inspiratória e sua correlação com dados funcionais

Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91± 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2máx and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness

Ideais formativos de homem da emissora de Educação Rural de Caicó (Rio Grande do Norte, 1963-1978)

Under the aegis of the third diocese bishop of Caicó, Dom Manuel Tavares de Araújo, the Broadcasting Station of Rural Education of that city was founded, in May 1 s" 1963 with the ideal of being then an educational city, preferentially for youths and adults, rural meu and women of the arca of Seridó in Rio Grande do Norte state. In the year of its 40th birthday (2003), we began the investigation of that radio station choosing as study object its educational and formative programming, in the inc1usion of the first fifteen years of its existence (1963-1978), period that reaches the official inauguration of the Radio Station and the end of the bishopric of its fOllllder as Bishop of Caicó. Elucidating and showing Man's formative ideaIs longed by that Catholic educational broadcasting station, underlying to its radiophonic programming, such as the idealization for it reached, is the objective of this Doctorate work. It was considered pertinent to discover the guidelines that historically have permeated the Social Doçtrine of the Catholic Church addressing its aggiornamento, especially in what concerns to the employment of the modern ways of communication for the distance with the aim of evangelizing and educating. In arder to understand the ideaIs of the investigated educational Radio, we have delimited the research to the thematic Catholic Church, means of social communication and base education. In face of the study object and the aim to be reached it was appealed, methodologically, to the notion of cultural action present in Certeau (1995), and to the understanding of educational formation backgrounded fIam the modern thinkers that discuss it. Such frame references have allowed us to analyze in a wider spectrum tl)e programming broadcasted on the air by the sound wavys of that educ(itional Çatholic Radio, as well as, the very acts of cultural idealizations that has orientated it in its foundations. The thesis here defended is that. the Radio, at procJaiming itself as a broadcasting station of rural education directed preferably to the rural sertanejo countrymen, without neglecting its admitted ends, has surpassed them in its overall range. It was identified an articulate approach of its programmatic modules with the guid,elines emanateq from the Catholic Teaching about the use of the. means of social communication. At conceiving, establishin,g and executing an ec1ectic programmatic and div,ersified grating, the Rural Radio of Caicó has transcended to a strict human-Christian formation to request the development of the human, spiritual and cQrporaldimensions, jointly. With suchprogramming, it addressed to the seridoenses as real meu and women inserted in the "sertanej.o" environment with effective structural and existential problems of alI types, induding the hunger, the thirst, the syndical organization, the cQoperativism, the colIective modero work and the absence of universalizing school education. Its radiophonic transmissions, I}lled by the demands of an enlarged, open, dialogic and responsible communication, wheneIllbracing dedicated modules to religious and catechetical emissions, to the entertainment, to the radiojoumalism, to the country root culture, and to the school education of b se for the modality of the School and of the radiophonic classes, subsumed to ideaIs that longed for the formation of a multifaceted and pluridimensional sertanejo Man; of men and women that, without abjuring the Catholicism, were able to understand, to dialogued and to live together with the general demands of a society in progressive mutation, whose economical, social, cultural and educational demands it IDade themselves to be felt through the sertão potiguar of the Serido region, equal way of the intemationalized world

A luta do Bispo Dom José de Medeiros Delgado por educação escolar para todos (Caicó-RN, 1941-1951)

The socioeducational program of actions developed by Dom José de Medeiros Delgado, first Bishop of Diocese of Caicó city in Rio Grande do Norte, from 1941 to 1951, is analyzed by the present work in a historical perspective, based upon the school culture refecence.Through this reference point, the general and peculiar school culture proper of catholic schools founded by Dom Delgado was learned.The schools are: the Ginásio Diocesano Seridoense (1942), the Escola Doméstica Popular Darci Vargas (1943, the Prevocacional School of Caicó (1944) and the Santo Cura d ars Seminar (1946). The socioeducational actions of Dom Delgado Bishop affected seven other towns surrounding Caicó. Places where catholic schools were founded and named after Escola do Pobre . In fight for schools for all social segments of city and rural natures, Dom Delgado founded four rural schools in the surroundings of Serra Negra, São João do Sabugi, Jardim do Seridó e Lagoa Nova. It is also part of his beneficial work the creation of rural cooperatives for the parents of the students from such schools

Viabilidade do processo de enfermagem no contexto hospitalar

The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others.

Prevalência de incontinência urinária e fatores associados em idosos institucionalizados

Urinary incontinence (UI) is a geriatric syndrome that is especially prevalent in institutionalized individuals, and that causes economic and social impacts derived from treatment costs and overload of caregiver. UI also entails physical consequences to the health of the elderly, such as urinary tract infections or pressure ulcers, among other health problems. However, the existing national research on this condition is still scarce and comprises serious methodological biases. Therefore, the objective of this study is to determine the prevalence of urinary incontinence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December, 2013 and carried out in 10 nursing homes in the city of Natal (Northeast Brazil). UI was verified through the program Minimum Data Set version 3.0, which was also used to assess fecal incontinence, urinary devices and UI control programs. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). Bivariate analysis was performed using the Chi-Square Test (or Fisher‟s Exact Test) and the Linear Chi-Square Test, calculating the prevalence ratio with 95% confidence interval. Variables with p value under 0.20 were included in the multivariate analysis, which was performed using the Stepwise Forward logistic regression. The inclusion of variables in the final model depended on the likelihood ratio test, absence of multicollinearity and on the Hosmer-Lemeshow test. A statistical significance level of 0.05 was considered. Six (1.8%) hospitalized elderly, one individual in palliative care (0.3%) and one (0.3%) individual under the age of 60 were excluded from the study. The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 59.43% and the final model revealed statistically a significant association between UI and white race, physical inactivity, stroke, mobility constraints and cognitive decline. The most frequent UI type was functional UI due to physical or cognitive disability, and incontinence control measures were applied only to a minority of residents (approximately 8%). It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke and other geriatric syndromes such as immobility and cognitive disability. Most of these associated factors are modifiable and therefore the findings of this study highlight the importance of UI prevention and treatment in nursing homes, which include general measures, such as physical and psychosocial activities, and specific measures, such as prompted voiding