Knowledge of firefighters with special paramedic training of the emergency management of avulsed teeth

Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.

Evaluating the knowledge of sports participants regarding dental emergency procedures

Dental trauma is a common consequence of sports practice to which emergency treatment is critical. The purpose of this study was to evaluate the knowledge of sports participants about dental trauma procedures, particularly tooth avulsion. A specific questionnaire concerning concepts, experiences and behaviors after dental trauma and the use of mouthguard was standardized and validated with 80 people. The validated questionnaire was then distributed to 310 sports participants. The results showed that 28.4% had experienced a kind of dental trauma; 42.6% would look for a dentist for treatment; 51.7% reimplanted or would reimplant the avulsed tooth; 6.5% would maintain the avulsed tooth in milk. Although 47.4% of the participants were aware of the possibility of accidents during sports practice, only 13.9% reported to use a mouthguard. This study showed an overall lack of knowledge of sportsmen and sportswomen with regards to tooth avulsion, thus reinforcing the need for educational campaigns to improve the immediate emergency treatment of tooth avulsion.

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects on permanent teeth after luxation injuries to the primary predecessors: a study in children assisted at an emergency service

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Residues of calcium hydroxide-based intracanal medication associated with different vehicles: A scanning electron microscopy evaluation

This study evaluated the presence of residues after removal of calcium hydroxide [Ca(OH)2] associated with different vehicles. Thirty single-rooted teeth were instrumented to a master apical file #25 using 2.5% NaOCl as main irrigant and 17% trisodium EDTA (ethylenediaminetetraacetic acid) as final agent irrigant. Then, the root canals were dressed with Ca(OH)2 associated with silicone oil (Group 1), 2% chlorhexidine gluconate (Group 2), or propylene glycol (Group 3). After coronal sealing, all teeth were kept in a moist environment at room temperature. After 7 days, the teeth were reopened and medicaments were removed using 5 mL of saline solution and instrumentation with master apical file followed by new irrigation with 5 mL of 2.5% NaOCl. Subsequently, teeth were split longitudinally and assessed by scanning electron microscopy. The wall cleanliness of the cervical and apical thirds of the roots were evaluated and scored by three blinded examiners. Statistical analysis was performed using KruskalWallis and Wilcoxon tests at 5% level of significance. All roots had residues of Ca(OH)2 on the canal walls. All experimental groups had similar results (P > 0.05) regardless of the third evaluated. There was significant difference between the apical and cervical thirds only in Group 3 (P < 0.05). Association of different vehicles to Ca(OH)2 does not influence the persistence of residues on the root canal walls. Microsc. Res. Tech. 2012. (C) 2012 Wiley Periodicals, Inc.

Knowledge of general dentists in the current guidelines for emergency treatment of avulsed teeth and dental trauma prevention

A high prevalence of dental trauma exists and its effects on function and esthetics deserve the attention of general dentists. The aim of this study was to assess the level of general dental practitioners' (GDPs) knowledge about guidelines for dental avulsion and its prevention using a questionnaire. The 21-item questionnaire was distributed among 264 GDPs and the survey was realized between August-November 2006. The data obtained were statistically analyzed using descriptive analysis and Pearson's Chi-square test to determine associations between knowledge regarding emergency treatment and dentists from public or private dental schools and years of experience. The results showed that the participants exhibited appropriate knowledge concerning procedures in cases of tooth avulsion and its prevention. The number of correct answers was low in relation to recommended treatment at the site of injury. Storage medium, preparation of the alveolus and splint time for receiving the avulsed tooth received a high number of correct answers. One statistically significant association between years of experience and recommended treatment at the site of the injury in the case an avulsed tooth (KH2 = 9.384, P = 0.009). In conclusion, this survey showed appropriate knowledge of dental avulsion management and its prevention among the surveyed dentists. The findings also showed that communication between dentists and the population is deficient, especially concerning practitioners of high risk and contact sports.

Repetition of Suicide Attempts Data from Emergency Care Settings in Five Culturally Different Low- and Middle-Income Countries Participating in the WHO SUPRE-MISS Study

Background: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource-poor settings. Aims: To evaluate a brief educational intervention and periodic follow-up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People's Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Methods: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt - the secondary outcome measure presented in this paper - were identified by follow-up calls or visits. Subsequent completed suicide - the primary outcome measure has been reported in a previous paper. Results: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, chi(2) = 0.013; p = .909), but there were differences in rates across the five sites. Conclusions: This study from five low-and middle-income countries does not confirm the effectiveness of brief educational intervention and follow-up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments.

Numerical simulation of viscous three-dimensional flow over aerospace vehicles using Euler/boundary-layer zonal approach

This paper presents a viscous three-dimensional simulations coupling Euler and boundary layer codes for calculating flows over arbitrary surfaces. The governing equations are written in a general non orthogonal coordinate system. The Levy-Lees transformation generalized to three-dimensional flows is utilized. The inviscid properties are obtained from the Euler equations using the Beam and Warming implicit approximate factorization scheme. The resulting equations are discretized and approximated by a two-point fmitedifference numerical scheme. The code developed is validated and applied to the simulation of the flowfield over aerospace vehicle configurations. The results present good correlation with the available data.

Time and distance in acceleration of road commercial vehicles

The time and the distance traveled during the acceleration and the velocity retaking are parameters used for the comparison and the project of vehicles. In this paper equations for the calculation of those parameters are presented. Several criteria are presented for the shift gears. It is also verified the occurrence or not of total slip during the acceleration of the vehicle. The theoretical models were implemented in a developed computational system. Such system was applied in a Mercedes-Benz do Brazil sample vehicle, in order to facilitate comparisons between the simulate values and the experimental road tests. Copyright © 1997 Society of Automotive Engineers, Inc.

Fuel consumption of road commercial vehicles in the driving schedule

The fuel consumption is an important factor in the vehicle development due the fact that it has a direct effect on its trade aims. Besides that, it is known that the petrol is a scarce fuel. In this paper it is presented a procedure of fuel consumption calculation for a vehicle traveling in driving schedule. In such calculation it has been taken into account the operational conditions (load, pavement, climbing road, among others) and the building characteristics (map engine, transmission, frontal area, tire, among others) of road vehicles. There has also been an application of the theoretical model developed in a sample Mercedes-Benz do Brasil vehicle which has been compared with the values of experimental tests. Copyright © 1997 Society of Automotive Engineers, Inc.

Prospective analysis about the world wide strategy of commercial vehicles development

The main objective of this paper is to make a prospective analysis about the tendencies of the world wide strategies of commercial vehicles development, in relation of the current local and international scenery. It has been done a research by using the Delphi method, which consists into regulate, systematically, the presentation of questions about a specified problem to a group of specialists. In order to guarantee more representative data, it has been adopted three distinct groups: academics, OEMs managers and Tier 1 suppliers managers. The results showed that the three mentioned groups have similar opinion about the necessity of having a product development in the subsidiaries companies; also it has been pointed the necessity of having more taylor made vehicles, due to the intrinsic characteristics of this industry segment. Copyright © 2008 SAE International.

A multi-agent system with a percolation approach to simulate the driving pattern of Plug-In ELectric Vehicles

A multi-agent system with a percolation approach to simulate the driving pattern of Plug-In Electric Vehicle (PEV), especially suited to simulate the PEVs behavior on any distribution systems, is presented. This tool intends to complement information about the driving patterns database on systems where that kind of information is not available. So, this paper aims to provide a framework that is able to work with any kind of technology and load generated of PEVs. The service zone is divided into several sub-zones, each subzone is considered as an independent agent identified with corresponding load level, and their relationships with the neighboring zones are represented as network probabilities. A percolation approach is used to characterize the autonomy of the battery of the PVEs to move through the city. The methodology is tested with data from a mid-size city real distribution system. The result shows the sub-area where the battery of PEVs will need to be recharge and gives the planners of distribution systems the necessary input for a medium to long term network planning in a smart grid environment. © 2012 IEEE.

Controlling traffic jams on urban roads modeled in Coloured Petri net using Genetic Algorithm

This paper presents an application to traffic lights control in congested urban traffic, in real time, taking as input the position and route of the vehicles in the involved areas. This data is obtained from the communication between vehicles and infrastructure (V2I). Due to the great complexity of the possible combination of traffic lights and the short time to get a response, Genetic Algorithm was used to optimize this control. According to test results, the application can reduce the number of vehicles in congested areas, even with the entry of vehicles that previously were not being considered in these roads, such as parked vehicles. © 2012 IEEE.

Optimal charging of electric vehicles considering constraints of the medium voltage distribution network

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)