TMD and GOHAI indices of Brazilian institutionalised and community-dwelling elderly

Considering the controversy in the literature regarding several aspects of temporomandibular dysfunction (TMD) in elderly populations and the absence of reliable data on elderly Brazilians in this field, this study consisted of an evaluation of TMD prevalence and the self-perception of oral health among institutionalised and community-dwelling elderly in Sao JosE dos Campos, Brazil.Two hundred and fifteen community-dwelling and 185 institutionalised elderly people were evaluated by the Helkimo anamnestic (Ai) and clinical dysfunction (Di) indices and answered a questionnaire using the Geriatric Oral Health Assessment Index (GOHAI).The major prevalence of TMD symptoms was for the Ai0 (symptom-free) group (69.5%), while the major prevalence of clinical signs was for the DiI (mild) group (56%). Women presented a higher AiII classification than men (chi(2) test, p = 0.049). Community-dwelling elderly presented a significantly lower Ai0 classification than the institutionalised ones (Two ratios equality test, p < 0.001). There was no relationship between the institutionalised status and the clinical dysfunction index for Di0 and DiIII classification (Two ratios equality test, p = 0.194 and 0.535 respectively). The institutionalised elderly presented greater (One-way anova = 0.005) self-perception of oral health (33.45) than did the community-dwelling group (32.66). There were only weak Pearson's correlations among the anamnestic (-33.0%) or clinical (-14.7%) findings by the TMD and GOHAI indices. Symptom-free (Ai0) institutionalised elderly presented better scores in all GOHAI dimensions and elderly representing an absence of clinical TMD signs (Di0) presented higher GOHAI physical dimension scores in both groups.The prevalence of TMD symptoms among this sample of elderly individuals was relatively low, self-perception of oral health was reasonable and a weak, inverse correlation was found between TMD signs and symptoms and elderly self-perception of oral health measured by the GOHAI index.

A contribuição do canto para a voz falada do ator

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Identification of dementia cases in the community: A Brazilian experience

OBJECTIVES: To describe the application in Brazil of a simple, low-cost procedure, developed in India by the 10/66 Dementia Research Group, for the identification of dementia cases in the community.DESIGN: Community-based dementia case-finding method.SETTING: Piraju, São Paulo, Brazil.PARTICIPANTS: Twenty-five community health workers were trained to identify dementia cases in 2,222 people aged 65 and older in Piraju, a Brazilian town with 27,871 inhabitants.MEAUREMENTS: After the training, the health workers prepared a list of possible cases that afterward an experienced psychiatrist clinically evaluated, according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria and the Clinical Dementia Rating.RESULTS: of the 72 cases that were clinically assessed, 45 met the DSM-IV diagnostic criteria for dementia. Therefore, the positive predictive value of this case finding method was 62.5%; the estimated frequency of dementia was 2%. Most of the confirmed cases met clinical criteria for Alzheimer's disease and vascular dementia.CONCLUSION: This simple method was appropriate to identify cases of dementia in the general population and can possibly be extended to other developing countries with limited resources to be applied in health programs.

Antibiotic treatment schemes for very severe community-acquired pneumonia in children: a randomized clinical study

Objective. To compare clinical response to initial empiric treatment with oxacillin plus ceftriaxone and amoxicillin plus clavulanic acid in hospitalized children diagnosed with very severe community-acquired pneumonia (CAP).Methods. A prospective randomized clinical study was conducted among children 2 months to 5 years old with a diagnosis of very severe CAP in the pediatric ward of São Paulo State University Hospital in Botucatu, São Paulo, Brazil, from April 2007 to May 2008. Patients were randomly divided into two groups by type of treatment: an oxacillin/ceftriaxone group (OCG, n = 48) and an amoxicillin/clavulanic acid group (ACG, n = 56). Analyzed outcomes were: time to clinical improvement (fever and tachypnea), time on oxygen therapy, length of stay in hospital, need to widen antimicrobial spectrum, and complications (including pleural effusion).Results. The two groups did not differ statistically for age, sex, symptom duration before admission, or previous antibiotic treatment. Time to improve tachypnea was less among ACG patients than OCG patients (4.8 +/- 2.2 versus 5.8 +/- 2.4 days respectively; P = 0.028), as was length of hospital stay (11.0 +/- 6.2 versus 14.4 +/- 4.5 days respectively; P = 0.002). There were no statistically significant differences between the two groups for fever improvement time, time on oxygen therapy, need to widen antimicrobial spectrum, or frequency of pleural effusion.Conclusions. Both treatment plans are effective in treating very severe CAP in 2-monthto 5-year-old hospitalized children. The only analyzed outcome that favored amoxicillin/clavulanic acid treatment was time required to improve tachypnea.

Competition and phylogeny determine community structure in Mullerian co-mimics

Until recently, the study of negative and antagonistic interactions (for example, competition and predation) has dominated our understanding of community structure, maintenance and assembly(1). Nevertheless, a recent theoretical model suggests that positive interactions (for example, mutualisms) may counterbalance competition, facilitating long-term coexistence even among ecologically undifferentiated species(2). Mullerian mimics are mutualists that share the costs of predator education(3) and are therefore ideally suited for the investigation of positive and negative interactions in community dynamics. The sole empirical test of this model in a Mullerian mimetic community supports the prediction that positive interactions outweigh the negative effects of spatial overlap(4) (without quantifying resource acquisition). Understanding the role of trophic niche partitioning in facilitating the evolution and stability of Mullerian mimetic communities is now of critical importance, but has yet to be formally investigated. Here we show that resource partitioning and phylogeny determine community structure and outweigh the positive effects of Mullerian mimicry in a species-rich group of neotropical catfishes. From multiple, independent reproductively isolated allopatric communities displaying convergently evolved colour patterns, 92% consist of species that do not compete for resources. Significant differences in phylogenetically conserved traits (snout morphology and body size) were consistently linked to trait-specific resource acquisition. Thus, we report the first evidence, to our knowledge, that competition for trophic resources and phylogeny are pivotal factors in the stable evolution of Mullerian mimicry rings. More generally, our work demonstrates that competition for resources is likely to have a dominant role in the structuring of communities that are simultaneously subject to the effects of both positive and negative interactions.

Fish community alterations due to pollution and damming in Tiete and Paranapanema rivers (Brazil)

The Tiete River crosses the metropolitan region of São Paulo (Brazil) and receives a large amount of pollution, in contrast to Paranapanema River which runs in a less populated area. In the inferior portions of the basins of these rivers, a series of reservoirs has been built for hydroelectric energy generation which improve the water quality due to the decantation of suspended soils and aeration in the water spills.Twenty-nine sampling sites were established along the two rivers and in each sampling site, two groups of eight gillnets were used with standardized sizes in two seasons: winter (dry season: June-September 1994) and summer (rainy season: December-March 1995). The fishes were measured and weighed.Twenty-five parameters related. to the water were recorded. PCA and cluster analysis helped to identify two groups of sampling sites. The first one corresponds to the rainy season samples, while the second corresponds to the dry season samples, so evidencing strong seasonal environmental variation. However, the dry season group is still divided into polluted and non-polluted sites, showing that during drought there are larger effects of pollutant concentration due to the decreased flow.A total of 415 kg of fish were caught, corresponding to 8324 individuals belonging to 64 different species, in 22 families and four orders of Teleostei. The largest catches occurred in the middle Tiete River. The catches in the reservoirs of the Tiete River, during the rainy season are superior to those of the dry season. on the other hand, sampling sites located in running water presented an inverse pattern with the largest catches in the dry-season. In river Paranapanema, catches are lower than in the Tiete River, except in Rosana Reservoir during the rainy season. Fish diversity was shown to be a good-indicator of environmental stress. In Tiete River an expressive fall in species richness was detected in the polluted stretches, with dominance of one or two species. In the intermediary stretches, the presence of rapids increases the amount of dissolved oxygen, allowing the development of the most abundant and diverse fish community of the river. Fish communities in the reservoirs of the inferior stretch of Tiete River are more diverse. on the other hand, the damming of the superior reaches of Paranapanema River provoked a decrease in diversity. 0 the whole, types of local fish communities detected, showing different compositions and specific abundances, revealed different ecological situations. A discriminant analysis revealed that the parameters of the water influencing the fish community were: dissolved oxygen, conductivity, nitrogen (nitrate, ammoniacal and albuminoid), phosphate, alkalinity, hardness and iron. Copyright (C) 2003 John Wiley Sons, Ltd.

The WIPO development agenda and the contribution of the international library community

Purpose - The purpose of this paper is to analyze the international strengthening of copyright law in developing countries and the active involvement of the international library community in the movement against it.Design/methodology/approach - The paper describes the overprotection of intellectual property rights through international and bilateral treaties, the reaction against such through the proposal of a WIPO development agenda, and the contribution of the international library organizations to the debates and discussions in the WIPO arena.Findings - The initiative for a development agenda for WIPO has proven much more successful than many had imagined, even its promoters. The most relevant proposals made by the international library community were included in the final list of approved recommendations.Originality/value - The paper raises awareness of the relationship between copyright and access to knowledge and, in consequence, the need for library organizations to exert influence in such legislation.

Pathological and behavioral risk factors for higher serum c-reactive protein concentrations in free-living adults - A Brazilian community-based study

Low-grade chronic systemic inflammation is often associated with chronic non-communicable diseases, and its most frequently used marker, the C-reactive protein (CRP), has become an identifier of such diseases as well as an independent predictor for cardiovascular disorders and mortality. CRP is produced in response to pro-inflammatory signaling and to individual and behavioral factors, leading to pathological states. The aim of this study was to rank the predicting factors of high CRP concentrations in free-living adults from a community-based sample. We evaluated 522 adults (40-84 years old; 381 women) for anthropometric characteristics, dietary intake, clinical and physical tests, and blood analysis. Subjects were assigned to groups, according to CRP concentrations, as normal CRP (G1;<3.0 mg/L; n = 269), high CRP (G2; 3.0-6.0 mg/L; n = 139), and very high CRP (G3; >6.0 mg/dL; n = 116). Statistical comparison between groups used one-way ANOVA or Kruskal-Wallis tests, and prediction of altered values in increasing CRP was evaluated by proportional hazard models (odds ratio). CRP distribution was influenced by gender, body mass index, body and abdominal fatness, blood leukocytes, and neutrophil counts. The higher CRP group was discriminated by the above variables in addition to lower VO2max, serum metabolic syndrome components (triglycerides, glucose, and HDL cholesterol), higher insulin, homeostasis assessment of insulin resistance, uric acid, gamma-GT, and homocysteine. After adjustments, only fatness, blood leukocytes, and hyperglycemia remained as independent predictors for increased serum CRP concentrations. Intervention procedures to treat low-grade chronic inflammation in overweight women would mainly focus on restoring muscle mass and functions in addition to an antioxidant-rich diet. © 2012 Springer Science+Business Media, LLC.

Community structure of mites (Arachnida: Acari) in six rubber tree clones

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Bacterial community associated with traps of the carnivorous plants Utricularia hydrocarpa and Genlisea filiformis

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

Tree species community spatial structure in a terra firme Amazon forest, Brazil

All trees with diameter at breast height dbh >= 10.0 cm were stem-mapped in a "terra firme" tropical rainforest in the Brazilian Amazon, at the EMBRAPA Experimental Site, Manaus, Brazil. Specifically, the relationships of tree species with soil properties were determined by using canonical correspondence analyses based on nine soil variables and 68 tree species. From the canonical correspondence analyses, the species were grouped into two groups: one where species occur mainly in sandy sites, presenting low organic matter content; and another one where species occur mainly in dry and clayey sites. Hence, we used Ripley's K function to analyze the distribution of species in 32 plots ranging from 2,500 m(2) to 20,000 m(2) to determine whether each group presents some spatial aggregation as a soil variations result. Significant spatial aggregation for the two groups was found only at over 10,000 m(2) sampling units, particularly for those species found in clayey soils and drier environments, where the sampling units investigated seemed to meet the species requirements. Soil variables, mediated by topographic positions had influenced species spatial aggregation, mainly in an intermediate to large distances varied range (>= 20 m). Based on our findings, we conclude that environmental heterogeneity and 10,000 m(2) minimum sample unit sizes should be considered in forest dynamic studies in order to understand the spatial processes structuring the "terra firme" tropical rainforest in Brazilian Amazon.

Medicinal plants in pregnancy and lactation: perception of the health risk and practical educational group in Araraquara, São Paulo State, Brazil

The use of medicinal plants among pregnant women and lactating is a common practice in diverse countries. However, many medicinal plants are contraindicated during pregnancy and lactating, due to various adverse effects, such as teratogenic, embryotoxic and abortive effects, exposing these women, their fetus and babies to health unknown risks. Thus, the purpose of this commentary, was to analyze the perception about the use of medicinal plants by pregnant women and lactating registered in the "baby on board" NGO, Araraquara, São Paulo state, Brazil, between 2010 at 2013. The group was constituted by 48 women, between the first and last trimester of pregnancy or whilst breastfeeding. Information was collected during group meetings by oral interview, using a questionnaire, as script. The nature of the study was a qualitative analysis. The results were based on reports about the use of medicinal plants by pregnant women during group meetings: use, indication of use, knowledge about risks. All participants received written and oral information about the study and they gave a written informed consent. The use of medicinal plants is a reality among pregnant and lactating women of the "baby on board" NGO. They reported that they feel that "natural" products are not harmful for their health. The primary information sources for the majority of women about medicinal plants during pregnancy are family, neighbors and herbalists. The plants most cited (in popular name in Brazil) were: senna, chamomile, boldo, lemon balm, lemon grass. They were used mainly for: nausea, heartburn, indigestion, flatulence, intestinal and abdominal pain, anxiety, intestinal constipation and low milk production. The pregnant and lactating women lacked knowledge about the health risks of the use of medicinal plants and herbal medicines in pregnancy and lactation. They also reported difficulties in clarifying some questions about the use of medicinal plants with their doctors. The results of the present study showed that educative actions about the rational use of medicinal plants in pregnancy and breastfeeding could be part of the operating protocols to promote the maternal and child health programs in Araraquara. Thus, our results also suggest the importance of creating institutionalized places, to the implementation of continued education programs about rational use of medicinal plants in pregnancy and lactation. These targeted programs are not only for health professionals, but also for community members, pregnant women and breastfeeding. Our results pointed out the importance of guidance of doctors and healthcare professionals on the scientific studies about medicinal plants and herbal medicines and the risk/benefit of using herbs during pregnancy. Finally, it is noted the importance of the health professionals to inform women of childbearing on risks to their health, as well as on possibilities of utilization of herbs during fertile period, giving special attention to the potential risk of self-medication.