Prevalence of untreated caries in deciduous teeth in urban and rural areas in the state of Sao Paulo, Brazil

Objectives. To describe the prevalence of dental caries in children with deciduous teeth in urban and rural areas in the state of Sao Paulo, Brazil, and to identify associated factors. Methods. The study included 24 744 children ( 5 - 7 years of age) examined as part of an epidemiological survey on oral health carried out in the state of Sao Paulo ( Levan-tamento Epidemiologico de Sa de Bucal do Estado de Sao Paulo). Multilevel analysis was used to investigate whether the prevalence of untreated caries was associated with the sociodemographic characteristics of the children examined or with the socioeconomic aspects of the participating cities. Results. Being black or brown ( adjusted odds ratio ( OR) = 1.27), attending school in rural areas ( adjusted OR = 1.88), and attending public school ( adjusted OR = 3.41) were identified as determinants for an increased probability of presenting deciduous teeth with untreated caries. Being a female ( adjusted OR = 0.83) was identified as a protective factor. The negative coefficients obtained for second- level independent variables indicate that the oral health profile of the cities included in the study were positively impacted by a higher municipal human development index ( beta = - 0.47) and fluoridated drinking water ( beta = - 0.32). Conclusions. The prevalence of untreated caries is influenced by individual and sociodemographic factors. The present study provides epidemiological information concerning the rural areas in the state of Sao Paulo. This information is useful for strategic planning and for establishing guidelines for oral health actions in local health systems, thereby contributing to oral health equity.

Nutritional information of meals supplied by companies, participating in the workers` meal program in Sao Paulo, Brazil

Objective. To compare the nutritional value of meals provided by companies participating in the Workers` Meal Program in the city of Sao Paulo, Brazil, to the nutritional recommendations and guidelines established by the Ministry of Health for the Brazilian population. Methods. The 72 companies studied were grouped according to economic sector (industrial, services, or commerce), size (micro, small, medium, or large), meal preparation modality (prepared on-site by the company itself, on-site by a hired caterer, or off-site by a hired caterer), and supervision by a dietitian (yes or no). The per capita amount of food was determined based on the lunch, dinner, and supper menus for three days. The nutritional value of the meals was defined by the amount of calories, carbohydrates, protein, total fat, polyunsaturated fat, saturated fat, trans fat, sugars, cholesterol, and fruits and vegetables. Results. Most of the menus were deficient in the number of fruits and vegetables (63.9%) and amount of polyunsaturated fat (83.3%), but high in total fat (47.2%) and cholesterol (62.5%). Group 2, composed of mostly medium and large companies, supervised by a dietician, belonging to the industrial and/or service sectors, and using a hired caterer, on averaged served meals with higher calorie content (P < 0.001), higher percentage of polyunsaturated fat (P < 0.001), more cholesterol (P = 0.015), and more fruits and vegetables (P < 0.001) than Group 1, which was composed of micro and small companies from the commercial sector, that prepare the meals themselves on-site, and are not supervised by a dietitian. Regarding the nutrition guidelines set for the Brazilian population, Group 2 meals were better in terms of fruit and vegetable servings (P < 0.001). Group I meals were better in terms of cholesterol content (P = 0.05). Conclusions. More specific action is required targeting company officers and managers in charge of food and nutrition services, especially in companies without dietitian supervision.

Barriers to interventions aimed at promoting the health of health care workers in Brazil

Objective. To search the literature for circumstances that impede injury and disease prevention and other activities intended to improve the health of the health care worker. Methods. The SciELO database was searched for articles published in 1967-2008. This was supplemented by a PubMed search for the period 1950-2008. The following key words were used to identify articles in English, Portuguese, and Spanish: work, health personnel, occupational, risks, diseases, ergonomics, work ability, quality of life, organization, accidents, work conditions, intervention, and administration. Articles on injury and disease prevention and occupational health in a health care setting in Latin America were selected, along with articles focused on health promotion in the health sector. Results. The following shortcomings were identified: activities lacked a sound theoretical foundation and were not integrated with the health services management; a failure to evaluate the effectiveness of the activity; health surveillance focused solely on a specific disease or injury; management not committed to the proposed activity; miscommunication; inability of workers to participate, or control the work environment; and, programs or efforts that were limited to changing the workers` behaviors. Conclusions. The literature shows that all the barriers identified by this study affect both the health care workers` health as well as their productivity.

Scientific output trends in oral health in Brazil

Objective. To describe dental research trends in Brazil (especially population-based oral health) in the early Twenty-first Century. Methods. The abstracts of studies presented at meetings of the Brazilian Society for Dental Medicine Research (Sociedade Brasileira de Pesquisa Odontologica) from 2001-2006 were assessed in terms of methodological design (aggregate or population-based and individual-based studies, observational and intervention studies, cross-sectional and longitudinal studies); general type (literature review, studies with human subjects, and laboratory studies); and classification into one of the 19 specialty categories recognized by the Brazilian Federal Dentistry Council. Of the 10 406 abstracts presented in this period, 5 203 (50%) were reviewed. Results. Concerning methodological design, 87.5% of the abstracts referred to individual-based studies, whereas 12.5% were of aggregate studies. Concerning the general category, 41.7% referred to studies with human subjects. The remaining abstracts (58.3%) described in vitro (31.1%) or in vivo (23.6%) laboratory research and literature reviews (3.6%). Concerning the Council`s specialty categories, only five had a frequency higher than 10.0%: esthetic dentistry, periodontics, endodontics, pediatric dentistry, and population-based oral health. Conclusions. Brazil`s scientific output in the field of oral health for the period 2001-2006 was balanced, with increasing interest in the area of population-based oral health.

Impact of chronic disease on quality of life among the elderly in the state of Sao Paulo, Brazil: a population-based study

Objectives. To assess the impact of chronic disease and the number of diseases on the various aspects of health-related quality of life (HRQOL) among the elderly in Sao Paulo, Brazil. Methods. The SF-36 (R) Health Survey was used to assess the impact of the most prevalent chronic diseases on HRQOL. A cross-sectional and population-based study was carried out with two-stage stratified cluster sampling. Data were obtained from a multicenter health survey administered through household interviews in several municipalities in the state of Sao Paulo. The study evaluated seven diseases-arthritis, back-pain, depression/anxiety, diabetes, hypertension, osteoporosis, and stroke-and their effects on quality of life. Results. Among the 1958 elderly individuals (60 years of age or older), 13.6% reported not having any of the illnesses, whereas 45.7% presented three or more chronic conditions. The presence of any of the seven chronic illnesses studied had a significant effect on the scores Of nearly all the SF-36 (R) scales. HRQOL achieved lower scores when related to depression/anxiety, osteoporosis, and stroke. The higher the number of diseases, the greater the negative effect on the SF-36 (R) dimensions. The presence of three or more diseases significantly affected HRQOL in all areas. The bodily pain, general health, and vitality scales were the most affected by diseases. Conclusions. The study detected a high prevalence of chronic diseases among the elderly population and found that the degree of impact on HRQOL depends on the type of disease. The results highlight the importance of preventing and controlling chronic diseases in order to reduce the number of comorbidities and lessen their impact on HRQOL among the elderly.

Stochastic simulations of the Madden-Julian oscillation activity

The Madden-Julian oscillation (MJO) is the most prominent form of tropical intraseasonal variability. This study investigated the following questions. Do inter-annual-to-decadal variations in tropical sea surface temperature (SST) lead to substantial changes in MJO activity? Was there a change in the MJO in the 1970s? Can this change be associated to SST anomalies? What was the level of MJO activity in the pre-reanalysis era? These questions were investigated with a stochastic model of the MJO. Reanalysis data (1948-2008) were used to develop a nine-state first order Markov model capable to simulate the non-stationarity of the MJO. The model is driven by observed SST anomalies and a large ensemble of simulations was performed to infer the activity of the MJO in the instrumental period (1880-2008). The model is capable to reproduce the activity of the MJO during the reanalysis period. The simulations indicate that the MJO exhibited a regime of near normal activity in 1948-1972 (3.4 events year(-1)) and two regimes of high activity in 1973-1989 (3.9 events) and 1990-2008 (4.6 events). Stochastic simulations indicate decadal shifts with near normal levels in 1880-1895 (3.4 events), low activity in 1896 1917 (2.6 events) and a return to near normal levels during 1918-1947 (3.3 events). The results also point out to significant decadal changes in probabilities of very active years (5 or more MJO events): 0.214 (1880-1895), 0.076 (1896-1917), 0.197 (1918-1947) and 0.193 (1948-1972). After a change in behavior in the 1970s, this probability has increased to 0.329 (1973-1989) and 0.510 (1990-2008). The observational and stochastic simulations presented here call attention to the need to further understand the variability of the MJO on a wide range of time scales.

A Lagrangian identification of major sources of moisture over Central Brazil and La Plata Basin

[1] This work examines the main sources of moisture over Central Brazil and La Plata Basin during the year through a new Lagrangian diagnosis method which identifies the humidity contributions to the moisture budget over a region. This methodology computes budgets of evaporation minus precipitation by calculating changes in the specific humidity along back-trajectories for the previous 10 d. The origin of all air masses residing over each region was tracked during a period of 5 years (2000-2004). These regions were selected because they coincide with two centers of action of a known dipole precipitation variability mode observed in different temporal scales (from intra seasonal up to inter decadal timescales) and are related to the climatic variability of the South American Monsoon System. The results suggested the importance of the tropical south Atlantic as a moisture source for Central Brazil, and of recycling for La Plata basin. It seems that the Tropical South Atlantic plays an important role as a moisture source for Central Brazil and La Plata basin along the year, particularly during the austral summer. The north Atlantic is also an additional source for both regions during the austral summer.

Evaluation of Experimental Autoimmune Uveitis in Mice Treated with FTY720

PURPOSE. FTY720 (fingolimod) is an immunomodulatory drug capable of preventing T-cell migration to inflammatory sites by binding to and subsequently downregulating the expression of sphingosine-1 phosphate receptor 1 (S1P(1)) leading in turn to T-cell retention in lymphoid organs. Additional effects of FTY720 by increasing functional activity of regulatory T cells have recently been demonstrated, raising the conversion of conventional T cells into regulatory T cells and affecting the sequestration of regulatory T cells in normal mice. In this study, the action of FTY720 in the ocular autoimmune model in mice was investigated. METHODS. Mice were immunized with 161-180 peptide and pertussis toxin and were treated with 1 mg/kg/d FTY720 by gavage (7-21 days postimmunization [dpi]) or left untreated. Spleen cells, harvested 21 dpi, were cultured and assayed for cytokine production. Draining lymph node, spleen, and eye cells 21 dpi were assayed for quantification of T-cell populations. Disease severity was evaluated by histologic examination of the enucleated eyes at 21 and 49 dpi. In addition, anti-IRBP antibodies were analyzed by ELISA. RESULTS. FTY720 was effective in suppressing the experimental autoimmune uveitis score. Although there was a reduction in the number of eye-infiltrating cells, FTY did not prevent Treg accumulation at this site. FTY720 leads to a significant increase of CD4(+)IFN-gamma(+) and CD4(+)Foxp3(+) cell percentages in lymph nodes, suggesting that this site could be the source of Treg cells found in the eye. CONCLUSIONS. The data showed that treatment in vivo with FTY720 was able to suppress EAU in mice. These results are indicative of the possible therapeutic use of FTY720 in ocular autoimmune processes. (Invest Ophthalmol Vis Sci. 2010;51:2568-2574) DOI:10.1167/iovs.09-4769

Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil

Objectives. A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in Sao Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state. Methods. A postal dosimetric kit with thermoluminescence dosimeters was used to evaluate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the annual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were included, and 1 415 values of ESD were measured. Results. The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary localizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic reference levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. Conclusions. Despite the reduced number of ESD values and rooms for the pediatric patient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out.

Controle político da burocracia no presidencialismo americano: uma perspectiva comparada com o Brasil

Pretende-se examinar os mecanismos institucionais de controle político da burocracia no presidencialismo americano, bem como os diferentes enfoques teóricos que explicam sua eficácia ou não. Enfatizando os limites do controle pelo poder legislativo, a estudo estabelece comparação com o Brasil e também indica, com base na literatura, algumas propostas para ampliar a responsabilidade política dos governantes.

Para uma análise critica da orientação educacional: subsídios para compreensão e definição de sua pratica no Brasil

O principal objetivo desse estudo foi o de verificar as situações que, na prática da orientação educacional no Brasil. Possam ser responsabilizadas pelas dificuldades que a atividade vem encontrando para se desenvolver e se efetivar nas escolas brasileiras. Foi organizado em cinco capítulos, onde estão analisadas informações, resultantes basicamente de consulta bibliográfica a livros, artigos em periódicos, documentos e pesquisas relacionadas ao assunto. No primeiro capítulo encontram-se resumidos alguns preceitos teóricos que têm fundamentado a atividade de orientação educacional. No segundo capítulo apresentamos uma síntese da orientação, tal como ela se desenvolve nos EEUU, porque tomamos sua forma de atuação no sistema escolar norte-americano como referência para as interpretações de sua aplicabilidade nas escolas brasileiras. No terceiro capítulo caracterizamos a prática da atividade no sistema de ensino brasileiro, assinalando fatos que evidenciam a defasagem entre os objetivos e princípios postulados pela orientação educacional no Brasil, suas condições de efetivação e o quadro de inconsistência pelo qual ê conhecida e criticada. No quarto capítulo, analisamos e interpretamos as causas que determinam, a nosso ver, as dificuldades para a orientação se firmar nas escolas do país. Nossos questionamentos foram discutidos em torno de três hipóteses básicas que poderiam explicar o quadro de insatisfação e incerteza de sua prática e dos profissionais que são responsabilizados por sua efetivação: influência da DE das escolas norte-americanas, posição da OE na política Educacional Brasileira e aspectos da formação dos Orientadores Educacionais. Finalmente, sob influência do quadro de incoerências denunciando, organizamos, em forma de sugestões, no capítulo cinco, algumas propostas de estudo que poderiam ser desenvolvidas para ajudar a definir a orientação educacional no sistema de ensino brasileiro e I transformá-la numa prática realmente útil ao processo educacional.

O desenvolvimento constitucional da pena de morte nos Estados Unidos

Regulamentada desde as legislações mais arcaicas, como o Código de Hamurabi na Babilônia de 4.000 a.C., a pena de morte é um dos institutos mais antigos da humanidade. É também um dos temas mais controvertidos do Direito, cerne de debates que se intensificam na medida na medida em que os direitos humanos são universalizados, principalmente em meados do século XX. Diante disso, a audaciosa manutenção da pena de morte no sistema jurídico norte-americano, o último reduto do instituto no mundo ocidental, é o resultado de longo e árduo processo de desenvolvimento constitucional, orientado principalmente pelos constantes avanços da jurisprudência da Suprema Corte dos Estados Unidos sobre a pena capital. O presente trabalho tem como escopo apresentar o histórico de tais decisões, bem como fundamentos de cunho criminológico, moral, filosófico e econômico aplicáveis à sistemática da pena de morte, expondo ainda dados sobre a aplicação da pena capital e perspectivas para o futuro da sanção nos Estados Unidos.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Comparação antropométrica, composição corporal, somatotipo e saltos verticais de atletas de voleibol de praia masculino

The kinanthropometric characteristics are used by the sports science as selection criteria and detection of talents. Hence, this study aimed at comparing the anthropometrical profile, the body composition, the somatotype and the vertical jumps of the beach volleyball players. This study consists of 79 male beach volleyball players, being forty nine (n=49) Brazilian participants of the National Circuit and thirty (n=30) of 15 countries participating in the XV Pan American Games. In order to analyze the vertical jumps of the Brazilian the participants were allocated into two groups (G1 and G2) in agreement with the national ranking of their teams. The vertical jump protocol developed by Smith and collaborators was used to evaluate the vertical jumps of spike and block. The Heath-Carter anthropometrical technique (1990) was used for calculating the somatotype. The Student s t test with the Bonferroni adjustment was used to calculate the differences among the investigated variables. The multiple regression analysis was used to identify the contributions of the anthropometrical variables in the performance of the vertical jumps and the multivariance analysis was used to calculate the differences among the components of the somatotype. The Brazilian athletes of G1 were better than G2 in the spike jump (p <0.01), block jump (p <0.01) and in the block difference (p <0.01). The prediction model of the spike jump of G2 included the body mass and standing spike reach (adjusted R2 = 0.77), the body mass and the standing block reach were also included in the model of the block jump (adjusted R2 = 0.73). The regression model of G1 was not statistically significant. As for the somatotype, statistically significant differences were found between the Brazilians and the Pan Americans (Wilks' lambda = 0.498; p <0.05). The Brazilian somatotype was classified as balanced mesomorph (2.7-4.3-3.0) and the Pan American somatotype as endomorphic mesomorph (3.5-4.6-2.4). As to the specific position of the block game (2.8-4.3-2.9) and the defense game (2.6-4.4-3.0), the Brazilian somatotype was classified as balanced mesomorph and the Pan American somatotype, the block (3.7-4.4-2.4) and the defense (3.4-4.9-2.3), was classified as endomorphic mesomorph. In conclusion, the vertical jump height (spike and block) influences the male Brazilian beach volleyball players performance. The physical type of the Brazilian blockers and defenders was similar with relationship to the somatotype. The Brazilian and Pan American beach volleyball players differ in terms of kinanthropometric characteristics. This work had a multidisciplinary feature with the participation of several departments and laboratories, like the Physiotherapy Department, the Nutrition Department, the Physical Education Laboratory, thus corroborating the multidisciplinary research feature

Avaliação das condições higiênico-sanitárias de manipuladores de alimentos e utensílios de mesa de escolas públicas municipais de Natal, RN

In Brazil school food is constitutionally guaranteed to public school students at the preschool and elementary level. This food must be nutritious, hygienic and sanitary. The aim of the present study was to assess the hygienic/sanitary conditions of food and table utensil handlers in municipal public schools in Natal, Brazil. In total, 27 public schools were assessed, using a checklist and microbiological analysis of the hands and table utensils. For the microbiological analyses of the hands, coliforms were analyzed at 45ºC and for the utensils aerobic mesophilic bacteria, using methods recognized by AOAC, 2002 and APHA, 1992, respectively. Most of the schools studied did not exhibit good food and utensil handling practice procedures in any of the variables analyzed. It was shown that 74.1% of the handlers received no periodic training, 51.9% did not undergo annual health examinations and 100% did not practice proper hand hygiene, which reflected significantly (p < 0.05) in hand contamination, where fecal coliforms were detected on 55.6% of the hands analyzed. With respect to the utensils, it was found that 100% of the schools studied did not follow correct hygiene practices and most were classified as very bad ; that is, aerobic mesophilic bacteria values above the limits established by PAHO (Pan American Health Organization), with schools in the north and south districts recording the highest percentages. The results show that the hygienic-sanitary conditions of the food and utensil handlers in the schools studied were inadequate, demonstrating the need for implanting good handling practices aimed at protecting the health of children that take part in the program and offering safer foods. Researchers from the areas of food microbiology, nutrition, public health and statistics participated in this study, a decisive factor for characterizing it as multidisciplinary