Scanning electron microscope assessment of several resharpening techniques on the cutting edges of gracey curettes

Aim: Treatment of periodontal diseases is based on efficient scaling and root planing (SRP) and adequate maintenance of the patient. The effectiveness of SRP is influenced by operator skill, access to the subgingival area, root anatomy, and the quality and type of instrument used for SRP. The aim of this study was to evaluate the cutting edges of Gracey curettes after manufacturing and after resharpening using several techniques. Methods and Material: The cutting edges of a total of 41 new #5-6 stainless steel Gracey curettes were evaluated blindly using scanning electron microscopy (SEM). The quality of the cutting edges was evaluated blindly by a calibrated examiner using micrographs. Data were analyzed using a Kruskal Wallis test and nonparametric two-way multiple comparisons. Results and Conclusions: Different sharpening techniques had significantly different effects on the sharpeness of cutting edges (p<0.05). Sharpening by passing the lateral face of curettes over a sharpening stone and then a #299 Arkansas stone produced a high frequency of smooth, sharp edges or slightly irregular edges between the lateral and coronal faces of the curettes. Sharpening by passing a blunt stone over the curette's lateral face produced the poorest quality cutting edge (a bevel). Sharpening of the coronal curette face produced extremely irregular cutting edges and non-functional wire edges. Sharpening with rotary devices produced extremely irregular cutting edges.

An assessment of the economic impact of climate change on the tourism sector in Jamaica

Climate change is a continuous process that began centuries ago. Today the pace of change has increased with greater rapidity because of global warming induced by anthropogenically generated greenhouse gases (GHG). Failure to effectively deal with the adverse outcomes can easily disrupt plans for sustainable economic development. Because of the failure of export agriculture over the last several decades, to provide the economic stimuli needed to promote economic growth and development, Jamaica, like many other island states in the Caribbean subregion, has come to rely on tourism as an instrument of transformation of the macro-economy. It is believed this shift in economic imperative would eventually provide the economic impetus needed to generate much needed growth and development. This assessment has shown that tourism is not only a leading earner of foreign exchange in Jamaica and a major creator of both direct and indirect jobs but, also, one of the principal contributors to the country‟s Gross Domestic Product (GDP). The rapid expansion of the industry which occurred over the last several decades coupled with disregard for sound environmental practices has led to the destruction of coral reefs and the silting of wetlands. Because most of the industry is located along the coastal region it is extremely vulnerable to the adverse effects of climate change. Failure to address the predictable environmental challenges of climate change, with some degree of immediacy, will not only undermine, but quickly and seriously impair the capacity of industry to stimulate and contribute to the process of economic development. To this end, it important that further development of industry be characterised by sound economic and social planning and proper environmental practices.

Construction and validation of an instrument to assess the reading comprehension of students from the third to the fifth grades of elementary school

Objetivo:Este estudo teve como objetivo construir e validar um instrumento de avaliação da compreensão de leitura a fim de caracterizar o perfil de leitura e detectar dificuldades de compreensão em escolares do terceiro ao quinto ano do Ensino Fundamental.Métodos:Participaram 378 escolares divididos em trés grupos para avaliação da compreensão de proposições literais e inferenciais de micro e macroestruturas de dois textos expositivos e dois textos narrativos por meio de questões de múltipla escolha.Resultados:Os dados analisados estatisticamente indicaram valores do teste alfa de Cronbach apresentando consisténcia interna nos quatros textos aplicados para os trés grupos.Conclusão:Foi possível constatar que os escolares apresentaram menor número de erros com o aumento da escolarização e que cada tipo de texto apresentou uma dificuldade específica para os escolares.

Tradução e adaptação transcultural do Minnesota Handwriting Assessment para aplicação no Brasil

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Postsurgical Alveolar Bone Graft Patients: Elaboration and Application of a Data-Gathering Instrument for Nutrition and Nursing

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Translation and cultural adaptation of Brazilian Detailed Assessment of Speed of Handwriting: conceptual and semantic equivalence

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

Validation of a measuring instrument for the perception of oral health in women

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Safety assessment of essential medicines for elderly people: a bibliographic survey

Certain medicines are considered potentially inappropriate (PIM) for elderly people as they increase the risk of adverse drug events (ADE) and because safer alternative therapies are available on the market. In this context, in order to identify the instruments that assess the quality of medical prescriptions for elderly and to determine which drugs are considered PIM, a bibliographic survey was conducted in PUBMED, LILACS and PAHO databases, in February and March/2010. The search strategy included the use of health descriptors and a manual search in the references cited by selected papers. During the period of data collection, 15 instruments were identified. In 2012, with the publication of the update of Beers criteria, this instrument was included in the study. We identified 163 PIM of 25 therapeutic classes, of which 125 (76.7%) are marketed in Brazil. Of these, 31 (24.8%) are essential medicines (RENAME 2012), of which 13 have safer therapeutic equivalents and 19 (15.2%) are over-the-counter drugs. Data suggest the need for inclusion of safer alternatives for the elderly in the national list of essential medicines and the pharmaceutical care for early detection of ADE in this age group, in order to contribute to the safe use of medicines.

Tradução para o português brasileiro, adaptação transcultural e validação do 3D Assessment of Hand Function

Pós-graduação em Bases Gerais da Cirurgia - FMB

Initial stages of attitude’s instrument adaptation to brazilian sports competitions

The aim of this study was to adapt and initiate validation of an instrument of attitudes toward mathematics to sports competitions. So through a correlational study, we adapted the instrument counting on a total sample of 260 young athletes (n=260), all students, divided into three rounds, and the confirmatory purpose we apply a pre competitive stress scale in order to show mappable symptoms. An initial reliability of the instrument, Alpha 0.83 to negative attitudes, and 0.90 for positive attitudes, with the average results of 2.52 (±0.86) to negative attitudes and 4.66 (±0.84) was determined for attitudes positive; we conclude that the instrument performed well in this first test, and should be applied in a larger sample, by un mounting this case study that young athletes have positive attitudes toward sports competition, so they enjoy participating in the competition.

Cross-cultural adaptation and assessment of the reliability and validity of the Core Outcome Measures Index (COMI) for the Brazilian-Portuguese language

The use of patient-orientated questionnaires is of utmost importance in assessing the outcome of spine surgery. Standardisation, using a common set of outcome measures, is essential to aid comparisons across studies/in registries. The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument validated for patients with spinal disorders. This study aimed to produce a Brazilian-Portuguese version of the COMI. A cross-cultural adaptation of the COMI into Brazilian-Portuguese was carried out using established guidelines. 104 outpatients with chronic LBP (> 3 months) were recruited from a Public Health Spine Medical Care Centre. They completed a questionnaire booklet containing the newly translated COMI, and other validated symptom-specific questionnaires: Oswestry Disability Index (ODI) and Roland Morris disability scale (RM), and a pain visual analogue scale. All patients completed a second questionnaire within 7-10 days to assess reproducibility. The COMI summary score displayed minimal floor and ceiling effects. On re-test, the responses for each individual domain of the COMI were within 1 category in 98% patients for the domain 'function', 96% for 'symptom-specific well-being', 97% for 'general quality of life', 99% for 'social disability' and 100% for 'work disability'. The intraclass correlation coefficients (ICC2,1) for COMI pain and COMI summary scores were 0.91-0.96, which compared favourably with the corresponding values for the RM (ICC, 0.99) and ODI (ICC, 0.98). The standard error of measurement for the COMI was 0.6, giving a "minimum detectable change" (MDC95%) of approximately 1.7 points i.e., the minimum change to be considered "real change" beyond measurement error. The COMI scores correlated as hypothesised (Rho, 0.4-0.8) with the other symptom-specific questionnaires. The reproducibility of the Brazilian-Portuguese version of the COMI was comparable to that of other language versions. The COMI scores correlated in the expected manner with existing but longer symptom-specific questionnaires suggesting good convergent validity for the COMI. The Brazilian-Portuguese COMI represents a valuable tool for Brazilian study-centres in future multicentre clinical studies and surgical registries.

Assessment of tuberculosis treatment accessibility for patients co-infected or not with the human immunodeficiency virus

This study aimed to evaluate accessibility to treatment for people with TB co-infected or not with HIV. This cross-sectional study addressed issues regarding accessibility to treatment in a city in the interior of Sao Paulo state, Brazil. The instrument Primary Care Assessment Tool was utilized with 95 people. To evaluate access to treatment, Student's t test was used. The mean scores of variables were analyzed separately and compared between two groups (people with TB co-infected with HIV and people with TB not co-infected with HIV). Mean scores showed that HIV co-infected people presented greater difficulties in gaining access than those not co-infected. Professionals visited co-infected people more often when compared to those not co-infected; the co-infected people almost never accessed treatment for their disease in the Health Unit nearest their home. There is, therefore, the need for greater integration and communication between the programs for treatment of Tuberculosis and STD/AIDS.

Assessment of referrals to an OT consultation-liaison service: a retrospective and comparative study

The objective was to conduct a retrospective and comparative study of the requests for consultation-liaison (RCLs), during a period of six years, sent to the Occupational Therapy (OT) team that acts as the Consultation-liaison Service in Mental Health. During the studied period 709 RCLs were made and 633 patients received OT consultations. The comparison group was extended to 1 129 consecutive referrals to the psychiatric CL service, within the same period and that were also retrospectively reviewed. Regarding to RCLs to the OT team, most of the subjects were women with incomplete elementary schooling, with a mean age of 39.2 years, and were self-employed or retired. Internal Medicine was responsible for most of the RCLs. The mean length of hospitalization was 51 days and the mean rate of referral was 0.5%, with the most frequent reason for the request being related to the emotional aspects and the most frequent psychiatric diagnosis was mood disorder. It is concluded that there is a clear demand for the development of consultation-liaison in OT, particularly with regard to the promotion of mental health in general hospitals.

Trauma and countertransference: development and validity of the Assessment of Countertransference Scale (ACS)

Objectives: The aim of the present study was to investigate the construct validity of the Assessment of Countertransference Scale (ACS) in the context of the trauma care, through the identification of the underlying latent constructs of the measured items and their homogeneity. Methods: ACS assesses 23 feelings of CT in three factors: closeness, rejection and indifference. ACS was applied to 50 residents in psychiatry after the first appointment with 131 victims of trauma consecutively selected during 4 years. ACS was analyzed by exploratory (EFA) and confirmatory (CFA) factor analysis, internal consistence and convergent-discriminant validity. Results: In spite of the fact that closeness items obtained the highest scores, the EFA showed that the factor rejection (24% of variance, alpha = 0.88) presented a more consistent intercorrelation of the items, followed by closeness (15% of variance, alpha = 0.82) and, a distinct factor, sadness (9% of variance, alpha = 0.72). Thus, a modified version was proposed. In the comparison between the original and the proposed version, CFA detected better goodness-of-fit indexes for the proposed version (GFI = 0.797, TLI = 0.867, CFI = 0.885 vs. GFI = 0.824, TLI = 0.904, CFI = 0.918). Conclusions: ACS is a promising instrument for assessing CT feelings, making it valid to access during the care of trauma victims.

Short Assessment of Health Literacy for Portuguese-Speaking Adults

OBJECTIVE: To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS: The Short Assessment of Health Literacy for Portuguese-speaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defined as failure to fully understand standard medical prescriptions. RESULTS: Moderate to high correlations were found in the assessment of construct validity (Spearman's coefficients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coefficient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS: The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy.