Avaliação da eficácia de remoção do biofilme oral após a instrução da escovagem dentária em pacientes com necessidades educativas especiais

No âmbito da Medicina Dentária define como Paciente com Necessidades Especiais (PNE) todos o indivíduo que apresenta determinados desvios dos padrões de normalidade, identificáveis ou não e que por isso necessitam de atenção e abordagens especiais por um período da sua vida ou indefinidamente. De acordo com a Organização Mundial de Saúde (OMS), cerca de 10% da população mundial é constituída por pacientes especiais, sendo 50% portadores de deficiência mental, 20% de deficiência física, 15% de deficiência auditiva, 5% de deficiência visual e, 10% de alterações múltiplas. Indivíduos com necessidades especiais têm um risco elevado de ter doenças orais. Se, por um lado, um dos grandes objetivos deste trabalho é realçar a importância da higiene oral, não será menos importante, por outro lado, refletir sobre a eficácia da remoção do biofilme dentário através da técnica mais adequada para pacientes com necessidades educativas especiais. Assim, os principais objetivos deste estudo são: i. Perceber previamente ao estudo, quais as noções de higiene oral dos encarregados de educação dos alunos com necessidades educativas especiais e os hábitos de saúde oral que lhes estão associados; ii. Promover e melhorar a saúde oral desta população através de técnicas de motivação como jogos, apresentações de slides através do programa Microsoft powerpoint, filmes; iii. Levar os alunos com NEE a aprender a técnica mais adaptada às suas necessidades através do treino em macromodelos; iv. Comparar os valores do índice de placa no início e no final do estudo para perceber se houve ou não melhoria. Foi utilizada a base de dados do Pubmed, tendo sido pesquisados artigos com as palavras-chave “dental care in special children”, “especial needs”, “oral hygiene”, “oral health”; “deaf children and oral health”, “dental plaque” e “mechanic plaque control”. Foram incluídos os artigos escritos em Português e Inglês, aos quais houvesse acesso integral do artigo, dos últimos 10 anos. Foi realizada também uma consulta de livros relacionados com o tema. A população alvo foram os utentes da instituição CERCIPENICHE, portadores de dificuldade intelectual e desenvolvimental (DID) que compreendiam idades entre os 20 e os 57 anos. A amostra é constituída por 53 indivíduos. O estudo inclui todos aqueles alunos da instituição que conseguiam realizar a escovagem dentária sozinhos, sem qualquer ajuda. A investigação dividiu-se em 3 fases: na primeira fase foi avaliada a eficácia da escovagem dentária dos utentes sem qualquer instrução por parte do investigador, recorrendo a um revelador de placa bacteriana sem qualquer contraindicação para a saúde do indivíduo; numa segunda etapa foram dadas instruções de técnicas de escovagem com base nos resultados da fase anterior, auxiliando com atividades de motivação para a higiene da cavidade oral; por fim foi realizada uma nova avaliação do índice de placa bacteriana para verificar se houve ou não eficácia na remoção do biofilme dentário. Apesar das limitações físicas e mentais destes pacientes atuarem como um travão para uma boa higiene oral, os resultados são positivos, indicam que se verificou a existência de melhorias significativas no IHO-s após a intervenção. Do primeiro para o segundo momento houve uma diminuição dos valores médios deste índice, ou seja, houve uma melhoria na higiene oral desta população, após a instrução. Conclui-se que é importante para estes pacientes reforçar-se continuamente os hábitos de higiene oral, uma vez que reforça a interiorização do conhecimento, havendo não só melhorias na saúde oral destes indivíduos como melhoria na sua qualidade de vida e na saúde em geral.

FY 2014-15 & 2015-16 Evaluation of State-Funded Full-Day 4K, part I

This report documents the expansion of 4K and expenditure of funds in Fiscal Years 2014-15 and 2015-16; provides 2015-16 projections for the number of at-risk four-year-olds in each school district and the number of at-risk four-year-olds served in a publicly funded program using available information; details the results of the CIRCLE assessment, which was administered to children in publicly-funded four-year-old (4K) and five-year-old (5K) kindergarten during the 2014-15 school year; describes the four language and literacy assessments that measure 4K and 5K students’ abilities during the 2015-16 school year; and discusses how 4K quality can be defined and the important role of teacher-child instructional interactions in assessing quality of publicly-funded 4K.

Nicaragua y el Lawfare: el derecho internacional como sucedáneo de la guerra

El interés de esta monografía es evaluar la relación entre el derecho internacional, la guerra y la política exterior a la luz del concepto de lawfare. Esta relación se evalúa a la luz del caso de las relaciones de Nicaragua con sus vecinos. Se analiza y explican las distintas nociones de derecho internacional desarrolladas por las teorías de Relaciones y sus limitaciones; la utilización de la guerra jurídica como estrategia sustitutiva de la guerra material en el caso de Nicaragua. Utilizando el concepto desarrollado por Charles Dunlap, el trabajo busca demostrar que el lawfare explica algunas relaciones entre derecho, guerra, y relaciones internacionales que las teorías clásicas no pueden y, adicionalmente da razón de las acciones de Nicaragua mediante la utilización del Derecho Internacional.

El efecto de la definición regulatoria de banda ancha sobre la difusión y la competencia del mercado de servicios de Internet fijo en Colombia

A partir de la dinámica evolutiva de la economía de las Tecnologías de la Información y las Comunicaciones y el establecimiento de estándares mínimos de velocidad en distintos contextos regulatorios a nivel mundial, en particular en Colombia, en el presente artículo se presentan diversas aproximaciones empíricas para evaluar los efectos reales que conlleva el establecimiento de definiciones de servicios de banda ancha en el mercado de Internet fijo. Con base en los datos disponibles para Colombia sobre los planes de servicios de Internet fijo ofrecidos durante el periodo 2006-2012, se estima para los segmentos residencial y corporativo el proceso de difusión logístico modificado y el modelo de interacción estratégica para identificar los impactos generados sobre la masificación del servicio a nivel municipal y sobre las decisiones estratégicas que adoptan los operadores, respectivamente. Respecto a los resultados, se encuentra, por una parte, que las dos medidas regulatorias establecidas en Colombia en 2008 y 2010 presentan efectos significativos y positivos sobre el desplazamiento y el crecimiento de los procesos de difusión a nivel municipal. Por otra parte, se observa sustituibilidad estratégica en las decisiones de oferta de velocidad de descarga por parte de los operadores corporativos mientras que, a partir del análisis de distanciamiento de la velocidad ofrecida respecto al estándar mínimo de banda ancha, se demuestra que los proveedores de servicios residenciales tienden a agrupar sus decisiones de velocidad alrededor de los niveles establecidos por regulación.

Una retrospección y visión de futuro sobre el uso e implementación de las tecnologías de la información y la comunicación, para el aprendizaje virtual en el contexto de la División de Educología de la Universidad Nacional de Costa Rica

Division de Educología (School of Education for Secondary Level) of Universidad Nacional in Costa Rica, (UNA) has been aware of the necessary planning and thought of a future that demands a continuous reflection between what is possible and what is desirable. In this sense, the formation of future educators of the country in different specialties, should promote not only the use of the technology, but also the development of critical and objective thinking that will embrace its advantages and its limitations in the noble exercise of what is teaching and learning. Under the light of these precepts, in the year 2007, the educational research activity emerged by the name of Didactic Resources for Learning with a bimodal focus. The present article exposes the main ideas that have been matured after an experience of more than two years with this course, and it is also searching for recapturing a responsible way of planning, implementing and managing the policies of ICTs (Information and Communication Technologies) for the bimodal learning in the context of the Division de Educología (School of Education for Secondary Level) of UNA.

Field-oriented assessment of agricultural crops through temporal segmentation of modis VI data.

Monitoring agricultural crops constitutes a vital task for the general understanding of land use spatio-temporal dynamics. This paper presents an approach for the enhancement of current crop monitoring capabilities on a regional scale, in order to allow for the analysis of environmental and socio-economic drivers and impacts of agricultural land use. This work discusses the advantages and current limitations of using 250m VI data from the Moderate Resolution Imaging Spectroradiometer (MODIS) for this purpose, with emphasis in the difficulty of correctly analyzing pixels whose temporal responses are disturbed due to certain sources of interference such as mixed or heterogeneous land cover. It is shown that the influence of noisy or disturbed pixels can be minimized, and a much more consistent and useful result can be attained, if individual agricultural fields are identified and each field's pixels are analyzed in a collective manner. As such, a method is proposed that makes use of image segmentation techniques based on MODIS temporal information in order to identify portions of the study area that agree with actual agricultural field borders. The pixels of each portion or segment are then analyzed individually in order to estimate the reliability of the temporal signal observed and the consequent relevance of any estimation of land use from that data. The proposed method was applied in the state of Mato Grosso, in mid-western Brazil, where extensive ground truth data was available. Experiments were carried out using several supervised classification algorithms as well as different subsets of land cover classes, in order to test the methodology in a comprehensive way. Results show that the proposed method is capable of consistently improving classification results not only in terms of overall accuracy but also qualitatively by allowing a better understanding of the land use patterns detected. It thus provides a practical and straightforward procedure for enhancing crop-mapping capabilities using temporal series of moderate resolution remote sensing data.

La ricerca archeologica e il regime dei ritrovamenti e delle scoperte nel sottosuolo e nei fondali marini. La disciplina del Codice tra attuazione e prospettive di riforma anche alla luce di un'analisi comparativa con l'esperienza francese e spagnola.

Il lavoro è volto all’approfondimento, anche in chiave comparatistica, della vigente normativa riguardante la tutela e la valorizzazione dei beni archeologici. Nell’ambito della disciplina predisposta nell’ordinamento italiano si sono prese le mosse dal regime delle scoperte e dei ritrovamenti, per passare successivamente all’approfondimento della tutela approntata nella legislazione nazionale anche con riferimento alle limitazioni alla libera disponibilità e circolazione. Una particolare attenzione è stata dedicata alla tutela del territorio in cui i beni archeologici sono inseriti e quindi alla tutela indiretta, ai vincoli ope legis e alla pianificazione paesaggistica, mentre una specifica trattazione ha riguardato il regime dell’archeologia preventiva e la valorizzazione e fruizione di aree e parchi archeologici nel reciproco interfacciarsi delle legislazioni regionali e delle linee guida emanate con il d.m. MiBAC 18 aprile 2012. Un’indagine articolata ha avuto per oggetto la tutela del patrimonio archeologico subacqueo e in particolare la Convenzione dell’UNESCO adottata a Parigi nel 2001, nonché la tutela sovranazionale dei beni culturali, con riferimento alla disciplina dell’Unione europea e a quella della Convenzione europea per la protezione del patrimonio archeologico del 16 gennaio 1992 e della Convenzione UNIDROIT del 24 giugno 1995 sui beni culturali rubati o esportati illegalmente. Hanno infine fatto seguito due specifiche indagini sulla tutela del patrimonio archeologico in Spagna e in Francia. Quanto alla prima si è esaminato l’attuale quadro costituzionale in cui si inserisce la tutela del patrimonio culturale con particolare attenzione alle disposizioni della Ley 16/1985 del 25 giugno 1985 e alla legislazione delle Comunidades autónomas. Per quanto riguarda la seconda una particolare attenzione è stata dedicata alla Legge 27 settembre 1941 che ha introdotto in Francia la prima disciplina organica relativa agli scavi e ai ritrovamenti archeologici. Nel quadro normativo vigente un’analisi particolareggiata è stata dedicata al Code du Patrimoine, il cui quinto libro è interamente dedicato all’archeologia.

A comparison between vertical mixing parameterizations in the Levantine Sea

The goal of this thesis was the study of an optimal vertical mixing parameterization scheme in a mesoscale dominated field characterized from a strong vorticity and the presence of a layer of colder, less saline water at about 100 m depth (Atlantic Waters); in these conditions we compared six different experiments, that differ by the turbulent closure schemes, the presence or not of an enhanced diffusion parameterization and the presence or not of a double diffusion mixing parameterization. To evaluate the performance of the experiments and the model we compared the simulations with the ARGO observations of temperature and salinity available in our domain, in our period of interest. The conclusions were the following: • the increase of the resolution gives better results in terms of temperature in all the considered cases, and in terms of salinity. • The comparisons between the Pacanovski-Philander and the TKE turbulent closure schemes don’t show significant differences when the simulations are compared to the observations. • The removing of the enhanced diffusion parameterization in presence of the TKE turbulent closure submodel doesn’t give positive results, and show limitations in the resolving of gravitational instabilities near the surface • The k-ϵ turbulent closure model utilized in all the GLS experiments, is the best performing closure model among the three considered, with positive results in all the salinity comparison with the in situ observation and in most of the temperature comparisons. • The double mixing parameterization utilized in the k-ϵ closure submodel improves the results of the experiments improving both the temperature and salinity in comparison with the ARGO data.

The role of tax policy in the context of the crisis: possibilities and limitations

Includes bibliography

A Foundation System and a State System - Private-School Implications on Welfare and Education Expenditure

This paper examines the effects of two different education - financing systems: a foundation system and a state system on the level and distribution of resources devoted to education in the presence of private schools. We use political economy approach where households differ in their level of income, and the central tax rate used to nance education is determined by a majority vote. Our analysis focuses on implications of allowing for a private-school option. To evaluate the importance of private schools we develop a computational model and calibrate it using USA data. The results reveal that the private school option is very important quantitatively in terms of welfare, total resources spent on education and equity.

Redistributive taxation, public expenditure, and size of governent

We introduce a model of redistributive income taxation and public expenditure. This joint treatment permits analyzing the interdependencies between the two policies: one cannot be chosen independently of the other. Empirical evidence reveals that partisan confrontation essentially falls on expenditure policies rather than on income taxation. We examine the case in which the expenditure policy (or the size of government) is chosen by majority voting and income taxation is consistently adjusted. This adjustment consists of designing the income tax schedule that, given the expenditure policy, achieves consensus among the population. The model determines the consensus in- come tax schedule, the composition of public expenditure and the size of government. The main results are that inequality is negatively related to the size of government and to the pro-rich bias in public expenditure, and positively or negatively related to the marginal income tax, depending on substitutability between government supplied and market goods. These implications are validated using OECD data.

Assessment of Physical Activity and Energy Expenditure by GPS Combined With Accelerometry in Real-Life Conditions.

Background: Physical activity (PA) and related energy expenditure (EE) is often assessed by means of a single technique. Because of inherent limitations, single techniques may not allow for an accurate assessment both PA and related EE. The aim of this study was to develop a model to accurately assess common PA types and durations and thus EE in free-living conditions, combining data from global positioning system (GPS) and 2 accelerometers. Methods: Forty-one volunteers participated in the study. First, a model was developed and adjusted to measured EE with a first group of subjects (Protocol I, n = 12) who performed 6 structured and supervised PA. Then, the model was validated over 2 experimental phases with 2 groups (n = 12 and n = 17) performing scheduled (Protocol I) and spontaneous common activities in real-life condition (Protocol II). Predicted EE was compared with actual EE as measured by portable indirect calorimetry. Results: In protocol I, performed PA types could be recognized with little error. The duration of each PA type could be predicted with an accuracy below 1 minute. Measured and predicted EE were strongly associated (r = .97, P < .001). Conclusion: Combining GPS and 2 accelerometers allows for an accurate assessment of PA and EE in free-living situations.

Do Nasty and Pleasant Surprises Regarding Tax Revenue Explain Spending Drifts ? : The Case of the Swiss Cantons

This article aims to explain the difference between the expenditure reported in governmental end-of-the-year budgets and the amounts previously forecasted in the approved beginning-of-the-year budgets. We measure how political, financial, and institutional variables affect this spending drift. We focus on two much-debated factors, namely, tax revenue budgeting errors and the stringency of fiscal rules. Our econometric approach uses a panel based on the 26 Swiss cantons covering the period of 1980 to 2011. Results suggest that stringent fiscal rules discourage budget overruns, whereas underestimating tax revenue-i.e., a budgetary "pleasant surprise"-offers the opportunity for some overspending.

Public health expenditure and spatial interactions in a decentralized national health system

One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a potential solution is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions

Public health expenditure and spatial interactions in a decentralized national health system

One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a potential solution is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions