A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters

P>Aim The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. Materials and methods Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. Results Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p > 0.05). Conclusion Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.

Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy : pain status, self-rated health and family situation

Background: Pelvic girdle pain (PGP) in pregnancy is distinct from pregnancy-related low back pain (PLBP). However, women with combined PLBP and PGP report more serious consequences in terms of health and function. PGP has been estimated to affect about half of pregnant women, where 25% experience serious pain and 8% experience severe disability. To date there are relatively few studies regarding persistent PLBP/PGP postpartum of more than 3 months, thus the main objective was to identify the prevalence of persistent PLBP and PGP as well as the differences over time in regard to pain status, self-rated health (SRH) and family situation at 12 months postpartum. Methods: The study is a 12 month follow-up of a cohort of pregnant women developing PLBP and PGP during pregnancy, and who experienced persistent pain at 6 month follow-up after pregnancy. Women reporting PLBP/PGP (n = 639) during pregnancy were followed up with a second questionnaire at approximately six month after delivery. Women reporting recurrent or persistent LBP/PGP at the second questionnaire (n = 200) were sent a third questionnaire at 12 month postpartum. Results: A total of 176 women responded to the questionnaire. Thirty-four women (19.3%) reported remission of LBP/PGP, whereas 65.3% (n = 115) and 15.3% (n = 27), reported recurrent LBP/PGP or continuous LBP/PGP, respectively. The time between base line and the 12 months follow-up was in actuality 14 months. Women with previous LBP before pregnancy had an increased odds ratio (OR) of reporting 'recurrent pain' (OR = 2.47) or 'continuous pain' (OR = 3.35) postpartum compared to women who reported 'no pain' at the follow-up. Women with 'continuous pain' reported statistically significant higher level of pain at all measure points (0, 6 and 12 months postpartum). Non-responders were found to report a statistically significant less positive scoring regarding relationship satisfaction compared to responders. Conclusions: The results from this study demonstrate that persistent PLBP/PGP is a major individual and public health issue among women 14 months postpartum, negatively affecting their self-reported health. However, the perceived relationship satisfaction seems to be stable between the groups.

An evidence-based approach to podiatry workforce enhancement and service provision in Western Victoria

Aims & rationale/Objectives : The objectives of this workforce and service enhancement project include: (i) establishing the magnitude of podiatry needs; and (ii) developing a model that can be used to enhance podiatry workforce and podiatry services.
Methods : Surveys to podiatrists and health agencies to determine vacancies, waiting lists, work practices and recruitment methods. Desktop analysis of predictive data for burden of disease and population changes per local government area (LGA). Meetings with podiatrists and their professional association, health care agencies, universities, and Local and State Governments.
Principal findings : Results showed
Long podiatry waiting lists (up to 12 months)
Podiatry vacancies and service gaps
Absence of qualified foot assistants
A high chronic disease burden
A population age mix that is predicted to change dramatically over the next 25 years in favour of those who are 60 years of age or older
Ineffective recruitment methods
The workforce enhancement model that emanated from the meetings with the steering group includes podiatrists as well as auxiliaries such as foot-care assistants who work together in an interprofessional model of care that expands across the region. In addition to training foot-care assistants and the development of a podiatry teaching clinic to enhance student placement, the model builds onto a current continuous professional development program for allied health professionals.
Discussion : Although the allied health workforce (including podiatry) is playing an increasingly important role in the prevention and treatment of chronic diseases, rural areas in particular are disadvantaged by recruitment and retention problems. The podiatry workforce shortage is compounded by ageing populations. Age is associated with increased podiatry usage due to chronic diseases such as diabetes, cardiovascular disease and osteoarthritis.
Implications : A strategic plan developed in consultation with stakeholders aims to improve rural podiatry services in a sustainable manner. The project will be implemented when adequate funding is allocated this year and will be evaluated on its impact on services.
Presentation type : Paper

Effectiveness of a modified mother–infant transaction program on outcomes for preterm infants from 3 to 24 months of age

Mothers of hospitalised preterm infants were randomised into an intervention or control condition. Intervention mothers received a modified Mother–Infant Transaction Program over seven sessions prior to infant discharge and two sessions over the next 3 months. Infant temperament, mother–infant interaction and parenting stress were assessed at 3 and 6 months and infant development was measured by parental report at 24 months. Intervention compared with control dyads showed enhanced mother–infant interactions, infants were temperamentally more “approaching” and “easier”, had fewer regulatory problems (colic, sleep, excessive crying), and had more developed communication skills, while mothers were less stressed by their infant at 3 months. These early gains in the development of preterm infants and in the relationship with and adjustment of their mothers, may explain the process by which intervention infants in the original study showed increasing cognitive advantages to 9 years of age [Rauh, V. A., Nurcombe, B., Achenbach, T., & Howell, C. (1990). The mother–infant transaction program. Clinical Perinatology, 17, 31–45].

The impact of past direct-personal traumatic events on 12-month outcome in first episode psychotic mania: trauma and early psychotic mania

Past traumatic events have been associated with poorer clinical outcomes in people with bipolar disorder. However, the impact of these events in the early stages of the illness remains unclear. The aim of this study was to investigate whether prior traumatic events were related to poorer outcomes 12 months following a first episode of psychotic mania.

Gambling participation and problem gambling severity in a stratified random survey : Findings from the second social and economic impact study of gambling in Tasmania

Demographic characteristics associated with gambling participation and problem gambling severity were investigated in a stratified random survey in Tasmania, Australia. Computer-assisted telephone interviews were conducted in March 2011 resulting in a representative sample of 4,303 Tasmanian residents aged 18 years or older. Overall, 64.8 % of Tasmanian adults reported participating in some form of gambling in the previous 12 months. The most common forms of gambling were lotteries (46.5 %), keno (24.3 %), instant scratch tickets (24.3 %), and electronic gaming machines (20.5 %). Gambling severity rates were estimated at non-gambling (34.8 %), non-problem gambling (57.4 %), low risk gambling (5.3 %), moderate risk (1.8 %), and problem gambling (.7 %). Compared to Tasmanian gamblers as a whole significantly higher annual participation rates were reported by couples with no children, those in full time paid employment, and people who did not complete secondary school. Compared to Tasmanian gamblers as a whole significantly higher gambling frequencies were reported by males, people aged 65 or older, and people who were on pensions or were unable to work. Compared to Tasmanian gamblers as a whole significantly higher gambling expenditure was reported by males. The highest average expenditure was for horse and greyhound racing ($AUD 1,556), double the next highest gambling activity electronic gaming machines ($AUD 767). Compared to Tasmanian gamblers as a whole problem gamblers were significantly younger, in paid employment, reported lower incomes, and were born in Australia. Although gambling participation rates appear to be falling, problem gambling severity rates remain stable. These changes appear to reflect a maturing gambling market and the need for population specific harm minimisation strategies. © 2014 Springer Science+Business Media New York.

Environmental and genetic determinants of vitamin D insufficiency in 12-month-old infants

We aimed to investigate the relationship between genetic and environmental exposure and vitamin D status at age one, stratified by ethnicity. This study included 563 12-month-old infants in the HealthNuts population-based study. DNA from participants' blood samples was genotyped using Sequenom MassARRAY MALDI-TOF system on 28 single nucleotide polymorphisms (SNPs) in six genes. Using logistic regression, we examined associations between environmental exposure and SNPs in vitamin D pathway and filaggrin genes and vitamin D insufficiency (VDI). VDI, defined as serum 25-hydroxyvitamin D3(25(OH)D3) level ≤50 nmol/L, was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Infants were stratified by ethnicity determined by parent's country of birth. Infants formula fed at 12 months were associated with reduced odds of VDI compared to infants with no current formula use at 12 months. This association differed by ethnicity (P;bsubesub;= 0.01). The odds ratio (OR) of VDI was 0.29 for Caucasian infants (95% CI, 0.18-0.47) and 0.04 for Asian infants (95% CI, 0.006-0.23). Maternal vitamin D supplementation during pregnancy and/or breastfeeding were associated with increased odds of infants being VDI (OR, 2.39; 95% CI, 1.11-5.18 and OR, 2.5; 95% CI, 1.20-5.24 respectively). Presence of a minor allele for any GC SNP (rs17467825, rs1155563, rs2282679, rs3755967, rs4588, rs7041) was associated with increased odds of VDI. Caucasian infants homozygous (AA) for rs4588 had an OR of 2.49 of being associated with VDI (95% CI, 1.19-5.18). In a country without routine infant vitamin D supplementation or food chain fortification, formula use is strongly associated with a reduced risk of VDI regardless of ethnicity. There was borderline significance for an association between filaggrin mutations and VDI. However, polymorphisms in vitamin D pathway related genes were associated with increased likelihood of being VDI in infancy. © 2014 Elsevier B.V. All rights reserved.

Validity of 12-month falls recall in community-dwelling older women participating in a clinical trial

Objectives. To compare 12-month falls recall with falls reported prospectively on daily falls calendars in a clinical trial of women aged ≥70 years. Methods. 2,096 community-dwelling women at high risk of falls and/or fracture completed a daily falls calendar and standardised interviews when falls were recorded, for 12 months. Data were compared to a 12-month falls recall question that categorised falls status as “no falls,” “a few times,” “several,” and “regular” falls. Results. 898 (43%) participants reported a fall on daily falls calendars of whom 692 (77%) recalled fall(s) at 12 months. Participants who did not recall a fall were older (median 79.3 years versus 77.8 years, ). Smaller proportions of fallers who sustained an injury or accessed health care failed to recall a fall (all ). Among participants who recalled “no fall,” 85% reported zero falls on daily calendars. Few women selected falls categories of “several times” or “regular” (4.1% and 0.4%, resp.) and the sensitivity of these categories was low (30% to 33%). Simply categorising participants into fallers or nonfallers had 77% sensitivity and 94% specificity. Conclusion. For studies where intensive ascertainment of falls is not feasible, 12-month falls recall questions with fewer responses may be an acceptable alternative.

Long-term cost-effectiveness of weight management in primary care

Background:  As obesity prevalence and health-care costs increase, Health Care providers must prevent and manage obesity cost-effectively.

Methods:  Using the 2006 NICE obesity health economic model, a primary care weight management programme (Counterweight) was analysed, evaluating costs and outcomes associated with weight gain for three obesity-related conditions (type 2 diabetes, coronary heart disease, colon cancer). Sensitivity analyses examined different scenarios of weight loss and background (untreated) weight gain.

Results:  Mean weight changes in Counterweight attenders was −3 kg and −2.3 kg at 12 and 24 months, both 4 kg below the expected 1 kg/year background weight gain. Counterweight delivery cost was £59.83 per patient entered. Even assuming drop-outs/non-attenders at 12 months (55%) lost no weight and gained at the background rate, Counterweight was ‘dominant’ (cost-saving) under ‘base-case scenario’, where 12-month achieved weight loss was entirely regained over the next 2 years, returning to the expected background weight gain of 1 kg/year. Quality-adjusted Life-Year cost was £2017 where background weight gain was limited to 0.5 kg/year, and £2651 at 0.3 kg/year. Under a ‘best-case scenario’, where weights of 12-month-attenders were assumed thereafter to rise at the background rate, 4 kg below non-intervention trajectory (very close to the observed weight change), Counterweight remained ‘dominant’ with background weight gains 1 kg, 0.5 kg or 0.3 kg/year.

Conclusion:  Weight management for obesity in primary care is highly cost-effective even considering only three clinical consequences. Reduced healthcare resources use could offset the total cost of providing the Counterweight Programme, as well as bringing multiple health and Quality of Life benefits.

Reação de mercado associada à disponibilidade de informação

O racional teórico das finanças comportamentais se sustenta em dois grandes pilares: limites de arbitragem e irracionalidade dos investidores. Dentre os desvios de racionalidade conhecidos, um foi de particular interesse para este estudo: o viés da disponibilidade. Este viés acontece nas situações em que as pessoas estimam a frequência de uma classe ou a probabilidade de um evento pela facilidade com que instâncias ou ocorrências podem ser lembradas. O advento da internet permitiu a verificação do viés de disponibilidade em larga escala por meio da análise dos dados de buscas realizadas. I.e., se uma determinada ação é mais procurada que outras, podemos inferir que ela está mais disponível na memória coletiva dos investidores. Por outro lado, a literatura das finanças comportamentais tem um braço mais pragmático, que estuda estratégias capazes de fornecer retornos anormais, acima do esperado pela hipótese do mercado eficiente. Para os fins deste estudo, destaca-se o efeito momento, no qual o grupo de ações de melhor resultado nos últimos J meses tende a fornecer melhores resultados pelos próximos K meses. O propósito deste estudo foi verificar a possibilidade de se obter retornos acima dos identificados pelo efeito momento segmentando-se as carteiras de maior e menor viés de disponibilidade. Os resultados obtidos foram positivos e estatisticamente significativos na amostra selecionada. A estratégia cruzada entre efeito momento e disponibilidade produziu, para J=6 e K=6, retornos médios mensais de 2,82% com estatística t de 3,14. Já a estratégia só de efeito momento, para o mesmo período de formação e prazo de manutenção, gerou retornos médios mensais de apenas 1,40% com estatística t de 1,22.

Taxa não inflacionária da capacidade utilizada: uma abordagem usando microdados brasileiros

Esta dissertação baseia-se na criação de uma taxa não inflacionária da capacidade utilizada (NIRCU) para economia brasileira, utilizando microdados da Sondagem da Indústria de Transformação e Índice de Preços ao Produtor Amplo – M (IPA-M), pesquisas desenvolvidas pela FGV/IBRE. Foram criadas três taxas: NIRCU Sondagem, NIRCU Coincidente e NIRCU Antecedente. A primeira utiliza apenas dados da sondagem e a ideia é verificar que não há pressão inflacionária quando as empresas informam para sondagem que não irão variar os seus preços para os próximos três meses e que o número de turnos trabalhado é igual à média do setor. Já as demais, cruzam as informações das empresas que respondem tanto a Sondagem da Indústria de Transformação quanto no IPA-M e verifica se as que informam que não irão alterar os seus preços nos próximos três meses se concretiza quando comparados às variações do índice. A diferença entre as duas últimas abordagens é que a primeira, NIRCU Coincidente, verifica no mesmo período e a outra, NIRCU Antecedente, no trimestre seguinte. A forma encontrada para verificar a eficácia dos indicadores em mensurar a existência de pressão inflacionária foi inserir os diferentes hiatos de produto das NIRCU no modelo de Curva de Phillips, usando a metodologia de Mínimos Quadrados Ordinários (MQO). De acordo com as estimativas, a NIRCU Antecedente foi a única das três que não apresentou um bom desempenho no resultado; as NIRCU Sondagem e Coincidente tiveram uma performance muita boa, principalmente a última. Ou seja, esses dois indicadores tiveram um resultado tão bom quanto as mais tradicionais medidas de hiato de produto.

Fatores que influenciam a intenção de compra online: aplicação de um modelo adaptado de aceitação da tecnologia para o comércio eletrônico

This research aims to understand the factors that influence intention to online purchase of consumers, and to identify between these factors those that influence the users and the nonusers of electronic commerce. Thus, it is an applied, exploratory and descriptive research, developed in a quantitative model. Data collection was done through a questionnaire administered to a sample of 194 graduate students from the Centre for Applied Social Sciences of UFRN and data analysis was performed using descriptive statistics, confirmatory factorial analysis and simple and multiple linear regression analysis. The results of descriptive statistics revealed that respondents in general and users of electronic commerce have positive perceptions of ease of use, usefulness and social influence about buying online, and intend to make purchases on Internet over the next six months. As for the non-users of electronic commerce, they do not trust the Internet to transact business, have negative perceptions of risk and social influence over purchasing online, and does not intend to make purchases on Internet over the next six months. Through confirmatory factorial analysis six factors were set up: behavioral intention, perceived ease of use, perceived usefulness, perceived risk, trust and social influence. Through multiple regression analysis, was observed that all these factors influence online purchase intentions of respondents in general, that only the social influence does not influence the intention to continue buying on the Internet from users of electronic commerce, and that only trust and social influence affect the intention to purchase online from non-users of electronic commerce. Through simple regression analysis, was found that trust influences perceptions of ease of use, usefulness and risk of respondents in general and users of electronic commerce, and that trust does not influence the perceptions of risk of non-users of electronic commerce. Finally, it was also found that the perceived ease of use influences perceived usefulness of the three groups. Given this scenario, it was concluded that it is extremely important that organizations that work with online sales know the factors that influence consumers purchasing intentions in order to gain space in their market

Incidência da varíola, causada por Asperisporium caricae, em folhas de mamoeiros submetidos ao manejo orgânico, em diferentes ambientes de cultivo

Mudas de mamoeiro da cultivar Baixinho de Santa Amália foram transplantadas para covas de 40x60x40 cm, em áreas de três estruturas contíguas: (a) estufa sombreada (cobertura de plástico), (b) estufa sombreada + sombrite (cobertura adicional de sombrite com 30% de sombreamento sobre o plástico) e (c) telado (cobertura exclusiva de sombrite 30%). Ao lado de tais estruturas foi implantada uma área de cultivo de mamoeiro em ambiente natural. Os tratos culturais aplicados foram os condizentes às normas técnicas vigentes na agricultura orgânica. As irrigações foram procedidas com mangueira plástica, evitando-se molhar folhas e frutos. Aos 45 dias pós-transplantio e, subseqüentemente, a intervalos mensais, as plantas foram inspecionadas em relação à incidência de lesões foliares causada pelo fungo Asperisporium caricae. Para efeito de análise estatística, após o teste de homogeneidade das variâncias, foram consideradas quatro repetições por ambiente (tratamento), com seis plantas úteis por parcela. O modelo de quantificação da doença indicou efeito altamente significativo dos ambientes protegidos, estufa e estufa sombreada, quanto à incidência de sintomas, em comparação com ambientes de telado e em área natural de cultivo. Durante os 12 meses de avaliações foi constatada alta correlação entre incidência da doença e pluviosidade e umidade relativa do ar. As estruturas cobertas com plástico demonstraram alto potencial de controle de A. caricae, sendo, portanto, recomendáveis no sistema orgânico de produção do mamoeiro.

Efeito do tempo de experiência de operadores de Harvester no rendimento operacional

A mecanização da colheita de madeira permite maior controle dos custos e pode proporcionar reduções em prazos relativamente curtos. Além disso, tem um lugar de destaque na humanização do trabalho florestal e no aumento do rendimento operacional. O presente trabalho teve por objetivo avaliar o desempenho de operadores de harvester em função do tempo de experiência na atividade. Foram avaliados oito operadores do sexo masculino, com idade entre 23 e 46 anos. O estudo consistiu na análise do volume de madeira colhida pelo harvester. O tempo de experiência afeta significativamente o rendimento operacional dos operadores de harvester. Tal rendimento aumenta expressivamente nos primeiros 18 meses de experiência, mantendo-se em ascensão nos próximos 26 meses. Após os 44 meses de experiência, o rendimento dos operadores tende a reduzir, revelando as possíveis acomodações do cotidiano. Tais resultados permitem concluir que por volta dos 50 meses de experiência na atividade de operação de harvester, se faz necessária a adoção de medidas de reciclagem, motivação, entre outras, a fim de proporcionar aos operadores melhores condições de trabalho que os possibilitem continuar exercendo a atividade de forma eficiente e rentável à empresa.

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS