RESUMEN

AIM: Traumatic dental injuries (TDIs) among children and adolescents have been acknowledged as of public health concern worldwide. The aim of the study was to assess the relationship between contextual and individual characteristics and TDIs in 12-year-old schoolchildren. MATERIALS AND METHODS: A cohort study was conducted with 355 schoolchildren living in deprived communities in the city of Manaus, Brazil. Contextual factors (place of residence and socio-economic indicators) and individual characteristics, including sex, family income, parents/guardians years of schooling, overjet and open bite (Dental Aesthetic Index), self-esteem (Rosenberg Self-Esteem Scale), sense of coherence (Sense of Coherence Scale), oral health beliefs, social support (Social Support Appraisals) were assessed at baseline. TDIs were measured at baseline and at 2-year follow-up using the O'Brien Index. Data were analysed through confirmatory factor analysis and structural equation modeling. RESULTS: The baseline prevalence of TDIs was 17.6% and the incidence of TDIs at 2-year follow-up was 26.8%. Better psychosocial status had a direct protective effect on the incidence of TDIs (ß = -.184). Better contextual characteristics (ß = -.135) and greater overjet (ß = -.203) were directly associated with poor psychosocial status. Higher schooling of parents/guardians directly predicted better psychosocial status (ß = .154). Psychosocial status mediated the relationship of greater overjet (ß = .036), contextual factors (ß = .024) and parental/guardian schooling (ß = -.027) with TDIs. CONCLUSIONS: Contextual factors and individual characteristics predicted TDIs. Psychosocial status was a relevant individual attribute in the causal network of TDIs, due to the direct effect on the incidence of TDIs as well as a mediator on the influence of contextual factors, overjet and parents/guardians schooling on the incidence of TDIs.

RESUMEN

This study investigated the role of oral health-related functional limitations and social well-being, self-perceived health, psychosocial factors, and social support in mediating the impact of malocclusion on health-related quality of life (HRQoL). A school-based 6-month cohort study was conducted with 376 12-year-old deprived adolescents. Measures at baseline included malocclusion (DAI score), dental caries, sociodemographic characteristics, psychosocial traits (self-esteem, sense of coherence, oral health beliefs), and social support. The oral health-related functional limitations and symptoms (social well-being) domains of the CPQ11-14 , self-perceived health, and HRQoL (Kiddo-KINDL) were evaluated at the 6-month follow-up. Associations between observed and latent variables (social support, psychosocial factors, and HRQoL) were evaluated using structural equation modelling, according to the Wilson and Cleary theoretical model. Malocclusion was indirectly associated with worse HRQoL, mediated by functional limitations, social well-being, and self-perceived health. Better psychosocial status was directly associated with better HRQoL, and higher social support was indirectly associated with better HRQoL via psychosocial factors. Dental caries experience, female sex, and lower family income were indirectly associated with worse HRQoL. The impact of malocclusion on HRQoL was mediated by oral health-related functional limitations, social well-being, and self-perceived health. Sociodemographic and psychosocial factors, and social support also impacted HRQoL.

Asunto(s)

RESUMEN

A identidade é um tema de grande relevância política e social na atualidade, seja quando tratamos de movimentos minoritários que buscam reconhecimento e direitos, seja pelo crescimento de movimentos reacionários que se fundam em identidades que excluem a diferença e promovem comportamentos sociais hostis a sujeitos alterizados. No campo psicanalítico, por vezes, se trata a questão identitária como alheia às nossas discussões, utilizando-se o argumento de que trabalhamos com identificações em vez de identidades e encerrando-se, apressadamente, o debate. Com este artigo, pretendemos afirmar a importância do tema da identidade para a psicanálise e discutir, junto aos estudos decoloniais, maneiras de pensar a questão que levem em conta os seus aspectos problemáticos e, ao mesmo tempo, coloquem em evidência modos de relação com as identidades que se direcionam para a relacionalidade e para o enfrentamento dos mecanismos de dominação do mundo contemporâneo. Buscamos, para tanto, tocar nas especificidades dos processos identitários nos contextos marcados pelos efeitos da colonialidade do poder e investigar como as obras freudiana e lacaniana podem fornecer caminhos para pensar a identidade de acordo com o direcionamento proposto por este estudo.

Identity is a highly relevant political and social theme in contemporary times, whether we are discussing minority movements seeking recognition and rights, or the growth of reactionary movements that are founded on identities that exclude difference and promote social behaviors hostile to marginalized subjects. In the psychoanalytic field, the issue of identity is sometimes treated as irrelevant to our discussions, using the argument that we work with identifications instead of identities and hastily ending the debate. With this article, we intend to assert the importance of the theme of identity for psychoanalysis and discuss, together with decolonial studies, ways of thinking about the issue that take into account its problematic aspects while highlighting modes of relationship with identities that are directed towards relationality and confronting the mechanisms of domination in the contemporary world. To this end, we aim to touch on the specificities of identity processes in contexts marked by the effects of the coloniality of power and to investigate how the works of Freud and Lacan can provide pathways for thinking about identity in accordance with the direction proposed by this study.

La identidad es un tema de gran relevancia política y social en la actualidad, ya sea cuando tratamos de movimientos minoritarios que buscan reconocimiento y derechos, o por el crecimiento de movimientos reaccionarios que se basan en identidades que excluyen la diferencia y promueven comportamientos sociales hostiles hacia sujetos alterizados. En el campo psicoanalítico, a veces se trata la cuestión de la identidad como ajena a nuestras discusiones, utilizando el argumento de que trabajamos con identificaciones en lugar de identidades y cerrando el debate precipitadamente. Con este artículo, pretendemos afirmar la importancia del tema de la identidad para el psicoanálisis y discutir, junto con los estudios decoloniales, maneras de pensar la cuestión que tengan en cuenta sus aspectos problemáticos y, al mismo tiempo, pongan en evidencia modos de relación con las identidades que se dirigen hacia la relacionalidad y hacia el enfrentamiento de los mecanismos de dominación del mundo contemporáneo. Buscamos abordar las especificidades de los procesos identitarios en los contextos marcados por los efectos de la colonialidad del poder e investigar cómo las obras freudiana y lacaniana pueden proporcionar caminos para pensar la identidad de acuerdo con la orientación propuesta por este estudio.

Asunto(s)

RESUMEN

OBJECTIVES: This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries amongst 12-year-old schoolchildren living in deprived communities in Manaus, Brazil. METHODS: A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents' schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling. RESULTS: The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (ß = 0.103) and sedentary behaviour (ß = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (ß = -0.243) and higher sedentary behaviour (ß = 0.227). Higher social support directly predicted lower sugar consumption (ß = -0.114). Lower socio-economic status (ß = -0.046) and lower social support (ß = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour. CONCLUSIONS: In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries amongst schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries amongst children living in deprivation. CLINICAL SIGNIFICANCE: Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.

Asunto(s)

RESUMEN

Resumo Introdução O lazer é considerado uma ocupação presente nos estudos, avaliações e intervenções da terapia ocupacional. Na América Latina, há poucos trabalhos que se dedicam à construção do entendimento dos profissionais ou suas percepções acerca do lazer. São ainda mais escassos os estudos que correlacionam com a ciência ocupacional o entendimento destes profissionais sobre tal ocupação dentro do campo da saúde mental. Objetivo Conhecer o entendimento de lazer por terapeutas ocupacionais atuantes na saúde mental de serviços públicos substitutivos ao modelo psiquiátrico asilar. Metodologia Esta pesquisa foi qualitativa, descritiva e exploratória, com desenho transversal. Foi utilizado grupo focal e análise temática da informação advinda do processo de construção coletiva de terapeutas ocupacionais, atuantes em serviços públicos de base territorial de urgência em saúde mental, da cidade de Belo Horizonte, Minas Gerais, Brasil, sobre seus entendimentos quanto ao lazer. Resultados Três categorias emergiram: (a) Lazer - prazer; (b) Lazer - livre escolha; e (c) Lazer - transcendência da dureza. Conclusão O lazer é uma ocupação importante para terapeutas ocupacionais atuantes em saúde mental no território; pode encontrar ressonância em práticas que fomentam a contratualidade e autonomia, especialmente ao se aliar aos princípios da ciência ocupacional de valorização do fazer humano em suas variáveis formas de vivenciá-lo. Acredita-se que esta pesquisa possa auxiliar terapeutas ocupacionais e cientistas da ocupação no entendimento do lazer contemporâneo, em diálogo com o cuidado no território e posicionamento antimanicomial.

Abstract Introduction Leisure is considered an occupation present in studies, evaluations and interventions of occupational therapy. In Latin America, there are few works dedicated to building the understanding of professionals or their perceptions about leisure. There are even fewer studies that correlate the understanding of these professionals with occupational science on this occupation within the field of mental health. Objective To know the understanding of leisure by occupational therapists working in the mental health of public services that substitute the asylum psychiatric model. Methodology : This research was qualitative, descriptive and exploratory, with a cross-sectional design. A focus group and thematic analysis of information arising from the process of collective construction of occupational therapists, working in public services with a territorial base of urgency in mental health, in the city of Belo Horizonte, Minas Gerais, Brazil, on their understandings regarding leisure were used. Results Three categories emerged: (a) Leisure - pleasure; (b) Leisure - free choice; and (c) Leisure - transcendence of hardness. Conclusion Leisure is an important occupation for occupational therapists working in mental health in the territory; may find resonance in practices that encourage contractuality and autonomy, especially when combined with the principles of occupational science of valuing human doing in its variable ways of experiencing it. It is believed that this research can help occupational therapists and occupation scientists in understanding contemporary leisure, in dialogue with care in the territory and anti-asylum positioning.

RESUMEN

BACKGROUND: To examine the role of dental pain, sense of coherence (SOC) and social support on the relationship between dental caries and oral health-related quality of life (OHRQoL) in children aged 12 years. METHODS: A cross-sectional study involving 400 schoolchildren selected from public schools in a socioeconomically disadvantaged region in the city of Manaus, Brazil was carried out. The predictors of OHRQoL were selected according to the Wilson and Cleary theoretical model, including number of decayed teeth and its clinical consequence (component D of the DMFT index and PUFA/pufa index), dental pain (symptom status), and SOC and social support (individual and environmental characteristics). Statistical analysis was conducted through structural equation modelling and multivariable negative binomial regression. The significance level established for all analyses was 5%. RESULTS: Number of dental caries was indirectly linked with OHRQoL (ß = 0.19, 95% CI 0.11/0.29) through dental pain, SOC and social support. Clinical consequences of untreated caries directly predicted poor OHRQoL (ß = 0.12, 95% CI 0.01/0.23). Dental pain, SOC and social support did not moderate the effect of dental caries measures on OHRQoL. CONCLUSION: Our findings suggest the role of dental pain, SOC and social support as mediator factors on the link between dental caries and OHRQoL. Tackling dental caries along with psychosocial factors may attenuated the impact of oral health on OHRQoL in children.

Asunto(s)

RESUMEN

BACKGROUND: To investigate the influence of change on sense of coherence (SOC) on dental services use in adolescents over a two-year period. METHODS: A prospective follow-up study was conducted involving 334 12-year-old adolescents from public schools in the city of Manaus, Amazonas, Brazil. The predictors of use of dental services in the last 12 months were selected according to the Andersen's behavioural theoretical model. The predisposing factors included sex, self-reported skin colour and SOC. The enabling factors were dental insurance, monthly family income and parents/guardians schooling. Dental pain, perceived oral health status, dental caries and gingival status were used to assess need factors. Multivariable Poisson regression with robust variance was used to estimate incidence-rate ratios (IRR) and 95% confidence intervals between the independent variables and use of dental services. RESULTS: Adolescent's SOC scores decreased significantly between baseline and one-year follow-up. SOC decline decreased the likelihood of using dental services in the last 12 months (IRR = 0.96 95%CI 0.92-0.99). Dental caries (IRR = 1.03 95%CI 1.01-1.04) and gingival bleeding (IRR = 1.01 95%CI 1.01-1.02) remained associated with use of dental services in the last 12 months. Adolescents with dental pain were more likely to have visited a dentist in the last year (IRR = 1.03, 95%CI 1.01-1.06). CONCLUSION: SOC decrease over one-year period was a meaningful factor of dental services use among 12-year-old adolescents. Dental pain and clinical conditions were also relevant factors that can influence use of dental services in this group.

Asunto(s)

RESUMEN

This case series reports on the clinical and subjective success of tooth fragment reattachment in 2 girls and 2 boys aged 8 to 11 years (mean age of 9.5 years). A total of 7 fractured maxillary central incisors were evaluated, and 5 were treated with tooth fragment reattachment. One of the teeth undergoing the reattachment procedure had a complicated fracture, and 4 had uncomplicated fractures. The period of follow-up ranged from 9 months to 4 years. During the follow-up examinations, the restorations were evaluated clinically and radiographically to verify the position and stability of the dental fragment and signs of endodontic pathosis. The restorations were evaluated clinically according to the Ryge (US Public Health Service) criteria. The oral health-related quality of life (OHRQoL) was the subjective outcome, assessed through the Oral Health Impact Profile-Aesthetic (OHIP-Aes) questionnaire, which was completed before and after treatment. The perceived clinical changes were a small gap, marginal discoloration, or slight color change in 3 of the teeth. In 4 teeth the periodontium and periapical region remained normal, and 1 tooth presented a periapical lesion requiring endodontic treatment. The mean (SD) OHIP-Aes scores were 25.25 (7.14) pretreatment and 3.75 (3.30) posttreatment. The results of this case series suggest that tooth fragment reattachment is an effective, conservative technique that has good long-term clinical outcomes and can improve the patient's OHRQoL.

Asunto(s)

RESUMEN

BACKGROUND: The possible link between dental status and school performance has been investigated. The influence of the clinical consequences of untreated dental caries in this association, however, has been minimally explored. AIM: To assess the relationship between clinical consequences of untreated dental caries and school performance in adolescents, and to examine the demographics and socioeconomic status pathways by which clinical consequences of untreated dental caries is associated with school performance. DESIGN: A cross-sectional study involving 363 low-income school adolescents was conducted in the city of Manaus, Brazil. Dental clinical measures were registered by five calibrated examiners to evaluate dental caries experience (decayed, missing, and filled teeth index [DMFT]) and clinical sequelae of dental caries (PUFA/pufa index). School performance was assessed using school grade history obtained from official records. Statistical analysis was conducted using pathway analysis to estimate beta coefficients (ß) of the direct and indirect effects between variables. RESULTS: DMFT and PUFA/pufa mean were 1.93 and 0.30, respectively. PUFA/pufa scores (ß = -0.19) and male sex (ß = 0.35) directly predicted poor school performance. DMFT was indirectly linked to poor school performance via PUFA/pufa scores (ß = -0.03). CONCLUSIONS: Dental caries and clinical consequences of dental caries were important predictors of poor school performance in low-income adolescents via direct and indirect effects.

Asunto(s)

RESUMEN

BACKGROUND/AIMS: This study evaluated the relationships of clinical consequences of untreated dental caries, individual characteristics, and environmental factors on self-reported oral health measures in adolescents. METHODS: A follow-up prevalence study was conducted involving 406 twelve-year-old adolescents selected from public schools in the eastern area of the city of Manaus, Brazil. Baseline data included clinical consequences of untreated caries (PUFA/pufa index), DMFT, sociodemographic characteristics (sex, parental schooling, and family income), psychosocial factors (sense of coherence [SOC-13 scale], oral health beliefs and self-esteem [Rosenberg Self-Esteem Scale]), and social support (SSA questionnaire). Oral health-related quality of life (OHRQoL [CPQ11-14]) and self-rated oral health were assessed at the 6-month follow-up. Structural equation modelling was used to explore the relationships between variables according to the Wilson and Cleary model. RESULTS: The prevalence of PUFA/pufa was 17.8% and mean DMFT was 1.5. The number of teeth with clinical consequences of untreated caries predicted poor self-rated oral health at the 6-month follow-up. Low parental schooling predicted low family income and clinical consequences of untreated dental caries. Psychosocial factors predicted OHRQoL directly and self-rated oral health indirectly. OHRQoL was linked to self-rated oral health. Clinical consequences of untreated dental caries mediated the relationship of parental schooling with OHRQoL and self-rated oral health. OHRQoL mediated the relationship of psychosocial factors and sex with self-rated oral health. Clinical consequences of untreated dental caries was associated with adolescents' self-rated oral health. Furthermore, the former was an important mediator on the link between low parental education and adolescents' self-reported oral health measures. CONCLUSIONS: Socioeconomic status, psychosocial factors, and social support were related to OHRQoL and self-rated oral health via direct and indirect pathways.

Asunto(s)

RESUMEN

BACKGROUND: Evidence on the possible influence of social and psychosocial factors on gingival status in socially disadvantaged children is scarce. The aim of this study is to assess the relationships among socioeconomic status, pattern of dental visits, self-esteem, oral health beliefs, toothbrushing frequency, oral hygiene effectiveness, and gingivitis in low social status adolescents. METHODS: A cross-sectional study was performed involving 406 12-year-old students recruited in Manaus, Brazil. Socioeconomic status (family income, parent's schooling, number of goods, and household crowding), self-esteem, oral health beliefs, and frequency of toothbrushing were collected through self-completed questionnaires. Gingival status (bleeding on probing) and oral hygiene effectiveness (dental calculus) were evaluated by calibrated dentists through oral examinations. Structural equation modeling assessed the direct and indirect relationships between variables guided by a theoretical model. RESULTS: The prevalence of gingivitis was 77.6%. Worse socioeconomic status and poor oral hygiene effectiveness directly predicted gingival bleeding. Socioeconomic status was also linked to toothbrushing frequency. Positive oral health beliefs and higher self-esteem predicted higher frequency of toothbrushing. The latter was directly linked to greater oral hygiene effectiveness. Oral health beliefs and self-esteem indirectly predicted gingival bleeding via toothbrushing frequency and oral hygiene effectiveness. CONCLUSION: The present findings suggest the importance of socioeconomic status and psychosocial factors on gingival status in underprivileged adolescents. Poor oral hygiene mediated the associations between psychosocial factors and gingival status.

Asunto(s)

RESUMEN

OBJECTIVES: To test the relationship of predisposing, enabling and need characteristics with dental services utilization and pattern of dental attendance among 12-year-old schoolchildren living in a socially deprived urban area. METHODS: A cross-sectional study was carried out involving 358 children enrolled in public schools located in a deprived area of the city of Manaus, Brazil. Predisposing, enabling, and need characteristics were selected according to Andersen's behavioral conceptual model. Self-completed questionnaires were used to collect the predisposing characteristics (child's gender, sense of coherence, self-esteem, oral health beliefs). Parents or guardians provided data on enabling characteristics, including dental health insurance and socioeconomic status. Evaluated need characteristics included oral clinical status assessed through dental examinations conducted by five calibrated examiners. Structural equation modeling was used to test the predictors of dental services utilization and pattern of dental attendance. RESULTS: Predisposing characteristics, including male gender and low parents/guardians sense of coherence predicted poor dental services utilization and inadequate pattern of dental attendance, respectively. Low socioeconomic status and poor oral clinical status were linked to poor dental services utilization and worse children's pattern of dental attendance. CONCLUSIONS: The present findings suggest that predisposing (child's gender and parental sense of coherence), enabling (socioeconomic conditions) and evaluated need characteristics (oral clinical status) are associated with dental services utilization among children.

Asunto(s)

RESUMEN

PURPOSE: This study assessed the relationships between socioecononic status (SES), social support, oral health beliefs, psychosocial factors, health-related behaviours and health-related quality of life (HRQoL) in adolescents. METHODS: A school-based follow-up study involving 376 12-year-old adolescents was conducted in Manaus, Brazil. Baseline data included sociodemographic characteristics (sex, parental schooling, family income, household overcrowding and number of goods), social support (SSA questionnaire), oral health beliefs and psychosocial factors (Sense of Coherence [SOC-13 scale] and self-esteem [Rosenberg Self-Esteem Scale]). Health-related behaviours (toothbrushing frequency, sedentary behaviour, smoking and sugar consumption) and HRQoL [KINDL questionnaire] were assessed at 6-month follow-up. Structural Equation Modelling assessed the relationships between variables. RESULTS: Greater social support (ß = 0.30), higher SOC (ß = 0.23), higher self-esteem (ß = 0.23), higher toothbrushing frequency (ß = 0.14) and less smoking (ß = - 0.14) were directly linked with better HRQoL. SES (ß = 0.05), social support (ß = 0.26), oral health beliefs (ß = - 0.02) were indirectly linked to HRQoL. Higher SES directly predicted higher toothbrushing frequency (ß = 0.14) and less smoking (ß = - 0.22). Greater social support also directly predicted higher SOC (ß = 0.55), positive oral health beliefs (ß = - 0.31) and higher self-esteem (ß = 0.58). Greater social support indirectly predicted less smoking via oral health beliefs (ß = - 0.05) and less sugar consumption via SOC (ß = - 0.07). CONCLUSION: Socioeconomic status, social support, oral health beliefs and psychosocial factors were important predictors of adolescent's health behaviours and HRQoL over 6-month period through direct and indirect mechanisms. Health behaviours also directly influenced HRQoL.

Asunto(s)

RESUMEN

La reforma psiquiátrica brasileña, además de un modelo de cuidado para las personas con trastornos de salud mental, presentó también una nueva manera de entender sus derechos y su modo de vida. En este artículo, a partir de la entrevista a una moradora de una residencia terapéutica de Belo Horizonte, Brasil, se realiza un análisis sobre el ocio a la luz del conocimiento de los autores de las Ciencias Sociales Elias y Dunning, quienes hablan de excitación y placer en el ocio, y se plantean algunas implicaciones para Terapia Ocupacional. Es posible comprender las vivencias de deseo sexual de la residente como formas de vivir el ocio que ejercen una función en su convivencia con la sociedad y resignifican sus posibilidades de probar, inventar y reinventar el ocio y la cotidianidad en su nuevo rol.

In addition to a model of care for people with mental health disorders, the Brazilian psychiatric reform also presented a new way of understanding their rights and way of life. In this article, based on an interview with a resident of a therapeutic residence in Belo Horizonte, Brazil, an analysis of leisure is carried out based on the knowledge of Elias and Dunning, Social Science authors, who discuss excitement and pleasure in leisure. Subsequently, some implications for Occupational Therapy are raised. It is possible to understand the resident's experiences of sexual desire as ways of living through leisure. Sexual desire has a function in her coexistence with society and redefines her possibilities of trying, inventing, and reinventing leisure and everyday life in her new role.

A reforma psiquiátrica brasileira, além de um modelo de cuidado às pessoas com transtornos psiquiátricos, também apresentou uma nova maneira de ver os direitos e o modo de vida das pessoas. Neste artigo, a partir de uma entrevista semiestruturada, realizada com uma moradora de residência terapêutica em Belo Horizonte, Brasil, foi elaborada uma análise sobre o lazer, à luz do conhecimento de autores das Ciências Sociais, Elias e Dunning (1992). Os autores falam de excitação e prazer no lazer e algumas implicações para a Terapia Ocupacional são destacadas. É possível compreender as experiências de desejo sexual da moradora como formas de viver o lazer. Tais formas exercem uma função na sua convivência com a sociedade e ressignificam suas possibilidades de experimentar, inventar e reinventar o lazer, bem como o cotidiano em seu novo papel.

Asunto(s)

RESUMEN

Resumo Objetivo Realizar a adaptação transcultural do instrumento: Autism Classification System of functioning: Social communication (ACSF: SC), que permite classificar o nível da função da comunicação social de crianças com transtorno do espectro autista (TEA), para uso no Brasil. Método Estudo metodológico de adaptação transcultural do instrumento ACSF: SC. Foram seguidas recomendações para adaptação transcultural de protocolos da área da saúde, que incluiu a permissão assegurada, tradução, tradução reversa, revisão e painel de especialistas. Resultados A avaliação dos especialistas evidenciou que a versão traduzida do instrumento ACSF: SC foi bem compreendida conceitualmente e adequada culturalmente, com 48 frases apresentando índice de concordância maior que 90% quanto à equivalência conceitual e cultural. Frases que não obtiveram níveis adequados de concordância foram revisadas, conforme sugestões dos especialistas. Conclusão A equivalência entre o instrumento ACSF: SC original e a tradução está garantida, obtendo índice de concordância acima de 90%. O instrumento estará apto para uso clínico em breve, após validação de suas propriedades de medida.

Abstract Objective To conduct a cross-cultural adaptation of the instrument: Autism Classification System of functioning: Social communication (ACSF: SC), which allows clinicians to classify the level of the social communication function of children with autism spectrum disorder (ASD), for its use in Brazil. Method Methodological study of cross-cultural adaptation of the instrument ACSF: SC. We followed recommendations for transcultural adaptation of health protocols, which included assured permission, translation, reverse translation, review, and panel of experts. Results The evaluation of the experts revealed that the translated version of the ACSF: SC instrument was well understood conceptually and culturally adequate, with 48 sentences presenting a concordance index greater than 90% regarding conceptual and cultural equivalence. Phrases that did not achieve adequate levels of agreement were reviewed, according to experts' suggestions. Conclusion Equivalence between the original ACSF: SC and its translated into Brazilian Portuguese is guaranteed, as it reached a concordance index above 90%. The Brazilian version of the ACSF: SC will be suitable for clinical use once its psychometrics properties are established.

RESUMEN

The effect of experimental parameters on the frequency of chemical oscillators has been systematically studied since the first observations of clock reactions. The approach is mainly based on univariate changes in one specific parameter while others are kept constant. The frequency is then monitored and the effect of each parameter is discussed separately. This type of analysis, however, does not take into account the multiple interactions among the controllable parameters and the synergic responses on the oscillation frequency. We have carried out a multivariate statistical analysis of chemical (BZ-ferroin catalyzed reaction) and electrochemical (Cu/Cu2O cathodic deposition) oscillators and identified the contributions of the experimental parameters on frequency variations. The BZ reaction presented a strong dependence on the initial concentration of sodium bromate and temperature, resulting in a frequency increase. The concentration of malonic acid, the organic substrate, affects the system but with lower intensity compared with the combination of sodium bromate and temperature. On the other hand, the Cu/Cu2O electrochemical oscillator was shown to be less sensitive to changes in the temperature. The applied current density and pH were the two parameters which most perturbed the system. Interestingly, the frequency behaved nonmonotonically with a quadratic dependence. The multivariate analysis of both oscillators exhibited significant differences - while the homogenous oscillator displayed a linear dependence with the factors, the heterogeneous one revealed a more complex dependence with quadratic terms. Our results may contribute, for instance, in the synthesis of self-organized materials in which an accurate frequency selection is required and, depending on its value, different physicochemical properties are obtained.

RESUMEN

The aim of this study was to investigate the association between orthodontic treatment need and oral health-related quality of life (OHRQoL) among 12-yr-old children. The study also assessed whether self-esteem modifies and/or moderates this relationship. Cross-sectional data on 406 schoolchildren aged 12 yr were analyzed. Data on socio-economic and demographic characteristics, dental pain, self-esteem, and OHRQoL were collected using validated questionnaires. Orthodontic treatment need was assessed, through dental examinations, using the dental aesthetic index (DAI). Multiple negative binomial regression and path analysis were used to estimate the association of orthodontic treatment need and self-esteem with OHRQoL. A modifying effect of self-esteem on the relationship between DAI and OHRQoL was observed. Self-esteem did not mediate the abovementioned relationship. Children with lower scores of self-esteem had worse OHRQoL among those with lower orthodontic treatment need (a DAI score of < 31). However, self-esteem did not influence the association between DAI and OHRQoL in children with greater orthodontic treatment need (a DAI score of ≥ 31). Self-esteem attenuated the impact of malocclusion on OHRQoL in children with minor or definite malocclusion, but not among those with severe or very severe malocclusion. Self-esteem appears to buffer the impact of malocclusion on OHRQoL in children with minor orthodontic treatment need.

Asunto(s)

RESUMEN

Hemophagocytic lymphohistiocytosis or hemophagocytic syndrome is represented by an uncontrolled inflammatory response characterized by marked histiocyte activation and a cytokine storm. The entity may present a primary or genetic type, and the secondary type is usually triggered by infectious diseases of any kind, autoimmune disease, or neoplasia. This entity, although well described and with definite diagnostic criteria, still remains misdiagnosed because of the overlap presentation with other inflammatory processes. The authors present the case of a 13-year-old girl who was submitted to an appendicectomy complicated with a pericolic abscess, which required a second operation in order to be drained surgically. During the postoperative period of this second surgical procedure, the patient remained febrile, developing cytopenias, and multiple organ failure. Unfortunately, she died despite the efforts of the intensive care staff. The autopsy findings were characteristic of hemophagocytic syndrome. The authors report the case to call attention to this diagnosis whenever unexpected outcomes of infections are experienced.