Racial inequalities in dental service utilisation: exploring individual and contextual determinants among a sample of middle-aged Brazilian adults

Dental service helps to alleviate and prevent pain and suffering and promote oral health. International evidence has shown that some racial/ethnic minority groups are less likely to use dental services compared to Whites. In Brazil, where individuals are classified according to their colour/race, researchers also observed colour/race inequalities in dental service, but evidence concerning this issue is scarce. Therefore, this thesis investigated the differences between Pardos (mixed) and Blacks compared to Whites in dental service utilisation in a national sample of 35 to 44-year-old Brazilian adults taking into consideration the role of individual-level and contextual-level characteristics. The final overall sample was 6,157 individuals nested in the 27 Brazilian State Capitals. Dependent variables were time since last dental visit, reason for the last dental visit, and type of service used. The main exploratory variable was self-reported colour/race (White, Pardo, or Black). Individual-level and contextual-level characteristics were considered covariates. The results showed that for the time since last dental visit, the individual-level characteristics fully explained the differences between groups. The same occurred for differences between Blacks and Whites for visits due to pain or extraction, and due to treatment. However, Pardos were 1.24 and 1.21 times more likely, respectively, to visit the dentist due to pain or extraction, and due to treatment compared to Whites even after the adjustment for individual and contextual-level covariates. Additionally, Pardos and Blacks were 1.24 and 1.69 times more likely, respectively, to visit the public dental service compared to Whites after the adjustment for all covariates. To conclude, colour/race differences in dental service utilisation were evident for middle-aged adults in Brazil. Individual-level characteristics, especially level of education and income, were more relevant to reduce differences compared to contextual-level characteristics, but these reductions were not sufficient to fully explain the inequalities observed for some of the investigated outcomes

“The forces that came together to infl ict thatpain”: Class, Race, and Sexuality in Ellen Feldman’s Scottsboro

In the infamous Scottsboro case (Alabama, 1931), nine black youths were falsely accused of raping two low-class white girls that happened to be sexually promiscuous with both white and black males. The Scottsboro Boys were innocent victims of the southern rape complex and the automatic legal lynching of any black male accused of raping a white woman. The main character of Ellen Feldman’s novel Scottsboro(2008) is based largely on two progressive northern reporters, Mary Heaton Vorse and Hollace Ransdall, both of whom looked into the case. She visits Alabama and learns about the complex racial, class, and genderrelations there, as well as her own bigotry and class-privilege. Like Ransdall and Vorse, she reports on an eventin which two poor victims of capitalist oppression are elevated from the level of “white trash” to be made representatives of “defiled” white womanhood, while eight of the nine black youths, stereotyped as hypersexualized and inherently criminal, are given death sentences because of the tyranny of valueswhich mean nothing in the life of the girls themselves.En el infame caso de Scottsboro (Alabama, 1931), nueve jóvenes negros fueron acusados falsamente de violar a dos jóvenes blancas de clase baja y conocidas por su promiscuidad sexual con hombres blancos y negros. Los Chicos de Scottsboro fueron víctimas inocentes del llamado “southern rape complex” y del linchamiento legal automático de cualquier varón negro acusado de violar a una mujer blanca. La protagonista de Scottsboro, basada en gran medida en dos reporteras progresistas del Norte, Mary Heaton Vorse y Hollace Ransdall, que investigaron el caso, aprende sobre las complejas relaciones raciales y de clase vigentes en el Sur, así como sobre su propios prejuicios y privilegios de clase. Al igual que Ransdall y Vorse, informa sobre un episodio en el que dos víctimas de la opresión capitalista son elevadas del nivel de "basura blanca" para convertirse en representantes de la feminidad blanca "profanada", mientras ocho de los nueve jóvenes negros, estereotipados como hipersexualizados e intrínsecamente criminales, reciben sentencias de muerte, todo ello debido a la tiranía de unos valores que no significan nada en la vida de las jóvenes que les acusan

“So Far as I and my people are concerned the South is fascist now and always has been”: Carson McCullers y el problema racial

Carson McCullers was deeply aware of the guilt of southern whites with respect to the oppression of blacks, and her fiction presents an intricate web of different configurations of the racial problem in her native South. In The Heart Is a Lonely Hunter she paints a very sympathetic and complex portrait of an African American man, a Martin Luther King avant la lettre. He actively fights for the civil rights of his race, yet paradoxically his obsessive blackness draws him close to the whiteness that oppresses him. In The Member of the Wedding McCullers connects racial oppression with gender oppression in the context of the prejudice of the reactionary South of the 1940s, linking the failed desire for gender fluidity with a similarly failed desire for racial hybridity. In Clock without Hands she brings existentialist influences to bear on the attitudes of her white characters with respect to the violent racial relations at the outset of the civil rights movement, and explores the tragic consequences here, for both whites and blacks, of polarized conceptions of blackness and whiteness.Carson McCullers tenía una aguda conciencia de la culpa de los sureños blancos en relación con la opresión de los afroamericanos, y su ficción presenta una compleja red de diferentes configuraciones del problema racial en el sur estadounidense. En The Heart Is a Lonely Hunter nos legó el retrato de un afroamericano, un Martin Luther King avant la lettre que lucha por los derechos civiles de los negros, aunque paradójicamente su negritud obsesiva lo aproxima a la blancura que le oprime. En The Member of the Wedding la autora conecta la opresión racial con la opresión de género en el contexto del Sur reaccionario en la década de 1940, y relaciona el fracaso del deseo de fluidez sexual con el fracaso de la aspiración al hibridismo racial. En Clock without Hands vemos el influjo del existencialismo en las actitudes de personajes blancos en relación con las violentas relaciones raciales a principios del movimiento por los derechos civiles, y cómo McCullers explora las consecuencias trágicas de concepciones raciales extremas.S

Tratamento da cisticercose subcutânea co praziquantel: um novo agente cestoidicida

Twenty adult patients presenting dermal cysticercosis without cerebral or ocular involvement were treated with praziquantel. The first eleven cases received 60 mg/kg/day and the last nine cases 30 mg/kg/day. In both groups the daily dose was split into three oral intakes 4 to 6 hours apart and the drug administration lasted for 6 consecutive days. The latter group of patients also got dexamethasone, 3 mg daily, from one day before until four days after the treatment period with praziquantel. The drug proved to be 100% efficacious as demonstrated histopathologically by the death of the cysticerci of Taenia solium (Cysticercus cellulosae) in serial biopsies taken from the 2nd week on after the end of treatment, as well as clinically by the steady disappearence of the dermal nodules during the 6 months following the therapy. Tolerance of praziquantel was good as the incidence and severity of side-effects were not relevant. The drug safety was confirmed through laboratory tests which failed to detect any abnormal findings related to the hematopoietic, liver and kidney functions

Rastreio virológico de carnívoros errantes e caracterização genética viral

Dissertação de Mestrado Integrado em Medicina VeterináriaABSTRACT - Virological survey in stray carnivores and viral genetic characterisation - Free-roaming stray or feral dogs and cats living in urban areas can be responsible for the spread and maintenance of several infectious diseases. To investigate the presence of viral agents and the genomic diversity of canine and feline coronavirus (CCoV, FCoV) in Lisbon’s Municipal kennel, a virological survey was conducted which included canine distemper virus (CDV), canine and feline parvovirus (CPV,FPV), CCoV and FCoV, feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). Blood samples and faecal swabs were collected from 50 dogs and 50 cats at the time of euthanasia, and 24 environmental swabs were collected at a later date. Samples were either tested using a commercial ELISA kit, or amplified by PCR and RT-PCR. All coronavirus positive samples were further characterized by RT-PCR to assess the presence of different FCoV and CCoV genotypes. All PCR products were observed on 1,5%.agarose gel. Antibodies against FIV were found in 18% of the samples, while FeLV antigen was found in 10%. Viral nucleic acid was detected in 8.2% samples for CDV, 32.7% for CCoV, 59.6% for FPV/CPV, and 70% for FCoV. Seven (43.8%) samples were positive for CCoV type I, 9 (56.2%) for CCoV type II, and as for FCoV, 9 (25,7%), 6 (17%) and 12 (34.3%) samples were positive for FCoV type I, type II and both types, respectively. No differentiation was possible in 8 (23%) of the FCoV samples. There were positive environmental samples for CDV (50%), FPV/CPV (62.5%) and FCoV (87.5%). The results found on this study, particularly on parvovirus and FCoV brought to our attention the need for a continued and more precise evaluation of the health status of free-roaming stray or feral animals in the municipal kennel, to correctly evaluate their role as viral reservoirs within and without the kennel premises. The high prevalence of coronavirus infection found in both dogs and cats in the Lisbon Municipal Kennel allowed the viral genetic characterization, showing a high rate of co-infection with both genotypes of FCoV and absence of co-infected animals with CCoV I and II. However, further investigation is needed in order to maintain a molecular epidemiological surveillance and help identify further CoV strains, as well as understand the pathogenic potential of these viruses.RESUMO - Rastreio virológico de carnívoros errantes e caracterização genética viral - Os animais errantes ou assilvestrados que habitam áreas urbanas podem ser responsáveis pela distribuição e manutenção de diversas doenças infecciosas. Com o objectivo de investigar a presença de agentes virais e avaliar a diversidade genética de coronavirus canino e felino (CCoV, FCoV) no Canil Municipal de Lisboa, realizámos um rastreio virológico em que foram avaliados o vírus da esgana canina (CDV), parvovirus canino e felino (CPV, FPV), CCoV e FCoV, o vírus da imunodeficiência felina (FIV) e o vírus da leucemia felina (FeLV). Foram colhidas amostras de sangue e zaragatoas rectais de 50 cães e 50 gatos na altura da eutanásia, e 24 zaragatoas ambientais numa data posterior. Avaliámos as amostras utilizando um teste comercial de ELISA ou amplificando as amostras por PCR e RT-PCR. Todas as amostras positivas para coronavirus foram caracterizadas por RT-PCR para avaliar a presença de genótipos diferentes de FCoV e CCoV. Todos os produtos de PCR foram visualizados num gel de agarose a 1,5%. Foram encontrados anticorpos contra FIV em 18% das amostras e antigénio de FeLV em 10%. Detectámos ácido nucléico viral em 8.2% das amostras para CDV, 32.7% para CCoV, 59.6% para FPV/CPV a 70% para FCoV. Sete (43.8%) amostras foram positivas para CCoV tipo I, 9 (56.2%) para CCoV tipo II, e em relação ao FCoV, 9 (25,7%), 6 (17%) e 12 (34.3%) amostras foram positivas para FCoV tipo I, tipo II, e para ambos os tipos, respectivamente. Não foi possível obter diferenciação em 8 (23%) das amostras para FCoV. Houve amostras ambientais positivas a CDV (50%), FPV/CPV (62.5%) e FCoV (87.5%). Os resultados deste estudo demonstraram a importância de uma avaliação contínua e mais precisa do estatuto sanitário dos animais errantes ou assilvestrados no canil municipal, principalmente em relação ao parvovirus e ao FCoV, de modo a avaliar correctamente o seu papel de reservatórios de doenças, tanto dentro como fora do canil. A alta prevalência de infecções por coronavirus em cães e gatos no Canil Municipal de Lisboa permitiu a caracterização genética viral, demonstrando uma percentagem elevada de co-infecções com os dois genótipos de FCoV, mas uma ausência de animais co-infectados com CCoV I e II. No entanto, é necessário mais investigação para manter uma vigilância epidemiológica ao nível molecular, de forma a ajudar na identificação de possíveis novas estirpes de coronavirus, assim como compreender o potencial patogénico destes vírus

Influencia de la educación sexual temprana para la prevención del abuso sexual infantil

Being the case that 10% to 20% girls and less than 10% boys are sexually victimize before 18, child sexual abuse must be addressed. Child sexual abuse is a big concern for families and the community and this has to stop. The main purpose for this research is to teach parents how to talk to their children, in order to improve family communication and to prevent child sexual abuse. Parents or caregivers (N=37) between 20 and 42 years old participated in this study, there were 20 females and 17 males and their children between 5 and 12 years old, 18 males and 12 females. For this research, we evaluate the comfort rates when the parents talk to their children between 4 and 13 years old about sexuality before and after they received a sexual education workshop. For this measure we use a paired T-test. The results show that there were significative differences between the comfort rate before and after the workshop (t = -4.07; p ˂ 0,05). The parents showed more discomfort (x = 2,05) before the educational workshop than after (x = 2,91). T-test analyses showed that there were no differences in sex and comfort rates when talking to their children about sexuality (t = 1,27; p ˃ 0,05). Fathers (x = 2,29) as much as mothers (x = 2,35) show discomfort when talking to their children about sexuality before the workshop, and after the workshop there were no differences between fathers and mothers and comfort levels (t = 0,95; p ˃ 0,05), both show less discomfort about talking about sexuality with their children. Results show that early sexual education where parents were involved, improved comfort levels when talking to their children about sexuality, and they achieve positive attitudes towards sexuality and prevention of sexual child abuseTomando en cuenta que, del 10 al 20% de niñas y menos del 10% de niños son abusados sexualmente antes de los 18 años; el abuso sexual infantil es un problema importante a tratar por la comunidad y las familias, es importante tomar medidas para que el abuso sexual cese. El principal propósito de esta investigación es impartir educación sexual para familias con el propósito de mejorar la comunicación entre padres e hijos y prevenir el abuso sexual. La muestra para este estudio consistió en padres de familia (N=37) con un rango de edad de 20 a 42 años; de los cuales, 20 fueron femeninos y 17 masculinos, y sus respectivos hijos (N=30), niños entre las edades de 5 a 12 años; de los cuales, 18 son hombres y 12 mujeres. Este estudio consiste en analizar la diferencia en el nivel de confort que tienen los padres al hablar de sexualidad antes y después de realizar el taller de educación sexual. El análisis evidenció efectivamente existe una diferencia significativa en el nivel de comodidad de los sujetos (t = -4.07; p ˂ 0,05). Los sujetos experimentan incomodidad (x = 2,05) mayormente al hablar con sus hijos de sexualidad mientras que posterior al desarrollo del taller de educación sexual muestran mayor comodidad (x = 2,91). Además, se observó si la variable independiente sexo tiene efecto en el nivel de comodidad que experimentan los padres al hablar sobre sexualidad con sus hijos antes y después de realizado el taller. El análisis T-Test encontró no hay diferencia significativa (t = 1,27; p ˃ 0,05), en el nivel de comodidad de los padres antes de la realización del taller mostró que de tal forma que tanto las mujeres (x = 2,35) así como los hombres (x = 2,29) mostraron incomodidad al hablar de sexualidad con sus hijos. Tanto las mujeres (x = 3,00) como los hombres (x = 2,82) mostraron mayor comodidad al abordar el tema de sexualidad con sus hijos posterior a asistir al taller de educación sexual para niños y sus familias. Se debe aclarar que la información referente a los resultados fue realizada conjuntamente con Fernanda Duque para este estudio. Los resultados sugieren que la educación sexual temprana impartida a los padres, aumenta los niveles de comodidad para hablar sexualidad con los hijos. De esta manera, se puede lograr cambios en la actitud hacia la sexualidad y la prevención del abuso sexual

Sugammadex un cambio en la anestesiología

La relajación neuromuscular es uno de los cuatro componentes fundamentales en Anestesia General, dependiendo del procedimiento quirúrgico se amerita diferentes grados. El rocuronio un fármaco relajante neuromuscular no despolarizante esteroideo de acción intermedia tiene un perfil favorable por su latencia corta y un perfil de seguridad aceptable, sin embargo la finalización de su efecto no es controlable. El descubrimiento de sugammadex ha cambiado este factor y a su vez el manejo anestésico, de manera dosis dependiente nos permite revertir desde el grado moderado hasta el intenso y gracias a la monitorización con aceleromiografía tenemos gran seguridad como se ha evidenciado en RCTs y metanálisis. El rocuronio nos permite realizar inducción de secuencia rápida equiparable a la succinilcolina y ahora el sugammadex disminuye el riesgo que se tenía previamente de relajación residual y ventilación mecánica prolongada. Es de importancia recalcar su aplicación en paciente obstétricas, ancianos, patologías neuromusculares y como se va evidenciando en pacientes con insuficiencia renal y población pediátrica

Monitoring psychological factors when using “reading to speak” strategies to prevent development of mute english phenomenon in efl classrooms

Supervise changes to psychological factors when applying “Reading to Speak strategies” to avoid the development of the Mute English Phenomenon in an EFL classroom.Motivación, ansiedad y auto estima son factores psicológicos que generan el fenómeno de “Inglés Silencioso” en las clases de idioma extranjero. Esta investigación presenta una guía paso a paso para incluir estrategias de “Reading to Speak” que permitan prevenir el Fenómeno de “Inglés Silencioso” en las clases de inglés como lengua extranjera. Este estudio fue aplicado a estudiantes que se encuentran cursando el último año escolar en una institución de nivel secundario; y sus maestros también participaron a fin de poder recolectar evidencia de las prácticas docentes utilizadas para desarrollar la producción oral en ese idioma. Se aplicó un enfoque de investigación mixto con la finalidad de obtener resultados cuantitativos, primero; y, luego cualitativos, y combinados, alcanzar resultados vívidos, prominentes y confiables. Además, se siguió un diseño investigativo secuencial, descriptivo, no experimental. La propuesta de esta investigación estuvo enfocada a la obtención de consecuencias positivas del uso de una variedad de actividades académicas que incrementen el interés de los estudiantes por alcanzar su objetivo principal de aprender el idioma extranjero, y ser capaces de convertirse en usuarios eficientes e independientes de dicho idioma, mediante el correcto desarrollo de las habilidades orales del inglés.Maestrí