Assessment of the adhesion of dentists and students of dentistry to the protocol of infection control in the practice of oral radiology

Orientador: Gláucia Maria Bovi AmbrosanoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Nas radiografias intrabucais é frequente o contato com saliva dos pacientes, sendo que a preocupação com a contaminação existe pelo fato da saliva ser um meio condutor dos microrganismos presentes na cavidade bucal. Assim, é importante que os profissionais sigam corretamente os protocolos de controle de infecção para evitar a contaminação cruzada da equipe odontológica e dos pacientes. Entretanto, pouco se conhece sobre a adesão dos dentistas aos protocolos de controle de infecção em Radiologia Odontológica. O objetivo desse estudo foi avaliar a adesão de dentistas e estudantes de Odontologia ao protocolo de controle de infecção na prática de Radiologia Odontológica. Para a realização deste estudo, foram selecionados 2209 participantes, onde 1006 eram dentistas e 1203 eram estudantes de Odontologia, os quais responderam um questionário sobre controle de infecção em radiologia odontológica (QICOR) previamente validado. Esse questionário, era composto por 14 questões de múltipla escolha relacionadas ao controle de infecção e dividido em 9 domínios (lavagem das mãos, luvas, vestimenta, acessórios, receptores radiográficos, proteção/desinfecção do equipamento radiográfico, situações em que as sobre-luvas são utilizadas no equipamento radiográfico/cadeira do paciente e no filme radiográfico, situações em que as sobre-luvas são utilizadas especificamente no sistema radiográfico digital, e limpeza e desinfecção). A partir da mediana dos escores total dos questionários, os participantes foram separados em dois grupos (baixa e alta adesão ao controle de infecção). Utilizou-se modelos de regressão logística para analisar a associação entre a adesão (baixa e alta) e cada variável independente, estimando-se os odds ratios brutos com os respectivos intervalos de 95% de confiança. As variáveis com p0,05). Também não houve diferenças entre radiologistas e dentistas de outras especialidades clínicas (p>0,05). Os estudantes do último ano da graduação em Odontologia apresentam 1,70 (IC95%: 1,13-2,57) vezes mais chances de ter menor adesão ao controle da infecção (p?0,05) quando comparados com os estudantes do segundo ano. Além disso, para a amostra de estudantes, não houve associação significativa com relação a sexo, idade e escolas públicas ou privadas (p>0,05). Em conclusão, verificou-se que dentistas do sexo masculino e alunos do último ano do curso de graduação em Odontologia apresentaram menores chance de adesão ao controle de infecção em Radiologia OdontológicaAbstract: In intraoral radiographs, contact with patients' saliva is frequent, and the concern with contamination is due to saliva being a conductive medium of the microorganisms present in the oral cavity. Thus, it is important for dentists to correctly follow infection control protocols to avoid cross-contamination of the dental team and patients. However, little is known about the dentists' adherence to infection control protocols in Oral Radiology. The objective of this study was to assessment the adhesion of dentists and students of the dentistry to the infection control protocol in the practice of Oral Radiology. For this study, 2209 participants were selected, where 1006 were dentists and 1203 were students of the dentistry, who answered a questionnaire about infection control in dental radiology (QICOR) previously validated. This questionnaire was composed of 14 multiple choice questions related to infection control and divided into 9 domains (handwashing, gloves, clothing, accessories, radiographic receivers, protection/disinfection of radiographic equipment, situations where the overgloves are used in the radiographic equipment/patient's chair and radiographic film, situations where the overgloves are used specifically in the digital radiographic system, and cleaning and disinfection). From the median of the total scores of the questionnaires, the participants were separated into two groups (low and high adherence to infection control). Logistic regression models were used to analyze the association between the adhesion (low and high) and each independent variable, estimating the crude odds ratios with the respective 95% confidence intervals. The variables with p 0.05). There were also no differences among radiologists and dentists of other clinical specialties (p> 0.05). The students of the last year of the course of the Dentistry presented 1.70 (95% CI: 1.13-2.57) more chances of lower adherence to infection control (p?0, 05) when compared to students of the second year. In addition, for the sample of students, there was no significant association with sex, age, and public or private schools (p>0.05). In conclusion, it was verified that male dentists and students of the last year of the undergraduate course in Dentistry had a lower chance of adherence to infection control in Oral RadiologyDoutoradoRadiologia OdontologicaDoutora em Radiologia OdontológicaCAPE

Interprofessional education in Brazil: Building synergic networks of educational and healthcare processes

Univ Fed Rio Grande do Norte, Escola Multicampi Ciencias Med, Caico, BrazilUniv Fed Sao Paulo, Dept Saude Educ & Soc, Santos, BrazilPontificia Univ Catolica Rio Grande do Sul, Fac Serv Social, Porto Alegre, RS, BrazilUniv Fed Minas Gerais, Dept Fisioterapia, Belo Horizonte, MG, BrazilUniv Estado Rio Grande do Norte, Dept Enfermagem, Campus Profa Maria Elisa de Albuquerque Maia, BR-59900000 Pau Dos Ferros, BrazilUniv Estadual Paulista, Fac Med Botucatu, Dept Saude Publ, Botucatu, SP, BrazilUniv Sao Paulo, Escola Enfermagem, Sao Paulo, BrazilUniv Kingston, Ctr Hlth & Social Care Res, London, EnglandUniv London, London, EnglandUniv Fed Sao Paulo, Dept Saude Educ & Soc, Santos, BrazilWeb of Scienc

Fatores associados à utilização de práticas de governo eletrônico: uma pesquisa aplicada a servidores públicos

This research aimed to verify the determining factors for using e-government practices from the perception of civil servants. We used a questionnaire with a five-point Likert scale to conduct the study. Data were analyzed using descriptive statistics, confirmatory factor analysis, and multiple linear regression, which evaluated five research hypotheses. The study sample included 206 federal and state civil servants from the Northeast region of Brazil. We confirmed that expectation of effort and performance, facilitating conditions, and social inclusion influence the intention to use e-government. At the same time, the hypothesis of innovative capacity was refuted, warning that servants do not need to have an entrepreneurial profile to adopt modern practices. Moreover, we found that the social influence factor is the one that has the most significant power of positive influence on the intent to use, demonstrating that the environment in which they live encourages the use of electronic practices.A pesquisa objetivou verificar os fatores determinantes para a utilização de práticas de governo eletrônico, perante a percepção dos servidores públicos. Para a realização do estudo, foi utilizado um questionário com escala de avaliação Likert de cinco pontos. Os dados foram analisados através da estatística descritiva, análise fatorial confirmatória e regressão linear múltipla, que avaliou 5 hipóteses de pesquisa. A amostra do estudo contou com 206 servidores federais e estaduais da região nordeste do Brasil. Foi confirmado que expectativa de esforço e desempenho, condições facilitadoras e inclusão social são aspectos que influenciam na intenção de uso do governo eletrônico, já a hipótese da capacidade inovadora foi refutada, alertando que o servidor não precisa ter um perfil empreendedor para adotar práticas modernas. Ainda, constatou-se que o fator da influência social é o que apresenta maior poder de influência positiva sobre a intenção de uso, demonstrando que o meio em que vive incentiva o uso de práticas eletrônicas.La investigación tuvo como objetivo verificar los factores determinantes para el uso de prácticas de gobierno electrónico, frente a la percepción de los servidores públicos. Para llevar a cabo el estudio se utilizó un cuestionario con una escala tipo Likert de cinco puntos. Los datos fueron analizados mediante estadística descriptiva, análisis factorial confirmatorio y regresión lineal múltiple, que evaluó 5 hipótesis de investigación. La muestra del estudio incluyó 206 funcionarios públicos federales y estatales de la región noreste de Brasil. Se confirmó que la expectativa de esfuerzo y desempeño, las condiciones facilitadoras y la inclusión social son aspectos que influyen en la intención de utilizar el gobierno electrónico, mientras que se refutó la hipótesis de capacidad innovadora, advirtiendo que el servidor no necesita tener un perfil emprendedor para adoptar practicas Aun así, se encontró que el factor influencia social es el que tiene mayor poder de influencia positiva sobre la intención de uso, demostrando que el entorno en el que viven incentiva el uso de prácticas electrónicasRevista do Serviço Público - RSP, v. 74, n. 3, 677-702 p.Gestão PúblicaISSN Impresso: 0034-9240ISSN Eletrônico: 2357-801

Estimating the global conservation status of more than 15,000 Amazonian tree species

Estimates of extinction risk for Amazonian plant and animal species are rare and not often incorporated into land-use policy and conservation planning. We overlay spatial distribution models with historical and projected deforestation to show that at least 36% and up to 57% of all Amazonian tree species are likely to qualify as globally threatened under International Union for Conservation of Nature (IUCN) Red List criteria. If confirmed, these results would increase the number of threatened plant species on Earth by 22%. We show that the trends observed in Amazonia apply to trees throughout the tropics, and we predict thatmost of the world’s >40,000 tropical tree species now qualify as globally threatened. A gap analysis suggests that existing Amazonian protected areas and indigenous territories will protect viable populations of most threatened species if these areas suffer no further degradation, highlighting the key roles that protected areas, indigenous peoples, and improved governance can play in preventing large-scale extinctions in the tropics in this century

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geographic patterns of tree dispersal modes in Amazonia and their ecological correlates

Aim: To investigate the geographic patterns and ecological correlates in the geographic distribution of the most common tree dispersal modes in Amazonia (endozoochory, synzoochory, anemochory and hydrochory). We examined if the proportional abundance of these dispersal modes could be explained by the availability of dispersal agents (disperser-availability hypothesis) and/or the availability of resources for constructing zoochorous fruits (resource-availability hypothesis). Time period: Tree-inventory plots established between 1934 and 2019. Major taxa studied: Trees with a diameter at breast height (DBH) ≥ 9.55 cm. Location: Amazonia, here defined as the lowland rain forests of the Amazon River basin and the Guiana Shield. Methods: We assigned dispersal modes to a total of 5433 species and morphospecies within 1877 tree-inventory plots across terra-firme, seasonally flooded, and permanently flooded forests. We investigated geographic patterns in the proportional abundance of dispersal modes. We performed an abundance-weighted mean pairwise distance (MPD) test and fit generalized linear models (GLMs) to explain the geographic distribution of dispersal modes. Results: Anemochory was significantly, positively associated with mean annual wind speed, and hydrochory was significantly higher in flooded forests. Dispersal modes did not consistently show significant associations with the availability of resources for constructing zoochorous fruits. A lower dissimilarity in dispersal modes, resulting from a higher dominance of endozoochory, occurred in terra-firme forests (excluding podzols) compared to flooded forests. Main conclusions: The disperser-availability hypothesis was well supported for abiotic dispersal modes (anemochory and hydrochory). The availability of resources for constructing zoochorous fruits seems an unlikely explanation for the distribution of dispersal modes in Amazonia. The association between frugivores and the proportional abundance of zoochory requires further research, as tree recruitment not only depends on dispersal vectors but also on conditions that favour or limit seedling recruitment across forest types

Mapping density, diversity and species-richness of the Amazon tree flora

Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.Publisher PDFPeer reviewe