32 research outputs found

    Accuracy of the Simplified Thylstrup & Fejerskov Index in Rural Communities with Endemic Fluorosis

    Get PDF
    The aim of the present study was to compare the values of the Thylstrup & Fejerskov Index (TF index) for the determination of the prevalence of dental fluorosis using either all teeth (gold standard) or six upper anterior teeth (simplified TF index). The sample was made up of 396 individuals aged six to 22 years from three Brazilian cities with endemic fluorosis caused by the ingestion of water with high fluoride concentration. The prevalence of dental fluorosis was evaluated by a single trained examiner with excellent intraexaminer agreement (kappa = 0.95). Intraexaminer reproducibilities were calculated at tooth level. Sensitivity, specificity, positive and negative predictive values of the simplified TF compared to gold standard were 90.6 (95%CI: 86.6 to 93.6), 100 (95%CI: 95.3 to 100), 100 (95%CI: 98.3 to 100) and 77.5 (95%CI: 69.8 to 83.5), respectively. The ROC value was 0.953 (95%CI: 0.933 to 0.973). The simplified TF index proved suitable for determining the prevalence of dental fluorosis in regions with endemic fluorosis caused by the ingestion of water with high concentrations of fluoride

    “When a Tihik drinks kaxmuk he neither has a father, nor a mother, or a brother” : perceptions of Maxakali on the effects of sugarcane liquor consumption

    Get PDF
    Este artigo explora um dos aspectos mais interessantes e menos estudados no Brasil: as consequĂȘncias das experiĂȘncias complexas e contraditĂłrias da substituição total de bebidas tradicionais indĂ­genas pela cachaça, introduzida pelo contato interĂ©tnico. Contribui com a carĂȘncia de ampliação de estudos na temĂĄtica, analisando as consequĂȘncias negativas do uso de ĂĄlcool Maxakali. Enquanto estudos antropolĂłgicos enfatizam funçÔes do beber tradicional e contemporĂąneo como “lubrificantes” sociais, as percepçÔes sociais Maxakali ressaltam consequĂȘncias negativas do uso da cachaça vendida ou trocada no contato interĂ©tnico. Interpretou-se no cotidiano, sĂ­mbolos e significados dessas consequĂȘncias, narradas por 21 lideranças em grupos focais. Com a substituição da Kaxmuk pelos Maxakali, ocorreram adaptaçÔes surgidas pelo contato interĂ©tnico, com relaçÔes negativas para quem bebe, suas famĂ­lia, aldeia e comunidade. No mundo-da-vida, as consequĂȘncias negativas apresentaram-se em forma de acidentes, desarmonias conjugais, negligĂȘncias, alĂ©m de comportamentos violentos, doenças e mortes. Este estudo reforça a importĂąncia de produção de conhecimentos aprofundados e abrangentes visando a identificação de grupos vulnerĂĄveis em busca de soluçÔes participantes.This study explores one of the most interesting and least studied issues in Brazil: the consequences of complex and contradictory experiences by replacing the traditional drinks by cachaça, introduced through interethnic contact. Given the rarity of the study of Maxakali alcohol consumption in research, this study aims to understand, from the native’s point of view, the negative aftereffect of alcohol consumption. Although anthropological studies emphasize functions of traditional and contemporary drinking as social “lubricants”, social perceptions of the Maxakali highlight the problems of cachaça bought through interethnic contact. Symbols and meanings of these consequences were interpreted through their daily life histories, recorded by 21 leaders in focus group. Through the interethnic contact, some adaptations have occurred in the Maxakali alcohol use, with negative consequences for those who drink, their families, their villages and their community. In the world-of-life, these changes these changes can be seen through accidents, insults, marital disharmony, neglects, violent behavior, illness and death. This study’s findings highlight the importance of producing comprehensive and in-depth knowledge in search of to identify vulnerable groups and to develop participatory solutions

    Factors Associated to Endemic Dental Fluorosis in Brazilian Rural Communities

    Get PDF
    The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The Thystrup & Fejerskov index was employed by a single examiner for the diagnosis of dental fluorosis. A sampling campaign of deep groundwater in the rural communities of interest was carried out concomitantly to the epidemiological survey for the determination of physiochemical parameters. Multilevel modeling of 276 individuals from seven rural communities was achieved using the non-linear logit link function. Parameters were estimated using the restricted maximum likelihood method. Analysis was carried out considering two response variables: presence (TF 1 to 9) or absence (TF = 0) of any degree of dental fluorosis; and presence (TF ≄ 5—with loss of enamel structure) or absence of severe dental fluorosis (TF ≀ 4—with no loss of enamel structure). Hydrogeological analyses revealed that dental fluorosis is influenced by the concentration of fluoride (OR = 2.59 CI95% 1.07–6.27; p = 0.073) and bicarbonate (OR = 1.02 CI95% 1.01–1.03; p = 0.060) in the water of deep wells. No other variable was associated with this prevalence (p > 0.05). More severe dental fluorosis (TF ≄ 5) was only associated with age group (p < 0.05). No other variable was associated to the severe dental fluorosis (p > 0.05). Dental fluorosis was found to be highly prevalent and severe. A chemical element besides fluoride was found to be associated (p > 0.05) to the prevalence of dental fluorosis, although this last finding should be interpreted with caution due to its p value
    corecore