Tag: pubmed

Fam Med. 2021 Apr;53(4):256-266. doi: 10.22454/FamMed.2021.406778.

ABSTRACT

BACKGROUND AND OBJECTIVES: The feasibility of funding an additional year of residency training is unknown, as are perspectives of residents regarding related financial considerations. We examined these issues in the Family Medicine Length of Training Pilot.

METHODS: Between 2013 and 2019, we collected data on matched 3-year and 4-year programs using annual surveys, focus groups, and in-person and telephone interviews. We analyzed survey quantitative data using descriptive statistics, independent samples t test, Fisher’s Exact Test and χ2. Qualitative analyses involved identifying emergent themes, defining them and presenting exemplars.

RESULTS: Postgraduate year (PGY)-4 residents in 4-year programs were more likely to moonlight to supplement their resident salaries compared to PGY-3 residents in three-year programs (41.6% vs 23.0%; P=.002), though their student debt load was similar. We found no differences in enrollment in loan repayment programs or pretax income. Programs’ descriptions of financing a fourth year as reported by the program director were limited and budget numbers could not be obtained. However, programs that required a fourth year typically reported extensive planning to determine how to fund the additional year. Programs with an optional fourth year were budget neutral because few residents chose to undertake an additional year of training. Resources needed for a required fourth year included resident salaries for the fourth year, one additional faculty, and one staff member to assist with more complex scheduling. Residents’ concerns about financial issues varied widely.

CONCLUSIONS: Adding a fourth year of training was financially feasible but details are local and programs could not be compared directly. For programs that had a required rather than optional fourth year much more financial planning was needed.

PMID:33887047 | DOI:10.22454/FamMed.2021.406778

J Appl Oral Sci. 2021 Apr 19;29:e20200799. doi: 10.1590/1678-7757-2020-0799. eCollection 2021.

ABSTRACT

OBJECTIVES: This study aimed to investigate patterns and risk factors related to the feasibility of achieving technical quality and periapical healing in root canal non-surgical retreatment, using regression and data mining methods.

METHODOLOGY: This retrospective observational study included 321 consecutive patients presenting for root canal retreatment. Patients were treated by graduate students, following standard protocols. Data on medical history, diagnosis, treatment, and follow-up visits variables were collected from physical records and periapical radiographs and transferred to an electronic chart database. Basic statistics were tabulated, and univariate and multivariate analytical methods were used to identify risk factors for technical quality and periapical healing. Decision trees were generated to predict technical quality and periapical healing patterns using the J48 algorithm in the Weka software.

RESULTS: Technical outcome was satisfactory in 65.20%, and we observed periapical healing in 80.50% of the cases. Several factors were related to technical quality, including severity of root curvature and altered root canal morphology (p<0.05). Follow-up periods had a mean of 4.05 years. Periapical lesion area, tooth type, and apical resorption proved to be significantly associated with retreatment failure (p<0.05). Data mining analysis suggested that apical root resorption might prevent satisfactory technical outcomes even in teeth with straight root canals. Also, large periapical lesions and poor root filling quality in primary endodontic treatment might be related to healing failure.

CONCLUSION: Frequent patterns and factors affecting technical outcomes of endodontic retreatment included root canal morphological features and its alterations resulting from primary endodontic treatment. Healing outcomes were mainly associated with the extent of apical periodontitis pathological damages in dental and periapical tissues. To determine treatment predictability, we suggest patterns including clinical and radiographic features of apical periodontitis and technical quality of primary endodontic treatment.

PMID:33886941 | DOI:10.1590/1678-7757-2020-0799

J Appl Oral Sci. 2021 Apr 14;29:e20200978. doi: 10.1590/1678-7757-2020-0978. eCollection 2021.

ABSTRACT

Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases.

OBJECTIVES: To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals.

METHODOLOGY: A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher’s exact test and chi-square test (p<0.05).

RESULTS: For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals.

CONCLUSION: The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals.

PMID:33886944 | DOI:10.1590/1678-7757-2020-0978

Epidemiol Serv Saude. 2021 Apr 16;30(1):e2020835. doi: 10.1590/S1679-49742021000100030. eCollection 2021.

ABSTRACT

OBJECTIVE: To define the list of priority congenital anomalies for improving their recording on the Brazilian Live Birth Information System (Sinasc).

METHODS: Based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), international protocols and meetings with specialists, the list of priority anomalies was built considering two main criteria: being diagnosable at birth and having intervention available at different levels. The list was submitted for consideration by the Brazilian Medical Genetics and Genomics Society.

RESULTS: The list comprised eight groups of congenital anomalies distributed according to the type of related anomaly, as well as the affected part of the body and its corresponding code in ICD-10 Chapter XVII.

CONCLUSION: The list of priority congenital anomalies for notification provides a basis for improving case recording on Sinasc.

PMID:33886939 | DOI:10.1590/S1679-49742021000100030

Rev Gaucha Enferm. 2021 Mar 12;42:e20200088. doi: 10.1590/1983-1447.2021.20200088. eCollection 2021.

ABSTRACT

OBJECTIVE: To identify the attitudes of nurses working in Primary Health Care towards the person with mental disorder and the variables related to health care provided.

METHODOLOGY: Descriptive, correlational study with 250 nurses from 69 Basic Health Units in the city of São Paulo. Data collection took place between April and August 2019 using the “Opinions about Mental Illness” scale. The data were analyzed using the KrusKal-Wallis test, with a 95% confidence level and statistical significance of p <0.05.

RESULTS: The global mean of the scale was 197, which shows negative attitudes especially in the dimensions of Authoritarianism (44.6), Social Restriction (42.0), and positive in the dimension of Benevolence (51.7).

CONCLUSION: Nurses tend to have a stigmatizing attitudinal profile. It is necessary formative and permanent intervention so that it is possible to reduce stigma and improve community-based care recommended in the guidelines of the Psychosocial Care Network.

PMID:33886923 | DOI:10.1590/1983-1447.2021.20200088

Rev Bras Enferm. 2021 Apr 9;74(1):e20200731. doi: 10.1590/0034-7167-2020-0731. eCollection 2021.

ABSTRACT

OBJECTIVES: to identify and map the invasive procedures performed by nursing that can cause Healthcare-Associated Infections in patients in Intensive Care Units.

METHODS: this is a scoping review carried out in the first half of 2018, based on search for studies in national and international databases, in which 2,209 studies were found, of which 35 constituted the final sample. The data were analyzed and organized by simple descriptive statistics.

RESULTS: among the invasive procedures performed by nursing that provide Healthcare-Associated Infections, delayed bladder catheter was indicated in 34 (66.67%) studies, the nasogastric catheter in 10 (19.61%) and the nasoenteral catheter in two (03.92%).

CONCLUSIONS: in the face of such problems, better nursing planning and guidance for care in these invasive techniques becomes relevant and thus minimizes the incidence of infections.

PMID:33886931 | DOI:10.1590/0034-7167-2020-0731

Rev Esc Enferm USP. 2021 Apr 16;55:e03679. doi: 10.1590/S1980-220X2019023003679. eCollection 2021.

ABSTRACT

OBJECTIVE: To evaluate telephone monitoring for symptoms, quality of life, distress, admissions to the emergency center and the satisfaction of cancer patients undergoing esophagectomy and gastrectomy.

METHOD: Randomized controlled study in two groups, carried out at the Cancer Institute of the State of Sao Paulo; the intervention group received telephone monitoring for four moments after the surgery, while the control group received only institutional care.

RESULTS: Of the 81 patients evaluated, the domain most affected by quality of life was social relationships domain. Distress had no significant difference between groups and moments. In both groups, admissions to the emergency center were similar (p=0.539). Pain was the most reported symptom in telephone monitoring. There was statistical significance regarding patient satisfaction with monitoring (p=0.002).

CONCLUSION: Telephone monitoring provided greater patient satisfaction in the intervention group, demonstrating the real impact of this process on the care of cancer patients.

PMID:33886909 | DOI:10.1590/S1980-220X2019023003679

Rev Gaucha Enferm. 2021 Mar 12;42:e20190406. doi: 10.1590/1983-1447.2021.20190406. eCollection 2021.

ABSTRACT

OBJECTIVE: To investigate workplace violence against nursing professionals, its relationship with personal, health and work variables, and to know possibilities for prevention.

METHOD: Descriptive and cross-sectional study, with quantitative approach, conducted with 267 nursing professionals from urgency and emergency units between 2015 and 2017. The Questionnaire of socio-demographic, life style and work and health aspects and Questionnaire on Workplace violence collected data, after submitted to statistical analysis.

RESULTS: 61.6% reported having been victims of verbal abuse, sexual harassment, or physical violence at work in the last 12 months. Statistically significant relationships were identified between suffering or not violence and personal, health and work variables. Possibilities for prevention were revealed and constituted a multidimensional model.

CONCLUSION: More than half of the sample reported having suffered workplace violence in the previous year, and possibilities of how to avoid it were revealed to support prevention protocols.

PMID:33886920 | DOI:10.1590/1983-1447.2021.20190406

Rev Bras Epidemiol. 2021 Apr 16;24(suppl 1):e210020. doi: 10.1590/1980-549720210020.supl.1. eCollection 2021.

ABSTRACT

OBJECTIVES: To analyze the prevalence at birth and the spatial and temporal distribution of congenital anomalies (CAs) among live births in the state of Maranhão in 2001 to 2016. To describe demographic, gestational and neonatal variables of interest.

METHODS: Ecological, population-based study, using secondary data from the Live Birth Information System (SINASC). Annual prevalence of total and per-group CAs was calculated. Spatial analyzes were based on the Local Indicators of Spatial Association (LISA) and the Moran I Index, and interactive maps were generated. Demographic, gestational and neonatal variables of interest available from SINASC were described in the group of newborns with CAs.

RESULTS: 1,831,830 live births, 6,110 with CAs (33.4/10,000) were included. Higher frequencies occurred in more recent years. Spatial clusters have been observed in specific years. The prevalence of newborns with CAs was different between categories of variables considered as risk factors for this outcome.

CONCLUSION: The prevalence at birth of total CAs was lower than expected for major human defects (3%). The temporal peak of records in 2015/2016 is probably related to the increase in CAs caused by gestational infection by the Zika virus. The spatial clusters were probably due to variations at random due to the small number of births as they are not repeated in other years. Studies like this are the basis for the establishment of CA surveillance programs.

PMID:33886893 | DOI:10.1590/1980-549720210020.supl.1

Rev Esc Enferm USP. 2021 Apr 16;55:e03669. doi: 10.1590/S1980-220X2019011803669. eCollection 2021.

ABSTRACT

OBJECTIVE: To map and analyze the knowledge produced about strategies aimed at promoting support to health professionals in the condition of second victim.

METHOD: Scoping review, developed in portals, databases and academic websites, whose inclusion criteria were articles and materials indexed in the respective search sites, between January 2000 and December 2019, in Portuguese, English and Spanish. The findings were summarized and analyzed based on descriptive statistics and narrative synthesis.

RESULTS: A total of 64 studies were included, 100% international; 92.2% in English and 50% from secondary research. The support strategies were grouped into four categories and most of the studies referred to the use of the forYOU, Medically Induced Trauma Support Services and Resilience in Stressful Events programs and the interventions represented, through dialogue with peers, family, friends and managers.

CONCLUSION: Support strategies for the second victim are pointed out in international studies and mostly developed through programs/services and interventions. It is recommended to develop studies to learn about the phenomenon and to structure feasible support strategies in Brazilian health organizations.

PMID:33886900 | DOI:10.1590/S1980-220X2019011803669