Clinical efficacy of periodontal endoscopy-assisted subgingival scaling and root planning and its effect on psychology and quality of life in patients with periodontitis / 口腔疾病防治

Objective@#To investigate the clinical efficacy and effects of periodontal endoscope (PE)-assisted subgingival scaling and root planning (SRP) and traditional SRP on the psychological and quality of life of patients with periodontitis.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Patients with periodontitis who were treated in the Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University from April 2018 to December 2022 with residual periodontal pockets (PD ≥ 5 mm) 6 weeks after traditional SRP treatment were enrolled, and the residual periodontal pockets were further treated with PE-assisted SRP (PE+SRP). After 6 weeks of traditional SRP treatment and 3 months of PE+SRP treatment, clinical indicators, including plaque index (PLI), probing depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP), were measured, and periodontal tissue self-awareness scale scores, oral health impact profile-14 (OHIP-14) score and dental fear scale (DFS) score were collected. Moreover, visual analog scale (VAS) scores were collected after traditional SRP and PE-assisted SRP treatments.@*Results@#Twenty-three patients with periodontitis, including 832 sites of 486 affected teeth, were included in the clinical study. Three months after PE+SRP treatment, all clinical periodontal indicators, PLI (t = 9.254, P<0.001), PD (t = 50.724, P<0.001), CAL (t = 22.407, P<0.001) and BOP (t = 9.217, P<0.001), were significantly improved. Compared with traditional SRP (VAS: 2.48 ± 1.70), the pain caused by PE+SRP (VAS: 2.57±1.80) was not significantly different (t = 0,192, P = 0.850). There was no significant difference in the scores of the periodontal tissue self-awareness scale between the two groups (t = 1.485, P = 0.152). The OHIP-14 (SRP: 12.13±7.63; PE+SRP: 10.26 ± 5.25, t = -1.589, P = 0.126) and DFS (SRP: 40.70 ± 12.63; SRP+PE: 41.57 ± 12.61, t = 0.404, P = 0.690) scores were not significantly different.@*Conclusion@#All clinical periodontal indicators were significantly improved after PE-assisted SRP treatment of residual periodontal pockets, and compared with traditional SRP, PE-assisted SRP had no negative impact on the quality of life or psychological status of patients with periodontitis. Therefore, PE+SRP can be promoted in clinical practice.

Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil / Impacto de uma pesquisa-ação nos indicadores vacinais em Minas Gerais

ABSTRACT OBJECTIVE Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS). METHODS The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test. RESULTS All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%. CONCLUSIONS Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.

RESUMO OBJETIVO Analisar o impacto do projeto estadual de pesquisa-ação nos indicadores de imunização (coberturas vacinais - CV, homogeneidade de cobertura vacinal - HCV, taxa de abandono - TA e classificação de risco) antes e após a intervenção em municípios e Gerências Regionais de Saúde/Superintendências Regionais de Saúde (GRS/SRS) prioritários. MÉTODOS O projeto estadual de pesquisa-ação foi um ensaio clínico comunitário, do tipo antes-depois, realizado em 212 municípios pertencentes a oito GRS/SRS do estado de Minas Gerais, Brasil. Compuseram a amostra do estudo as SRS/GRS com tendência decrescente para a cobertura vacinal de rotina em crianças menores de 1 ano, no período de 2015 a 2020. Neste estudo, foram utilizados dados secundários de CV e TA de 10 imunobiológicos recomendados para crianças menores de 2 anos, no período de janeiro a dezembro de 2021 (período pré-intervenção, anterior ao projeto estadual de pesquisa-ação) e de janeiro a dezembro de 2022 (período pós-intervenção). As variáveis categóricas foram apresentadas em proporções e, inicialmente, realizou-se a comparação entre as de TA, HCV e a classificação de risco para a transmissão de doenças imunopreveníveis, segundo os dois períodos (2021 e 2022), utilizando-se o teste McNemar. RESULTADOS Observou-se um aumento de todos os indicadores de imunização após a realização do projeto de pesquisa-ação. No ano de 2021, 80,66% dos municípios do estado tiveram a classificação de risco para transmissão de doenças imunopreveníveis como "alto e muito alto risco". Em 2022, o valor foi reduzido para 68,40%. CONCLUSÕES A classificação de risco para transmissão de doenças imunopreveníveis é um mecanismo importante para auxiliar os gestores na definição de prioridades. O projeto estadual de pesquisa-ação empregou um método que possibilitou a construção e a execução de planos de ação singulares a cada município, direcionando a melhoria dos indicadores de imunização no estado.

Avaliação do impacto da implantação do novo sistema de informações da atenção primária à saúde nos registros de atendimentos e visitas domiciliares no Brasil / Evaluation of the impact of the implementation of the new primary health care information system on records of patient care and home visits in Brazil / Evaluación del impacto de la implantación del nuevo sistema de informaciones de la atención primaria de salud en los registros de atención y visitas domiciliarias en Brasil

Resumo: A substituição do Sistema de Informação da Atenção Básica (SIAB, 1998-2015), a partir de janeiro de 2016, pelo novo Sistema de Informação em Saúde para a Atenção Básica (SISAB) determinou novas formas de coleta, processamento e uso das informações, com possível impacto nos registros das atividades desenvolvidas na atenção primária à saúde no Brasil. O objetivo deste estudo foi avaliar o impacto da implantação do novo sistema de informação sobre registros de atendimentos de médicos e enfermeiros, e de visitas domiciliares de agentes comunitários de saúde (ACS) brasileiros entre 2007 e 2019. Para tal, utilizou-se uma abordagem bayesiana de modelo estrutural para séries temporais, com base em uma regressão difusa de espaço-estado. Ao longo do período de 2016 a 2019, foram registrados 463,47 milhões de atendimentos médicos, 210,61 milhões de atendimentos de enfermagem e 1,28 bilhão de visitas de ACS. Seguindo a tendência registrada antes da implantação, seriam esperados 598,86 milhões, 430,46 milhões e 1,5 bilhão de atendimentos de médicos, enfermeiros e visitas de ACS, respectivamente. Em termos relativos, houve um decréscimo de 25% nos atendimentos médicos, 51% nos atendimentos de enfermagem e 15% nas visitas de ACS quando comparado com o valor esperado pelo método bayesiano. O impacto negativo no registro de atendimentos e de visitas domiciliares identificado neste estudo, seja por dificuldade de adaptação ao novo sistema, seja por diminuição de registros indevidos, merece ser alvo de investigação para que se possa, de forma planejada, compreender e superar o desafio da melhoria do sistema de informação da atenção primária.

Abstract: The replacement of the Primary Care Information System (SIAB, 1998-2015), as of January 2016, by the new Health Information System for Primary Care (SISAB) determined new forms of collecting, processing, and using information, with a possible impact on the records of activities carried out in primary health care in Brazil. This study aimed to evaluate the implementation impact of the new information system on records of physicians' and nurses' patient care and home visits of community health workers (CHW) in Brazil from 2007 to 2019. To this end, a Bayesian structural time-series model approach was used, based on a diffuse state-space regression. From 2016 to 2019, 463.47 million physician care, 210.61 million nursing care, and 1.28 billion CHW visits were recorded. Following the trend recorded before the implementation, 598.86 million, 430.46 million, and 1.5 billion physician and nursing appointments and CHW visits would be expected, respectively. In relative terms, there was a decrease of 25% in physician care, 51% in nursing care, and 15% in CHW visits when compared to the value expected by the Bayesian method. The negative impact on the records of patient care and home visits identified in this study, whether due to difficulties in adapting to the new system or a reduction in improper records, must be investigated so that the challenge of improving the primary care information system can be understood and overcome in a planned way.

Resumen: La sustitución del Sistema de Información de la Atención Básica (SIAB, 1998-2015), desde enero de 2016, por el nuevo Sistema de Información en Salud para la Atención Básica (SISAB) estableció nuevas maneras para recolectar, procesar y utilizar las informaciones, con posibles impactos en los registros de las actividades desarrolladas en la atención primaria de salud en Brasil. El objetivo de este estudio fue evaluar el impacto de la implantación del nuevo sistema de información sobre los registros de atención de médicos y enfermeros y de visitas domiciliarias de agentes comunitarios de salud (ACS) en Brasil entre 2007 y 2019. Para eso, se utilizó un enfoque bayesiano de modelo estructural para series temporales basadas en una regresión difusa de espacio de estado. Entre los años 2016 y 2019, se registraron 463,47 millones de consultas médicas, 210,61 millones de consultas de enfermería y 1,28 mil millones de visitas de ACS. Siguiendo la tendencia registrada antes de la implantación, se esperarían 598,86 millones, 430,46 millones y 1,5 mil millones de consultas médicas y de enfermería y visitas de ACS respectivamente. En términos relativos, hubo una disminución del 25% en las consultas médicas, del 51% en las consultas de enfermería y del 15% en las visitas de ACS en comparación con el valor esperado por el método bayesiano. El impacto negativo en el registro de consultas y visitas domiciliarias identificado en este estudio, ya sea por dificultades en la adaptación al nuevo sistema o por la disminución de los registros indebidos, merece ser objeto de investigación para que se pueda, de manera planificada, comprender y superar el desafío continuo de mejorar el sistema de información de la atención primaria.

Health ramifications and recovery avenues for Sudan's April 2023 armed conflict: A review

Background: Sudan's history is marred by ongoing sociopolitical challenges, with deep cultural divisions fueling numerous wars. A new conflict erupted on April 15, 2023, pushing the country closer to a full-scale civil war. This war has severely crippled Sudan's already fragile healthcare system, rendering 70% of hospitals in combat zones nonoperational, causing 12,000 deaths, thousands of injuries, and leaving 11 million in dire need of healthcare. More than seven million people are displaced, half of which are children, and are facing severe health challenges, especially vulnerable groups. Heath situation is threatening with unchecked spread of outbreaks of communicable diseases that were previously controlled and marked failure in meeting the health demands of patients with noncommunicable diseases, reproductive and child health issues, and people with serious conditions that require adequate follow-up. Moreover, the projections threaten with more catastrophic consequences including famine, environmental destruction, and further displacement of people. This review article highlights the urgency of the situation and explores potential solutions to enrich global understanding of crisis management. Methods: To comprehensively assess the impact of the crisis and propose a way forward, we drew data by exploring search engines and databases such as Google, Humanitarian Agencies Websites, Google Scholer, and PubMed along with some relevant reports. The search terms included are "Sudan's war", "impact of war on healthcare systems", and "Sudan's armed conflicts". Results: More than 19 publications on the impact of the war on health in addition to periodic reports from international organizations and governmental authorities were reviewed. Conclusion: Although all publications point to the gravity of the situation and the need for prompt response, this crisis offers a unique opportunity to rebuild Sudan's struggling healthcare system with the principles of social accountability. Through domestic and international collaboration, this sector can become a model for similar nations, meeting the needs of its people and promoting sustainable development.

COVID-19 en Chile: análisis de su impacto por olas y regiones

Background: The effects of COVID-19 in Chile changed over time and among regions. Aim: To identify patterns in the impact and evolution of COVID-19 for each wave generated between 2020 and 2022 at the 16 regions of the country. Material and Methods: Several indicators related to the pandemic, their evolution and their consequences for the health system and the health of the population were calculated. Results: There are differences in the evolution of the infection across the regions of the country, as well as heterogeneity between waves. Specifically, the second wave in Chile was identified as the one with the greatest impact, with a national death rate of 123.5 deaths per 100,000 inhabitants and 66.4% intensive care unit occupancy rate due to COVID-19. Performing a geographic analysis, it was possible to find systematic patterns, for example, between regions with higher immunization rates and lower rates of lethality, such as the cases of Ñuble and Atacama regions. Conclusions: These results emphasize the need to consider regional differences and the temporal context for the elaboration of strategies to the efficient management of a pandemic.

Factores asociados a la calidad de vida relacionada con la salud bucal en preescolares de una comunidad andina / Factors associated with oral health related-quality of life in preschoolers from an Andean community

Objective : To analyze the oral health status and its relationship with the quality of life of Andean children of the community of Paucarbamba in Huancavelica, Peru. Material and Methods : The observational, cross-sectional, and correlational study was conducted on a sample of 120 children aged 3-5 years. Early childhood caries was considered using the dmft index. In addition, presence and type of malocclusion were assessed. The oral health-related quality of life was measured by The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire. Univariate and bivariate analysis were performed. Linear regression and Spearman correlation were conducted to identify the factors that most explained the ECOHIS score. Results : Multiple linear regression by least squares method did not consider gender, age, malocclusion, and simplified oral hygiene index as significant. This analysis only included dmft index as significant (p<0.05) to explicate the ECOHIS score. The estimated regression model was ECOHIS score = 11.67 + 0.79*dmft, in which the score increased by 0,79 for each unit obtained of the dmft index, and the dmft in a R2 = 30% (p<0.001) explained the variability of the ECOHIS score achieved. Conclusions : There is a negative impact of dental caries on the quality of life of preschool children and their families in an Andean community in Paucarbamba, Peru.

Objetivo : Analizar el estado de salud bucal y su relación con la calidad de vida de los preescolares de una comunidad andina y vulnerable del Perú. Material y Métodos : El estudio observacional, correlacional y transversal se realizó en una muestra de 120 niños de 3 a 5 años. La caries de la primera infancia se determinó mediante el índice ceod. También se consideró la presencia y el tipo de maloclusión. El cuestionario Early Childhood Oral Health Impact Scale (ECOHIS) midió la calidad de vida relacionada con la salud bucal. Los factores y variables orales se analizaron de manera univariada y bivariada. Se realizó un análisis de correlación de Spearman y regresión lineal para identificar los factores y en qué medida explicaban la puntuación del cuestionario. Resultados : El análisis de regresión lineal múltiple por el método de mínimos cuadrados solo incluyó como significativa (p <0,05) la contribución de ceod para explicar la puntuación del cuestionario, dejando de lado variables como el sexo, la edad, la maloclusión y el índice de higiene bucal simplificado. El modelo de regresión estimado fue Puntuación del Cuestionario = 11,67 + 0,79*ceod, donde la puntuación del cuestionario aumentó en 0,79 por cada unidad ganada de ceod, y la variabilidad de las puntuaciones obtenidas se explica por el ceod en un R2 = 30% (p<0,001). Conclusiones : Existe un impacto de la caries dental en la calidad de vida de los preescolares de uma comunidade andina del Perú y sus familias.

Research progress of microbes in subway air / 环境与职业医学

Accumulating studies suggest that, as the subway is one of the important means of transport in cities, airborne microorganisms in its system have potential effects on human health, but previous studies have mainly focused on some foreign cities. We reviewed the spatio-temporal distribution characteristics of airborne microorganisms in subway stations in different cities, including diurnal, weekly, and seasonal variations, and the distribution of microorganisms in different regions of the world. The factors affecting airborne microorganisms, such as human activities, temperature and humidity, ventilation, and particulate matter, were presented. The potential health effects were described. Although there was no significant risk of infection from using subway, many pathogens do exist in the air. The influence of microorganisms in subway air on health has become a public health problem that cannot be ignored.

Health Impact Assessment of the Mining Industry / Монголын Анагаах Ухаан

@#Health impact assessment is a means of evidence-based policy-making for improvement in health. It is a combination of methods whose aim is to assess the health consequences to a population of a policy, project, or program that does not necessarily have health as its primary objective. It is described as being “the leading global network on best practice in the use of impact assessment for informed decision-making regarding policies, programs, plans and projects”. In recent years, much evidence was revealed that the mining, metal mining, and processing industry has a greatly impact on humans. Residing population has affected directly and indirectly influenced to the health and wellbeing of human. </br>The mining, metal mining and processing industries play an important role in the economic and social development of Mongolia. With the rapid development of the mining industry in Mongolia, environmental protection and environmental rehabilitation have become a priority. Currently, there are 27 laws governing environmental legal acts in our country, and chapter 3 of the Hygiene Law covers environmental and health impact assessment. As stated the implementation of the law shall be financed from the state and local budgets, the central state administrative organization and the Governor at the appropriate level shall order the relevant professional organizations to carry out environmental research and analysis work and to develop projects, and in addition to financing with budget funds, as well as conducting research with their funds for interested citizens, enterprises, and organizations were are arrangements to support the implementation of the laws and its regulation. </br>However, Within the scope of the Law on Environmental Protection and Detailed Environmental Impact Assessment Procedures, the negative impact on the environment is identified but in the area of health impact, it is a lack of information on how the activities are conducted, and health impact assessments are not conducted according to procedures and methods. Thus, there are need to conduct health impact assessments of the mining area and its affected population.

Traditional national sports' injuries in college students / Lesões esportivas de esportes nacionais tradicionais em estudantes universitários / Lesiones deportivas en deportes nacionales tradicionales en estudiantes universitarios

ABSTRACT Introduction: There are 56 ethnic groups in China. Many ethnic groups have their sports, which can cause sports injuries to the human body. Objective: This paper analyzes the impact of national sports on college students' physical health, investigates the most common sports injuries in college students, and specifies scientifically-based prevention and intervention measures. Methods: 312 college students who regularly participate in various national sporting events at 10 colleges and universities volunteered to investigate common injuries sustained by participating in national sporting activities. The main injury factors were analyzed using statistical methods. Results: The investigation shows that college students' errors of judgment regarding accidents, risky behaviors, and poor sports facilities are the main causes of sports injuries. Injuries are mainly concentrated in the lower limbs and pelvic girdle. Conclusion: College students' participation in national sports activities is conducive to improving their physical and mental health. However, attention to preventing injury factors in the sports process is needed to ensure safe and healthy participation in national sports. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Existem 56 grupos étnicos na China. Muitos grupos étnicos têm os seus próprios esportes, que podem causar lesões esportivas no corpo humano. Objetivo: Este artigo analisa o impacto dos esportes nacionais na saúde física dos estudantes universitários, investiga as lesões esportivas mais comuns nos estudantes universitários praticantes, além de especificar medidas de prevenção e intervenção com embasamento científico. Métodos: 312 estudantes universitários que participam regularmente em vários eventos esportivos nacionais em 10 faculdades e universidades foram voluntários de uma investigação sobre as lesões esportivas comuns sofridas no processo de participação em atividades esportivas nacionais. Analisou-se os principais fatores de lesão utilizando métodos estatísticos. Resultados: A investigação mostra que os erros de julgamento dos estudantes universitários quanto a acidentes, comportamentos de risco e instalações esportivas deficitárias são as principais causas de lesões esportivas. As lesões concentram-se principalmente nos membros inferiores e na cintura pélvica. Conclusão: A participação dos estudantes universitários em atividades esportivas nacionais é propícia à melhoria da sua saúde física e mental, porém é necessária uma atenção quanto à prevenção de fatores de lesão no processo esportivo para garantir uma participação segura e saudável nos esportes nacionais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: En China hay 56 grupos étnicos. Muchos grupos étnicos tienen sus propios deportes, que pueden causar lesiones deportivas en el cuerpo humano. Objetivo: Este artículo analiza el impacto del deporte nacional en la salud física de los estudiantes universitarios, investiga las lesiones deportivas más comunes en los estudiantes universitarios y especifica las medidas de prevención e intervención con base científica. Métodos: 312 estudiantes universitarios que participan regularmente en diversos eventos deportivos nacionales en 10 colegios y universidades se ofrecieron como voluntarios para una investigación de las lesiones deportivas comunes sufridas en el proceso de participación en actividades deportivas nacionales. Los principales factores de lesión se analizaron mediante métodos estadísticos. Resultados: La investigación demuestra que los errores de apreciación de los estudiantes universitarios en relación con los accidentes, los comportamientos de riesgo y las malas instalaciones deportivas son las principales causas de las lesiones deportivas. Las lesiones se concentran principalmente en los miembros inferiores y la cintura pélvica. Conclusión: La participación de los estudiantes universitarios en actividades deportivas nacionales favorece la mejora de su salud física y mental, pero es necesario prestar atención a la prevención de los factores de lesión en el proceso deportivo para garantizar una participación segura y saludable en los deportes nacionales. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Health Impact Assessment in protected areas: a proposal for urban contexts in Brazil / Avaliação de Impacto à Saúde em áreas protegidas: uma proposta para contextos urbanos no Brasil / Evaluación del Impacto en la Salud en áreas protegidas: una propuesta para contextos urbanos en Brasil

Abstract: The use of Health Impact Assessment (HIA) in the establishment of an urban protected area can enhance the positive impacts and mitigate the negative impacts resulting from its implementation. Brazil hosts some of the most important biodiversity hotspots in the world and the HIA may benefit biodiversity and human health. These areas are commonly created without any preceding survey to assess their impacts on health. Protected areas located in urban zones are essential to maintain environmental balance and quality of life in cities. It promotes positive impacts on health, providing ecosystem services and salutogenic benefits. However, they can generate negative impacts such as the violation of human rights, property speculation, spread of vectorial diseases, and psychosocial stress. Based on the identification of the potential impacts of urban protected areas on health and best practices, this qualitative and exploratory study justifies the use of HIA in urban protected areas, especially in the Brazil, and indicates the main elements for the construction of a methodological approach to contribute to the Sustainable Development Goals and one of its alternatives, the Buen Vivir approach.

Resumo: O uso da Avaliação de Impacto à Saúde (AIS) na criação de uma área protegida urbana pode potencializar os impactos positivos e mitigar os impactos negativos resultantes de sua implementação. O Brasil abriga alguns dos mais importantes hotspots de biodiversidade do mundo e a implementação da AIS pode beneficiar tanto estas áreas como a saúde humana. As áreas protegidas urbanas são comumente estabelecidas sem qualquer avaliação prévia de seus impactos na saúde e são essenciais para manter o equilíbrio ambiental e a qualidade de vida nas cidades. Além disso, as áreas protegidas impactam positivamente a saúde, fornecendo serviços ecossistêmicos e benefícios salutogênicos. Contudo, podem gerar impactos negativos, como violação de direitos humanos, especulação imobiliária, disseminação de doenças vetoriais e estresse psicossocial. Com base na identificação dos impactos potenciais das áreas protegidas urbanas na saúde e nas melhores práticas para aplicá-las, este estudo qualitativo e exploratório justifica o uso da AIS em áreas protegidas urbanas, especialmente no Brasil, e indica os principais elementos para a construção de uma abordagem metodológica que contribua com os Objetivos de Desenvolvimento Sustentável e uma de suas alternativas, a abordagem Buen Vivir.

Resumen: Usar la Evaluación del Impacto en la Salud (EIS) para crear un área protegida urbana puede potenciar los impactos positivos y mitigar los impactos negativos resultantes de su implementación. En Brasil se pueden encontrar algunos de los hotspots de biodiversidad más importantes del mundo e implementar la EIS puede beneficiar tanto estas áreas como la salud humana. Las áreas protegidas urbanas, en general, se establecen sin cualquier evaluación previa de sus impactos en la salud y son esenciales para mantener el equilibrio ambiental y la calidad de vida en las ciudades. Además, las áreas protegidas tienen un impacto positivo en la salud, proporcionando servicios ecosistémicos y beneficios salutogénicos. Sin embargo, pueden generar impactos negativos, como la violación de los derechos humanos, la especulación inmobiliaria, la propagación de enfermedades vectoriales y el estrés psicosocial. Con base en la identificación de los posibles impactos de las áreas protegidas urbanas en la salud y en las mejores prácticas para aplicarlas, este estudio cualitativo y exploratorio justifica el uso de la EIS en áreas protegidas urbanas, sobre todo en Brasil, e indica los elementos principales para construir un enfoque metodológico que contribuya a los Objetivos de Desarrollo Sostenible y una de sus alternativas, el enfoque Buen Vivir.

Dance sports influence female university students' physical health in ethnic universities / Influência da dança esportiva sobre a saúde física das universitárias em universidades étnicas / Influencia de la danza deportiva en la salud física de las estudiantes en universitarias étnicas

ABSTRACT Introduction Ensuring healthy growth with high cultural quality in the population is an important part of Chinese revitalization. University students, as a group of high cultural quality, have the mission and responsibility entrusted by the state and the people. It is believed that these goals can be achieved by using sports dance, which has a wide range and high demands; dancers should have motor skills, physical qualities, understanding of the art of dress, and psychological balance as basic requirements. Objective To test and evaluate whether sports dance activities in physical education students are conducive to promoting students' healthy physical development. Methods This paper examines the influence of teaching sports dance on the physical health of female college students in Ethnic Colleges and its countermeasures. It also discusses the strategies for teaching sports dance to provide viable suggestions for follow-up dance instruction. Conclusion The combination of sports and femininity in exercise has a good fitness effect, improves the artistic feelings of college women, and is conducive to the healthy development of the physical quality of college women. Level of evidence III; Analysis based on alternatives and limited costs.

RESUMO Introdução Garantir o crescimento saudável com alta qualidade cultural na população é parte importante da revitalização chinesa. Estudantes universitários, como um grupo de alta qualidade cultural, possuem a missão e responsabilidade confiada pelo Estado e pelo povo. Acredita-se que essas metas possam ser alcançadas utilizando a dança esportiva, que tem um vasto leque e altas exigências nesse sentido, os dançarinos devem ter habilidades motoras, qualidades físicas, compreensão na arte de vestuário e equilíbrio psicológico, como requisitos básicos. Objetivo Testar e avaliar se as atividades de dança esportiva nos alunos de educação física são propícias na promoção do desenvolvimento físico saudável dos alunos. Métodos Este artigo analisa a influência do ensino de dança esportiva sobre a saúde física de universitárias em Faculdades Étnicas e suas contramedidas. Também se discute as estratégias de ensino da dança esportiva, a fim de fornecer sugestões viáveis para o ensino de dança de acompanhamento. Conclusão A combinação de esportes e feminilidade no exercício tem um bom efeito de aptidão física, melhora os sentimentos artísticos das universitárias e é propício ao desenvolvimento saudável da qualidade física das Universitárias. Nível de evidência III; Análises baseadas em alternativas e custos limitados.

RESUMEN Introducción Garantizar un crecimiento saludable con una alta calidad cultural en la población es una parte importante de la revitalización de China. Los universitarios, como grupo de alta calidad cultural, tienen la misión y la responsabilidad encomendadas por el Estado y el pueblo. Se cree que estos objetivos pueden alcanzarse mediante el uso de la danza deportiva, que tiene una amplia gama y altas exigencias en este sentido, los bailarines deben tener habilidades motoras, cualidades físicas, la comprensión en el arte de vestir y el equilibrio psicológico como requisitos básicos. Objetivo Comprobar y evaluar si las actividades de danza deportiva en los estudiantes de educación física favorecen el desarrollo físico saludable de los alumnos. Métodos Este trabajo analiza la influencia de la enseñanza de la danza deportiva en la salud física de las estudiantes universitarias de los colegios étnicos y sus contramedidas. También se analizan las estrategias de enseñanza de la danza deportiva con el fin de ofrecer sugerencias viables para el seguimiento de la enseñanza de la danza. Conclusión La combinación de deporte y feminidad en el ejercicio tiene un buen efecto de aptitud física, mejora los sentimientos artísticos de las universitarias y favorece el desarrollo saludable de la calidad física de las universitarias. Nivel de evidencia III; análisis basado en alternativas y costes limitados.

Impact assessment of emergency care units on hospitalizations for respiratory system diseases in Brazil / Avaliação do impacto das unidades de pronto atendimento sobre as internações por doenças do aparelho respiratório no Brasil

Abstract Emergency Care Units (UPAs) are part of a national health policy implemented by the Brazilian Government. UPAs are fixed prehospital components of the Brazilian Unified Health System (SUS), whose purpose is to provide resolutive emergency care to patients suffering from acute clinical conditions, and to perform the first care in cases of surgical nature. According to the Ministry of Economy, 750 units are operational throughout the country since 2008, and 332 are under construction. Being a public policy in expansion, it is imperative to assess the impact of such units as part of SUS. However, we found few studies that assessed UPAs' impact, which have examined their specific impact on mortality rates. In our research, we aimed to evaluate the impact of UPAs on hospitalization rates for diseases of the respiratory system. To measure the impact, we used a strategy of Machine Learning through the Bayesian Additive Regression Trees (BART) algorithm. The results point to a decrease in the hospitalization rates by respiratory diseases due to Emergency Care Units. Therefore, these units generate a benefit for the Brazilian health system, being an important element for the care of patients with respiratory diseases.

Resumo As Unidades de Pronto Atendimento 24h (UPAs) compõem a Política de Atenção a Urgências e Emergências (PNAU) implementada pelo Governo Federal. São componentes pré-hospitalares fixos do SUS, cujo objetivo é o atendimento resolutivo de urgência a pacientes que sofrem quadros clínicos agudos, e o primeiro atendimento em casos cirúrgicos. Desde 2008, funcionam 750 unidades no Brasil, e há 332 em construção, conforme dados de 2020 do Ministério da Economia. Diante de uma política em expansão, é indispensável avaliar seus efeitos como parte do SUS. No entanto, foram encontrados poucos trabalhos avaliando o impacto das UPAs, e esses mediram os efeitos sobre taxas de mortalidade. Este trabalho objetiva mensurar o efeito das UPAs nas taxas de internação por doenças do aparelho respiratório. Para isso, utilizou-se uma estratégia de Machine Learning por meio do algoritmo Bayesian Additive Regression Trees (BART). Os resultados apontam uma diminuição nas taxas de internações por doenças do aparelho respiratório devido às UPAs. Assim, as evidências são de que essas unidades geram benefício para o sistema de saúde, sendo uma peça importante na linha de cuidado dos pacientes com doenças respiratórias.

Increment of Maternal Mortality Among Admissions for Childbirth in Low-risk Pregnant Women in Brazil: Effect of COVID-19 Pandemic? / Aumento da taxa de mortalidade materna entre as admissões para parto em gestantes de baixo risco gestacional no Brasil: Efeito da pandemia do COVID-19?

Abstract Objective To assess the possible impact of the COVID-19 pandemic on maternal mortality among admissions for childbirth in 2020 in relation of the last 10 years. Methods An ecological study with pregnant women who underwent hospital births at the Brazilian unified public health service (SUS, in the Portuguese acronym) in Brazil from 2010 to 2020. The mortality among admissions for childbirth was obtained based on the number of admissions for childbirth with reported death as outcome divided by the total number of admissions. The underlying gestational risk and route of delivery were considered based on the national surveillance system. The average mortality for the period between 2010 and 2019 (baseline) was compared with the rate of deaths in 2020 (1st pandemic year); the rate ratio was interpreted as the risk of death in 2020 in relation to the average of the previous period (RR), with 95% confidence intervals (CIs). Results In 2020, the 1st year of the COVID-19 pandemic, 1,821,775 pregnant women were hospitalized for childbirth and 651 deaths were reported, which represents 8.7% of the total hospitalizations and 11.3% of maternal deaths between 2010 and 2020. There was an increase in maternal mortality after births in 2020 compared with the average for the period between 2010 and 2019, specially in low-risk pregnancies, both in vaginal (RR = 1.60; 95%CI:1.39-1.85) and cesarean births (RR = 1.18; 95%CI:1.04-1.34). Conclusion Maternal mortality among admissions for childbirth according to SUS data increased in 2020 compared with the average between 2010 and 2019, with an increment of 40% in low-risk pregnancies. The increase was of 18% after cesarean section and of 60% after vaginal delivery.

Resumo Objetivo Avaliar os possíveis impactos da pandemia de COVID-19 na mortalidade materna nas admissões para o parto em 2020 em relação ao histórico dos últimos 10 anos. Métodos Estudo ecológico com gestantes que realizaram parto hospitalar pelo Sistema Unificado de Saúde do Brasil (SUS) de 2010 a 2020. Para obter-se a taxa de mortalidade entre as admissões para o parto, foi utilizado o número de internações para parto que tiveram óbito como desfecho dividido pelo total de internações. O risco gestacional e o tipo de parto foram considerados a partir do sistema de vigilância nacional. A média de mortalidade no período de 2010 a 2019 (linha de base) foi comparada com a taxa de mortalidade pós-parto de 2020 (1° ano pandêmico); a razão das taxas foi interpretada como risco de óbito em 2020 em relação à média no período anterior (RR), com intervalo de confiança (IC) de 95%. Resultados Em 2020, 1° ano da pandemia de COVID-19, 1.821.775 gestantes foram internadas para o parto e 651 óbitos foram registrados, o que representa 8,7% do total de internações e 11,3% das mortes maternas entre 2010 e 2020. Houve aumento na mortalidade materna após partos em 2020 em relação à média do período entre 2010 e 2019, especialmente em gestações de baixo risco, tanto em partos normais (RR = 1.60; IC95%: 1.39-185) quanto em cesáreas (RR = 1.18; IC95%: 1.04-1.34). Conclusão A mortalidade entre as admissões para o parto pelo SUS aumentou em 2020 em relação à média de óbitos entre 2010 e 2019, com um incremento de 40% em mulheres de baixo risco gestacional. O aumento verificado foi de 18% após cesárea e de 60% após parto vaginal.

Compulsory notification of injuries in aesthetic procedures. Impact on patient safety

Abstract The disparity between the number of aesthetic procedures performed worldwide, and the complications described in the literature is remarkable. Doubts regarding the underreporting are reasonable and should be considered. The aim of this study is to demonstrate the scarcity of scientific publications on complications in aesthetic procedures compared to the abundance of these procedures performed worldwide. Based on this knowledge, it will be demonstrated to the health authorities the importance of compulsory notification of complications in aesthetic procedures that require medical attention so that the available data will allow their prevention. The limitation of knowledge regarding complications was demonstrated in the data collection for the preparation of the thesis ‟Deaths Related to Liposuction in Brazil" presented in 2018 and published in Surgical and Cosmetical Dermatology in 2020. The definition of complication in aesthetic procedures needs to be objective to prevent different and subjective interpretations. With the compulsory notification of complications in aesthetic procedures, it is intended to learn about their causes to develop guidelines for their prevention.

The health impact of domestic violence for well-being: A cross-sectional study

Background: The consequences of domestic violence are intense and it has pessimistic effects on health and happiness of individuals as well as on the well-being of entire communities. Aim and Objectives: The objectives are as follows (i) to study the health impact of domestic violence on abused women and their children and (ii) to find out health-seeking behavior of abused women. Materials and Methods: A cross-sectional community base study was carried out among randomly selected 600 ever married women of 15–49 years of age. All the necessary information was collected by pretested questionnaire. The questionnaire was self-administered and the confidentiality measures were taken appropriately and strictly. Results: Out of total 600 participants, 231 participants were victims of domestic violence. An evaluation revealed that about 9% of the victims reported to be suffering from chronic pain, about 47% of the victims were underweight, 36% reported to be suffering from depression, and about 22% had reported pregnancy complications. Domestic violence also has its consequences on the health status of children. Only about 29% of the victims approached the health care center to tackle the health problem due to violence. Conclusion: The violence affects the physical, mental, and sexual health of the sufferer and also has consequences on children’s well-being.

Acolhimento integral em Centros de Atenção Psicossocial Álcool e Drogas na perspectiva da proteção dos direitos humanos / Integrated embracement in Psychosocial Care Centers for Alcohol and Drugs in the perspective of the protection of human rights

Resumo Este artigo tem por objetivo avaliar se os resultados do acolhimento integral em Centros de Atenção Psicossocial Álcool e Drogas III (CAPS AD III) atendem aos padrões de qualidade para proteção e respeito dos direitos humanos dos usuários. Desenvolvemos um estudo avaliativo, quantitativo e de desenho longitudinal com 122 usuários acolhidos integralmente em dois CAPS AD III, com follow-up após 14 e 90 dias. Os resultados dos indicadores qualidade de vida, consequências da dependência de substâncias e reabilitação psicossocial, foram posteriormente analisados à luz do referencial QualityRights. Três temas e nove padrões foram avaliados. Quatro padrões foram classificados como alcance total, quatro como alcance parcial e um como alcance iniciado. O direito a usufruir do padrão mais elevado possível de saúde física e mental foi o padrão mais atingido pelo acolhimento integral (tema 2). O direito a exercer a capacidade legal e o direito à liberdade pessoal e segurança foi atendido com algumas fragilidades (tema 3). O direito de viver de forma independente e ser incluído na comunidade, necessita de outros recursos sociais, além do cuidado especializado em saúde mental, para ser melhorado (tema 5).

Abstract This article aims to assess whether or not the results of integrated embracement in Psychosocial Care Centers for Alcohol and Drugs III (CAPS AD III) meet the quality standards necessary for the protection of and respect for users' human rights. An evaluative, quantitative, and longitudinal design was developed through a study with 122 users, embraced in two CAPS AD III follow-ups after 14 and 90 days. This study analyzed the quality of life indicators, consequences of substance abuse, and psychosocial rehabilitation in the light of the QualityRights framework. Three themes and nine patterns were evaluated. In this study, four patterns were classified as total reach, four as partial reach, and one as initiated reach. The right to enjoy the highest possible standard of physical and mental health was the standard most achieved by integrated embracement (theme 2). The right to exercise legal capacity and the right to personal freedom and security were achieved, but with some weaknesses (theme 3). The right to live independently and be included in the community requires other social resources, in addition to specialized mental health care in order to be improved (theme 5).

Relationship between sense of coherence, OHRQoL, and dental caries among nursing students in South India

Background: Dental caries is one of the most common dental diseases that affect all population and is associated with the avoidance of care. Research has reported that sense of coherence (SOC) is related to many aspects of health including oral health. SOC determines the quality of health and might have a direct association with the development of subjective assessments of oral health. Objectives: To find the association between SOC, Oral Health?Related Quality of Life (OHRQoL) and caries status among nursing college students in southern state of India. Design: Cross?sectional design using questionnaire and assessment of caries status. Participants: Nursing students from south India. Methods: Convenience sampling method was followed and students who were present on the day of the study and consented to participate were included in the study. The total study sample consisted of 494 nursing students. SOC and OHRQoL were measured by a self?administered questionnaire; caries status was assessed using Decayed, Missing and Filled Tooth (DMFT) index. Results: Association between SOC and Oral Health Impact Profile (OHIP) and caries status and OHIP was found to be statistically significant. Correlation between dental caries and OHIP was found to be statistically significant, with R?value –0.251 shows that OHIP is negatively correlated with caries status. Conclusion: SOC as a psychosocial resource is capable of facilitating the motivation for positive oral health behaviours. These resources along with socio?economic and demographic factors can create an environment that is partially responsible for the individuals’ cognitive and physical functions that can express themselves as the individuals’ well?being and positive health behaviours.

Translation and Validation of Marathi Version of Oral Health Impact Profile?14, a Measure of Oral Health?Related Quality of Life

Background: A quality of life (QoL) assessment tool needs to be translated and validated in the language of the participants to whom it is administered. Therefore, the oral health impact profile-14 (OHIP-14) scale, developed originally in English, has been translated into different languages like Hindi, Gujrati, etc. The Marathi version of OHIP-14 will be useful to assess in regions where the Marathi language is prominently spoken. Thus, the present study was carried out to translate and validate the Marathi version of the OHIP-14 instrument to measure the oral health-related quality of life. Aims & Objectives: To translate and validate the English Version of the OHIP-14 instrument in the Marathi Language. Materials and Methods: This was a descriptive cross-sectional study in which 128 participants were selected through a convenient sampling method. The English version of the OHIP-14 was translated using the forward-backward translation technique, and participants were given English and the Marathi versions of the OHIP-14 questionnaire. The filled questionnaires were subjected to statistical analysis. Result: The difference in mean scores was not statistically significant(p=0.828). Pearson’s correlation coefficient test was 0.999, suggesting that the translated Marathi version is highly correlated with the original English version. Conclusion: The Marathi version of OHIP-14 is a valid, and reliable instrument for assessing QoL among the population who speak Marathi.

Adolescent Obesity � Emerging Public Health Problem of 21st Century

Many Countries struggle to tackle the consequences of under nutrition and infectious diseases. At the same time, they are also now showing a rapid increase in non-communicable diseases and their risk factors like obesity and overweight, especially in urban areas. In the present era, it is quite common to find co-existence of under nutrition and obesity within a country, within a community and even within a household. Children living in developing and under-developed countries are more susceptible to poor nutrition during antenatal period, infancy and childhood. On the contrary, children also have easy access to food products with increased salt and fat percentage, decreased levels of micro nutrients and more junk calories. The synergistic effects of high calorie intake and low physical activity lead to increase in prevalence of childhood overweight and obesity. This article discusses about the aetiology, epidemiology and determinants of adolescent obesity.

Development and validation of a novel Middle childhood oral health impact scale (MCOHIS)

Purpose: The study was planned to develop and validate a novel middle childhood oral health impact scale (MCOHIS) for 6- to 9-year-old children in India. Methodology: A cross-sectional study design was employed to develop and validate MCOHIS in the sequential phases. A panel of ten pediatric dentists evaluated a pool of 36 items corresponding to the oral health-related quality of life (OHRQoL) of children. MCOHIS with 20 items under five domains was formulated and content validation was done. Cohen's kappa statistics was employed to measure the concordance between the child's self-report and the caregiver's proxy report. Concurrent validation was done among 130 participants from 13 districts of Tamil Nadu state, India. Discriminant validity was checked among another sample of 60 participants. Internal consistency and test-retest reliability of MCOHIS were assessed using Cronbach's alpha and Kappa statistics respectively. Results: MCOHIS had adequate content validation with Scale Level Content Validity Index / Average score of 0.94 for relevance. There was a statistically significant inter-rater reliability observed between the child's self-report and caregivers' proxy report in all items with a moderate to substantial agreement. Concurrent validation showed a statistically significant positive correlation with a Rho value of 0.712. There was a statistically significant difference noted in overall discriminant validity (P < 0.001). Acceptable internal consistency reliability was observed with Cronbach's alpha value of 0.75. Test-retest reliability showed a high stability coefficient of 0.98. Conclusions: MCOHIS was found to be a valid and reliable age-specific tool for assessing the OHRQoL of Indian children aged 6–9 years.