Mental disorders in judicial workers: analysis of sickness absence in a cohort study.

OBJECTIVE: To analyze risk factors for sickness absence due to mental disorders among judicial workers in Bahia, Brazil. METHODS: Retrospective cohort with follow-up from 2011 to 2016 with 2,660 workers of a judicial sector in Bahia, Brazil. The main outcome measures were survival curves estimated for the independent variables using the Kaplan-Meier product limit estimator and risk factors for the first episode of sickness absence calculated based on the Cox regression model. RESULTS: The survival estimate of the population of this study for the event was 0.90 and from the Cox model the risk factors for the first episode of sickness absence due to mental disorders were: female (HR = 1.81), occupation of magistrate (HR = 1.80), and age over 30 years old (HR = 1.84). In addition, the risk for new cases of sickness absence among women reached 4.0 times the risk for men, in 2015. The estimated relative risks of sickness absence and the observed survival reduction behavior over time add information to the literature on sociodemographic and occupational factors associated with sickness absence due to mental disorders in the public sector. CONCLUSION: These results highlight the need for further research to more precisely identify vulnerable groups at risk of preventable mental health-related sickness absence in the workplace, better identify the workplace organizational factors that contribute to these disorders as well as studies on the effectiveness of workplace interventions to improve mental health among judicial and other public sectors workers.

Prevalence of musculoskeletal disorders in the lower limbs among artisanal fisherwomen / shellfish gatherers of Brazil / Prevalência de distúrbios musculoesqueléticos nos membros inferiores de pescadoras artesanais/marisqueiras do Brasil

Introduction: Small-scale fishing is responsible for at least 40% of the fish consumed in the world. In Brazil, the worker in this sector is the artisanal fisherman, who accounts for one in every 200 Brazilians. Artisanal fishing is part of the informal economy; therefore, the pathologies that affect these fishermen are invisible in the country's official statistics. Musculoskeletal disorders represent a major socioeconomic and public health problem, but their prevalence is little known among non-formal workers. Objective: to estimate the prevalence of musculoskeletal disorders (MSDs) in the lower limbs and to verify the associated factors among artisanal fishermen/ fisherwomen from Saubara, Bahia, Brazil. Methodology: a cross-sectional study, using the Nordic Musculoskeletal Questionnaire (NMQ), the Brazilian version of the Job Content Questionnaire (JCQ) and a questionnaire about physical demands, were used to collect information in a random sample of artisanal fishermen/shellfish gatherers, in 2013. Results: the prevalence of MSDs in lower limbs in the sample was 65.5% (n=137). The prevalence of MSDs in the thigh/knee segment, leg and ankle/foot were 48.7% (n=92), 47.7% (n=95) and 38.1% (n=72), respectively. There was also a high frequency of obesity, poor education, low wages, early age at onset of labor, and excessive workload. Factors such as age, smoking, physical demands, working time, absence of breaks and having had a previous job were associated with MSDs in the lower limbs. Conclusion: the high prevalence of MSDs in lower limbs in female artisanal fishermen indicates the need to develop strategies for prevention, diagnosis and reporting of these diseases.

Introdução: a pesca em pequena escala é responsável por pelo menos 40% do pescado consumido no mundo e, no Brasil, o trabalhador desse setor é o pescador artesanal, que contabiliza um a cada 200 brasileiros. Por se tratar de uma atividade da economia informal, as patologias que afetam esses pescadores são praticamente invisíveis nas estatísticas oficiais do país. Nesse contexto, os distúrbios musculoesqueléticos representam um grande problema socioeconômico e de saúde pública, mas sua prevalência é pouco conhecida entre trabalhadores não formais. Objetivo: estimar a prevalência de distúrbios musculoesqueléticos nos membros inferiores e fatores associados, em pescadores artesanais/marisqueiras de Saubara, Bahia, Brasil. Metodologia: trata-se de um estudo transversal, utilizando o Nordic Musculoskeletal Questionnaire, a versão brasileira do Job Content Questionnaire e um questionário sobre demandas físicas, para a coleta de informações em uma amostra aleatória de pescadores artesanais/marisqueiras, ocorrida em 2013. Resultados: a prevalência de distúrbios musculoesqueléticos em membros inferiores na amostra foi de 65,5% (n=137); a prevalência no segmento coxa/joelho, perna e tornozelo/pé foi de 48,7% (n=92), 47,7% (n=95) e 38,1% (n=72), respectivamente. Observaram-se também alta frequência de obesidade, baixa escolaridade, baixos salários, idade precoce para o início do trabalho e carga horária excessiva. Fatores como idade, tabagismo, demandas físicas, tempo de trabalho, ausência de pausas e trabalho anterior, estavam associados aos referidos distúrbios. Conclusão: A alta prevalência de distúrbios musculoesqueléticos dos membros inferiores em pescadoras artesanais indica a necessidade de desenvolver estratégias de prevenção, diagnóstico e notificação dessas doenças

Longevity of composite restorations is definitely not only about materials.

OBJECTIVES: This review study provides an overview of factors that influence the longevity of all types of direct resin composite restorations. METHODS: A systematic search was performed in PubMed, Scopus, and Web of Science databases for articles reporting data from primary longitudinal clinical studies on composite longevity published 2011-2021. Prospective or retrospective studies with restorations in permanent dentition, with follow-up periods of at least 5 years were included. RESULTS: In total, 33 articles were included with different study designs, practice settings, datasets, countries of origin, and sample sizes. Annual failure rates of restorations ranged from 0.08% to 6.3%. Survival rates varied between 23% and 97.7%, success rates varied between 43.4% and 98.7%. Secondary caries, fractures, and esthetic compromise were main reasons for failures. Risk factors for reduced restoration durability included patient-level factors (e.g., caries risk, parafunctional habits, number of check-ups per year, socioeconomic status), dentist factors (different operators, operator's experience), and tooth/restoration factors (endodontic treatment, type of tooth, number of restored surfaces). Patient gender and the composite used generally did not influence durability. SIGNIFICANCE: A number of risk factors are involved in the longevity of composite restorations. Differences between composites play a minor role in durability, assuming that materials and techniques are properly applied by dentists. Patient factors play a major role in longevity. The decision-making process implemented by dentists relative to the diagnosis of aging or failed restorations may also affect the longevity of restorations. Clinicians should treat patients comprehensively and promote a healthy lifestyle to ensure longevity.

Mental disorders in judicial workers: analysis of sickness absence in a cohort study

ABSTRACT OBJECTIVE To analyze risk factors for sickness absence due to mental disorders among judicial workers in Bahia, Brazil. METHODS Retrospective cohort with follow-up from 2011 to 2016 with 2,660 workers of a judicial sector in Bahia, Brazil. The main outcome measures were survival curves estimated for the independent variables using the Kaplan-Meier product limit estimator and risk factors for the first episode of sickness absence calculated based on the Cox regression model. RESULTS The survival estimate of the population of this study for the event was 0.90 and from the Cox model the risk factors for the first episode of sickness absence due to mental disorders were: female (HR = 1.81), occupation of magistrate (HR = 1.80), and age over 30 years old (HR = 1.84). In addition, the risk for new cases of sickness absence among women reached 4.0 times the risk for men, in 2015. The estimated relative risks of sickness absence and the observed survival reduction behavior over time add information to the literature on sociodemographic and occupational factors associated with sickness absence due to mental disorders in the public sector. CONCLUSION These results highlight the need for further research to more precisely identify vulnerable groups at risk of preventable mental health-related sickness absence in the workplace, better identify the workplace organizational factors that contribute to these disorders as well as studies on the effectiveness of workplace interventions to improve mental health among judicial and other public sectors workers.

Deterioration of anterior resin composite restorations in moderate to severe tooth wear patients: 3-year results.

OBJECTIVES: Deterioration in anterior resin composite restorations placed in tooth wear patients was investigated after 36 months. MATERIALS AND METHODS: Data collected prospectively for 47 participants of the Radboud Tooth Wear Project were used (41 ± 8 years, 90% male, n = 270 restorations). Restorations were individually evaluated using intraoral photographs and 3D scans to rate modified FDI scores and to record the presence of degradation features. Four groups with distinct combinations of composites and techniques were assessed, and multivariable logistic regression models were used to analyze the data (p < 0.05). RESULTS: For all groups together, early degradation signs were present at 1 month: irregularities (41.5%) and ditching (7.4%) were observed at the surface and adhesive interfaces. The frequency of irregularities decreased in the 36-month evaluation (37%), but ditching (12.2%) and fractures (10.7%) were more common. The most frequent deterioration (based on photographs) was observed for staining (44%) and loss of luster (31%). In 3D scans, the most frequent were for wear (25%), marginal adaptation (24%), and the presence of irregularities (19%). Canines had 5.5 times more chances of deterioration by ditching than incisors (p < 0.001). The differences between composites and restorative techniques were minor. CONCLUSIONS: A continuous degradation process of restorations placed in tooth wear patients was observed in anterior teeth restored with different composites, with a progression of the deterioration over 36 months. CLINICAL RELEVANCE: When placing anterior resin composite restorations in tooth wear patients, it could be important to establish realistic expectations and the need for checkup appointments.

Efetividade das terapias em grupo na qualidade de vida de pacientes com fibromialgia: uma revisão sistemática / Effectiveness of group therapies on the quality of life of patients with fibromyalgia: a systematic review

Introdução: A fibromialgia é uma síndrome dolorosa muito comum na prática clínica, caracterizada, principalmente, por dor musculoesquelética crônica e generalizada, bem como fadiga, rigidez articular e distúrbios do sono. No entanto, possui uma apresentação clínica bastante vasta e heterogênea, comprometendo diversas esferas da vida dos pacientes. O objetivo foi verificar a efetividade das terapias em grupo na qualidade de vida dos pacientes fibromiálgicos. Método: Trata-se de uma revisão sistemática, a qual buscou analisar as pesquisas relacionadas ao tema entre 2010 e 2020. A busca dos artigos ocorreu na BVS nas bases de dados LILACS e MEDLINE, sendo incluídos apenas artigos originais disponíveis na íntegra. Resultados: Foram encontradas 86 publicações científicas e, após exclusão de duplicados, aplicação de filtros e análise inicial, foram selecionados 6 artigos para compor o corpo amostral. Posteriormente, os artigos foram agrupados de acordo com a sua temática central em: 1) Efeitos positivos da terapia interdisciplinar em grupo nos sintomas físicos e psicossociais da fibromialgia; 2) Empoderamento do paciente no enfrentamento da fibromialgia; e 3) Qualidade da assistência profissional e a rede de apoio social da terapia em grupo. Conclusão: Verificou-se que a aplicação das terapias em grupos impactou, positivamente, a qualidade de vida dos pacientes em sua dimensão física, psicoemocional e social. Além disso, concluiu-se que incluir o paciente como protagonista do seu tratamento e construir uma rede de apoio são fundamentais para o enfrentamento da doença. [au]

Introduction: Fibromyalgia is a very common pain syndrome in clinical practice, characterized mainly by chronic and generalized musculoskeletal pain, as well as fatigue, joint stiffness and sleep disorders. However, it has a very wide and heterogeneous clinical presentation, compromising several spheres of patients' lives. The objective was to verify the effectiveness of group therapies on the quality of life of fibromyalgia patients. Method: This is a systematic review, which sought to analyze research related to the topic between 2010 and 2020. The search for articles took place in the VHL in the LILACS and MEDLINE databases, including only original articles available in full. Results: 86 scientific publications were found and, after exclusion of duplicates, application of filters and initial analysis, 6 articles were selected to compose the sample body. Subsequently, the articles were grouped according to their central theme in: 1) Positive effects of interdisciplinary group therapy on the physical and psychosocial symptoms of fibromyalgia; 2) Empowerment of the patient in coping with fibromyalgia; and 3) Quality of professional assistance and the social support network of group therapy. Conclusion: It was found that the application of therapies in groups positively impacted the quality of life of patients in their physical, psycho-emotional and social dimensions. In addition, it was concluded that including the patient as the protagonist of their treatment and building a support network are essential for coping with the disease. [au]

Impacto do câncer em pacientes com doença arterial periférica / Impact of cancer in patients with peripheral artery disease

Introdução e Objetivo: O impacto do câncer em pacientes com DAP sobre nível de atividade física diária, capacidade funcional, função cardiovascular e qualidade de vida ainda não é conhecido, sendo, portanto, o objetivo deste presente estudo. Métodos: Estudo transversal com 299 pacientes. Nível de Atividade física (acelerômetro), capacidade funcional (teste de caminhada de 6 minutos, Handgrip, Short Physical Performance Battery, Walking Impairment Questionnaire-WIQ e o Walking Estimated-Limitation Calculated by History), função cardiovascular (pressão arterial braquial, variabilidade da frequência cardíaca e rigidez arterial) e qualidade de vida (WHOQOL-bref) foram comparados entre os pacientes com DAP com e sem histórico de câncer. Resultados: Pacientes com DAP e câncer (N=27) apresentaram melhor desempenho no domínio da distância e da velocidade do WIQ (21±37 vs 14±26, p=0.036; 29±18 vs 22±15, p=0.022, respectivamente) comparado aos pacientes com DP sem câncer. Os outros parâmetros foram similares entre os grupos. Conclusão: Os pacientes com DAP e câncer apresentaram

Introduction and Objective: The impact of cancer in patients with PAD on the level of daily physical activity, functional capacity, cardiovascular function and quality of life is not yet known, thus being the objective of this present study. Methods: Cross-sectional study with 299 patients. Physical activity level (accelerometer), functional capacity (6-minute walk test, Handgrip, Short Physical Performance Battery, Walking Impairment Questionnaire-WIQ and the Walking Estimated-Limitation Calculated by History), cardiovascular function (brachial blood pressure, variability of heart rate and arterial stiffness) and quality of life (WHOQOL-bref) were compared between patients with PAD with and without a history of cancer. Results: Patients with PAD and cancer (N=27) performed better in the distance and speed domains of the WIQ (21±37 vs 14±26, p=0.036; 29±18 vs 22±15, p=0.022, respectively) compared to PD patients without cancer. The other parameters were similar between groups. Conclusion: Patients with PAD and cancer had better results for subjectively assessed functional capacity.

The Ability of Two Chewing Simulation Devices in Emulating the Clinical Deterioration of Anterior Composite Restorations in Severely Worn Teeth.

PURPOSE: This study investigated the ability of two chewing simulation devices to emulate in vitro the clinical deterioration observed in anterior composite restorations in severe tooth-wear patients. MATERIALS AND METHODS: Advanced tooth wear was simulated in bovine incisors, which were restored with palatal and buccal direct composite veneer restorations. The incisal edges of restorations were subjected to 960K cycles of either compressive loading (Biocycle-V2; 125 N at 2 Hz) or wear and mechanical loading (Rub and Roll; 30 N at 20 rpm). Surface degradation was rated using FDI scores to compare the chewing devices (Fisher's test, a = 0.05). Topography and deterioration of restorations was analyzed using SEM. The ability to emulate the deterioration was investigated by comparing the surface degradation observed in vitro with the clinical degradation observed in restorations placed in severe tooth-wear patients after 3.5 years. RESULTS: Distinct degradation patterns were observed between the simulation devices: Biocycle-V2 generated deterioration that was not comparable to the clinical situation, including contact damage, minor wear, and localized roughening. The degradation caused by Rub and Roll was more similar to the in vivo situation, including wear facets, chipping, delamination, staining, and marginal ditching. The FDI scores were different between the chewing devices for surface/marginal staining, material/retention, and marginal adaptation (p = 0.003). SEM analysis showed microcracking at the interface between composite layers at the incisal edges. CONCLUSIONS: The Rub and Roll chewing device was able to emulate the clinical deterioration observed in anterior restorations in severe tooth-wear patients and thus may be used as an oral-cavity simulation method, contributing to translational research.

Health managers and professionals' perception on the care of child and adolescent obesity in Brazil's Unified Health System / Percepção de gestores e profissionais de saúde sobre o cuidado da obesidade infanto-juvenil no Sistema Único de Saúde

The study aimed to analyze the perception of health managers and professionals on the care of children and adolescents with overweight and obesity in the Unified Health System of Sergipe, Brazil. This is a qualitative and exploratory study with sample composed of 46 actors and semi-structured interviews as data collection method. The existing care was perceived as poor and fragmented, regardless of the health care level. The main difficulties were the professionals' work process, care management and organization, family support and insufficient resources. Potentialities related to management, teams and professionals, which could contribute to the implementation of a comprehensive care line, were also identified. However, the organization of care for child obesity still requires the connectivity of different actors' roles and tasks, with the agreement and co-responsibility between services, professionals and family. Key words: Obesity. Child. Adolescent. Comprehensive Health Care. Unified Health System.

O estudo teve como objetivo analisar a percepção de gestores e profissionais de saúde sobre o cuidado disponível para crianças e adolescentes com sobrepeso e obesidade no Sistema Único de Saúde em Sergipe, Brasil. Trata-se de um estudo qualitativo e exploratório, com amostra composta por 46 atores e coleta por meio de entrevistas semiestruturadas. O cuidado existente foi percebido como falho e fragmentado, independente do nível de atenção. As principais dificuldades abrangeram o processo de trabalho, a gestão e organização do cuidado, a adesão familiar e a insuficiência de recursos. Potencialidades relacionadas à gestão, equipes e profissionais, que poderiam contribuir para implantação de uma linha de cuidado integral, foram também identificadas. Contudo, a organização do cuidado à obesidade infantil ainda requer uma conectividade dos papéis e tarefas dos diversos atores, por meio da pactuação e corresponsabilização entre os serviços, profissionais e a família. Palavras-chave: Obesidade. Criança. Adolescente. Assistência Integral à Saúde. Sistema Único de Saúde.

Effect of luting cement thickness on the bond strength of glass fiber posts to dentin.

The objective of this study was to evaluate the effect of cement thickness and luting cement type on the push-out bond strength of glass fiber posts (GFPs) to root dentin. Sixty human maxillary root-filled canines or premolars with single straight roots were randomly divided into 6 groups (n = 10) according to the GFP configuration (conventional or relined with composite resin) and the cement used (RelyX U200, Ketac Cem, or Allcem Core). After endodontic treatment and GFP cementation, all of the roots were sectioned perpendicular to their long axis to obtain 1.0-mm-thick slices (n = 6 per group), which were mounted on a universal testing machine and submitted to a push-out test. The data (n = 45 to 51 specimens per group because of pretest failures) were analyzed by means of 2-way analysis of variance (ANOVA) and Tukey tests (α = 0.05). The type of failure was determined under a stereomicroscope, and representative specimens were observed with scanning electron microscopy. Significant interactions between the cements and GFP configurations were detected in the coronal and apical thirds (P < 0.05; 2-way ANOVA). For the coronal third, both RelyX U200 cement groups exhibited the greatest push-out bond strengths but were not significantly different from the Allcem Core relined group. For the middle third, no statistically significant interactions were observed between the cements and GFP configurations (P = 0.232; 2-way ANOVA). Adhesive failure between the dentin and cement layer was the most frequently observed failure mode. As expected, because of the composite resin added to relined GFPs, the cement layer was thinner in those groups. The type of cement used played an important role in the push-out bond strength.

Laboratory methods to simulate the mechanical degradation of resin composite restorations.

OBJECTIVES: This study reviewed the literature to identify in vitro approaches that have been used to simulate the mechanical degradation and fatigue of resin composite restorations. METHODS: A search for articles was carried out in 4 databases and included studies in which composite restorations were bonded to teeth and subject to cyclic loading. Articles were assessed for eligibility, and the following items were the extracted from the included studies: authors, country, year, materials tested, simulation device and details including load magnitude and frequency, number of cycles, type of antagonist, test medium, and temperature. Data were analyzed descriptively. RESULTS: The 49 studies included showed a high level of heterogeneity in methods, devices, and test parameters. Nineteen different simulation devices were used, applying loads varying between 30 and 2900 N, and frequencies varying between 0.4 and 12 Hz. The load and frequency used most often were ~ 50 N (63.3%) and 1.5-1.7 Hz (32.7%). The number of cycles varied between 10 K and 2.4 M, 1.2 M was the most prevalent (40.8%). The majority of studies combined cyclic loading with at least one additional aging method: static liquid storage, thermo-mechanical cycling applied simultaneously, and thermal cycling as a discrete aging step were the three most frequent methods. The overall evidence indicated reporting problems, and suggested a lack of clinical validation of the research methods used. SIGNIFICANCE: Validation studies, underlying clinical supporting data, and better reporting practices are needed for further improving research on the topic. Specific suggestions for future studies are provided.

Percepção de gestores e profissionais de saúde sobre o cuidado da obesidade infanto-juvenil no Sistema Único de Saúde / Health managers and professionals' perception on the care of child and adolescent obesity in Brazil's Unified Health System

Resumo O estudo teve como objetivo analisar a percepção de gestores e profissionais de saúde sobre o cuidado disponível para crianças e adolescentes com sobrepeso e obesidade no Sistema Único de Saúde em Sergipe, Brasil. Trata-se de estudo qualitativo e exploratório, com amostra composta por 46 atores e coleta de dados por meio de entrevistas semiestruturadas. O cuidado existente foi percebido como falho e fragmentado, independentemente do nível de atenção à saúde. As principais dificuldades abrangeram o processo de trabalho, a gestão e organização do cuidado, a adesão familiar e a insuficiência de recursos. Potencialidades relacionadas à gestão, equipes e profissionais, que poderiam contribuir para a implantação de uma linha de cuidado integral, foram também identificadas. Contudo, a organização do cuidado à obesidade infantil ainda requer uma conectividade dos papéis e tarefas dos diversos atores, por meio da pactuação e corresponsabilização entre os serviços, profissionais e a família.

Abstract The study aimed to analyze the perception of health managers and professionals on the care of children and adolescents with overweight and obesity in the Unified Health System of Sergipe, Brazil. This is a qualitative and exploratory study with sample composed of 46 actors and semi-structured interviews as data collection method. The existing care was perceived as poor and fragmented, regardless of the health care level. The main difficulties were the professionals' work process, care management and organization, family support and insufficient resources. Potentialities related to management, teams and professionals, which could contribute to the implementation of a comprehensive care line, were also identified. However, the organization of care for child obesity still requires the connectivity of different actors' roles and tasks, with the agreement and co-responsibility between services, professionals and family.

Ceramic Laminate Veneers Luted with Preheated Resin Composite: A 10-Year Clinical Report.

Resin cement and preheated restorative resin composite may be used for luting laminate veneers. The main advantage of resin composite is increased wear resistance, which could lead to better marginal performance in long term. This article reports a clinical treatment with feldspar laminate veneers luted to the maxillary teeth with preheated resin composite in a private practice. Case was finalized in May 2009 and followed by 10 years. Excellent clinical service and remarkable long-lasting marginal integrity were observed after 123 months. Scanning electron microscopy analysis showed no wear, gaps, or ditching at the margins. Restorative margins showed a smooth transition between ceramic and tooth with no signs of degradation. Preheated resin composite for luting ceramic laminate veneers may be considered an excellent clinical option.

Clinical performance of direct composite resin restorations in a full mouth rehabilitation for patients with severe tooth wear: 5.5-year results.

OBJECTIVES: To evaluate the 5.5-year performance of direct resin composite restorations, prescribed for patients with severe tooth wear, requiring full-mouth rehabilitation. METHODS: A convenience sample of 34 patients were recruited to a prospective trial between December 2010 and June 2013. The participants were provided 1269 full-mouth direct resin composite restorations (Clearfil AP-X) by 5 experienced operators, using the DSO-technique. Treatment resulted in an increase in the vertical dimension of occlusion (VDO). Failure was assessed at three levels. Frequencies of failure were analysed using Kaplan Meier survival curves and the effects of the relevant variables calculated with a multifactorial Cox regression (p < 0.05). RESULTS: Annual failure rates (for all levels of failure, 'Level 3- ') of ≤ 2.2% and ≤ 2.9% were respectively reported for the anterior and posterior restorations with a mean observation time of 62.4 months. The completion of an anterior restoration with the need for further appointments resulted in significantly more Level 2- & 3- failures. An evaluation of the performance of the premolar and posterior maxillary restorations showed significantly lowered risks of certain types of failures, compared to the molar and posterior mandibular restorations. CONCLUSIONS: At 5.5 years, 2.3% of the overall restorations displayed catastrophic, (Level 1) failures. Molar restorations, posterior mandibular restorations and the anterior restorations requiring two further sessions for completion, were associated with significantly higher risks for failure. CLINICAL SIGNIFICANCE: Direct resin composite can offer an acceptable medium-term option for the treatment of severe, generalized tooth wear; molar restorations may require higher maintenance.

The effect of pre-treatment levels of tooth wear and the applied increase in the vertical dimension of occlusion (VDO) on the survival of direct resin composite restorations.

OBJECTIVES: To investigate the effects of the level of pre-treatment tooth wear and increasing the VDO on the performance of direct resin composite restorations for the rehabilitation of pathological tooth wear. METHODS: Full-mouth (pre-treatment) grading was performed on digital greyscale scan records for 34 participants (35.3 ± 8.4 years) with signs of moderate-to-severe generalised tooth wear, using the Tooth Wear Evaluation System and the Basic Erosive Wear Examination. Each participant received full-mouth direct resin composite restorations, with increased VDO. The post-treatment increase in the VDO was determined. Recalls were planned after 1 month, and after 1, 3, and 5 years. Three 'levels' of restoration failure were described. The effects of the variables on the frequencies of restoration failure were calculated with a multivariable Cox regression, (p < 0.05). RESULTS: 1269 restorations were placed with a mean observation period of 62.4 months. Increasing the VDO by 1 mm significantly reduced the risks of all levels of anterior restoration failure (HR ≤ 0.62, p ≤ 0.025). A higher anterior BEWE surface score was associated with increased risks of Level 2- & 3- failures, (HR ≥ 1.29, p ≤ 0.019). Premolar restorations showed lower risks of Level 2- & 3- failure, compared to the molar restorations, (HR ≤ 0.5, p ≤ 0.005). CONCLUSION: Levels of pre-treatment wear and the applied change in the VDO significantly affected failure risk. CLINICAL RELEVANCE: Direct resin composite restorations for the rehabilitation of wear should be made as voluminous as possible, respecting the presenting biological, functional, and esthetic constraints.

Risk factors for absenteeism due to musculoskeletal diseases in workers in the judiciary sector.

Introduction: Musculoskeletal diseases represent an important health problem for workers, due to the degree of suffering caused by pain and to the high frequency of absenteeism. Objectives: To identify risk factors for absenteeism due to musculoskeletal disease in employees at a judiciary court and to describe incidence, frequency, and duration of sick leaves. Methods: This is a 6-year follow-up study conducted in the state of Bahia, Brazil. The dependent variable was absenteeism, measured by the time of the first sick leave in the period. The Kaplan-Meier method was used to estimate survival functions, whereas risk factors for absenteeism were obtained by Cox regression. Results: Overall, 594 workers took sick leaves, with an incidence of 23% at the end of the period. The most frequent diagnoses were back pain (38.5%), shoulder lesions (11.7%), and synovitis and tenosynovitis (8.8%). Cases of one episode of sick leave per worker over the 6 years predominated (42.8%). Cox regression multivariate analysis identified the following variables as posing the greatest risk for sick leave: female sex (hazard ratio 1.39), age older than 40 years (hazard ratio 2.57), judicial technician workers (hazard ratio 1.48), and administrative workers (hazard ratio 1.30). Conclusions: Women, older adults, and individuals who hold technical positions are worthy of attention from health management department of the court, since they presented the highest rates of incapacity to work during the study period. Back pain was the main reason for musculoskeletal disability.

Introdução: As doenças musculoesqueléticas representam um importante agravo na saúde dos trabalhadores devido ao grau de sofrimento gerado pelos quadros de dor e às elevadas frequências de absenteísmo. Objetivos: Identificar os fatores de risco para o absenteísmo por doença musculoesquelética em trabalhadores de um tribunal do setor judiciário e descrever a incidência, os indicadores de frequência e a duração das licenças médicas. Métodos: Estudo com seguimento de 6 anos, conduzido na Bahia. A variável dependente foi absenteísmo, medida através do tempo até a primeira licença médica no período. Utilizou-se o método de Kaplan-Meier para estimar as funções de sobrevida, enquanto os fatores de risco para o absenteísmo foram obtidos pela regressão de Cox. Resultados: Um total de 594 trabalhadores apresentaram licenças médicas, sendo a incidência ao final do período igual a 23%. Observou-se maior frequência de diagnósticos de dorsalgia (38,5%), lesões no ombro (11,7%) e sinovite e tenossinovite (8,8%). Predominaram casos de episódio único de licença médica por trabalhador ao longo dos 6 anos (42,8%). A análise múltipla com regressão de Cox identificou as seguintes variáveis como de maior risco para o afastamento do trabalho: sexo feminino (hazard ratio 1,39), idade acima de 40 anos (hazard ratio 2,57), cargo de técnico judiciário (hazard ratio 1,48) e atuantes na área administrativa (hazard ratio 1,30). Conclusões: Mulheres, pessoas com maioridade e indivíduos que ocupam cargo técnico devem receber atenção da gestão do tribunal, visto que apresentaram a maior incapacidade para o trabalho no período estudado. As dorsalgias figuraram como o principal motivo da incapacidade musculoesquelética.

Viscosity and thermal kinetics of 10 preheated restorative resin composites and effect of ultrasound energy on film thickness.

OBJECTIVE: This study investigated viscosity and thermal kinetics of 10 selected preheated restorative resin composites and the effect of ultrasound energy on film thickness. METHODS: A range of different resin composites was tested: Charisma Diamond, IPS Empress Direct, Enamel Plus HRi, Essentia, Estelite Omega, Filtek Z100, Filtek Z350 XT, Gradia, TPH Spectrum and VisCalor. A flowable resin composite (Opallis Flow) and two resin cements (RelyX Veneer, Variolink Esthetic LC) also were tested. Viscosity (Pa s) was measured at 37 °C and 69 °C (preheating temperature) using a rheometer. Film thickness (µm) was measured before and after application of ultrasound energy. Temperature loss within resin composite following preheating (°C/s) was monitored. Data were statistically analyzed (α = 0.05). RESULTS: Viscosity at 69 °C was lower than at 37 °C for all materials except the flowable resin composite. Preheating reduced viscosity between 47% and 92% for the restorative resin composites, which were generally more viscous than the flowable materials. Film thickness varied largely among materials. All preheated resin composites had films thicker than 50 µm without ultrasound energy. Application of ultrasound reduced film thickness between 21% and 49%. Linear and nonlinear regressions did not identify any relationship between filler loading, viscosity, and/or film thickness. All materials showed quick temperature reduction following preheating, showing maximum temperature loss rates after approximately 10 s. SIGNIFICANCE: Distinct restorative resin composites react differently to preheating, affecting viscosity and film thickness. The overall performance of the preheating technique depends on proper material selection and use of ultrasound energy for reducing film thickness.

Degradation of antibiotic ciprofloxacin by different AOP systems using electrochemically generated hydrogen peroxide.

The present work reports the degradation of the antibiotic ciprofloxacin (CIP) by different advanced oxidative process systems (UV; Anodic Oxidation; H2O2; H2O2/UV; H2O2/Fe2+ and H2O2/UV/Fe2+) in an electrochemical cell using gas diffusion electrode (GDE) for the synthesis of hydrogen peroxide. CIP degradation and mineralization were evaluated by high efficiency liquid chromatography (HPLC) and total organic carbon (TOC) techniques. Of all the systems investigated, the photoelectro-Fenton system presented the best degradation efficiency; this system promoted highly significant mineralization percentages of 54.8% and 84.6% in 90 and 360 min, and relatively lower energy consumption rates of 4110.0 and 9808.2 kWh kg-1 TOC, respectively. In 6 h period of experiment, the main degradation products of ciprofloxacin were identified, and the aliphatic acids obtained helped confirm the rupture of the aromatic ring. The application of the photoelectro-Fenton process with in situ eletroctrogeneration of H2O2 using GDE has proved to be suitably promising for the treatment of organic pollutants.

Servidores com deficiência vinculados à administração pública indireta no nordeste do Brasil / Disabled civil servants with ties to the indirect public administration in the northeast of Brazil / Servidores públicos con discapacidad vinculados a la administración pública indirecta en el noreste de Brasil

Resumo A Constituição Federal de 1988 estabeleceu vagas específicas às pessoas com deficiência no setor público brasileiro. O artigo teve por objetivo traçar o perfil demográfico e socioeconômico das pessoas com deficiência nos nove estados do Nordeste e compará-lo ao dos servidores sem deficiência, no ano de 2017. Estudo transversal com dados secundários da Relação Anual de Informações Sociais sobre 312.194 servidores. Calcularam-se as frequências de servidores com e sem deficiência segundo sexo, tipo de deficiência, faixa etária, escolaridade, ocupação, tipo de vínculo, tempo de emprego, remuneração e carga horária semanal. O percentual de pessoas com deficiência esteve abaixo de 2%, idade média 44,2 anos (DP 10,4), predomínio do sexo masculino, escolaridade fundamental completo e vínculo celetista. Ao estratificar por tipo de vínculo e demais variáveis, o servidor sem deficiência possui maior tempo de emprego, maior salário-hora, maior remuneração e menor carga horária semanal do que servidores com deficiência. A menor presença feminina entre as pessoas com deficiência no setor público e as menores remunerações percebidas no grupo de servidores com deficiência podem nortear, dentro desses espaços, a necessidade de mais políticas de inclusão e isonomia e de estudos nessa linha de investigação.

Abstract The 1988 Brazilian Federal Constitution established specific posts for disables people in the public sector. The present article had the goal of describing the demographic and socioeconomic profile of disabled persons in the nine states of the Northeastern region of Brazil and compare it to that of the civil servants without disabilities in 2017. It is a cross-sectional study with secondary data from the Annual List of Social Data about 312,194 civil servants. We calculated the frequencies of the civil servants with and without disabilities according to gender, type of disability, age group, level of schooling, occupation, type of employment bond, time on the job, wage, and weekly working hours. The percentage of people with disabilities was below 2%, and the sample had a mean age of 44.2 years (standard deviation: 10.4), a higher prevalence of the male gender, basic level of schooling, and their jobs were tied to the Brazilian Consolidated Labor Legislation. By stratifying by type of employment bond and other variables, the civil servant without disability has a longer time on the job, higher hourly wages, higher wages, and lower weekly working hours than the disabled civil servants. The lower presence of women among the persons with disabilities in the public sector, as well as the lower wages verified among the group of disabled civil servants may guide, within those spaces, the need for more policies of inclusion and isonomy, as well as for more studies following this line of investigation.

Resumen La Constitución Federal Brasileña de 1988 estableció plazas específicas para las personas con discapacidad en el sector público. El artículo tiene el objetivo de describir el perfil demográfico y socioeconómico de las personas con discapacidad en los nueve estados de la región Noreste de Brasil y compararlo con el de los servidores sin discapacidad en el año 2017. Se trata de un estudio transversal con datos secundarios de la Relación Anual de Informaciones Sociales sobre 312.194 servidores. Calculamos las frecuencias de servidores con y sin discapacidad según el género, el tipo de discapacidad, la franja etaria, la escolaridad, la ocupación, el tipo de vínculo, el tiempo en el trabajo, la remuneración y las horas semanales de trabajo. El porcentaje de personas con discapacidad estuvo abajo del 2%, y la muestra tenía edad media de 44,2 años (desviación estándar: 10,4), predominio del género masculino, escolaridad básica completa, y vínculo con la Consolidación de Leyes Laborales. Al estratificar por tipo de vínculo y por otras variables, el servidor sin discapacidad tiene más tempo en el trabajo, sueldo horario más alto, remuneración más alta, y menos horas de trabajo semanales que los servidores con discapacidad. La menor presencia femenina entre las personas con discapacidad en el sector público y las remuneraciones más bajas verificadas en el grupo de servidores con discapacidad pueden nortear, en eses espacios, la necesidad de más políticas de inclusión e isonomía, y de estudios en esa línea de investigación.

Factors associated with musculoskeletal disorders in artisanal fisherwomen/shellfish gatherers in Saubara, Bahia, Brazil. / Fatores associados com os distúrbios musculoesqueléticos em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil.

This article aims to identify the factors associated with musculoskeletal disorders (MSDs) in the neck/shoulder and distal upper limb in artisanal fisher/shellfish gatherers in Saubara, Bahia, Brazil. This cross-sectional epidemiological study was conducted with shellfish gatherers. The Brazilian version of the Job Content Questionnaire (JCQ), the Nordic Musculoskeletal Questionnaire (NMQ), and a questionnaire containing physical demands adapted to the labour of shellfish gatherers were used in this study. Factor analysis was performed to aggregate the physical demands. Multivariate analyses were performed according to the risk factors for MSDs in the neck or shoulder and MSDs in the distal upper limb. For MSDs in the neck or shoulders, a prevalence ratio (PR) of 1.28 (95% confidence interval [95% CI]: 1.09-1.49) was found, according to the aggregate physical demands. For MSDs in the distal upper limb, the PRs were as follows: 1.26 (95% CI: 1.07-1.47) according to the daily hours devoted to work as shellfish gatherers, 0.74 (95% CI: 0.57-0.96) according to the development of other current work and 1.38 (95% CI: 1.05-1.83) according to the aggregate physical demands. The activities performed by shellfish gatherers contribute to the occurrence of MSDs.

O presente artigo tem como objetivo identificar os fatores associados com os distúrbios musculoesqueléticos (DME) em pescoço/ombro e membros superiores distais em pescadoras artesanais/marisqueiras em Saubara, Bahia, Brasil. Trata-se de um estudo de corte transversal realizado com 209 pescadoras artesanais/marisqueiras. Foram utilizados para este estudo a versão brasileira do questionário de conteúdo do trabalho e do questionário nórdico e um questionário das demandas físicas para o trabalho. As análises multivariadas foram feitas de acordo com os principais fatores de risco para DME. Algumas demandas físicas agrupadas, nas etapas da coleta dos mariscos e na cata, se associaram, respectivamente, com DME em pescoço ou ombro [Razão de Prevalência - RP: 1,28 (IC95%: 1,09-1,49)] e DME em membros superiores distais [RP: 1,38 (IC95%: 1,05-1,83)], no modelo final ajustado. As RP ajustadas para DME em membros superiores distais foram de 1,26 (IC95%: 1,07-1,47), de acordo com as horas diárias dedicadas ao trabalho como marisqueira, e 0,74 (IC95%: 0,57-0,96) de acordo com o desenvolvimento de outro trabalho atualmente. O modo em que é desenvolvido o trabalho da marisqueira é importante para ocorrência dos DME.