Using information and communication technologies (ICTs) to solve the repressed demand for primary dental care in the Brazilian Unified Health System due to the COVID-19 pandemic: a randomized controlled study protocol nested with a before-and-after study including economic analysis.

BACKGROUND: With the COVID-19 pandemic, thousands of children had their dental care interrupted or postponed, generating a pent-up demand for primary care. To minimize the impact of this outage, information and communication technologies (ICT) could be an alternative. The aim of this study is to elucidate the impact of implementing the ICTs in primary dental care for children on resolving the pent-up demand for primary dental care to children in the national health system service (SUS) due to the COVID-19 pandemic. METHODS: Different research strategies are being proposed to demonstrate such effect and extrapolating findings to a real-world context to guide further research, practice and policies: two clinical trials (one randomized controlled by the waiting list trial (RCT) and a before-and-after study), one simulation study to prospect trial results to a broader population and three economic evaluations using different effects. Children enrolled in a reference dental unit will be invited to participate in the before-and-after study for trials. The first 368 families will be randomized for the RCT to the intervention vs waiting list. All participants will receive the intervention, but the waiting list group will be assessed before the intervention is available for them. The intervention comprises standardized non-face-to-face primary dental care using the V4H platform. The problem-solving and the family's perception will be the primary outcomes set for the before-and-after study and RCT, respectively. They will be measured 2 weeks after randomization. Based on trial findings, we will develop theoretical models to estimate how the intervention could benefit the population included in the national health system.  Three economic evaluations will be carried out considering different trial effects (cost-effectiveness analyses). A societal perspective and the pandemic time horizon will be considered. Possible social impact (inequalities) will also be explored. DISCUSSION: This ongoing trial may be an essential contribution to clarify positive and negative aspects related to the use of technologies for non-face-to-face dental care for children. Trial products may bring relevant contributions to the pandemic context and the post-pandemic period. Potential benefits may be feasible to implement and preserve in the health system even in the post-pandemic period. Trial registration Clinicaltrials.gov registration NCT04798599 (registered March 2021).

Análise comparativa de características tomográficas de nódulos e massas pulmonares benignas e malignas / Comparative analysis of tomographic features of benign and malignant nodules and lung masses

Introdução: a análise quantitativa das características de nódulos e massas pulmonares por meio da tomografia computadorizada pode auxiliar o diagnóstico médico a estratificar o risco de malignidade. Objetivo: comparar características tomográficas de massas e nódulos pulmonares benignos e malignos, identificando a intensidade em escala de Hounsfield e padrões de textura. Método: estudo transversal, quantitativo, descritivo de levantamento. Foram selecionados prontuários de pacientes internados no Hospital Nossa Senhora da Conceição (HNSC) em Tubarão-SC, no ano de 2014 com diagnósticos de neoplasia benigna dos brônquios e do pulmão (NPB) (D143) e neoplasia maligna do lobo superior, do brônquio ou pulmão (NPM) (C34). Resultados: Foi observado que a chance para malignidade esteve relacionada ao sexo masculino OR=9,4 (IC 95% 1,7­51,1) com p=0,009, área>13,18 cm2 OR=14,6 (IC 95% 2,6­82,1) com p=0,002, nos parâmetros de textura, a correlação≤0,166550 OR=10,3 (IC 95% 2,1­49,2) com p=0,004 e momento inverso da diferença> 0,166550 OR=28,0 (IC 95% 4,2­184,3) com p=0,001. Conclusão: houve diferença entre os grupos NPB e NPM entre os parâmetros clínico-epidemiológicos e entre algumas características de textura analisadas.

Introduction: the quantitative analysis of the characteristics of nodules and lung masses by computed tomography can help the medical diagnosis to stratify the risk of malignancy. Objective: to compare the characteristics of benign and malignant pulmonary masses and nodules, identifying the intensity of the Hounsfield scale and texture patterns. Method: cross-sectional, quantitative, descriptive survey. A selection of medical records was made, observing patients hospitalized at Hospital Nossa Senhora da Conceição (HNSC) in Tubarão-SC in the year 2014 with diagnosis of benign neoplasms of the bronchi and lungs (BNL) (D143) and malignant neoplasms of the upper lobe, bronchus or lung (MNL) (C34). Results: It was observed that a chance for malignancy was related to male OR = 9.4 (95% CI 1.7-51.1) with p = 0.009, area> 13.18 cm2 OR = 14.6 (95% CI 2.6-82.1) with p = 0.002, in texture, the correlation <0.166550 OR = 10.3 (95% CI 2.1-49.2) with p = 0.004 and inverse difference time> 0.166550 OR = 28.0 (CI 95% 4.2-184.3) with p = 0.001. Conclusion: there was a difference between the BNL and MNL groups between the clinical-epidemiological criteria and some texture characteristics analyzed.

Passages on Brazilian scientific cinema.

The article examines the conditions of production and recognition of scientific cinema in Brazil by comparing three distinct moments and contexts: the first moment takes place in the nineteenth century, and it is related to the contribution of a Brazilian astronomer otherwise little known to Brazilian film scholars, the second addresses Benedito Junqueira Duarte's voluminous mid-twentieth-century filmography, and the third moment documents recent scientific film experiences within ultra high resolution movies transmitted over photonic networks. Future trajectories for aesthetic concerns and practical issues such as the archiving of ultra high definition cinema are usefully informed by these histories of scientific cinema, even as a current generation of multidisciplinary teams including scientists, filmmakers, computer scientists, and network engineers reinvent, rediscover, and necessarily expand the scientific cinema toward concerns of real time collaboration and teaching.

Dispositivos de atenção psicossocial

O conteúdo deste e dos demais módulos do Curso de Especialização em Saúde Mental abordam temas relativos ao cuidado territorial e à prática da atenção psicossocial voltada às pessoas em sofrimento psíquico. Inicialmente, abordam a noção de sofrimento e sua vinculação às dimensões de vida que compõem os sujeitos. Discute-se princípios, diretrizes e dispositivos da abordagem territorial como vínculo, ação territorial, responsabilização, projeto terapêutico singular, matriciamento, construção de projetos de vida, redução de danos, gestão do cuidado. Finalmente, abordam os dispositivos da Atenção Psicossocial, como as práticas de convivência, as práticas culturais, as ações de reabilitação psicossocial, o habitar, os projetos de inserção no trabalho, o protagonismo de usuários e familiares, elementos da saúde mental infanto-juvenil, e discute o conceito de Reforma Psiquiátrica e de Desinstitucionalização.