Abstract This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06–0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64–26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained.

Resumo Esta revisão avaliou o conhecimento dos profissionais de saúde (PS) sobre amamentação e fatores que levam ao desmame. Realizou-se buscas em quatro bancos de dados eletrônicos e literatura cinzenta. A estratégia de busca incluiu termos Mesh e sinônimos. Não se adotou restrição de idioma ou data. Estudos avaliando o conhecimento dos PS sobre amamentação e desmame foram elegíveis. Estudos recuperados pelas buscas foram avaliados por dois examinadores independentes. Dos 1.417 estudos recuperados, 35 foram incluídos. Muitos países e PS de diferentes áreas foram analisados. Nenhum estudo avaliou o conhecimento dos dentistas. Embora os PS conheçam os benefícios da amamentação, a duração recomendada pela Organização Mundial da Saúde, exclusiva ou não, não está alinhada com o endosso de todos os PS. Considerando o desmame, a informação é escassa. No entanto, os PS estão atentos às principais causas potenciais do desmame precoce. O conhecimento dos PS é conflitante sobre amamentação e incomum sobre o desmame. Não foram encontrados estudos que apresentassem dados sobre o conhecimento de dentistas sobre a temática. Investigações quanto ao conhecimento dos mesmos e medidas de educação para todos os PS são necessárias, considerando que são frequentemente questionados sobre o tema.

Abstract This review evaluated the knowledge of health professionals (HP) about breastfeeding and factors that leading the weaning. A search was performed in four electronics databases and the grey literature. The search strategy included Mesh terms and synonyms. No language or date restrictions were adopted. Studies that evaluated the knowledge of HP about breastfeeding and weaning were considered eligible. The studies retrieved by the searches were evaluated by two independently examiners. From 1,417 studies retrieved, 35 were included. Many countries and professionals from different health areas were analyzed. No studies evaluated the dentists’ knowledge. Although the included HP know the benefits of breastfeeding for health, the length of breastfeeding recommended by the World Health Organization, exclusive or not, was not aligned with all professionals’ endorsement. Information about weaning is scarce; however, HP are mindful of the main potential causes of early weaning. The knowledge of HP is conflicting about breastfeeding and unusual about weaning. Furthermore, no studies were found that presented data on the knowledge of dentists on the subject. Thus, assessments of dentists’ knowledge and education measures for HP are necessary since they are frequently questioned about these issues.

Resumo Esta revisão avaliou o conhecimento dos profissionais de saúde (PS) sobre amamentação e fatores que levam ao desmame. Realizou-se buscas em quatro bancos de dados eletrônicos e literatura cinzenta. A estratégia de busca incluiu termos Mesh e sinônimos. Não se adotou restrição de idioma ou data. Estudos avaliando o conhecimento dos PS sobre amamentação e desmame foram elegíveis. Estudos recuperados pelas buscas foram avaliados por dois examinadores independentes. Dos 1.417 estudos recuperados, 35 foram incluídos. Muitos países e PS de diferentes áreas foram analisados. Nenhum estudo avaliou o conhecimento dos dentistas. Embora os PS conheçam os benefícios da amamentação, a duração recomendada pela Organização Mundial da Saúde, exclusiva ou não, não está alinhada com o endosso de todos os PS. Considerando o desmame, a informação é escassa. No entanto, os PS estão atentos às principais causas potenciais do desmame precoce. O conhecimento dos PS é conflitante sobre amamentação e incomum sobre o desmame. Não foram encontrados estudos que apresentassem dados sobre o conhecimento de dentistas sobre a temática. Investigações quanto ao conhecimento dos mesmos e medidas de educação para todos os PS são necessárias, considerando que são frequentemente questionados sobre o tema.

Abstract This review evaluated the knowledge of health professionals (HP) about breastfeeding and factors that leading the weaning. A search was performed in four electronics databases and the grey literature. The search strategy included Mesh terms and synonyms. No language or date restrictions were adopted. Studies that evaluated the knowledge of HP about breastfeeding and weaning were considered eligible. The studies retrieved by the searches were evaluated by two independently examiners. From 1,417 studies retrieved, 35 were included. Many countries and professionals from different health areas were analyzed. No studies evaluated the dentists’ knowledge. Although the included HP know the benefits of breastfeeding for health, the length of breastfeeding recommended by the World Health Organization, exclusive or not, was not aligned with all professionals’ endorsement. Information about weaning is scarce; however, HP are mindful of the main potential causes of early weaning. The knowledge of HP is conflicting about breastfeeding and unusual about weaning. Furthermore, no studies were found that presented data on the knowledge of dentists on the subject. Thus, assessments of dentists’ knowledge and education measures for HP are necessary since they are frequently questioned about these issues.

A pandemia da COVID-19 tem levado a mudanças em indivíduos e famílias, com efeitos psicológicos adversos, principalmente em adultos jovens, mulheres e pais e mães. O estudo buscou averiguar a prevalência de episódio depressivo maior atual (EDMA) em mães de pré-escolares (até 5 anos de idade) e estressores associados durante a pandemia da COVID-19 em uma cidade no Sul do Brasil. Este é um estudo transversal aninhado em um estudo de base populacional com mães. Todas as mães foram entrevistadas através de contato telefônico durante a pandemia da COVID-19. Os autores usaram a Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para avaliar a presença de EDMA. A análise estatística foi realizada, calculando o qui-quadrado e a regressão logística multivariada. Foram avaliadas 666 mães. A prevalência de EDMA foi de 12,3%. Mães com perdas financeiras apresentaram probabilidade 2,1 vezes maior (IC95%: 1,3-3,4) de apresentar EDMA, comparadas com aquelas que mantiveram a situação financeira. Com base nos resultados, os autores observaram que perdas financeiras foram determinantes para a prevalência maior de depressão materna.

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

La pandemia de COVID-19 ha provocado cambios en los individuos y las familias, causando efectos psicológicos adversos, especialmente en los adultos jóvenes, las mujeres y los padres y madres. El objetivo de este estudio fue verificar la prevalencia del episodio depresivo mayor actual (EDMA) en madres de preescolares (hasta 5 años) y sus estresores asociados durante la pandemia de COVID-19 en una ciudad del sur de Brasil. Se trata de un estudio transversal anidado en un estudio poblacional con madres. Todas las madres fueron entrevistadas mediante contacto telefónico durante la pandemia de COVID-19. Se utilizó la Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para evaluar la presencia de EDMA. El análisis estadístico se realizó calculando la prueba de chi-cuadrado y una regresión logística multivariante. Se evaluaron 666 madres. La prevalencia de EDMA fue del 12,3%. Las madres con pérdidas económicas tenían un 2,1 (IC95%: 1,3-3,4) más probabilidades de presentar EDMA que las que mantuvieron su situación económica. Teniendo en cuenta los resultados, observamos que las pérdidas económicas fueron determinantes para la mayor prevalencia de depresión materna.

A pandemia da COVID-19 tem levado a mudanças em indivíduos e famílias, com efeitos psicológicos adversos, principalmente em adultos jovens, mulheres e pais e mães. O estudo buscou averiguar a prevalência de episódio depressivo maior atual (EDMA) em mães de pré-escolares (até 5 anos de idade) e estressores associados durante a pandemia da COVID-19 em uma cidade no Sul do Brasil. Este é um estudo transversal aninhado em um estudo de base populacional com mães. Todas as mães foram entrevistadas através de contato telefônico durante a pandemia da COVID-19. Os autores usaram a Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para avaliar a presença de EDMA. A análise estatística foi realizada, calculando o qui-quadrado e a regressão logística multivariada. Foram avaliadas 666 mães. A prevalência de EDMA foi de 12,3%. Mães com perdas financeiras apresentaram probabilidade 2,1 vezes maior (IC95%: 1,3-3,4) de apresentar EDMA, comparadas com aquelas que mantiveram a situação financeira. Com base nos resultados, os autores observaram que perdas financeiras foram determinantes para a prevalência maior de depressão materna.

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

La pandemia de COVID-19 ha provocado cambios en los individuos y las familias, causando efectos psicológicos adversos, especialmente en los adultos jóvenes, las mujeres y los padres y madres. El objetivo de este estudio fue verificar la prevalencia del episodio depresivo mayor actual (EDMA) en madres de preescolares (hasta 5 años) y sus estresores asociados durante la pandemia de COVID-19 en una ciudad del sur de Brasil. Se trata de un estudio transversal anidado en un estudio poblacional con madres. Todas las madres fueron entrevistadas mediante contacto telefónico durante la pandemia de COVID-19. Se utilizó la Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para evaluar la presencia de EDMA. El análisis estadístico se realizó calculando la prueba de chi-cuadrado y una regresión logística multivariante. Se evaluaron 666 madres. La prevalencia de EDMA fue del 12,3%. Las madres con pérdidas económicas tenían un 2,1 (IC95%: 1,3-3,4) más probabilidades de presentar EDMA que las que mantuvieron su situación económica. Teniendo en cuenta los resultados, observamos que las pérdidas económicas fueron determinantes para la mayor prevalencia de depresión materna.

Abstract: The purpose of this review was to systematically evaluate all the existing literature on the efficacy of treatments used to relieve the signs and symptoms associated with teething. A systematic search up to February 2021, without restrictions on language or date of publication, was carried out in MEDLINE/PubMed, SCOPUS, Web of Science, The Cochrane Library, EMBASE, LILACS, BBO, OpenGrey, Google Scholar, Portal de Periódicos da CAPES, clinicaltrials.gov, and the references of the included studies. Clinical studies that evaluated the effect of any intervention to alleviate the signs and symptoms associated with teething in babies and children were included. The risk of bias was assessed using the ROB-2 and ROBINS-I tools. The characteristics and results of the individual studies were extracted and synthesized narratively. The GRADE approach was followed to rate the certainty of the evidence. Three randomized and two non-randomized clinical trials were included. The outcomes of these five articles were classified as high or serious risk of bias. Three studies using homeopathy reported improvement in appetite disorders, gum discomfort, and excess salivation. One study showed a new gel with hyaluronic acid was more effective than an anesthetic gel in improving signs and symptoms such as pain, gingival redness, and poor sleep quality. Another study applied non-pharmacological treatments, which were more effective, especially against excess salivation. Although the present systematic review suggests some therapies could have a favorable effect on signs and symptoms related to teething, definitive conclusions on their efficacy cannot be drawn because of the very low certainty of the evidence. The existing literature on the subject is scarce and heterogeneous and has methodological flaws; therefore, further high-quality investigations are necessary.

RESUMO: O objetivo deste estudo foi medir a Disposição dos Consumidores a Pagar (DCP) por ingressos em atrações turísticas que eles nunca haviam visitado anteriormente, depois de visualizar imagens de atração turística como as mostradas no Instagram, por exemplo. Este artigo avaliou os possíveis efeitos das imagens na disposição dos jovens a pagar ingressos, em três atrações turísticas, em cada um dos cinco países mais visitados por brasileiros em 2017, a saber, Estados Unidos da América, Espanha, Argentina, França e Portugal. Primeiramente, foi feito um estudo piloto que contou com a participação de 60 universitários, com idades entre 18 e 35 anos e que nunca haviam viajado ao exterior, com uma única pergunta: qual o valor mínimo e máximo que estariam dispostos a pagar para cada uma das atrações turísticas apresentadas? Duas semanas depois, aplicou-se um questionário com essa mesma pergunta para 400 universitários com as mesmas particularidades supracitadas. Após responderem a esse questionário, foram convidados a visualizarem uma imagem de cada um dos atrativos para, em seguida, tornar a responder a mesma pergunta. Os resultados mostraram que a “imagem” melhorou sua DCP, embora em 20% das atrações os efeitos fossem contrários. Os resultados sugeriram contribuições importantes para os setores público e privado quando relacionados ao marketing do turismo.

ABSTRACT: The aim of this study was to measure consumers’ willingness-to-pay (WTP) for tickets to tourist attractions that they have never previously visited, after viewing images of the tourist attraction on Instagram and other media. It evalutes the possible effects of images on the young peoples’ willingness to pay for tickets, to three tourist attractions in each of the five countries most visited by Brazilians in 2017: the United States, Spain, Argentina, France, and Portugal. The sample included 400 Brazilians who had never travelled abroad before. First, a pilot study was carried out with 60 university students aged between 18 and 35 years who had never traveled abroad, asking them a single question: “What is the minimum and maximum amount you would be willing to pay for each of the tourist attractions presented?” Two weeks later, the same question was applied to 400 university students with the same profile. After answering the question, they were invited to look at some images of the attractions and then answer the same question again. The results showed that for most of the attractions, the “image” enhanced their WTP. However, for 20% of the attractions the opposite effect was seen. The results suggest that image makes an important contribution for the public and private sectors, when used in tourism marketing.

RESUMEN: El objetivo de este estudio fue medir la voluntad de pago del consumidor (VPC) para boletos a atracciones turísticas que nunca habían visitado antes, después de ver imágenes de ‘atracciones turísticas’ como las que se muestran en Instagram, por ejemplo. Este artículo evaluó los posibles efectos de las imágenes en la disposición de los jóvenes a pagar los boletos, en tres atracciones turísticas, en cada uno de los cinco países más visitados por los brasileños en 2017, a saber, los Estados Unidos de América, España, Argentina, Francia y Portugal. La muestra tenía 400 brasileños que nunca habían viajado al extranjero. En primer lugar, se realizó un estudio piloto con 60 estudiantes universitarios de entre 18 y 35 años que nunca habían viajado al exterior, con una sola pregunta: cuál es la cantidad mínima y máxima que estarían dispuestos a pagar por cada turista. Dos semanas después, se aplicó un cuestionario con la misma pregunta a 400 estudiantes universitarios con las mismas particularidades mencionadas anteriormente. Después de responder este cuestionario, se encontró que veían cada una de las imágenes de las atracciones para responder la misma pregunta. Los resultados mostraron que la “imagen” mejoró su VCP, aunque en el 20% de las atracciones los efectos fueron opuestos. Los resultados sugirieron importantes contribuciones a los sectores público y privado cuando se relacionan con el marketing turístico.

RESUMO Objetivo: Descrever as caracteristicas sociodemograficas, a capacidade funcional e a situacao vacinal de idosos, e verificar os fatores associados a situacao vacinal incompleta e a ausencia do cartao de vacinas. Método: Estudo transversal e analitico conduzido com idosos residentes na zona urbana de Uberaba (MG). Procedeu-se as analises descritiva, bivariada e regressao logistica multinomial (p<0,05). Resultados: Participaram 576 idosos. Predominaram os idosos do sexo feminino, na faixa etaria de 70├80 anos, com companheiro, baixa escolaridade e renda, que moravam acompanhados, independentes nas atividades basicas da vida diaria e com dependencia parcial nas atividades instrumentais. O maior percentual foi para os idosos que possuiam situacao vacinal incompleta, sobretudo em relacao a ausencia da imunizacao para Hepatite B. Foram associados a situacao vacinal incompleta a renda individual mensal ≤ 1 salario minimo (p=0,002) e o arranjo de moradia unipessoal (p=0,010); e a ausencia do cartao de vacinas, a menor escolaridade (p=0,039). Conclusão: As baixas renda e escolaridade, bem como residir sozinho, sao fatores associados as situacoes vacinais inadequadas dos idosos da comunidade. Ressalta-se a necessidade de que o enfermeiro da atencao primaria desenvolva estrategias para aumentar a cobertura vacinal entre os idosos com essas caracteristicas.

ABSTRACT Objective: To describe the sociodemographic characteristics, functional capacity and vaccination status of older adults, and to verify the factors associated with the incomplete vaccination status and the absence of the vaccination card. Method: Cross-sectional and analytical study conducted with older adults living in the city of Uberaba (MG). The following analyzes were carried out: descriptive, bivariate and multinomial logistic regression (p<0.05). Results: A total of 576 older adults participated. Most of them were women, in the 70-80 age group, with partner, low education and income, living with someone, independent in basic activities of daily living and with partial dependence on instrumental activities. The highest percentage was for older adults who had incomplete vaccination status, especially regarding the absence of immunization for Hepatitis B. Individual monthly income < 1 minimum wage (p=0.002) and single-person housing arrangement (p=0.010) were associated with the incomplete vaccination status, and the absence of the vaccination card, with the lowest level of education (p=0.039). Conclusion: Low income and education, as well as living alone, are factors associated with inadequate vaccination status among older adults in the community. The need for primary care nurses to develop strategies to increase vaccination coverage among older adults with these characteristics is emphasized.

RESUMEN Objetivo: Describir las caracteristicas sociodemograficas, la capacidad funcional y la situacion vacunal de los adultos mayores y comprobar los factores asociados con la situacion vacunal incompleta y la ausencia del carnet de vacunacion. Método: Se trata de un estudio transversal y analitico llevado a cabo con adultos mayores residentes en el area urbana de Uberaba, Minas Gerais, mediante un analisis descriptivo, bivariado y de regresion logistica multinomial (p<0,05). Resultados: Participaron 576 adultos mayores. Predominaban las mujeres de edad avanzada, 70├80 anos, con pareja, bajo nivel de escolaridad e ingresos, que vivian solas, independientes en las actividades basicas de la vida diaria y parcialmente dependientes de las actividades instrumentales. El porcentaje mas alto correspondia a los adultos mayores que tenian un estado de vacunacion incompleto, especialmente en lo que respecta a la ausencia de inmunizacion contra la hepatitis B. Los ingresos mensuales individuales ≤ 1 salario minimo (p=0,002) y la disposicion de una vivienda unifamiliar (p=0,010) estaban asociados con el estado de vacunacion incompleta, y la ausencia del carnet de vacunacion, con un nivel de escolaridad bajo (p=0,039). Conclusión: Los ingresos bajos y la educacion, asi como el hecho de vivir solo, son factores que estan asociados a un estado de vacunacion inadecuado en adultos mayores de la comunidad. Es importante que el enfermero de atencion primaria desarrolle estrategias para aumentar la cobertura de vacunacion entre los adultos mayores con dichas caracteristicas.

Abstract Objective: To evaluate the scientific evidence concerning the behavior rating scales efficiency to identify behavioral changes in preschool children undergoing dental treatment, through a systematic review. Material and Methods: MEDLINE/PubMed, Scopus, Cochrane Library, Web of Science, BVS databases and grey literature were searched. Also, a hand search of the included studies reference lists was conducted. Studies that evaluated healthy preschoolers’ behavior before and after invasive dental treatments to observe behavioral changes were included. Two independent reviewers selected studies, extracted data and analyzed the risk of bias with a tool for before-and-after studies. The certainty of the evidence was evaluated with the GRADE approach. Results: Three studies were included. The Frankl Scale and North Carolina Behavior Scale were used in these studies. Both scales were able to identify behavioral changes in preschool children undergoing a dental intervention, although two of these included studies were considered fair with a high risk of bias, and one considered good with a low risk of bias. Conclusion: Although Frankl and North Carolina behavior scales were able to identify changes in the children`s behavior during dental treatment, these findings are not supported by strong evidence. Thus, further well-designed studies are needed to confirm this evidence.

Abstract The main constituents of the Euterpe oleracea Mart., Arecaceae, fruits (açaí) are anthocyanins. This paper aimed to standardize the extraction process and characterize an anthocyanin-rich dry extract obtained from this fruit. A 23 full factorial design was used. The volumes of ethanol 92% and acetic acid and the extraction time were used as factors. Total solids and anthocyanins content were used as feedback. The dry extract was obtained by freeze-drying. The content of anthocyanins was determined spectrophotometrically. Fourier Transform Infrared Spectroscopy, Differential Scanning Calorimeter, Thermogravimetry, Scanning Electron Microscopy, and Atomic Absorption Spectrometry were used for characterizingthe dry extract. The DPPH method was used for evaluating radical scavenging activity. The extraction conditions were established. The most influent factor was the volume of acetic acid. The dry extract moisture content was equal to 1.39 ± 0.25%, the evaporation residue 97.25 ± 1.28%, total ashes 0.62 ± 0.12%, and the anthocyanin content was 61.75 ± 3.28%. The elemental composition shows the presence of manganese 4.85 ppm, iron 1.62 ppm, zinc 0.05, copper 1.38 ppm, calcium 1.01 ppm, cadmium 0.003 ppm, nickel 0.37 ppm, and lead 0.38 ppm. The dried extract IC50 estimated by the radical scavenging assay with DPPH was 31.25 ± 2.31 ppm. The optimal extraction conditions were: the volume of ethanol 92%: 400 ml; volume of acetic acid: 75 ml; an extraction time: 4 h.

Resumo Introdução A alimentação escolar é uma importante estratégia na formação de hábitos alimentares saudáveis. Objetivo Analisar os cardápios ofertados aos alunos do Ensino Fundamental em Moju-PA e o número de nutricionistas atuantes no Programa Nacional de Alimentação Escolar. Método Estudo transversal, descritivo e quantitativo realizado em escolas de Ensino Fundamental, no ano de 2015. Analisou-se a composição química dos alimentos dos cardápios, a oferta de frutas, hortaliças, doces e/ou preparações doces e alimentos restritos, e o número de profissionais contratados. Para a análise da composição química, utilizou-se a Tabela Brasileira de Composição de Alimentos, o Instituto Brasileiro de Geografia e Estatística. O consumo e as adequações de macro e micronutrientes foram baseados na Resolução n.º 26/2013, considerando 20% das necessidades nutricionais diárias. Para o número de nutricionistas, considerou-se a Resolução CFN n.º 465/2010. Resultados O município contou com uma nutricionista e a oferta de 38 cardápios, sendo 60,5% para área urbana e 39,5% para área rural. Todos os cardápios estavam inadequados em energia, fibra, macro e micronutrientes. Observou-se oferta baixa de frutas e hortaliças, e elevada oferta de doces e/ou preparações doces, além de alimentos restritos. Conclusão Constatou-se número baixo de nutricionistas, além de cardápios inadequados.

Abstract Background School feeding is an important strategy in the formation of healthy eating habits. Objective To analyze the menus offered to elementary school students in Moju / PA and the number of nutritionists working in the National School Feeding Program. Method A cross-sectional, descriptive and quantitative study was carried out in elementary schools in 2015. The chemical composition of the menus, the offer of fruits, vegetables, sweets and / or sweet preparations, which was restricted to foods and the number of professionals were analyzed. For the analysis of the chemical composition, the Brazilian Table of Food Composition, the Brazilian Institute of Geography and Statistics were used. Macro and micronutrient consumption and adjustments were based on Resolution 26/2013, considering 20% of daily nutritional needs. For the number of nutritionists, we considered the CFN Resolution No. 465/2010. Results The city counted on 1 nutritionist and the offer of 38 menus, which 60.5% for urban area and 39.5% for rural area. All menus were inadequate concerning to the following aspects: energy, fiber, macro and micronutrient. There was a low supply of fruits and vegetables and a high supply of sweets and / or sweet preparations, in addition to restricted foods. Conclusion It was found a low number of nutritionists, as well as inadequate menus.

RESUMO Objetivo: comparar a geometria nasal entre dois grupos de pacientes com diferentes graus de apneia obstrutiva do sono e correlacionar índice e gravidade da apneia e grau de sonolência diurna com áreas e volume nasais. Métodos: 20 adultos (15 mulheres e 5 homens - idade média de 52,0±11,4 anos) sem obstrução nasal, submetidos à polissonografia e divididos em dois grupos: a) dez indivíduos sem ou com apneia em grau leve; b) dez com apneia moderada ou grave. A geometria nasal foi avaliada por rinometria acústica. Foram considerados o volume (distância da válvula nasal até a parte posterior da concha nasal média) e as três áreas seccionais: válvula nasal, parte anterior e parte posterior da concha nasal inferior. Foram aplicados os testes de Mann-Whitney e t de Student para amostras independentes e coeficiente de correlação de Spearman, com nível de significância de 5%. Resultados: o grupo 2 apresentou valores menores na área da válvula nasal, à direita, e maiores valores nas áreas das conchas nasais. Não houve correlação entre escala de sonolência e geometria nasal. Conclusão: a área da válvula nasal foi menor, unilateralmente, no grupo com apneia moderada e grave. Não houve correlação entre volumes e áreas nasais e sonolência diurna excessiva.

ABSTRACT Purpose: to compare nasal geometry between two groups of patients with different degrees of obstructive sleep apnea and to correlate apnea-hypopnea index, apnea severity and degree of daytime sleepiness with nasal areas and volume. Methods: a total of 20 adults (15 women and 5 men, mean age of 52.0±11.4 years old) without nasal obstruction were submitted to polysomnography. The subjects were divided into two groups: a) 10 individuals without apnea or with mild-grade apnea; b) 10 with moderate or severe apnea. Nasal geometry was evaluated by acoustic rhinometry. The volume, comprising the distance from the nasal valve to the posterior part of the middle nasal turbinate, and the three sectional areas corresponding to nasal valve, anterior part of the inferior nasal turbinate and posterior part of the inferior nasal turbinate, were considered. The Shapiro-Wilk, Mann-Whitney, Student’s t tests for independent samples and Spearman’s correlation coefficient were used for the analysis, with a significance level lower than 5%. Results: group 2 presented lower values in the area corresponding to the nasal valve (on the right), and higher values in the nasal turbinate areas. There was no correlation between the drowsiness scale and nasal areas and volumes. Conclusion: the area of the nasal valve was unilaterally smaller in the group with moderate and severe apnea. There was no correlation between volumes and nasal areas and excessive daytime sleepiness.

Abstract We report a case of encephalitis associated with Zika virus infection and reactivation of varicella-zoster virus in the central nervous system of a Brazilian child. This case raises the possibility that reactivation of the latent varicella-zoster virus may be a mechanism of neurological impairment induced by acquired Zika virus infection.

RESUMO Objetivo Este estudo tem por objetivo analisar a implementação da Estratégia Amamenta e Alimenta Brasil em uma capital do Nordeste brasileiro. Métodos Trata-se de pesquisa exploratória, com abordagem qualitativa, realizada com cinco tutores e três gestores envolvidos com a referida Estratégia. Elaborou-se uma representação gráfica da árvore de problema da Estratégia Amamenta e Alimenta Brasil e, com isso, construiu-se o diagrama com a estruturação da Estratégia de acordo com os componentes do Modelo Lógico. Resultados Foram identificadas fragilidades nas informações dos documentos oficiais da Estratégia, bem como problemas na sua implementação. A partir do Modelo Lógico foi possível propor ações para a modificação dessa realidade. Conclusão O Modelo Lógico é uma importante ferramenta de gestão, que pode contribuir para fortalecer e expandir a referida Estratégia, a fim de aumentar os índices de aleitamento materno e alimentação complementar saudável, com vistas à redução da morbimortalidade infantil.

ABSTRACT Objective This study aimed to analyze the implementation of the Brazilian Breastfeeding and Feeding Strategy in a Brazilian northeast capital. Methods This exploratory research uses a qualitative approach that was served with five tutors and three managers related to the strategy. The approach elaborated a graphic representation of the problem tree of the Brazilian Breastfeeding and Feeding Strategy, and subsequently, a diagram with the strategy structure was developed per the components of Logframe model. Results The study identified weaknesses on the information shown in official documents from this strategy as well as principal issues in the implementation. Using the Logframe Model, the research proposed actions to modify this reality. Conclusion The Logframe Model is an important management instrument that can contribute to strengthening and expanding the Brazilian Breastfeeding and Feeding Strategy. Therefore, it can increase breastfeeding and healthy complementary feeding rates to reduce infant mortality and morbidity.

Abstract Botulinum toxin type A is effective in reducing excessive gingival display caused by hyperfunctional upper lip elevator muscles; however, this effect is transient. This study aimed to determine the duration of the effectiveness of botulinum toxin type A on a gummy smile. A systematic search was conducted using Medline (PubMed), Scopus, and Web of Science electronic databases, from 1970 to March 2017 with no language restriction; the search included studies evaluating adult patients with excessive gingival display who were treated with botulinum toxin and were followed-up for at least 3 months. OpenGrey and Clinical Trial Registry were also consulted. Quality assessment was applied to determine the level of evidence and bias, and a meta-analysis was performed. Of 2181 full texts, 71 were obtained, with 3 prospective studies meeting the selection criteria. The gingival display was significantly reduced to baseline with 2, 4, and 8 weeks of treatment. The gingival display considerably reduced at the baseline-2-week comparison (–4.44 mm using raw data and–4.05 mm using the standard difference) and increased throughout the weeks of follow-up. There is scant evidence to determine the duration of the effectiveness of toxin type A on a gummy smile. The effect tends to be stable until at least 8 weeks of follow-up, and the gingival exposure may not return to baseline within 12 weeks of follow-up. Well-designed randomized clinical trials with a minimum of 6 months of follow-up are necessary to strengthen the evidence.