Interpersonal physical violence was identified as a factor associated with oral-maxillofacial trauma, specifically mandibular fracture, facial contusion, and dental concussion.

Robot-Assisted Therapy (RT) is an innovative approach to neurological rehabilitation that uses intensive, repetitive, interactive, and individualized practice. This systematic review aimed to investigate the effectiveness of RT on the body function and structure of people with upper limb impairments (PROSPERO registration: CRD42017054982). A search strategy conducted on seven databases identified randomized controlled studies. Methodological quality was assessed using the PEDro scale. When possible, the data were pooled, the strength of evidence was assessed using the GRADE system, and the effect sizes were assessed using Cohen coefficient. Subgroup analyses investigated the impact on the estimated effects of the following parameters: methodological quality; portion of the assessed upper limb; duration of stroke; and intervention dose and duration. Thirty-eight studies involving 1174 participants were included. Pooled estimates revealed small effects of RT on motor control and medium effects on strength compared with other intervention (OI) at a short-term follow-up. Standardized differences in means were as follows: 0.3 (95% CI 0.1 to 0.4) and 0.5 (95% CI 0.2 to 0.8). Effects at other time points and on other investigated outcomes related to body function and structure were not found (p>0.05). The strength of the current evidence was usually low quality. Subgroup analyses suggested that the methodological quality, and duration and dose of RT may influence the estimated effects. In conclusion, RT has small effects on motor control and medium effects on strength in people with limited upper limb function. Poor methodological quality, and lower treatment dose and duration may impact negatively the estimated effects.

The aim of the present study was to identify risk factors for facial fractures in patients treated in the emergency department of a hospital. The medical charts of 1121 patients treated in an emergency ward over a three-year period were analyzed. The independent variables were gender, age, place of residence (urban or rural area) and type of accident. The dependent variables were fractured mandible, zygoma, maxilla, nasal bone and more than one fractured facial bone. Statistical analysis was performed using the chi-square test (α < 0.05), univariate and multivariate Poisson distributions and the logistic regression analysis (p < 0.20). Maxillofacial trauma was recorded in 790 charts (70.5%), with 393 (35.1%) charts reporting facial fractures. Motorcycle accidents were found to be the main risk factor for mandibular fractures (PR = 1.576, CI = 1.402-1.772) and simultaneous fractures of more than one facial bone (OR = 4.625, CI = 1.888-11.329) as well as the only risk factor for maxillary bone fractures (OR = 11.032, CI = 5.294-22.989). Fractures of the zygomatic and nasal bones were mainly associated with accidents involving animals (PR = 1.206, CI = 1.104-1.317) and sports (OR = 8.710, CI = 4.006-18.936), respectively. The determinant for the majority of facial fractures was motorcycle accidents, followed by accidents involving animals and sports.

Resumo: Em face do elevado número de indivíduos com deficiências, bem como da importância dos dispositivos de tecnologia assistiva (DTAs) para a melhoria de seu desempenho ocupacional, as elevadas taxas de abandono destes dispositivos e os altos custos a estes associados, esta revisão tem o objetivo de identificar fatores relacionados ao abandono de dispositivos de tecnologia assistiva. A metodologia utilizada foi uma revisão crítica da literatura utilizando as palavras-chave: tecnologia assistiva/assistive technology, abandono/abandonment, rejeição/rejection, e desuso/disuse, de publicações entre os anos de 2002 e 2013. Foi realizada a busca nas bases de dados MEDLINE, LILACS e SciELO, e identificado um total de 49 artigos, sendo que nove publicações atenderam aos critérios de inclusão. Constatou-se que os fatores mais citados relacionados ao abandono dos dispositivos são: problemas com o estado físico do usuário; falta de informação e treinamento tanto de profissionais quanto de usuários; dor; limitações funcionais; preferência por outro DTA ou utilização de capacidades remanescentes; peso elevado; alterações nas condições do DTA; dificuldade de uso; insatisfação; desconforto; inadequação/inapropriação, e "muito barulho".Compreender melhor esses fatores é fundamental para melhorar a eficácia da prescrição e da intervenção por parte dos profissionais, o que é imprescindível para aumentar a adesão e promover resultados efetivos. Palavras-chave: Tecnologia Assistiva, Rejeição, Dispositivos, Ação Terapêutica, Cadeiras de Rodas, Sistemas deComunicação Alternativos e Aumentativos. Assistive technology devices: abandonment related factorsAbstract: This review aims to identify factors related to abandonment of assistive technology devices in face of the increased number of individuals with disabilities, as well as the importance of the assistive technology devices (ATD) to improve their occupational performance, the increased abandonment rates of these devices and the high costs associated with them. We used a critical literature review with the keywords: assistive technology/tecnologia assistiva, abandonment/abandono, rejection/rejeição, and disuse/desuso, published between the years 2002 and 2013. The search was conducted in MEDLINE, LILACS and SciELO and identified a total of 49 articles and 9 publications that met the inclusion criterion. It found that the most cited factors related to the abandonment of devices are problems with the user's physical condition; lack of information and training both professionals and users; pain; lack of functionality; ATD preference or other use of remaining capacity; increased weight; changes in ADT conditions; use difficulty; unsatisfactoriness; discomfort; inadequacy/inappropriate; and "lot of noise".The better understanding of these factors is critical to improve the effectiveness of prescription and intervention by professionals and imperative to increase membership and promote effective results.

Enquadramento: Os serviços de urgência e emergência têm representado a principal porta de entrada no sistema de saúde, gerando uma sobrelotação nas unidades. Reorganizar esses serviços tornou-se primordial no intuito de estabelecer critérios para que o paciente não sofra prejuízos decorrentes da espera. Objectivo: Caracterizar a população classificada em relação ao Sistema de Triagem de Manchester num serviço de urgência de uma instituição hospitalar de um município de Minas Gerais, Brasil. Metodologia: Trata-se de um estudo transversal realizado em 500 fichas de atendimento de pacientes seleccionados por aleatorização sistemática. Resultados: A média de idade foi de 43,85 anos (dp=26,10), a maioria (56,4%) do sexo masculino e natural do município de Diamantina (87,4%). Os 34 fluxogramas mais utilizados foram indisposição no adulto, dor abdominal, dor torácica, dor de garganta, feridas e vómitos e estes corresponderam a 44% das classificações. Entre os pacientes 50,8% foram classificados nas cores, verde ou azul. Conclusão: A unidade é utilizada como porta de entrada ao serviço de saúde e as queixas mais relevantes que levam as pessoas a buscar pelo atendimento poderiam ser resolvidas no nível primário de atenção à saúde.Palavras-chave: enfermagem; serviços médicos de emergência; triagem.Marco contextual: los servicios de urgencia y de emergencia han representado la principal puerta de entrada al sistema de salud, lo que ha provocado una aglomeración en las unidades. Reorganizar esos servicios se ha convertido en algo fundamental para establecer criterios para que el paciente no se vea perjudicado por la espera. Objetivo: caracterizar a la población clasificada como Sistema de Triaje Manchester en un servicio de urgencia de un hospital en la ciudad de Minas Gerais (Brasil). Metodología: se realizó un estudio transversal en 500 historias clínicas de pacientes seleccionados por aleatorización sistemática. Resultados: la edad media fue de 43,85 años (dp=26,10), la mayoría (56,4 %) eran hombres y naturales del municipio de Diamantina (87,4 %). Los 34 diagramas de flujo más utilizados fueron malestar en el adulto, dolor abdominal, dolor torácico, dolor de garganta, llagas y vómitos, los cuales corresponden al 44 % de las clasificaciones. Entre los pacientes, el 50,8 % fue clasificado en verde o azul. Conclusión: la unidad se utiliza como puerta de entrada a los servicios de salud y los motivos más relevantes que hacen que la gente solicite ayuda podrían ser resueltos en el nivel primario de atención sanitaria.Palabras clave: enfermería; servicios médicos de urgencia; triaje.Theoretical framework: Urgent and emergency services have represented the main gateway into the health system, leading to unit overcrowding. Rearranging these services has become paramount for establishing criteria so that patients do not suffer further harm due to waiting times. Aim: To characterize the population under analysis using the Manchester Triage System in the emergency service of a hospital from one city in the state of Minas Gerais, Br...

sTNFR2 is associated with silicosis severity and early exposure to silica.

BackgroundThe aim of study was to determine the occurrence of tooth injuries and associated factors among patients treated at a hospital emergency ward.MethodsA cross-sectional study was conducted involving the analysis of 790 patient charts. The independent variables were gender, place of residence and type of accident. The dependent variable was tooth injury (fractures, concussion, luxation and avulsion). Statistical analysis involved the chi-square test, Poisson analysis and logistic regression. Explanatory variables with a p-value < 0.20 in the bivariate analysis were incorporated into the multivariate model.ResultsA total of 681 (86.2 %) patients had tooth injury, among whom 159 (20.1 %) had tooth fractures. Tooth concussion was associated with residence in urban areas (PR = 1.635; 95 % CI: 1.199-2.230), the male gender (PR = 1.673; 95 % CI: 1.225-2.285), violence (PR = 1.940; 95 % CI: 1.263-2.982) and sports (PR = 1.863; 95 % CI: 1.287-2.696). The prevalence rate of tooth fracture was higher among individuals having suffered a motorcycle (PR = 1.597; 95 % CI: 1.295-1.968) or bicycle accident (PR = 1.484; 95 % CI: 1.245-1.769). Victims of bicycle accidents had a 42.6-fold greater chance of suffering luxation (95 % CI: 20.917-86.808) and a threefold greater chance of suffering avulsion (95 % CI: 1.620-5.848). Victims of motorcycle accidents had a 2.96-fold greater chance of suffering avulsion (95 % CI: 1.471-5.937).ConclusionsIn the study, concussion was the most frequent type of tooth injury. Motorcycle and bicycle accidents were associated with tooth fractures, luxation and avulsion, whereas sports and violence were associated with dental concussion. The findings on tooth injuries can contribute to public health policies regarding the prevention and health promotion measures.

Magnitude processing is one of the most central cognitive mechanisms that underlie persistent mathematics difficulties. No consensus has yet been reached about whether these difficulties can be predominantly attributed to deficits in symbolic or nonsymbolic magnitude processing. To investigate this issue, we assessed symbolic and nonsymbolic magnitude representations in children with low or typical achievement in school mathematics. Response latencies and the distance effect were comparable between groups in both symbolic and nonsymbolic tasks. The results indicated that both typical and low achievers were able to access magnitude representation via symbolic and nonsymbolic processing. However, low achievers presented higher error rates than typical achievers, especially in the nonsymbolic task. Furthermore, measures of nonsymbolic magnitude explained individual differences in school mathematics better than measures of symbolic magnitude when considering all of the children together. When examining the groups separately, symbolic magnitude representation explained differences in school mathematics in low achievers but not in typical achievers. These results suggest that symbolic magnitude is more relevant to solving arithmetic problems when mathematics achievement is particularly low. In contrast, individual differences in nonsymbolic processing appear to be related to mathematics achievement in a more general manner.