BACKGROUND: Public health facilities are used by the majority of South Africans, and healthcare utilisation surveys have been a useful tool to estimate the burden of disease in a given areaOBJECTIVES: To describe care-seeking behaviour in a periurban site with a high prevalence of HIV infection, as well as barriers to seeking appropriate healthcareMETHODS: We conducted a cross-sectional household survey in 22 wards of the Msunduzi municipality in KwaZulu-Natal Province, South Africa, from October to December 2013 using a simple random sample of households selected from a 2011 census enumeration. A primary caregiver/adult decision-maker was interviewed regarding demographic data as well as health status and recent self-reported episodes of selected illnesses and healthcare utilisationRESULTS: Of the 2 238 eligible premises visited, 1 936 households (87%) with a total of 9 733 members were enrolled in the study. Of these, 635 (7%) reported one or more episodes of infectious illness during the study period. Public health clinics were most frequently consulted for all illnesses (361/635, 57%). Private healthcare (general practitioner, private clinic, private hospital) was sought by 90/635 of individuals (14%), only 13/635 (2%) reported seeking care from traditional healers, religious leaders or volunteers, and 71/635 (11%) did not seek any medical care for acute illnesses. Individuals in the lowest income group were more likely to seek care at public health facilities than those in the highest income group (70% v. 32%CONCLUSIONS: Public health facility-based surveillance may be representative of disease patterns in this community, although surveillance at household level shows that high-income individuals may be excluded because they were more likely to use private healthcare, and the proportion of individuals who died at home would have been missed by facility-based surveillance. Data obtained in such surveys may be useful for public health planning

Resumo A substituição do metal utilizado como infraestrutura de restaurações protéticas pela cerâmica policristalina à base de zircônia tetragonal estabilizada por ítria (Y-TZP) resultou em dúvidas sobre a qualidade de união entre as cerâmicas de infraestrutura e de recobrimento. Assim, surgiram alguns tratamentos de superfície com o intuito de melhorar a união porcelana-Y-TZP. O objetivo deste estudo foi avaliar o efeito de um tratamento de superfície na resistência de união entre a porcelana e a Y-TZP, bem como comparar os resultados com um grupo controle metal-cerâmica. Três grupos experimentais foram avaliados (n=10): YC - infraestrutura de Y-TZP recoberta com porcelana VM9; YB - infraestrutura de Y-TZP recoberta com um agente de união e porcelana VM9; MC - infraestrutura de níquel-cromo recoberta com opaco e porcelana VM13. Os corpos de prova foram confeccionados usando lâminas do material de infraestrutura, e sobre elas foi construído um cilindro de porcelana (3 mm de diâmetro, 6 mm de altura), sinterizado de acordo com as instruções do fabricante. Os grupos foram submetidos ao teste de cisalhamento em uma máquina de ensaio universal com velocidade de 0,5 mm/min. Após os testes, as falhas foram classificadas como adesiva, mista ou coesiva. Os dados de resistência de união (σf) foram analisados estatisticamente com Anova de um fator (α=0,05). As médias (desvio-padrão) de σf (MPa) foram: YC - 19,7 (7,8); YB - 22,5 (6,4); MC - 24,2 (6,6). Não foi encontrada diferença estatística entre os grupos (p=0,377). Houve relação entre o grupo experimental e o modo de falha. Apenas os grupos YC e YB apresentaram falha coesiva na porcelana. Concluiu-se que a infraestrutura à base de Y-TZP tem resistência de união à porcelana semelhante ao “padrão ouro” metal-cerâmica. A aplicação de um agente de união não teve influência na resistência de união entre porcelana e Y-TZP.

Abstract The replacement of the metal used as infrastructure in prosthetic restorations with yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) raised questions regarding the quality of the bond strength between the ceramic infrastructure and veneer. Therefore, surface treatments were developed in order to improve porcelain-Y-TZP bond strength. The objective of this study was to evaluate the effect of a surface treatment on the bond strength between the porcelain veneer and Y-TZP, as well as to compare the results with a metal-ceramic control group. Three experimental groups were evaluated (n=10): YC - Y-TZP infrastructure veneered with VM9 porcelain; YB - Y-TZP infrastructure veneered with a bond agent and VM9 porcelain; MC - nickel-chrome infrastructure veneered with opaque and VM13 porcelain. Specimens were produced using slices of the infrastructure materials. A porcelain cylinder (3 mm diameter, 6 mm height) was built over the infrastructures and sintered according to the manufacturer recommendation. Specimens were subjected to a shear bond strength test in a universal testing machine at 0.5 mm/min cross-head speed. After testing, failure modes were classified as adhesive, cohesive or combined. Shear bond strength (σf) data were analyzed with one-way ANOVA (α=0.05). σf mean values (standard deviation) in MPa were: YC - 19.7 (7.8); YB - 22.5 (6.4); MC - 24.2 (6.6). There was no statistical difference between groups (p=0.377). There was an association among the experimental group and the failure mode. Only YC and YB groups showed porcelain cohesive failure. It was concluded that Y-TZP infrastructure show similar shear bond strength to the porcelain than the “gold standard” metal-ceramic. The application of a bond agent had no influence in the bond strength results.