ABSTRACT Objective: To assess the comprehension of dentists in Primary Health Care (PHC) regarding the interplay between obesity and periodontitis and evaluate the presence of practical approaches for managing these patients. Material and Methods: For this cross-sectional study, 187 general dental practitioners from different regions of Brazil were selected by convenience. A specific instrument was developed to assess the knowledge and practices of PHC dentists concerning this topic. The data underwent descriptive and analytical statistical analyses, followed by Poisson regression analysis with robust variance to test associations. Results: Regarding knowledge, most dentists have a limited understanding of the link between obesity and periodontitis, despite 43% recognizing the higher susceptibility of individuals with obesity to oral issues. About 20% of professionals considered their knowledge “adequate." Better knowledge was observed among dentists who worked only in the public sector, which has concluded some post-graduation (p<0.05). Regarding the professional's practical conduct, around 57% of the dentists do not diagnose obesity, and 64% of the professionals do not refer these patients to a nutritionist. Conclusion: The study's outcomes underscore the prevailing lack of awareness among this sampled group of dental practitioners concerning the association between obesity and periodontitis. Furthermore, it was observed that multidisciplinary treatment for obese patients within the realm of PHC is generally underperformed. Objective (PHC Methods crosssectional cross sectional study 18 convenience topic analyses associations Results 43 issues 20 adequate. adequate “adequate. sector postgraduation post graduation p<0.05. p005 p p<0.05 . 0 05 (p<0.05) professional s conduct 57 64 nutritionist Conclusion studys Furthermore underperformed 1 4 2 “adequate p00 p<0.0 (p<0.05 5 6 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

Abstract Effective freight transportation planning through different modes drives countries economic growth by ensuring the delivery of goods safely and sustainably. This article provides a systematic literature review focused on intermodal transport tactical planning, addressing logistical technical factors for efficient transportation modes management in cargo delivery. The methodology is based on the research questions definition, search process, and article selection criteria, exploring the network structures evolution to verify technical factors influencing network structures, including mode combinations, geographical distribution, and mathematical models’ decision variables and constraints. According to the research question proposed, the most relevant technical factors for intermodal planning network structures are flow cargo, transport modal activation, flow conservation, delivery time, and vehicle management, generally found in countries with extensive road infrastructure and a high modal integration capacity, as China, Europe, and USA. Considering the decision variables and constraints, flow conservation is a common element observed in intermodal transport mathematical models. Thus, a balance between transportation costs and transportation modes utilization was verified, and insights into the relation between technical logistics factors application and network structures for cargo delivery efficiency were revealed. Finally, the systematic literature review contributes to understanding the main intermodal transportation planning evolving landscape, offering valuable insights for future research and practical implementations. sustainably definition process criteria combinations distribution models constraints proposed activation time capacity China Europe USA Thus verified revealed Finally landscape implementations

Resumo Este artigo apresenta uma pesquisa cujo objetivo foi verificar a percepção de professores da educação infantil de três escolas públicas municipais situadas em São Bernardo do Campo/SP sobre quatro dimensões do conceito de clima escolar: a) as relações sociais e os conflitos na escola; b) as regras, as sanções e a segurança na escola; c) as relações com o trabalho; d) a gestão e a participação. Trata-se de uma pesquisa qualitativa, de caráter exploratório, que utilizou como procedimento de coleta de dados o questionário eletrônico do Clima Escolar elaborado por Vinha, Morais e Moro, em 2017, testado e validado para as escolas brasileiras. O problema da investigação gira em torno das concepções de professores das escolas pesquisadas para compreender se eles concebem como significativo o ambiente social escolar na transformação das unidades escolares em espaços adequados para a convivência sob o marco da democracia. A pesquisa aponta resultados parcialmente positivos, pois os vinte e cinco professores investigados dizem estar satisfeitos com seus gestores e se sentem valorizados em seus ambientes de trabalho. No entanto, um ponto relevante é que as crianças não participam das discussões de regras, as quais são elaboradas somente pelos gestores. As quatro dimensões do clima escolar analisadas são bastante relevantes para a (re)estruturação de ambientes de aprendizagem mais democráticos, colaborativos e autônomos, sobretudo quanto à indicação de criar meios que oportunizem vez e voz ao público da educação infantil, bem como potencializem o trabalho coletivo, autônomo e ético entre professores e gestores. CampoSP Campo SP escola b regras c d participação Tratase Trata qualitativa exploratório Vinha Moro 2017 brasileiras democracia positivos entanto reestruturação re estruturação democráticos autônomos coletivo 201 20 2

Abstract This article presents a research whose objective was to verify the perception of early childhood education teachers from three municipal public schools located in São Bernardo do Campo/SP about four dimensions of the School Climate concept: a) social relations and conflicts at school; b) the rules, sanctions and safety at school; c) relations with work; d) management and participation. This is a qualitative, exploratory research, which used as a data collection procedure the Electronic School Climate questionnaire prepared by Vinha, Morais and Moro, in 2017, tested and validated for Brazilian schools. The problem of the investigation revolves around the conceptions of teachers of the schools surveyed to understand if they conceive the school social environment as significant in the transformation of school units into adequate spaces for coexistence under the framework of democracy. The research shows partially positive results, as the twenty-five teachers investigated say they are satisfied with their managers and feel valued in their work environments. However, a relevant point is that children do not participate in the discussions of rules, which are elaborated only by the managers. The four dimensions of the School Climate analyzed are quite relevant for the (re)structuring of more democratic, collaborative and autonomous learning environments, especially regarding the indication of creating means that give opportunity and voice to the public of early childhood education, as well as enhance work collective, autonomous and ethical between teachers and managers. CampoSP Campo SP concept b rules c d participation qualitative Vinha Moro 2017 democracy results twentyfive twenty five environments However restructuring re structuring democratic collective 201 20 2

A procedure using disposable pipette tips adapted for solid-phase extraction, known as DPX SPE, was used as an alternative way for the chromium determination in wastewater samples. DPX-SPE consists of a device which allows a dynamic contact between the sample and the solid-phase. A residue obtained from the processing of coffee beans, denominate coffee silverskin, was used as a new adsorbent. Characterization techniques revealed properties of lignocellulosic materials with potential application for chromium adsorption. The parameters including adsorbent mass (25.00 mg), elution solvent (0.1 mol L-1 HCl, 200 μL) and pH (2.0) were optimized. Thus, 1.00 mL of deionized water for conditioning, 4.00 mL of sample, 2 extraction cycles and 1 elution cycle were the employed conditions. Enrichment factor of 12, limit of detection of 6.00 µg L-1 and relative standard deviation (RSD) 1.3% (n = 3) were obtained. The method proved to be fast, cheap, environmentally friendly, and simple, providing good recoveries (104-113%), and it was satisfactorily applied in real samples.

RESUMO Objetivo comparar os efeitos imediatos da fotobiomodulação com laser nos comprimentos de onda 660 nm e 808 nm na fadiga do músculo orbicular da boca. Métodos trata-se de um estudo experimental randomizado, com 60 mulheres, com idade entre 19 e 43 anos. As participantes foram divididas em quatro grupos. O grupo GV recebeu irradiação com laser de comprimento de onda de 660 nm em quatro pontos do orbicular da boca; o grupo GIV recebeu irradiação com laser de comprimento de onda de 808 nm nos mesmos pontos; o grupo controle não recebeu irradiação e o grupo placebo passou pelos mesmos procedimentos dos grupos GV e GIV, porém o equipamento não foi acionado. A irradiação foi realizada com laser de 100 mW de potência, 4 J de energia por ponto e 133,3 J/cm2 de fluência. Avaliação eletromiográfica foi realizada antes e após a irradiação, concomitantemente ao exercício de protrusão labial sustentada até a sensação de fadiga. O índice de fadiga eletromiográfica foi calculado a partir da frequência mediana. A amplitude do sinal foi avaliada, examinando o RMS, e os valores normalizados pelo pico. A diferença na amplitude entre lábios superiores e inferiores também foi analisada. Todas as variáveis foram comparadas antes e após a irradiação. Resultados não foram encontradas diferenças significativas nas medidas antes e após a irradiação. Conclusão a fotobiomodulação, com os parâmetros investigados neste estudo, não resultou em efeitos imediatos sobre a fadiga do músculo orbicular da boca.

ABSTRACT Purpose To compare the immediate effects of laser photobiomodulation at wavelengths of 660 nm and 808 nm on fatigue of the orbicularis oris. Methods This is a randomized study with 60 women aged between 19 and 43 years. The participants were divided into four groups. Group RG received photobiomodulation with a laser wavelength of 660 nm at four points of the orbicularis oris; group IRG received photobiomodulation with a laser wavelength of 808 nm at the same points; the control group did not receive light treatment; and the placebo group underwent the same procedures as RG and IRG but with the equipment switched off. The irradiation was performed with a laser of 100 mW of power, 4 J of energy per point and 133.3 J/cm2 of fluency. An electromyography evaluation was performed before and after the irradiation, concomitantly with the exercise of lip protrusion maintained until the sensation of fatigue. Fatigue was evaluated by a median frequency using the electromyographic fatigue index. The amplitude of the signal was evaluated, examining the root mean square, and the values were normalized by the peak. The difference in amplitude between the upper and lower lips was also analyzed. All variables were compared before and after irradiation. Results No significant difference was found between the measures taken before and after irradiation. Conclusion Photobiomodulation with the parameters investigated in this study had no immediate effect on orbicular oris fatigue.

RESUMO Objetivo pesquisar a atividade elétrica do músculo orbicular da boca em quatro diferentes tarefas isométricas e indicar a mais apropriada para utilização como referência na normalização do sinal elétrico do músculo orbicular da boca pela contração voluntária máxima. Métodos participaram do estudo 22 indivíduos, sendo dez do sexo masculino e 12 do feminino, com idades entre 20 e 33 anos. A atividade elétrica das porções superior e inferior do músculo orbicular da boca foi registrada durante a realização das seguintes tarefas isométricas: protrusão labial com fechamento, protrusão labial sem fechamento, contrarresistência com a placa de resistência labial e preensão de lábios. A ordem de realização das tarefas foi randomizada entre os participantes. Os dados foram comparados entre as tarefas, para cada seguimento labial. Resultados no segmento marginal superior, a tarefa com maior média e mediana de amplitude foi preensão labial, embora sem diferença significativa entre tarefas. O menor coeficiente de variação foi obtido na tarefa de contrarresistência com a placa de resistência labial. No segmento marginal inferior, a tarefa com maior média e mediana de amplitude foi protrusão labial com fechamento, que também teve o menor coeficiente de variação e diferença significativa entre as tarefas protrusão labial com fechamento e preensão, sendo os maiores valores obtidos na primeira. Conclusão indica-se como referência para a normalização do sinal elétrico do músculo orbicular da boca, pela contração voluntária máxima, a tarefa de protrusão labial com fechamento.

ABSTRACT Purpose To verify the electrical activity of the orbicularis oris in four different isometric tasks and to indicate the most appropriate task for use as a reference in the normalization of the electrical signal of the orbicularis oris muscle by maximum voluntary contraction. Methods Twenty-two individuals participated in the study, of which 10 were male and 12 were female, with ages ranging from 20 to 33 years. The electrical activity of the upper and lower parts of orbicularis oris muscle was recorded during the following isometric tasks: lip protrusion with bilabial closure; lip protrusion without bilabial closure; the counter resistance using the plate of labial resistance and lips prehension. The order of the tasks was randomized among participants. Data were compared between tasks for each lip part. Results in the upper marginal segment, the task with the highest mean and median amplitude was lip prehension, although there was no significant difference between tasks. The lowest coefficient of variation was obtained in the counter resistance task with the plate of labial resistance. In the lower marginal segment, the task with the highest mean and median amplitude was labial protrusion with lips closure, which also had the lowest coefficient of variation. In this segment, there was a significant difference between labial protrusion with lips closure and prehension, with the highest values obtained in the first task. Conclusion lip protrusion with bilabial closure is suggested as reference for the normalization of the electrical signal of the orbicularis oris muscle, by maximum voluntary contraction.

ABSTRACT Objective: To evaluate the remineralizing potential of a hydrocolloid-based, controlled fluoride-releasing system added to dentifrice formulas. Material and Methods: Sixty-five human enamel blocks were prepared and the surface microhardness (SH0) values were determined. The artificial caries lesions were induced and the demineralization surface microhardness (SH1) was evaluated. The blocks were randomly allocated into five groups (n = 13): (1) 100-TGF (100% NaF with Tara gum added); (2) 50-TGF (50% free NaF + 50% NaF with Tara gum added); (3) 100% TG (100% Tara gum without fluoride); (4) 100% NaF (positive control); and (5) placebo (without Tara gum and NaF). The blocks were submitted to 7 days pH cycling and treated with dentifrice slurries twice a day. Finally, surface hardness (SH2) was assessed and the percentage of surface hardness recovery (%SMHR) was calculated. Analysis of variance (ANOVA) followed by Bonferroni test was used for statistical analysis. Results: A positive %SMHR was found in the 100% NaF (5.07) and 50-TGF (0.64) groups, while the 100-TGF (-1.38), 100% TG (-3.88) and placebo (-0.52) did not undergo remineralization. Statistically significant differences were observed between 100% NaF and all the groups except for 50-TGF (p<0.05). Conclusion: The presence of hydrocolloid (Tara gum) promoted minimal remineralization when associated with NaF. In the applied model, Tara gum may have compromised remineralization, preventing free fluoride from acting effectively in the carious lesion.

A magnetic solid-phase microextraction procedure was developed to detect lead in aqueous samples by flame atomic absorption spectrometry (FAAS). Fe3O4 nanoparticles were synthesized by coprecipitation and the crystalline phase was confirmed by X-ray diffraction. The point of zero charge (PZC) indicated that the oxide surface was negatively charged at pH levels above 9.4. pH 9.0 is the best for adsorption and the influence of stirring time and adsorbent mass were analyzed and set at 4 min and 3.0 mg, respectively. The best desorption conditions were obtained for 500 µL of 0.5 mol L-1 HNO3 as eluant. The limit of quantification (LOQ) and relative standard deviation (RSD) were 16.48 µg L-1 and 0.25%, respectively. The linear range was found to be 16.48‑500 µg L-1. The accuracy was evaluated by recovery tests in mineral water, micellar water and aqueous makeup remover samples, showing values in the range of 95.94 to 118%.

RESUMO Introdução: No Brasil, uma lista contendo 71 ervas medicinais foi divulgada pelo Ministério da Saúde com intuito de conduzir pesquisas e desenvolvimento de fitoterápicos para uso no Sistema Único de Saúde. Objetivo: Avaliar in vitro a atividade antimicrobiana de extratos de ervas medicinais sugeridos pelo Ministério da Saúde para utilização no Sistema Único de Saúde frente a bactérias orais. Métodos: Os extratos vegetais selecionados estavam na forma de óleo essencial (Eucalyptus globulus, Mentha piperita e Schinus terebinthifolius) ou tintura (Erythrina mulungu, Casearia sylvestris e Maytenus ilicifolia) e foram avaliados sobre Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) e S. salivarius (ATCC 7073). Realizou-se o teste de difusão em ágar com confecção de poços e adição de 50 μL dos extratos. Após 48 h em estufa bacteriológica, os halos de inibição foram medidos através de paquímetro. Para determinação da concentração inibitória mínima e da concentração bactericida mínima, realizou-se a técnica de microdiluição em microplacas e de esgotamento, respectivamente. A concentração inibitória mínima correspondeu a menor diluição na qual se verificou ausência de crescimento bacteriano visível. O controle positivo utilizado foi Clorexidina 0,12 %. Todos os testes foram realizados em triplicata e analisados descritivamente. Resultados: O extrato de Maytenus ilicifolia apresentou halos de inibição discretamente maiores aos demais produtos. Erythrina mulungu apresentou a menor da concentração inibitória mínima frente S. mutans (2,81 mg/mL) entre as tinturas e Mentha piperita (9,00), entre os óleos essenciais. Erythrina mulungu e Mentha piperita foram os únicos extratos que apresentaram concentração bactericida mínima frente às cepas utilizadas. Conclusão: Os extratos vegetais apresentaram atividade antimicrobiana frente a microrganismos orais destacando Mentha piperita e Erythrina mulungu.

ABSTRACT Introduction: A list of 71 medicinal herbs has been published by the Brazilian Ministry of Health with the purpose of studying and developing medicines obtained from herbs for their potential use in the Unified Health System. Objective: Evaluate the in vitro antimicrobial activity of extracts from medicinal herbs proposed by the Ministry of Health with a view to their possible use in the Unified Health System to combat oral bacteria. Methods: Extracts were obtained from the plants selected in the form of essential oil (Eucalyptus globulus, Mentha piperita and Schinus terebinthifolius) or tincture (Erythrina mulungu, Casearia sylvestris and Maytenus ilicifolia), and were tested against Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) and S. salivarius (ATCC 7073). The agar diffusion test was performed by making wells and adding 50 μL of the extracts. After 48 h in a bacteriological incubator, the inhibition haloes were measured with calipers. Minimum inhibitory concentration and minimum bactericidal concentration were determined by microplate microdilution and depletion technique, respectively. The minimum inhibitory concentration corresponded to the lowest dilution, at which there was no visible bacterial growth. The positive control used was 0.12% chlorhexidine. All the tests were performed in triplicate and analyzed descriptively. Results: Maytenus ilicifolia extracts exhibited slightly higher inhibition haloes than the other products. Erythrina mulungu had the lowest minimum inhibitory concentration against S. mutans (2.81 mg/mL) among tinctures, and Mentha piperita (9.00) among essential oils. Erythrina and Mentha piperita extracts were the only two displaying minimum bactericidal concentration against the strains used. Conclusions: The study plant extracts displayed antimicrobial activity against oral microorganisms, particularly against Mentha piperita and Erythrina mulungu.

RESUMEN Introducción: En Brasil, una lista de 71 hierbas medicinales fue divulgada por el Ministerio de Salud con la meta de llevar a cabo la investigación y desarrollo de medicinas basadas en hierbas para su uso en el Sistema Único de Salud. Objetivo: Evaluar la actividad antimicrobiana in vitro de extractos de hierbas medicinales sugeridas por el Ministerio de Salud para su uso en el Sistema Único de Salud contra las bacterias bucales. Métodos: Los extractos de plantas seleccionadas fueron en forma de aceite essencial (Eucalyptus globulus, Mentha piperita e Schinus terebinthifolius) o tintura (Erythrina mulungu, Casearia sylvestris e Maytenus ilicifolia) y se evaluaron en Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) y S. salivarius (ATCC 7073). Se llevó a cabo la prueba de difusión en agar con la producción de los pozos y la adición de 50 μL de extractos. Después de 48 h en una incubadora bacteriológica, los halos de inhibición se midieron usando calibradores. Para determinar la concentración inhibitoria mínima y la concentración bactericida mínima, se empleó la técnica de microdilución en microplaca y el agotamiento, respectivamente. La concentración inhibitoria mínima correspondió a la dilución más baja en la que no hubo ningún crecimiento bacteriano visible. El control positivo usado fue de clorhexidina 0,12 %. Todas las pruebas se realizaron por triplicado y se analizaron de manera descriptiva. Resultados: Los extractos de Maytenus ilicifolia presentaron los halos de inhibición ligeramente superior a otros productos. Erythrina mulungu mostró la más baja concentración inhibitoria mínima frente a S. mutans (2,81 mg/mL) entre lãs tinturas y Mentha piperita (9,00) entre los aceites esenciales. Los extractos de Erythrina y Mentha piperita fueron los únicos que mostraron concentración bactericida mínima frente a las cepas utilizadas. Conclusiones: Los extractos de plantas mostraron actividad antimicrobiana contra microorganismos bucales, entre los que se destacan Mentha piperita y Erythrina mulungu.

RESUMO Objetivo: analisar a influência do laser de baixa intensidade no desempenho muscular e identificar os parâmetros dosimétricos mais utilizados. Métodos: a busca de artigos foi realizada nas plataformas PubMed, BVS, Web of Science e SciELO. Foram selecionados artigos originais, com resumo disponível e que avaliaram o uso da fotobiomodulação sobre o desempenho muscular. Os dados foram analisados de acordo com o autor, ano de publicação, amostra, local de aplicação, parâmetros avaliados, comprimento de onda, dosimetria utilizada e resultados encontrados. Resultados: a amostra final consistiu de 27 artigos publicados entre os anos de 2008 e 2017. O tamanho das amostras nos estudos variou entre oito e 60 indivíduos, com faixa etária entre 17 e 70 anos. Observou-se maior uso do comprimento de onda infravermelho, com aplicações pontuais no trajeto do músculo. Em relação à dose, houve variação de 0,24 a 50 joules por ponto. Do total, apenas cinco (18,5%) trabalhos não encontraram respostas significativas para as variáveis pesquisadas. Conclusão: a maioria dos estudos apontou que o laser de baixa intensidade pode promover a melhora do desempenho muscular. A metodologia utilizada nos trabalhos foi diversa, o que dificultou a compilação dos dados e impossibilitou estabelecer os parâmetros dosimétricos ideais para esse objetivo.

ABSTRACT Purpose: to analyze the influence of low-level laser on muscle performance and to identify the most used dosimetric parameters. Methods: the search for articles was carried out on the PubMed, BVS, Web of Science and SciELO platforms. The articles selected were original ones, with available abstracts and that evaluated the use of photobiomodulation on muscular performance. The data were analyzed according to the author, year of publication, sample, place of application, parameters evaluated, wavelength, dosimetry used and results found. Results: the final sample consisted of 27 articles published between 2008 and 2017. The sample size in the studies ranged from 8 to 60 individuals, aged from 17 to 70 years. A greater use of infrared wavelength, with punctual applications carried out in the path of the muscle, was observed. Regarding the dose, there was a variation from 0.24 to 50 joules per point. Of the total, only 5 (18.5%) studies had not found significant answers for the considered variables. Conclusion: most of the studies pointed out that low-level laser can improve muscle performance. The methodology used in the work was diversified, rendering data compilation difficult, being impossible to set the ideal parameters for this purpose.

Resumo Esta pesquisa teve como objetivo determinar a influência de águas fluoretadas subterrâneas e do dentifrício com 1.100 ppm de fluoreto nos biomarcadores de exposição ao flúor em pré-escolares. Foi realizado um estudo transversal em trinta pré-escolares recrutados em áreas naturalmente fluoretadas e não fluoretadas (n = 15). A ingestão diária total de flúor (TDFI) a partir da dieta e do dentifrício, assim como a excreção urinária diária de flúor (DUFE), foram medidas ao longo de 24 horas. Amostras de unhas foram coletadas duas vezes durante 30 dias. As análises de flúor foram realizadas usando um eletrodo específico para íon flúor. Os dados foram analisados utilizando o teste t de Student e pareado, a análise de correlação de Pearson, e a análise de regressão linear múltipla (a≤0,05). As águas subterrâneas e dentifrícios fluoretados foram as fontes dominantes (r2>0,83) do TDFI em crianças da área naturalmente fluoretada e não fluoretada, respectivamente. Uma correlação positiva entre TDFI e DUFE (r=0,50) e entre [F] nas unhas das mãos e dos pés (r=0,60) foi encontrada em crianças da área naturalmente fluoretada. A [F] nas unhas das mãos e dos pés não foi correlacionada com TDFI. O consumo de águas subterrâneas fluoretadas influenciou a concentração de flúor na urina. Além disso, o uso de dentifrício com 1.100 ppm de fluoreto não influenciou a concentração de fluoreto na urina e nas unhas.

Abstract This research aimed to determine the influence of fluoridated groundwater and 1,100 ppm fluoride dentifrice on biomarkers of exposure to fluoride in preschoolers. A cross-sectional study was performed on thirty preschoolers recruited from naturally fluoridated and non-fluoridated areas (n=15). Total Daily Fluoride Intake (TDFI) from diet and dentifrice, and Daily Urinary Fluoride Excretion (DUFE) was measured over 24 h. Nails samples were collected twice during 30 days. Fluoride analyses were performed using a fluoride-ion-specific electrode. Data were evaluated using the Student and paired t-test, Pearson correlation analysis, multiple linear regression analysis (α≤0.05). Fluoridated groundwater and dentifrice were the dominant sources (r2 > 0.83) of TDFI in children from a naturally fluoridated and a non-fluoridated area, respectively. A positive correlation between TDFI and DUFE (r=0.50), and between [F] in fingernails and toenails (r=0.60) were found in children from a naturally fluoridated area. The [F] in nails of finger and toe were not correlated to TDFI. The consumption of fluoridated groundwater influenced the fluoride concentration in urine. In addition, the use of 1,100 ppm fluoride dentifrice did not influence the fluoride concentration in urine and fingernails.

RESUMO Objetivo: Adaptar um jogo educativo pré-existente, tornando-o específico para o ensino da medida auscultatória da pressão arterial, e aplicar esse jogo em estudo-piloto. Método: As cartas do jogo original foram alteradas pelos autores e submetidas a validação de conteúdo por seis especialistas na área. Após reformulações, o jogo foi aplicado a 30 sujeitos, que responderam a um questionário (pré-teste e pós-teste) sobre medida auscultatória. Os dados foram analisados descritivamente e pelos testes t de Student pareado e Wilcoxon pareado. Resultados: Em todo o processo de validação de conteúdo, foram modificadas 17 das 28 cartas originais. Destas 17, 13 obtiveram 80% de concordância, e as demais foram modificadas conforme sugestões dos juízes. As notas obtidas aumentaram significantemente entre o pré-teste e o pós-teste. Conclusão: Concluiu-se que o jogo reformulado apresentou evidências satisfatórias de validade de conteúdo. Sua utilização enquanto método de ensino-aprendizagem foi eficaz para esta amostra.

ABSTRACT Objective: To adapt a pre-existing educational game, making it specific to the teaching of blood pressure auscultatory measurement, and to apply this game in a pilot study. Method: The original game cards were altered by the authors and submitted to content validation by six experts in the field. After redesigns, the game was applied to 30 subjects, who answered a questionnaire (pre-test and post-test) on auscultatory measurement. Data were analyzed descriptively and by the paired Student's t-test and paired Wilcoxon test. Results: Throughout the content validation process, 17 of the 28 original cards were modified. Of these 17 cards, 13 obtained 80% agreement, and the rest were modified according to the judges' suggestions. The obtained grades significantly increased between pre- and the post-test. Conclusion: It was concluded that the reformulated game presented satisfactory evidence of content validity. Its use as a teaching-learning method was effective for this sample.

RESUMEN Objetivo: Adaptar un juego educativo ya existente, al dejarlo específico para enseñar a medir la presiónarterial por la auscultación, y aplicarlo en un estudio piloto. Método: Las cartas del juego original fueron cambiadas por los autores y sometidas a la validaciónde contenido por seis expertos en el área. Tras las reformulaciones, se aplicóel juego a treinta personas, que contestaron preguntas (antes de la prueba y despuésde la prueba) acerca de la mediciónpor la auscultación. Se analizaron los datos descriptivamente y por intermedio de las pruebas t de Student pareada y Wilcoxon pareada. Resultados: Durante el proceso de validación de contenido, se cambiaron 17 de 28 cartas originales. De las diecisiete, trece tuvieron el 80% de concordancia, y las demás fueron cambiadas según las sugerencias de los expertos. Las notas obtenidas aumentaron significativamente entre antes de la prueba y despuésde la prueba. Conclusión: Se concluye que el juego reformulado presentó satisfactorias evidencias para la validación de contenido. Su uso mientras método de enseñanza-aprendizaje fue eficaz para esta muestra.

ABSTRACT Objective: To adapt a pre-existing educational game, making it specific to the teaching of blood pressure auscultatory measurement, and to apply this game in a pilot study. Method: The original game cards were altered by the authors and submitted to content validation by six experts in the field. After redesigns, the game was applied to 30 subjects, who answered a questionnaire (pre-test and post-test) on auscultatory measurement. Data were analyzed descriptively and by the paired Student's t-test and paired Wilcoxon test. Results: Throughout the content validation process, 17 of the 28 original cards were modified. Of these 17 cards, 13 obtained 80% agreement, and the rest were modified according to the judges' suggestions. The obtained grades significantly increased between pre- and the post-test. Conclusion: It was concluded that the reformulated game presented satisfactory evidence of content validity. Its use as a teaching-learning method was effective for this sample.

RESUMEN Objetivo: Adaptar un juego educativo ya existente, al dejarlo específico para enseñar a medir la presiónarterial por la auscultación, y aplicarlo en un estudio piloto. Método: Las cartas del juego original fueron cambiadas por los autores y sometidas a la validaciónde contenido por seis expertos en el área. Tras las reformulaciones, se aplicóel juego a treinta personas, que contestaron preguntas (antes de la prueba y despuésde la prueba) acerca de la mediciónpor la auscultación. Se analizaron los datos descriptivamente y por intermedio de las pruebas t de Student pareada y Wilcoxon pareada. Resultados: Durante el proceso de validación de contenido, se cambiaron 17 de 28 cartas originales. De las diecisiete, trece tuvieron el 80% de concordancia, y las demás fueron cambiadas según las sugerencias de los expertos. Las notas obtenidas aumentaron significativamente entre antes de la prueba y despuésde la prueba. Conclusión: Se concluye que el juego reformulado presentó satisfactorias evidencias para la validación de contenido. Su uso mientras método de enseñanza-aprendizaje fue eficaz para esta muestra.

RESUMO Objetivo: Adaptar um jogo educativo pré-existente, tornando-o específico para o ensino da medida auscultatória da pressão arterial, e aplicar esse jogo em estudo-piloto. Método: As cartas do jogo original foram alteradas pelos autores e submetidas a validação de conteúdo por seis especialistas na área. Após reformulações, o jogo foi aplicado a 30 sujeitos, que responderam a um questionário (pré-teste e pós-teste) sobre medida auscultatória. Os dados foram analisados descritivamente e pelos testes t de Student pareado e Wilcoxon pareado. Resultados: Em todo o processo de validação de conteúdo, foram modificadas 17 das 28 cartas originais. Destas 17, 13 obtiveram 80% de concordância, e as demais foram modificadas conforme sugestões dos juízes. As notas obtidas aumentaram significantemente entre o pré-teste e o pós-teste. Conclusão: Concluiu-se que o jogo reformulado apresentou evidências satisfatórias de validade de conteúdo. Sua utilização enquanto método de ensino-aprendizagem foi eficaz para esta amostra.

RESUMO Introdução: Após o diagnóstico e tratamento do câncer de mama, algumas mulheres passam por alterações físicas, sociais e emocionais que repercutem muitas vezes na qualidade de vida e na autoestima. O objetivo é avaliar a qualidade de vida e autoestima de pacientes mastectomizadas submetidas ou não à reconstrução mamária após um mês de cirurgia. Métodos: A casuística foi composta por 89 pacientes, com idade igual ou superior a 30 anos, submetidas ou não à reconstrução mamária, e oriundas dos ambulatórios de Cirurgia Plástica e Mastologia do Hospital São Paulo e do Hospital Pérola Byington. O grupo 1 (n = 30) composto pelas pacientes mastectomizadas sem reconstrução mamária; o grupo 2 (n = 29) mastectomizadas com reconstrução mamária; e o grupo 3 (n = 30) pacientes sem alterações nas mamas. Para a avaliação da qualidade de vida, foram aplicados os instrumentos validados para uso no Brasil EORTC QLQ-C30 e Escala de Autoestima de Rosenberg UNIFESP/EPM. Resultados: Não foram observadas repercussões na qualidade de vida e autoestima das pacientes submetidas à mastectomia com ou sem a reconstrução mamária após um mês de cirurgia. Conclusão: Mulheres mastectomizadas com ou sem reconstrução mamária após um mês da cirurgia não apresentaram repercussões na qualidade de vida e na autoestima, quando comparadas entre si, bem como comparadas às mulheres sem história de câncer. É necessário que este tipo de avaliação, por meio dos questionários EORTC QLQ-C30 e QLQ-BR23, seja realizado no momento do diagnóstico do câncer de mama até o momento da pós-reconstrução mamária, com a finalidade de identificar em que fase se instalam as repercussões na qualidade de vida e autoestima. Introdução físicas Métodos 8 anos Byington n 29 mamas QLQC30 QLQC QLQ C30 C QLQ-C3 UNIFESPEPM UNIFESP EPM UNIFESP/EPM Resultados Conclusão si QLQBR23, QLQBR23 QLQBR BR23, BR23 BR QLQ-BR23 pósreconstrução pós QLQC3 C3 QLQ-C QLQBR2 BR2 QLQ-BR2 QLQ-BR

ABSTRACT Introduction: After diagnosis and treatment of breast cancer, some women go through physical, social, and emotional changes that often have an impact on their quality of life and self-esteem. This study aimed to assess the quality of life and self-esteem of mastectomized patients with or without breast reconstruction a month after surgery. Methods: The study consisted of 89 patients aged ≥ 30 years with or without breast reconstruction. They were recruited from the Plastic Surgery and Mastology clinic of São Paulo Hospital and Pérola Byington Hospital. Group 1 (n = 30) consisted of mastectomized patients without breast reconstruction; group 2 (n = 29) consisted of mastectomized patients with breast reconstruction; and group 3 (n = 30) consisted of patients without changes in the breasts. The EORTC QLQ-C30 and Rosenberg Self-Esteem Scale UNIFESP/EPM instruments, which are validated in Brazil, were used to assess their quality of life. Results: There were no observed effects in the quality of life and self-esteem of the patients who underwent mastectomy with or without breast reconstruction a month after surgery. Conclusion: The women with mastectomy with or without breast reconstruction a month after surgery showed no changes in their quality of life and self-esteem when compared among themselves and to women with no cancer history. It is necessary that this assessment, employing the EORTC QLQ-C30 and QLQ-BR23 questionnaires, be performed from the time of breast cancer diagnosis until after breast reconstruction to identify the stage when the quality of life and self-esteem are affected. Introduction physical social selfesteem. selfesteem self esteem. esteem Methods 8 n 29 breasts QLQC30 QLQC QLQ C30 C QLQ-C3 SelfEsteem Self Esteem UNIFESPEPM UNIFESP EPM instruments Brazil Results Conclusion history assessment QLQBR23 QLQBR BR23 BR QLQ-BR2 questionnaires affected QLQC3 C3 QLQ-C QLQBR2 BR2 QLQ-BR