Search

The article is based on the idea of human formation in its broadest sense, which includes the formation of the senses, corporeality, habits and practices, emotional life, the cultivation of relationships and of reflection on the existential meaning of the singular human life. It is assumed that the postulate is accepted that education is a specific and intentional process of human formation, with the same wide-ranging formative objectives of such formation. The article situates this understanding of education in the Brazilian educational field and presents a curriculum component designed to promote the human formation of young people and adults in technological training establishments in Brazil, over 18 weekly meetings of three hours each. This curriculum component was implemented and evaluated with 206 students from different technological courses by means of pre-and post-testing with a questionnaire, using a Likert technique, drawn up especially for this research study. It is designed to gauge (a) the understanding of relationships and emotions, (b) the understanding and cultivation of the virtues, and (c) the predisposition to take responsible decisions and actions. The results showed a statistically significant difference in the three subscales between pre and post-testing, with the higher scores being achieved in the latter.

This study clinically validated the nursing diagnosis of "sedentary lifestyle" (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel--Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining characteristics were statistically significant: "average daily physical activity less than recommended for gender and age," "preference for activity low in physical activity," "nonengagement in leisure time physical activities," and "diminished respiratory capacity." An SL showed statistically significant associations with the following related factors: insufficient motivation for physical activity; insufficient interest in physical activity; insufficient resources for physical activity; insufficient social support for physical activity; attitudes, beliefs, and health habits that hinder physical activity; and insufficient confidence for practicing physical exercises. The study highlighted the four defining characteristics and six related factors for making decisions related to SL among adolescents.

This paper presents a non-parametric imputation technique, named random forest, from the machine learning field. The random forest procedure has two main tuning parameters: the number of trees grown in the prediction and the number of predictors used. Fifty experimental conditions were created in the imputation procedure, with different combinations of predictors (from 1 to 10) and number of trees (10, 50, 100, 500 and 1000). We examined how each experimental condition affected the items fit and the difficulty of an inductive reasoning test to the dichotomous Rasch model. The results point that using random forest to impute missing values is a reliable technique to be used in psychological researches, since it led to statistically significant differences in the infit's median only in 4% of the experimental conditions investigated, compared to the original data set result. However, researchers should be aware that in 32% of the experimental conditions, the imputation procedure significantly increased the median of the estimated items' difficulty, compared to the original data set.

Purpose: The purpose of this study was to investigate the physiological adaptations of resistance training (RT) in prepubertal boys. Methods: Eighteen healthy boys were divided into RT (n = 9, M[subscript age] = 10.4 ± 0.5 years) and control (CTR; n = 9, M[subscript age] = 10.9 ± 0.7 years) groups. The RT group underwent a resistance training during 12 weeks, 3 times per week, performing 3 sets of 6 to 15 repetitions at intensities ranging from 60% to 80% of maximal dynamic strength (1-repetition maximum [1-RM] values). Before and after the training, the groups were assessed in their body mass and composition (dual-energy X-ray absorptiometry), isokinetic dynamometry, 1-RM, and ergoespirometry. Moreover, force per unit of muscle volume was calculated by the quotient between 1-RM and lean mass. Results: Both groups presented statistically significant (p < 0.05) increases in the 1-RM and force per unit of muscle volume in the knee extension and elbow flexion, but these strength increases were statistically significantly greater in the RT group (effect size [ES] = 2.83-9.00) than in the CTR group (ES = 0.72-1.00). Moreover, both groups statistically significantly increased in lean body mass variables (ES = 0.12-0.38). However, increases in the fat mass variables occurred only in the CTR group (ES = -0.01-0.50), whereas no changes were observed in the RT group. Furthermore, there were statistically significant increases in all bone mineral content variables (ES = 0.13-0.43), without differences between groups. No cardiorespiratory changes were observed. Conclusion: Twelve weeks of RT was effective in improving strength and force per unit of muscle volume and prevented fat mass increases in boys.

Purpose: We sought to compare the effects of physical practice (PP) and mental practice (MP) on the immediate and long-term learning of the finger-to-thumb opposition sequence task (FOS) in children; in addition, we investigated the transfer of this learning to an untrained sequence of movements and to the contralateral untrained hand. Method: This study included thirty-six 9-and 10-year-old children who were randomly allocated into 3 groups: MP, PP, and no practice (NP). The MP and PP groups were subjected to a single session of training with the dominant trained hand. MP participants were trained by mentally rehearsing the movements, PP participants were trained by executing the movements, and the NP group had no training. The performance of the trained sequence (TS) and untrained reverse sequence (URS) by each of the 3 groups was evaluated under identical conditions before training, after 5 min, and at 4 days, 7 days, and 28 days after training. Results: Whereas both trained groups (MP and PP) showed statistically significant improvement in TS using the trained hand at all assessment points after the training, only MP participants were able to transfer the performance gains from the TS to the URS and from the trained hand to the untrained opposite hand. Conclusion: Children were able to learn the FOS through MP or PP with a similar level of performance. Unlike PP, MP allowed for the transfer of performance gain to the URS and to the opposite hand, suggesting that the internal representations developed by MP were effector-independent.

Background The duration of the protective effect of tuberculosis preventive therapy (TPT) is controversial. Some studies have found that the protective effect of TPT is lost after cessation of therapy among people with human immunodeficiency virus (HIV) in settings with very high tuberculosis incidence, but others have found long-term protection in low-incidence settings. Methods We estimated the incidence rate (IR) of new tuberculosis disease for up to 12 years after randomization to 4 months of rifampin or 9 months of isoniazid, among 991 Brazilian participants in a TPT trial in the state of Rio de Janeiro, with an incidence of 68.6/100 000 population in 2022. The adjusted hazard ratios (aHRs) of independent variables for incident tuberculosis were calculated. Results The overall tuberculosis IR was 1.7 (95% confidence interval [CI], 1.01– 2.7) per 1000 person-years (PY). The tuberculosis IR was higher among those who did not complete TPT than in those who did (2.9 [95% CI, 1.3–5.6] vs 1.1 [.4–2.3] per 1000 PY; IR ratio, 2.7 [1.0–7.2]). The tuberculosis IR was higher within 28 months after randomization (IR, 3.5 [95% CI, 1.6–6.6] vs 1.1 [.5–2.1] per 1000 PY between 28 and 143 months; IR ratio, 3.1 [1.2–8.2]). Treatment noncompletion was the only variable associated with incident tuberculosis (aHR, 3.2 [95% CI, 1.1–9.7]). Conclusions In a mostly HIV-noninfected population, a complete course of TPT conferred long-term protection against tuberculosis. [ABSTRACT FROM AUTHOR]

Hunting comprises the extraction of wild animals from their natural environment for use in various purposes. In this sense, based on the Socioecological Theory of Maximization (TSM), semi-structured forms were applied to 45 hunters from rural communities located in the Caatinga region in the state of Bahia/Brazil to verify the influence of cost-benefit, perceived abundance, taste preference and multiple uses in the selection of hunted species. Fourteen species were selected to test whether hunting intensity is influenced by the presented variables. It was found that the only variable that showed statistical significance was flavor preference, increasing the chance of a species being hunted by up to three times (OR = 3.09). It is concluded that subjective variables related to culture significantly influence species selection in the study region. [ABSTRACT FROM AUTHOR]

This paper aims to construct a Green Development Index for emerging economies, focusing on the BRICS nations as the research subjects. The study measures the index of various indicators and explores the influencing factors from 2012 to 2021 using the entropy value method. The trend analysis indicates that the global level of green development is gradually increasing, albeit with significant fluctuations. China and Brazil lead with the highest levels of green development, while Russia consistently maintains a lower level. Regression results, in terms of estimated coefficients and statistical significance, suggest the greatest impact comes from industrial structure, followed by technological R&D, with human capital having the least impact. Implications are policy changes in emerging economies to enhance industrial structures, human capital, and sci-tech research. [ABSTRACT FROM AUTHOR]

Objectives: We carried out this work with the aim of assessing the effectiveness of a set of interventions over time for the administration of antibiotics. Design: Prospective observational study. Setting: Patients admitted to the emergency room and ICU of the hospital where the study was conducted are evaluated daily for some sociodemographic and clinical variables. Among them are some quality indicators, such as the time between the diagnosis of sepsis or septic shock until the start of the infusion of antibiotics. This indicator reflects several aspects related to a set of assistance measures (adequacy of antibiotic dispensation, rapid response team (RRT), sepsis care quality improvement program, antimicrobial management program, improvements in emergency department assistance). Patients or participants: Patients with sepsis or septic shock were admitted to the ICU of a university and public hospital in southern Brazil. Main variables of interest: The time between the diagnosis of sepsis or septic shock and the beginning of the infusion of antibiotics. Results: Between 2013 and 2018, 1676 patients were evaluated. The mean time for antibiotic infusion decreased from 6.1 ± 8.6 hours to 1.7 ± 2.9 hours (p < 0.001). The percentage of patients who received antibiotics in the first hour increased from 20.7 to 59.0% (p < 0.001). Conclusion: In this study, we demonstrated that a set of actions adopted in a large tertiary hospital was associated with decreased time to start antibiotic therapy in septic patients. [ABSTRACT FROM AUTHOR]

Background: Over the last decades, enormous successes have been achieved in reducing malaria burden globally. In Latin America, South East Asia, and the Western Pacific, many countries now pursue the goal of malaria elimination by 2030. It is widely acknowledged that Plasmodium spp. infections cluster spatially so that interventions need to be spatially informed, e.g. spatially targeted reactive case detection strategies. Here, the spatial signature method is introduced as a tool to quantify the distance around an index infection within which other infections significantly cluster. Methods: Data were considered from cross-sectional surveys from Brazil, Thailand, Cambodia, and Solomon Islands, conducted between 2012 and 2018. Household locations were recorded by GPS and finger-prick blood samples from participants were tested for Plasmodium infection by PCR. Cohort studies from Brazil and Thailand with monthly sampling over a year from 2013 until 2014 were also included. The prevalence of PCR-confirmed infections was calculated at increasing distance around index infections (and growing time intervals in the cohort studies). Statistical significance was defined as prevalence outside of a 95%-quantile interval of a bootstrap null distribution after random re-allocation of locations of infections. Results: Prevalence of Plasmodium vivax and Plasmodium falciparum infections was elevated in close proximity around index infections and decreased with distance in most study sites, e.g. from 21.3% at 0 km to the global study prevalence of 6.4% for P. vivax in the Cambodian survey. In the cohort studies, the clustering decreased with longer time windows. The distance from index infections to a 50% reduction of prevalence ranged from 25 m to 3175 m, tending to shorter distances at lower global study prevalence. Conclusions: The spatial signatures of P. vivax and P. falciparum infections demonstrate spatial clustering across a diverse set of study sites, quantifying the distance within which the clustering occurs. The method offers a novel tool in malaria epidemiology, potentially informing reactive intervention strategies regarding radius choices of operations around detected infections and thus strengthening malaria elimination endeavours. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between the optimum power load in the bench press (BP), shoulder press (SP), and prone bench pull (PBP) exercises and acceleration (ACC) and speed performances in 11 National Team wheelchair basketball (WB) players with similar levels of disability. All athletes were previously familiarized with the testing procedures that were performed on the same day during the competitive period of the season. First, athletes performed a wheelchair 20-m sprint assessment and, subsequently, a maximum power load test to determine the mean propulsive power (MPP) in the BP, SP, and PBP. A Pearson product–moment correlation was used to examine the relationships between sprint velocity (VEL), ACC, and the MPP in the three exercises. The significance level was set as p <.05. Large to very large significant associations were observed between VEL and ACC and the MPP in the BP, SP, and PBP exercises (r varying from.60 to.77; p <.05). The results reveal that WB players who produce more power in these three exercises are also able to accelerate faster and achieve higher speeds over short distances. Given the key importance of high and successive ACCs during wheelchair game-related maneuvers, it is recommended that coaches frequently assess the optimum power load in BP, SP, and PBP in WB players, even during their regular training sessions. [ABSTRACT FROM AUTHOR]

Body perception is an individual's ability to recognize their body in attitudinal and/or dimensional aspects. We investigated women's body perceptions before and after bariatric surgery. Participants were 31 women (M age = 36.23, SD = 7.95 years old) with an average pre-operative body mass index of 44.58 (SD = 4.65) kg/m2. We collected anthropometric and body perception measures (attitudinal body image [ABI] and dimensional body image [DBI]) before bariatric surgery and 30, 60, 90, and 120 days after it. There was an average decrease of 21.09% in participants' body weight over the 120 days. Regarding ABI, 51.61% of participants had high body dissatisfaction before surgery, and this proportion of dissatisfied participants decreased to 3.23% 120 days after surgery. We observed no statistically significant differences in DBI perceptions. Fast weight loss caused by bariatric surgery appeared to generate a perception of ghost fat. Somatosensory interventions and/or a longer follow-up are needed to alter this persistent distortion of body dimensions. [ABSTRACT FROM AUTHOR]

In the study, it is aimed to determine under the Environmental Kuznets Curve Hypothesis whether the newly industrialized countries, which need high output in order to gain competitive advantage, provide their economic development by considering environmental policies. For this purpose, the hypothesis was tested with panel data analysis for the years 1980-2021. In the study, CADF unit root, Westerlund cointegration and Augmented Mean Group Estimator (AMG) tests were used. According to the obtained findings, although it is observed that there is a long-term relationship between the variables, it has been determined that the increase in per capita income in Brazil and Turkey reduces carbon emissions. In Mexico and the Philippines, it has been observed that increases in income and per capita income, respectively, increase carbon dioxide emissions. Although there is no statistical significance in terms of income per capita for the panel in general within the scope of newly industrialized countries that have not yet completed their development, it has been determined that increases in income used as a control variable increase CO2 emissions. The results show that the environmental Kuznets curve, which states that increases in per capita income first increase environmental pollution and then decrease it, is valid only in Brazil and Turkey. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Enfermagem Digital Cuidado e Promoção da Saúde is the property of Revista Enfermagem Digital Cuidado e Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The assessment of knowledge about cardiovascular diseases through instruments helps to identify gaps and educational needs of the target audience. To validate and verify the psychometric properties of the Brazilian version of the Heart Disease Knowledge Questionnaire (HDKQ-BR) for adults in Brazil. Cross-sectional methodological study carried out in a Brazilian city with 300 participants. Internal consistency, temporal stability (test-retest) and convergent structural validity were verified. Item Response Theory (IRT) was used to determine parameters a (discrimination) and b (difficulty) of each item and the unidimensionality of the instrument and the differential item functioning (DIF) for sex, education and age. The internal consistency of the HDKQ-BR was 0.694. The test-retest reliability was confirmed by the intraclass correlation coefficient (ICC = 0.779). According to the IRT, parameter a was between 0.176 and 1.175 and parameter b between −10.834 and 4.969. The HDKQ-BR showed unidimensional structure and adequate psychometric performance for its application in populations with the same profile in Brazil. To assess the knowledge of an adult population about CVDs is important for improving the health literacy. The study focused on Area I of Responsibilities for Health Education Specialists (Assessment of Needs and Capacity). [ABSTRACT FROM AUTHOR]

Hand-foot syndrome (HFS), or palmar-plantar erythrodysesthesia, is characterised by erythema, oedema and dysesthesia, which can progress to blistering and ulceration. This condition is described as a common adverse effect of the chemotherapeutic agent capecitabine. The study set out to evaluate real-world incidences; assess severity based on clinical criteria, such as local symptoms, dyschromia, erythema, oedema and ulcerations; and associated factors, such as type of solid tumour, chemotherapy regimen, number of cycles, sex, age and Eastern Cooperative Oncology Group Performance Scale of HFS, related to the use of capecitabine. This is a single-centre prospective cohort study carried out jointly by the departments of clinical oncology and dermatology of a university hospital in the southeast of Brazil. The study showed a 34% incidence of HFS, with most cases classified as mild. There was statistical significance in the correlation of the syndrome with sex and performance scores. HFS is the most common and limiting adverse reaction to capecitabine, and causes significant functional and quality impairments in patients with cancer. With this study, we have reinforced the importance of multidisciplinary assessment for early diagnosis and adequate follow-up. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. Methods: Retrospective single-center study including 250 consecutive patients that received del Nido cardioplegia (DN group) with a mandatory reperfusion period of 30% of cross clamp time and 250 patients that received a modified St. Thomas' solution (ST group). Groups were matched by age, weight, gender, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores. Preoperative hematocrit and oxygen saturation were also recorded. Outcomes analyzed were the vasoactive inotropic score (VIS), lactate, ventilation time, ventricular dysfunction with low cardiac output syndrome (LCOS), intensive care unit (ICU) length of stay (LOS), hospital LOS, bypass and aortic cross-clamp times, and in-hospital mortality. Results: Both groups were comparable demographically. Statistically significant differences (p ⩽ 0.05) were noted for cardiac dysfunction with LCOS, hematocrit at end of surgery (p = 0.0038), VIS on ICU admission and at end of surgery (p = 0.0111), and ICU LOS (p = 0.00118) with patients in the DN group having more desirable values for those parameters. Other outcome measures did not reach statistical significance. Conclusion: In our congenital cardiac surgery population, del Nido cardioplegia strategy was associated with less ventricular dysfunction with LCOS, a lower VIS and decreased ICU LOS compared with patients that received our standard myocardial protection using a modified St. Thomas' solution. Despite the limitation of this study, including its retrospective nature and cohort size, these data supported our transition to incorporate del Nido cardioplegia solution with a mandatory reperfusion period as the preferred myocardial protection method in our program. [ABSTRACT FROM AUTHOR]

The main objective of this work was the development and evaluation of usage of a new water quality index (WQI) that linked the information of the parameters that compose it and the practicality of calculation to the current legislation in Brazil. For this, 30 water monitoring stations were selected, in the hydrographic unit of Upper Iguaçu-Parana-Brazil. Three methods of WQIs calculation were applied: National Sanitation Foundation- NSF (WQINSF), Bascaran (WQIb), and the new method proposed called Bascaran-CONAMA (WQIc). The calculation of the WQIc was adapted based on the WQIb and had its parameters based on Brazilian legislation (CONAMA 357). Statistical analysis at a significance level of 1% was performed in the comparison of the three indexes, by monitoring station and seasonal periods. It was verified that the results obtained through the calculation of the new index proposed had a greater coherence with the Brazilian scenario. Keywords: Brazilian Water Quality Index; Water Pollution; Watersheds Monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study aims to identify the beliefs, attitudes, and opinions of nursing professionals associated with tobacco smoking and its prohibition in a psychiatric hospital in Brazil. Methods: Using a cross-sectional epidemiologic study, a total of 73 nursing professionals in a smoke-free psychiatric hospital were interviewed. The Varimax Rotation and the Fisher's exact test at a 5% significance level were used to analyze the responses. Findings: Most nursing professionals reported observations of patients becoming calmer after smoking (n = 59, 80.8%) and tobacco withdrawal worsening patients' mental health symptoms, suggesting agreement among professionals that some psychiatric patients need to smoke tobacco. Most respondents stated that patients with mental health disorders have more difficulty with smoking cessation (79.4%) and are less interested in quitting smoking than those without disorders (95.9%). While one-third mentioned having used cigarettes as a reward or bribe, the majority (83.6%) was in favor of continuing the smoking ban, with more support observed from those working on a night shift and those who worked in the public psychiatric wards. Over 71% noted improvements in their health after the smoking ban. Conclusion: The nursing professionals were surprised by the effectiveness of the smoking ban and highlighted the improvement in the hospital environment after its implementation. Clinical relevance: As trusted healthcare professionals, nurses are essential in the fight against smoking and can contribute to awareness promotion, supporting patients during nicotine withdrawal, and decision-making processes for health policies. [ABSTRACT FROM AUTHOR]

Background: Breast Cancer (BC) is the most common cancer in women worldwide and, although 70% of patients are responsive to selective Estrogen Receptor (ER) modulators such as Tamoxifen (Tam), patients' survival is comprised by resistance to endocrine therapy. Brazilian flora, especially the Amazon biome, is one of the richest global sources of native species with potentially bioactive compounds. Arrabidaea chica is a plant native to the Amazon that has been used in the treatment of different diseases. However, its action on BC remains unclear. Methods: Herein the biological effects of the chloroform extract of A. chica (CEAC) were evaluated on BC cells and in in vivo model. After confirmation of CEAC antioxidant capacity, cells were treated with CEAC and Tam, alone and with CEAC+Tam. The cell viability was evaluated by MTT and hormone receptor transcripts levels were assessed (ESR1, ESR2 and AR). Finally, anticarcinogenicity of CEAC was recorded in Drosophila melanogaster through Epithelial Tumor Test (ETT). Results: The study confirmed the antioxidant activity of CEAC. CEAC was selective for MCF-7, downregulating ESR2 and AR transcripts and upregulating ESR2 expression. The modulatory effects of CEAC on ERs did not differ between cells treated with Tam and with CEAC+Tam. Interestingly, previous treatment with CEAC, followed by treatment with Tam promoted a significant decrease in cell viability. The extract also presented anticarcinogenic effect in in vivo assay. Conclusion: The bioassays on breast tumor cells demonstrated the antiproliferative activity of the extract, which modulated the expression of hormone receptors and sensitized luminal tumor cells to Tam. These results suggest that CEAC could be a complementary treatment for BC. [ABSTRACT FROM AUTHOR]

Objective: analyze the association between drug use and body dissatisfaction among adolescents in three Brazilian cities. Method: cross-sectional study, using a nested randomized controlled trial to evaluate the drug use prevention program #TamoJunto2.0 of the Ministry of Health in Brazilian schools. The sample consisted of 5,213 students from 73 schools in three Brazilian cities. The outcome body satisfaction was analyzed using the Stunkard scale and the explanatory variables were drug use and sociodemographic data. Results: the adolescents were between 12 and 14 years old; about 69.9% of them reported body dissatisfaction, and 35.67% used alcohol in the previous year. Dissatisfaction due to overweight was higher among girls (41.5%) and dissatisfaction due to underweight was higher among boys (33.1%). Adolescents who used marijuana were 39% (OR=1.39) more likely to feel dissatisfied due to underweight and being a girl increased the chances of feeling dissatisfied due to overweight by 24% (OR=1.24). Conclusion: the levels of body dissatisfaction deserve attention in hebiatric nursing care and reinforce the importance of educational strategies addressing body image and drug use, relating them to the various subjective attributes that can affect the health of adolescents, whether in the community or at school. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Pelvic-drop exercises are often used to strengthen the gluteus medius (GM) muscle with the aim of increasing or prioritizing its recruitment. However, the effect of hip rotation on the performance of the action of the GM is unknown. Objective: To evaluate the effect of hip rotation on the recruitment of the GM, tensor fasciae latae (TFL), and quadratus lumborum (QL). Method: Seventeen healthy subjects performed 2 sets of 4 repetitions of pelvic-drop exercise in random order with pelvic-drop lateral, medial, and neutral rotation of the hip. Main Outcome Measures: The electromyographic (EMG) activity of the GM, TFL, and QL was evaluated using surface electromyography. Results: There were significant increases in the activation of the GM with medial and neutral rotation compared with lateral rotation (P = .03, P = .01, respectively), and there was no difference between medial and neutral rotation (P = 1.00). There was no difference in EMG activity of the TFL and QL in any of the positions. The GM:TFL ratio was the same in all analyzed positions. Regarding the GM:QL ratio, there was a significant increase with medial rotation compared with lateral rotation (P = .02). Conclusions: Pelvic-drop exercises are more efficient for activating the GM when the hip is in medial rotation and neutral position. [ABSTRACT FROM AUTHOR]

The effects of an enforced fast start on long-distance performance are controversial and seem to depend on the athlete's capacity to delay and tolerate metabolic disruption. The aim of this study was to investigate the effects of an enforced start on 10-km-running performance and the influence of the some physiological and performance variables on the ability to tolerate an enforced fast start during the running. Fifteen moderately trained runners performed two 10-km time trials (TTs): free pacing (FP-TT) and fast start (FS-TT). During FS-TT, speed during the first kilometer was 6% higher than in FP-TT. Maximal oxygen uptake (VO2max), peak velocity (PV), velocity associated with VO2max (vVO2max), ventilatory threshold, and running economy at 10 and 12 km/h and FP-TT average velocity (AV-10 km) were individually determined. There were no differences between FP-TT and FS-TT performance (45:01 ± 4:08 vs 45:11 ± 4:46 min:s, respectively, P = .4). Eight participants improved (+2.2%) their performance and were classified as positive responders (PR) and 7 decreased (-3.3%) performance and were classified as negative responders (NR). Running speed was significantly higher for PR between 6 and 9.2 km (P < .05) during FS-TT. In addition, PR presented higher PV (P = .02) and vVO2max (P = .01) than NR, suggesting that PV and vVO2max might influence the ability to tolerate a fast-start strategy. In conclusion, there was an individual response to the enforced fast-start strategy during 10-km running, and those who improved performance also presented higher vVO2max and PV, suggesting a possible association between these variables and response to the strategy adopted. [ABSTRACT FROM AUTHOR]

We analyse seasonal and annual trends of extreme indices of air temperature and precipitation over Brazil during the period 1961–2018. The main goal is to investigate whether the climate is changing and if so, to explore if there is any marked seasonality in such changes. The daily observed datasets of maximum and minimum temperatures, and precipitation, are provided by the Brazilian National Institute of Meteorology and National Water Agency. We use the Sen Curvature and Mann‐Kendall statistical tests to compute the magnitudes and to evaluate the statistical significance of climate extremes trends, respectively. The results show that the warm extremes frequency of occurrence is increasing significantly while the opposite occurs for cold extremes, which reveals a very consistent and widespread warming over Brazil. The highest increases in warm extremes occur during austral spring and summer while for the cold extremes the greatest decreases are observed during austral winter. Unlike temperature, precipitation extremes show heterogeneous signals for most of the country. In Northeast Brazil, there are changes towards a drier climate, especially in summer and autumn. In the Southern region, the climate is becoming wetter, with a reduction in consecutive dry days, especially in spring. For the other regions, there is no strong clear change sign, but both positive and negative precipitation extreme trends, without statistical significance (mostly in Southeast Region). [ABSTRACT FROM AUTHOR]

Adult trans women in Brazil are highly impacted by HIV, but little is known about risk for young trans women. Our study was conducted to compare the HIV prevalence and correlates of risk for young trans women ages 18–24 years old to adult trans women in Brazil. Trans women were recruited from Rio de Janeiro and Baixada (the metropolitan area of Rio de Janeiro), Brazil (N = 345). Youth ages 18–24 years of age had significantly greater odds of being HIV negative than adults (OR 0.4, 95% CI 0.2–0.6, p = 0.0002), but significantly lower odds of having post-exposure prophylaxis (PEP) knowledge (OR 0.5, 95% CI:0.3–0.9, p = 0.02) and PrEP awareness (OR 0.5, 95% CI: 0.3–0.8, p = 0.01). Young trans women also had significantly higher odds of using substances (OR 1.8, 95% CI 1.1–2.9, p = 0.02) and condomless anal intercourse with their last three sexual partners (OR 1.8, 95% CI: 1.1–3.0, p = 0.03) compared to adults. Already by age 24, one in four trans women in Brazil were infected with HIV pointing to a new generation at high risk of acquiring HIV. HIV prevention interventions are needed to change the healthcare system to reach and engage young trans women. [ABSTRACT FROM AUTHOR]

Objectives: to analyze the spatial distribution of fetal deaths before and after implementation of surveillance for this event in the city of Recife, in the Northeast Region of Brazil. Methods: an ecological study whose spatial analysis unit was the 94 neighborhoods. The gross fetal mortality rates were calculated and the local empirical Bayesian estimator was adopted to smooth out random fluctuations of such rates. To analyze the spatial autocorrelation, the Global Moran's Index was used, and spatial clusters were located by the Local Moran's Index. Results: during the period before implementation of death surveillance, 1,356 fetal deaths were reported, a coefficient of 9.9 deaths per thousand births. During the second period, 1,325 fetal deaths occurred, a coefficient of 9.6 deaths per thousand births. The Global Moran's Indexes (I) were I=0.6 and I=0.4 for the first and second periods, respectively, with statistical significance (p<0.05). For both periods analyzed, spatial clusters of high-risk neighborhoods were identified in the northern and eastern regions of the city. Conclusion: the spatial analysis indicated areas that persist as priorities for planning surveillance and health assistance actions to reduce fetal mortality. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study examined the sensitivity of maximal (Yo-Yo Intermittent Recovery [IR] 1 and 2) and submaximal (5'-5') tests to identify training adaptations in futsal players along with the suitability of heart-rate (HR) and HR-variability (HRV) measures to identify these adaptations. Methods: Eleven male professional futsal players were assessed before (pretraining) and alter (posttraining) a 5-wk period. Assessments included 5'-5' and Yo-Yo IR1 and IR2 performances and HR and HRV at rest and during the IR and 5'-5' tests. Magnitude-based-inference analyses examined the differences between pre- and posttraining, while relationships between changes in variables were determined via correlation. Results: Posttraining, Yo-Yo IR1 performance likely increased while Yo-Yo IR2 performance almost certainly increased. Submaximal HR during the Yo-Yo IR1 and Yo-Yo IR2 almost certainly and likely, respectively, decreased with training. HR during the 5'-5' was very likely decreased, while HRV at icst and during the 5-5 was likely increased alter training. Changes in both Yo-Yo IR performances were negatively correlated with changes in HR during the Yo-Yo IR1 test and positively correlated with the change in HRV during the 5'-5'. Conclusions: The current study has identified the Yo-Yo IR2 as more responsive for monitoring training-induced changes of futsal players than the Yo-Yo IR1. Changes in submaximal HR during the Yo-Yo IR and HRV during the 5'-5' were highly sensitive to changes in maximal performance and are recommended for monitoring training. The 5'-5' was recommended as a time-efficient method to assess training adaptations for futsal players. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Along with other countries in America, plague reached Brazil through the sea routes during the third pandemic. A brief ports phase was followed by an urban phase that took place in smaller inland cities and finally, it attained the rural area and established several foci where the ecological conditions were suitable for its continued existence. However, the geographic dispersion of plague in Brazil is still poorly studied. To better understand the disease dynamics, we accessed satellite-based data to trace the spatial occurrence and distribution of human plague cases in Pernambuco, Northeastern Brazil and using the municipality of Exu as study case area. Along with the satellite data, a historical survey using the Plague Control Program files was applied to characterize the spatial and temporal dispersion of cases in the period of 1945–1976. Kernel density estimation, spatial and temporal clusters with statistical significance and maximum entropy modeling were used for spatial data analysis, by means of the spatial analysis software packages. The use of geostatistical tools allowed evidencing the shift of the infection from the urban to the wild-sylvatic areas and the reemergence of cases after a period of quiescence, independent of the reintroduction from other plague areas. [ABSTRACT FROM AUTHOR]

The number of reports of tick parasitism in amphibians and reptiles has increased over the past few years, including new host and location records for Amblyomma rotundatum and Amblyomma dissimile. However, knowledge of the geographical distribution remains incomplete, and in many regions of Brazil, the presence of these vectors has not been investigated. Several candidate models were built using a correlative maximum entropy approach, and best-fitting models were selected based on statistical significance, predictive ability, and complexity based on current climatic trends and future projected climate changes. Final models showed a good ability to discriminate A. rotundatum and A. dissimile current and future potential distributions. The entire country had higher predicted suitability for A. rotundatum while A. dissimile was mainly restricted to the Amazon and Pantanal biomes. A. rotundatum is a species with enormous potential for dissemination in the next decades, potentially through the legal and illegal transport of reptiles and amphibians. The proposed model is useful for targeting surveillance efforts increasing the efficiency and accuracy of future ecological research and tick management efforts. [ABSTRACT FROM AUTHOR]

To evaluate the factors associated with functional capacity in patients with chronic kidney disease (CKD). All patients were submitted to six-minute walk test (6MWT), 10-repetition sit-to-stand test (STS-10) and SF-36 health-related quality of life questionnaire (HRQoL). Patients with functional capacity ≥80% exhibited higher education level, family income, body mass index, estimated glomerular filtration rate, and lower age and STS-10 time. Multiple linear regression showed that gender, age, family income, chronic kidney disease stage, STS-10 time, and physical component summary of HRQoL were significantly associated with the 6MWT distance. Functional capacity was significantly associated with gender, age, family income, CKD stage, STS-10 time, and physical component of HRQoL. The progression of CKD has an impact on the decrease in functional capacity in these patients. [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the effects of a very congested match schedule on the total distance (TD) covered, high-intensity-running (HIR) distance, and frequency of accelerations and body-load impacts (BLIs) performed in a team of under-15 soccer players (N = 10; 15.1 ± 0.2 y, 171.8 ± 4.7 cm, 61 ± 6.0 kg) during an international youth competition. METHODS: Using global positioning systems, player performances were repeatedly monitored in 5 matches performed over 3 successive days. RESULTS: Significant differences were observed between matches (P < .05) for the frequency of accelerations per minute, BLIs, and BLIs per minute. No differences were observed for the TD covered, TD run per minute, number of high-intensity runs, distance covered in HIR, per-minute peak running speed attained, or frequency of accelerations. The frequency of accelerations per minute decreased across the competition while BLIs were higher during the final than in all other matches. CONCLUSIONS: These results suggest that BLIs and acceleration might be used as an alternative means to represent the external load during congested match schedules rather than measures related to running speed or distance covered. [ABSTRACT FROM AUTHOR]

This study aimed to determine the influence of age, anthropometry, and distance on stroke parameters of 10- to 17-y-old swimmers. Forty-six male swimmers were divided into 4 chronological age groups. Anthropometry and sexual maturity were assessed, and maximal efforts of 100, 200, and 400 m using front-crawl style were performed to determine stroke rate (SR), length (SL), and index (SI). Multiple linear regression, 1-way, and mixed ANOVA for repeated measures were used for statistical analyses. There was significant effect of distance for all stroke parameters (P < .001) and an age effect only for SL and SI (P < .001). Post hoc showed that the 10- to 17-year-old group significantly reduced SR with increasing distance (effect size -0.8 to -1.5 comparing 100, 200, and 400 m) but were not effective in offsetting this adaptation with increased SL, especially from 200- to 400-m distance, at which no group made both adjustments, highlighting the decreased efficiency with significant SI reduction (effect size -0.2 to-0.4 comparing 100,200, and 400 m). Considering all stroke parameters, the performances were almost 100% explained, but SI itself could explain around 90% of the performance; furthermore, limb length contributed to explain all stroke parameter, and SI was the variable best predicted (around 75%) by anthropometrical (upper limbs and height) and descriptive variables (age and y of systematic training).Thus, distinct effects of distance and advancing age were found during childhood and adolescence on stroke parameters, and SI was highlighted as the best predictor of 100-, 200-, and 400-m maximal performances. [ABSTRACT FROM AUTHOR]

People who are obese sustain very high foot pressures when standing, with potential consequences to their feet soles' cutaneous sensibility. In the current investigation, we performed a detailed assessment of foot sole sensibility in women with morbid obesity (n = 13; age = 38.85, SD = 8.09 years) status in comparison with leaner women (n = 13; age = 37.62, SD = 7.10 years). We estimated tactile feet sole sensibility through graduated monofilament light touch applied at several hotspots of both feet soles, covering the toes, metatarsal heads, midfoot internal and lateral arches, and heel. Intergroup comparisons per foot sole region indicated significantly lower sensibility for the group with morbid obesity under the fifth and third metatarsal heads, midfoot lateral and internal arches and heel. We found a large variation across the sole regions, with the lowest difference between the obese and lean groups observed under the hallux (18%) and the largest difference observed under the lateral arch of the midfoot (76%). Correlation analyses between body weight and sensibility scores revealed a significant positive correlation among participants who were leaner (r s = 0.56, p = 0.05) but not among participants who were obese (r s = –0.06, p = 0.83). Mainly, our results showed that morbid obesity was associated with significantly higher cutaneous sensibility thresholds, with large variability of the sensibility deficit across different regions of both feet soles. Due to its functional relevance for body balance control, reduced sensibility thresholds among women who are morbidly obese may have implications for stance stability. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a practical, generic and widely used tool to assess the functioning and disability in several settings and health conditions. Although the use of categorical variables is common, this choice to present data could separate persons with very close functioning profiles into different categories. PURPOSE: This study aims to compare different ways of expressing the WHODAS score and give elements for the researcher to understand and choose the most appropriate way to statistically analyse the WHODAS scores. METHODS: A methodological study with secondary data of one hundred ninety-five women. The WHODAS score was analysed in different ways and associated with sociodemographic characteristics, lifestyle, and health aspects. The Poisson regression was chosen with the final WHODAS score in four variations (continuous, dichotomous, polytomous, and quartiles), and the presence of chronic disease. RESULTS: The analysis showed statistical significance in the univariate analysis for the adjustment variables and all the variations of the disability variable. The distribution analysis of the prevalence ratio and the AIC evidenced that the WHODAS score as a continuous variable had the lower AIC and statistical significance, as well as the most significant area under the ROC curve. CONCLUSIONS: These results show that the use of the continuous variable is the most indicated and that the categorization of the WHODAS score should be avoided. [ABSTRACT FROM AUTHOR]

This is a cross‐sectional study conducted with 537 family caregivers of people with mental disorders. The objective was to quantify the degree of burden experienced by men and women, and identify the most affected dimensions of their lives and the factors associated with burden manifestation by gender. The Zarit Burden Interview (ZBI) scale was used to assess burden. Mean burden was 22.8 points (SD = 6.3) for men and 27.8 points (SD = 17.8) for women. The most affected dimensions among the two groups were the same; however, among the 22 items on the scale, 11 presented significantly higher means among women. The factors associated with the manifestation of burden in both groups were as follows: low income; use of psychotropic drugs; greater degree of dependence of the service user; not receiving family support; and dissatisfaction with family relationships. For men, manifestation of burden was also associated with age. For women, there were further associations of the outcome with the presence of health problems, not having someone to share care with, and caring for the assisted person for >10 years. Our findings suggest that the degree of burden of family members caring for those with mental disorders is associated with gender, and this should be considered by services responsible for planning care shared by professionals and relatives. Guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE Statement) were adhered to in this study. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To evaluate (1) the effect of a salivary substitute prepared using chamomile (Matricaria chamomilla L.) flower and flax (Linum usitatissimum L.) seed to relieve Primary burning mouth syndrome (BMS) symptoms, (2) their effect on the inhibition of matrix metallopeptidase 2 (MMP2) and MMP9 metalloproteinases, and (3) their potential cellular cytotoxic effect. Subjects: 40 women aging >40 years with diagnosis of primary BMS. Settings/Location: Center of Diagnosis of Diseases of the Mouth, Federal University of Pelotas, Brazil. Design: This was an open clinical trial where primary BMS patients used the homemade salivary. At the first appointment, after 30 and 60 days, the authors evaluated the pattern and intensity of BMS and xerostomia symptoms, and then determined and compared the unstimulated salivary flow rate (SFR), viscosity, and salivary pH. MMP2 and MMP9 activities in saliva and cytotoxicity were assessed using different concentrations of chamomile flower and flax seed separately. Interventions: Subjects used the homemade salivary substitute for 3 months and were instructed to rinse their mouth three to four times daily for 1 min. Outcome measures: A numeric rating scale to evaluate the intensity of burning sensation and xerostomia symptoms, salivary flow rate (SFR) to determine salivary volume, dynamic rheology technique for viscosity and a digital meter for salivary pH. MMP2 and MMP9 activities in saliva and cytotoxicity were assessed by zymography and cell viability assay respectively. Results: After treatment, severity of BMS symptoms decreased, the SFR increased, salivary viscosity decreased, and severity of xerostomia sensation (in patients who reported having this symptom) improved (p < 0.05). Chamomile flower and flax seed had no effect on inhibiting MMP2 and MMP9 activities, and neither showed cellular cytotoxic effects. Conclusion: This homemade salivary substitute is an economical, viable, easily manipulated, noncytotoxic, and a practical alternative to relieve BMS symptoms. [ABSTRACT FROM AUTHOR]

Background & Aim: To investigate the association between the genetic polymorphisms FokI (rs2228570) and BglI (rs739837) in vitamin D receptor (VDR) with dental caries and gingivitis susceptibility. Design: This study included 353 Brazilian children (8 to 11 years old). Dental caries was assessed using ICDAS (International System for Detection and Assessment of Carious Lesions) and gingival bleeding using Community Periodontal Index (CPI). The presence of visible biofilm was also evaluated. DNA was extracted from saliva, and real‐time PCR was used to evaluate genetic polymorphisms in VDR: rs2228570 (FokI, A>G/Met>Thr) and rs739837 (BglI, G>T). Dental caries was evaluated as a continuous data (mean and standard deviation‐SD) and was also categorized (ICDAS0versus ICDAS1‐6 or ICDAS1‐2versus ICDAS3‐6). Gingivitis was categorized in with and without. One‐way ANOVA was used for comparisons of caries among genotypes. Chi‐square test, logistic regression, and haplotype analysis were performed (P <.05). Results: Biofilm was associated with dental caries susceptibility and gingivitis (P <.05). The mean distribution of the caries lesions and cavitated caries lesions among FokI and BgII genotypes were not statistically significant (P >.05). Genotype distributions among caries groups (in the two different cut‐offs) and among gingivitis and non‐gingivitis groups were not statistically significant (P >.05). Conclusion: The polymorphisms FokI and BglI in VDR were not associated with dental caries or gingivitis. [ABSTRACT FROM AUTHOR]

BACKGROUND: We sought to evaluate the acute effects of different inspiratory loads using nasal and oral interfaces on the volumes of the chest wall and its compartments, breathing pattern, and respiratory muscle activation in children with mouth-breathing syndrome. METHODS: Children with mouth-breathing syndrome were randomized into 2 groups, one with an inspiratory load intensity 20% of maximum inspiratory pressure (n = 14), and the other with an inspiratory load intensity 40% of maximum inspiratory pressure (n = 15). The chest wall volumes and electromyography of sternocleidomastoid, rectus abdominis, scalene, and internal intercostal muscles were used to analyze respiration against the 2 load intensities and using 2 interfaces (ie, nasal and oral). RESULTS: A total of 72 children with mouth-breathing syndrome were recruited, and 29 were evaluated in this study. The use of inspiratory load promoted improvement in the components of the breathing pattern: breathing frequency (P = .039), inspiratory time (P = .03), and total respiratory time (P = .043); and increases in tidal volume (P < .001), end-inspiratory volume (P < .001), and electrical activity of scalene muscles and sternocleidomastoid muscles (P < .001) when compared to quiet breathing. The load imposed via a nasal interface versus an oral interface provided an increase in tidal volume (P = .030), end-inspiratory volume (P = .02), and electrical activity of scalene muscles (P < .001) and sternocleidomastoid muscles (P = .02). CONCLUSIONS: The use of acute inspiratory loads improved the breathing pattern and increased lung volume and electrical activity of inspiratory muscles. This work brings new perspective to the investigation of using nasal interfaces during the application of inspiratory loads. The nasal interface was more effective compared to the oral interface commonly used in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the therapeutic potential of one-stage, full-mouth, ultrasonic debridement (FMUD) as a treatment for type 2 diabetic patients with generalized severe chronic periodontitis. Method and Materials: Sixteen patients diagnosed with generalized severe chronic periodontitis and type 2 diabetes mellitus were allocated to the diabetic group; another 15 subjects with periodontitis but without metabolic disorders were placed in the nondiabetic group. Both groups were treated using the FMUD protocol, a unique 45-minute session of ultrasonic debridement of all sites presenting periodontal disease. Patients were analyzed for the following parameters: plaque and bleeding indices, gingival recession, probing depth, and clinical attachment level. Further, diabetic subjects were assessed using fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) tests. Patients were evaluated at 3 and 6 months for all parameters. ANOVA and the Turkey test were used for data analysis (P < .05). Results: Both groups showed improved periodontal health after treatment. There were no significant differences between the groups for any of the parameters assessed (P > .05). Diabetic subjects treated with FMUD had a clinical response similar to that of nondiabetic subjects at all pocket depths. No adverse effects or medical disturbances were observed in either group during treatment. FPG and HbA1c levels remained unaltered after treatment. Conclusion: Within the limitations of this study, FMUD promoted clinical improvements in patients with type 2 uncontrolled diabetes and generalized severe chronic periodontitis. [ABSTRACT FROM AUTHOR]