RESUMO
The aim of this study was to evaluate the effectiveness of motivational interviewing on improving oral hygiene behavior in patients with fixed orthodontics appliances. A parallel-group randomized clinical trial was conducted with 45 patients of the Orthodontic Clinic of Unibe's Postgraduate Unit. A computer-generated list of numbers created with SPSS V21.0 was used to randomly allocate participants into the experimental or the control group. Monthly oral hygiene instructions and an oral hygiene kit from GUM® with special orthodontic hygiene tools were given to the participants. Furthermore, the experimental group underwent motivational interviewing sessions facilitated by a periodontist who received training from two expert psychologists. These psychologists also provided supervision to the interviewer, ensuring the accurate implementation of the intervention. Simplified Oral Hygiene Index (SOHI), Gingival Index (GI), Periodontal Probing Depth (PPD) and Bleeding on Probing (BoP) were recorded at baseline, three and six months after the beginning of the study. The participant and the evaluator (another periodontist who recorded the data) were masked. Repeated-measures mixed- model analysis of variance and chi-squared test were conducted. Mean SOHI, GI, PPD and BoP scores did not differ significantly across the three time points (baseline, three and six months). Nevertheless, a significant interaction on SOHI scores (F (2, 58) = 3.463, p = .038, h2 = .052) was found between the sessions and the treatment conditions (experimental vs control group) at the third and sixth month. Motivational interviewing plus oral hygiene instructions appears to maintain a better control of dental biofilm and calculus in comparison with conventional oral hygiene instructions alone.
El objetivo de este trabajo fue evaluar la efectividad de las entrevistas motivacionales para mejorar el comportamiento de higiene oral en pacientes con aparatos ortodóncicos fijos. Se llevó a cabo un ensayo clínico aleatorizado de grupos paralelos con 45 pacientes de la Clínica de Ortodoncia de la Unidad de Posgrado de Unibe. Se utilizó una lista de números generada por computadora con SPSS V21.0 para asignar aleatoriamente a los participantes al grupo experimental o de control. Se les proporcionó a los participantes instrucciones mensuales de higiene oral y un kit de higiene oral de GUM® con utensilios de higiene especiales para ortodoncia. Además, el grupo experimental recibió sesiones de entrevista motivacional facilitadas por un periodoncista capacitado por dos psicólogas expertas. Estas psicólogas también supervisaron al entrevistador, asegurando la implementación precisa de la intervención. Se registró el Índice Simplificado de Higiene Oral (IHO-S), el Índice Gingival (IG), la Profundidad de Sondaje Periodontal (PS) y el Sangrado al Sondaje (SS) al inicio, a los tres y seis meses después del inicio del estudio. Tanto el participante como el evaluador (otro periodoncista que registró los datos) estaban enmascarados. Se realizaron análisis de varianza de medidas repetidas con modelo mixto y pruebas de chi-cuadrado. Las puntuaciones medias del IHO-S, IG, PS y SS no difirieron significativamente en los tres momentos (inicio, tres y seis meses). Sin embargo, se encontró una interacción significativa en las puntuaciones del IHO-S (F (2, 58) = 3.463, p = .038, h2 = .052) entre las sesiones y las condiciones de tratamiento (grupo experimental vs grupo de control) en el tercer y sexto mes. Las entrevistas motivacionales junto con las instrucciones de higiene oral parecen mantener un mejor control de la biopelícula dental y el cálculo en comparación con las instrucciones convencionales de higiene oral por sí solas.
RESUMO
Background: The purpose of the study was to determine the psychometric properties of the Dominican System for Measuring Early Childhood Development (SIMEDID, for its Spanish acronym), to adjust the sequence of item presentation, and to provide age-standardized norms for each item, to enable policy and program managers to make decisions based on specific and structured data. Methods: After approval from an ethics committee, a total of 948 children from 0 to 60 months participated in this study. Participants were evaluated on four early childhood development domains (gross motor, fine motor, language development, and socio-emotional development). The data were collected from November 2021 to February 2022, either at early childhood care centers or at home, using mobile devices that guided the evaluators through the screener. Data were later synced to a global database. Psychometric properties were calculated using Cronbach's alpha and split-half parallel reliability. For reorganizing item presentation and to obtain age-standardized norms, we conducted a logistic regression analysis for each item on dependent variable item success, and independent variable age. Results: The instrument showed excellent reliability and additional evidence of validity. The item presentation order was rearranged according to the probability of item success progression. In addition, the study characterized the expected evolution of item success probability across participants' age. Conclusions: SIMEDID is a valid and reliable instrument for depicting childhood development in national evaluations. Its integration with electronic platforms for national monitoring represents a cost-effective, time-efficient screening tool adapted to the Dominican sociocultural context. This represents a promising tool to strengthen strategies that support early childhood development.
Assuntos
Desenvolvimento Infantil , Psicometria , Humanos , Pré-Escolar , Lactente , Masculino , Feminino , Psicometria/métodos , Recém-Nascido , República Dominicana , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: This study aimed to identify the risk factors associated with preterm birth, and to determine the prevalence of preterm births in the Dominican Republic. DESIGN: Case-control study. SETTINGS: Seven National Reference Hospitals from different regions of the Dominican Republic. PARTICIPANTS: A probabilistic sampling of both cases and controls was performed with a ratio of 2.92:1, and a power analysis was performed with α=0.05, P1 =0.5, P2 =0.6, and ß=0.08, to yield a distribution of 394 cases and 1150 controls. Estimation of gestational age was based on neonatologist reports. PRIMARY OUTCOME MEASURES: A protocol was created to obtain maternal and obstetric information. RESULTS: The main risk factors were a family history of premature births (p<0.001, OR: 14.95, 95% CI 8.50 to 26.29), previous preterm birth (p=0.005, OR: 20.00; 95% CI 12.13 to 32.96), advanced maternal age (over 35 years; p<0.001, OR: 2.21; 95% CI 1.57 to 3.09), smoking (p<0.001, OR: 6.65, 95% CI 3.13 to 13.46), drug consumption (p=0.004, OR: 2.43, 95% CI 1.37 to 4.30), premature rupture of membranes (p<0.001, OR: 2.5) and reduced attendance at prenatal consultations (95% CI 6 to 7, Z=-10.294, p<0.001). CONCLUSION: Maternal age greater than 35 years, previous preterm birth, family history of preterm births and prelabour rupture of membranes were independent risk factors for preterm birth. Adolescence, pregnancy weight gain and prenatal consultations, on the other hand, were protective factors for preterm birth. Although the prevalence of premature births in this study was 25%, this could have been biased.
Assuntos
Nascimento Prematuro , Adulto , Estudos de Casos e Controles , República Dominicana/epidemiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Fatores de RiscoRESUMO
Mosquito-borne diseases are a major public health concern in the Caribbean. Domestic water-storage containers are preferred breeding habitats for synanthropic mosquito species, among which Aedes aegypti stands out due to its role in arbovirus transmission. To determine the microenvironmental features associated with container-dwelling mosquitoes, a house-to-house cross-sectional entomological survey was carried out in 9 Dominican provinces affected by Zika virus in 2016. All containers with the potential to store water were sampled, all immature mosquitoes were collected, and information on the type, capacity, volume of stored water, building material, presence of flowers, and house location was documented. The specimens were identified and larval indices (House index [HI], Container index [CI], Breteau index [BI], and Ae. aegypti Breeding Percentage) were applied. A total of 665 dwellings were surveyed across 30 neighborhoods. A total of 1,420 water-filled container habitats were sampled, 19.3% of which harbored immature mosquitoes of 5 species, including 4 important vectors. The dominance of Ae. aegypti was marked, as it was present in all sampled neighborhoods, inhabiting 272 containers (19.1%). Larval indices were higher than the threshold values accepted (5% for the HI and BI, and 3% for the CI) in almost all neighborhoods. The presence of Aedes spp. was associated with the serviceability of water-holding containers (χ2 = 16.56522; P < 0.001), and the difference in volume between water-holding containers was associated with the presence of Aedes spp. infection (χ2 = 4; P < 0.001), the containers up to 5 liters being the most infested. This is the first entomological research based on synanthropic mosquito breeding habitats that cover urban areas of the 3 macro-regions of the Dominican Republic.
Assuntos
Distribuição Animal , Culicidae/fisiologia , Meio Ambiente , Animais , Culicidae/crescimento & desenvolvimento , República Dominicana , Feminino , Larva/crescimento & desenvolvimento , Larva/fisiologia , Masculino , Pupa/crescimento & desenvolvimento , Pupa/fisiologiaRESUMO
Introducción: Aedes spp. y la dinámica del virus del dengue está altamente influenciada por factores ambientales. Una relación detallada entre el clima y la enfermedad en los períodos inter e intra-epidémicos podrían beneficiar la vigilancia del dengue para optimizar la preparación y las políticas adecuadas de control de vectores. Métodos: se analizaron los informes de casos de dengue y las variables climáticas en Santo Domingo, República Dominicana, para determinar la correlación del período 2012- 2018 y los diferentes tiempos de retraso. Se llevó a cabo un análisis de regresión de dichas variables para comprender mejor las relaciones entre las tasas de incidencia del dengue y los cambios climáticos. Resultados: durante los brotes epidémicos, la temperatura (r = 0.73, p <0.001) y la humedad relativa (r = -0.2, p = 0.009) se correlacionan significativamente con la incidencia del dengue con un retraso de 9 semanas, el análisis de regresión muestra que la temperatura media (b = 62.401, p < 0.001), precipitación (b = 2.810, p <0.001) y humedad relativa (b = -5.462, p = 0.025) fueron predictores significativos. Durante los períodos inter-epidémico, la temperatura (r = 0.23, p <0.001) tuvo una correlación significativa con la incidencia del dengue con un retraso de 7 semanas, la humedad relativa (b = 1.454, p <0.05) y la temperatura media (b = 5.14, p <0.01) son predictores significativos de la cantidad de casos de dengue. La precipitación no se correlacionó significativamente con la incidencia del dengue. Conclusiones: existe una relación no lineal entre los factores climáticos y la incidencia del dengue. La infección por dengue depende del clima, y la temperatura parece jugar un papel importante en los factores climáticos.
Introduction: Aedes spp. and Dengue Virus dynamics are highly influenced by environmental factors. A detailed relationship between climate and disease in inter and intra-epidemic periods may benefit dengue surveillance, preparedness, and adequate vector control policies. Methods: Dengue case reports and climatic variables in Santo Domingo, Dominican Republic, were analyzed for climate variables correlation from the period 2012-2018 and varying lag times. Regression analysis of climatic variables was carried out to better understand significant correlations between dengue incidence rates and changes in climate. Results: During epidemic outbreaks, temperature (r = 0.73, p < 0.001) and relative humidity (r = -0.22, p = 0.009) demonstrated a significant correlation with dengue incidence. Our regression analysis demonstrates an increase 62.4 cases for each degree Celsius increased with a 9-week-lag. Regression analysis also demonstrated mean temperature (b= 62.401, p < 0.001), precipitation (b = 2.810, p < 0.001), and relative humidity (b = -5.462, p = 0.025) to be significant predictors. During inter-epidemic periods, temperature (r = 0.23, p < 0.001) had a significant correlation with dengue incidence with a 7-week-lag, which demonstrates that relative humidity (b = 1.454, p < 0.05), and mean temperature (b = 5.14, p < 0.01) are significant predictors of the quantity of dengue cases. Precipitation did not significantly correlate with dengue incidence. Conclusions: A non-linear relationship between climatic factors and dengue incidence exists in the Dominican Republic. Dengue infection is climate-dependent and temperature seems to play a significant role in climatic factors
Assuntos
Transmissão de Doença Infecciosa , Vírus da Dengue , Clima , República DominicanaRESUMO
BACKGROUND: Human immunodeficiency virus (HIV) increases the risk of acquiring human T-cell lymphotropic virus (HTLV) and subsequently HTLV's progression to tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Existing data have exclusively reported generalized rates of HIV and HTLV-1 chronic viral infections in the Dominican Republic. To our knowledge, no published studies have focused on the rates of HTLV-1/2 in transactional sex workers and drug users, both higher risk groups, in the Dominican Republic. METHODS: From December 2012 to April 2013 we conducted a study to estimate the seroprevalence of HTLV-1/2 immunoglobulin G (IgG) and HIV antibodies among transactional sex workers and intravenous drug users in Santo Domingo, Dominican Republic. Serological status was analysed with behaviour and demographic data. RESULTS: We collected and analysed plasma from 200 participants with a mean age of 27.4 y in men and 25.2 y in women. The overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (95% CI 7.59 to 20.23) in men and 10.59% (95% CI 4.05 to 17.13) in women. The overall weighted seroprevalence of HIV-1 was 13.91% (95% CI 7.59 to 20.23%) in men and 17.65% (95% CI 9.55 to 25.75) in women. Male intravenous drug users had an exceptionally high rate of HTLV-positive HIV co-infection, at 75% (95% CI 44.99 to 105.01). Although there an association has been found between HTLV/HIV co-infections and sex work, the adjusted odds revealed a confounding role of HIV infection. CONCLUSIONS: The results highlight the urgent need for enhanced public health preventive strategies among high-risk populations in the Dominican Republic and other resource-constrained Caribbean settings, as well as global adoption of routine screening for HTLV-associated infections, particularly in these high-risk, underserved populations.