Avaliação da eficácia do laser de baixa intensidade no tratamento das disfunções têmporo-mandibular: estudo clínico randomizado

OBEJTIVO: avaliar a eficácia do laser de baixa intensidade no tratamento da dor em pacientes com desordens temporomandibulares. MÉTODO:consistiu de um ensaio clínico randomizado divididos em dois grupos: Grupo 1: laser AsGaAl, Grupo 2: laser InGaAlP, do qual participaram 20 pacientes entre 19 e 35 anos de idade, com diagnóstico de sinais e sintomas de DTM. Os pacientes tinham a amplitude de movimento para abertura máxima da boca e lateralidade registados no início e no final do tratamento a laser. O Laser foi aplicado em quatro pontos pré-auriculares, totalizando 12 sessões três vezes por semana, durante um mês. Dor dos pacientes foi registrado com base na utilização da escala analógica visual (EAV) e também por exame físico dos pontos álgicos. RESULTADOS: observou-se redução significante (p<0,028) do nível de dor em ambos os grupos, porém no G1 a significância foi maior. A evolução do limiar de sensibilidade muscular evidenciou diferença estatisticamente significante (p<0,05) para G1 e G2. A laserterapia no Grupo 1 melhorou a abertura bucal em média de 4,643 mm, enquanto no Grupo 2, a média foi de 3,71 mm por paciente. CONCLUSÃO: houve eficácia em ambos os lasers no controle da dor e abertura bucal dos pacientes

Teaching handwashing with soap for schoolchildren in a multi-ethnic population in northern rural Vietnam

Background: In Vietnam, initiatives have been started aimed at increasing the practice of handwashing with soap (HWWS) among primary schoolchildren. However, compliance remains low. Objective: This study aims to investigate responses to a teacher-centred participatory HWWS intervention in a multi-ethnic population of primary schoolchildren in northern rural Vietnam. Design: This study was implemented in two phases: a formative research project over 5 months (July&#x2013;November 2008) and an action research project with a school-based HWWS intervention study in two rural communes during 5 months (May, September&#x2013;December 2010). Based upon knowledge from the formative research in 2008, schoolteachers from four selected schools in the study communes actively participated in designing and implementing a HWWS intervention. Qualitative data was collected during the intervention to evaluate the responses and reaction to the intervention of teachers, children and parents. This included semi-structured interviews with children (15), and their parents (15), focus group discussions (FGDs) with schoolchildren (32) and school staff (20) and observations during 15 HWWS involving children. Results: Observations and interview data from children demonstrated that children were visibly excited and pleased with HWWS sessions where teachers applied active teaching methods including rewards, games and HWWS demonstrations. All children, schoolteachers and parents also viewed the HWWS intervention as positive and feasible, irrespective of ethnicity, gender of schoolchildren and background of schoolteachers. However, some important barriers were indicated for sustaining and transferring the HWWS practice to the home setting including limited emphasis on hygiene in the standard curriculum of schools, low priority and lack of time given to practical teaching methods and lack of guidance and reminding HWWS on a regular basis at home, in particular by highland parents, who spend most of their time working away from home in the fields. Access to soap and water at the household level did not seem a barrier for the uptake of HWWS but continuous access to these might be a challenge at schools. Conclusions: This study demonstrated that it is feasible to engage teachers and implement active teaching methods for behaviour change of HWWS in a group of multi-ethnic primary schoolchildren without the need for major investments in water and hygiene infrastructures. However, in those areas there was limited transfer of practice from school promotion to home. Continuous access to soaps at schools needs to be invested