Perceptions and conducts of oral and maxillofacial surgeons during the COVID-19 pandemic: A qualitative study

Oral and maxillofacial surgeons are among the frontline healthcare workers and are classified as a high-risk group for COVID-19 infection; however, it has not yet been defined how these professionals were impacted. The aim of this study was to explore the conducts and perceptions of oral and maxillofacial surgeons during the COVID-19 pandemic in Brazil. Nine individuals, mean age 34.8 years, 66.6% men, were included in the study. A semi-structured interview with a qualitative approach was applied to professionals belonging to a messaging application group (WhatsApp). Content analysis was performed in the light of Hellerian theory in its daily theoretical framework for the interpretation of the memories reported by the participants. Four themes were identified. The lack of knowledge about COVID-19 and the fear of being contaminated during care were the main factors responsible for changes in the professionals' work routine. An important point was the collective reflection of the participants about the increase in biosafety barriers, which ensured a greater sense of security. The need for social isolation to contain the virus was also described. As a result, there was a great distance between professionals and their families, which generated high levels of anxiety in the former. Repetitive reports of slowness and reduced attendance directly related to financial loss and aggravated stress were also highlighted. The findings of this study reveal that oral and maxillofacial surgeons had their professional-personal axis affected in terms of daily habits, family life and financial strain, aspects that were responsible for impacting stress and anxiety levels.

Integration of School Health Program actions among health and education professionals: a case study in Belo Horizonte, Minas Gerais

ABSTRACT The School Health Program aims to build healthy schools. This qualitative case study aimed to identify and understand how professionals involved in the School Health Program behave in the integration based on their inclusion in the recommended activities. The consensus was reached with experts to develop a matrix of indicators after building the Program’s logical model, resulting in a semi-structured roadmap. Twenty-five interviews were held in the Basic Health Units, Elementary Schools, and the Regional Health and Education Administrations. The practices were multisectoral, with no combined efforts and effective co-participation, planned by a single sector or professional, the existing gaps are recognized as much as the importance of the program, and the practices are implemented with a low bond between teams. The fragmented perception of students’ problems hinders this integration.

Integração das ações do Programa Saúde na Escola entre profissionais da saúde e da educação: um estudo de caso em Belo Horizonte, Minas Gerais

RESUMO O Programa Saúde na Escola tem como meta a construção de escolas saudáveis. Estudo de caso, de abordagem qualitativa com intenção de identificar e compreender como se comportam, no esforço de integração, profissionais envolvidos no Programa Saúde na Escola, a partir de sua inserção nas atividades preconizadas. Após construção do modelo lógico do programa, foi realizado consenso com experts para elaboração de matriz de indicadores, originando roteiro semiestruturado. Foram realizadas 25 entrevistas, nas Unidades Básicas de Saúde e Escolas de Ensino Fundamental, além das Gerências Regionais da Saúde e da Educação. As práticas foram consideradas multissetoriais, sem soma de esforços e coparticipação efetiva, sendo planejadas por um único setor ou profissional; os gaps existentes são reconhecidos tanto quanto a importância do programa; as práticas acontecem com baixo vínculo entre equipes. A forma fragmentada de perceber os problemas dos escolares dificulta essa integração.

Dentists’ perceptions and attitudes towards emergency care for women in situations of violence: a scope review

Abstract The purpose of this study was to evaluate, through a scope review, studies that address the perceptions and attitudes of dentists regarding the care of women in situations of violence. Using the descriptors women violence, dentist attendance or dentist care, 473 articles were identified, of which 13 were included at the end of the selection process. Although the need for training was predominant, it was not sufficient. There is a weakness in understanding violence as a health problem, in understanding the role of the professional in solving this problem, and the factors that can contribute to its growth or its control. The results revealed that the dentist had greater difficulty than other professionals in coping with the issue and required extensive training. The recognition of these cases of abuse by the dentist requires the incorporation of educational measures that cause cultural changes, deconstruction of gender norms and the denaturalization of this social phenomenon.

Development and Validation of the Quality of Life in the Neighborhood Questionnaire for Children 8 to 10 Years of Age (QoL-N-Kids 8-10)

Create and evaluate the psychometric properties of the Quality of Life in the Neighborhood Questionnaire for Children 8 to 10 years of Age (QoL-N-Kids 8-10). The present study was conducted in a medium-sized city in southeastern Brazil with children at four public schools and one private school. The study involved three phases: a) generation and validation of the content of the items through a qualitative study and expert panel (n = 8); b) face validity through a pilot study and interviews with children (n = 30); and c) application of the final version (n = 261) for the evaluation of internal consistency, temporal stability, construct validity and discriminant validity. All statistical tests applied during this step were interpreted considering a 5% significance level. Among the 56 items generated, 38 were maintained in the scale and submitted to face validation. In this phase, the children suggested the inclusion of an additional item, resulting in a measure with 39 items. The questionnaire was submitted to reliability tests (Cronbach's alpha) and exploratory factor analysis, leading to a questionnaire with 27 items distributed among five domains. The measures exhibited good internal consistency (Cronbach's alpha = 0.805) and good test-retest reliability (weighted Kappa = 0.305 to 0.724; intraclass correlation coefficient = 0.917). Regarding discriminant validity, differences between groups (p < 0.001) were found for sex, age, income and place of residence. The QoL-N-Kids 8-10 instrument exhibited satisfactory psychometric properties and has potential for the assessment of neighborhood quality of life in children eight to ten years of age.

Brazilian Children's Understanding of the Quality of Life in Their Living Environment: A Qualitative Study

(1) Objective: To understand the perception of Brazilian children about the Quality of Life (QoL) considering their living environment. (2) Methods: This is a qualitative study conducted with children aged 6–10 years, from a medium-sized Brazilian municipality, recruited from public and private schools. An adaptation of the “draw, write, and say” method was used to collect data. At first, all children (n = 252) drew a “neighborhood with QoL”. On the same day, the researcher analyzed the graphic elements of the representations and intentionally selected the two best-detailed drawings from each class (n = 49) and the children were invited to narrate them. The narratives were analyzed through content analysis. (3) Results: Two major themes emerged from the content analysis, namely, the physical environment and social environment. The first included the needs to live in a community, such as housing, places of leisure, essential services, and natural elements. The second was relationships with family and friends. (4) Conclusion: The children presented the meaning of an environment with QoL, pointing out essential items to have this ideal environment. The social environment and the physical environment were perceived interdependently; that is, any change in one of these aspects may affect children’s QoL.

Construction and Validation of a Tool for the Assessment of the Oral Health in Primary Health Care Through the Perspective of Patients

OBJECTIVE: To construct and validate a questionnaire to evaluate the quality of oral health services in primary health care, from patients. METHODS: Initially a theoretical model of evaluation of Primary Health Care was elaborated, based on the evaluation of primary care and integrality in primary care. This model served as the basis for the script of a focus group with patients, aiming to verify the attributes perceived as important for such evaluation. The focus group results substantiated the first version of the questionnaire. Content validation was performed through a committee of experts (five teachers/researchers) and face validation in two pre-tests (37 patients each pre-test). For construct validation, factor analysis was performed and reliability (Kappa coefficient) and internal consistency (Cronbach&#39;s alpha) were verified. RESULTS: Thirty questions were considered for exploratory factor analysis. The anti-image matrix of covariances showed the need to exclude fourteen questions (values &lt;0.5). After this initial analysis, 16 questions remained in the questionnaire. The KMO test, considering the 16 questions, presented a value of 0.84. Cronbach&#39;s alpha was 0.919. The final version contains 16 questions divided into two dimensions: my health unit and the care in my health unit. CONCLUSIONS: The questionnaire allows a strategy that easily evaluates oral health services in primary care, based on the perception of patients.

Associação entre o uso de prótese dentária total e o tipo de serviço odontológico utilizado entre idosos edêntulos totais

Resumo A reabilitação protética foi prevista pela política nacional de saúde bucal em função da alta prevalência de perda de todos os dentes e do baixo uso de prótese dentária entre idosos. Há necessidade de se avaliar o impacto dessa política de reabilitação. Portanto, objetivou-se investigar se o tipo de serviço odontológico utilizado foi um dos fatores associados ao uso de prótese dentária total entre idosos. Trata-se de um estudo transversal conduzido em uma amostra probabilística de idosos (60 anos ou mais) residentes na zona urbana de um município brasileiro de pequeno porte populacional por examinadores calibrados. Realizaram-se análises descritiva, bivariada e múltipla (Regressão logística - odds ratio - OR). Participaram 287 idosos, destes, 186 (64,8%) faziam uso de prótese dentária total. O uso de prótese dentária total foi associado a maiores chances de uso de serviços odontológicos supletivos ou particulares (OR = 4,19; p < 0,001) e a presença de lesão no palato (OR = 7,52; p = 0,002) e, também, a menores chances em idades maiores ou iguais a 73 anos (OR = 0,52; p = 0,023) e entre os com comprometimento na dimensão incapacidade física do OHIP-14 (OR = 0,20; p = 0,002). O uso de prótese dentária total foi associado ao tipo de serviço odontológico entre idosos, sendo maior o uso entre usuários dos serviços supletivos ou particulares.

Epidemiological and spatial characteristics of interpersonal physical violence in a Brazilian city: A comparative study of violent injury hotspots in familial versus non-familial settings, 2012-2014

This study explores both epidemiological and spatial characteristics of domestic and community interpersonal violence. We evaluated three years of violent trauma data in the medium-sized city of Campina Grande in North-Eastern Brazil. 3559 medical and police records were analysed and 2563 cases were included to identify socioeconomic and geographic patterns. The associations between sociodemographic, temporal, and incident characteristics and domestic violence were evaluated using logistic regression. Using Geographical Information Systems (GIS), we mapped victims’ household addresses to identify spatial patterns. We observed a higher incidence of domestic violence among female, divorced, or co-habitant persons when the violent event was perpetrated by males. There was only a minor chance of occurrence of domestic violence involving firearms. 8 out of 10 victims of domestic violence were women and the female/male ratio was 3.3 times greater than that of community violence (violence not occurring in the home). Unmarried couples were twice as likely to have a victim in the family unit (OR = 2.03), compared to married couples. Seven geographical hotspots were identified. The greatest density of hotspots was found in the East side of the study area and was spatially coincident with the lowest average family income. Aggressor sex, marital status, and mechanism of injury were most associated with domestic violence, and low-income neighbourhoods were coincident with both domestic and non-domestic violence hotspots. These results provide further evidence that economic poverty may play a significant role in interpersonal, and particularly domestic violence.

Insatisfação com os serviços odontológicos entre idosos brasileiros dentados e edentados: análise multinível

Resumo Avaliou-se a insatisfação com os serviços odontológicos entre idosos brasileiros dentados e edentados e sua associação com variáveis contextuais e individuais. Foram utilizados os dados do Levantamento Nacional de Saúde bucal realizado em 2010 e dados contextuais referentes aos municípios. Análises descritivas, bivariadas e multinível foram realizadas. Incluiu-se 1.989 idosos. Destes, 11,2% dos idosos dentados e 22,1% dos edentados estavam insatisfeitos. Entre os dentados, a insatisfação foi associada com variáveis contextuais (localização do município, índice de desenvolvimento humano, Índice de GINI, presença de Centro de Especialidades Odontológicas e cobertura das equipes de saúde bucal) e individuais pertencentes à atenção à saúde e condições de saúde bucal. Para os idosos edentados, não foi identificado associação com variáveis contextuais. Apenas o motivo do uso do serviço e a satisfação com dentes e boca foram associados. Identificou-se uma prevalência considerável de insatisfação com os serviços, sendo maior entre os idosos edentados. Entre os idosos dentados, foi observado associação com variáveis contextuais.

Occurrence of violence in the elderly and its associated factors

ABSTRACT Objective: to analyze the occurrence of violence in the elderly and its associated factors in the city of Betim, Minas Gerais. Method: cross-sectional study constituted by a population survey conducted through structured interviews. The sample was stratified by clusters and included 178 elderly people at the end. Data were analyzed by the chi-square test and was performed a Correspondence Analysis. Results: The most prevalent forms of violence were: lack of access to social rights (31%), verbal violence (22%), moral/psychological (19%), lack of care (16%), physical violence (6%), sexual (3%) and discrimination (3%). Women suffered more abuse than men and violence had greater association with the degree of depressive symptoms. Conclusion: our research has direct implication for the sectors interested in coping with violence in the elderly, especially for nurses, because it shows violence is part of a cycle with characteristic associated factors that conforms a model nested mainly in the family relationship.

Assistive technologies for improving the oral hygiene of leprosy patients residing in a former leprosy colony in Betim, Minas Gerais, Brazil

BACKGROUND

This study deals with management of a group of elderly patients with a history of leprosy and hand deformities by a multidisciplinary team of dentists and occupational therapists. Assistive technology devices have been developed to allow such patients to obtain independence in oral self-care and can be a cost-effective approach to improving oral care in this population. The objective of this study was to describe the development of assistive devices to facilitate daily oral hygiene in older people with enduring leprosy-related impairments.

METHODOLOGY

Case study realized among elders with a history of leprosy residents in a former isolation colony in Betim, Minas Gerais, Brazil. The elders were evaluated for dependence on others for denture hygiene and mouthwash using the Daily Oral Hygiene Activity Index (ADOH). Those deemed partially or completely dependent on others were eligible for an intervention based on assistive technology. We adopted a personalized approach to each case, taking into account medical history, physical impairment and living environment. Six months after the intervention, the participants were assessed again using the ADOH and an unstructured interview about use of the devices.

PRINCIPAL FINDINGS

Assistive devices for denture hygiene and mouthwash were developed for 16 elders. These devices facilitated oral hygiene in most patients and there was no worsening in any of the cases. Patients' report suggested they were satisfied with the devices provided.

CONCLUSIONS

This study demonstrated that assistive devices can facilitate oral hygiene activities in leprosy patients. It also reinforces the importance of using a multidisciplinary team for the rehabilitation of these patients.

Padrão espacial e diferencial de renda dos domicílios de adolescentes e adultos jovens vítimas de traumatismo maxilofacial por agressão com arma de fogo

Resumo O estudo investigou o padrão espacial dos casos de traumatismo maxilofacial decorrentes de agressão com arma de fogo em adolescentes e adultos jovens a partir do local de domicílio das vítimas e analisou comparativamente os diferenciais de renda dessas áreas. Estudo transversal com dados de vítimas atendidas em três hospitais de Belo Horizonte-MG, entre janeiro de 2008 e dezembro de 2010. Endereços foram georeferenciados por geocodificação. Tendências de aleatoriedade e densidade de pontos foram analisadas por Função K de Ripley e mapas de Kernel. A interação espacial entre os domicílios de adolescentes e adultos jovens foi verificada através da Função K12. Encontrouse registros de 218 casos de agressão com arma de fogo, com predomínio do sexo masculino (89,9%) e adultos jovens (70,6%). Os domicílios se distribuíram de forma agregada no espaço urbano com nível de confiança de 99% e níveis de agregação espacial semelhantes. Os clusters de domicílios convergiram para 7 favelas ou regiões vizinhas com população de maior renda revelando propagação de eventos. Os hotspots se concentraram em favelas com histórico de crimes ligados ao narcotráfico. A incorporação do espaço na dinâmica dos eventos mostrou que a condição econômica isoladamente não limitou a vitimização.

Influência do grupo de pares e uso de drogas ilícitas entre adolescentes brasileiros: um estudo transversal

O estudo teve como objetivo examinar o uso de drogas ilícitas e as associações com fatores socioeconômicos e influência do grupo de pares entre adolescentes brasileiros de 15 a 19 anos de idade. Foi adotada uma amostra de clusters em dois estágios, com a seleção aleatória de escolas públicas e privadas entre os nove distritos administrativos de uma capital de estado, e a seleção aleatória de turmas em cada escola. A variável de desfecho foi o uso de drogas ilícitas, medido pela seguinte pergunta: “Você já usou drogas ilícitas (maconha, inalantes, hipnóticos, cocaína/crack, alucinógenos, anfetaminas e/ou opióides) alguma vez na vida?”. Os grupos de pares foram classificados como: escola, família, atividades religiosas e esportes/cultura. O nível socioeconômico foi avaliado com o Índice de Vulnerabilidade em Saúde (IVS) baseado em área. Foram analisados os dados de 91 adolescentes com o teste do qui-quadrado e regressão logística. A proporção global de uso de drogas ilícitas foi 15,2%. A heterogeneidade por gênero dentro de grupos (OR = 3,14; IC95%: 1,63-6,06), amizades baseadas em religião (OR = 0,36; IC95%: 0,17-0,75) e amizades baseadas em esportes/cultura (OR = 0,44; IC95%: 0,22-0,87) permaneceram associadas significativamente com o uso de drogas ilícitas. Os adolescentes que residiam em áreas menos vulneráveis mostraram maior probabilidade de uso de drogas ilícitas, quando comparados aos jovens em áreas mais vulneráveis. As amizades baseadas em religião e esportes/cultura parecem ter um efeito protetor contra o uso de drogas ilícitas. A heterogeneidade de gênero dentro de grupos e a residência em áreas menos vulneráveis aumentaram as chances de uso de drogas ilícitas por adolescentes.

Avaliação do preenchimento da Caderneta de Saúde da Criança e qualidade do preenchimento segundo o tipo de serviço de saúde usado pela criança

Resumo Objetivou-se avaliar o preenchimento da Caderneta de Saúde da Criança (CSC) e a associação entre qualidade do preenchimento e o tipo de serviço usado para o acompanhamento da saúde das crianças. Estudo transversal com amostra estratificada e proporcional aos 9 Distritos Sanitários de Belo Horizonte, selecionada entre crianças de 3 a 5 anos, no Dia da Campanha de Vacinação Infantil 2014. Realizou-se entrevista com os pais e observação de 21 itens da CSC. A variável dependente foi definida pela qualidade (satisfatória/insatisfatória) do preenchimento da CSC, sendo considerado satisfatório o preenchimento > 60%. As variáveis independentes foram o tipo de serviço para acompanhamento da saúde da criança, características demográficas e condições de saúde da mãe e da criança, e atenção em saúde recebida pela criança. Participaram 367 pais. A proporção de preenchimento insatisfatório foi 55,5%. Não houve associação significativa entre qualidade de preenchimento e tipo de serviço de saúde. O preenchimento insatisfatório esteve associado à idade gestacional < 37 semanas, falta de acesso a informações sobre a CSC e ausência de anotações dos pais na CSC. A CSC tem sido insatisfatoriamente empregada como um instrumento de vigilância da saúde independentemente do tipo de serviço usado pela criança.

Validade da autopercepção da presença de cárie dentária como teste diagnóstico e fatores associados entre adultos

Resumo: Objetivou-se investigar a validade da autopercepção da presença da cárie dentária e fatores associados, mediante estudo com 795 adultos (35-44 anos). A variável dependente foi autopercepção da presença da cárie dentária, as independentes reunidas em blocos. Três modelos logísticos foram conduzidos: (1) todos os adultos; (2) adultos com lesões de cárie normativa; e (3) adultos sem tais lesões. A autopercepção da presença da cárie dentária apresentou sensibilidade de 77,7%, especificidade de 58%, acurácia de 65%, valor preditivo positivo de 52% e valor preditivo negativo de 81%. No Modelo 1, a autopercepção da presença da cárie dentária foi associada ao tempo de uso dos serviços odontológicos, acesso à informação, uso de fio dental, lesões normativas, percepção da necessidade de tratamento, dor, insatisfação com a saúde bucal e geral. No Modelo 2, a autopercepção da presença da cárie dentária foi associada ao tempo de uso dos serviços odontológicos, percepção da necessidade de tratamento e insatisfação com a saúde bucal e geral. No Modelo 3, autopercepção da presença da cárie dentária foi associada ao tempo de uso dos serviços odontológicos, acesso à informação, percepção da necessidade de tratamento, insatisfação com a saúde bucal e uso de fio dental. A autopercepção da presença da cárie dentária mostrou utilidade limitada como método de diagnóstico.

Funcionalidade familiar de idosos brasileiros residentes em comunidade

Resumo Objetivo Avaliar a funcionalidade familiar de idosos brasileiros; testar a influência de fatores determinantes. Métodos Estudo transversal com 2.052 idosos, a partir de dados coletados da linha base referente ao estudo “Aging, Gender and Quality of Life (AGEQOL)”, responderam questionários sobre funcionamento familiar; atividades básicas e instrumentais de vida diária (AVD e AIVD); estado cognitivo; e características sociodemográficas. Modelos multivariados de regressão ordinal e análise de correspondência múltipla identificaram fatores associados à boa funcionalidade familiar. Resultados A maior parte dos idosos gozava de boa funcionalidade familiar (76,3%), era casada e vivendo com cônjuge (55,5%), tinha mais de seis filhos e netos (85,4% e 76,7%, respectivamente) e independente para AIVD (71,5%). Análise de correspondência resultou em três grupos: alta, moderada e baixa funcionalidade familiar e perfil de idosos com distintas condições socioeconômicas. Conclusão Infere-se dos resultados implicações para a prática e política de atenção à família com membros idosos segundo seu funcionamento e distintas condições de vida e saúde das pessoas idosas.

Binge drinking and associated factors among adolescents in a city in southeastern Brazil: a longitudinal study

Abstract: The aim of this study was to investigate changes in the frequency of binge drinking and associated factors in the city of Belo Horizonte, Minas Gerais State, Brazil. The sample consisted of 436 adolescents. Data collection involved the Alcohol Use Disorders Identification Test and the Alcohol, Smoking and Substance Involvement Screening Test. Ordinal logistic regression was used in the multivariate analysis. An increase in the frequency of binge drinking was found among adolescents who lived in areas of greater social vulnerability (OR = 1.64; 95%CI: 1.01-2.68), those whose mothers consumed alcoholic beverages (OR = 1.75; 95%CI: 1.05-2.92), those whose fathers consumed alcoholic beverages (OR = 2.02; 95%CI: 1.11-3.68), those with an increased risk of tobacco use (OR = 2.82; 95%CI: 1.07-7.42) and those who attended religious services (OR = 2.10; 95%CI: 1.30-3.38). Knowledge regarding factors associated with a change in the frequency of binge drinking among adolescents can assist in the establishment of public policies directed at health promotion and the prevention of adverse health conditions.

Impact of oral health conditions on the quality of life of workers

Occupational health has been the scope of numerous studies, primarily due to the concern that the worker should enjoy good working conditions and a satisfactory quality of life. This study seeks to analyze the impact of oral health on the quality of life of workers at a public university using the simplified version of the Oral Health Impact Profile (OHIP-14) and associated factors. A cross-sectional study was conducted with 326 workers who responded the questions of OHIP-14 about self-rated health, oral morbidity, and socioeconomic and demographic questions. Multiple linear regression analysis was performed to verify the association between the independent variables and OHIP-14. About 40% of the impact of oral health on quality of life can be explained by the variables: education level (p = 0,03), age (p = 0,03), reason for visiting a dentist (p = 0,01), oral health perception (p < 0,01) and satisfaction with teeth and mouth (p < 0,01). The use of OHIP-14 can be useful for planning programs and actions focused on health education for occupational health, prioritizing workers with greater psychosocial impacts caused by oral problems.

Equidade no uso de serviços odontológicos provenientes do SUS entre idosos: estudo de base populacional

Resumo Propõe-se caracterizar os idosos usuários de serviços odontológicos ofertados pelo Sistema Único de Saúde, considerando o princípio da equidade. Trata-se de um estudo transversal analítico com modelagem hierarquizada, conduzido a partir de uma amostra probabilística, complexa, por conglomerados de idosos (65-74 anos) residentes em um município brasileiro de grande porte populacional. Foram incluídas variáveis independentes referentes a: características sociodemográficas, acesso a informações em saúde, comportamentos/sistema de atenção à saúde e desfechos em saúde. Realizou-se análises descritivas, bivariadas e múltiplas hierarquizadas. Dos 480 idosos incluídos, 138 (31,2%) utilizaram serviços odontológicos provenientes do SUS. O uso desses serviços foi maior à medida que diminuíam a renda per capita e a escolaridade dos idosos, menor entre os que não haviam realizado o autoexame da boca e maior entre os que usavam os serviços odontológicos para procedimentos que não fossem rotina. Além disso, verificou-se que utilizaram mais o SUS pessoas que tiveram o relacionamento afetado pela saúde bucal e uma autopercepção negativa da sua aparência. Conclui-se que o uso dos serviços odontológicos no SUS foi predominante entre os idosos que vivem sob condições de vulnerabilidade.

Avaliação da assistência oftalmológica na perspectiva dos usuários

RESUMO: Estimou-se as prevalências da necessidade, do acesso e da insatisfação com a assistência oftalmológica entre os que a obtiveram no último ano; identificaram-se os fatores associados a essa insatisfação. Considerou-se uma amostra probabilística complexa. Conduziu-se análises descritivas, bivariadas e múltiplas com correção pelo efeito de desenho. Dos 2.582 participantes, 76% necessitavam de assistência, dentre os que necessitavam, 82,5% tiveram acesso. Dentre os que obtiveram assistência no último ano, 13,1% estavam insatisfeitos. A insatisfação foi maior entre mais velhos, os que foram andando ou de bicicleta para o local da consulta e os que relataram que foi regular/ruim/péssima: a experiência de ter sido recebido e tratado com respeito, a clareza com que o prestador explicou as coisas e a liberdade que teve para escolher o seu prestador de assistência oftalmológica. A maioria necessitava e teve acesso à assistência. A insatisfação foi baixa. A idade do paciente, o meio de transporte utilizado para chegar ao local da consulta, o relacionamento paciente/profissional e a liberdade de escolha intervêm na insatisfação.

[Maxillofacial injuries as markers of urban violence: a comparative analysis between the genders]

Urban violence is a widely discussed topic in various sectors of society, either due to its impact on public health indicators and its influence on the everyday life of individuals or the constant presence of casualties in the health services. This study compares differences in victimization between the genders based on maxillofacial injuries as markers of urban violence. This is a cross-sectional study with data collected in three hospitals of reference for multiple traumatic injuries in Belo Horizonte in the state of Minas Gerais, between January 2008 and December 2010. The analysis included descriptive and multivariate statistics using logistic regression. There were records of 7,063 victims, 55.1% of which involved interpersonal violence. The majority of victims were males (71.2%). Among the male victims, firearm and knife-inflicted aggression and motorcycle accidents were more frequent than aggression without the use of a weapon. Multiple fractures were the type of injury that best characterized the profile of victimization among males compared to soft tissue injuries. Gender is an important factor in victimization resulting in maxillofacial injuries and urban violence, in which males are the main victims.

Access to information on how to avoid oral health problems among elderly persons registered with the Family Health Strategy

Objectives : To identify the level of access to information regarding how to prevent oral health problems among the elderly, and verify if such levels were higher among members of households registered with the Family Health Strategy Program. Methods : An analytic cross-sectional study was conducted of a probabilistic complex sample of elderly (65-74 years old) members of the population of a large city. The level of access was estimated with adjustment for the design effect, as well as the magnitudes of association. Descriptive, bivariate and logistic regression (OR/CI95%) analysis was performed. Variables related to personal determinants, health services, health-related behavior and health outcomes were considered. Results : Of the 490 participants, 53.4% reported they had access to information about how to prevent oral health problems. This access was higher among elderly persons living in a household registered with the Family Health Strategy Program (2.04/1.14-3.67), and who had at least five years of schooling (2.53/1.67-3.83), regularly used dental services (1.84/1.07-3.17), did not smoke either now or in the past (1.79/1.13-2.82), did not suffer from chronic diseases (2.14/1.34-3.42) and had not suffered social impacts because of their oral health conditions (1.77/1.08-2.91). Conclusion : Most of the elderly persons had access to information about how to prevent oral health problems, with such access being greater among those registered with the Family Health Strategy Program.

Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira

O objetivo deste artigo é relacionar as condições gengival e socioeconômica e distribuição demográfica de adolescentes residentes em uma região desfavorecida brasileira. O estudo transversal foi realizado com amostra probabilística de 450 adolescentes (15-19 anos) em 13 municípios sorteados no Vale do Jequitinhonha (MG). A condição gengival foi avaliada por um examinador calibrado (Kappa ≥ 0,85) e baseado Índice Periodontal Comunitário (CPI). Foram calculadas as frequências para indivíduos e sextantes com posterior Análise de Correspondência Múltipla (Anacor) que explorou relações entre o CPI e as características sociodemográficas. Como resultados: 16 (3,6%) apresentaram-se sem alterações gengivais, 235 (52,2%) com sangramento, 36 (8,0%) com cálculo dental e 163 (36,2%) com sangramento e cálculo. A Anacor identificou dois grupos que guardavam semelhanças entre si em relação à doença periodontal. O grupo 1 reuniu os adolescentes com CPI sadio, 19 anos de idade, que trabalham e têm maior renda familiar. No grupo de CPI com sangramento, tem-se os adolescentes com 15 e 16 anos de idade, de ambos os sexos, cursando o ensino fundamental, menor renda familiar e que se autodeclararam pardos ou negros. A gengivite foi relacionada às condições socioeconômicas e demográficas de adolescentes da região.

Maxillofacial Injuries as Markers of Interpersonal Violence in Belo Horizonte-Brazil: Analysis of the Socio-Spatial Vulnerability of the Location of Victim's Residences

The aim of the present study was to analyze the spatial pattern of cases of maxillofacial injuries caused by interpersonal violence, based on the location of the victim's residence, and to investigate the existence of conditions of socio-spatial vulnerability in these areas. This is a cross-sectional study, using the data of victims attended in three emergency hospitals in Belo Horizonte-Brazil between January 2008 and December 2010. Based on the process of spatial signature, the socio-spatial condition of the victims was identified according to data from census tracts. The spatial distribution trends of the addresses of victims were analyzed using Kernel maps and Ripley's K function. Multicriteria analysis was used to analyze the territorial insertion of victims, using a combination of variables to obtain the degree of socio-spatial vulnerability. The residences of the victims were distributed in an aggregated manner in urban areas, with a confidence level of 99%. The highest densities were found in areas of unfavorable socioeconomic conditions and, to a lesser extent, areas with worse residential and neighborhood infrastructure. Spatial clusters of households formed in slums with a significant level of socio-spatial vulnerability. Explanations of the living conditions in segregated urban areas and analysis of the concentration of more vulnerable populations should be a priority in the development of public health and safety policies.

Individual and collective empowerment and associated factors among Brazilian adults: a cross-sectional study

Background

The empowerment embedded in the health area is defined as a process that can facilitate control over the determinants of health of individuals and population as a way to improve health. The aim of this study was to verify the association between individual and collective empowerment with sociodemographic conditions, lifestyle, health conditions and quality of life.

Method

A cross-sectional analytical study was conducted with 1150 individuals (aged 35 to 44 years). The empowerment was determined by questions from the Integrated Questionnaire for the Measurement of Social Capital (IQ-MSC). The quality of life was measured using the WHOQOL (World Health Organization Quality of Life-Bref). Lifestyle and health conditions were obtained by adapted questions from the Fantastic Lifestyle Questionnaire The DMFT Index was incorporated in the health conditions questions. Logistic regression or multinomial regression was performed.

Results

The practice of physical activity was related to individual (OR: 2.70) and collective (OR: 1.57) empowerment. Regarding individual empowerment, people with higher education level (5–11 years – OR: 3.46 and ≥12 years – OR: 4.41), who felt more able to deal with stress (OR:3.76), who presented a high score on quality of life (psychological domain) (OR:1.23) and that smoked (OR:1.49) were more likely to feel able to make decisions and participate in community activities. The increase in the DMFT Index represented less chance of individuals to feel more able to make decisions (OR: 0.96). Regarding the collective empowerment, being religious (catholic) (OR: 1.82), do not drink or drink just a little (OR: 1.66 and 2.28, respectively), and increased score of overall quality of life (OR: 1.08) were more likely to report that people cooperate to solve a problem in their community.

Conclusion

The two approaches to empowerment, the individual and collective are connected, and the physical activity showed to be a good strategy for the empowerment construction.

Users' dissatisfaction with dental care: a population-based household study

OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users' dissatisfaction with such are. METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users' dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals. RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms. CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units.

Tobacco use and friendship networks: a cross-sectional study among Brazilian adolescents

AIM

To determine the prevalence of tobacco use and its association with types of friendship networks, socioeconomic status and gender among Brazilian adolescents.

METHODS

A cross-sectional study was carried out with a representative sample of 905 students aged 15 to 19 years. Information on social networks and tobacco use was collected by the self-administered questionnaire 'Alcohol, Smoking and Substance Involvement Screening Test" and the question "What is your most important group of close friends?'. Socioeconomic status was assessed using an area-based social vulnerability index and type of school. Multinomial logistic regression analysis was employed to test associations between tobacco use and the independent variables.

RESULTS

The overall prevalence of tobacco use was 18.9%. Female adolescents had 3.80-fold greater odds of reporting weekly to daily tobacco use compared to male adolescents. Participants who reported that their most important groups of close friends were from church had a lower risk of reporting weekly to daily tobacco use in comparison to those who reported that their best friends were from school.

CONCLUSIONS

The prevalence of tobacco use was high and was associated with school-based (as compared to church-based) friendship networks, female gender and higher area-level socioeconomic status.

Assessment of the management of the Family Health Strategy via the tool Assessment for Quality Improvement in municipalities of Minas Gerais, Brazil

The self-assessment of the quality ofthe Family Health Strategy(FHS) was assessed in the context ofmanagement and its correlation with characteristics of FHS and of the municipality. Managers, coordinators and Family Health Unit managers of municipalities in the Northeast region of Minas Gerais replied with tools 1, 2 and 3 of the Assessment for Improving the Quality of Family Health Strategy (AIQ). Scores were defined for each subdimension, according to the number of features compliant with the standards of the AIQ. We tested the correlation of this score with coverage and the deployment time of the FHS, with the municipal population and the HDI (Human Development Index). The lowest scores were for Work Management, Permanent Education and Inputs, Immunobiologicals and Medicines. There was a positive correlation between the municipal population and Strengthening of Coordination, Support for Teams, Permanent Education Management and Standardization and a negative one with Infrastructure and Equipment. The use of the AIQ tools permitted the identification of subdimensions and municipalities which will require greater attention and intervention by the municipal management.

Prevalence of oral cancer self-examination among elderly people treated under Brazil's Unified Health System: household health survey

The aim of this study was to examine the prevalence of oral cancer self-examinationamong the elderly and confirm whether prevalence was higher among users of the dental services provided by Brazil's Unified Health System (SUS, acronym in Portuguese). A transversal study of elderly people aged between 65 and 74 years living in a large-sized Brazilian municipality was conducted using simple random sampling. Logistic regression was conducted and results were corrected for sample design and unequal weighting using the SPSS(r) software. The study assessed 740 individuals. A total of 492 met the inclusion criteria, of which 101 (22.4%) reported having performed an oral cancer self-examination. Prevalence was higher among users of the dental services provided by the SUS, higher-income individuals, people with higher levels of education, individuals that used a removable dental prosthesis, and people who had not experienced discomfort attributed to oral condition, and lower among people who sought regular and periodic dental treatment and individuals who did not have a drinking habit. This type of self-care should be encouraged by public health policies which respond to the needs of the elderly, with emphasis on users of private and philanthropic services, and other services outside the public health network.

Gender differences in predictors of self-rated health among older adults in Brazil and Chile

Background

The determinants of self-rated health (SRH) have been widely investigated to explain social differences and gender differences in health. This study aimed to investigate the gender differences in predictors of SRH among Brazilian and Chilean older adults.

Methods

We used two samples of older people: 2052 Brazilian community-dwelling participants (1226 women and 862 men) and 1301 Chilean community-dwelling participants (855 women and 446 men). Sequential logistic regression analysis was used to examine the relationships between SRH and potential predictors in a hierarchical model.

Results

Overall, 35.5% and 52.1% of individuals in Chile and Brazil, respectively, reported good SRH. There was a gradient association between good SRH and chronic diseases in both countries. Chilean men without chronic disease or with one had a higher chance of good SRH, compared to two or more diseases. For Brazilian men, no or one chronic disease was associated with good SRH. For women, the set of independent predictors for good SRH included no chronic diseases or one chronic disease, and no activities of daily living limitation. For men, the set also included instrumental activities limitation. For Brazilian adults of both genders, depression demonstrated the strongest independent association with good SRH.

Conclusions

We conclude that when examining gender differences in predictors of SRH, the similarities are greater than the differences between Brazilian and Chilean older adults. In both countries, physical health was the most important predictor of SRH. In addition, absence of depression was the strongest predictor of good health in older Brazilian adults.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1666-9) contains supplementary material, which is available to authorized users.

A integralidade no cotidiano da atenção à saúde bucal: revisão de literatura

O objetivo deste trabalho foi realizar uma revisão integrativa na literatura sobre integralidade e atenção à saúde bucal. Pesquisaram-se publicações posteriores a 2004, oficiais (site do Ministério da Saúde) e trabalhos acadêmicos (Biblioteca Virtual em Saúde), com utilização de cinco descritores (‘integralidade saúde bucal’, ‘integralidade odontologia’, ‘integrality oral health’, ‘comprehensiveness oral health’, ‘integralidade’ – filtro ‘saúde bucal’). Após critérios de exclusão, foram lidas e analisadas, à luz dos sentidos da integralidade, 39 referências, dentre elas dois documentos oficiais e 37 trabalhos acadêmicos. Posturas profissionais diferenciadas, o modo como os serviços de saúde são organizados e o planejamento de políticas voltadas para a integralidade são conteúdos presentes nos trabalhos. A ideia de integralidade esteve ligada aos seus dispositivos (acolhimento, vínculo, responsabilização), à formação acadêmica, ao trabalho em equipe e à necessidade de diferentes níveis de assistência. Outros aspectos, como processo de trabalho, mecanismos de gestão e intersetorialidade, devem fazer parte de estudos futuros que envolvam a interface da integralidade com a saúde bucal.

Is there an association between traumatic dental injury and social capital, binge drinking and socioeconomic indicators among schoolchildren?

OBJECTIVES

Traumatic dental injury is defined as trauma caused by forces on a tooth with variable extent and severity. The aim of the present study was to investigate the prevalence of traumatic dental injury and its association with overjet, lip protection, sex, socioeconomic status, social capital and binge drinking among 12-year-old students.

RESEARCH DESIGN AND METHOD

A cross-sectional study was conducted with a sample of 633 12-year-old students. Data were collected through a clinical exam and self-administered questionnaires. Socioeconomic status was determined based on mother's schooling and household income. The Social Capital Questionnaire for Adolescent Students and Alcohol Use Disorders Identification Test (AUDIT-C) were used to measure social capital and binge drinking, respectively.

RESULTS

The prevalence of traumatic dental injury was 29.9% (176/588). Traumatic dental injury was more prevalent among male adolescents (p = 0.010), those with overjet greater than 5 mm (p < 0.001) and those with inadequate lip protection (p < 0.001). In the multiple logistic regression analysis, overjet [OR = 3.80 (95% CI: 2.235-6.466), p < 0.0001], inadequate lip protection [OR = 5.585 (95% CI: 3.654-8.535), p < 0.0001] and binge drinking [OR = 1.93 (95% CI: 1.21-3.06), p = 0.005] remained significantly associated with traumatic dental injury.

CONCLUSIONS

The present findings suggest that a high level of total social capital and trust are not associated with TDI in adolescents, unlike binge drinking. The effects of social and behavioral factors on TDI are not well elucidated. Therefore, further research involving other populations and a longitudinal design is recommended.

Measuring social capital through multivariate analyses for the IQ-SC

Background

Social capital can be viewed as a societal process that works toward the common good as well as toward the good of the collective based on trust, reciprocity, and solidarity.

Our study aimed to present two multivariate statistical analyses to examine the formation of latent classes of social capital using the IQ-SC and to identify the most important factors in building an indicator of individual social capital.

Findings

A cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample consisted of 363 individuals, and data were collected using the World Bank Questionnaire for measuring social capital. First, the participants were grouped by a segmentation analysis using the Two Step Cluster method based on the Euclidian distance and the centroid criteria as the criteria for aggregate answers. Using specific weights for each item, discriminant analysis was used to validate the cluster analysis in an attempt to maximize the variance among the groups with respect to the variance within the clusters. “Community participation” and “trust in one’s neighbors” contributed significantly to the development of the model with two distinct discriminant functions (p < 0.001). The majority of cases (95.0%) and non-cases (93.1%) were correctly classified by discriminant analysis.

Conclusions

The two multivariate analyses (segmentation analysis and canonical discriminant analysis), used together, can be considered good choices for measuring social capital. Our results indicate that it is possible to form three social capital groups (low, medium and high) using the IQ-SC.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-015-0978-2) contains supplementary material, which is available to authorized users.

Quality of life of elderly practitioners of physical activity in the context of the family health strategy

Cross-sectional, descriptive and correlational study with 107 elderly enrolled in two basic health units in Minas Gerais, in order to describe the sociodemographic profile and evaluate the interdependence of quality of life of the elderly and physical activity, in the face of possible factors. Initially we performed a descriptive analysis of the socioeconomic profile of the sample and the tests applied to the elderly. We sought to explore joint relationships between quality of life, physical activity and exploratory variables through principal component analysis. Three distinct profiles were identified in two dimensions that explained the relationship between quality of life and physical activity. We concluded that the quality of life for the elderly is good and is influenced by regular physical activity, absence of depression, greater cognitive ability and good family functioning.

Aging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults

BACKGROUND

In Brazil, a rapidly aging country suffering from large inequalities, the study of the quality of life (QOL) of aged people is important for the future health. The aim of this study was to examine the associations among QOL, gender, and physical and psychosocial health in older Brazilian community-dwelling adults to identify factors that are associated with better QOL.

METHODS

The "Aging, Gender and Quality of Life (AGEQOL)" study, which included 2,052 respondents aged 60 or older, was conducted in Sete Lagoas, Brazil between January and July 2012. The respondents answered questions regarding their socioeconomic and demographic information, health and social situations, cognitive impairment, depressive symptoms and family satisfaction. The authors also applied the Brazilian version the World Health Organization Quality of Life QOL Assessment-Brief Instrument (WHOQOL-BREF) and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Ordinal logistic regression with the Proportional-Odds and Logit function was used to test the association between QOL and physical and psychosocial health according to age and socioeconomic status.

RESULTS

Older adults of both genders with five or more years of education, good self-rated health, an absence of depressive symptoms, and no family dysfunction reported better QOL. Retired men had a better QOL compared to non-retired men (OR = 2.2; 95% CI = 1.4-3.2), but this association was not observed in females. Men living in mixed arrangements (OR = 0.5; p = 0.033) and women who did not practice physical activity (OR = 0.7; p = 0.022) tended to have poorer QOL.

CONCLUSIONS

We conclude that there are gender differences related to better QOL in this sample. Women with good physical and psychosocial health are more likely to have a better QOL. For men, the best QOL was associated with high socioeconomic conditions and good physical and psychosocial health.

Association between social determinants of health and functional dentition in 35-year-old to 44-year-old Brazilian adults: a population-based analytical study

OBJECTIVES

To verify the association between functional dentition and social determinants of health in 35-year-old to 44-year-old adults residing in the metropolitan municipalities of Minas Gerais, Brazil.

METHODS

This cross-sectional study assessed a sample of 850 adults obtained using a cluster sampling scheme. Five of 33 municipalities were randomly selected, followed by the random selection of census tracts and neighborhood blocks. Every household in the randomly selected blocks was visited and every resident adult was interviewed and examined by five previously calibrated researchers (κinter , 0.8-0.9; κintra , 0.8-1.0) between May and December 2010. The condition of the dental crown was recorded using the World Health Organization (WHO) criteria, with the exception of the third molars. The dependent variable functional dentition was defined as the presence of 20 or more teeth in the mouth and obtained by counting the number of teeth lost due to any reason, followed by subtraction of this number from the total of 28 teeth. Independent variables were grouped, according to a theoretical model adapted from those proposed by Dahlgren and Whitehead and Petersen, into distal factors (contextual, socioeconomic, and housing conditions), intermediate factors (availability and use of oral health services), and proximal factors (lifestyle, risk behaviors, and demographic conditions). The association between functional dentition and the independent variables was investigated using simple and multiple Poisson regression with robust variance, which followed a modeling strategy in accordance with the hierarchy outlined by the theoretical model. The analyses were processed on SPSS 17.0.

RESULTS

The average age of the participants was 39.4 ± 3.2 years, and the average per capita monthly family income was US$214.52 ± 261.11. Most adults presented functional dentition (80.6%; 95% CI: 77.3-83.5). Independently of marital status, age group and sex, the prevalence ratio (PR) of subjects with a per capita monthly family income ≥US$168.54 was 1.09 (P = 0.048); the PR of adults with at least an undergraduate degree was 1.14 (P = 0.001), and the PR of the participants who most often used a dental service other than a public service supplementary healthcare plan or private service was 1.13 (P = 0.021). The prevalence of functional dentition was 17% higher among nonsmokers (P = 0.012) and 16% higher among those who used dental floss (P = 0.006).

CONCLUSIONS

Income, education, type of dental service most often used, lifestyle, risk behaviors and demographic conditions are distal, intermediate and proximal social determinants of health associated with functional dentition in adults, demonstrating the need for public policies aimed to promoting oral health including intersectoral actions.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

Background

Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

Methods

This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression.

Results

Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions.

Conclusions

There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

Satisfação com saúde bucal de idosos brasileiros: um estudo de gênero com modelo hierárquico

Os objetivos do presente estudo foram identificar as diferenças de gênero em relação aos fatores associados à satisfação com saúde bucal de idosos e estimar a prevalência de edentulismo por gênero e faixa etária. Foram incluídos 2.052 idosos com 60 anos e mais de idade, residentes em Sete Lagoas, Minas Gerais, Brasil. A regressão de Poisson foi utilizada para estimar a prevalência de edentulismo. A associação entre satisfação bucal e as variáveis independentes foi realizada por meio da regressão ordinal com modelo hierárquico multidimensional. A prevalência de edentulismo nos gêneros masculino e feminino foi de 63% e 68,8%, respectivamente. A maioria dos idosos do gênero masculino (63%) e feminino (57%) estava satisfeita com a saúde bucal. O modelo final ajustado, para ambos os gêneros, foi formado por variáveis referentes ao ambiente externo, comportamentos de saúde e condições de saúde bucal. Conclui-se que a satisfação com a saúde bucal é influenciada fortemente pelas condições de saúde bucal e por comportamentos de saúde, e que os fatores associados são diferentes para cada gênero.

Empoderamento e qualidade de vida de adolescentes trabalhadores assistidos por uma entidade filantrópica de apoio ao adolescente

O objetivo deste trabalho foi medir o empoderamento de adolescentes trabalhadores e testar sua possível associação com a qualidade de vida. Estudo transversal realizado com 363 adolescentes trabalhadores assistidos por uma Entidade Filantrópica de Apoio ao Adolescente. A coleta de dados ocorreu por meio da aplicação de dois questionários, sendo um utilizado para mensurar a qualidade de vida (WHOQoL-Bref) e as questões sobre empoderamento do Questionário Integrado para Medir Capital Social do Banco Mundial (QIMCS). A variável dependente (empoderamento) foi construída pelo agrupamento dos participantes, por meio da análise de segmentação. O teste Kruskal-Wallis foi utilizado para a comparação dos escores dos domínios do WHOQoL-Bref (físico, psicológico, relações sociais e meio ambiente) entre os clusters, com 5% de significância. Em relação à análise de segmentação, 126 (34,7%) adolescentes foram classificados como de baixo empoderamento, 161 (44,4%) formaram o grupo moderado e 70 (19,3%) possuíam maior empoderamento. O cluster com alto empoderamento apresentou as maiores médias dos escores de qualidade de vida em todos os domínios. O teste Kruskal-Wallis revelou diferenças estaticamente significantes entre os clusters para os domínios psicológico (p=0,001), relações sociais (p=0,003) e global (p=0,024). Concluiu-se que melhores escores de qualidade de vida foram encontrados no grupo de adolescentes com maior empoderamento.

The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil

The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).

[Access to information on oral hygiene and tooth loss due to caries among adults]

This study sought to establish the association between tooth loss due to dental caries and variables related to access to information on oral health in adults aged 35-44 years (n = 780) who participated in a large epidemiological study. The dependent variable was total tooth loss due to caries. The independent variables were grouped into blocks: demographic and socio-economic characteristics, use of dental service, access to oral health information (about how to prevent oral problems; oral hygiene; and diet), and behaviors. The analysis was conducted using hierarchical multiple linear regression. The mean number of lost teeth due to caries was 7.03. High numbers of lost teeth were higher among females and older adults; low levels of education; adults who rarely/never received oral hygiene information; those who brushed their teeth once a day or less; and those adults who did not use dental floss (p < 0.05). Adults who rarely/never received oral hygiene information from dental services lost 2.15 more teeth due to caries than those who always/often received such information (p = 0,000). Thus, it is suggested that access to information should be encouraged to contribute to greater equity in oral health.

[Inequalities in the distribution of dental caries in Brazil: a bioethical approach]

The scope of this paper was to analyze the problem of dental caries as a public health issue of epidemiological relevance. It is a case study based on documentary analysis of national epidemiological surveys on oral health in the years 1986, 2003 and 2010, with the Bioethics of Protection as an analytical support. The surveys revealed inequalities between population groups; and such inequalities were analyzed with respect to the reduction of the disease in the younger population, access to oral health care, and tooth loss, which is the worst outcome for tooth decay. The good results presented in the surveys have not reached the whole population; data have shown inequalities regarding family income and Brazilian region. It was also found that from 2003 government interventions in protective actions such as the adoption of criteria of equity in the allocation of health resources and inclusion of vulnerable population have contributed to a reduction in caries. Nevertheless, it is considered necessary update oral health care models by using Epidemiology as a structuring tool, and an interface with socially responsible protective bioethics, since regional differences continued to be marked in the analysis.

Traumatismos maxilofaciais como marcadores de violência urbana

A violência tem sido um tema amplamente discutido em diversos setores da sociedade, quer pelo reflexo nos indicadores de segurança pública, pela influência no cotidiano dos indivíduos ou pela presença constante de vítimas nos serviços de saúde. O estudo avaliou comparativamente as diferenças de vitimização entre os gêneros a partir dos traumatismos maxilofaciais como marcadores de violência urbana. Trata-se de um estudo transversal com dados coletados em três hospitais especializados no atendimento a politraumatismos em Belo Horizonte (MG), entre janeiro de 2008 e dezembro de 2010. As análises envolveram estatística descritiva e multivariada por regressão logística. Identificou-se o registro de 7.063 vítimas, sendo 55,1% de violência interpessoal. A maioria das vítimas era do sexo masculino (71,2%). Nos homens, as agressões por arma de fogo, arma branca e acidentes motocilísticos foram as mais importantes quando comparadas às agressões nuas ou sem uso de armas. As fraturas múltiplas foram o tipo de traumatismo que melhor caracterizou o perfil de vitimização para o sexo masculino comparativamente às lesões de partes moles. O gênero é um importante fator na vitimização por traumatismo maxilofacial e violência urbana, sendo que os homens são as principais vítimas.

Social determinants of health and periodontal disease in Brazilian adults: a cross-sectional study

BACKGROUND

Recently, increasing importance has been placed on the social determinants of health and disease. The present study aimed to determine the prevalence of periodontal disease in Brazilian adults and identify possible relationships with social determinants.

METHODS

A cross-sectional study was performed using a sample of 743 adults (aged 35-49 years) living in an urban area of a large city in southeastern Brazil. The condition of the periodontium was assessed using the Community Periodontal Index (CPI) according to the diagnostic criteria established by the World Health Organization (WHO). The variables related to social determinants were collected using a structured questionnaire. A descriptive analysis of all study variables was performed. Multiple correspondence analysis was subsequently performed to identify relationships between periodontal disease and the social determinants of health.

RESULTS

The periodontal exams showed that 36.5% of adults had a healthy periodontium, 2.0% had gingival bleeding, 47.1% had calculus and 9.5% had periodontal pockets of 4-5 mm. Periodontal pockets of 6 mm or more were the worst periodontal condition found (affecting only 2.1% of the participants). The correspondence analysis enabled us to form three groups with different profiles. The first group was distinguished by the presence of bleeding (gingivitis) or a healthy periodontium. The members of this group were typically aged 35 to 39 years and had 9-12 years or more than 12 years of education. The second group consisted of subjects with calculus and periodontal pockets of 4-5 mm. The members of this group were typically white men aged 40-44 years with incomes greater than $ 300.00. The third group was distinguished by the presence of periodontal pockets of 6 mm or more. The members of this group were typically adult females, black and mixed individuals who had 8 years or less of schooling, individuals with incomes ≤ $ 300.00 and widowers.

CONCLUSION

The results suggest that periodontal health is worse in the group for which the social indicators are worse. Therefore, the social determinants of health also affect the severity of periodontal disease in adults Brazilian society.

Perfil do paciente idoso referenciado ao consultório odontológico do Instituto Jenny de Andrade Faria HC/UFMG

INTRODUÇÃO: Com o aumento da expectativa de vida, medidas de saúde públicas devem ser planejadas e executadas para garantir atendimento à população idosa. Neste contexto, pode-se citar a saúde bucal como importante fator para garantir bem- estar e qualidade de vida. OBJETIVO: Este estudo foi realizado com o objetivo de identificar o perfil do paciente geriátrico encaminhado ao consultório odontológico do Instituto Jenny de Andrade Faria do HC/UFMG. MATERIAL E MÉTODO: Trata-se de um estudo transversal e descritivo, realizado por meio da coleta de dados dos prontuários de 48 pacientes. RESULTADO: Os principais resultados mostraram que esta população é composta, em sua maioria, por mulheres; estes indivíduos apresentam comprometimento sistêmico, grande parte está sob o uso de polifarmácia e a taxa de pacientes edêntulos é alta. CONCLUSÃO: Há necessidade da inserção do cirurgião-dentista na equipe multidisciplinar, que esteja apto a cuidar de pacientes complexos, bem como da instalação de equipamentos odontológicos para que o tratamento seja efetivamente realizado em consultório próprio da instituição.