Are laws restricting soft drinks sales in Brazilian schools able to lower their availability?

ABSTRACT OBJECTIVE To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages. METHODS We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE - National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother's educational level, score of goods and services. We performed multivariate analyses using Poisson regression. RESULTS The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66). CONCLUSION Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.

Formação profissional e conhecimento sobre biossegurança de Auxiliares de Saúde Bucal dos setores público e privado / Professional training and knowledge on biosafety by Oral Health Assistants of the public and private sectors

Na Odontologia, o conhecimento de medidas de biossegurança relacionadas ao controle de infecção constituem preocupação constante, já que conhecimentos adquiridos podem ser aplicados para a prevenção, minimização ou eliminação de riscos à saúde. O objetivo deste estudo foi verificar a relação entre a formação profissional e o conhecimento sobre biossegurança de Auxiliares de Saúde Bucal (ASBs) dos serviços público e privado em uma cidade do sudoeste da Bahia. Trata-se de um estudo transversal envolvendo 44 profissionais, sendo 16 do setor público e 28 do setor privado. Utilizou-se questionário semiestruturado com 22 questões. Os dados foram analisados por meio de estatística descritiva e pelo teste Qui-quadrado. A análise dos dados revelou que 45,5% das ASBs ainda não haviam realizado curso técnico profissionalizante, capacitação ou atualização e 77,3% não possuíam registro no Conselho Regional de Odontologia. As participantes que haviam recebido algum tipo de informação técnico-científica mostraram saber mais sobre o significado do termo biossegurança (p<0,05) e realizar com maior frequência a lavagem das mãos entre um paciente e outro (p<0,05). As profissionais do serviço público mostraram maior conhecimento sobre o significado do termo biossegurança (p<0,05) e a possiblidade de transmissão de doenças para os pacientes (p<0,05), em comparação às do serviço privado. Observou-se neste estudo que uma melhor formação profissional das ASBs pode interferir positivamente sobre os conhecimentos de biossegurança referentes ao controle de infecção (AU).

In dentistry, knowledge of biosafety measures related to infection control is a constant concern, since acquired knowledge can be applied to the prevention, minimization, or elimination of health risks. The objective of this study was to verify the relationship between professional training and biosafety knowledge of Oral Health Assistants (OHAs) of the public and private sectors in a city in southwestern Bahia. This is a cross-sectional study involving 44 professionals, 16 from the public sector and 28 from the private sector. A semi-structured questionnaire with 22 questions was used. Data were analyzed using descriptive statistics and a chi-square test. Data analysis revealed that 45.5% of the OHAs had not yet completed a vocational technical training or refresher course, and 77.3% had not registered with the Regional Council of Dentistry. Participants who had received some kind of technical-scientific information showed more knowledge about the meaning of the term biosafety (p<0.05) and performed handwashing more frequently between patients (p<0.05). The public sector professionals showed greater knowledge about the meaning of the term biosafety (p<0.05) and the possibility of disease transmission to patients (p<0.05) compared to those in the private sector. It was observed in this study that better professional training of the OHAs can positively influence the knowledge of biosafety regarding the control of infection (AU).

Tooth Erosion Association with Obesity: Findings from a Brazilian Survey in Schoolchildren

Objective: To evaluate a possible association between tooth erosion and weight status in Brazilian schoolchildren. Material and Methods: 1211 children aged 8-12-year-old from public and private schools in Southern Brazil were selected by a two-stage cluster method. Oral conditions were assessed by six trained and calibrated examiners. Tooth erosion assessment was determined by using the O´Sullivan index. Anthropometric measures were taken in order to obtain the body mass index. Socio-demographic and behavioral data were collected using questionnaires in children and parents. Multivariate Poisson regression model considering the cluster sample was used for data analysis (Prevalence ratio - PR; 95% Confidence Interval - CI). Results: Tooth erosion was observed in 25.1% of the children. Obesity and overweight prevalence was 34.6%. In the multivariate adjusted model, tooth erosion was associated with children from private schools (PR 1.68; 95%CI 1.05-2.68) and higher frequency of physical activity weekly (PR 1.48; 95%CI 1.04-2.09), whereas dental crowding in both arches was considered a protective effect (PR 0.55; 95%CI 0.34-0.89). In the stratified analysis regarding the type of school, children from private schools presented a positive association between tooth erosion and obesity (PR 3.26; 95%CI 1.38-7.69). Conclusion: Tooth erosion was not associated with obesity in the total sample. Socioeconomic differences seem to influence the relationship tooth erosion and obesity.

Telegenetics: application of a tele-education program in genetic syndromes for Brazilian students

With the high occurrence of genetic anomalies in Brazil and the manifestations of communication disorders associated with these conditions, the development of educative actions that comprise these illnesses can bring unique benefits in the identification and appropriate treatment of these clinical pictures. Objective The aim of this study was to develop and analyze an educational program in genetic syndromes for elementary students applied in two Brazilian states, using an Interactive Tele-education model. Material and Methods The study was carried out in 4 schools: two in the state of São Paulo, Southeast Region, Brazil, and two in the state of Amazonas, North Region, Brazil. Forty-five students, both genders, aged between 13 and 14 years, of the 9th grade of the basic education of both public and private system, were divided into two groups: 21 of São Paulo Group (SPG) and 24 of Amazonas Group (AMG). The educational program lasted about 3 months and was divided into two stages including both classroom and distance activities on genetic syndromes. The classroom activity was carried out separately in each school, with expository lessons, graphs and audiovisual contents. In the activity at a distance the educational content was presented to students by means of the Interactive Tele-education model. In this stage, the students had access a Cybertutor, using the Young Doctor Project methodology. In order to measure the effectiveness of the educational program, the Problem Situation Questionnaire (PSQ) and the Web Site Motivational Analysis Checklist adapted (FPM) were used. Results The program developed was effective for knowledge acquisition in 80% of the groups. FPM showed a high satisfaction index from the participants in relation to the Interactive Tele-education, evaluating the program as "awesome course". No statistically significant differences between the groups regarding type of school or state were observed. ...

The teaching of temporomandibular disorders and orofacial pain at undergraduate level in Brazilian dental schools

Objectives: Evaluate the way the topics for the study of pain mechanisms in general, and Orofacial Pain (OFP) and temporomandibular disorders (TMDs) more specifically, are addressed in undergraduate courses curricula, and also to verify the existence of specialist OFP/TMD teachers in Brazilian dental schools. Methods: Between July 2010 and January 2011, course Coordinators/Directors of all dental schools duly registered at the Ministry of Education were invited to answer a questionnaire on topics related to OFP/TMD teaching in their institutions. Results: Fifty-three dental schools representatives answered the questionnaire. The study of pain mechanisms was found to cover an average of less than 10% of the courses' total time. Pharmacology, Endodontics and Physiology were identified as the departments usually responsible for addressing pain mechanisms in dental courses. Psychosocial aspects were found to occupy a very small proportion in the syllabi, while most of the content referred to biological or somatic aspects. OFP/TMD is addressed by a specific department in only 28.4% of the participating dental schools, while in most cases (46.3%), OFP/TMD is under the responsibility of the Prosthodontics department. Only 38.5% of respondents indicated that they had a specialist OFP/TMD teacher in their Schools. Conclusion: Among the Brazilian dental schools participating in the study, the teaching of OFP/TMD was found to be insufficient, segmented or with an extremely restricted focus. This initial assessment indicates that Curricular Guidelines for the study of OFP/TMD at undergraduate dental schools should be developed and implemented to facilitate their appropriate inclusion into the curricula and in specific pedagogical projects. .

Análise da assistência odontológica prestada por empresas da região metropolitana de Campinas / Analysis of dental care provided by companies in the metropolitan region of Campinas

Objetivo: analisar a existência e o tipo de assistência odontológica prestada por empresas da região metropolitana de Campinas, já que com o intuito de melhorar a qualidade de vida dos trabalhadores e diminuir o absenteísmo, muitas empresas têm serviços de odontologia assistencial, contratados ou conveniados para o seu atendimento clínico assim como de seus dependentes. Material e métodos: foi enviado questionário por correio eletrônico a 115 empresas de médio e grande porte cadastradas no Centro das Indústrias do Estado de São Paulo e apenas 35 responderam. Resultados: 27 (77%) empresas oferecem o serviço de odontologia assistencial aos seus trabalhadores como benefício, sendo que a maioria contrata serviços de terceiros. A cooperativa odontológica foi a modalidade de prestadora de assistência odontológica contratada por 16 (67%) empresas. Foi identificada em apenas uma empresa a integração do cirurgião dentista à equipe do Serviço Especializado em Engenharia de Segurança e Medicina do Trabalho. Das empresas pesquisadas, 13 (37%) relataram realizar algum tipo de atividade preventiva odontológica, sendo as palestras proferidas durante a Semana Interna de Prevenção de Acidentes de Trabalho a atividade mais prevalente (77%). Conclusão: a assistência odontológica para os funcionários é uma realidade nas empresas de médio e grande porte. No Brasil, esse benefício não é obrigatório, ficando a cargo de a empresa decidir por sua implantação ou não. Embora fiquem claros os benefícios que a implantação dos serviços de odontologia pode trazer para os trabalhadores, faltam dados mais tangíveis e atualizados acerca da saúde bucal do trabalhador. Seriam necessárias mais pesquisas para sanar essa lacuna.

Objective: to examine the existence and type of dental care provided by companies in the metropolitan region on Campinas. In order to improve the quality of life of workers and reduce absenteeism, many businesses have dental care services, contracted or convened to your clinical care as well as their dependents. Material and methods: questionnaire was sent by electronic mail to 115 companies of medium and large registered in Center of Industries of the State of São Paulo and only 35 responded. Results: 27 (77%) companies offer the service of dental care to their workers as a benefit, and that most hires services of others. The cooperative was the type of dental provider of dental care contracted by 16 (67%) companies. Has been identified in only one company the integration of the dentist of the team service specializes in safety and work medicine. Of the companies surveyed, 13 (37%) reported conducting some type of activity preventive dental, and the speeches given during the work accident prevention week activity more prevalent (77%). Conclusion: it is concluded that the dental assistance for workers is a reality in companies of medium and large. In Brazil, this benefit is not mandatory, leaving it to the company decides on its implementation or not. Although the benefits are clear that the deployment of dental services can bring to workers, there are more tangible and updated data on the oral health of the worker. More searches would be necessary to remedy this shortcoming.

Impacto da sistematização de uma prática de promoção de saúde dos procedimentos clínicos em um atendimento coletivo privado / The impact of a treatment systematic in a dental practice based on health promotion on clinical procedure in a collective private dental health system

O objetivo deste trabalho foi o de fazer uma avaliação do impacto produzido pela adoção de uma nova sistemática de atenção baseada no paradigma de promoção de saúde, em um sistema odontológico coletivo privado. Por essa razão, os dados de um levantamento realizado nos registros gerenciais da carteira de usuários do Rio de Janeiro de uma empresa de planos de saúde, entre os anos de 1998 e 2003, foram tratados estatisticamente e analisados. No delineamento da pesquisa, foram considerados três períodos distintos: o de pré-intervenção (período 2) e o de pós-intervenção (período 3). O mês de maio de 2003, foi tomado como referência para a análise dos resultados, por tratar-se do ponto mais distante do fato observado e para o qual, existiam registros disponíveis. Para o tratamento estatístico, foi usada uma análise exploratória dos registros relativos a diversos procedimentos clínicos executados durante o atendimento dos usuários do plano de saúde, sendo construídas, para isso, médias-síntese e tabelas, com seus respectivos gráficos. Os dados apurados, mês a mês, foram analisados, via modelo de regressão linear simples e estratificados em função dos períodos de pré e pós-intervenção (1 e 3). Houve preocupação em identificar os perfis (padrões) da série para tentar comprovar a hipótese de que a nova influenciaria o número e a predominância dos tipos de procedimentos clínicos realizados durante o atendimento dos usuários. Através dos resultados obtidos, foi possível concluir que as mudanças paradigmáticas e da sistemática do atendimento impactaram, positivamente, na atenção odontológica oferecida, tendo dado ao sistema um maior potencial de controle da atividade das doenças, além de levar a uma redução na quantidade geral de procedimentos restauradores realizados e de influenciar na escolha do tipo de restauração a ser inserida. Foram detectadas, também, importantes diminuições no quantitativo de cirurgias periodontais e de tratamentos endodônticos

Projeto Bambuí: avaliação de serviços odontológicos privados, públicos e de sindicato / Bambuí Project: an evaluation of private, public and unionized dental services

Partindo do princípio de que um dos objetivos dos serviços odontológicos públicos é reduzir os efeitos das desigualdades sociais sobre a saúde bucal, investigou-se se essas desigualdades estão presentes entre usuários dos serviços odontológicos públicos, privados e de sindicato. A população estudada foi constituída por uma amostra representativa de adultos residentes na cidade de Bambuí, MG. Os participantes foram entrevistados por meio de um questionário estruturado. Entre os 1.664 moradores amostrados, 1.382 (83,1 por cento) participaram do inquérito de saúde bucal. Destes, 656 preenchiam os critérios de inclusão (idade >= 18 anos, presença de pelo menos um dente natural e visita ao dentista pelo menos uma vez na vida) e participaram do trabalho. Os usuários dos serviços privados estavam mais satisfeitos com a aparência dos dentes (OR (AJ) = 3,03; IC95 por cento=1,70-5,39) e com a matisgação (OR (AJ)=2,27; IC95 por cento=1,17-4,40) do que os usuários de serviços públicos. Aqueles também percebiam menos necessidade atual de tratamento odontológico (OR (AJ)=0,39;IC95 por cento=0,18-0,86) e receberam com mais frequência tratamento restaurador (OR (AJ)=9,57;IC95 por cento=4,72-19,43) ou preventivo (OR (AJ)=5,57; IC95 por cento=2,31-13,40) na última visita ao dentista. Aqueles que usaram os serviços do sindicato também receberam mais tratamentos restauradores (OR (AJ)=8,51;IC95 por cento=2,80-25,92) e preventivos (OR (AJ)=11,42;IC95 por cento=3,49-37,43) na última visita ao dentista do que os usuários de serviços públicos. Nenhuma diferença foi encontrada em relação à satisfação com a aparência dos dentes, à capacidade de matisgação e à precepção de necessidade de tratamento odontológico. Os serviços públicos odontológicos, com base no estudo da comunidade local, aparentemente não têm conseguido reduzir as desigualdades sociais com referência à saúde bucal