Are healthcare workers immunized after receiving hepatitis B vaccination according to recommended guidelines? A systematic review and meta-analysis.

OBJECTIVES: Nowadays, it is believed that more than 240 million people worldwide are infected with the hepatitis B virus (HBV), associated with irreversible health-related consequences, represented by hepatic failure, cirrhosis, and hepatocellular carcinoma, and already are ranked as 15th cause of human death around the world. METHODS: A systematic review and a meta-analysis were performed to evaluate the effectiveness of vaccination and immunization on health professionals against HBV. The review was registered at the PROSPERO database (CRD42017075643). A search for cross-sectional studies was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and in the gray literature. The Effective Public Health Practice Project Modified Scale was used to evaluate the internal quality of the studies included. RESULTS: A total of 1865 articles were identified after the removal of duplicates. Of these, 790 studies remained after screening the titles and abstracts. Finally, ten studies remained after full-text reading for qualitative analysis, all of which were used in the meta-analysis. A significant difference was found in the vaccine protocol for health professionals immunized against hepatitis B, compared to those not immunized. The risk ratio was 7.37 (95% confidence interval = 3.92-13.83; P < 0.00001). CONCLUSION: This study showed that the vaccine protocol is effective in immunizing health professionals against hepatitis B.

Association of taste receptor gene polymorphisms with dental caries.

This study was performed to evaluate the interplay between dental caries, nutritional status, and genetic polymorphisms in TAS1R1 and TAS1R2 (taste receptor, type 1, member 1 and 2) in preschool children and pre-adolescents. We included 525 subjects (306 preschool children and 219 pre-adolescents). Parents/caregivers answered a self-administered questionnaire about their children's systemic health, characteristics, oral hygiene habits, and diet. Clinical examination was performed to evaluate dental caries and nutritional status. Saliva samples were collected for DNA extraction. The genotyping of rs17492553 ( TAS1R1 ), rs3935570, and rs4920566 ( TAS1R2 ) polymorphisms was performed using real-time PCR with Taqman Genotyping Master Mix and SNP assay. Both univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis. In preschool children, consumption of sweets between meals increased the prevalence of dental caries by 85% (PR c = 1.85; 95%CI 1.39-2.46; p < 0.001), whereas in pre-adolescents, this prevalence increased by 34% (PR a = 1.34; 95%CI 1.11-1.62; p = 0.002), regardless of genetic polymorphisms . Moreover, individuals carrying at least one allele C in rs17492553 presented 23% more prevalence of dental caries (PR a = 1.23; 95%CI 1.02-1.49 p = 0.030). Nutritional status was not associated with dental caries, neither with genetic polymorphisms . Consumption of sweets between meals increased the prevalence of dental caries. In pre-adolescents, rs17492553 genetic polymorphism in TAS1R1 was associated with dental caries.

Association of taste receptor gene polymorphisms with dental caries

Abstract This study was performed to evaluate the interplay between dental caries, nutritional status, and genetic polymorphisms in TAS1R1 and TAS1R2 (taste receptor, type 1, member 1 and 2) in preschool children and pre-adolescents. We included 525 subjects (306 preschool children and 219 pre-adolescents). Parents/caregivers answered a self-administered questionnaire about their children's systemic health, characteristics, oral hygiene habits, and diet. Clinical examination was performed to evaluate dental caries and nutritional status. Saliva samples were collected for DNA extraction. The genotyping of rs17492553 ( TAS1R1 ), rs3935570, and rs4920566 ( TAS1R2 ) polymorphisms was performed using real-time PCR with Taqman Genotyping Master Mix and SNP assay. Both univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis. In preschool children, consumption of sweets between meals increased the prevalence of dental caries by 85% (PR c = 1.85; 95%CI 1.39-2.46; p < 0.001), whereas in pre-adolescents, this prevalence increased by 34% (PR a = 1.34; 95%CI 1.11-1.62; p = 0.002), regardless of genetic polymorphisms . Moreover, individuals carrying at least one allele C in rs17492553 presented 23% more prevalence of dental caries (PR a = 1.23; 95%CI 1.02-1.49 p = 0.030). Nutritional status was not associated with dental caries, neither with genetic polymorphisms . Consumption of sweets between meals increased the prevalence of dental caries. In pre-adolescents, rs17492553 genetic polymorphism in TAS1R1 was associated with dental caries.

Self-Perception of Gerontoism according to Social Support and Family Functionality.

BACKGROUND: The gerontoism, a neologism adopted here, is a form of discrimination regarding age and can occur in rational, emotional, and behavioral contexts, and could be influenced by many factors. This study aimed to identify if the social support and the family functionality interfere in the self-perception of gerontoism. METHODS: Participants were 376 elderly in good physical and mental condition. They participated in the Group Living organization in the Municipality of Curitiba, State of Paraná, Brazil, in 2012. Information was collected about sociodemographic profile using a structured questionnaire. The social support, the family functionality, and the self-perception of gerontoism were defined by the Medical Outcomes Study, the Family APGAR index, and Ageism Survey, respectively. The variables were analyzed by Pearson's correlation coefficient, One Way ANOVA, Tukey's HSD test, and the Student's t-test. RESULTS: Most of the participants came from small cities from the interior (48.7%), were female (94.4%), with age ranging 60-69 yr-old (45.5%), whites (76.1%), widowers (47.1%), with children (93.9%), with low schooling (55.3%), with family income from 1-2 minimum wage (31.4%), and retirees not working (44.1%). It was not observed correlation between sociodemographic variables and self-perception of gerontoism. Statistical significance was observed between self-perception of gerontoism and social support (r= -0.26, P=0.00), and between the self-perception and family functionality (r = -0.28, P=0.00). Once the scores of self-perception of gerontoism increased, the ones from social support and family functionality, decreased. CONCLUSION: Lower self-perception of gerontoism was observed in elderly with higher social support and family functionality.

Perfil dos pacientes atendidos na clínica de odontopediatria de uma universidade privada de Curitiba, PR, Brasil / Profile of patients attended in the clinic of pediatric dentistry of a private university of Curitiba, PR, Brazil

Introdução: Propôs-se traçar o perfil dos pacientes atendidos na Clínica de Odontopediatria da Universidade Positivo, Curitiba, PR, Brasil. Métodos: Com desenho analítico, observacional e transversal, foram selecionados todos os prontuários (n=1527) dos pacientes atendidos no período de janeiro de 2009 a dezembro de 2017. As informações coletadas foram: ano de atendimento, gênero, cor da pele, motivo da consulta, idade da primeira consulta, hábitos deletérios, escovação e uso do fio dental. Os dados foram tabulados e apresentados em tabelas de frequências por meio do SPSS, versão 21. Resultados: A média da idade foi igual a 8 } 2,7 anos, com maior frequência de meninas (51,3%) e crianças de cor branca (83,7%). Como motivo da consulta houve predomínio da categoria "rotina" (43,5%) e "tratamento ortodôntico" (20,6%). A maioria das crianças (69,4%) realizou a primeira consulta na clinica com idade superior a quatro anos. Constatou-se que 52,9% das crianças não apresentaram hábitos deletérios. Em relação a escovação dentaria, 99,0% da amostra relataram faze-la, entretanto, o uso do fio dental não foi uma pratica adotada por boa parte dos pesquisados (64,6%). Conclusões: O perfil aqui determinado poderá servir de subsídios para o desenvolvimento de estratégias de promoção e de recuperação da saúde ofertadas pelo serviço em questão.

Introduction: It was proposed to delineate the profile of patients attended in the Pediatric Dentistry Clinic of Universidade Positivo, Curitiba, PR, Brazil. Methods: With analytical, observational and cross-sectional design, all records (n=1,527) of patients attended in the period from January 2009 to December 2017, were selected. The data collected were: year of attendance, gender, skin color, reason for consultation, age at first examination, deleterious habits, brushing, and flossing. Data were tabulated and shown in frequency tables using the SPSS, version 21. Results: The mean of the age was 8 } 2,7 years old, with higher frequency of girls (51.3%) and white children (83.7%). The prevailing reason for the consultation was "routine" (43.5%) and "orthodontic treatment" (20.6%). Most of the children (69.4%) performed the first consultation above four years of. It was found that 52.9% of children did not present showed deleterious habits. Regarding tooth brushing, more than 99.0% of the sample reported doing so, however, the use of dental floss was not a practice adopted by a good part of the total sample of researched (64.6%). Conclusions: The profile determined here may serve as a basis for the development of health promotion and recovery strategies offered by the service in question.

A preventive practice and its educational role with an academic community of Dentistry

The study aimed to verify the adherence of undergraduate Dentistry students to the hepatitis B and tetanus vaccination campaign in a private Dental school. The hypothesis tested was that the vaccination campaign would be an effective program in prevention of HBV and tetanus infection. The vaccination's card copies and the Anti-HBs exam were analyzed as main outcome. Data were submitted to bivariate and multivariate Poisson regression analyses (0.05). Age, admission year, studying shift, doses of hepatitis B and tetanus vaccinations were independent variables. Out of the 485 students, 318 delivered the vaccination's card, and 295 presented the Anti-HBs exam. The median age of the students was 21 years (76.1% female and 23.9% male). In the univariate and multivariate Poisson regression model, failure to receive the tetanus vaccination was considered as a risk factor. Undergraduate students enrolled in the initial years were more likely to have not received the vaccination than the senior years (p ≤0.001). Out of the total number of students (318) who submitted the documentation for hepatitis B, 86.1% completed the vaccination protocol (3 doses), while 13.9% the incomplete protocol (1 or 2 doses). Older students were more likely to have refrained from taking the vaccinations compared to younger (p ≤ 0.001). In relation to the Anti-HBs, 73.9% had positive protective titer. Vaccination campaigns for undergraduate students may be effective if adherence of the individuals to the schedule can be ensured. Strategies for greater adherence of students, should be thought and planned by Dental Schools (AU).

O estudo objetivou verificar a adesão dos estudantes de graduação em Odontologia à campanha de vacinação contra hepatite B e tétano em uma escola particular de Odontologia. A hipótese testada foi que a campanha de vacinação seria um programa efetivo na prevenção da infecção pelo HBV e tétano. O cartão de vacinação e o exame anti-HBs foram analisados como desfecho principal. Os dados foram submetidos à regressão de Poisson bivariada e multivariada (0, 5). Idade, ano de admissão, turno de estudos, número de doses de vacinas para hepatite B e vacinação para tétano foram variáveis independentes. Dos 485 estudantes, 318 entregaram a cópia do cartão de vacinação e 295 apresentaram o exame anti-HBs. A mediana de idade dos estudantes foi de 21 anos (76,1% do sexo feminino, 23,9% do sexo masculino). Nos modelos de regressão de Poisson univariada e multivariada, a não vacinação contra o tétano foi considerada fator de risco. Os alunos de graduação matriculados nos anos iniciais foram mais propensos a não receberem a vacinação do que aqueles dos anos finais (p≤0,001). Do total de alunos (318) que entregaram a documentação para hepatite B, 86,1% completaram o protocolo de vacinação (3 doses), enquanto 13,9% o protocolo incompleto (1 ou 2 doses). Os estudantes mais velhos foram mais propensos a não terem tomado as vacinas em comparação com mais jovens (p≤0,001). Em relação ao anti-HBs, 73,9% apresentaram título de proteção positivo. As campanhas de vacinação para estudantes de graduação podem ser efetivas se a adesão dos indivíduos ao calendário vacinal puder ser assegurada. Estratégias para maior adesão dos estudantes, como essa campanha, devem ser pensadas e planejadas pelos cursos de Odontologia (AU).

Grau de satisfação entre os usuários de uma unidade básica de saúde no estado do Paraná, Brasil / Degree of satisfaction among users of a basic health unit in the state of Paraná, Brazil

OBJETIVOS: Avaliar o grau de satisfação dos usuários com a estrutura e os serviços prestados em uma unidade básica do Sistema Único de Saúde. MÉTODOS: Este estudo transversal incluiu indivíduos com idade ≥18 anos, de ambos os gêneros, entrevistados individualmente de março a maio de 2018 na unidade básica de saúde Ferraria, em Campo Largo, Paraná, Brasil. Um questionário estruturado continha informações sociodemográficas e questões adaptadas do instrumento utilizado no Programa Nacional de Avaliação de Serviços de Saúde, acerca da satisfação com a equipe, tempo de espera e estrutura física local. A análise descritiva dos dados foi seguida dos testes U de Mann-Whitney, Kruskal-Wallis, Qui-quadrado e regressão de Poisson, considerando como significativo p<0,05. RESULTADOS: A amostra foi constituída por 373 usuários que atenderam aos critérios de inclusão, sendo 72,9% do gênero feminino, 82,8% de raça/cor da pele branca, 69,0% com baixa renda e 36,4% com baixa escolaridade. A equipe de saúde foi o item melhor avaliado (73,3% das respostas nas categorias "muito bom" e "bom"); e o tempo de espera para o atendimento foi o item pior avaliado (61,5% "ruim" ou "muito ruim"). Na análise bivariada o atendimento da equipe de saúde não foi associado a nenhuma variável independente. Na avaliação geral do estabelecimento, as categorias "muito bom/bom", "regular", "ruim" e "muito ruim" foram avaliadas respectivamente por 84 (27,4%), 128 (41,7%), 67 (21,8%) e 28 (9,1%) brancos; e 22 (34,9%), 34 (54,0%), 7 (11,1%) e 0 (0,0%) não brancos (p=0,006). No modelo de regressão de Poisson, a baixa escolaridade foi associada a uma chance 1,5 vezes maior de não saber onde reclamar em caso de mau atendimento. CONCLUSÕES: O grau de satisfação dos usuários da unidade básica de saúde Ferraria foi influenciado por fatores como raça/cor da pele e escolaridade. Os usuários não brancos expressaram um grau de satisfação maior do que os usuários brancos; e aqueles com baixa escolaridade sabiam menos onde reclamar caso o atendimento não fosse satisfatório. Apesar da avaliação em geral ter sido positiva, alguns quesitos foram identificados como não satisfatórios, merecendo medidas corretivas.

AIMS: To evaluate the users' degree of satisfaction with the structure and services provided in a Basic Health Unit of the Public Health System. METHODS: This cross-sectional study included individuals aged ≥18 years, of both genders, individually interviewed from March to May 2018 at the Ferraria Basic Health Unit, Campo Largo, Paraná, Brazil. A structured questionnaire contained sociodemographic information and questions adapted from the instrument used in the National Health Services Evaluation Program, regarding satisfaction with the staff, waiting time and local physical structure. Descriptive analysis of the data was followed by the Mann-Whitney U, Kruskal-Wallis, Chi-square and Poisson regression tests. Values of p<0.05 were considered statistically significant. RESULTS: The sample consisted of 373 users who met the inclusion criteria, of whom 72.9% were female, 82.8% were white race/skin color, 69.0% had low income and 36.4% had low schooling. The health team was the best evaluated item (73.3% of answers in the categories "very good" and "good"); and the waiting time for service was the worst evaluated item (61.5% of answers "bad" or "very poor"). In the bivariate analysis, the health team care was not associated with any independent variables. In the general evaluation of the establishment, the categories "very good/good", "regular", "bad" and "very bad" were evaluated respectively by 84 (27.4%), 128 (41.7%), 67 (21.8%) and 28 (9.1%) white users; and 22 (34.9%), 34 (54.0%), 7 (11.1%) and 0 (0.0%) non-white users (p=0.006). In the Poisson regression model, low schooling was associated with a 1.5 times greater chance of not knowing where to complain in case of poor care. CONCLUSIONS: The degree of satisfaction of the users of the Ferraria Basic Health Unit was influenced by factors such as race/skin color, income and schooling. Non-white users expressed a higher degree of satisfaction than white users. Users with low schooling knew less where to complain if service was not satisfactory. Although the evaluation was generally positive, some items were identified as unsatisfactory, deserving corrective measures.

Uma década da Odontogeriatria brasileira / A decade of Brazilian Geriatric Dentistry

Introdução: O rápido crescimento do contingente de idosos na população brasileira é acompanhado por mudanças epidemiológicas que necessitam de especial atenção por parte dos profissionais da saúde, bem como dos setores da gestão pública. A atual condição de saúde bucal dos idosos brasileiros reflete uma somatória de crenças e valores acerca das necessidades percebidas, vividas e experimentadas por esses indivíduos ao longo de suas existências. A atenção à saúde e a qualidade dos serviços odontológicos prestados no passado também contribuíram para essa realidade. No início deste milênio, a Odontologia atentou para o fato de que a saúde bucal dos idosos requer muito mais do que domínios de técnicas e materiais.Assim, em 2001, a Odontogeriatria foi reconhecida pelo Conselho Federal de Odontologia como uma especialidade,a qual se fundamenta em razões que outrora pareciam ser desconhecidas pela maioria dos cirurgiões-dentistas. Entretanto, a quantidade de profissionais capazes de prestar atendimento odontológico adequado a essa parcela da população ainda parece inadequada. O acesso aos serviços de qualidade apresenta uma série de condicionantes que interferem de maneira direta na saúde das pessoas. Conclusão:Frente ao atual panorama de transição demográfica e epidemiológica, o presente estudo de revisão apresenta as principais características dos idosos brasileiros e a atual condição de saúde bucal desse coletivo.A estrutura em tópicos permite uma série de observações inerentes à Odontologia, aos seus profissionais e à formação e qualificação de recursos humanos em Odontogeriatria.

Introduction: The fast growth of elderly population in Brazil is followed by epidemiological changes thatneed special attention from health professionals, as well as sectors of the Government. The present conditionsof oral health of elderly in Brazil can be reflected in a sum of beliefs and values around perceived necessitiesand experienced by those individuals throughout life. The attention to health and the quality of dental servicesprovided in the past also contributed to this reality. In the beginning of this millennium, Dentistry sciencerealized that the oral health of elderly requires more than mastered techniques and materials. So, in 2001,Geriatric Dentistry was recognized by the Brazilian Federal Council of Dentistry as a specialty, based onreasons that once seemed to be unknown to dental surgeons. However, the number of professionals capableof offering the necessary treatment to this group of people still seems inadequate. The access to high-qualityservices presents a series of conditions that affect directly people´s health. Conclusion: In accordance to thecurrent demographical and epidemiological transition, this review study presents the main characteristics ofBrazilian elderly and their current oral health status. The structure in topics allows a series of inherentobservations to Dentistry, to its professionals and to the training and qualification of human resources inGeriatric Dentistry.

Envelhecimento humano e ancianismo: revisão / Human aging and ageism: review

OBJETIVO: Apresentar e discutir fatos contemporâneos relacionados a estereótipos relacionados com o processo de envelhecimento. Para alcançar o objetivo proposto, este trabalho foi estruturado em tópicos. DISCUSSÃO E CONCLUSÃO: Observou-se que a desinformação impede a transformação de atitudes e de comportamentos em relação à velhice, enaltece algumas crenças que tendem a relegar os idosos às margens da sociedade e da família, além de contribuir para a imagem que esses sujeitos fazem de si próprios. Porém, tanto a participação social dos idosos quanto o conhecimento acerca do processo de envelhecimento podem influenciar de maneira positiva na quebra de estereótipos e de preconceitos para com as pessoas em idade avançada.

OBJECTIVE: This review is aimed to expose some contemporary facts related to stereotyping related with the aging process. DISCUSSION AND CONCLUSION: The misinformation prevents the transformation of attitudes and behaviors in relation to old age, exalts some beliefs that tend to relegate the elderly to the margins of society and the family, and contribute to the image that the aged make of themselves. It was concluded that both the social participation of older people as the knowledge about the aging process can influence in a positive manner in the fall of stereotypes and prejudices towards people in old age.