Spatial density of adolescents aged 14 years old, victims of dental: A longitudinal study.

BACKGROUND/AIM: Knowledge about the spatial density of the domiciles of dental trauma victims can assist in the identification of the most vulnerable areas and contribute to the planning of prevention, promotion, control, and treatment actions, focusing on the most affected areas. The aim of this study was to analyze the spatial density of domiciles of 14-year-old adolescent victims of dental trauma, in the city of Diamantina, Brazil, after a two-year follow-up period. MATERIAL AND METHODS: This longitudinal study was carried out with 584 adolescents between 2013 and 2015. Dental trauma, overjet, and lip protection were assessed by two trained and calibrated examiners (K > 0.70). Information about binge drinking was collected among the adolescents through the Alcohol Use Disorders Identification Test and sociodemographic indicators were obtained through a questionnaire answered by the caregivers of the adolescents. Spatial analyses were performed to evaluate the spatial density of adolescents with dental trauma and the independent variables of interest according to the domicile using Ripley's K function and the Kernel Map. RESULTS: Ripley's K function revealed spatial aggregation of the domiciles of adolescent victims of dental trauma in relation to males, binge drinking and overjet, with a confidence interval of 95%. The higher density of domiciles with adolescents with two or more traumatized teeth was found in the north-east region of the city. Boys were the most affected, their homes were located in the north, north-west, and south-east regions at baseline and follow-up. The largest density of domiciles of adolescents with overjet greater than 5 mm and inadequate lip protection was in the north-east region. Similar spatial distribution was identified for binge drinking for both years. CONCLUSION: The majority of adolescents with dental trauma lived in the north-east and south-east regions, characterized by high population density and greater social vulnerability.

Trends of maxillofacial injuries resulting from physical violence in Brazil.

BACKGROUND/AIM: A large proportion of interpersonal violence results in maxillofacial injuries. The monitoring of maxillofacial injuries in the context of gender violence has been little explored. The aim of this study was to analyze trends in cases of maxillofacial injuries resulting from interpersonal physical violence considering the gender of the victim and perpetrator. MATERIALS AND METHODS: A time-series study was conducted. Data regarding maxillofacial injury cases due to interpersonal physical violence were collected from reports at a forensic institute of a city in northeastern Brazil, between 2008 and 2014 (84 months). Rates of interpersonal physical violence per 100 000 inhabitants were determined for each gender. A negative binomial regression model was used to evaluate trends. The cycle plot was used to investigate the occurrence of seasonality, considering subseries for each month. RESULTS: A total of 3561 reports were analyzed, revealing higher rates of female victims and male perpetrators throughout the series. There was no indication of seasonality. The annual percentage of injuries involving male victims reduced significantly by 6.8% (P < .001), while injuries involving female victims increased significantly by 4.5% (P = .002). Regarding perpetrators, rates remained constant over time, following the same pattern for both genders. CONCLUSIONS: The data demonstrate greater victimization involving maxillofacial injuries against women perpetrated more often by men, with a trend toward an increase in female victims and a reduction in male victims.

Dentists' perceptions and attitudes towards emergency care for women in situations of violence: a scope review. / Percepção e atitude do cirurgião-dentista diante do atendimento emergencial a mulheres em situação de violência: uma revisão de escopo.

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.

Avaliar por meio de uma revisão de escopo estudos que abordam a percepção e atitude do cirurgião-dentista diante do atendimento a mulheres em situação de violência. Utilizando os descritores women violence, dentist attendence ou dentist care, foram identificados 473 artigos, sendo incluídos 13, ao final da seleção. Embora a necessidade de capacitação tenha sido predominante, ela não é suficiente. Existe uma fragilidade em se compreender a violência como problema de saúde, de entender o papel do profissional na solução desse problema, os fatores que podem contribuir com seu crescimento ou seu controle. Os resultados revelaram que o cirurgião-dentista apresentou maior dificuldade do que os outros profissionais no enfrentamento e exigem um amplo aprendizado. O reconhecimento dos referidos casos pelo cirurgião-dentista exige a incorporação de medidas educativas que provoquem mudanças culturais, desconstrução de normas de gênero e a desnaturalização desse fenômeno social.

Self-reported oral health among Brazilian adults: results from the National Health Surveys 2013 and 2019. / Condições de saúde bucal autorrelatadas entre adultos brasileiros: resultados das Pesquisas Nacionais de Saúde de 2013 e 2019.

OBJECTIVE: To evaluate indicators of oral health conditions and behaviours among Brazilian adults in the 2019 National Health Survey (PNS) and analyse the evolution of those indicators compared to the 2013 PNS. METHODS: Cross-sectional study. Prevalence ratios of oral health conditions and behaviours, in 2019, were estimated by demographic characteristics. Risk ratios were computed using Poisson regression, and absolute differences (Dif.) between indicators in 2013 and 2019 were calculated. RESULTS: Prevalence of brushing teeth twice a day, using toothbrush/toothpaste/floss and edentulism were, respectively, 93.6% (95%CI 93.3;93.9), 63.0% (95%CI 62.3;63.6) and 10.3% (95%CI 9.93;10.7). There was increase in prevalence of brushing teeth ≥ 2 a day (Dif. = 4.5; 95%CI 3.9;5.1), using toothbrush/toothpaste/floss (Dif. = 10.0; 95%CI 8.6;11.3) and a decrease in prevalence of edentulism (Dif. = -0.7; 95%CI -1.3;-0.1). CONCLUSION: Respondents who were younger, more educated, with higher income and lived in urban areas had better oral health indicators. Most indicators demonstrated positive improvement.

Binge drinking, alcohol outlet density and associated factors: a multilevel analysis among adolescents in Belo Horizonte, Minas Gerais State, Brazil.

Our study sought to evaluate the prevalence of binge drinking in adolescents and its association with density of alcohol outlets around schools. This cross-sectional study was conducted in Belo Horizonte, Minas Gerais State, Brazil, with 436 high-school students aged between 17 and 19 and enrolled in 18 public and private schools. The students completed the Alcohol Use Disorder Identification Test (AUDIT-C), consisting of questions about alcohol consumption by parents and siblings, and socioeconomic status (type of school, mother's education level). Data from geographic information systems were used to estimate the density of alcohol outlets around schools participating. The association between exploratory variables and binge drinking was investigated using multilevel logistic regression analysis (p < 0.05) with random intercepts and fixed slopes. A three-step sequential modeling strategy was adopted. The prevalence of binge drinking was 39.9%. The alcohol consumption among adolescents was lower for those studying in areas with low density of alcohol outlets around schools (OR = 0.32; 95%CI: 0.14; 0.73) and the consumption of alcohol by mothers was associated with binge drinking among adolescents (OR = 1.94; 95%CI: 1.14; 3.30). Our study concluded that binge drinking among adolescents was associated with density of alcohol outlets around the schools and mother's alcohol consumption.

[Spatial and differential income pattern of households of adolescents and young adults who are victims of maxillofacial injuries resulting from firearm aggression]. / Padrão espacial e diferencial de renda dos domicílios de adolescentes e adultos jovens vítimas de traumatismo maxilofacial por agressão com arma de fogo.

The study investigated the spatial pattern of cases of maxillofacial injury resulting from firearm aggression among teenagers and young adults and analyzed the comparison of income differentials in these areas based on the residence of the victims. This is a cross-sectional study with data from victims attended in three hospitals in Belo Horizonte, State of Minas Gerais, from January 2008 to December 2010. The addresses of the victims were georeferenced by geocoding. Randomness and point density trends were analyzed using Ripley's K function and Kernel maps. The spatial interaction between the homes of adolescents and young adults was verified through the K12 function. Records of 218 cases of assault with a male predominance (89.9%) and young adults (70.6%) were found. Household clusters were distributed on an aggregate basis in the urban space with a confidence level of 99% and similar spatial aggregation levels. The hotspots converged on 7 shantytowns or neighboring regions with higher income population revealing spread of events. Hotspots focused on slums with a history of crimes linked to drug trafficking. The incorporation of space in the dynamics of events showed that the economic condition in isolation did not limit victimization.

Condições de saúde bucal autorrelatadas entre adultos brasileiros: resultados das Pesquisas Nacionais de Saúde de 2013 e 2019 / Condiciones de salud bucal autoinformadas en brasileños adultos: resultados de las Encuestas Nacionales de Salud 2013 y 2019 / Self-reported oral health among Brazilian adults: results from the National Health Surveys 2013 and 2019

Objetivo: Analisar indicadores das condições e comportamentos relacionados à saúde bucal de brasileiros adultos na Pesquisa Nacional de Saúde (PNS) 2019 e sua evolução em relação a 2013. Métodos: Estudo transversal que estimou prevalências de comportamentos e condições de saúde bucal segundo variáveis demográficas. Foram calculadas as razões de prevalência, por regressão de Poisson, e estimadas diferenças absolutas (Dif.) entre os indicadores de 2013 e 2019. Resultados: Em 2019, as prevalências de escovação ≥ 2 vezes ao dia, uso de escova/dentifrício/fio dental e edentulismo foram, respectivamente, 93,6% (IC95% 93,3;93,9), 63,0% (IC95% 62,3;63,6) e 10,3% (IC95% 9,9;10,7). Escovação ≥ 2 vezes/dia (Dif. = 4,5; IC95% 3,9;5,1) e uso de escova/dentifrício/fio dental (Dif. = 10,0; IC95% 8,6;11,3) aumentaram, enquanto o edentulismo (Dif. = -0,7; IC95% -1,3;-0,1) foi reduzido. Conclusão: Observaram-se melhores indicadores de saúde bucal entre pessoas mais jovens, com ensino superior, maior renda e residentes na zona urbana. Verificou-se melhoria na maioria dos indicadores estudados.

Objetivo: Evaluar los indicadores de salud bucal en la población brasileña adulta en base a los datos de la Encuesta Nacional de Salud (PNS) 2019, y analizar su evolución en relación a PNS 2013. Métodos: Se trata de un estudio transversal. Se estimó la prevalencia de conductas y condiciones de salud bucal en 2019, según características sociodemográficas. Se calcularon razones de prevalencia con regresión de Poisson y se estimaron las diferencias (Dif.) entre los indicadores de 2013 y 2019. Resultados: La prevalencia de cepillado ≥ 2 veces al día, uso de cepillo/pasta/hilo dental y edentulismo ha sido, respectivamente, 93,6% (IC95% 93,3;93,9), 63,0% (IC95% 62,3;63,6) y 10,3% (IC95% 9,93;10,7). Prevalencia de cepillado ≥ 2 veces al día (Dif. = 4,5; IC95% 3,9;5,1) y uso de cepillo/pasta/hilo dental (Dif. = 10,0; IC95% 8,6;11,3) aumentó, mientras que el edentulismo (Dif. = -0,7; IC95% -1,3; -0,1) disminuyó. Conclusión: Se observaron mejores indicadores entre jóvenes, con educación superior, mayores ingresos y en áreas urbanas. Hubo mejora en la mayoría de los indicadores.

Objective: To evaluate indicators of oral health conditions and behaviours among Brazilian adults in the 2019 National Health Survey (PNS) and analyse the evolution of those indicators compared to the 2013 PNS. Methods: Cross-sectional study. Prevalence ratios of oral health conditions and behaviours, in 2019, were estimated by demographic characteristics. Risk ratios were computed using Poisson regression, and absolute differences (Dif.) between indicators in 2013 and 2019 were calculated. Results: Prevalence of brushing teeth twice a day, using toothbrush/toothpaste/floss and edentulism were, respectively, 93.6% (95%CI 93.3;93.9), 63.0% (95%CI 62.3;63.6) and 10.3% (95%CI 9.93;10.7). There was increase in prevalence of brushing teeth ≥ 2 a day (Dif. = 4.5; 95%CI 3.9;5.1), using toothbrush/toothpaste/floss (Dif. = 10.0; 95%CI 8.6;11.3) and a decrease in prevalence of edentulism (Dif. = -0.7; 95%CI -1.3;-0.1). Conclusion: Respondents who were younger, more educated, with higher income and lived in urban areas had better oral health indicators. Most indicators demonstrated positive improvement.

Percepção e atitude do cirurgião-dentista diante do atendimento emergencial a mulheres em situação de violência: uma revisão de escopo / Dentists' perceptions and attitudes towards emergency care for women in situations of violence: a scope review

Resumo Avaliar por meio de uma revisão de escopo estudos que abordam a percepção e atitude do cirurgião-dentista diante do atendimento a mulheres em situação de violência. Utilizando os descritores women violence, dentist attendence ou dentist care, foram identificados 473 artigos, sendo incluídos 13, ao final da seleção. Embora a necessidade de capacitação tenha sido predominante, ela não é suficiente. Existe uma fragilidade em se compreender a violência como problema de saúde, de entender o papel do profissional na solução desse problema, os fatores que podem contribuir com seu crescimento ou seu controle. Os resultados revelaram que o cirurgião-dentista apresentou maior dificuldade do que os outros profissionais no enfrentamento e exigem um amplo aprendizado. O reconhecimento dos referidos casos pelo cirurgião-dentista exige a incorporação de medidas educativas que provoquem mudanças culturais, desconstrução de normas de gênero e a desnaturalização desse fenômeno social.

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.

Characterization of victims of aggression and transportation accidents treated at the Forensic Medicine and Dentistry Institute - Campina Grande, Paraíba, Brazil - 2010.

The objective of this cross-sectional census study was to characterize agression and land-based transport accidents in a city in the Northeast of Brazil. Data was analyzed from live victims who were treated at a forensic service (N = 2.379). In the descriptive analysis, the majority of events were represented by aggression (71.6%); which occurred on weekdays (65%), with 35.1% at night. Trauma occurred to the whole body (63.6%) and to soft tissue (74.2%). On the basis of multiple correspondence analysis, two dimensions were formed: the first dimension (internal reliability = 0.654) was formed by the cause of the event, the trauma and the age group and the second dimension (reliability = 0.514), by age group, occupation and civil status. Three groups with distinct profiles were formed for accidents and aggression: young women who suffered aggression, with trauma to the face and soft tissues during the evening and at weekends; adult men who suffered car accidents, in the morning and on work days; and retired elderly widowers, who were run over.

Binge drinking, alcohol outlet density and associated factors: a multilevel analysis among adolescents in Belo Horizonte, Minas Gerais State, Brazil / Consumo excessivo episódico de álcool, densidade de locais de venda de bebidas alcoólicas e fatores associados: uma análise multinível entre adolescentes em Belo Horizonte, Minas Gerais, Brasil / Consumo de alcohol compulsivo, densidad de locales de venta de alcohol y factores asociados: un análisis multinivel entre adolescentes procedentes de Belo Horizonte, estado de Minas Gerais, Brasil

Our study sought to evaluate the prevalence of binge drinking in adolescents and its association with density of alcohol outlets around schools. This cross-sectional study was conducted in Belo Horizonte, Minas Gerais State, Brazil, with 436 high-school students aged between 17 and 19 and enrolled in 18 public and private schools. The students completed the Alcohol Use Disorder Identification Test (AUDIT-C), consisting of questions about alcohol consumption by parents and siblings, and socioeconomic status (type of school, mother's education level). Data from geographic information systems were used to estimate the density of alcohol outlets around schools participating. The association between exploratory variables and binge drinking was investigated using multilevel logistic regression analysis (p < 0.05) with random intercepts and fixed slopes. A three-step sequential modeling strategy was adopted. The prevalence of binge drinking was 39.9%. The alcohol consumption among adolescents was lower for those studying in areas with low density of alcohol outlets around schools (OR = 0.32; 95%CI: 0.14; 0.73) and the consumption of alcohol by mothers was associated with binge drinking among adolescents (OR = 1.94; 95%CI: 1.14; 3.30). Our study concluded that binge drinking among adolescents was associated with density of alcohol outlets around the schools and mother's alcohol consumption.

O estudo teve como objetivo avaliar a prevalência de consumo excessivo episódico de álcool entre adolescentes e a associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas. Um estudo transversal foi realizado em Belo Horizonte, Minas Gerais, Brasil, com 436 estudantes de segundo grau entre 17 e 19 anos de idade matriculados em 18 escolas públicas e privadas. Os estudantes responderam perguntas do Alcohol Use Disorder Identification Test (AUDIT-C) sobre consumo de álcool pelos pais e irmãos, além de características socioeconômicas (tipo de escola, escolaridade materna). Foram utilizados dados de sistemas de informações geográficas para calcular a densidade de locais de venda de bebidas alcoólicas em torno das escolas participantes. A associação entre variáveis independentes e consumo excessivo episódico de álcool foi investigada por análise de regressão logística multivariada (p < 0,05) com interceptos randômicos e inclinações fixas. Foi adotada uma estratégia de modelagem sequencial em três passos. A prevalência de consumo excessivo episódico de álcool foi de 39,9%. O consumo de álcool entre adolescentes foi mais baixo naqueles que estudavam em áreas com baixa densidade de locais de venda de bebidas alcoólicas em torno das escolas (OR = 0,32; IC95%: 0,14; 0,73), e o consumo de álcool pelas mães esteve associado ao consumo excessivo episódico de álcool pelos adolescentes (OR = 1,94; IC95%: 1,14; 3,30), Em conclusão, consumo excessivo episódico de álcool por adolescentes mostrou associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas e com o consumo materno de álcool.

El objetivo de este estudio fue evaluar la prevalencia del consumo compulsivo de alcohol por parte de adolescentes y su asociación con la densidad de establecimientos de venta de alcohol próximos a escuelas. Este estudio transversal se realizó en Belo Horizonte, Minas Gerais, Brasil, con 436 estudiantes de escuelas secundarias con edades comprendidas entre los 17-19 años, inscritos en 18 escuelas públicas y privadas. Los estudiantes completaron con Alcohol Use Disorder Identification Test (AUDIT-C) preguntas sobre el consumo de alcohol por parte de padres y hermanos, así como de su estatus socioeconómico (tipo de escuela, nivel de escolarización de la madre). Los datos del sistema de informaciones geográficas se usaron para calcular la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas participantes. La asociación entre las variables exploratorias y el consumo compulsivo de alcohol fue investigado usando un análisis de regresión logística multinivel (p < 0,05) con intersecciones aleatorias y curvas fijas. Se adoptó una estrategia de modelado secuencial en tres pasos. La prevalencia de consumo compulsivo de alcohol fue de 39,9%. El consumo de alcohol entre adolescentes fue más bajo entre quienes estudiaban en áreas con baja densidad de establecimientos de venta de alcohol alrededor de las escuelas (OR = 0,32; IC95%: 0,14; 0,73), además el consumo de alcohol en madres estuvo asociado con el consumo de alcohol en adolescentes (OR = 1,94; IC95%: 1,14; 3,30). La conclusión fue que el consumo compulsivo de alcohol en adolescentes estaba asociado con la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas y el consumo de alcohol por parte de la madre.

Oral Cancer: Socio-Spatial Analysis of a Brazilian Sample / Câncer Bucal: Análise Socioespacial de uma Amostra Brasileira / Cáncer Oral: Análisis Socioespacial de una Muestra Brasileña

Introduction:Socio-spatial measures are largely used in health research, but it is still unusual in oral cancer investigation. Objective: This study aims to describe the sociodemographic and clinical features of oral cancer and analyze the spatial distribution of the disease in relation to the neighborhood socioeconomic status including availability of health care centers.Method: Sociodemographic, clinical and histopathologic data were collected from patients treated from 2005 to 2015. Descriptive data analyses of all variables were performed. The spatial analysis was carried out through the program R. Geographic distribution of patients' home addresses was analyzed using Ripley's K function and Kernel maps. The socio-spatial vulnerability was defined by household income and home adequacy. Results: Of the 127 patients included, the majority were males (76.4%), Caucasian or Brown (82.7%), married (35.4%), with low educational level (71.6%) and mean age of 59.5 years. Cases were distributed in clusters characterized by lower median income and inadequate sanitary conditions. Primary health care centers were homogeneously distributed throughout the city. Conclusion: These oral cancer cases are concentrated in regions under relatively low socioeconomic conditions, and despite the homogeneous distribution of primary health care centers, it is not enough to promote access for patients and oral cancer remains being diagnosed late

Introdução: Medidas socioespaciais são amplamente utilizadas na pesquisa em saúde, mas ainda pouco exploradas em relação ao câncer de boca.Objetivo: Descrever as características sociodemográficas e clínicas do câncer de boca e analisar a distribuição espacial da doença em relação ao status socioeconômico do bairro, incluindo a disponibilidade de centros de saúde. Método: Foram coletados dados sociodemográficos, clínicos e histopatológicos dos pacientes atendidos no período de 2005 a 2015. Foram realizadas análises descritivas dos dados de todas as variáveis. A análise espacial foi realizada por meio do programa R. A distribuição geográfica dos endereços residenciais dos pacientes foi analisada usando a função K de Ripley e mapas de Kernel. A vulnerabilidade socioespacial foi definida pela renda familiar e adequação do domicílio. Resultados: Dos 127 pacientes incluídos, a maioria era do sexo masculino (76,4%), branca ou parda (82,7%), casada (35,4%), com baixa escolaridade (71,6%) e idade média de 59,5 anos. Os casos foram distribuídos em grupos caracterizados por menor renda mediana e condições sanitárias inadequadas. Conclusão: Os casos de câncer oral estão concentrados em regiões de baixa condição econômica. Embora os centros de atenção primária à saúde tenham sido homogeneamente distribuídos por toda a cidade, isso não é suficiente para promover o acesso dos pacientes e o câncer de boca continua sendo diagnosticado tardiamente.

Introducción: Las medidas socioespaciales son ampliamente utilizadas en las investigaciones relacionadas con la salud, sin embargo, existen pocos estudios en relación con el cáncer oral. Objetivo: Describir las características sociodemográficas y clínicas del cáncer oral y analizar la distribución espacial de la enfermedad en relación con el estado socioeconómico del vecindario, la disponibilidad de centros de salud. Método: Se recogieron datos sociodemográficos, clínicos e histopatológicos de pacientes tratados entre 2005 y 2015. Se realizaron análisis descriptivos de los datos para todas las variables. El análisis espacial se realizó utilizando el programa R. La distribución geográfica de las direcciones de los hogares de los pacientes se analizó utilizando la función K de Ripley y los mapas de Kernel. La vulnerabilidad socioespacial se definió por el ingreso familiar y la adecuación del hogar. Resultados: De los 127 pacientes incluidos, la mayoría eran hombres (76.4%), blancos o morenos (82.7%), casados (35.4%), con baja educación (71.6%) y edad promedio 59,5 años. Los casos se distribuyeron en grupos caracterizados por ingresos medios más bajos y condiciones sanitarias inadecuadas. Los centros de atención primaria de salud se distribuyeron de manera homogénea en toda la ciudad. Conclusión: Estos casos de cáncer están concentrados en regiones con condiciones socioeconómicas relativamente mas bajas. A pesar de la distribución de la atención primaria, esta no suficiente para promover el acceso de los pacientes a ella y su diagnóstico continúa siendo tardío.

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.

[Maxillofacial injuries as markers of urban violence: a comparative analysis between the genders]. / Traumatismos maxilofaciais como marcadores de violência urbana: uma análise comparativa entre gêneros.

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.

Associação do uso de drogas lícitas e ilícitas, sexo e condição socioeconômica entre adolescentes de 12 anos de idade / Association between use of licit and illicit drugs, sex, and socioeconomic status among 12-year-old adolescents

Resumo Introdução O uso de drogas entre adolescentes está aumentando, e o hábito vem se enraizando cada vez mais precocemente. Objetivo Investigar a associação do uso de drogas lícitas e ilícitas, sexo e condição socioeconômica entre adolescentes de 12 anos. Método Estudo transversal foi realizado em amostra representativa de adolescentes matriculados em escolas públicas e privadas da área urbana de Diamantina, Minas Gerais. Dados foram coletados por meio de questionários autoaplicados. O consumo de drogas foi investigado utilizando o instrumento ASSIST (Teste para Triagem do Envolvimento com Álcool, Cigarro e Outras Substâncias). Para investigar a condição socioeconômica, foram utilizados os indicadores: tipo de escola, renda familiar e escolaridade materna. As associações foram testadas pelos testes do Qui-quadrado de Pearson e Exato de Fisher (p < 0,05). Resultados A prevalência do consumo de álcool foi de 45,6% (260/588); uso de maconha, de 1,5% (9/588); de cocaína, 0,3% (2/588); e de inalantes, 1,7% (10/588). Sexo masculino esteve associado estatisticamente com consumo de maconha (p = 0,018) e de álcool (p = 0,012), mas não com uso de inalantes (p = 0,536). Na amostra estudada, não foi observada associação estatisticamente significativa entre o consumo de drogas ilícitas e os indicadores socioeconômicos. O consumo de álcool esteve associado ao uso de maconha p = 0,013 [OR:9,814 (1,220-78,984)]. Conclusão O consumo de álcool e o uso de maconha estiveram estatisticamente associados com o sexo masculino, mas não com os indicadores socioeconômicos.

Abstract Background Drug use among adolescents is on the rise, and the habit has been taking root at an increasingly early age. Objective Investigate the correlation between use of licit and illicit drugs, sex, and socioeconomic conditions among 12-year-old adolescents. Method Cross sectional study conducted with a representative sample of adolescents enrolled in public and private schools in the urban area of ​​ Diamantina, Minas Gerais state, Brazil. Data were collected through self-administered questionnaires. Consumption of drugs was investigated using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) instrument. School type, family income, and maternal education were used to investigate socioeconomic condition. Associations were tested using the Pearson's chi-square and Fisher's exact tests (p < 0.05). Results The following drug consumption prevalence values were found: alcohol, 45.6% (260/588); marijuana, 1.5% (9/588), cocaine, 0.3% (2/588); inhalants, 1.7% (10/588). The male gender was statistically associated with consumption of marijuana (p = 0.018) and alcohol (p = 0.012), but not with use of inhalants (p = 0.536). No statistically significant correlation was observed between consumption of licit and illicit drugs and the socioeconomic indicators adopted. Alcohol consumption was associated with use of marijuana (p = 0.013) [OR:9.814 (1.220 to 78.984)]. Conclusion Alcohol consumption and use of marijuana were statistically associated with the male gender, but not with socioeconomic indicators.

Padrão espacial e diferencial de renda dos domicílios de adolescentes e adultos jovens vítimas de traumatismo maxilofacial por agressão com arma de fogo / Spatial and differential income pattern of households of adolescents and young adults who are victims of maxillofacial injuries resulting from firearm aggression

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.

Abstract The study investigated the spatial pattern of cases of maxillofacial injury resulting from firearm aggression among teenagers and young adults and analyzed the comparison of income differentials in these areas based on the residence of the victims. This is a cross-sectional study with data from victims attended in three hospitals in Belo Horizonte, State of Minas Gerais, from January 2008 to December 2010. The addresses of the victims were georeferenced by geocoding. Randomness and point density trends were analyzed using Ripley's K function and Kernel maps. The spatial interaction between the homes of adolescents and young adults was verified through the K12 function. Records of 218 cases of assault with a male predominance (89.9%) and young adults (70.6%) were found. Household clusters were distributed on an aggregate basis in the urban space with a confidence level of 99% and similar spatial aggregation levels. The hotspots converged on 7 shantytowns or neighboring regions with higher income population revealing spread of events. Hotspots focused on slums with a history of crimes linked to drug trafficking. The incorporation of space in the dynamics of events showed that the economic condition in isolation did not limit victimization.

Consumo de drogas ilícitas como fator de risco para traumatismo dentário em adolescentes / Illicit drugs use as risk factor of dental trauma among adolescents

Resumo Traumatismo dentário e consumo de drogas ilícitas podem comprometer gravemente a saúde dos adolescentes e são considerados sérios problemas de saúde pública. Objetivo Investigar a associação do traumatismo dentário com o uso de drogas ilícitas e condição socioeconômica entre adolescentes de 12 anos de idade. Métodos Estudo transversal envolvendo 633 adolescentes de escolas públicas e privadas da cidade de Diamantina, no Estado de Minas Gerais. Os dados foram coletados por meio de exame clínico e questionários. Traumatismo dentário foi avaliado pela classificação de Andreasen, e consumo de drogas ilícitas, pelo instrumento ASSIST (Teste para Triagem do Envolvimento com Álcool, Cigarro e Outras Substâncias). As associações foram testadas pelo teste do qui-quadrado e teste Exato de Fisher (p<0,05). Resultados A presença do traumatismo dentário foi observada em 176 adolescentes (29,9%). A prevalência reportada do uso de maconha foi de 1,5% (9/588), de cocaína, 0,3% (2/588), e de inalantes, 1,7% (10/588). Traumatismo dentário foi mais prevalente entre adolescentes do sexo masculino (p=0,010) que tinham usado maconha (p=0,024) na vida. Conclusão A associação observada entre o uso de drogas ilícitas e o sexo masculino com o traumatismo dentário sugere a necessidade de adoção de políticas voltadas para o controle efetivo dessas condições, principalmente em idade precoce.

Abstract The dental trauma and consumption of illicit drugs can seriously jeopardize adolescents’ health and are considered serious public health problems. Objective To investigate the association between dental trauma and the use of illicit drugs and socioeconomic status among adolescents 12 years of age. Methods Cross-sectional study involving 633 adolescents enrolled in public and private schools of the city Diamantina-MG. Data were collected through self-administered questionnaires and clinical examination. The dental trauma was assessed by Andreasen classification and consumption of illicit drugs was investigated using the ASSIST instrument (Involvement Screening Test for with Alcohol, Cigarette and Other Substances). Associations were tested using the Chi-square test and Fisher's Exact test (p <0.05). Results The presence of dental trauma was observed in 176 adolescents (29.9%). The reported prevalence of marijuana use was 1.5% (9/588), 0.3% cocaine (2/588) and inhalants 1.7% (10/588). Dental trauma was more prevalent among adolescent males (p=0.010) who had used marijuana (p=0.024) in life. Conclusion The observed association between illicit drug use and male with dental trauma suggests the need to adopt policies for the effective control of these conditions especially at an early age.

Characterization of victims of aggression and transportation accidents treated at the Forensic Medicine and Dentistry Institute - Campina Grande, Paraíba, Brazil - 2010 / Caracterização de vítimas de agressão e de acidentes de transporte atendidas no Instituto de Medicina e Odontologia Forense - Campina Grande, Paraíba, Brasil - 2010

The objective of this cross-sectional census study was to characterize agression and land-based transport accidents in a city in the Northeast of Brazil. Data was analyzed from live victims who were treated at a forensic service (N = 2.379). In the descriptive analysis, the majority of events were represented by aggression (71.6%); which occurred on weekdays (65%), with 35.1% at night. Trauma occurred to the whole body (63.6%) and to soft tissue (74.2%). On the basis of multiple correspondence analysis, two dimensions were formed: the first dimension (internal reliability = 0.654) was formed by the cause of the event, the trauma and the age group and the second dimension (reliability = 0.514), by age group, occupation and civil status. Three groups with distinct profiles were formed for accidents and aggression: young women who suffered aggression, with trauma to the face and soft tissues during the evening and at weekends; adult men who suffered car accidents, in the morning and on work days; and retired elderly widowers, who were run over.

O objetivo deste estudo tranversal censitário foi caracterizar a agressão e os acidentes de transporte terrestre em uma cidade do nordeste do Brasil. Foram analisados os dados de vítimas vivas que foram atendidas em um serviço forense (N = 2.379). Na análise descritiva, a maioria dos eventos foi a agressão (71,6%); que ocorreu nos dias úteis (65%), sendo 35,1% no período noturno. Os traumas ocorreram no corpo todo (63,6%) e envolveram o tecido mole (74,2%). A partir da análise de correspondência múltipla formaram-se duas dimensões: a primeira dimensão (confiabilidade interna = 0,654) foi formada pela causa do evento, o trauma e a faixa etária e, a segunda dimensão (confiabilidade interna = 0,514), pela faixa etária, a ocupação e o estado civil. Formaram-se três grupos com perfis distintos para os acidentes e agressão. Mulheres jovens que sofreram agressões com traumas faciais, em tecidos moles, no período da tarde e durante os finais de semana. Homens, adultos que sofreram acidentes automobilísticos, pela manhã e em dias úteis, e idosos, viú vos, aposentados e que sofreram atropelamento. Há um elevado número de vítimas de agressão interpessoal, seguido por acidentes de moto e os tipos de acidentes estão associados a grupos populacionais.

Traumatismos maxilofaciais como marcadores de violencia urbana: uma analise comparativa entre generos / Maxillofacial injuries as markers of urban violence: a comparative analysis between the genders

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. .

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.

A formação de valores e a prática da atenção primária na saúde com estudantes de odontologia / La formación de valores y la práctica de atención primaria en salud con estudiantes de odontología / Training in values and the practice of primary health care with oral health students

As ações que o sistema público de saúde brasileiro, chamado Sistema Único de Saúde (SUS) propõe passam pela valorização da Atenção Primária na Saúde (APS). Para isso os recursos humanos envolvidos precisam estar preparados. O objetivo desse trabalho foi avaliar concepções de dimensões relacionadas à APS junto a alunos do 8º e 9º períodos de uma faculdade de odontologia de uma universidade pública no Brasil, com participação do universo dos alunos. Questionários individuais abordando as dimensões foram aplicados por um único pesquisador. As respostas foram analisadas pelo programa BioStat 4.0. Os pesquisados entendem “visão do processo saúde-doença“ de maneira ampliada e que “tecnologias apropriadas” são limitadas às chamadas tecnologias duras e leve-duras com muito pouca menção ao uso de tecnologias leves. Para “humanização do atendimento” definem que ética representa um compromisso com a dignidade da vida humana e solidariedade deve ser entendida de maneira politizada; vínculo é estabelecido além de competências técnicas profissionais e responsabilização reflete a priorização da pessoa. Por outro lado não compreendem que ética e solidariedade são tecnologias passíveis de estudo aprofundado sendo entendidas pelos alunos como “valores” que não podem ser sistematizados em conteúdos curriculares.

Las acciones que propone el sistema brasilero de salud pública, llamado Sistema Único de Salud (SUS), dependen de la valorización de de la Atención Primaria en Salud (APS). Por ello, los recursos humanos involucrados deben estar preparados. El objetivo de este trabajo fue evaluar conceptos de dimensiones relacionadas con APS entre estudiantes de octavo y noveno periodos de una facultad de odontología en una universidad pública de Brasil, con la particpación de un universo de alumnos. Para abordar las dimensiones, un solo investigador aplicó cuestionarios individuales. Las respuestas fueron analizadas con el programa BioStat 4.0. Los encuestados entienden “el proceso salud-enfermedad” de manera amplia y que las “tecnologías adecuadas” están limitadas a las llamadas tecnologías duras y medianamente duras, con muy poca mención del uso de tecnologías livianas. Respecto de la “humanización de la atención”, piensan que la ética representa un compromiso con la dignidad humana y que la solidaridad debe entenderse de manera política; además, establecen un vínculo entre experiencia técnica y responsabilidad, reflejada en la priorización de la persona. Por otro lado, no comprenden que es posible un estudio profundo de la ética y la solidaridad, entendiéndolas en cambio como “valores” que no pueden ser sistematizados en el contenido curricular.

The interventions that public health Brazilian system propose, denominated Unique Health System (UHS) depend on the value given to Primary Health Care (PHC). Therefore, human resources involved must be prepared. The aim of this study was to evaluate dimension concepts related to PHC by students of eight and nine periods of Dentistry Department of a Brazilian Public University, with the participation of a sample of students. In order to study the dimensions, one researcher applied individual questionnaires. The answers were analyzed with BioStat 4.0 program. Respondents understand broadly “the process health-disease” and that “adequate technologies” are limited to hard and medium technologies, with little mention to the use of soft technologies. With respect to “humanizing health care”, they belief that ethics represent a compromise with human dignity and that solidarity must be understood politically; furthermore, they establish a link between technical experience and responsibility, reflected in giving priority to the person. On the other hand, they do not understand that it is possible a deep study of ethics and solidarity, understanding them more as “values” which cannot be systematized in curricular content.

A violência urbana contra crianças e adolescentes em Belo Horizonte: uma história contada através dos traumas maxilofaciais / The urban violence against children and adolescents in Belo Horizonte: a story told through the maxillofacial traumas

Os traumas maxilofaciais decorrentes da violência contra crianças e adolescentes impactam suas vidas, física e psiquicamente, pelas deformidades que podem provocar e pela exposição da lesão na face das vítimas. O objetivo deste trabalho é identificar a prevalência dos traumas maxilofaciais em crianças e adolescentes decorrentes da violência urbana em Belo Horizonte- Brasil. O estudo foi conduzido no Hospital Municipal Odilon Behrens, único hospital municipal de referência nesse tipo de atendimento em Belo Horizonte. Coletaram-se os registros de vítimas atendidas de janeiro a dezembro de 2007. O principal evento de violência sofrido entre crianças e adolescentes foi agressão física, 44,2 por cento e 64,7 por cento, respectivamente. Entre as crianças, o tipo de trauma mais comum foi o trauma dentoalveolar (53,8 por cento), e entre os adolescentes, trauma de tecidos moles (47,5 por cento). O maior número de ocorrências se deu no período noturno: crianças (84,6 por cento) e adolescentes (74,8 por cento). O gênero mais vitimado foi o masculino, crianças (63,5 por cento) e adolescentes (68,3 por cento). Estratégias apropriadas para identificação do evento de violência e do agressor são necessários para que melhor sejam planejados mecanismos de proteção da criança e do adolescente, uma vez que a violência sofrida por crianças e adolescentes no Brasil, considerando a complexidade dessa fase da vida, assume um quadro sombrio, desconstruindo o desenvolvimento, a sociabilidade e comprometendo a visão das vítimas sobre si mesmas e sobre o mundo que as cercam.

The maxillofacial traumas resulting from violence against children and adolescents have physical and psychical impact on their lives, because of the deformities and the injuries on their faces. This study aims to identify the prevalence of maxillofacial traumas in children and adolescents caused by urban violence in Belo Horizonte, Brazil. The study was conducted at Hospital Municipal Odilon Behrens, the primary reference hospital in this type of care in Belo Horizonte. We collected records of victims attended between January and December 2007. Among children and adolescents, the most recurring violence event was physical aggression, 44,2 percent and 64.7 percent respectively. Among children, the most common type was the dental-alveolar trauma (53.8 percent), while among adolescents, soft tissues trauma (47.5 percent). The highest number of occurrences was at night, for both children (84.6 percent) and adolescents (74.8 percent). The most victimized gender was masculine, children (63.5 percent), and adolescents (68.3 percent). Appropriate strategies to indentify violent events, as well as the aggressor himself, are necessary for planning better protection mechanisms for children and adolescents, since the violence suffered by this group in Brazil, considering the complexity of this stage of life, takes a gloomy picture, deconstructing their development, sociability, and undermining the victims' perspective about themselves and the world around them.