Cross-sectional and longitudinal relationships between psychological violence and teacher burnout.

OBJECTIVE: This study aimed to identify cross-sectional and longitudinal relationships between psychological violence (PV) and burnout after two years of follow-up. METHODS: This is a longitudinal study involving 430 public school teachers from a city in southern Brazil. PV was defined as insults by students, humiliation or embarrassment by colleagues or superiors or threats by any member of the school. Burnout was measured using the emotional exhaustion (EE) and depersonalization (DP) subscales of the Maslach Burnout Inventory-Human Services Survey. Analyses were performed using structural equation models in R. RESULTS: Younger age (ß = - .167) and poor/fair relationship with students (ß = .275) had a direct effect on PV. Temporary employment (ß = - .111) and poor/fair perception of the number of students in the classroom (ß = .124) had a direct effect on EE. Cross-sectionally, PV showed a direct effect at both T0 and T1 on EE (T0: ß = .435; T1: ß = .334) and on DP (T0: ß = .332; T1: ß = .325). Longitudinally, PV at T0 did not have a significant direct effect on burnout at T1. However, indirect effects of PV on EE (ß = .459) and DP (ß = .428) at T1 were observed. CONCLUSIONS: The effect of PV on burnout occurs in a short period of time. However, the long-term effect should be considered because there is a cumulative burden of exposure to violence over time.

Prudent dietary pattern influences homocysteine level more than folate, vitamin B12, and docosahexaenoic acid: a structural equation model approach.

PURPOSE: A structural equation model (SEM) was used to test multiple and simultaneous relationships between socio-demographic factors, dietary patterns, biochemical levels of folate, vitamin B12, docosahexaenoic acid (DHA), and its effects on homocysteine (Hcy) level. METHODS: Socio-demographic and lifestyle characteristics, blood sample, anthropometric measurements, and a food-frequency questionnaire (FFQ) were obtained from 281 individuals of ISA-Capital study (Sao Paulo, Brazil). The dietary patterns (DP) were estimated using factor analysis with principal component's estimation based on the frequency of daily intake derived from the 38-item FFQ. The SEM considered a theoretical model where the DP were expected to be directly associated with Hcy level, and indirectly via biochemical levels of folate, vitamin B12, and DHA. The variables sex, age, ethnicity, and MTHFR C677T polymorphism were included in the model. RESULTS: The Prudent DP (- 0.12, p = 0.04) had a negative effect, while MTHFR C677T polymorphism (0.16, p = 0.01), age (0.22, p < 0.01), and being man (0.16, p = 0.01) had a positive effect on Hcy level. There were no indirect effects of any dietary patterns on Hcy level, neither via folate, vitamin B12, nor DHA. DHA was negatively associated with the Modern DP (- 0.12, p = 0.04) and positively associated with the Prudent DP (0.19, p < 0.01). CONCLUSIONS: The DP mainly composed of fruits and vegetables, natural juices, potato/cassava/cooked cornmeal, fish, and chicken, which was negatively associated with the Hcy level in this population. These findings support the role of a healthy dietary pattern in health outcomes, rather than promoting specific foods or nutrients, for policy-based health promotion strategies.

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.

Correction to: User satisfaction with public oral health services in the Brazilian unified health system.

Following publication of the original article [1], the authors have reported that there is an error in Table 2 - Distribution of users concerning satisfaction with oral health services: the categories 'No' and 'Yes' should swap places.

User satisfaction with public oral health services in the Brazilian Unified Health System.

BACKGROUND: User satisfaction represents a patient-centered measure that should be used to assess the quality of oral health services. This study investigated the differences in user satisfaction with public oral health services according to the sociodemographic user profile and the quality of oral health services in primary health care in Brazil. METHODS: Secondary data from a national program obtained through interviews with users were analyzed. Satisfaction was based on the Swan' model relating to perceptions regarding the service performance, assessment of overall satisfaction and the intention to avoid the service in the future. The exploratory variables were demographic characteristics of the users and the quality of the primary service from the user's viewpoint, considering the dimensions: access; receptivity of spontaneous demand; integral health care; bonding, accountability, and coordination of care. RESULTS: A total of 37,262 users participated, and 65.51% reported satisfaction with the oral health service, that was higher among those > 20 years old and beneficiaries of the Family Grant Program and lower among users with a higher level of schooling and those who reported being employed. Users who rated oral health service positively were more satisfied. CONCLUSIONS: Socioeconomically disadvantaged user was more satisfied with oral health services and the satisfaction increased with age. The improvement in the quality of oral health services in primary care can result in greater satisfaction.

What is the impact of interventions that prevent fetal mortality on the increase of preterm live births in the State of Sao Paulo, Brazil?

BACKGROUND: There is a global growing trend of preterm births and a decline trend of fetal deaths. Is there an impact of the decline of fetal mortality on the increase of preterm live births in State of Sao Paulo, Brazil? METHODS: The time trends were evaluated by gestational age through exponential regression analysis. Data analyzed included the fetal mortality ratio, proportion of preterm live births, fertility rate of women 35 years and over, prenatal care, mother's education, multiple births and cesarean section deliveries. A survival analysis was carried out for 2000 and 2010. RESULTS: Preterm births showed the highest annual increase (3.2%) in the less than 28 weeks of gestation group and fetal mortality ratio decreased (7.4%) in the same gestational age group. There was an increase of cesarean section births and it was higher in the < 28 weeks group (6.1%). There was a decreased annual trend of mothers with inadequate prenatal care (6.1%) and low education (8.8%) and an increased trend in multiple births and fertility rates of women of 35 years and over. The variables were highly correlated to which other over time. In 2000, 8.2% of all pregnancies resulted in preterm births (0.9% in fetal deaths and 7.3% in live births). In 2010, the preterm birth increased to 9.4% (0.8% were preterm fetal deaths and 8.6% preterm live births). CONCLUSIONS: The results suggest that 45.2% could be the maximum contribution of successful interventions to prevent a fetal death on the increase in preterm live births. This increasing trend is also related to changes of the women reproductive profile with the change of the women reproductive profile and access to prenatal care.

[Self-perceived health and clinical characteristics in young adult students from the Brazilian northeast]. / Autopercepção de saúde e características clínicas em adultos jovens escolares de um interior do nordeste brasileiro.

OBJECTIVE: To analyze the association between socioeconomic situation, clinical characteristics referred and the family history of cardiovascular disease, with the Self-perceived health of young adults education and their implications for clinical characteristics observed. METHOD: Analytical study conducted with 501 young adults who are students in countryside city in the Brazilian Northeast. We used binary logistic regression. RESULTS: The final model explained 83.3% of the self-perceived positive health, confirming the association of Self-perceived health with male, residence in the community, have excellent/very good lifestyle and does not have or do not know that there are cases of stroke in the family. CONCLUSION: Health perception was often optimistic, being important to identify devices to be worked closer to their perception of their actual health condition, increasing the effectiveness of health promotion activities undertaken by professionals.

Prevalence and risk of stillbirth according to biologic vulnerability phenotypes in the municipality of São Paulo, Brazil: A population-based cohort study.

OBJECTIVE: To estimate the prevalence and risk of stillbirths by biologic vulnerability phenotypes in a cohort of pregnant women in the municipality of São Paulo, Brazil, 2017-2019. METHODS: Retrospective population-based cohort study. Fetuses were assessed as small for gestational age (SGA), large for gestational age (LGA), adequate for gestational age (AGA), preterm (PT) as less than 37 weeks of gestation, non-PT (NPT) as 37 weeks of gestation or more, low birth weight (LBW) as less than 2500 g, and non-LBW (NLBW) as 2500 g or more. Relative risks (RR) with robust variance were estimated using Poisson regression. RESULTS: In all 442 782 pregnancies, including 2321 (0.5%) stillbirths, were included. About 85% (n = 1983) of stillbirths had at least one characteristic of vulnerability, compared with 21% (n = 92524) of live births. Fetuses with all three markers of vulnerability had the highest adjusted RR of stillbirth-SGA + LBW + PT (RR 155.00; 95% confidence interval [CI] 136.29-176.30) and LGA + LBW + PT (RR 262.04; 95% CI 206.10-333.16) when compared with AGA + NLBW + NPT. CONCLUSION: Our findings show that the simultaneous presence of prematurity, low birth weight, and abnormal intrauterine growth presented a higher risk of stillbirths. To accelerate progress towards reducing preventable stillbirths, one must identify the circumstances of greatest biologic vulnerability.

Experience of Discrimination and Oral Health Self-Perception: A Cross-Sectional Study among Brazilian Adults.

This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; poor + very poor). Reported experiences of discrimination included attributions based on the respondent's race/skin color, social class, income, occupation, illness, sexual orientation, religion, sex, and age. Covariates included sociodemographic data, oral health conditions, access to healthcare services, health habits, mental health, and participation in social and/or religious activities. Data were analyzed using ordinal logistic regression for non-proportional odds, considering sample weights and complex samples. Among 60,202 adults, 5.84% perceived their oral health as poor + very poor, with a significantly higher proportion among those experiencing discrimination (9.98%). Adults who experienced discrimination were 1.39 times more likely to report a "poor/very poor/fair" oral health self-perception compared to those who did not experience discrimination. Those who suffered discrimination were 1.28 times more likely to have a "very poor/poor" oral health self-perception than their counterparts who were not affected by discrimination. These findings underscore the importance of considering discrimination experiences as part of the social determinants influencing oral health.

Assessing the risks for stillbirth in São Paulo, Brazil: protocol for a multidisciplinary case-control study - FetRisks.

Stillbirth is a fundamental component of childhood mortality, but its causes are still insufficiently understood. This study aims to explore stillbirth risk factors by using a multidisciplinary approach to stimulate public policies and protocols to prevent stillbirth, improve maternal care and support bereaved families. METHODS AND ANALYSIS: In this case-control study with stillbirths and live births in 14 public hospitals in São Paulo, mothers are interviewed at hospitals after delivery, and hospital records and prenatal care registries are reviewed. Maternal and umbilical cord blood samples and placentas are collected to analyse angiogenesis and infection biomarkers, and the placenta's anatomopathological exam. Air pollutant exposure is estimated through the participant's residence and work addresses. Traditional and non-invasive autopsies by image-guided histopathology are conducted in a subset of stillbirths. Subsample mothers of cases are interviewed at home 2 months after delivery on how they were dealing with grief. Information contained in the official prenatal care registries of cases and controls is being compiled. Hospital managers are interviewed about the care offered to stillbirth mothers. Data analysis will identify the main risk factors for stillbirth, investigate their interrelations, and evaluate health services care and support for bereaved families. We hope this project will contribute to the understanding of stillbirth's risk factors and related health services in Brazil, providing new knowledge about this central public health problem, contributing to the improvement of public policies and prenatal and puerperal care, helping to prevent stillbirths and improve the healthcare and support for bereaved families. ETHICS AND DISSEMINATION: This study protocol was approved by the Ethics Committee of the Municipal Health Secretary (process no 16509319.0.3012.5551) and of the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (process no 16509319.0.0000.0068). Results will be communicated to the study participants, policy-makers and the scientific community.

Mortality of Bolivian immigrants in São Paulo, Brazil: analysis of avoidable causes. / Mortalidade de imigrantes bolivianos em São Paulo, Brasil: análise de causas evitáveis.

The objective was to analyze the mortality of Bolivian immigrants compared to the Brazilian population, living in the city of São Paulo, with an emphasis on the analysis of avoidable deaths. Descriptive study of deaths in the city of São Paulo, between 2007 and 2018, registered in the Mortality Information System. Deaths of people aged 5 to 74 years were analyzed, according to "Brazilian List of Causes of Preventable Deaths", according to groups and sex; Pearson's chi-square test was used to compare nationalities. The temporal trend of avoidable deaths was evaluated by Prais-Winsten regression. There were 1.123 Bolivians deaths and 883.116 among Brazilians, with a predominance of male deaths and the Bolivians died on average 13.6 years younger. The proportion of deaths from preventable causes was similar between Bolivians (71.0%) and Brazilians (72.8%) and the trend did not show significant proportional annual variation for both nationalities. There is a higher frequency, among Bolivians, of external causes (27.6%) and of causes reducible by actions to health promotion, prevention, control, and care for infectious diseases (20.8%) than to Brazilians. Conclusion: Bolivians died younger and showed no reduction in the proportion of potentially avoidable causes, which may indicate unequal access to health services.

Objetivou-se analisar a mortalidade dos imigrantes bolivianos residentes no município de São Paulo comparada à dos brasileiros, com ênfase na análise das mortes evitáveis. Estudo descritivo dos óbitos do município de São Paulo entre 2007 e 2018 registrados no Sistema de Informações sobre Mortalidade. Foram analisados os óbitos de pessoas de 5 a 74 anos, conforme a lista de causas de mortes evitáveis por intervenções do Sistema Único de Saúde, segundo grupos e sexo; o teste de qui-quadrado foi utilizado na comparação das nacionalidades. A tendência temporal foi avaliada pela regressão de Prais-Winsten. Houve 1.123 óbitos de bolivianos e 883.116 de brasileiros, com predomínio de óbitos masculinos, com idade média ao morrer menor (-13,6 anos) para bolivianos. A proporção de óbitos por causas evitáveis foi semelhante entre bolivianos (71,0%) e brasileiros (72,8%) e a tendência não apresentou variação anual proporcional significante para ambas as nacionalidades. Para bolivianos, houve maior frequência de causas externas (27,6%) e de causas reduzíveis por ações de promoção, prevenção, controle e atenção às doenças infecciosas (20,8%). Os bolivianos exibiram mortalidade mais jovem, sem redução na proporção de causas evitáveis, o que pode indicar acesso desigual aos serviços de saúde.

Risk factors for perinatal death in high-risk pregnant women at a tertiary hospital in Curitiba-PR, Brazil: a case-control study. / Fatores de risco para óbito perinatal em gestantes de alto risco de um hospital terciário de Curitiba-PR, Brasil: estudo caso-controle.

A case-control study was carried out to estimate risk factors for perinatal mortality in a referral hospital for high-risk pregnancies in Curitiba-PR. Sociodemographic, maternal, pregnancy and concept characteristics data were obtained from the hospital records of 316 cases and 316 controls from 2013 to 2017. A hierarchical multiple logistic regression analysis was performed, remaining in the final model variables with p < 0.05. The results show an increased risk of perinatal death in mothers with blood type B (OR = 2.82; 95%CI: 1.07-7.43), who did not undergo prenatal care (OR = 30.78; 95%CI: 4.23-224.29), fetuses with congenital malformations (OR = 63.90; 95%CI: 27.32-149.48), born under 28 (OR = 24.21; 95%CI: 1, 10-531.81) and between 28-31 weeks of gestation (OR = 6.03; 95%CI: 1.34-27.17) and birth weight below 1,000g (OR = 51.94; 95%CI: 4.31-626.46), between 1,000-1,499g (OR = 11.17; 95%CI: 2.29-54.41) and between 1,500-2,499g (OR = 2.75; 25-6.06). Concepts of pregnancies with premature outcome, low birth weight and the presence of congenital malformations are the main risk factors for perinatal death. On the other hand, adequate prenatal care is an important protective factor.

Estudo caso-controle com o objetivo de estimar os fatores de risco da mortalidade perinatal em um hospital de referência para gestações de alto risco em Curitiba-PR. Os dados de características sociodemográficas, maternas, da gestação e do concepto foram obtidos dos prontuários hospitalares de 316 casos e 316 controles do período de 2013 a 2017. Foi realizada análise de regressão logística múltipla hierarquizada, permanecendo no modelo final variáveis com p < 0,05. Os resultados mostram aumento do risco de óbito perinatal em mães com tipo sanguíneo B (OR = 2,82; IC95%: 1,07-7,43), que não realizaram pré-natal (OR = 30,78; IC95%: 4,23-224,29), conceptos com malformações congênitas (OR = 63,90; IC95%: 27,32-149,48), nascidos com menos de 28 (OR = 24,21; IC95%: 1,10-531,81) e entre 28-31 semanas de gestação (OR = 6,03; IC95%: 1,34-27,17) e peso ao nascer abaixo de 1.000g (OR = 51,94; IC95%: 4,31-626,46), entre 1.000-1.499g (OR = 11,17; IC95%: 2,29-54,41) e entre 1.500-2.499g (OR = 2,75; IC95%: 1,25-6,06). Conceptos de gestações com desfecho prematuro, baixo peso ao nascer e presença de malformações congênitas são os principais fatores de risco para o óbito perinatal. Em contrapartida, a assistência pré-natal adequada é importante fator de proteção.

Is parenthood associated with self-rated health among women in Brazil?

BACKGROUND: Previous studies conducted in Europe and North America addressing the relationship between self-rated health and parenthood offer inconsistent results, with effects ranging from nonsignificant to significant and in opposite directions. The aim of the present study was to explore the relationship between parenthood and self-rated health (SRH) among women in Brazil (a country with strong inequalities) considering the time interval from the last delivery in the analyses, as proposed in previous studies set in Sweden. METHODS: The study used data from cross-sectional National Health Surveys in Brazil conducted from 2013 to 2014 and 2019 to 2020 with selected groups of 20,046 and 25,100 women for whom complete data were available on the variables of interest. The primary outcome was self-rated health measured on a five-point scale. Partial proportional odds models were employed. RESULTS: Compared to women that were not a parent, primiparous women whose delivery was within less than one year had a lower likelihood of worse SRH (OR (95% CI): 0.58-0.84 in 2013, and 0.64-0.94 in 2019), whereas multiparous women whose last delivery was more than one year earlier had greater likelihood of worse SRH (OR (95% CI): 1.08-1.27 in 2013, and 1.21-1.39 in 2019). CONCLUSIONS: An association was found between parenthood and SRH among Brazilian women. Considering the epidemiological relevance of SRH, different aspects of parenthood concerning parity and time since the last delivery should be considered in further analyses.

Psychometric properties of an oral health literacy scale for people living with diabetes.

This study evaluated the construct validity of the instrument Oral Health Literacy among diabetics. A probabilistic random sample of 239 diabetics from an infinite population answered the 10 items of the questionnaire. The structural validity was assessed by confirmatory factor analysis and goodness of fit, chi-square per degrees of freedom ratio (X2/df), comparative fit index (CFI), goodness-of-fit index (GFI), and root-mean-square error of approximation (RMSEA). Internal consistency was estimated by the average variance extracted (AVE) and composite reliability (CR). The scores were dichotomized with the upper limit of the 95% confidence interval as the cutoff point. The three-dimensional model presented good quality parameters (X2 /df = 2.459; CFI = 0.988; TLI = 0.981) and poor RMSEA (0.078). Internal consistency was adequate; AVE for the Access, Understand/appraise, and Apply subscales were 0.831, 0.981, and 0.954 and the CR for these subscales were 0.893, 0.962, and 0.822, respectively. Inadequate literacy ranged from 41.8 to 48.1%. The three-dimensional model identified (access, understand/appraise, and apply) showed structural validity, good internal consistency, and understandability.

A comprehensive integrated dataset on Brazilian health facilities: from 2005 to 2021.

OBJECTIVES: The National Registry of Healthcare Facilities is a system with the registry of every healthcare facility in Brazil with information on the capacity building and healthcare workforce regarding its public or private nature. Despite being publicly available, it can only be accessed in separated disjoint tables, with different primary units of analysis. The objective is to offer an interoperable dataset containing monthly data from 2005 to 2021 with information on healthcare facilities, including their physical and human resources, services and teams, enriched with municipal information. DATA DESCRIPTION: Database with historical data and geographic information for each health facility in Brazil. It is composed by 5 distinct tables, organized according to combinations of time, space, and types of resources, services and teams. This database opens up a range of possibilities for research topics, from case studies in a single health facility and period, analysis of a group of health facilities with characteristics of interest, to a broader study using the entire dataset and aggregated data by municipality. Furthermore, the fact that there is a row for each health facility/month/year facilitates the integration with other datasets from the Brazilian healthcare system. In addition to being a potential object of study in the health area, the dataset is also convenient in data science, especially for studies focused on time series.

Dataset on infant mortality rates in Brazil.

OBJECTIVES: Surveillance of infant and fetal deaths is of paramount importance in thinking about government strategies to reduce these rates, provide greater visibility of these mortality figures in the country, enable the adoption of prevention measures, as well as contribute to a better record of deaths. DATA DESCRIPTION: The dataset comprises fetal, neonatal, early neonatal, late neonatal, and perinatal Mortality Rates of Brazilian municipalities with their respective information, between 2010 to 2020, aggregated by epidemiological week.

Live births of immigrant mothers in Brazil: A population-based study.

Introduction: Migration has become a major challenge for many countries, and women constitute half of the migrants in the world. Few studies have been conducted on migrant mothers in Brazil. We aim to identify differences in the pregnancies, childbirths, and live birth (LB) indicators of immigrant women, compared with those of Brazilian women living in the municipality of São Paulo (MSP), Brazil. Methods: The LB characteristics of immigrant mothers from Bolivia (15,886), China (3861), Paraguay (1370), and Peru (1039) were compared with those of Brazilian mothers (967,921) living in the MSP between 2012 and 2017. Pearson's chi-square test was used to compare proportions with a significance level of 5%. Results: Teenage pregnancy and low education were more frequent among Bolivian (13.1 and 31.7%, respectively) and Paraguayan mothers (13.1 and 36.2%). Bolivian women exhibited a high percentage of late-onset prenatal care (8.7%), few prenatal visits (14.3%), vaginal birth (77.0%), home delivery (1.6%), and postterm (3.6%). Bolivian (13.6%), Peruvian (10.6%), and Paraguayan (7.9%) women exhibited a higher prevalence of macrosomia than Chinese (4.3%) and Brazilian (4.0%) women. There was a high prevalence of preterm and low birth weights among Paraguayan (12.5 and 7.7%, respectively) and Brazilian mothers (11.0 and 9.7%) and a high rate of cesarean sections among Chinese (42.1%) and Brazilian (53.5%). Conclusion: Differences were observed in the sociodemographic profiles for the pregnancies, childbirths, and LBs of immigrant mothers, in view of their increase and diversity in the MSP. There was greater vulnerability among immigrant mothers, compared with Brazilian mothers, particularly regarding access to prenatal care.

Use of oral health services among elderly Brazilians: mediation by tooth loss. / Uso de serviços de saúde bucal entre idosos brasileiros: mediação pela perda dentária.

The present study analyzed factors associated with the use of oral health services among elderly Brazilians. This was a cross-sectional study with data from the latest National Oral Health Survey (SB Brazil 2010), which considered a sample of 7,619 elderly individuals (65-74 years) for analysis. Structural Equation Modeling (SEM) was used, investigating the association between latent or observed variables, directly or mediated, in relation to the use of oral health services. Least squares estimators adjusted by mean and variance, were used by means of standardized coefficients, and standard error and confidence intervals, by applying the bootstrapping method with 1,500 iterations. Elderly individuals with a higher socioeconomic status, fewer missing teeth, and the presence of impacts of oral health conditions on their lives were directly associated with the outcome. Other factors associated with the mediated use of oral health services among elderly Brazilians included socioeconomic status, gender, age, and the use of prostheses, in addition to finding a correlation between prosthesis use and missing teeth. Tooth loss, along with other factors, played a prominent role in this study regarding the use of oral health services among elderly Brazilians, pointing to the need to expand access to dental prostheses in primary care.

Analisaram-se fatores associados ao uso de serviços de saúde bucal (USSB) entre idosos brasileiros. Estudo transversal, que considerou a amostra de 7.619 idosos (65-74 anos) do SB Brasil 2010. Utilizou-se modelagem com equações estruturais (MEE), investigando associação entre variáveis latentes ou observadas, de forma direta ou mediada, em relação ao USSB. Utilizaram-se estimadores de mínimos quadrados ajustados pela média e variância, por meio de coeficientes padronizados, erro padrão e intervalos de confiança, com o método bootstrapping com 1.500 iterações. Idosos com melhor condição socioeconômica, menor número de dentes perdidos e presença de impactos das condições de saúde bucal em sua vida foram associados de forma direta ao desfecho. Ainda estiveram associados ao USSB de forma mediada, a condição socioeconômica, sexo e idade; bem como o uso de próteses; além de se encontrar correlação entre uso de próteses e dentes perdidos. A perda dentária exerceu papel de destaque, apontando para a necessidade de ampliação do acesso às próteses dentárias na atenção básica.

COVID-19 Morbidity Among Oral Health Professionals in Brazil.

BACKGROUND: We evaluated and compared the cumulative incidence of confirmed COVID-19 cases between oral health professionals and the general population in Brazil. METHODS: Secondary data from notification of laboratory unconfirmed and confirmed cases of COVID-19 in the National data system for 41 epidemiological weeks were analysed and compared between oral health professionals (dentist + oral health technicians/assistants) and the general population. The cumulative incidences of COVID-19 were obtained by the ratio of the total number of confirmed cases to the total Brazilian population or the population of oral health professionals registered with the Federal Council of Dentistry and adjusted by age. The incidences were then compared. RESULTS: The age-standardised cumulative incidences were 18.70/1000 for oral health professionals and 17.71/1000 for the population, with a ratio of 1.05. The highest incidences were observed in the states of Roraima (67.05/1000), Tocantins (58.81/1000), and Amazonas (58.24/1000). In 14 states, the age-standardised cumulative incidences were higher among oral health professionals than in the general population. There was a decrease in the number of new cases between the 29th and 30th epidemiological weeks in both populations. CONCLUSIONS: COVID-19 infections among oral health professionals was similar to that of the general population. However, the cumulative incidence was 5% higher among oral health professionals, varying among Brazilian states. PRACTICAL IMPLICATIONS: Infection control practices might help lower the risk of contamination in dental settings.

[Time trend in hospitalizations from motor vehicle accidents in the city of São Paulo, Brazil, 2000-2019]. / Tendência temporal das internações por acidentes de trânsito na cidade de São Paulo, Brasil, 2000-2019.

This study assessed the hospitalization rates from motor vehicle accidents in the Brazilian Unified National Health System (SUS) in residents of the city of São Paulo, Brazil, from 2000 to 2019, according to sex, age bracket, and means of transportation (pedestrians, cyclists, motorcyclists, and motor vehicle occupants). A segmented regression model with negative binomial response was adjusted with inflection points to accommodate possible changes in trends. 189,765 hospitalizations were recorded during the study period, mostly males (80.5%) and from 20 to 49 years of age (71.2%). The most frequent type of accident involved motorcyclists (42.8%), followed by run-over pedestrians (33.7%). In general, the period from 2000 to 2007 was marked by increasing hospitalization rates from motor vehicle accidents involving all means of transportation, in both sexes, and in most age brackets. The year when the rates stopped increasing (or in some cases began to drop) differed according to the means of transportation. For vehicle occupants and cyclists, the trend in most age brackets turned downward in 2008, but the same did not happen with pedestrians and motorcyclists until 2012. Starting in 2015, the decline stopped in pedestrians, and the rates in cyclists turned upward again in most age brackets. For motorcyclists, the rates turned upward again in men 20 to 59 years of age (7.2% per year, exceeding 140 per 100,000 inhabitants in 2019) and in women 15 to 39 years of age (4.9% per year). The benefits of traffic safety measures implemented thus far in Brazil may have reached their limit, so that the current control and prevention measures need to be revised.

Este estudo avaliou a tendência das taxas de internação por acidentes de trânsito no Sistema Único de Saúde (SUS), de residentes no Município de São Paulo, Brasil, entre 2000 e 2019, segundo sexo, faixa etária e meio de transporte (pedestres, ciclistas, motociclistas e ocupantes de veículo). Foi ajustado um modelo de regressão segmentada com resposta binomial negativa, com pontos de inflexão para acomodar possíveis mudanças de tendência. Foram registradas 189.765 internações durante o período de estudo, a maioria de homens (80,5%) com idade entre 20 e 49 anos (71,2%). O tipo de acidente mais frequente foi com motocicleta (42,8%), seguido dos atropelamentos de pedestres (33,7%). De um modo geral, o período de 2000 a 2007 foi marcado pelo crescimento das taxas de hospitalização por acidentes de trânsito para todos os meios de transporte, em ambos os sexos e na maioria das faixas etárias. O momento em que as taxas pararam de crescer ou que eventualmente passaram a cair foi diferente para os diferentes meios de transporte. Para ocupantes de veículos e ciclistas, a tendência na maioria das faixas etárias inverteu-se para uma de queda em 2008, mas para pedestres e motociclistas, isto só ocorreu em 2012. A partir de 2015, a queda cessou em pedestres e as taxas em ciclistas voltaram a subir, na maioria das faixas etárias. Para motociclistas, as taxas voltaram a crescer em homens de 20 a 59 anos (7,2% ao ano, atingindo valores superiores a 140 por 100 mil habitantes em 2019) e em mulheres, de 15 a 39 anos (4,9% ao ano). É possível que os benefícios das medidas de segurança implementadas até agora tenham atingido seu limite, de modo que as atuais medidas de controle e prevenção devem ser revistas.

Este estudio evaluó la tendencia de las tasas de internamiento por accidentes de tránsito en el Sistema Único de Salud, de residentes en el Municipio de São Paulo, Brasil, entre 2000 y 2019, según sexo, franja de edad y medio de transporte (peatones, ciclistas, motociclistas y ocupantes de vehículo). Fue ajustado a un modelo de regresión segmentada con respuesta binomial negativa, con puntos de inflexión para acomodar posibles cambios de tendencia. Se registraron 189.765 internamientos durante el período de estudio, la mayoría de hombres (80,5%) con edad entre 20 y 49 años (71,2%). El tipo de accidente más frecuente fue con motocicleta (42,8%), seguido de atropellamientos de peatones (33,7%). De modo general, el período de 2000 a 2007 estuvo marcado por el crecimiento de las tasas de hospitalización por accidentes de tránsito para todos los medios de transporte, en ambos sexos, y en la mayoría de las franjas de edad. El momento en el que las tasas pararon de crecer, o que eventualmente pasaron a caer, fue diferente para los diferentes medios de transporte. En el caso de ocupantes de vehículos y ciclistas, la tendencia en la mayoría de las franjas de edad se invirtió hacia una caída en 2008, pero en peatones y motociclistas, esto solo ocurrió en 2012. A partir de 2015, la caída cesó en peatones y las tasas en ciclistas volvieron a subir, en la mayoría de las franjas de edad. Para los motociclistas, las tasas volvieron a crecer en hombres de 20 a 59 años (7,2% al año, alcanzando valores superiores a 140 por 100 mil habitantes en 2019) y en mujeres, de 15 a 39 años (4,9% al año). Es posible que los beneficios de las medidas de seguridad implementadas hasta ahora hayan alcanzado su límite, de modo que las actuales medidas de control y prevención deben ser revisadas.