Factors associated with the proportion of abnormal results in screening mammograms: ecological study.

OBJECTIVE: To analyze the factors associated with the proportion of abnormal results in screening mammograms. METHODS: Ecological study, with data from DATASUS/SISCAN, Atlas Brasil do Desenvolvimento Humano, Fundação SEADE, and Sistema e-Gestor, from 2016 to 2019, of women aged 50 to 69 years in the 645 municipalities of São Paulo (Brazil). Independent variables were associated with the outcome: proportion of unsatisfactory coverage of abnormal test results (Breast Imaging Reporting and Data System - BI-RADS® 0, 4 and 5 proportion >10% of tests performed). Multiple Poisson regression was used. RESULTS: Higher proportion of screening mammography (PR=1.20; 95%CI: 1.00;1.45), higher percentage of poor (PR=1.20; 95%CI: 1.07;1.36), low (PR=1.57; 95%CI: 1.38;1.78) and medium coverage of the Family Health Strategy (ESF) (PR=1.30; 95%CI: 1.09;1.52) were associated to the outcome. CONCLUSION: Socioeconomic and FHS coverage factors mediate the proportion of mammograms with abnormal results in public health services. Therefore, they are important aspects in the fight against breast cancer.

[Malocclusion in adolescents in the State of São Paulo: spatial and hierarchical analysis]. / Má oclusão em adolescentes do estado de São Paulo: análise espacial e hierárquica.

The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.

O objetivo foi analisar a distribuição espacial da má oclusão (MO) em adolescentes, estimar a prevalência e avaliar os fatores associados. Estudo com dados de 5.558 adolescentes entre 15 e 19 anos de idade do inquérito - SB São Paulo 2015. O desfecho foi a MO. As variáveis independentes foram os aspectos sociodemográficos, acesso aos serviços odontológicos, cárie e perdas dentárias. Foram incluídos 162 municípios do estado de São Paulo e aplicadas técnicas de estatística espacial. Foram realizados modelos de regressão logística hierarquizada. A prevalência de MO foi de 29,3%. Houve um padrão de espalhamento entre os tipos de MO e correlação espacial positiva (p<0,05). Adolescentes não brancos (OR=1,32, IC95%: 1,24-1,42), com menor tempo de estudo (OR=1,30, IC95%: 1,22-1,42) e com dentes extraídos por cárie (OR=1,40, IC95%: 1,03-1,88) tiveram mais chances de apresentarem MO. O acesso dos adolescentes à consulta odontológica não contribuiu para reduzir a chance de apresentar a MO, independentemente de a consulta ao dentista ter ocorrido há menos (OR=2,02, IC95%: 1,65-2,47) ou há mais de um ano (OR=1,63, IC95%: 1,31-2,03). Assim, a ocorrência de MO é desigualmente distribuída no estado de São Paulo, e associada a condições sociodemográficas de acesso à consulta e perda dentária por cárie.

Prevalence and associated factors of mental health disorders among Brazilian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study.

The COVID-19 pandemic in Brazil affected mental health among healthcare workers. To objective of this study was to evaluate the mental health of healthcare workers in in the central-west region of the Brazil, estimating the prevalence of mental health disorders, and investigating associated factors, perceptions of safety, and self-perceptions about mental health in times of the COVID-19 pandemic. The questionnaire was divided into two parts that included general information and perceptions about the work process and identified symptoms using the Depression Anxiety Stress Scale-21 (DASS-21), and multiple linear regression analysis was conducted. A total of 1,522 healthcare workers participated in the survey. Overall prevalence of symptoms was calculated for depression (58.7%), anxiety (59.7%), and stress (61.7%). Physicians had 3.75 times greater risk of depression (1.59-8.85, 95% CI). Independent variables associated with depression symptoms were not feeling safe with the way services were organized (1.12:1.03-1.21, 95% CI) and self-perception of poor mental health (8.06: 4.03-16.10% CI). Working in management was protective, and married professionals had 12% lower risk of exhibiting symptoms of depression (0.79-0.99, 95% CI). Participants with self-perception of poor mental health had 4.63 greater risk for symptoms of anxiety (2.58-8.31, 95% CI). Protective factors were not having sought support for mental health (0.90: 0.82-0.99, 95% CI), having a graduate degree (0.71: 0.54-0.94, 95% CI), and not having been diagnosed with COVID-19 (0.90: 0.83-0.98, 95% CI). Perception of poor mental health was associated with 6.95-fold greater chance of developing stress symptoms. Protective factors from stress were having a degree in dentistry (0.81: 0.68-0.97, 95% CI), residing in Mato Grosso do Sul (0.91: 0.85-0.98, 95% CI), and not having sought mental health support services (0.88: 0.82-0.95, 95% CI). The prevalence of mental health disorders is high among healthcare workers, and is associated with professional category, organization of services provided, and self-perception of poor mental health, reinforcing the need for preventative measures.

Association between social conditions and oral health in school failure.

OBJECTIVE: To evaluate the association of school failure among Brazilian adolescents with social conditions and aspects of oral health through hierarchical analysis. METHODS: A state-wide survey of 5,558 adolescents from the state of São Paulo, Brazil, inquired about the sociodemographic and social capital of participants by using a structured questionnaire. Trained and calibrated professionals performed intraoral examinations and interviews in the households. Questions about the access to dentist, reason for and frequency of using dental services, toothache episodes and impact of oral conditions on daily activities (OIDP) were applied. Oral examinations evaluated caries experience, tooth losses, periodontal problems, presence of open bite, and maxillary and mandibular overjet. School failure was estimated according to the teenagers' years of schooling. The independent variables were grouped into three blocks: sociodemographic and economic characteristics, social capital and oral health aspects. The multiple hierarchical logistic regression model was used to identify the factors associated with school failure. RESULTS: Of the total sample, information about schooling of 5,162 adolescents was obtained, of whom 29.6% presented school failure. We found that adolescents over the age of 16 years who did not declare themselves as white, female, with feelings of insecurity, unhappiness, with toothache, caries, tooth losses, affected by dentofacial and/or periodontal changes, were more likely to fail at school. CONCLUSION: Oral disorders and social factors were associated with school failure in adolescents. A successful school trajectory was a strong determinant of health, therefore actions between the educational and health sectors must be developed for adolescents, especially those with this profile.

Quality of life, cohesion and adaptability in beneficiary families of the "Bolsa Família" Program. / Qualidade de vida, coesão e adaptabilidade em famílias beneficiárias do Programa Bolsa Família.

We evaluated the association between quality of life, family cohesion and sociodemographic factors of beneficiary families of the BolsaFamília Program (PBF). This was an analytical, cross-sectional study with exploratory methodology. The sample was composed of 385 respondents. The dependent variable was the quality of life (WHOQOL-BREF), and the independent variables were sociodemographic characteristics, self-rated health, family cohesion and adaptability (FACES III). The best quality of life was associated with an age younger than or equal to 36 years (OR = 2.15), higher educational level (OR = 1.54), good/very good health (OR = 6.39), not having current health problem (OR = 5.68), no treatment (OR = 1.76), moderate (OR = 3.39) and high (OR = 3.66) family cohesion and moderate adaptability (OR = 2.23). Individuals from families with moderate and high family cohesion were more likely to have a better quality of life than those from families with low cohesion. The male volunteers were 3.54 times more likely to have a better quality of life. It was concluded that moderate and high levels of cohesion may impact positively to the quality of life of persons receiving the PBF, indicating that social programs should seek to strengthen these dynamics.

Avaliou-se a associação entre qualidade de vida, coesão familiar e fatores sociodemográficos de famílias beneficiárias do Programa Bolsa Família (PBF). Estudo transversal, analítico e de caráter exploratório com amostra representativa de 385 entrevistados. A variável dependente foi a qualidade de vida (WHOQOL-BREF), e as variáveis independentes quantificadas em características sociodemográficas, autopercepção sobre saúde, coesão e adaptabilidade familiar (FACES III). A melhor qualidade de vida associou-se com idade menor ou igual a 36 anos (OR = 2,15), maior nível educacional (OR = 1,54), boa/muito boa saúde (OR = 6,39), não ter problema de saúde atual (OR = 5,68), sem tratamento (OR = 1,76), moderada (OR = 3,39) e alta (OR = 3,66) coesão familiar e moderada adaptabilidade (OR = 2,23). Indivíduos provenientes de famílias com moderada e alta coesão familiar tiveram mais chance de ter uma melhor qualidade de vida do que aqueles vindos de famílias com baixa coesão. Os voluntários do sexo masculino tiveram 3,54 vezes mais chance de apresentar uma melhor qualidade de vida. Concluiu-se que níveis moderados e altos de coesão podem impactar positivamente uma melhor qualidade de vida das pessoas beneficiárias do PBF, indicando que as ações sociais devem buscar o fortalecimento dessa dinâmica.

Malocclusion and dental appearance in underprivileged Brazilian adolescents.

Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components.

Sense of coherence and factors associated with school performance of adolescents. / Senso de coerência e fatores associados ao desempenho escolar de adolescentes.

School performance is a key aspect for future professional and social success. The objective of the present study was to investigate factors associated with adolescents' school performance including sense of coherence (SOC) and oral health status. Three hundred eighty one schoolchildren between 15 and 18 years of age from the city of Campo Grande, Mato Grosso do Sul, Brazil, participated in the study. The outcome variable was school performance, assessed through the final grades of the Portuguese and Mathematics disciplines in 2013. Independent variables were sociodemographic data, self-perception of oral health, use of dental services and sense of coherence, obtained through a self-applied questionnaire. In addition, in a clinical assessment, the number of decayed, missing and filled teeth (DMFT index) was evaluated. Logistic regression analyses were performed, based on a hierarchical model. The mean age of students was 16 years; mean DMFT value 4.1, and SOC 44.5. In the final adjustment, the male subjects (p = 0.0021); those with the largest number of people residing at home (p = 0.0021) and weak SOC (p = 0.0005) showed an association with poorer school performance. In conclusion, school performance is a complex phenomenon associated with SOC and oral characteristics.

O desempenho escolar é um aspecto fundamental para o futuro sucesso profissional e social. O objetivo do presente estudo foi investigar os fatores associados ao desempenho escolar dos adolescentes, incluindo o Senso de Coerência (SOC) e o estado de saúde bucal. Foram incluídos, no estudo, 381 escolares entre 15 e 18 anos de idade da cidade de Campo Grande, Mato Grosso do Sul, Brasil. O desfecho foi o desempenho escolar avaliado por meio das notas finais das disciplinas de Português e Matemática em 2013. As variáveis independentes foram dados sociodemográficos, autopercepção de saúde bucal, uso de serviços odontológicos e Senso de Coerência, obtidos por um questionário autoaplicado. Além disso, avaliou-se o número de dentes cariados, perdidos e obturados (índice de CPO-D). Análises de regressão logística foram realizadas, com base em um modelo hierárquico. A idade média dos alunos foi de 16 anos; valor médio do CPO-D 4,1 e SOC 44,5. No ajuste final, os indivíduos do sexo masculino (p = 0,0021); aqueles com o maior número de pessoas que moravam em casa (p = 0,0021) e o SOC fraco (p = 0,0005) mostraram associação com o menor desempenho escolar. Em conclusão, o desempenho escolar é um fenômeno complexo, associado ao SOC e às características bucais.

Má oclusão em adolescentes do estado de São Paulo: análise espacial e hierárquica / Malocclusion in adolescents in the State of São Paulo: spatial and hierarchical analysis

Resumo O objetivo foi analisar a distribuição espacial da má oclusão (MO) em adolescentes, estimar a prevalência e avaliar os fatores associados. Estudo com dados de 5.558 adolescentes entre 15 e 19 anos de idade do inquérito - SB São Paulo 2015. O desfecho foi a MO. As variáveis independentes foram os aspectos sociodemográficos, acesso aos serviços odontológicos, cárie e perdas dentárias. Foram incluídos 162 municípios do estado de São Paulo e aplicadas técnicas de estatística espacial. Foram realizados modelos de regressão logística hierarquizada. A prevalência de MO foi de 29,3%. Houve um padrão de espalhamento entre os tipos de MO e correlação espacial positiva (p<0,05). Adolescentes não brancos (OR=1,32, IC95%: 1,24-1,42), com menor tempo de estudo (OR=1,30, IC95%: 1,22-1,42) e com dentes extraídos por cárie (OR=1,40, IC95%: 1,03-1,88) tiveram mais chances de apresentarem MO. O acesso dos adolescentes à consulta odontológica não contribuiu para reduzir a chance de apresentar a MO, independentemente de a consulta ao dentista ter ocorrido há menos (OR=2,02, IC95%: 1,65-2,47) ou há mais de um ano (OR=1,63, IC95%: 1,31-2,03). Assim, a ocorrência de MO é desigualmente distribuída no estado de São Paulo, e associada a condições sociodemográficas de acesso à consulta e perda dentária por cárie.

Abstract The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.

Factors associated with the proportion of abnormal results in screening mammograms: ecological study / Factores asociados a la proporción de resultados alterados en mamografías de tamizaje: estudio ecológico / Fatores associados a proporção de resultados alterados nas mamografias de rastreamento: estudo ecológico

ABSTRACT Objective: To analyze the factors associated with the proportion of abnormal results in screening mammograms. Methods: Ecological study, with data from DATASUS/SISCAN, Atlas Brasil do Desenvolvimento Humano, Fundação SEADE, and Sistema e-Gestor, from 2016 to 2019, of women aged 50 to 69 years in the 645 municipalities of São Paulo (Brazil). Independent variables were associated with the outcome: proportion of unsatisfactory coverage of abnormal test results (Breast Imaging Reporting and Data System - BI-RADS® 0, 4 and 5 proportion >10% of tests performed). Multiple Poisson regression was used. Results: Higher proportion of screening mammography (PR=1.20; 95%CI: 1.00;1.45), higher percentage of poor (PR=1.20; 95%CI: 1.07;1.36), low (PR=1.57; 95%CI: 1.38;1.78) and medium coverage of the Family Health Strategy (ESF) (PR=1.30; 95%CI: 1.09;1.52) were associated to the outcome. Conclusion: Socioeconomic and FHS coverage factors mediate the proportion of mammograms with abnormal results in public health services. Therefore, they are important aspects in the fight against breast cancer.

RESUMEN Objetivo: Analizar los factores asociados a la proporción de resultados alterados en las mamografías de tamizaje. Métodos: Estudio ecológico, con datos de DATASUS/SISCAN, Atlas Brasil do Desenvolvimento Humano, Fundação SEADE y Sistema e-Gestor, de 2016 a 2019, de mujeres de 50 a 69 años en los 645 municipios de São Paulo (Brasil). Las variables independientes se asociaron con el resultado: proporción de cobertura insatisfactoria de resultados de pruebas alteradas (BreastImagingReporting and Data System - BI-RADS® 0, 4 y 5 proporción >10% de pruebas realizadas). Se utilizó la regresión de Poisson múltiple. Resultados: Mayor proporción de mamografía de tamizaje (RP=1,20; IC95%: 1,00;1,45), mayor porcentaje de mala (RP=1,20; IC95%: 1,07;1,36), baja (RP=1,57; IC95%: 1,38) ;1,78) y cobertura media de la Estrategia Salud de la Familia (ESF) (RP=1,30; IC95%: 1,09;1,52) se asociaron al desenlace. Conclusión: Factores socioeconómicos y de cobertura de la ESF median la proporción de mamografías alteradas en el servicio público. Por lo tanto, son aspectos importantes en la lucha contra CM.

RESUMO Objetivo: Analisar os fatores associados aproporção de resultados alterados nas mamografias de rastreamento. Métodos: Estudo ecológico, com dados do DATASUS/SISCAN, Atlas Brasil do Desenvolvimento Humano, Fundação SEADE, e Sistema e-Gestor, de 2016 a 2019, de mulheres de 50 a 69 anos dos 645 municípios de São Paulo (Brasil).Variáveis independentes foram associadas ao desfecho: proporção de cobertura insatisfatória de resultados de exames alterados (proporção Breast Imaging Reporting and Data System - BI-RADS® 0, 4 e 5 >10% dos exames realizados). Utilizou-se regressão múltipla de Poisson. Resultados: Maior proporção de mamografia de rastreamento (RP=1,20; IC95%: 1,00;1,45), maior porcentagem de pobres (RP=1,20; IC95%: 1,07;1,36), baixa (RP= 1,57; IC95%: 1,38;1,78) e média cobertura de Estratégia Saúde da Família (ESF) (RP=1,30; IC95%: 1,09;1,52) foram associados ao desfecho. Conclusão: Fatores socioeconômicos e de cobertura da ESF medeiam a proporção de mamografias alteradas no serviço público. Portanto, são aspectos importantes no combate ao câncer de mama.

Perfil dos trabalhadores da Atenção Primária à Saúde e proteção de riscos ocupacionais na pandemia da Covid-19 no Brasil / Profile of Primary Health Care workers and occupational risk protection in the Covid-19 pandemic in Brazil / Perfil de los trabajadores de la Atención Primaria de Salud y protección de riesgos laborales en la pandemia de Covid-19 en Brasil

Resumo Este artigo teve como objetivo caracterizar o perfil dos trabalhadores da Atenção Primária à Saúde e analisar as medidas de proteção de riscos ocupacionais em dois estados brasileiros durante a pandemia da Covid-19. Trata-se de estudo quantitativo do tipo survey, com amostra aleatória de 259 profissionais de saúde da Atenção Primária dos estados de Mato Grosso do Sul e São Paulo no período inicial da pandemia. A maioria dos participantes era do sexo feminino (85,3%), profissionais de enfermagem (40,6%) com idade média de 39,1 anos (dp ± 9,5) e do estado de São Paulo (73%). Utilizaram-se análise descritiva e teste exato de Fisher. Quanto às medidas de proteção de risco ocupacional no trabalho, verificou-se que a imunização antecipada contra influenza teve maior frequência no Mato Grosso do Sul (93,8%), porém 47,7% não tiveram acesso aos testes de Covid-19 neste estado e 24,3% em São Paulo. Os profissionais de nível superior tiveram mais acesso à máscara N95/PFF2 (10,2%) em comparação aos auxiliares e técnicos, com 6,5% e 7,8%, respectivamente. Observaram-se possíveis diferenças nas gestões municipais dos respectivos estados, que parecem não ofertar o acesso equânime de profissionais da Atenção Primária à Saúde a proteção, imunizantes e testes para detecção de SARS-CoV-2.

Abstract This article aimed to characterize the profile of Primary Health Care workers and analyze occupational risk protection measures in two Brazilian states during the Covid-19 pandemic. This is a quantitative survey study, with a random sample of 259 primary care health professionals from the states of Mato Grosso do Sul and São Paulo during the initial period of the pandemic. Most of the participants were female (85.3%), nursing professionals (40.6%) with a mean age of 39.1 years (SD ± 9.5), and from the state of São Paulo (73%). Descriptive analysis and Fisher's exact test were used. As for occupational risk protection measures at work, it was found that early immunization against influenza had the highest frequency in Mato Grosso do Sul (93.8%), but 47.7% did not have access to Covid-19 testing in this state and 24.3% in São Paulo. Higher-level professionals had more access to the N95/PFF2 mask (10.2%) compared to assistants and technicians, with 6.5% and 7.8%, respectively. Possible differences were observed in the municipal administrations of the respective states, which do not seem to provide equitable access for Primary Health Care workers to protection, immunizers, and testing for SARS-CoV-2.

Resumen Este artículo tuvo como objetivo caracterizar el perfil de los trabajadores de la Atención Primaria de Salud y analizar las medidas de protección contra riesgos laborales en dos estados brasileños durante la pandemia de Covid-19. Se trata de un estudio cuantitativo de tipo survey, con una muestra aleatoria de 259 profesionales de salud de Atención Primaria provenientes de los estados de Mato Grosso do Sul y São Paulo en el período inicial de la pandemia. La mayoría de los participantes eran mujeres (85,3%), profesionales de enfermería (40,6%) con una edad media de 39,1 años (desviación estándar ± 9,5) y del estado de São Paulo (73%). Se utilizaron el análisis descriptivo y la prueba exacta de Fisher. En cuanto a las medidas de protección contra riesgos laborales en el trabajo, se constató que la inmunización temprana contra la influenza fue más frecuente en Mato Grosso do Sul (93,8%), pero el 47,7% no tuvo acceso a las pruebas de Covid-19 en ese estado y el 24,3% en São Paulo. Los profesionales de la educación superior tuvieron más acceso a la mascarilla N95/PFF2 (10,2 %) en comparación con los auxiliares y técnicos, con un 6,5 % y un 7,8%, respectivamente. Se observaron posibles diferencias en las administraciones municipales de los respectivos estados, que parecen no ofrecer un acceso equitativo a los profesionales de la Atención Primaria de Salud a la protección, inmunizaciones y pruebas para detección del SARS-CoV-2.

Quality of life and adherence to dental treatment in adolescents: a longitudinal analytical study

The study aimed to analyze the quality of life, oral health impact on daily activities and its association with adherence to dental treatment, and other factors, among vulnerable adolescents. It is a longitudinal analytical study performed with 15- to 19-year-old adolescents in the city of Piracicaba, São Paulo, from 2014 to 2015. The sample consisted of 476 adolescents referred for the treatment of caries and/or periodontal disease in family health units (initial phase). After 18 months, 325 individuals were assessed to investigate the dental treatment provided (final phase). The response variables considered in the final phase were the Quality of Life (WHOQOL-bref) and the Oral Impacts on Daily Performances (OIDP) questionnaires. The independent variables analyzed were sex, age, treatment adherence, and family cohesion and adaptability. A multiple regression model was used. The data on the physical (p<0.0001), social (p=0.0003), environmental (p<0.0001), and psychological (p<0.0001) domains of the WHOQOL collected in the initial phase had a positive relationship with the same domains assessed in the final phase. The WHOQOL data of the initial phase were associated with the WHOQOL data of the final phase (p=0.0341). The OIDP data of the initial phase were associated with the OIDP data of the final phase (p<0.0001). The OIDP of volunteers who did not adhere to dental treatment showed a higher impact (p=0.0234). The quality of life and impacts on daily performances of adolescents improved between the evaluation periods.

Analysis of the prevalence in sugar consumption in child care consultations / Análise da prevalência do consumo de açúcar em consultas de puericultura

Abstract Objectives: to analyze the prevalence of sugar consumption and associated factors in childcare consultations. Methods: cross-sectional study with 599 children > six months to < 24 months of age, assisted by the Family Health Units. Outcomes: daily consumption of sweetened beverages, sweets/candies, recorded in the Food and Nutrition Surveillance System; independent variables: sociodemographic data. Multiple logistic regression test was applied. Results: 62.10% of the children consume sugary drinks and 42.23%, sweets/candies. Consuming sugary drinks was associated with the age of 12-17 months and 29 days (OR=2.525; CI95%=1.68-3.78) and 18-17 months and 29 days (OR=2.90; CI95%=1.90-4.43); children living with more than four people at home (OR=1.59; CI95%=1.11-2.26), aged 12-17 months and 29 days (OR=2.05; CI95%=1.34-3.13) and 18-23 months and 29 days (OR=2.51; CI95%=1.62-3.87) were more likely to consume sweets/candies than younger children. Maternal aspects, such as age (OR=0.66; CI95%=0.46-0.93), marital status (OR=1.67; CI95%=1.06-2.6), schooling (OR=2.14; CI95%=1.12-4.08), and presence of government assistance (OR=2.03; CI95%=1.41-2.93), were conditions associated with the consumption of sweets. Conclusions: the prevalence of sugar in children's diet was high and was associated with sociodemographic aspects. Health education actions should be carried out in childcare, in order to promote healthy food, minimizing the consumption of sugar.

Resumo Objetivos: analisar a prevalência do consumo de açúcar e fatores associados em consultas de puericultura. Métodos: estudo transversal com 599 crianças >seis a <24 meses de idade, assistidas por Unidades de Saúde da Família. Desfechos: consumo diário de bebidas adoçadas, doces/guloseimas, registrados no Sistema de Vigilância Alimentar e Nutricional; variáveis independentes: dados sociodemográficos. Aplicou-se teste de regressão logística múltipla. Resultados: 62,10% das crianças consomem bebidas açucaradas e 42,23% doces/guloseimas. Consumir bebidas açucaradas associou-se à idade de 12-17 meses e 29 dias (OR=2,525; IC95%=1,68-3,78) e 18-17 meses e 29 dias (OR=2,90; IC95%=1,90-4,43); crianças residirem com mais de quatro pessoas na casa (OR=1,59; IC95%:1,11-2,26), terem idade de 12-17 meses e 29 dias (OR=2,05; IC95%=1,34-3,13) e 18-23 meses e 29 dias (OR=2,51; IC95%=1,62-3,87) apresentaram maior chance de consumir doces/guloseimas que crianças mais novas. Aspectos maternos como idade (OR=0,66; IC95%=0,46-0,93), estado civil (OR=1,67; IC95%=1,06-2,6), escolaridade (OR=2,14; IC95%=1,12-4,08), e presença de auxílio do governo (OR=2,03;IC95%=1,41-2,93), foram condições associadas ao consumo de doces/guloseimas. Conclusão: foi alta a prevalência de açúcar na dieta das crianças e esteve associada a aspectos sociodemográficos. Ações de educação em saúde devem ser realizadas na puericultura, a fim de fomentar a alimentação saudável, minimizando o consumo de açúcar.

Percepções dos recrutados sobre a ação estratégica "o brasil conta comigo" / Perceptions of the people recruited about the strategic action "o brasil conta comigo" (brazil counts on me) / Las percepciones de los reclutas sobre la acción estratégica "o brasil conta comigo" (el brasil cuenta conmigo)

RESUMO Objetivo: analisar as percepções de acadêmicos e supervisores sobre a ação estratégica "O Brasil Conta Comigo". Método: estudo transversal realizado em Mato Grosso do Sul - Brasil, de dezembro de 2020 a março de 2021, em duas etapas: 1) Exploratória (quantitativa), via análise de relatórios dos 33 supervisores e 90 acadêmicos convocados, aplicação de questionário on-line; 2) Profundidade (qualitativa), utilizando a técnica do grupo focal remoto, com amostra por conveniência. Realizada análise descritiva e de conteúdo. Resultados: foram identificados os motivos de adesão e permanência à ação (bolsa, horas de estágio e responsabilidade social), os aspectos pedagógicos (capacitação, avaliação e apoio das instituições de ensino e gestão) e as contribuições da ação (assistência e formação profissional). Conclusão: as percepções gerais dos recrutados são positivas. Aspectos pedagógicos relacionados à avaliação dos acadêmicos e apoio das instituições de ensino superior devem ser revistos, para ações mais assertivas em momentos de crise sanitária.

ABSTRACT Objective: to analyze the perceptions of academics and supervisors about the strategic action "O Brasil Conta Comigo"(Brazil counts on me). Method: cross-sectional study conducted in Mato Grosso do Sul - Brazil, from December 2020 to March 2021, in two stages: 1) Exploratory (quantitative), via analysis of reports of the 33 supervisors and 90 academics convened, application of an online questionnaire; 2) In-depth (qualitative), using the remote focus group technique, with convenience sampling. Descriptive and content analysis was performed. Results: the reasons for joining and remaining with the action (scholarship, internship hours, and social responsibility), the pedagogical aspects (training, evaluation, and support from educational institutions, and management), and the contributions of the action (assistance and professional training) were identified. Conclusion: the general perceptions of the recruits are positive. Pedagogical aspects related to the evaluation of academics and support from higher education institutions should be reviewed, for more assertive actions in times of health crisis.

RESUMEN Objetivo: analizar las percepciones de estudiantes y supervisores sobre la acción estratégica " El Brasil Cuenta Conmigo". Método: estudio transversal realizado en Mato Grosso do Sul - Brasil, de diciembre de 2020 a marzo de 2021, en dos etapas: 1) Exploratoria (cuantitativa), a través del análisis de los informes de los 33 supervisores y 90 académicos convocados, aplicación de un cuestionario en línea; 2) En profundidad (cualitativa), mediante la técnica de grupo focal a distancia, con muestreo de conveniencia. Se realizó un análisis descriptivo y de contenido. Resultados: se identificaron los motivos de adhesión y permanencia a la acción (bolsa, horas de estancia y responsabilidad social), los aspectos pedagógicos (capacitación, aval y apoyo a las instituciones de enseñanza y gestión) y las contribuciones de la acción (asistencia y formación profesional). Conclusión: la percepción general de los contratados es positiva. Los aspectos pedagógicos relacionados con la evaluación de los académicos y el apoyo de las instituciones de enseñanza superior deben ser revisados, para que las acciones sean más firmes en momentos de crisis sanitaria.

Caries experience in children under 5 years old in the Xingu indigenous park in Brazil

Aim: The present study sought to investigate dental caries experience and its association with sociodemographic, postnatal and breastfeeding variables in children in the agerange from 6 to 71 months of age, in the Xingu Indigenous Park, Mato Grosso, Brazil. Methods: This was an analytical cross-sectional study that used secondary data pertaining to 402 indigenous children of the Low, Middle and Eastern Xingu regions, who participated in the Oral Health Epidemiological Survey in 2013. The dependent variable was dental caries, dichotomized by the median (dmf-t≤1 and dmf-t>1). The data of independent variables were obtained by means of instruments of the Local Health Information System of the Xingu Indigenous Special Sanitary District (DSEI). Raw analyses were performed to test the association of the independent variables with the dependent variable. The variables were tested in the multiple logistic regression model. Results: The mean value of the dmf-t index was 2.60 and the prevalence of affected children was 51%. In the multiple analysis, only children older than 36 months (OR: 6.64; CI95%: 4.11 to 10.73) and those that were breastfed for a longer period of time (OR: 1.88; CI95%: 1.16 to 3.02) showed significant association with the dmf-t>1 index. Conclusion: Childhood dental caries among indigenous children was associated with age and breastfeeding prolonged for over 26 months, therefore, pointing out the need to offer dental follow-up care at earlier ages

Proporção de exodontia no estado de São Paulo e sua relação com a cobertura da Equipe de Saúde Bucal / Proportion of dental extraction in the state of São Paulo and its relation with the coverage of the Oral Health Team

Resumo Introdução O conhecimento dos fatores relacionados à perda dentária contribui para o planejamento das ações preventivas realizadas pelas Equipes de Saúde Bucal (ESBs). Objetivo Avaliar o indicador de proporção de exodontia nos municípios do estado de São Paulo e a sua relação com os indicadores socioeconômicos e cobertura das ESBs. Método Estudo ecológico com dados secundários dos 645 municípios do estado de São Paulo do ano de 2012. A variável dependente foi o percentual de exodontia mensurado pelo indicador de proporção de exodontia em relação aos procedimentos individuais realizados pelas ESBs, disponibilizado pelo Sistema de Informação da Atenção Básica. Foram considerados como variáveis independentes a cobertura populacional estimada pelas ESBs, o Produto Interno Bruto (PIB) dos municípios per capita, o Índice de Desenvolvimento Humano (IDH) e o Índice Paulista de Responsabilidade Social (IPRS). Foram aplicados modelos lineares generalizados, avaliados pelo p-valor do teste de Wald, AICC e grau de liberdade. Resultados Apresentaram maior proporção de extrações dentárias as cidades do estado de São Paulo com menor cobertura de ESBs (p < 0,0001), com menor valor de IDH (p < 0,0001) e com maior valor de IPRS (p = 0,0018). Conclusão A baixa cobertura de ESBs e as desigualdades socioeconômicas contribuem para aumentar as extrações dentárias no estado de São Paulo.

Abstract Background Knowledge about factors associated with tooth loss contributes to the planning of preventive actions carried out by Oral Health Teams (OHT). Objective To evaluate the proportion of dental extraction indicator in the cities of the state of São Paulo, Brazil, and its relationship with socioeconomic indicators and coverage of the OHT. Method Ecological study using secondary data from 654 municipalities in the state of São Paulo conducted in 2012. The dependent variable was the percentage of dental extraction measured by the proportion of this indicator in relation to individual procedures performed by the OHT provided by the Primary Health Care (PHC) Information System. The population coverage by the OHT, the per capita Gross Domestic Product (GDP), the Human Development Index (HDI), and the São Paulo Social Responsibility Index (IPRS) of the municipalities were evaluated as independent variables. Generalized linear models, formulated by the Wald test p-value, Corrected Akaike Information Criterion (AICc), and degree of freedom, were applied. Results Higher proportions of dental extraction were found in the municipalities with lower coverage by OHT (p<0.0001), lower HDI value (p<0.0001), and higher IPRS value (p=0. 0018). Conclusion Low coverage by OHT and socioeconomic inequalities contribute to increased proportion of dental extractions in the state of São Paulo.

Malocclusion and dental appearance in underprivileged Brazilian adolescents

Abstract Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components.

Qualidade de vida, coesão e adaptabilidade em famílias beneficiárias do Programa Bolsa Família / Quality of life, cohesion and adaptability in beneficiary families of the "Bolsa Família" Program

Resumo Avaliou-se a associação entre qualidade de vida, coesão familiar e fatores sociodemográficos de famílias beneficiárias do Programa Bolsa Família (PBF). Estudo transversal, analítico e de caráter exploratório com amostra representativa de 385 entrevistados. A variável dependente foi a qualidade de vida (WHOQOL-BREF), e as variáveis independentes quantificadas em características sociodemográficas, autopercepção sobre saúde, coesão e adaptabilidade familiar (FACES III). A melhor qualidade de vida associou-se com idade menor ou igual a 36 anos (OR = 2,15), maior nível educacional (OR = 1,54), boa/muito boa saúde (OR = 6,39), não ter problema de saúde atual (OR = 5,68), sem tratamento (OR = 1,76), moderada (OR = 3,39) e alta (OR = 3,66) coesão familiar e moderada adaptabilidade (OR = 2,23). Indivíduos provenientes de famílias com moderada e alta coesão familiar tiveram mais chance de ter uma melhor qualidade de vida do que aqueles vindos de famílias com baixa coesão. Os voluntários do sexo masculino tiveram 3,54 vezes mais chance de apresentar uma melhor qualidade de vida. Concluiu-se que níveis moderados e altos de coesão podem impactar positivamente uma melhor qualidade de vida das pessoas beneficiárias do PBF, indicando que as ações sociais devem buscar o fortalecimento dessa dinâmica.

Abstract We evaluated the association between quality of life, family cohesion and sociodemographic factors of beneficiary families of the BolsaFamília Program (PBF). This was an analytical, cross-sectional study with exploratory methodology. The sample was composed of 385 respondents. The dependent variable was the quality of life (WHOQOL-BREF), and the independent variables were sociodemographic characteristics, self-rated health, family cohesion and adaptability (FACES III). The best quality of life was associated with an age younger than or equal to 36 years (OR = 2.15), higher educational level (OR = 1.54), good/very good health (OR = 6.39), not having current health problem (OR = 5.68), no treatment (OR = 1.76), moderate (OR = 3.39) and high (OR = 3.66) family cohesion and moderate adaptability (OR = 2.23). Individuals from families with moderate and high family cohesion were more likely to have a better quality of life than those from families with low cohesion. The male volunteers were 3.54 times more likely to have a better quality of life. It was concluded that moderate and high levels of cohesion may impact positively to the quality of life of persons receiving the PBF, indicating that social programs should seek to strengthen these dynamics.

Senso de coerência e fatores associados ao desempenho escolar de adolescentes / Sense of coherence and factors associated with school performance of adolescents

Resumo O desempenho escolar é um aspecto fundamental para o futuro sucesso profissional e social. O objetivo do presente estudo foi investigar os fatores associados ao desempenho escolar dos adolescentes, incluindo o Senso de Coerência (SOC) e o estado de saúde bucal. Foram incluídos, no estudo, 381 escolares entre 15 e 18 anos de idade da cidade de Campo Grande, Mato Grosso do Sul, Brasil. O desfecho foi o desempenho escolar avaliado por meio das notas finais das disciplinas de Português e Matemática em 2013. As variáveis independentes foram dados sociodemográficos, autopercepção de saúde bucal, uso de serviços odontológicos e Senso de Coerência, obtidos por um questionário autoaplicado. Além disso, avaliou-se o número de dentes cariados, perdidos e obturados (índice de CPO-D). Análises de regressão logística foram realizadas, com base em um modelo hierárquico. A idade média dos alunos foi de 16 anos; valor médio do CPO-D 4,1 e SOC 44,5. No ajuste final, os indivíduos do sexo masculino (p = 0,0021); aqueles com o maior número de pessoas que moravam em casa (p = 0,0021) e o SOC fraco (p = 0,0005) mostraram associação com o menor desempenho escolar. Em conclusão, o desempenho escolar é um fenômeno complexo, associado ao SOC e às características bucais.

Abstract School performance is a key aspect for future professional and social success. The objective of the present study was to investigate factors associated with adolescents' school performance including sense of coherence (SOC) and oral health status. Three hundred eighty one schoolchildren between 15 and 18 years of age from the city of Campo Grande, Mato Grosso do Sul, Brazil, participated in the study. The outcome variable was school performance, assessed through the final grades of the Portuguese and Mathematics disciplines in 2013. Independent variables were sociodemographic data, self-perception of oral health, use of dental services and sense of coherence, obtained through a self-applied questionnaire. In addition, in a clinical assessment, the number of decayed, missing and filled teeth (DMFT index) was evaluated. Logistic regression analyses were performed, based on a hierarchical model. The mean age of students was 16 years; mean DMFT value 4.1, and SOC 44.5. In the final adjustment, the male subjects (p = 0.0021); those with the largest number of people residing at home (p = 0.0021) and weak SOC (p = 0.0005) showed an association with poorer school performance. In conclusion, school performance is a complex phenomenon associated with SOC and oral characteristics.

Associação entre o tipo de aleitamento na alta hospitalar do recém-nascido e aos seis meses de vida / Association between type of breastfeeding of newborns at hospital discharge and at six months of age

Resumo Introdução Os índices de aleitamento materno no Brasil permanecem muito abaixo dos considerados ideais, fazendo-se necessário o entendimento das variáveis envolvidas na fragmentação do aleitamento ao longo dos meses de vida da criança. Objetivo Objetivou-se, neste estudo, verificar a associação entre o tipo de aleitamento no momento da alta hospitalar do recém-nascido e a prática da amamentação aos seis meses de vida. Método Estudo transversal, com dados coletados do prontuário clínico de 301 crianças participantes de um programa de incentivo ao aleitamento materno. Foram considerados os fatores de risco e de proteção ao aleitamento, tais como: idade dos pais, presença do companheiro, paridade, renda familiar, permanência em alojamento conjunto, tempo decorrido do nascimento até a primeira mamada, tempo de hospitalização, tipo de amamentação na alta hospitalar e uso de chupeta ao longo dos seis meses de vida. Resultados Os resultados mostraram haver associação significativa entre aleitamento materno exclusivo na alta hospitalar e aos seis meses de idade (p=0,0205). Conclusão A observação desses dados permite concluir que é importante que, ao deixar a maternidade, o bebê esteja em amamentação exclusiva, pois, dessa forma, terá 2,5 vezes mais chances de manter esse tipo de aleitamento até os seis meses de vida.

Abstract Introduction Breastfeeding rates in Brazil remain far below those considered ideal, making it necessary understanding the variables involved in the fragmentation of this process over the months of a child's life. Objective The objective of this study was to investigate the association between type of breastfeeding of newborns at hospital discharge and at six months of age. Method A cross-sectional study with data collected from the medical records of 301 children participating in a program to encourage exclusive breastfeeding. The study considered risk and protection factors to breastfeeding such as age of parents, presence of mate, parity, family income, stay in room, time elapsed from birth to first breastfeeding, hospitalization time, type of breastfeeding at hospital discharge, and use of pacifier until the age of six months. Results The results revealed significant correlation between exclusive breastfeeding at hospital discharge and at six months of age (p=0.0205). Conclusion Observation of data enabled the following conclusion: it is important that newborns undergo exclusive breastfeeding after hospital discharge because, this way, they will be 2.5 times more likely to maintain this type of feeding until the age of six months.