Apelin and Visfatin Expression in Placental Tissue in Women With Preeclampsia and Overweight/Obesity.

BACKGROUND: Preeclampsia (PE) is a multifunctional and multisystem disorder. Several factors favor the development of PE, including obesity. Cytokines are also expressed in the placenta, predisposing to local alterations that favor the development of distinct pathological processes, including PE. This study aimed to evaluate the apelin and visfatin mRNA expression in the placental tissue of women with preeclampsia and overweight/obesity and correlates with maternal and fetal variables. METHODS: A cross-sectional analytical study was performed with 60 pregnant women and their newborns. Clinical, anthropometric, and laboratory variables were collected. Placental tissue samples were obtained, and the apelin and visfatin mRNA expression levels were assessed by qRT-PCR. RESULTS: The main findings evidenced lower levels of apelin expression in overweight/obese women, accompanied by a negative correlation with BMI and pre-pregnancy weight; a higher expression of apelin was also observed in women with late PE and no personal history of PE. For visfatin levels, higher expression levels were observed in women with late PE and term delivery. Furthermore, a positive correlation was observed between visfatin levels and fetal anthropometric parameters, such as weight, length, and head circumference. CONCLUSION: Apelin levels were less expressed in overweight/obese women. Apelin and visfatin levels were correlated/associated with maternal-fetal variables.

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.

Unraveling the signs and symptoms of oral conditions that affect daily life activities and oral health-related quality of life.

OBJECTIVES: Since oral conditions negatively affect oral health-related quality of life (OHRQoL), this study evaluated which oral clinical condition, signs, and symptoms are associated with the impact on OHRQoL, its domains, and specific daily life activities among adults. MATERIALS AND METHODS: Data from a probabilistic sample of adults (35-44 years old) was used. The Oral Impacts on Daily Performance (OIDP) was used to evaluate OHRQoL, its domains (physical, psychological, and social), and nine daily life activities. Signs and symptoms of oral diseases (dental caries, periodontal disease, need for dental prothesis, and tooth loss) and oral self-perception were considered. Descriptive, bivariate, and multi-level analyses were conducted. RESULTS: A total of 5,834 adults were included, of which 52.9% had some negative impact of oral conditions on OHRQoL. Difficulty in eating was the most affected daily life activity. For multiple models, dental caries lesions (cavities), filled teeth with caries, gingival bleeding, periodontal pocket, dental pain, need for upper or lower dental prosthesis, and oral health self-perception were associated (p < 0.05) with overall OHRQoL or at least one of its domains. The impact on daily life activities of each individual was associated with at least one oral condition. Dental caries lesions (cavity) and dental pain were associated (p < 0.05) with the impact on most daily life activities evaluated. CONCLUSIONS: Different signs and symptoms of prevalent oral diseases are associated with the impact on specific daily life activities among adults, which may compromise the OHRQoL. CLINICAL RELEVANCE: Knowledge of how signs, symptoms, and oral conditions affect OHRQoL and daily life activities can provide essential information for clinicians to establish proper disease management and preventive strategies focusing on improving patients' lives.

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

Abstract 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.

Avaliação da qualidade da assistência à saúde oftalmológica na percepção dos usuários / Evaluation of the quality of ophthalmic health care according to the perception of users

RESUMO Objetivo Avaliar e caracterizar a qualidade da assistência oftalmológica ofertada em uma unidade de serviços ambulatoriais da Atenção Secundária do Sistema Único de Saúde na percepção dos usuários e/ou dos responsáveis por esses usuários. Métodos Foi realizado estudo seccional de prevalência analítica entre usuários assistidos no período de setembro de 2019 a março de 2020 em um dos seis serviços de assistência oftalmológica ofertado pelo Sistema Único de Saúde, no município de Vitória da Conquista (BA). Foram avaliadas as condições demográficas e socioeconômicas e a autopercepção da saúde. Também foram avaliadas as características e os níveis de qualidade da assistência à saúde oftalmológica. A coleta das informações ocorreu por meio de entrevista telefônica. Resultados Participaram do estudo 389 usuários e/ou responsáveis. Observaram-se elevados níveis de satisfação, considerando as perguntas que compõem o constructo do instrumento. Identificaram-se níveis de qualidade comprometidos em relação à liberdade de escolher seu prestador de cuidado ocular (154; 39,7%). Menores níveis de satisfação associaram-se com as variáveis sexo masculino (razão de chance de 1,66; IC95% 1,04-2,65; p=0,033) e raça autodeclada branca (razão de chance de 6,89; IC95% 4,00-11,86; p=0,000). Conclusão Os usuários relataram bons níveis de satisfação da assistência à saúde oftalmológica. Observaram-se maiores chances de menores níveis de satisfação entre homens e aqueles com raça autodeclarada branca.

ABSTRACT Objective To evaluate and characterize the quality of ophthalmic care offered in an outpatient service unit of the SUS secondary care according to the perception of users and/or those responsible for these users. Methods A cross-sectional study of analytical prevalence was carried out among users assisted from September 2019 to March 2020, in one of the six ophthalmic care services offered by the SUS, in the municipality of Vitória da Conquista (BA), Brazil. Demographic and socioeconomic conditions, as well as self-perception of health, were evaluated. The characteristics and quality levels of ophthalmic health care were also evaluated. Data collection took place through a telephone interview. Results A total of 389 users and/or guardians participated in the study. Participants reported high levels of satisfaction, considering the questions that make up the instrument's construct. Compromised quality levels were observed in relation to the freedom to choose their eye care provider (n=154; 39.7%). Lower levels of satisfaction were associated with the variables male gender (OR=1.66; 95%CI=1.04-2.65; p=0.033) and self-reported white race (OR=6.89; 95%CI=4, 00-11.86; p=0.000). Conclusion Users reported good levels of satisfaction with eye health care. There were greater chances of lower levels of satisfaction among men and among those with a self-reported white race.

Construction and validation of educational videos for adolescents with Down Syndrome based on health literacy - LISA Down Program / Construção e validação de vídeos educativos para adolescentes com síndrome de down fundamentados no letramento em saúde - Programa LISA Down

Abstract Objectives: to construct and validate educational videos as part of the LISA Down Program - Literacy and Innovation in Health for Adolescents with Down Syndrome. Methods: this is a methodological study of construction and validation of educational videos based on health literacy designed for adolescents with Down syndrome, assisted by an Associação de Pais e Amigos dos Excepcionais (APAE) (Association of Parents and Friends of the Exceptional) located in the Northeast of Brazil. The stages of construction and validation of the vídeos were: pre-production, production and post-production. The storyboards were prepared according to the fundamentals of health literacy and validated by seven expert judges. Subsequently, the storyboards were transformed into videos (production) and these were evaluated by 13 adolescents with Down Syndrome (postproduction). Results: the storyboards totaled 248 scenes, ranging from 39 to 67 scenes each, were approved by the judges with percentages of agreement ranging from 94% to 100%. The vídeos recorded were approved by adolescentes with Down syndrome, in agreement of percentages ranging from 79.17% to 83.33%. Conclusion: the educational vídeos were validated and well evaluated and, therefore, can be used among adolescents in social spaces in which the focus of attention is adolescentes with Down syndrome.

Resumo Objetivos: construir e validar vídeos educativos como parte do Programa LISA Down- Letramento e Inovação em Saúde para Adolescentes com Síndrome de Down. Métodos: trata-se de estudo metodológico de construção e validação de vídeos educativos fundamentados no letramento em saúde arquitetados para adolescentes com síndrome de Down, atendidos por uma Associação de Pais e Amigos dos Excepcionais (APAE), localizada no Nordeste brasileiro. As etapas da construção e validação dos vídeos foram: pré-produção, produção e pósprodução. Os storyboards foram elaborados de acordo com os fundamentos do letramento em saúde e validados por sete juízes especialistas. Na sequência os storyboards foram transformados em vídeos (produção) e estes foram avaliados por 13 adolescentes com Síndrome de Down (pós-produção). Resultados: os storyboards totalizaram 248 cenas, variando de 39 a 67 cenas cada um, foram aprovados pelos juízes com percentuais de concordância que variaram de 94% a 100%. Os vídeos gravados foram aprovados pelos adolescentes com síndrome de Down, com percentuais de concordância que variaram de 79,17% a 83,33%. Conclusão: os vídeos educativos foram validados e bem avaliados e, portanto, podem ser utilizados entre adolescentes em espaços sociais nos quais o foco da atenção sejam os adolescentes com síndrome de Down.

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.

Validation of a reduced instrument Diabetes-21 for assessing health-related quality of life among people with diabetes. / Validação do instrumento reduzido Diabetes-21 para avaliação da qualidade de vida relacionada à saúde em pessoas com diabetes.

OBJECTIVE: To analyze the validity, reliability and interpretability of a short form instrument for assessing health-related quality of life among people with diabetes mellitus. METHODS: This was a validation study, comprised of the adaptation phases of the Diabetes-39 instrument (consisting of 5 domains and 39 items), pre-test, structural validity analyses (exploratory and confirmatory), reliability, concurrent validity and interpretability. RESULTS: The factorial structure of the short final version differed from the original instrument. The items were reduced from 39 to 21 and domains from 5 to 4. The factor loading, in exploratory and confirmatory analyses, ranged between 0.41 and 0.90 and between 0.51 and 0.89, respectively. Reliability was adequate (Cronbach's alpha=0.91; Kappa≥0.60 in all items; intraclass correlation coefficient =0.91). CONCLUSION: Diabetes-21, a short form instrument, was considered valid, reliable and interpretable for assessing health-related quality of life among people with diabetes mellitus.

Validity and reliability of the Smoking-related Health Literacy Assessment Scale.

OBJECTIVE: To create an instrument to assess smoking-related health literacy among smokers, and to estimate validity of its content and reliability. METHODS: A methodological, quantitative study. The creation of the instrument included the following steps: establishing a conceptual structure; defining objectives and target population; preparation of items or response scales; selecting and organizing items; instrument structuring; content validation and pre-test. The instrument was named Smoking-related Health Literacy Assessment Scale. RESULTS: The Smoking-related Health Literacy Scale had statistically significant measures of validity and reliability. Test-retest revealed substantial to almost perfect levels of reliability (reproducibility). CONCLUSION: The Smoking-related Health Literacy Scale can provide researchers with a valid and statistically significant instrument, regarding content validity and reliability.

Validation of a reduced instrument Diabetes-21 for assessing health related quality of life among people with diabetes / Validación de un instrumento reducido Diabetes-21 para evaluar la calidad de vida relacionada con la salud en personas con diabetes / Validação do instrumento reduzido Diabetes-21 para avaliação da qualidade de vida relacionada à saúde em pessoas com diabetes

Objective: To analyze the validity, reliability and interpretability of a reduced instrument for assessing health-related quality of life in diabetes. Methods: Crosssectional study with people with diabetes, consisting of the phases: adaptation of the Diabetes-39 instrument (5 dimensions and 39 items), pre-test, analysis of structural validity, reliability, concurrent validity and interpretability. Results: The factor structure of the final version of the reduced instrument was different from the original. There was a reduction from 39 to 21 items and a reduction from 5 to 4 dimensions. The factor loadings in the exploratory and confirmatory analyzes ranged between 0.41-0.90 and 0.51-0.89, respectively. Reliability was adequate (Cronbach's alpha=0.91; Kappa≥0.60 in all items; intraclass correlation coefficient=0.91). Conclusion: The Diabetes-21 instrument was considered valid, reliable and interpretable for assessing health-related quality of life among people with diabetes.

Objetivo: Analizar la validez, confiabilidad e interpretabilidad de instrumento reducido para evaluar la calidad de vida relacionada con la salud en diabetes. Métodos: Estudio transversal con personas con diabetes: adaptación del instrumento Diabetes-39 (5 dimensiones/39 elementos), pre-test, análisis de validez estructural, confiabilidad, validez concurrente e interpretabilidad. Resultados: La estructura factorial de la versión final del instrumento reducido presentado diferente a la original. Hubo una reducción de 39 a 21 ítems y de 5 a 4 dimensiones. Las cargas factoriales en los análisis exploratorios y confirmatorios variaron entre 0,41-0,90 y 0,51-0,89, respectivamente. La fiabilidad fue adecuada (alfa de Cronbach=0,91; Kappa≥0,60 en todos los ítems; coeficiente de correlación intraclase=0,91). Conclusión: El Diabetes-21 se consideró válido, confiable e interpretable para evaluar la calidad de vida relacionada con la salud en personas con diabetes.

Objetivo: Analisar a validade, confiabilidade e interpretabilidade de instrumento reduzido para avaliação da qualidade de vida relacionada à saúde entre pessoas com diabetes mellitus. Métodos: Estudo de validação, composto pelas fases de adaptação do instrumento Diabetes-39 (constituído por 5 dimensões e 39 itens), pré-teste, análises de validade estrutural (exploratória e confirmatória), confiabilidade, validade concorrente e interpretabilidade. Resultados: A estrutura fatorial da versão final reduzida diferiu do instrumento original. Reduziu-se os itens, de 39 para 21, e as dimensões, de 5 para 4. As cargas fatoriais, nas análises exploratória e confirmatória, variaram entre 0,41 e 0,90 e entre 0,51 e 0,89, respectivamente. A confiabilidade apresentou-se adequada (alfa de Cronbach=0,91; Kappa≥0,60 em todos os itens; coeficiente de correlação intraclasse=0,91). Conclusão: O instrumento reduzido Diabetes-21 foi considerado válido, confiável e interpretável para avaliação da qualidade de vida relacionada à saúde entre pessoas com diabetes mellitus.

Prevalência e Caracterização do Consumo de Tabaco entre Adolescentes de Montes Claros, Minas Gerais, 2019-2020 / Prevalence and Characterization of Tobacco Use Among Adolescents from Montes Claros, Minas Gerais, 2019-2020 / Prevalencia y Caracterización del Consumo de Tabaco en Adolescentes de Montes Claros, Minas Gerais, 2019-2020

Introdução: As doenças tabaco-relacionadas são responsáveis por cinco milhões de óbitos a cada ano. Em 2020, estimou-se que o número de óbitos anuais aumentaria para dez milhões, dos quais 70% ocorreriam nos países em desenvolvimento. Objetivo: Estimar a prevalência do tabagismo e caracterizar o consumo de tabaco entre adolescentes de 12 e de 15 anos na cidade de Montes Claros, Minas Gerais, em 2019-2020. Método: Estudo epidemiológico quantitativo transversal, parte do projeto "Levantamento epidemiológico sobre condições de saúde bucal entre escolares de Montes Claros, Minas Gerais, Brasil", realizado em 2019-2020. A amostra estimada foi de 354 escolares de 12 anos e 355 de 15 anos, calculada entre 4.458 escolares de 12 anos e 4.524 de 15 anos, respectivamente. Os dados foram analisados descritivamente por meio de medidas de tendência central, variância e frequência. Resultados: Houve prevalência do uso de tabaco entre adolescentes alguma vez na vida de 8,6 %, sendo 4,6% relativos ao consumo do cigarro Paiol. Conclusão: A prevalência do consumo encontrada entre os adolescentes é preocupante por causa dos efeitos deletérios à saúde. Conhecer o perfil dos desses usuários pode contribuir para as políticas de saúde coletiva com o objetivo de reduzir o seu uso

Introduction: Tobacco-related diseases are responsible for five million deaths each year. By 2020, the estimate is that the number of annual deaths would increase to ten million, of which 70% would occur in developing countries. Objective: Estimate the prevalence of smoking and characterize tobacco use among adolescents aged 12 and 15 in the city of Montes Claros, Minas Gerais in 2019-2020. Method: Cross-sectional quantitative epidemiological study, part of the project "Epidemiological survey on oral health conditions among students in Montes Claros, Minas Gerais, Brazil", conducted in 2019-2020.The sample consisted of 354 12-year-old and 355 15-year-old adolescents from a population of 4,458 12-year-old and 4,524 15-year-old adolescents, respectively. The data were analyzed through descriptive analysis with measures of central tendency, variance and frequency. Results: There was prevalence of tobacco use in adolescents at some point in their lives of 8.6%, being 4,6% for cigarettes made with pressed tobacco leaves. Conclusion: The prevalence of the use among adolescents is worrying due to the harmful effects to health. Knowing the profile of these users may support health policies aimed to reduce its use

Introducción: Las enfermedades relacionadas con el tabaco son responsables de cinco millones de muertes cada año. Para 2020, la estimación es que el número de muertes anuales aumentaría a diez millones, de los cuales el 70% ocurriría en países en desarrollo. Objetivo: Estimar la prevalencia del tabaquismo y caracterizar el consumo de tabaco en adolescentes de 12 y 15 años de la ciudad de Montes Claros, Minas Gerais, en 2019-2020. Método: Estudio epidemiológico cuantitativo transversal, parte del proyecto "Encuesta epidemiológica sobre condiciones de salud bucal en escolares de Montes Claros, Minas Gerais, Brasil", realizado en 2019-2020. La muestra estimada estuvo conformada por 354 de 12 años y 355 de 15 años, calculada a partir de 4.458 de 12 años y 4.524 de 15 años, respectivamente. Los datos fueron analizados mediante análisis descriptivo que estimaron medidas de tendencia central, variabilidad y frecuencia. Resultados: Esta investigación observó una prevalencia del consumo de tabaco entre los adolescentes en algún momento de su vida del 8,6%, con predominio del 4,6% en el consumo de cigarrillos. Conclusión: La prevalencia de consumo encontrada es preocupante, debido a los efectos nocivos para la salud. Conocer el perfil de los consumidores adolescentes de productos del tabaco puede contribuir a las políticas de salud colectiva para reducir este uso

Validação do instrumento reduzido Diabetes-21 para avaliação da qualidade de vida relacionada à saúde em pessoas com diabetes / Validación de un instrumento reducido Diabetes-21 para evaluar la calidad de vida relacionada con la salud en personas con diabetes / Validation of a reduced instrument Diabetes-21 for assessing health-related quality of life among people with diabetes

Objetivo: Analisar a validade, confiabilidade e interpretabilidade de instrumento reduzido para avaliação da qualidade de vida relacionada à saúde entre pessoas com diabetes mellitus. Métodos: Estudo de validação, composto pelas fases de adaptação do instrumento Diabetes-39 (constituído por 5 dimensões e 39 itens), pré-teste, análises de validade estrutural (exploratória e confirmatória), confiabilidade, validade concorrente e interpretabilidade. Resultados: A estrutura fatorial da versão final reduzida diferiu do instrumento original. Foram reduzidos os itens, de 39 para 21, e as dimensões, de 5 para 4. As cargas fatoriais, nas análises exploratória e confirmatória, variaram entre 0,41 e 0,90 e entre 0,51 e 0,89, respectivamente. A confiabilidade apresentou-se adequada (alfa de Cronbach=0,91; Kappa≥0,60 em todos os itens; coeficiente de correlação intraclasse=0,91). Conclusão: O instrumento reduzido Diabetes-21 foi considerado válido, confiável e interpretável para avaliação da qualidade de vida relacionada à saúde entre pessoas com diabetes mellitus.

Objetivo: Analizar la validez, confiabilidad y la interpretación del instrumento reducido para evaluar la calidad de vida relacionada con la salud en personas con diabetes mellitus. Métodos: Estudio de validación compuesto por las fases de: adaptación del instrumento Diabetes-39 (5 dimensiones/39 elementos), pre test, análisis de validez estructural, confiabilidad, validez concurrente y calidad de la interpretación. Resultados: La estructura factorial de la versión final del instrumento reducido fue diferente a la original. Hubo una reducción de 39 a 21 ítems y de 5 a 4 dimensiones. Las cargas factoriales en los análisis exploratorios y confirmatorios variaron entre 0,41-0,90 y 0,51-0,89, respectivamente. La fiabilidad fue adecuada (alfa de Cronbach=0,91; Kappa≥0,60 en todos los ítems; coeficiente de correlación intraclase=0,91). Conclusión: El Diabetes-21 se consideró válido, confiable e interpretable para evaluar la calidad de vida relacionada con la salud en personas con diabetes mellitus.

Objective: To analyze the validity, reliability and interpretability of a short form instrument for assessing health-related quality of life among people with diabetes mellitus. Methods: This was a validation study, comprised of the adaptation phases of the Diabetes-39 instrument (consisting of 5 domains and 39 items), pre-test, structural validity analyses (exploratory and confirmatory), reliability, concurrent validity and interpretability. Results: The factorial structure of the short final version differed from the original instrument. The items were reduced from 39 to 21 and domains from 5 to 4. The factor loading, in exploratory and confirmatory analyses, ranged between 0.41 and 0.90 and between 0.51 and 0.89, respectively. Reliability was adequate (Cronbach's alpha=0.91; Kappa≥0.60 in all items; intraclass correlation coefficient =0.91). Conclusion: Diabetes-21, a short form instrument, was considered valid, reliable and interpretable for assessing health-related quality of life among people with diabetes mellitus.

Validity and reliability of the Smoking-related Health Literacy Assessment Scale

ABSTRACT Objective To create an instrument to assess smoking-related health literacy among smokers, and to estimate validity of its content and reliability. Methods A methodological, quantitative study. The creation of the instrument included the following steps: establishing a conceptual structure; defining objectives and target population; preparation of items or response scales; selecting and organizing items; instrument structuring; content validation and pre-test. The instrument was named Smoking-related Health Literacy Assessment Scale. Results The Smoking-related Health Literacy Scale had statistically significant measures of validity and reliability. Test-retest revealed substantial to almost perfect levels of reliability (reproducibility). Conclusion The Smoking-related Health Literacy Scale can provide researchers with a valid and statistically significant instrument, regarding content validity and reliability.

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

Resumo 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.

Abstract 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.

Adherence to medication, physical activity and diet among older people living with diabetes mellitus: Correlation between cognitive function and health literacy.

BACKGROUND: Diabetes mellitus (DM) is a public health problem, which requires enhanced self-care in order to avoid complications. However, cognitive impairment can reduce these abilities and may affect health literacy (HL) of patients in terms to understand and apply information. Therefore, this study evaluated the correlation between cognitive condition and HL related to medication adherence, physical activity and nutritional status among people living with DM. METHODS: A cross-sectional study was carried out among elderly people (≥ 60 years old) with DM. The cognitive condition was evaluated using the Mini-Mental State Examination (MMSE) and the HL using the following questionnaires: Literacy Assessment for Diabetes (LAD-60), Nutritional Literacy among People with Diabetes (NLD), Health Literacy on the Practice of Physical Activities among Diabetics (HLPPA - D), and Health Literacy regarding Drug Adherence among Diabetics (HLDA-D). Sociodemographic and biochemical profile was also evaluated. Spearman correlation was used (p < 0.05). RESULTS: 187 individuals with DM were included. Regarding laboratory analyses, insulin dosage had a mean value of 12.3 microUI/mL (SD: ±15.7), mean blood glucose was 148.1 mg/dl (SD: ±59.7) and mean HbA1c was 7.54 % (SD: ±1.8). In the correlation analysis, higher age and lower income were weakly correlated with lower cognitive level. No correlation was identified for biochemical variables and cognitive condition. A positive and weak correlation between cognition and HL was observed in the studied population. CONCLUSIONS: In older people living with DM the cognitive condition is correlated to specific topics of HL (nutritional status, physical activity and medication adherence).

[Use of public dental services by elderly Brazilians: a multilevel analysis]. / Uso de serviços odontológicos públicos entre idosos brasileiros: uma análise multinível.

This study evaluated whether the use of dental services of the Unified Health System (SUS) by elderly Brazilians is equitable. Individual data collected by qualified professionals during the national oral health survey (2010) and contextual data from DATASUS and IBGE were used. The dependent variable was the type of service used: SUS and others. Multilevel analyses were conducted using logistic regression (α=5%) (OR/CI 95%) using SPSS 24.0. A total of 6,303 elderly people were included and the prevalence of dental service use in SUS was 30%. Associated contextual factors were: access to bathroom and running water (1.54/1.19-2.00) and the dental care index (1.41/1.10-1.81); the individual factors were: age (0.77/0.66-0.90), years of schooling (1.83/1.53-2.20), family income (2.57/2.20-3.01), reason for last dental visit (0.75/0.60-0.93), decayed teeth total (1.26/1.08-1.48), plugged teeth total (0.63/0.54-0.74), dental prosthesis use (2.23/1.91-2.59), dental pain (1.36/1.11-1.67), self-perception of the need for dental treatment (1.20/1.12-1.51) and need for dental prosthesis (1.38/1.20-1.59). Dental service from SUS has been equitable, however it is necessary to organize the working process, enabling its use in a regular and preventive manner, thereby seeking universality and comprehensiveness.

Avaliou-se, entre idosos brasileiros, se o uso dos serviços odontológicos provenientes do Sistema Único de Saúde (SUS) é equânime. Utilizaram-se dados individuais de exames conduzidos por profissionais calibrados do levantamento nacional de saúde bucal (2010) e dados contextuais originários do DATASUS e do IBGE. A variável dependente foi o tipo de serviço utilizado: SUS e Outros. Foram conduzidas análises multiníveis através de regressão logística (α = 5%) (OR/IC 95%), através do SPSS 24.0. Participaram 6.303 idosos, a prevalência do uso no SUS foi de 30%, os fatores contextuais associados foram o acesso a banheiro e a água encanada (1,54/1,19-2,00) e o índice de cuidados odontológicos (1,41/1,10-1,81); já os individuais: idade (0,77/0,66-0,90), anos de estudo (1,83/1,53-2,20), renda familiar (2,57/2,20-3,01), motivo da última consulta (0,75/0,60-0,93), no de dentes cariados (1,26/1,08-1,48), no de dentes obturados (0,63/0,54-0,74), uso de próteses (2,23/1,91-2,59), dor de dente (1,36/1.11-1,67), autopercepção da necessidade de tratamento odontológico (1,20/1,12-1,51) e da necessidade de próteses (1,38/1,20-159). O uso no SUS tem sido equânime, porém é preciso organizar o processo de trabalho, viabilizando tal uso de forma regular e preventiva buscando a universalidade e a integralidade.

Contextual and individual determinants of tooth loss in adults: a multilevel study.

BACKGROUND: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. METHODS: This was a multilevel cross-sectional study with data from 9564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. RESULTS: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. CONCLUSIONS: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

Violência contra a mulher em tempos de pandemia da COVID-19 no Brasil: uma revisão integrativa / Violence against women in covid-19 pandemic times in Brazil: literature narrative review

Objetivo: sintetizar as informações contidas em artigos originais publicados no ano de 2020 sobre violência doméstica em tempos de pandemia da COVID-19 no Brasil e identificar que medidas, inclusive jurídicas, podem ser tomadas para amparar a mulher frente a essa situação. Método: revisão integrativa de literatura realizada por meio de buscas entre os meses de abril e julho de 2020 nas bases de dados LILACS, BDENF, MEDLINE, no motor de buscas PUBMED, e em um buscador acadêmico (Google Scholar). Utilizou-se palavras chaves presentes nos Descritores em Ciências da Saúde (DeCS) e no Medical Subject Headings (MeSH), bem como revisão legislativa sobre a temática. Foram incluídos no estudo artigos originais que abordaram o tema violência doméstica em tempos de pandemia. Resultados: dos estudos encontrados, dois atenderam aos critérios pré-estabelecidos para a inclusão neste estudo. Após análise dos textos foi possível organizar as informações obtidas em duas abordagens: o que já se sabe sobre o aumento da violência doméstica em tempos de pandemia e o que pode ser feito, considerando medidas jurídicas, para amparar as mulheres vítimas de violência doméstica durante a pandemia da COVID-19. Conclusão: foram selecionados dois artigos originais cujos resultados e conclusões associados às produções científicas, legislações e relatórios de organizações nacionais e internacionais, consideradas na revisão podem subsidiar a prática de gestores e profissionais de saúde no enfrentamento da violência contra a mulher no Brasil em tempos de pandemia. Ficou evidente a necessidade de estudos originais sobre o tema.

Objective:to synthesize the information contained in scientific productions, legislation and reports of national and international organizations published in the year 2020 on domestic violence in the pandemic times of COVID-19 in Brazil and to identify what measures, including legal ones, can be taken to support women in this situation. Method:literature narrative review carried out through searches between the months of April and July 2020 in the LILACS, BDENF, MEDLINE databases, in the PUBMED search engine, and in an academic search engine (Google Scholar). Keywords used in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used, as well as a legislative review on the subject. Scientific productions, legislation and reports of national and international organizations that addressed the issue of domestic violence in times of pandemic were included in the study. Results:of the studies found, eighteen met the pre-established criteria for inclusion in this study. After analyzing the texts, it was possible to organize the information obtained in two approaches: what is already known about the increase in domestic violence in times of pandemic and what can be done, considering legal measures, to support women victims of domestic violence during the COVID-19 pandemic. Conclusion:The scientific productions, legislation and reports of national and international organizations considered in the review can support the practice of managers and health professionals in confronting violence against women inBrazil in times of pandemic. The need for original studies on the topic was evident.

Abordagem multinível quanto ao uso de serviços odontológicos no Sistema Único de Saúde entre adultos brasileiros / Multilevel approach to the use of dental services in SUS among Brazilian adults

Resumo Introdução Adultos usam serviços odontológicos públicos ou privados. Objetivo Identificar fatores associados ao uso dos serviços odontológicos provenientes do SUS entre adultos brasileiros, considerando aspectos contextuais e individuais. Método Foram utilizados dados contextuais de 177 municípios do DATA/SUS, do IBGE, do Atlas Brasil e do Projeto SB Brasil/2010, bem como dados individuais de uma amostra pobabilistica do SB Brasil/2010 coletados por dentistas calibrados. O SPSS 19.0® foi utilizado nas análises descritivas e bivariadas, e o STATA 14.0®, na análise multinível. Resultados A prevalência do uso de serviços no SUS foi de 37,9%. O uso de serviços no SUS foi maior nos municípios com pior acesso à coleta de lixo, em indivíduos com menor escolaridade e menor renda familiar, em negros/pardos/amarelos/indígenas, naqueles com dentes cariados e nos que avaliaram a consulta odontológica como regular/ruim/péssima. Já o uso foi menor nos municípios com menor cobertura de equipes de saúde bucal, entre os mais velhos e em indivíduos do sexo masculino. O maior uso entre os mais vulneráveis sugere equidade. Conclusão Constatou-se efeitos contextuais e individuais sobre o comportamento dos adultos quanto ao tipo de serviço odontológico utilizado que devem ser considerados nas políticas de saúde bucal.

Abstract Background Adults who demand for public or private dental services. Objective Factors associated with the use of dental services from SUS were identified among Brazilian adults, considering context and individual factors. Method It was used contextual data from 177 municipalities of DATA/SUS, IBGE, Atlas Brazil and SB Brazil / 2010 Project; and individual data from SB Brazil/2010. SPSS 19.0® was used in descriptive and bivariate analyzes and STATA 14.0® in multilevel analysis. Results The prevalence of use of services in SUS was 37.9%. The use of services in SUS was higher in municipalities with poor access to waste collection and lower in those with lower coverage of oral health teams. The use was lower among older men. Among those with lower schooling, lower family income, among blacks/brown/yellows and Indigenous, those with decayed teeth, and those who evaluated the dental appointment as regular/bad or bad. The greater use among the most vulnerable suggests equity. Conclusion Contextual and individual effects on the behavior of adults regarding the type of dental service used, which should be considered in oral health policies were verified in this study.

[Association between the use of total dental prosthesis (denture) and the type of oral health care service used by toothless elderly individuals]. / Associação entre o uso de prótese dentária total e o tipo de serviço odontológico utilizado entre idosos edêntulos totais.

Oral rehabilitation with dental prosthesis was mandated by national oral health policy in Brazil, due to the high prevalence of total teeth loss and low use of dental prosthesis among the elderly. There is a pressing need to assess the impact of this rehabilitation policy. An attempt was therefore made to investigate if the dental service used was one of the factors associated with the use of total dental prosthesis among the elderly. To achieve this, a cross-sectional study using a probabilistic sample of elderly (60 years and above) urban-area residents of a small city was conducted by qualified examiners. Descriptive, bivariate and multiple (logistic regression/odds ratio - OR) analyses were conducted on 287 elderly people, of which 186 (64.8%) used dental prosthesis. The use of total dental prosthesis was associated with a higher probability of being attended by private dental services (OR = 4.19; p < 0.001) and the presence of lesions on the palate (OR = 7.52; p = 0.002). Conversely, it was associated with lower probability in ages greater than or equal to 73 years (OR = 0.52; p = 0.023) and among those with impairment of OHIP-14 (OR = 0.20; p = 0.002) in the physical disability dimension. The use of total dental prosthesis was associated with the type of dental service used by the elderly, it being greater among private service users.

A reabilitação protética foi prevista pela política nacional de saúde bucal em função da alta prevalência de perda de todos os dentes e do baixo uso de prótese dentária entre idosos. Há necessidade de se avaliar o impacto dessa política de reabilitação. Portanto, objetivou-se investigar se o tipo de serviço odontológico utilizado foi um dos fatores associados ao uso de prótese dentária total entre idosos. Trata-se de um estudo transversal conduzido em uma amostra probabilística de idosos (60 anos ou mais) residentes na zona urbana de um município brasileiro de pequeno porte populacional por examinadores calibrados. Realizaram-se análises descritiva, bivariada e múltipla (Regressão logística - odds ratio - OR). Participaram 287 idosos, destes, 186 (64,8%) faziam uso de prótese dentária total. O uso de prótese dentária total foi associado a maiores chances de uso de serviços odontológicos supletivos ou particulares (OR = 4,19; p < 0,001) e a presença de lesão no palato (OR = 7,52; p = 0,002) e, também, a menores chances em idades maiores ou iguais a 73 anos (OR = 0,52; p = 0,023) e entre os com comprometimento na dimensão incapacidade física do OHIP-14 (OR = 0,20; p = 0,002). O uso de prótese dentária total foi associado ao tipo de serviço odontológico entre idosos, sendo maior o uso entre usuários dos serviços supletivos ou particulares.