Reemerging diseases in Brazil: sociodemographic and epidemiological characteristics of syphilis and its under-reporting.

INTRODUCTION: This paper analyzed sociodemographic and epidemiological data of individuals with syphilis as well as the compulsory reporting of the disease, for being a reemerging disease in Brazil. METHODS: General information and sociodemographic, epidemiological, clinical, and laboratory data were verified in compulsory reporting. RESULTS: From 2010 to 2016, 157 reporting forms were explored. Acquired and gestational syphilis occurred predominantly in those 20 to 29 years of age and those who did not complete secondary education. Compulsory reporting forms were not complete. CONCLUSIONS: The number of syphilis cases has varied over the years in the city. Incomplete compulsory reporting was noted.

Reemerging diseases in Brazil: sociodemographic and epidemiological characteristics of syphilis and its under-reporting

Abstract INTRODUCTION: This paper analyzed sociodemographic and epidemiological data of individuals with syphilis as well as the compulsory reporting of the disease, for being a reemerging disease in Brazil. METHODS: General information and sociodemographic, epidemiological, clinical, and laboratory data were verified in compulsory reporting. RESULTS: From 2010 to 2016, 157 reporting forms were explored. Acquired and gestational syphilis occurred predominantly in those 20 to 29 years of age and those who did not complete secondary education. Compulsory reporting forms were not complete. CONCLUSIONS: The number of syphilis cases has varied over the years in the city. Incomplete compulsory reporting was noted.

Análisis de la cumplimentación de certificados médicos por estudiantes y profesionales de odontología / Analysis of filling out dental certificates by dental students and professionals

Resumen: Este estudio tuvo el objetivo de analizar y comparar la cumplimentación de certificados médicos por estudiantes del cuarto año del curso de Odontología de una universidad pública brasileña y por profesionales de cursos de especialización específicos del área. Entre 2014 y 2016, se dejó a los encuestados una hoja de papel en blanco en cuyo encabezamiento sólo constaba la palabra "Certificado", a fin de que se lo elaboraran de la manera que juzgaran más adecuada. Se utilizó test para comparación de dos proporciones y Test de Chi- Cuadrado con nivel de significación del 5%. Participaron de la inves tigación 336 individuos, de los cuales 167 (49,7%) eran estudiantes y 169 (50,3%), profesionales de cursos de especialización de la Facultad de Odontología de Araçatuba. Solamente 73 (21,7%) individuos ela boraron el certificado correctamente. Entre los errores de los estu diantes se destaca la inserción de la Clasificación Estadística Interna cional de Enfermedades sin el consentimiento del paciente, y, de los profesionales, la falta del Documento Nacional de Identidad. Hubo diferencia estadística significativa entre las categorías respecto a la correcta cumplimentación del certificado (p=0). Se concluyó que una parte considerable de los encuestados rellena los certificados odonto lógicos incorrectamente, con menores errores entre los estudiantes de Odontología.

Abstract: The objective of this study was to analyze and compare the filling of the dental certificates by the students of the fourth year of the den tistry course of a Brazilian public university and professionals of specialization courses in the area. The respondents were given a blank sheet written "Certificate", for them to fill out. The period analyzed was from 2014 to 2016. The test was used to compare two proportions and the chi-square test, with a significance level of 5%. A total of 336 individuals participated in the study, of which 167 (49.7%) were fourth year students of the Dentistry course and 169 (50.3%) professionals of specialization courses of the School of Dentistry of Araçatuba. Only 73 (21.7%) correctly filled the certificate. Among the errors, we emphasize the students' insertion of the International Statistical Clas sification of Diseases without the patient's consent and among profes sionals the lack of the General Registry. There was a significant statis tical difference between the categories regarding the correct filling of the certificate (p = 0). We concluded that the dental certificates are filled incorrectly by a considerable portion of the respondents, with minor errors among dentistry students.

Exposição a material biológico no ambiente ocupacional: conhecimento e adoção de condutas preventivas / Exposure to biological material in the occupational environment: knowledge and adoption of preventive measures

A Biossegurança em saúde é o conjunto de ações voltadas para a prevenção, minimização ou eliminação de riscos inerentes às atividades de pesquisa, produção, ensino, desenvolvimento tecnológico e prestação de serviços, visando à saúde do homem, dos animais, preservação do meio ambiente e qualidade dos resultados. No presente trabalho, procurou-se realizar uma revisão integrativa da literatura sobre biossegurança e precauções padrão na odontologia. Para isso, foi feita uma busca de evidências presentes na literatura científica, por meio de um levantamento nas bases de dados "Scielo" e no "Portal Regional da BVS", utilizando uma estratégia de busca de acordo com a temática proposta. Além disso, verificou-se, por meio de um questionário semiestruturado com perguntas relacionadas ao tema, o conhecimento e adesão às precauções padrão, em especial a prática de reencapar agulhas; as ações a serem tomadas diante acidentes e aspectos relativos à prevenção de infecções, por acadêmicos e funcionários da Faculdade de Odontologia de Araçatuba (FOA -Unesp). Observou-se a localização dos recipientes de descarte de perfurocortantes nas clínicas da faculdade, as condições de preenchimento e os materiais descartados nos recipientes do grupo E. Analisaram-se as informações contidas nas Notificações de Acidente de Trabalho (NATs), a fim de estabelecer um perfil dos acidentes ocorridos na faculdade. A partir das buscas nas bases de dados, foram encontrados 95 artigos sobre a temática nos últimos 10 anos. No entanto, obtivemos um total de 18 artigos selecionados para a presente revisão integrativa de literatura, os quais obedeceram criteriosamente os critérios de inclusão e exclusão, e se relacionavam com o objeto de estudo. Participaram da pesquisa 91 acadêmicos de odontologia dos últimos anos, dos períodos integral e noturno e 21 funcionários terceirizados da limpeza da faculdade. 55 NATs foram analisadas no período de 2013 a 2017. Entre os alunos que responderam ao questionário, 79 (86,8%) afirmaram existir um protocolo na faculdade em caso de acidente, 82 (90,1%) disseram ter recebido orientações a respeito e 42 (46,2%) afirmaram saber o que são as PP. Entretanto, 74 (81,3%) afirmaram reencapar agulhas, na maioria dos casos com uma das mãos (78,4%), a fim de não deixar a agulha exposta na bancada (71,4%). 31 (34,1%) já sofreram acidentes com material biológico, sendo que 62 (68,1%) não sabiam quais os cuidados imediatos pós-exposição, 87 (95,6%) o prazo máximo para o início da profilaxia pós-exposição ao HIV, 78 (85,7%) a duração e 74 (81,3%) a eficácia. 63 (69,2%) não receberam orientação sobre o preenchimento da NAT. Entre os funcionários, 17 (81%) afirmaram existir um protocolo na faculdade em caso de acidente e terem recebido orientações a respeito; entretanto 7 (33,3%) não sabiam o que eram as PP. 20 (95,3%) não conheciam quais os cuidados imediatos pós-exposição, 18 (85,7%) não sabiam o prazo máximo para o início da profilaxia pós-exposição ao HIV, 20 (95,3%) a duração e a eficácia. Apesar de 9 (42,9%) afirmarem ter recebido orientação sobre o preenchimento da NAT, 11 (52,4%) não conheciam ou não responderam qual seria o prazo máximo para seu preenchimento. Em relação ao recipiente de descarte, a localização mostrou-se inadequada, pois o aluno precisava deslocar-se para realizar o descarte. Observaram-se 7.327 agulhas descartadas, onde 3.587 (49%) estavam reencapadas, dentre as quais 2.555 (71,2%) em um lado e 1.032(28,8%) em ambos os lados; além disso, foram verificados diferentes materiais não perfurocortantes descartados, como tubetes anestésicos, gaze e algodão. Em relação as NATs, a maioria foi emitida no ano de 2017 (45,4%), 50 (90,9%) eram do sexo feminino e tinham a média de idade de 48,78 anos (dp=9,52). 53 (96,4%) correspondiam à ocorrência de acidentes típicos, onde na maioria dos casos, a parte do corpo mais atingida foi às mãos (40%) e 12 (21,8%) dos pesquisadores pediram afastamento após o infortúnio. 29 (52,7%) dos acidentes ocorreram em uma unidade auxiliar de estrutura complexa da faculdade. Conclui-se que há alto percentual de acidentes com material biológico, em especial entre acadêmicos, além de deficiência no conhecimento das condutas pós-exposição e baixa adesão de medidas preventivas entre ambas as categorias pesquisadas; também o predomínio da ocorrência de acidentes em um setor específico da faculdade(AU)

Standard Precautions (SP) are recommendations, among them, the not recapping needles, which purpose is to minimize or prevent the transmission risk of blood borne pathogens. This study objective was to verify the knowledge and adhesion to the SP, especially the recapping needles practice; the actions to be taken before accidents and related aspects to infection prevention by academics and employees; besides the profile of accidents occurred in the Faculdade de Odontologia de Araçatuba (FOA - Unesp). Also observe the location of the sharps disposal containers in the school clinics, the filling conditions and disposed materials. Was applied a semi-structured questionnaire with related questions to 91 senior students from both periods and 21 outsourced cleaning staff from the school. Was also analyzed the information on the Employee's Report of Injury. Between the academics, 79 (86.8%) affirmed the existence of an accident protocol, 82 (90.1%) had received orientation about it and 42 (46.2%) affirmed to know what are the SP. However, 74 (81.3%) affirmed to recap needles, mostly using one hand (78.4%), in order to not let the needle exposed in the table (71.4%). 31 (34.1 %) already suffered an accident with biological material, being that 62 (68.1%) did not know the immediate post exposure care, 87 (95.6%) the maximum time to initiate the HIV post exposure prophylaxis, 78 (85.7%) the duration and 74 (81.3%) the efficiency. 63 (69.2%) did not received an orientation about the Employee's Report Injury. Among the staff, 17 (81 %) affirmed the existence of an accident protocol and have received orientation about it; however, 7 (33.3%) did not know the SP. 20 (95.3%) did not know the immediate post exposure care, 18 (85.7%) ignored the maximum time to initiate the HIV post exposure prophylaxis, 20 (95.3%) the duration and the efficiency. Despite of 9 (42.9%) affirmed to have received orientation about the Employee's Report of Injury, 11 (52.4%) ignored or did not responded about the maximum time to submit it. About the sharp disposal container, the location showed was inappropriate, once the academic had to move to realize the disposal. There was 7.327 needles disposed, where3.587 (49%) was recapped, being that 2.555 (71.2%) in one end and 1.032 (28.8%) in both ends; in addition, was noticed that non-sharpened materials, as anesthetic tubes, gauze and cotton. Was analyzed 51 Employee's Report of Injury in a period, being that 47 (92.2%) of the injured were female. 14 (25.7%) reports in volved sharp materials, and the body part were the hands. 36 (70.6%) of the injury occurred in an auxiliary unit of complex structure. It concludes that there is a high percentage of biological material accidents, especially among academics, and a deficiency in the knowledge about post exposure measures and low adhesion among both surveyed categories, besides the predominance of the occurrence of accidents in an specific sector of the school(AU)

O estigma de usuários do sistema público de saúde brasileiro em relação a indivíduos HIV positivo / The stigma of HIV positive users of the public health system

O conceito inicial de que a AIDS era uma doença que ocorria em indivíduos com atitudes desaprovadas pela sociedade causou estigmatização e preconceito em indivíduos HIV positivo. Objetivo: Analisar a existência de preconceito e atitudes discriminatórias de usuários do Sistema Único de Saúde (SUS) em relação a indivíduos soropositivos, considerando sua classe socioeconômica. Métodos: Trata-se de uma pesquisa descritiva, com caráter transversal e abordagem quantitativa. Aplicou-se o Critério de Classificação Econômica Brasil, para a classificação econômica da população, e um questionário estruturado com questões relacionadas ao preconceito e à discriminação, à percepção sobre esterilização e ao contágio de doenças; além de questões de manual do Ministério da Saúde que aborda o assunto. Resultados: A população estudada foi composta por 150 indivíduos, dos quais 77,3% afirmaram que aceitariam ser atendidos após um paciente soropositivo, e 92%, após um presidiário. Entretanto, 42% prefeririam o atendimento antes de um indivíduo soropositivo, e 23,3%, antes de um presidiário. A maioria relatou preocupação quanto à esterilização do material odontológico (98%), embora 42% não soubessem como o procedimento ora realizada. Existiu diferença significativa entre os indivíduos que inicialmente afirmaram aceitar o atendimento após um paciente HIV positivo (p=0,0029) ou um presidiário (p<0,0001) e os que posteriormente disseram preferir o atendimento antes. Não houve associação entre classe econômica e preconceito. Conclusão: Os usuários do SUS apresentam preconceito e atitudes discriminatórias em relação a pessoas soropositivas, expressa, às vezes, de maneira velada, independentemente da classe econômica do indivíduo.

The initial idea of AIDS as a disease that affects individuals with attitudes disapproved by society has caused stigmatization and prejudice among HIV positive individuals. Objective: To analyze the existence of prejudice and discriminatory attitudes of Unified Health System ("Sistema Único de Saúde" ­ SUS) users towards HIV positive individuals, according to socioeconomic class. Methods: This is a cross-sectional, descriptive research, with quantitative approaches. We categorized the population according to the Brazilian Criterion of Economic Classification, and applied a structured questionnaire related to prejudice, discrimination, and perceptions regarding sterilization and infectious diseases; as well as questions from a relevant Ministry of Health publication. Results: The study population consisted of 150 individuals, 77.3% of which asserted they would agree to be treated immediately after an HIV positive patient and 92% after a prisoner. However, 42% preferred being examined before HIV positive individuals, and 23.3% before a prisoner. The majority reported concern about the sterilization of dental material (98%), though 42% did not know how the procedure was carried out. There was significant difference between individuals who initially said they would not mind being received after HIV positive patients (p=0.0029) or inmates (p<0.0001), and those who later said they would rather be received before individuals in these conditions. There was no association between socioeconomic class and prejudice. Conclusion: SUS users show prejudicial and discriminatory attitudes toward HIV patients, often expressed in subtle manners, regardless of economic class of the individual.

Sociodemographic and epidemiological profile of leprosy patients in an endemic region in Brazil.

INTRODUCTION:: The incidence of Hansen's disease is high in overlooked populations. METHODS:: Data of Hansen's disease cases reported in the information system of the Department of Informatics, Brazilian Unified Health System, from 2013 to 2014 were analyzed. RESULTS:: Among 434 studied cases of Hansen's disease, the female sex (52.5%), adult age (73.7%), low educational level (61.8%), and multibacillary form were associated with higher prevalence rates. CONCLUSIONS:: Hansen's disease is more frequent among female adults with a low educational level, and the prevalence of multibacillary leprosy reflects disease detection at late stages.

Sociodemographic and epidemiological profile of leprosy patients in an endemic region in Brazil

Abstract: INTRODUCTION: The incidence of Hansen's disease is high in overlooked populations. METHODS: Data of Hansen's disease cases reported in the information system of the Department of Informatics, Brazilian Unified Health System, from 2013 to 2014 were analyzed. RESULTS: Among 434 studied cases of Hansen's disease, the female sex (52.5%), adult age (73.7%), low educational level (61.8%), and multibacillary form were associated with higher prevalence rates. CONCLUSIONS: Hansen's disease is more frequent among female adults with a low educational level, and the prevalence of multibacillary leprosy reflects disease detection at late stages.

DENTISTS' KNOWLEDGE AND EXPERIENCE REGARDING LEPROSY IN AN ENDEMIC AREA IN BRAZIL.

This study aims to analyze the dental surgeons' knowledge about leprosy and its ways of transmission, clinical characteristics and treatment, besides analyzing their experience with respect to diagnostic suspicion and case referrals. The study population comprised 242 dental surgeons working in the public dental service of the city of Cuiabá, Mato Grosso, Brazil. A self-applicable questionnaire containing questions about the dental surgeon's profile was used, including his/her knowledge on leprosy, as well as his/her practices concerning the disease. The results showed a predominance of female dental surgeons (65.7%), with ages ranging between 30 and 39 years old (43%) and professionals having six to 10 years of experience since graduation. Concerning their time working in the Unified Health System (SUS), the highest percentage of dental surgeons referred more than 10 years. Regarding the knowledge about the disease, 30.6% did not know the efficacy of the treatment of leprosy, 47% did not know the disease had to be notified compulsorily and only 8.3% had received information about leprosy at work. Besides that, most of them mentioned feeling little security when treating patients with leprosy (61.6%). Thus, dental surgeons' deficient knowledge on issues related to leprosy may be highlighted.

Estigma do HIV positivo expresso por meio do preconceito velado / Stigma of HIV positive expressed through veiled prejudice

O termo estigma foi criado pelos gregos da Antiguidade para referirem sinais feitos no corpo que evidenciavam algo ruim sobre a moral de quem os apresentava. Objetivo: Objetivou-se verificar a presença de atitudes discriminatórias de usuários do sistema público de saúde em relação a indivíduos HIV positivo, além da percepção dos mesmos sobre a possibilidade de contraírem algum tipo de doença durante o tratamento odontológico. Métodos: O instrumento de coleta de dados consistiu de um questionário semiestruturado. Realizaram-se entrevistas com perguntas relacionadas à concordância do indivíduo ao atendimento por um cirurgião-dentista HIV positivo, após o atendimento de um paciente soropositivo, ou um presidiário; a percepção da possibilidade de se contrair alguma doença no consultório odontológico; preocupação com relação à esterilização dos materiais utilizados e conhecimento sobre a forma de esterilização. Resultados: Foram entrevistados 200 indivíduos, sendo que 142 afirmaram que aceitariam ser atendidos após um paciente HIV positivo e 160 após um presidiário. Ainda, 162 se disporiam ser tratados por um cirurgião-dentista HIV positivo. Entretanto, quando questionados em relação à preferência, 93 prefeririam o atendimento antes de um indivíduo soropositivo e 60 antes de um presidiário. Conclusão: Conclui-se que os pacientes apresentam atitudes discriminatórias em relação a pessoas soropositivas, expressa às vezes de maneira velada e a percepção sobre a possibilidade de contrair algum tipo de infecção durante o tratamento odontológico.

The term stigma was coined by the ancient Greeks to refer to signs made in the body meaning something bad on the morale of those who had them. Objective: To verify the presence of discriminatory attitudes of users of Unified Health System regarding HIV-positive individuals, as well as the perception about the possibility of acquiring some kind of disease during dental treatment. Methods: The data collection instrument consists of a semi-structured questionnaire. This study included interviews asking the following questions: individuals agree to be treated by a HIV-positive dentist, after the treatment of a HIV-positive patient or an inmate; the perception of the possibility of acquiring illnesses in a dental office; concern regarding sterilization of materials used and the manner of sterilization. Results: Two hundred individuals were interviewed, 142 would accept to be treated after a HIV-positive patient and 160 after an inmate. Moreover, 162 would be available for treatment by a HIV-positive dentist. However, when questioned about the preference, 93 would prefer to be treated before a HIV-positive patient and 60 before an inmate. Conclusion: Patients showed discriminatory attitudes toward seropositive people, expressed sometimes in a veiled manner, and the perception about the possibility of getting some kind of infection during dental treatment.

Socioeconomic level and the parents' perception of the impact of oral diseases on their children's quality of life

Aim: To analyze how parents of different socioeconomic levels perceive the impact of oral diseases on their children's quality of life. Methods: All parents or guardians of students aged 11 to 14 years old, regularly enrolled in fundamental schooling at public schools of two towns in the northwestern region of the State of São Paulo, Brazil, were enrolled in the study. The questionnaire of "Socioeconomic Assessment Tool" was used to classify the families with regards to socioeconomic class and the "Parental-Caregiver Perceptions Questionnaire (P-CPQ)" was used to verify the parents' perception of the impact of oral diseases on their children's quality of life. Results: 172 (41.8%) individuals answered the survey. Among them, most belonged to the Upper Low Class (61%). 21.5% of the individuals answered that they considered their children's oral health "regular or bad" and 71.5% answered that their child's general well-being was not or was little affected by the condition of his/her teeth, lips, jaws or mouth. There was an association between the quality of life sub-scales, especially "oral symptoms", with all socioeconomic classes. Conclusions: There is a relationship between parents' socioeconomic class and the perception of the impact of oral disease on their children's quality of life (Au)

The stigma and prejudice of leprosy: influence on the human condition.

INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

The stigma and prejudice of leprosy: influence on the human condition

INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation. .

Adherence to standard precautions from the standpoint of the Health Belief Model: the practice of recapping needles.

The aim of this study was to apply the Health Belief Model to explain the adherence to the recommendation not to recap needles by dentists and dental assistants of the public health system in a municipality in the State of São Paulo. A questionnaire validated and adapted for the oral health area was used, which included variables related to the frequency of recapping and health beliefs using Likert-type scales. The relationship between beliefs and adherence to the recommendation not to recap needles was obtained by regression analysis. Of all the professionals in this study (n=79), the majority (83.5%) reported recapping needles at least once in the last month. Through regression analysis, it was observed that the relationship between the beliefs described by the model and the attitude whether or not to follow the recommendation not to recap needles was explained by a lower perception of psychological barriers and a greater perception of stimuli not to recap needles. The conclusion reached is that the acceptance of recommendations to prevent working accidents with biological material was explained by some dimensions of the Health Belief Model, enabling discussion about reformulation of training offered to professionals of the public health system.

Adherence to standard precautions from the standpoint of the Health Belief Model: the practice of recapping needles / Adesão às precauções padrão sob o prisma do Modelo de Crenças em Saúde: a prática de reencapar agulhas

The aim of this study was to applythe Health Belief Model to explain the adherence to the recommendation not to recap needles by dentists and dental assistants of the public health system in a municipality in the State of São Paulo. A questionnaire validated and adapted for the oral health area was used, which included variables related to the frequency of recapping and health beliefs using Likert-type scales. The relationship between beliefs and adherence to the recommendation not to recap needles was obtained by regression analysis. Of all the professionals in this study (n=79), the majority (83.5%) reported recapping needles at least once in the last month. Through regression analysis, it was observed that the relationship between the beliefs described by the model and the attitude whether or not to follow the recommendation not to recap needles was explained by a lower perception of psychological barriers and a greater perception of stimuli not to recap needles. The conclusion reached is that the acceptance of recommendations to prevent working accidents with biological material was explained by some dimensions of the Health Belief Model, enabling discussion about reformulation of training offered to professionals of the public health system.

Objetivou-se neste estudo aplicar o Modelo de Crenças em Saúde a fim de explicar a adesão à recomendação de não reencapar agulhas por cirurgiões-dentistas e auxiliares de saúde bucal da rede pública de um município paulista. Utilizou-se um questionário validado e adaptado para a área de saúde bucal, que contemplava variáveis relativas à frequência do reencape e crenças em saúde, por meio de escalas tipo Likert. A relação entre as crenças e a adesão à recomendação de não reencapar agulhas foi obtida por meio da análise de regressão. Da amostra de profissionais obtida por adesão ao estudo (n = 79), a maioria (83,5%) relatou ter reencapado agulhas pelo menos alguma vez no último mês. Por meio da análise de regressão, foi observado que a relação entre as crenças descritas pelo modelo e a atitude de aderir ou não à recomendação de não reencapar agulhas foi explicada por uma menor percepção de barreiras psicológicas e por uma maior percepção de estímulos para não reencapar agulhas. Conclui-se que a aceitação das recomendações para prevenir acidentes do trabalho com material biológico foi explicado por algumas dimensões do Modelo de Crenças em Saúde, possibilitando a discussão sobre a reformulação de capacitações oferecidas para profissionais do sistema público de saúde.

Relação entre a presença da equipe de saúde bucal na Estratégia Saúde da Família com o nível de conhecimento dos agentes comunitários de saúde / Relation between the insertion of the Oral Health Team in the Family Health Strategy and the level of knowledge of community health workers / Relación entre la inserción del Equipo de Salud Bucal en la Estrategia de Salud Familiar y el nivel de conocimiento de los agentes comunitarios de salud

Objetivo: identificar a relação entre o nível de conhecimento dos agentes comunitários de saúde sobre saúde bucal e a presença da Equipe de Saúde Bucal na Estratégia Saúde da Família. Métodos: uma pesquisa tipo inquérito foi realizada com 173 agentes comunitários de saúde alocados na rede pública de saúde em cinco municípios da região noroeste do estado de São Paulo, Brasil, por meio de um questionário autoaplicável, estruturado. O instrumento da pesquisa contemplava perguntas referentes à presença da Equipe de Saúde Bucal na Estratégia Saúde da Família e questões sobre saúde bucal. Resultados: a maioria dos agentes comunitários de saúde estava inserida em estratégias com a presença de Equipes de Saúde Bucal (60,1%). Verificou-se que o conhecimento em saúde bucal da maioria dos participantes foi bom (48%). Conclusão: existe relação entre o nível de conhecimento dos agentes comunitários de saúde e a presença da Equipe de Saúde Bucal na Estratégia Saúde da Família.

Objective: to identify the relation between the level of knowledge of community health workers on oral health and the presence of the Oral Health Team in the Family Health Strategy. Methods: we performed a survey with 173 community health workers allocated in public health services of five municipalities in the northwest of São Paulo, Brazil, through a self-administered and structured instrument. The survey instrument contemplated questions related to the presence of the Oral Health Team in the Family Health Strategy and questions regarding oral health. Results: the majority of community health workers was inserted in strategies with the presence of Oral Health Teams (60.1%). We found that the oral health knowledge of most participants was good (48%). Conclusion: there is relation between the level of knowledge of community health workers and the presence of the Oral Health Team in the Family Health Strategy.

Objetivo: identificar la relación del nivel de conocimiento de los agentes comunitarios de salud sobre salud bucal y la presencia del Equipo de Salud Bucal en la Estrategia Salud de la Familia. Métodos: se realizó una investigación tipo encuesta con 173 agentes comunitarios de salud de la red pública de salud en cinco municipios de la región noroeste del estado de São Paulo, Brasil, por medio de un cuestionario autoaplicable, estructurado. El instrumento de recogida de datos tenía preguntas sobre la presencia del Equipo de Salud Bucal en la Estrategia Salud de la Familia y cuestiones sobre salud bucal. Resultados: la mayoría de los agentes comunitarios de salud estaba inserta en estrategias con la presencia de equipos de salud bucal (60,1%). Se observó un buen conocimiento sobre salud bucal en la mayoría de los participantes (48%). Conclusión: hay relación entre el nivel de conocimiento de los agentes comunitarios de salud y la presencia del Equipo de Salud Bucal en la Estrategia Salud de la Familia.

Body mass index, dental caries and sugar intake in 2-5 year-old preschoolers

AIM: To determine the association between dental caries, Body Mass Index (BMI) and sugar intake in children attending primary school. METHODS: A cross-sectional study was conducted with 91 children, with mean age of 3.9 years (sd = ±1.0), considering anthropometric measurements, according to standardized methodology of the Ministry of Health and occurrence of dental caries was recorded from clinical examinations (dmft). The sugar intake level was measured with a questionnaire that was applied to parents/caretakers of the children. The association of the variables was checked using a correlation with the Contingency C coefficient test. RESULTS: 33 (36.3%) children were at risk for overweight, overweight or obese. Of these, 10 (30.3%) had dmft >1. An association was found between sugar added to the bottle and child dmft (coeff. C = 0.5853 and p <0.0001) and also with BMI (coeff. C = 0.5693 and p <0.0001). There was no association between BMI and caries (chi-square = 0.1447 and p-value = 0.7036). CONCLUSIONS: It was concluded that there was a correlation between sugar intake and dmft and BMI, but not between caries and BMI...

[Prevalence of non-nutritive sucking habits in preschoolers and parents' perception of its relationship with malocclusions]. / Prevalência de hábitos de sucção não nutritivos em pré-escolares e a percepção dos pais sobre sua relação com maloclusões.

This cross-sectional and descriptive study sought to verify the prevalence of sucking habits in preschoolers and their parents' perception of its relationship with the occurrence of malocclusion. The population consisted of a representative sample of parents of preschoolers aged between 4 months and 6 years old. A semi-structured, self-administered questionnaire was used, consisting of open and closed questions relating to frequency of use and knowledge of parents regarding non-nutritive sucking habits. Of the 356 respondents, 70.8% stated that the children had some oral habit, with pacifier sucking being the most frequent (45.6%). Although the majority (97.1%) of the parents or caregivers admitted being aware that these habits could be detrimental to teeth, 70.2% of the respondents had already offered a pacifier to children, in most cases to calm them (61.8%). There was a statistically significant association between offering a pacifier to a child and knowledge about the relationship of the existence of non-nutritive habits and the occurrence of malocclusion (p <0.0001 and Chi-square = 60.123). The conclusion is that the prevalence of oral habits of the population is high and, despite the majority of parents knowing that pacifier sucking can cause damage to oral health, they offer them to calm the child.

Prevalencia de habitos de succao nao nutritivos em pre-escolares e a percepcao dos pais sobre sua relacao com maloclusoes / Prevalence of non-nutritive sucking habits in preschoolers and parents' perception of its relationship with malocclusions

Este estudo transversal e descritivo objetivou verificar a prevalência de hábitos de sucção em pré-escolares e a percepção dos pais sobre a relação com a ocorrência de maloclusões. A população do estudo constituiu-se por uma amostra representativa de pais de pré-escolares de 4 meses a 6 anos de idade. Utilizou-se um questionário semiestruturado, composto por questões abertas e fechadas, referentes à frequência e conhecimentos dos pais frente aos hábitos de sucção não nutritivos. Dos 356 participantes da pesquisa, 70,8% afirmaram que as crianças apresentavam algum hábito bucal, sendo a sucção de chupeta o mais frequente (45,6%). Apesar da grande maioria dos pesquisados (97,1%) relatarem saber que os hábitos podiam causar prejuízo aos dentes, 70,2% deles já haviam oferecido chupeta à criança, na maioria das vezes para acalmá-la (61,8%). Houve associação estatisticamente significativa entre a oferta da chupeta à criança e o conhecimento sobre a relação da presença de hábitos não nutritivos e a ocorrência de maloclusão (p < 0,0001 e Qui-quadrado = 60,123). A prevalência de hábitos bucais na população estudada é alta e, apesar da maioria dos pais saberem que o hábito de sucção de chupeta pode causar danos à saúde bucal, ofertavam a chupeta a fim de acalmar a criança.

This cross-sectional and descriptive study sought to verify the prevalence of sucking habits in preschoolers and their parents' perception of its relationship with the occurrence of malocclusion. The population consisted of a representative sample of parents of preschoolers aged between 4 months and 6 years old. A semi-structured, self-administered questionnaire was used, consisting of open and closed questions relating to frequency of use and knowledge of parents regarding non-nutritive sucking habits. Of the 356 respondents, 70.8% stated that the children had some oral habit, with pacifier sucking being the most frequent (45.6%). Although the majority (97.1%) of the parents or caregivers admitted being aware that these habits could be detrimental to teeth, 70.2% of the respondents had already offered a pacifier to children, in most cases to calm them (61.8%). There was a statistically significant association between offering a pacifier to a child and knowledge about the relationship of the existence of non-nutritive habits and the occurrence of malocclusion (p <0.0001 and Chi-square = 60.123). The conclusion is that the prevalence of oral habits of the population is high and, despite the majority of parents knowing that pacifier sucking can cause damage to oral health, they offer them to calm the child.

Conhecimento sobre saúde bucal e práticas desenvolvidas por professores do ensino fundamental e médio / Oral health knowledge and practices developed by teachers of elementary and secondary local schools

Introdução: a educação em saúde bucal é um processo que visa a transformar atitudes e comportamentos e for-mar hábitos em benefício da saúde do indivíduo. Para que isso ocorra, fazem-se necessários um reforço e uma repetição contínua, possíveis no ambiente escolar. Objetivo: analisar o conhecimento dos professores so-bre saúde bucal, as práticas desenvolvidas no ambiente escolar, bem como a participação do cirurgião-dentista na orientação dos professores de ensino fundamental e médio. Sujeitos e método: utilizou-se um questionário semiestruturado, com perguntas abertas e fechadas so-bre a formação do professor, orientação recebida sobre saúde bucal, desenvolvimento de temas sobre saúde bucal em sala de aula e conhecimento acerca do as-sunto. Resultados: do total de entrevistados (n = 221), apenas 77 (34,8%) afirmaram que tiveram orientação sobre saúde bucal na sua formação para professor. Se-tenta (31,7%) disseram não desenvolver temas sobre saúde bucal em sala de aula e 91 (41,2%) que não existia interação entre dentista e professor. Observou--se deficiência no conhecimento dos professores sobre determinados assuntos relacionados à saúde bucal. Houve associação estatística significativa entre orienta-ção do dentista aos professores e o desenvolvimento de ações de saúde bucal, bem como o conhecimento do professor sobre o local de erupção do primeiro molar permanente (p < 0,01). Conclusão: apesar de a maior parte dos educadores desenvolver práticas educativas sobre saúde bucal no ambiente escolar, existe defici-ência no entendimento de determinados assuntos pelos professores, fazendo-se necessário maior participação do cirurgião-dentista na transmissão de conhecimentos técnicos e científicos aos educadores.

Stress levels and quality of sleep in subjects with temporomandibular joint dysfunction / Níveis de estresse e distúrbios do sono em indivíduos com disfunção temporomandibular

Purpose: The aim of this study was to test the association between quality of sleep and stress in individuals with temporomandibular disorder (TMD). Methods: The study sample consisted of 354 adult subjects (males and females) from the municipality of Piacatu, São Paulo state, in the Southeast region of Brazil. Data were collected using the Fonseca Questionnaire to record the level of TMD, the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep and the Social Readjustment Rating Scale (SRRS) to record stress level. The data were analyzed by the software Epi Info 2000 version 3.2 using a chi-square test at the 0.05 level of significance. Results: One hundred and eighty (50.8%) subjects had some level of TMD. The statistical analysis showed a significant relationship between the three stress scores and the presence or absence of sleep disorders, considering an overall PSQI score > 5 as an indicator of a subject with sleep problems (P<0.01). Conclusion: Both quality of sleep and stress levels were associated with TMD in this sample.

Objetivo: O objetivo deste trabalho foi comparar níveis de estresse e qualidade do sono em indivíduos com DTM. Metodologia: O universo desta pesquisa constituiu-se por 354 indivíduos de ambos os sexos do município de Piacatu, SP, Brasil. Os dados foram coletados através do uso de: Questionário de Fonseca para verificar o grau de DTM, Índice da Qualidade do Sono de Pittsburgh (PSQI) para a qualidade do sono e a Escala de Reajustamento Social (SRRS) para o grau de estresse. Os dados foram tabulados por meio do programa Epi Info 2000, versão 3.2, e analisados estatisticamente por meio do Teste Qui-Quadrado, ao nível de significância de 5%. Resultados: Do total, 180 (50,8%) apresentavam algum grau de disfunção temporomandibular, sendo que destes, 96 (53,3%) tinham distúrbios do sono e 107 (59,4%) graus mais elevados de estresse. O teste estatístico mostrou relação entre os fatores analisados (P<0,01). Conclusão: Há associação estatisticamente significativa entre qualidade do sono e estresse em indivíduos com DTM.