Assessment of the developmental defects of the enamel in children and adolescents with sickle cell disease: A comparative study.

BACKGROUND: Sickle cell disease (SCD) is the most important hemoglobinopathy in terms of frequency and social impact and can affect the stomatognathic system. AIM: To assess and compare the developmental defects of the enamel (DDE) in children and adolescents with and without SCD. DESIGN: This was a cross-sectional, analytical, and comparative study of 210 children and adolescents aged 5-18 years, who visited the Hematology and Hemotherapy Hospital of Pernambuco. RESULTS: Developmental defects of the enamel were observed in 55.2% of the SCD patients and 35.2% of the non-SCD patients (healthy group; p < .05). In the SCD group, DDE were more common in females than in males (69.1% vs. 40.0%; p < .05). The incidence of DDE in the permanent teeth was higher in the upper arch than in the lower arch (SCD group, 13.1% vs. 4.6%; healthy group, 8.9% vs. 3.6%; p < .05). CONCLUSION: Compared with the healthy group, the SCD patients were almost twice as likely to develop DDE, mostly affecting females and the permanent teeth. These findings suggest that individuals with SCD need early dental care to avoid future oral problems.

Fatores da desigualdade social e a sua associação com a gravidez na adolescência: uma revisão integrativa / Factors of social inequality and their association with teenage pregnancy: an integrative review

Objetiva-se identificar quais fatores da desigualdade social estão associados à gravidez na adolescência. Como método, utilizou-se a revisão integrativa da literatura e a busca dos artigos foi realizada entre junho/2021 e abril/2022 nos bancos de dados Pubmed via Medline, Scopus e Embase. A amostra final totalizou 28 artigos e verificou-se que os fatores de proteção associados à gravidez na adolescência foram a renda familiar mais elevada e a maior escolaridade do adolescente e dos pais. Como fatores de risco, destacaram-se o consumo de álcool, tabaco e outras drogas, a atividade sexual precoce e o perfil socioeconômico e demográfico. Investimentos em setores como o da educação contribuiriam para a redução das taxas de gravidez precoce porque a escola estimula a criação de projetos de vida e incentiva comportamentos mais adequados. O conhecimento acerca dos fatores da desigualdade social que aumentam o risco da gravidez precoce podem auxiliar a formulação de políticas públicas que diminuam as desigualdades em saúde.

The objective was to identify which factors of social inequality are associated with teenage pregnancy. As a method, an integrative literature review was used by searching for articles between June/2021 and April/2022 on the Pubmed databases via Medline, Scopus, and Embase. The final sample consisted of 28 articles, and we found that the protective factors associated with teenage pregnancy were: higher family income, higher schooling of the adolescent and parents; as risk factors, the following stood out: the consumption of alcohol, tobacco, and other drugs, early sexual activity, and socioeconomic and demographic profile. Investments in sectors such as education would contribute to reducing early pregnancy rates because school encourages the creation of life projects and more appropriate behaviors. Knowledge about the factors of social inequality that increase the risk of early pregnancy contributes to creating public policies that reduce health inequalities.

Is Binge Drinking Associated with Suicidal Behaviors among Brazilian Adolescents?

OBJECTIVE: To evaluate the association between suicidal behaviors and binge drinking among Brazilian adolescents. METHODS: A cross-sectional study was conducted with 2,476 students 14 to 19 years of age from 26 public high schools in the city of Olinda, Brazil. Data collection occurred between March and June 2018 through the self-administered Youth Risk Behavior Survey. Descriptive analysis and Poisson regression (p < 0.05, 95%CI) were performed. RESULTS: The prevalence of suicidal ideation, planning and attempt in the previous 12 months was 23.7%, 17.4% and 13.5%, respectively. Suicidal ideation was associated with binge drinking one to two days (PR:1.053, 95%CI:1.011-1.096) and ≥ three days in the previous 30 days (PR:1.069, 95%CI:1.016-1.125), sadness/hopelessness in the previous 12 months (PR:1.313, 95%CI:1.267-1.360), a report of family physical aggression in the previous 12 months (PR:1.111, 95%CI:1.068-1.155), the female sex (PR:1.082, 95%CI:1.049-1.115) and a non-nuclear family (PR:1.037, 95%CI:1.004-1.071). Suicidal planning was associated with sadness/hopelessness in the previous 12 months (PR:1.257, 95%CI:1.214-1.302), report of family physical aggression in the previous 12 months (PR:1.110, 95%CI:1.065-1.156) and the female sex (PR:1.072, 95%CI:1.041-1.104). Suicide attempt was associated with binge drinking ≥ three days in the previous 30 days (PR:1.062, 95%CI:1.008-1.119), sadness/hopelessness in the previous 12 months (PR:1.202, 95%CI:1.161-1.244), report of family physical aggression in the previous 12 months (PR:1.105, 95%CI:1.060-1.153) and the female sex (PR:1.064, 95%CI:1.034-1.095). The Catholic (PR:0.938, 95%CI:0.899-0.979; PR:0.925, 95%CI:0.888-0.9865; PR:0.937, 95%CI:0.899-0.977) and Evangelical (PR:0.956, 95%CI:0.922-0.992; PR:0.954, 95%CI:0.919-0.991) religions acted as a possible protective factor against suicidal behaviors. CONCLUSIONS: Suicidal ideation and attempt were associated with binge drinking.

Demand for health services or professionals among adolescents: a multilevel study. / Procura por serviços ou profissionais de saúde entre adolescentes: um estudo multinível.

This study aimed to analyze the demand for health services or professionals by adolescents with individual determinants and contextual variables (school teaching modality and Social Vulnerability Index). Data were collected from March to June 2018, in state public schools in Olinda, Pernambuco, Brazil, through a structured questionnaire with questions from the Youth Risk Behavior Survey (YRBS) and the National School Health Survey (PeNSE). Among the 2,454 adolescents, the proportion of those looking for a health service was higher among women; in adolescents whose mothers had a minimum of nine schooling years; in the physically active; and whose parents did not receive a family aid (Bolsa Família). We observed that the contextual variables did not influence the demand for health services among adolescents. In the third model of the multilevel analysis, which analyzed the individual variables, we observed that only females (OR=1,80), having a mother with schooling greater than or equal to 9 years of study (OR=1,30), not receiving Bolsa Família (OR=1,23), and physically active (OR=1,32) were associated with an increased demand for health services or professionals.

O objetivo deste estudo foi analisar a procura por serviços ou profissionais de saúde pelos adolescentes com determinantes individuais e com variáveis contextuais, modalidade de ensino da escola e Índice de Vulnerabilidade Social. Os dados foram coletados no período de março a junho de 2018, em escolas públicas estaduais de Olinda, Pernambuco, através de um questionário estruturado com questões do Youth Risk Behavior Survey (YRBS) e da Pesquisa Nacional de Saúde do Escolar (PeNSE). Dentre os 2.454 adolescentes, a proporção daqueles que procuram por um serviço de saúde foi maior: no sexo feminino; em adolescentes cujas as mães tivessem escolaridade mínima de nove anos; naqueles fisicamente ativos; e cujos responsáveis não recebiam Bolsa Família. Observou-se que as variáveis contextuais não influenciaram a procura por serviços de saúde entre os adolescentes. No terceiro modelo da análise multinível, que analisou as variáveis individuais, observou-se que apenas o sexo feminino (OR=1,80), ter mãe com escolaridade maior ou igual a nove anos de estudo (OR=1,30), não receber Bolsa Família (OR=1,23) e ser ativo fisicamente (OR=1,32) foram associados a uma maior procura por serviços ou profissionais de saúde.

Procura por serviços ou profissionais de saúde entre adolescentes: um estudo multinível / Demand for health services or professionals among adolescents: a multilevel study

Resumo O objetivo deste estudo foi analisar a procura por serviços ou profissionais de saúde pelos adolescentes com determinantes individuais e com variáveis contextuais, modalidade de ensino da escola e Índice de Vulnerabilidade Social. Os dados foram coletados no período de março a junho de 2018, em escolas públicas estaduais de Olinda, Pernambuco, através de um questionário estruturado com questões do Youth Risk Behavior Survey (YRBS) e da Pesquisa Nacional de Saúde do Escolar (PeNSE). Dentre os 2.454 adolescentes, a proporção daqueles que procuram por um serviço de saúde foi maior: no sexo feminino; em adolescentes cujas as mães tivessem escolaridade mínima de nove anos; naqueles fisicamente ativos; e cujos responsáveis não recebiam Bolsa Família. Observou-se que as variáveis contextuais não influenciaram a procura por serviços de saúde entre os adolescentes. No terceiro modelo da análise multinível, que analisou as variáveis individuais, observou-se que apenas o sexo feminino (OR=1,80), ter mãe com escolaridade maior ou igual a nove anos de estudo (OR=1,30), não receber Bolsa Família (OR=1,23) e ser ativo fisicamente (OR=1,32) foram associados a uma maior procura por serviços ou profissionais de saúde.

Abstract This study aimed to analyze the demand for health services or professionals by adolescents with individual determinants and contextual variables (school teaching modality and Social Vulnerability Index). Data were collected from March to June 2018, in state public schools in Olinda, Pernambuco, Brazil, through a structured questionnaire with questions from the Youth Risk Behavior Survey (YRBS) and the National School Health Survey (PeNSE). Among the 2,454 adolescents, the proportion of those looking for a health service was higher among women; in adolescents whose mothers had a minimum of nine schooling years; in the physically active; and whose parents did not receive a family aid (Bolsa Família). We observed that the contextual variables did not influence the demand for health services among adolescents. In the third model of the multilevel analysis, which analyzed the individual variables, we observed that only females (OR=1,80), having a mother with schooling greater than or equal to 9 years of study (OR=1,30), not receiving Bolsa Família (OR=1,23), and physically active (OR=1,32) were associated with an increased demand for health services or professionals.

LGB prevalence in schools is associated with unhealthy weight-control behaviors in lesbian, gay, and bisexual youth: a multilevel analysis.

BACKGROUND: Previous studies have found that a school climate of more heteronormativity is associated with adverse effects on the mental health of LGB students. Accordingly, our aim was to assess the association between lower LGB prevalence in schools and unhealthy weight-control behaviors among LGB youth. METHODS: A cross-sectional, multilevel study based in public high schools in the city of Olinda, Northeast Brazil. A multilevel logistic regression was performed, including 2500 adolescents enrolled in 27 schools. The contextual variable was the prevalence of LGB youth in each school (as a proxy for heteronormativity in schools), while the outcome was unhealthy weight-control behaviors (fasting, purging, and taking diet pills). We controlled for socioeconomic characteristics (age, sex, receiving a family allowance), obesity, and self-reported happiness. RESULTS: Lower LGB prevalence in schools was associated with higher odds of engaging in unhealthy weight-control behaviors (OR: 1.5, 95%CI: 1.0, 2.2) among all youth, regardless of sexual orientation. No cross-level interactions between school context and individual characteristics were statistically significant. CONCLUSION: Lower LGB prevalence in schools was associated with a higher risk of unhealthy weight-control behaviors in youth regardless of sexual orientation, which may reflect either the contextual influence of school climate, or may be due to residual confounding.

Diagnosis of ankyloglossia in newborns: is there any difference related to the screening method? / Diagnóstico de anquiloglossia em recém-nascidos: existe diferença em função do instrumento de avaliação?

PURPOSE: To diagnose ankyloglossia in newborns and compare two lingual frenulum assessment instruments. METHODS: This cross-sectional study was carried out in Recife, Pernambuco, Brazil, in 2018, with 147 mothers/newborns aged up to 30 days. The Bristol Tongue Assessment Tool and the Lingual Frenulum Evaluation Protocol for Infants were the instruments used. Sociodemographic data were also recorded. The two ankyloglossia diagnostic methods were compared using the McNemar test, obtaining the kappa agreement value and the confidence interval. RESULTS: Ankyloglossia was present in 4.8% when diagnosed with the Bristol Tongue Assessment Tool, and in 17.0% with the Tongue-Tie Test. Regarding sex, 53.1% of the newborns were males and 46.9% were females; however, there was no association between ankyloglossia and the newborn's sex in either of the assessment methods. CONCLUSION: The ankyloglossia diagnosis in newborns varied depending on the assessment instrument used.

OBJETIVO: Diagnosticar a anquiloglossia em recém-nascidos, comparando dois instrumentos de avaliação do frênulo lingual. MÉTODO: Tratou-se de um estudo transversal, realizado em Recife, PE, Brasil no ano de 2018, com 147 mães/recém-nascidos com idade de até 30 dias de vida. Foram utilizados o Instrumento Bristol Tongue Assessment Tool (BTAT) e o Protocolo de Avaliação do Frênulo da Língua para Bebês ("Teste da Linguinha"). Dados sociodemográficos também foram anotados. Para a comparação entre os dois métodos de diagnóstico da anquiloglossia, foi utilizado o teste de McNemar e foram obtidos o valor da concordância de Kappa e o respectivo intervalo de confiança. RESULTADOS: A presença de anquiloglossia foi de 4,8%, quando diagnosticada por meio do BTAT, e de 17,0%, quando utilizado o "Teste da Linguinha". Com relação ao sexo, 53,1% dos recém-nascidos eram do sexo masculino e 46,9% do sexo feminino; contudo, não houve associação entre a anquiloglossia e o sexo do recém-nascido nos dois métodos de avaliação. CONCLUSÃO: O diagnóstico da anquiloglossia em recém-nascidos variou em função do instrumento de avaliação utilizado.

Occlusal Disorders in Patients with Sickle Cell Disease: Critical Literature Review.

OBJECTIVE: To identify the association of occlusal disorders in patients with sickle cell disease (SCD). STUDY DESIGN: A literature review was conducted, and articles published between 2010 and 2019 were searched on Bireme and PubMed websites and in MEDLINE and LILACS databases, in English, Portuguese, and Spanish, using the keywords "malocclusion," "sickle cell disease," and "cephalometry," combined by Boolean operators AND and OR. One of the criteria for the selection of articles was the presence of adolescents in the sample. This methodology followed the PRISMA recommendations. Seventy-nine articles were found, seven of which were included in the review as they met the inclusion criteria and the study goals. RESULTS: The prevalence of malocclusion in SCD patients ranged from 62.9% to 100%, which was considered very severe in 30.1% to 80.6%. The most common occlusal changes were Angle's class II malocclusion, increased maxillary overjet, and anterior open bite. In addition, class II skeletal pattern was the most prevalent due to mandibular retrusion. CONCLUSION: Malocclusion prevalence in SCD patients is high and considered to be a risk factor, with a significant rate of very severe malocclusion when compared to healthy patients.

School academic climate and oral health (tooth loss) in adolescents.

BACKGROUND: Preventing tooth loss depends on oral health maintenance behaviors. This study hypothesized that adolescents with educational aspirations have greater motivation to invest in the future, including maintenance of oral health status. AIM: To analyze the association between a school academic climate of educational aspirations and tooth loss (first permanent molars) among adolescents. METHODS: A cross-sectional study was designed to include 2,500 adolescents (aged 14-19 years) enrolled in public high schools of Olinda located in Northeast Brazil. Multilevel Poisson regression random intercept models were conducted with tooth loss (first permanent molars) as the outcome. The primary cohort of interest was school academic climate, as measured by the proportion of students taking the national high school exams. RESULTS: Tooth loss of the first permanent molars (assessed by clinical exam) was more prevalent in adolescents from more disadvantaged backgrounds (receiving family allowance, low maternal education). However, after controlling for a wide range of individual characteristics, adolescents enrolled in schools with lower academic climate had a higher prevalence of tooth loss (PR 1.42, 95%CI: 1.09,1.85). CONCLUSION: The school academic climate is associated with tooth loss, suggesting that educational aspirations are linked to adolescent oral health maintenance behaviors.

Association between cigarette use and adolescents' behavior.

OBJECTIVE: To determine the prevalence of cigarette use among adolescents and to identify associated health risk behaviors. METHODS: This is a cross-sectional study with a representative sample, composed of 1059 adolescents between 13 and 19 years old, enrolled in primary and secondary public schools of Olinda, Pernambuco, in 2014. Information was obtained through self-administered questionnaires (validated version of YRBS 2007). Cigarette experimentation was defined as smoking at least once in life. Adolescents who smoked at least one day within 30 days prior to the survey were considered current smokers. Most students were female and 16 years old or older. RESULTS: Almost 30% used it in life and about 10% smoked within the 30 days before the survey. Suicidal ideation (PR = 1.51, 95%CI 1.25-1.82), alcohol use (PR = 1.41, 95%CI 1.03-1.92), marijuana (PR = 1.64, 95%CI 1.37-1.96), excessive alcohol consumption (PR = 1.57, 95%CI 1.15-2.16) and sexual experience (PR = 1.78, 95%CI 1.43-2.21) have increased the risk of using cigarettes. Feelings of sadness (PR = 1.70, 95%CI 1.22-2.36), alcohol use (PR=2.40, 95%CI 1.12-5.12), excessive alcohol consumption (PR = 2.5, 95% CI 1.24-5.38), marijuana (PR = 2.31, 95%CI.57-3.39) and cocaine (PR = 1.99, 95%CI.32-3.01) increased the risk of cigarette use within the 30 days before the survey. CONCLUSIONS: Cigarette use among adolescents from Olinda was high, being considered higher than the national prevalence. Possible factors associated with cigarette use were drug use (alcohol, marijuana, and cocaine) and behaviors related to sexual experience, feelings of sadness and suicidal ideation.

Prevalence of Erosive Tooth Wear and Related Risk Factors in Adolescents: An Integrative Review.

Purpose: Dental erosion has become increasingly frequent in adolescents and is considered an oral health problem in this phase of life. Several factors have been associated with the development of dental erosion in adolescents, including lifestyle, socioeconomic status, and risk behaviors. We performed an integrative review of the prevalence of dental erosion and associated factors in adolescents.
Methods: We analyzed studies, published between 2008 and 2018, available in Portuguese, English and Spanish, about the prevalence of and factors associated with dental erosion in adolescents between 10 and 19 years of age. Methodological quality was assessed using the Critical Appraisal Skill Program. The eligibility criteria defined the selection of articles available through searches of the LILACS, PubMed®, and MEDLINE databases conducted between July and September 2018.
Results: Among the 503 articles retrieved during the initial search, 471 did not meet the inclusion criteria. Among the 32 selected studies, five found no factors significantly associated with dental erosion and 27 found significantly associated factors, such as sociodemographic characteristics, diet, age, and others.
Conclusions: The prevalence of dental erosion in adolescents was considered high and associated with lifestyle, diet, and sociodemographic and economic characteristics.

Ankyloglossia and breastfeeding: what is the evidence of association between them? / Anquiloglossia versus amamentação: qual a evidência de associação?

ABSTRACT Purpose: to investigate the scientific evidence, in the literature, of the relationship between ankyloglossia and breastfeeding difficulties. Methods: an integrative review of the literature. The MEDLINE and PubMed databases were searched, using the following descriptors in combination: "ankyloglossia", "newborn" and "breastfeeding". The searches included articles published between 2014 and 2019, in Portuguese, English and Spanish. Original articles demonstrating an association between ankyloglossia and breastfeeding issues were selected. Results: a total of 31 articles was fully read in the analysis, 22 of which were excluded and 9 included in the review. There was a diversity of instruments used for the diagnosis of ankyloglossia. In four studies, no standardized evaluation instrument was used for the diagnosis of ankyloglossia, which may limit the analysis of the results. However, most studies have evidenced a possible influence of ankyloglossia on breastfeeding. According to the studies, babies with altered lingual frenulum were more likely to experience difficulties in sucking, showing early weaning, which shows the importance of neonatal screening as a routine protocol in maternity hospitals for the cases of ankyloglossia. Conclusions: ankyloglossia may be related to impaired breastfeeding. The standardization of instruments for the diagnosis of ankyloglossia is necessary to improve the evidence in future research.

RESUMO Objetivo: investigar as evidências científicas na literatura sobre a relação entre a anquiloglossia e as dificuldades no aleitamento materno. Métodos: tratou-se de uma revisão integrativa. Foram realizadas buscas nas bases de dados Medline e Pubmed, utilizando os descritores em associação: "anquiloglossia", "recém-nascido" e "amamentação", entre 2014 e 2019, em português, inglês e espanhol. Foram selecionados artigos originais que relacionassem a anquiloglossia aos problemas de amamentação. Resultados: trinta e um artigos foram analisados pelo texto lido na íntegra, dentre os quais 22 foram excluídos e 09 selecionados para a revisão. Houve uma diversidade de instrumentos utilizados para o diagnóstico da anquiloglossia. Em quatro estudos não foi utilizado nenhum instrumento de avaliação padronizado para o diagnóstico da anquiloglossia, o que pode limitar a análise dos resultados. No entanto, a maioria dos estudos evidenciou a possível interferência da anquiloglossia na amamentação. De acordo com as publicações, bebês com frênulo lingual alterado apresentaram maiores chances de apresentar dificuldades na sucção e desmame precoce, o que demonstra a importância da triagem neonatal como rotina nas maternidades para os casos de anquiloglossia. Conclusões: a anquiloglossia pode estar relacionada com prejuízos na amamentação e a padronização dos instrumentos para diagnóstico da anquiloglossia é necessária para melhorar as evidências nas futuras pesquisas.

Association between cigarette use and adolescents' behavior

ABSTRACT OBJECTIVE To determine the prevalence of cigarette use among adolescents and to identify associated health risk behaviors. METHODS This is a cross-sectional study with a representative sample, composed of 1059 adolescents between 13 and 19 years old, enrolled in primary and secondary public schools of Olinda, Pernambuco, in 2014. Information was obtained through self-administered questionnaires (validated version of YRBS 2007). Cigarette experimentation was defined as smoking at least once in life. Adolescents who smoked at least one day within 30 days prior to the survey were considered current smokers. Most students were female and 16 years old or older. RESULTS Almost 30% used it in life and about 10% smoked within the 30 days before the survey. Suicidal ideation (PR = 1.51, 95%CI 1.25-1.82), alcohol use (PR = 1.41, 95%CI 1.03-1.92), marijuana (PR = 1.64, 95%CI 1.37-1.96), excessive alcohol consumption (PR = 1.57, 95%CI 1.15-2.16) and sexual experience (PR = 1.78, 95%CI 1.43-2.21) have increased the risk of using cigarettes. Feelings of sadness (PR = 1.70, 95%CI 1.22-2.36), alcohol use (PR=2.40, 95%CI 1.12-5.12), excessive alcohol consumption (PR = 2.5, 95% CI 1.24-5.38), marijuana (PR = 2.31, 95%CI.57-3.39) and cocaine (PR = 1.99, 95%CI.32-3.01) increased the risk of cigarette use within the 30 days before the survey. CONCLUSIONS Cigarette use among adolescents from Olinda was high, being considered higher than the national prevalence. Possible factors associated with cigarette use were drug use (alcohol, marijuana, and cocaine) and behaviors related to sexual experience, feelings of sadness and suicidal ideation.

Bullying among adolescents and school measures to tackle it / Bullying entre adolescentes e medidas escolares para combatê-lo

Abstract Background Adolescents are particularly susceptible to the effects of negative social interactions. Thus, knowledge on the behavioral characteristics of adolescents who are targets of bullying can assist with establishing actions directed to protection of the victims. Objective Describe the types of bullying practice and how adolescents perceive this violence, as well as the methods adopted by school to tackle it. Method A cross-sectional study was conducted with 612 public school students aged 10-19 years. Data were collected through the application of a questionnaire developed by the UK-based Kidscape organization. Items were added to this questionnaire aiming to characterize the respondents and their perception regarding the conduct of school administrators in tackling the problem. Statistical analysis involved frequency description and measures of bivariate and multivariate association (α=5%). Results The prevalence of bullying was 21.7%. No significant associations were found between bullying and socio-demographic factors (p>0.05). In most cases, the onset of aggressions was at 6-11 years of age of the victim. Verbal aggression was the most frequently observed type of bullying (82.2%), and the classroom was the location where most aggressions occurred (60.2%). Installation of surveillance cameras was the main action taken by school administrators to tackle the problem. Conclusion Prevalence of bullying in the population studied may be considered high, and verbal aggression was the most frequent type of bullying. Actions of school administrators were concentrated on structural reforms.

Resumo Introdução Os adolescentes são particularmente suscetíveis aos efeitos das interações sociais negativas. Assim, o conhecimento das características comportamentais dos adolescentes alvos de bullying pode auxiliar no estabelecimento de ações voltadas à proteção das vítimas. Objetivo Descrever as formas de bullying e o modo como os adolescentes percebem essa violência, e os métodos adotados pela escola para combatê-la. Método Foi realizado um estudo transversal com 612 alunos de 10 a 19 anos de idade matriculados em escolas públicas. A coleta de dados foi realizada por meio de questionário desenvolvido pela instituição inglesa Kidscape, à qual foram adicionados itens para a caracterização dos respondentes e suas percepções sobre a conduta dos administradores escolares diante do problema. A análise estatística envolveu uma distribuição de frequência e medidas de associação bivariada e multivariada (α=5%). Resultados A prevalência de bullying foi de 21,7%. Não foram encontradas associações significativas entre bullying e fatores sociodemográficos (p>0,05). Na maioria dos casos, o início das agressões começou entre seis e 11 anos de idade da vítima. A forma verbal foi a mais frequente (82,2%) e a sala de aula foi a localidade onde ocorreu a maior parte das agressões (60,2%). A instalação de câmeras de segurança foi a principal ação tomada pelos administradores escolares para combater o problema. Conclusão A prevalência de bullying na população estudada pode ser considerada alta e o abuso verbal é a forma mais frequente. As ações dos administradores escolares concentraram-se em reformas estruturais.

Prevalência de cárie e condições clínicas associadas à asma em adolescentes / Caries prevalence and medical conditions associated with asthma in adolescents

Introdução: Adolescentes com asma apresentam problemas e necessidades distintas se comparados a outros grupos etários. O presente artigo tem como objetivo verificar as principais manifestações bucais e o acesso de adolescentes asmáticos aos serviços odontológicos. Materiais e métodos: Estudo do tipo transversal, realizado com 215 adolescentes asmáticos de 12 a 15 anos e de ambos os sexos, atendidos em centros de referência para o controle da asma. O levantamento dos dados foi realizado em duas etapas. Na primeira foi realizado o exame intrabucal para levantamento das principais condições bucais por uma examinadora calibrada (kappa = 0,78, 0,79 e 0,86, respectivamente). Para aferir o sangramento gengival, utilizou-se o Eastman Interdental Bleeding Index (EIBI). Na segunda etapa foram aplicados, por meio de entrevistas, formulários aos pais/responsáveis com perguntas objetivas e subjetivas sobre alguns aspectos relacionados à doença asma, fatores sociodemográficos e o acesso ao cirurgião-dentista. Os testes estatísticos empregados para a interpretação dos resultados foram Qui-quadrado de Pearson, Exato de Fisher, Mann-Whitney e Kruswal-Wallis, com margem de erro de 5,0%. Resultados: A prevalência de maloclusão foi de 64,7%. Os adolescentes do sexo masculino (65,8%), de 12 anos de idade (71,0%), portadores de asma moderada persistente (75,0%) e que faziam uso de medicação (68,6%) apresentaram maloclusões com maior frequência. Verificouse que a média do índice CPO-D foi igual a 1,63. Os maiores valores deste escore pertenceram ao sexo feminino (1,85), aos 14 anos de idade (2,18) e asmáticos graves (1,86). Aproximadamente metade dos adolescentes (47,4%) apresentou sangramento gengival. Destes, 48,3% pertenciam ao sexo masculino, 59,0% possuíam 14 anos de idade, 71,4% eram portadores da asma na sua forma mais grave, e 56,9% utilizavam fármacos para o controle desta patologia. Conclusões: As manifestações bucais mais prevalentes foram a maloclusão e o sangramento gengival. A maioria dos adolescentes asmáticos teve acesso ao cirurgião-dentista.

Introduction: Adolescents with asthma have problems and needs different from those of other age groups. This study aimed to investigate the main oral manifestations and access of asthmatic adolescents to dental services. Materials and Methods: This was a cross-sectional study of 215 asthmatic adolescents of both sexes aged 12 to 15 years attending asthma referral centers. Data were collected in 2 stages. In stage 1, intraoral examination was performed to identify the main oral conditions by calibrated examiners (kappa = 0.78, 0.79, and 0.86). Gingival bleeding was assessed by the Eastman interdental bleeding index (EIBI). In stage 2, parents/guardians were interviewed by using questionnaires with objective and subjective questions about asthma-related aspects, sociodemographic factors, and access to a dentist. Statistical analysis was performed with Pearson's chi-square, Fisher's exact, Mann-Whitney and Kruskal-Wallis tests, with a margin of error of 5.0%. Results: The prevalence of malocclusion was 64.7%. Malocclusion was more frequent in male adolescents (65.8%) aged 12 years (71.0%) with moderate persistent asthma (75.0%) who were taking medication (68.6%). The mean CPO-D index was 1.63, with the highest values among female adolescents (1.85) aged 14 years (2.18) with severe asthma (1.86). Approximately half of the adolescents (47.4%) had gingival bleeding. Of these, 48.3% were male, 59.0% were 14 years of age, 71.4% had the most severe form of asthma, and 56.9% used medications to control this condition. Conclusions: The most prevalent oral manifestations were malocclusion and gingival bleeding. Most adolescents with asthma had access to a dental surgeon.

Negative self-perceived health associated with school violence in adolescents. / Autopercepção negativa de saúde associada à violência escolar em adolescentes.

OBJECTIVE: To verify the association between negative self-perception of health and school violence in adolescent students of the Municipality of Olinda (PE), Brazil. METHODS: This is a cross-sectional, analytical and school-based study with a sample consisting of 2,614 adolescents selected through a strategy of random sampling in conglomerates. The information was obtained through the questionnaire "Youth Risk Behavior Survey" from which the issues of violence and self-perceived health were retrieved. Data were tabulated by Epi-data version 3.1 program and transcribed for SPSS version 22. The Chi-square test and the stepwise binary logistic regression model were used for data analysis. RESULTS: We observed that 26.7% of adolescents had a negative self-perception of health, and this was greater among girls. Concerning school violence, negative self-perception was associated with feelings of sadness, suicidal thoughts, bullying at school, robbery at school and safety at school. Gender and age were also associated (p < 0.05). CONCLUSION: We reinforce the need for culture and peace actions in adolescence, involving the school environment to reflect on poor health assessed by adolescents and reduce the rate of violence.

O objetivo deste artigo é verificar a associação entre autopercepção negativa em saúde e violência escolar em adolescentes estudantes do Município de Olinda - PE. Estudo transversal, analítico e de base escolar com amostra constituída por 2.614 adolescentes, selecionados por meio de uma estratégia de amostragem aleatória em conglomerados. As informações foram obtidas através do questionário "Youth Risk Behavior Survey" de onde foram retiradas as questões de violência bem como da autopercepção de saúde. Os dados foram tabulados pelo programa Epi-data versão 3.1 e transcrito para o SPSS versão 22. Utilizou-se os teste do Qui-quadrado e o modelo de regressão logística binária stepwise para análise dos dados. Observou-se que 26,7% dos adolescentes tinham uma autopercepção negativa em saúde, sendo maior entre as moças. Em relação à violência escolar, a autopercepção negativa esteve associada ao sentimento de tristeza, pensamento suicida, bullying na escola, roubado na escola e segurança na escola. Sexo e idade também se mantiveram associadas (p < 0.05). Reforça-se a necessidade de ações de cultura e paz na adolescência, envolvendo o ambiente escolar, a fim de refletir na analise de saúde pobre dos adolescentes reduzindo também o índice de violência.

Sociodemographic and behavioral factors associated with dental caries in preschool children: Analysis using a decision tree.

BACKGROUND: Untreated dental caries can result a negative impact on oral health-related quality of life. AIMS: The aim of the present study was to determine the prevalence of dental caries and associated factors in children enrolled in public preschools in the city of Recife, Brazil. SETTINGS AND DESIGN: A descriptive, analytical, cross-sectional study was conducted with a representative random sample of 556 children aged 3-5 years. MATERIALS AND METHODS: Data were collected through clinical examinations using the International Caries Detection and Assessment System. The parents answered a questionnaire addressing sociodemographic and behavioral characteristics. Two examiners underwent training and calibration exercise for the calculation of interexaminer agreement (Kappa index of 0.83). STATISTICAL ANALYSIS USED: In addition to descriptive data, an inductive decision tree was constructed to analyze the results (Algorithm J48; α = 5%). RESULTS: The prevalence of dental caries was 92.1%. The following factors were associated with dental caries: brushing performed by the child (prevalence ratio [PR] = 4.39, 95% confidence interval [CI]: 2.57-7.51 P < 0.001), household income less than the minimum wage (PR = 1.79; 95% CI: 1.18-2.72, P = 0.005), brushing frequency (PR = 1.50; CI 95%: 0.50-4.49; P = 0.001), and parent's/caregiver's school equal to an incomplete elementary school education (PR = 1.65, 95% CI: 1.56-1.74, P < 0.001). CONCLUSIONS: The occurrence of dental caries in children was high and was associated with brushing performed by the child, household income less than the monthly minimum wage, low brushing frequency, and low parent's/caregiver's schooling.

Prevalência e fatores associados à autopercepção negativa em saúde de adolescentes: um estudo piloto / Prevalence and factors associated with negative self-perception in adolescents' health: a pilot study

O objetivo desse estudo é identificar a prevalência de autopercepção em saúde negativa dos adolescentes de uma escola da cidade de Olinda ­ PE, assim como apresentar os fatores associados ao nível socioeconômico e aos hábitos comportamentais. Trata-se de um estudo Piloto, do tipo transversal, analítico e de base escolar, realizado em fevereiro de 2016. Foram selecionados para o estudo, adolescentes, devidamente matriculados, com idade entre 12 e 19 anos. Os dados foram coletados por meio do questionário adaptado, traduzido para o português do Brasil "Youth Risk Behavior Survey" versão 2013. A variável dependente para esse estudo foi a autopercepção negativa em saúde, que foi coletada a partir de uma pergunta: "De maneira geral, como você classifica sua saúde?" com opção de resposta tipo Likert com 5 pontos. Os adolescentes que optaram pela resposta "Nada saudável" e "Não muito saudável" foram alocados para o grupo de autopercepção negativa em saúde. No geral, 202 adolescentes fizeram parte da amostra, sendo 61,5% eram do sexo feminino. A prevalência de autopercepção negativa em saúde foi de 27,6% e os fatores associados foram: sexo (p<0,000); sentir-se triste nos últimos 30 dias (p<0,003); pensar em se suicidar (p<0,002) e percepção inadequada do seu peso corporal (p<0,003). Avaliar o estado de saúde e os fatores interligados a uma autopercepção negativa em adolescentes é uma importante ferramenta para diversas tomadas de decisões, especialmente, para intervir a nível da comunidade com o objetivo de contornar os comportamentos de riscos com finalidade de apresentar melhores níveis de saúde para essa população.

The purpose of this study is to identify the prevalence of negative self-perceived health in adolescents at a school in the city of Olinda, in the state of Pernambuco, as well as presenting the factors associated with socioeconomic level and behavioral habits. This is a cross-sectional, analytical and school-based pilot study developed in February 2016. Adolescents duly enrolled at school, aged between 14 and 19 years, were selected for this study. Data were collected using a questionnaire adapted from the Youth Risk Behavior Survey, version 2013, translated into Brazilian Portuguese. The dependent variable for this study was the negative self-perception of health, which was collected from the following question: "Overall, how do you rate your health?" with a Likert-type response option with 5 points in a scale. Adolescents who chose "Not healthy" and "Not very healthy" were placed into the negative self-perceived health group. Overall, a total of 202 adolescents were part of the sample, with 61.5% being girls. The prevalence of negative self-perception in health was 27.6% and the associated factors were: gender (p <0.000); feeling sad in the past 30 days (p <0.003); thinking about suicide (p <0.002); and inadequate perception of their body weight (p <0.003). Assessing the health status and factors associated with negative self-perception in adolescents is an important tool for many decision-making matters, especially for intervening at a community level with the aim of circumventing the risk behaviors to present better health levels for this population.

Autopercepção negativa de saúde associada à violência escolar em adolescentes / Negative self-perceived health associated with school violence in adolescents

Resumo O objetivo deste artigo é verificar a associação entre autopercepção negativa em saúde e violência escolar em adolescentes estudantes do Município de Olinda - PE. Estudo transversal, analítico e de base escolar com amostra constituída por 2.614 adolescentes, selecionados por meio de uma estratégia de amostragem aleatória em conglomerados. As informações foram obtidas através do questionário "Youth Risk Behavior Survey" de onde foram retiradas as questões de violência bem como da autopercepção de saúde. Os dados foram tabulados pelo programa Epi-data versão 3.1 e transcrito para o SPSS versão 22. Utilizou-se os teste do Qui-quadrado e o modelo de regressão logística binária stepwise para análise dos dados. Observou-se que 26,7% dos adolescentes tinham uma autopercepção negativa em saúde, sendo maior entre as moças. Em relação à violência escolar, a autopercepção negativa esteve associada ao sentimento de tristeza, pensamento suicida, bullying na escola, roubado na escola e segurança na escola. Sexo e idade também se mantiveram associadas (p < 0.05). Reforça-se a necessidade de ações de cultura e paz na adolescência, envolvendo o ambiente escolar, a fim de refletir na analise de saúde pobre dos adolescentes reduzindo também o índice de violência.

Abstract Objective To verify the association between negative self-perception of health and school violence in adolescent students of the Municipality of Olinda (PE), Brazil. Methods This is a cross-sectional, analytical and school-based study with a sample consisting of 2,614 adolescents selected through a strategy of random sampling in conglomerates. The information was obtained through the questionnaire "Youth Risk Behavior Survey" from which the issues of violence and self-perceived health were retrieved. Data were tabulated by Epi-data version 3.1 program and transcribed for SPSS version 22. The Chi-square test and the stepwise binary logistic regression model were used for data analysis. Results We observed that 26.7% of adolescents had a negative self-perception of health, and this was greater among girls. Concerning school violence, negative self-perception was associated with feelings of sadness, suicidal thoughts, bullying at school, robbery at school and safety at school. Gender and age were also associated (p < 0.05). Conclusion We reinforce the need for culture and peace actions in adolescence, involving the school environment to reflect on poor health assessed by adolescents and reduce the rate of violence.

Enamel defects and tooth eruption disturbances in children with sickle cell anemia.

Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.