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2.
Artigo em Inglês | MEDLINE | ID: mdl-33051884

RESUMO

OBJECTIVE: To determine the extent to which racial inequities in tooth loss and functional dentition are explained by individual socioeconomic status, smoking status and frequency/reason for the use of dental services. METHODS: Data came from the Brazilian Longitudinal Study of Ageing, a nationally representative sample of community-dwelling people aged 50 years and over. Tooth loss and functional dentition (ie 20+ natural teeth) were the outcomes. The main explanatory variable was self-classified race. Covariates included dental visits in the past 12 months, dental visits for check-ups only, smoking status, self-reported chronic conditions, depression and cognitive function. Logistic regression and Blinder-Oaxaca decomposition analysis were used to estimate the share of each factor in race-related tooth loss inequities. RESULTS: The analytical sample comprised of 7126 respondents. While the prevalence of functional dentition in White Brazilians was 37% (95% CI: 33.5;40.9), it was 29% (95% CI: 26.4;31.6) among Browns and 30% (95% CI: 25.1;35.4) among Blacks. The average number of lost teeth among Whites, Browns and Blacks were 18.7 (95% CI: 17.8;19.6), 20.4 (95% CI: 19.7;21.1) and 20.8 (95% CI: 19.5;22.0), respectively. Decomposition analysis showed that the selected covariates explained 71% of the racial inequalities in tooth loss. Dental visits in the previous year and smoking status explained nearly half of race-related gaps. Other factors, such as per capita income, education and cognitive status, also had an important contribution to the examined inequalities. The proportion of racial inequities in tooth loss that was explained by dental visits (frequency and reason) and smoking status decreased from 40% for those 50-59 years of age to 22% among participants aged 70-79 years. CONCLUSIONS: Frequency and reason for dental visits and smoking status explained nearly half of the racial inequity in tooth loss among Brazilian older adults. The Brazilian Family Health Strategy Program should target older adults from racial groups living in deprived areas.

3.
Rev Bras Epidemiol ; 23: e200100, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053093

RESUMO

OBJECTIVE: The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties. METHODS: Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. RESULTS: Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability. CONCLUSION: The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.


Assuntos
Comparação Transcultural , Inovação Organizacional , Psicometria/estatística & dados numéricos , Inquéritos e Questionários/normas , Brasil , Estudos Transversais , Humanos , Portugal , Reprodutibilidade dos Testes
4.
Public Health Nutr ; : 1-9, 2020 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-32847638

RESUMO

OBJECTIVE: To investigate the relationship between ultra-processed food consumption and early childhood caries. DESIGN: Cross-sectional analysis of baseline data from a cluster randomised controlled study. Outcomes included the prevalence of children with non-cavitated and cavitated caries. The main exposure was the total daily consumption of ultra-processed foods (up to three times and four times or more), assessed through a FFQ. Potential confounders were socio-demographic characteristics of the child and caregiver/family, child breast-feeding, oral hygiene and use of dental services. Poisson regression using robust variance adjustment was used to estimate prevalence ratios (PR) and their respective 95 % CI. SETTING: Primary Healthcare Centers in an urban area of Pelotas, Southern Brazil. PARTICIPANTS: Children aged 0-3 years (n 309). RESULTS: Consumption of ultra-processed foods four times or more a day was found in 67·6 % of children; 24·4 and 12·0 % presented non-cavitated and cavitated caries, respectively. After adjustment, children who consumed ultra-processed foods four times or more a day were more likely to present both non-cavitated caries (PR 2·25, 95 % CI 1·19, 4·27, P = 0·013) and cavitated caries (PR 3·48, 95 % CI 1·18, 10·30, P = 0·024) compared with those who have consumed them up to three times a day. CONCLUSIONS: Consumption of ultra-processed foods is associated with early childhood caries. Interventions aiming at reducing ultra-processed food consumption should be implemented to improve children's oral health.

5.
PLoS One ; 15(6): e0235258, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589647

RESUMO

OBJECTIVE: This study investigated whether the presence of care workers who completed a specialization course on family health was associated with improved care and maternal and child health indicators in municipalities in the state of Mato Grosso do Sul, Brazil. METHODS: Negative binomial regression models with fixed effects were used for the 79 municipalities in the state of Mato Grosso do Sul, with repeated observations for the period 2009-2015. For our reference, the parameter "number of professionals who completed the course" calculated the proportion of professionals who completed the course, and was divided by the total number of primary health care professionals in the municipality to create a ratio. The cutoff points used represented tertile distribution: T3: high (0.35-1.00), T2: intermediate (0.02-0.33) and T1: low (0.00-0.01); to avoid biased results, the analysis was also performed for the years prior to the beginning of the course in question (2009 and 2010). RESULTS: During the study period, enrollment of pregnant women, exclusive breastfeeding for children under 4 months, and up-to-date vaccinations in children younger than 1 year to 23 months increased (high to intermediate categories) in municipalities where professionals who completed the specialization course worked. Growth in the intermediate ratio was also observed in indicators related to cervical cancer screening and new diagnoses of congenital syphilis in infants under one year of age. CONCLUSIONS: The presence of care workers who completed a specialization course on family health was seen to be associated with improved care and indicators for maternal and child health in municipalities in the state of Mato Grosso do Sul, Brazil. These findings reaffirm the importance and effectiveness of policies on training and continuing education for the Brazilian Unified Health System.


Assuntos
Saúde da Criança/estatística & dados numéricos , Educação Continuada , Pessoal de Saúde/educação , Saúde Materna/estatística & dados numéricos , Adulto , Feminino , Humanos , Lactente , Masculino , Gravidez , Sistema de Registros
6.
Clin Oral Investig ; 24(2): 857-866, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31214794

RESUMO

OBJECTIVES: The objective of this study was to evaluate the combined risk of oral problems in the oral health-related quality of life (OHRQoL) of adolescents aged 15 to 19 years in São Paulo state (Brazil) in the year of 2015. MATERIALS AND METHODS: Data from the São Paulo State Oral Health Survey (SBSP-15) and the contextual characteristics of the cities of São Paulo state, evaluated in the year 2015 were accessed. Correlations were made between contextual factors (i.e., coverage of the family health team, average supervised tooth brushing, number of first dental appointments, and average income), individual sociodemographic variables (i.e., ethnicity, gender, and schooling) and dental problems (dental pain, caries, overjet, open bite, indication for endodontic and exodontic treatment, gingival bleeding, and dental trauma). These variables were correlated with the quality of life of the adolescents using the Oral Impacts on Daily Performance (OIDP) index. Multilevel Poisson regressions were performed to calculate the rate ratio (RR) with 95% confidence interval (CI). RESULTS: According to the bivariate analysis, the presence of low (RR, 1.62; 95% CI 1.07-2.46) and very intense (RR, 2.53, 95% CI 1.92-3.34) dental pain, indication for endodontic (RR, 1.31; 95% CI 1.05-1.63) or for exodontic (RR, 1.31; 95% CI 1.06-1.63) treatment, and gingival bleeding (RR, 1.41; 95% CI 1.11-1.80) reduced the quality of life of adolescents. All domains of OIDP scores were associated between healthy and unhealthy individuals (p < 0.001) increasing mean scores with combined oral health problems. Higher impact on quality of life was associated with simultaneous presence of dental pain, gingival bleeding, and indication for exodontic treatment (RR, 6.03; 95% CI, 4.02-9.04) in the adolescents. CONCLUSION: Individual and contextual factors and the various dental problems are independently associated with the quality of life of Brazilian adolescents aged 15 to 19 years, especially when they are associated with the perception of intense dental pain, gingival bleeding, and indication for exodontic treatment, with up to six times greater impact on OIDP. CLINICAL RELEVANCE: The study highlighted the importance for an integral treatment in adolescents, considering that the associated risk of several dental diseases can progressively affect the quality of life of this population.


Assuntos
Saúde Bucal , Adolescente , Brasil , Estudos Transversais , Cárie Dentária , Inquéritos de Saúde Bucal , Humanos , Qualidade de Vida , Fatores Socioeconômicos , Adulto Jovem
7.
Rev. bras. epidemiol ; 23: e200100, 2020. tab, graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1137766

RESUMO

RESUMO: Objetivo: Avaliar o grau em que profissionais da atenção primária e organizações de saúde estão prontos para implementar mudanças nos serviços de saúde, principalmente no que se refere à implementação de novas tecnologias, políticas públicas ou programas de inovação, que merecem especial atenção. Os objetivos deste estudo foram: conduzir a adaptação transcultural do questionário Organizational Readiness for Implementing Change (ORIC) para o português (Brasil); e iniciar a mensuração de suas propriedades psicométricas. Métodos: Por meio de estudo transversal, realizou-se a tradução do questionário ORIC, com 12 questões, e posterior aplicação numa amostra de trabalhadores de unidades primárias de saúde tradicionais em transformação para unidades de saúde da família. A análise estatística incluiu o coeficiente alfa de Cronbach, análise fatorial exploratória e confirmatória por modelo de equação estrutural e seguiu o checklist Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN). Resultados: Participaram do estudo 150 trabalhadores de 10 unidades de saúde em transformação. A análise confirmou dois fatores principais (Eficácia e Comprometimento), com autovalores > 1. A rotação pelo método ortogonal mostrou que as questões do instrumento confirmaram os fatores analisados pelo instrumento original. O alfa de Cronbach total do ORIC foi 0,94, mostrando ótima confiabilidade. Conclusão: A versão portuguesa (Brasil) do questionário ORIC-Br apresentou boas propriedades psicométricas, podendo ser utilizado em serviços de saúde para medição da prontidão organizacional, considerada um indicador do potencial alcance de sucesso na implementação de mudança em serviços de saúde.


ABSTRACT: Objective: The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties. Methods: Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Results: Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability. Conclusion: The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.

8.
Cad. saúde colet., (Rio J.) ; 27(4): 476-483, out.-dez. 2019. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1055680

RESUMO

Resumo Introdução O modelo tradicional de formação em saúde hegemônico e tecnicista limita as respostas às demandas atuais do Sistema Único de Saúde (SUS). Para superar essas fragilidades, a integração ensino-serviço-comunidade (IESC) e as metodologias ativas (MAs) se apresentam como estratégias de reorientação da formação profissional. Objetivo Este estudo analisou as percepções de estudantes de Odontologia da Universidade Federal de Mato Grosso do Sul (UFMS) acerca das práticas pedagógicas à luz das MAs e da IESC no e para o SUS. Método Trata-se de pesquisa qualitativa, realizada entre 2012 e 2013, com 73 estudantes que estavam matriculados e cursando a disciplina de Estágio Obrigatório de Odontologia em Saúde Coletiva II (EOOSC II). O convite para participar da pesquisa foi feito após o encerramento da disciplina, quando as notas já haviam sido lançadas. Utilizou-se de um roteiro contendo questões norteadoras, que versavam sobre a opinião dos estudantes acerca: (1) da disciplina; (2) das potencialidades e fragilidades da metodologia de ensino-aprendizagem utilizada e das unidades de saúde frequentadas; e (3) da intenção de, após a formatura, trabalhar no SUS/Estratégia Saúde da Família. Após a coleta, os dados foram transcritos, e, na sequência, foi processado o discurso do sujeito coletivo (DSC). Resultados A IESC, articulada com as MAs, propiciou aos estudantes conectar teoria e prática, integrada à realidade do SUS. Conclusão Os participantes da pesquisa relataram a relevância da educação permanente em saúde e as dificuldades/potencialidades da utilização de MAs integradas à IESC na formação profissional, apontando o SUS como real possibilidade de trabalho ao se formarem.


Abstract Background The traditional model of hegemonic and technicist health training limits the answers to the current demands of the Unified Health System (USH). To overcome these weaknesses, Teaching-Service-Community Integration (TSCI) and Active Methodologies (AM) are presented as strategies for reorienting vocational training. Objective This study analyzed the perceptions of dentistry students of Federal University of Mato Grosso do Sul (UFMS), related to pedagogical practices in light of AM and TSCI for and in the USH. Method It was a qualitative research, which was carried out between 2012 and 2013, with 73 students, who were enrolled and attending the Compulsory Internship in Collective Health Dentistry II (CICHD II). The invitation was made after the course end, when the grades had already been released. A script was used containing guiding questions, which dealt with students' opinions about: (1) the course; (2) the potentialities and weaknesses of the teaching-learning methodology used and the Health Units attended; And (3) the intention to, after graduation, work in the USH /Family Health Strategy. After the data collection, they were transcribed and, subsequently, the Collective Subject Discourse (CSD) was processed. Results The TSCI, which was articulated to the AM, allowed students to connect theory and practice, integrated to the realities of USH. Conclusion They noted the relevance of the permanent education in health and the difficulties/potentialities of using active methodologies integrated to the TSCI in the professional formation, pointing the UHS as a real possibility of work when they will be graduate.

9.
Geriatr., Gerontol. Aging (Impr.) ; 13(2): 62-68, abr-jun.2019.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1096816

RESUMO

OBJETIVO: Avaliar o estado nutricional, as condições de saúde e suas influências na capacidade funcional de idosos de um centro de convivência em Campo Grande, Mato Grosso do Sul. MÉTODOS: Trata-se de um estudo transversal, de base populacional, com 47 idosos de ambos os sexos, com idade entre 60 e 96 anos. A capacidade funcional foi definida por meio das atividades básicas e instrumentais da vida diária, operacionalizadas pelo índice de Katz e pela escala de Lawton e Brody. Foram aplicados um questionário sociodemográfico e dois recordatórios de 24 horas para avaliação do consumo alimentar; e foram avaliados a força de preensão manual e o estado nutricional. Um modelo de equação estrutural foi empregado para analisar a relação e as associações entre as variáveis. RESULTADOS: A amostra mostrou boa funcionalidade para as atividades básicas da vida diária, mas uma frequência alta de prejuízos nas atividades instrumentais, principalmente para tarefas como cuidar das finanças, preparar a própria refeição, limpar e realizar pequenos reparos domésticos. A baixa funcionalidade vai ao encontro da baixa força de preensão palmar encontrada. A maior parte dos idosos foi classificada como eutrófica (51,06%). Ao aplicar o modelo de equação estrutural, obteve-se um coeficiente padronizado de 0,45; indicando efeito médio e significativo (p = 0,02) do índice de massa corporal sobre a dependência para as atividades básicas, com efeito direto. CONCLUSÃO: O excesso de peso influencia negativamente a capacidade funcional de idosos para desempenhar atividades básicas da vida diária.


OBJECTIVE: To evaluate nutritional status, health conditions, and their impact on the functional capacity of aging adults in a community center in Campo Grande, state of Mato Grosso do Sul. METHODS: This is a cross-sectional, population-based study with 47 participants of both sexes, aged 60-96 years. Functional capacity was defined by the basic and instrumental activities of daily living, operationalized by the Katz index and the Lawton and Brody scale. A sociodemographic questionnaire and two 24-hour reminders were used to evaluate food consumption; hand grip strength and nutritional status were also evaluated. A structural equation model was used to analyze the relationship and associations between variables. RESULTS: The sample showed good functional capacity for the basic activities of daily living, but there was a high frequency of losses in instrumental activities, especially for tasks such as managing finances, cooking, cleaning and performing small domestic repairs. Low functional capacity is in agreement with the low hand grip strength found. Most participants were classified as eutrophic (51.06%). When applying the structural equation model, a standardized coefficient of 0.45 was obtained; indicating a mean and significant effect (p = 0.02) of body mass index on dependence for basic activities, with direct effect. CONCLUSION: Overweight negatively influences the functional capacity of older adults to perform basic activities of daily living.

10.
PLoS One ; 14(3): e0214485, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30913272

RESUMO

OBJECTIVE: The objective of this study was to verify whether the inclusion of professionals who completed a specialized distance learning course in family health teams is associated with rates of hospitalization for primary healthcare-sensitive conditions and better monitoring of chronic conditions in municipalities within the state of Mato Grosso do Sul, Brazil. METHODS: Negative binomial regression models with fixed effects were used for the 79 municipalities in the state, with repeated observations for the selected years (2009-2015). For our reference, the parameter "Municipality Ratio" was the number of professionals who completed the course divided by the total number of PHC professionals in the municipality. This ratio has been cumulative over the years. No reference values were found in the scientific literature, so three cutoff points were used for tertile distribution: T3:high (0.35-1.00), T2:intermediate (0.02-0.33), and T1:Low (0.00-0.01). In order to avoid capturing biased results, the analysis was also performed for the years before the specialization course was offered (2009 and 2010). RESULTS: Indicators of the share of hospitalizations for primary care-sensitive conditions (overall rate and specific rates for asthma, gastroenteritis, and heart failure) decreased during the study period when related to a high and intermediate proportion of professionals who completed the specialization course, and the same was seen for indicators of chronic conditions (diabetic and hypertensive patients) who were registered, monitored and group care. CONCLUSION: The specialization course impacted important indicators related to the attributions of primary health care professionals, considering that decreases in hospitalizations for primary care sensitive causes (overall rate of sensitive causes, specific rates for asthma, gastroenteritis and heart failure) were seen in the territories where professionals who completed this course worked, along with increased registration and monitoring of diabetic and hypertensive patients.


Assuntos
Educação a Distância/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Brasil , Doença Crônica , Humanos , Análise de Regressão , Fatores de Tempo
11.
Dent Traumatol ; 35(3): 171-180, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30866159

RESUMO

BACKGROUND/AIMS: Traumatic dental injuries (TDIs) stand out as one of the major public health problems worldwide, characterized by a high prevalence in children and adolescents. However, their association with the 15-19 years age group has not been fully described. The aim of this study was to evaluate TDIs in a population of Brazilian adolescents. METHODS: An association study was performed with 5558 adolescents attending the São Paulo State Oral Health Survey (SBSP-15). Individual predisposing variables (gender, age, schooling, ethnic, overjet, and molar relationship); contextual predisposing (city size and Municipal Human Development Index); individual enabling (per capita income and type of service used); contextual enabling (number of dentists, family health team coverage, and family median income); individual need (satisfaction and perception regarding treatment) and contextual needs (average supervised brushing, number of visits, and dental extractions per city), as well as health behaviors were analyzed. Andersen's behavioral model was used for the data analysis. A multilevel logistic regression with fixed effects was performed to calculate the odds ratio (OR), with 95% confidence interval (CI). RESULTS: The prevalence of TDIs in adolescents was 1.42% (95% CI: 0.94-2.13). Individual and contextual factors of need, predisposing factors, facilitators, and health behaviors were associated with TDIs. In the adjusted analysis, gender (OR = 0.32, 95% CI: 0.18-0.53), mean family income (OR = 2.52, 95% CI: 1.35-4.69), number of dental visits (OR = 0.40, 95% CI: 0.19-0.84), and time of last visit (OR = 2.64, 95% CI: 1.46-4.77) remained significant concerning trauma. CONCLUSION: At least one variable of the individual and contextual predisposing, enabling, and need factors (except for individual enabling variables) were associated with dental trauma in Brazilian adolescents aged 15-19 years. This information may help with the planning of preventive actions and dental treatment, especially in mid-sized and large cities.


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Inquéritos de Saúde Bucal , Renda , Aceitação pelo Paciente de Cuidados de Saúde , Traumatismos Dentários/epidemiologia , Adolescente , Brasil/epidemiologia , Criança , Estudos Transversais , Odontólogos , Feminino , Humanos , Masculino , Prevalência , Fatores Socioeconômicos , Adulto Jovem
12.
Rev Bras Ginecol Obstet ; 40(11): 686-692, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30485899

RESUMO

OBJECTIVE: The aim of the present study was to assess the anthropometric measures, food intake and food cravings during the menstrual cycle of undergraduate students of the faculty of nutrition. METHODS: A cross-sectional study was performed with 27 students from a public university in the state of Mato Grosso do Sul, Brazil, who had their food intake evaluated through a 24-hour food recall, their nutritional status evaluated based on anthropometric measures, and food cravings evaluated using the Food Desire Questionnaire. Data were collected during an evaluation in the follicular phase (between the 5th and the 9th day of the menstrual cycle) and another in the luteal phase (LP) (between the 20th and the 25th day of the menstrual cycle). For food intake variables, the analysis of variance (ANOVA) test was used, followed by the Tukey test. The Mann-Whitney test was used for the analysis of food cravings, considering a significance level of 5% (p < 0.05). RESULTS: The desire for foods rich in sugar, salt, and fat, such as chocolate, pastries, snacks and desserts were higher (p < 0.05) during the premenstrual period, although it did not reflect neither a higher energy intake nor an alteration in the distribution of macronutrients. A higher intake of carbohydrates, proteins, fibers, and calcium was observed during the LP; however, without statistical difference between the groups. There were no differences either in the intake of any food group or in the anthropometric measurements (p > 0.05). CONCLUSION: Food cravings of nutrition students differed between the phases of the menstrual cycle; however, with no difference in food intake and in anthropometric measures.


Assuntos
Fissura , Ingestão de Alimentos , Ciclo Menstrual/fisiologia , Estudos Transversais , Feminino , Humanos , Estado Nutricional , Adulto Jovem
13.
PLoS One ; 13(11): e0206730, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30403725

RESUMO

The objective of the present study was to analyze individual, contextual and social support factors associated with periodontal condition among 2332 dentate elderly Brazilian participants from the São Paulo State Oral Health Survey 2015 (SBSP-15). METHODS: This study used the database compiled by the SBSP-15, conducted from January to December in 2015. The associations were made by relative risk (RR), with Multilevel Poisson Regressions, among individual, contextual and social support variables, and had periodontal diseases as outcomes. RESULTS: The mean age of elders was 70.13 years (SD 5.67). The risk factors for all outcomes of periodontal diseases were male gender and self-perceived color of non-white skin. Regarding social support, feeling unhappy was a risk factor for the presence of shallow periodontal pockets (3-5mm) RR 1.43(CI 95% 1.10-1.86). The coverage of the Family Health Strategy (FHS) was a protective factor for gingival bleeding RR = 0.7(CI 95% 0.44-0.99) and calculus RR = 0.75(CI 95% 0.60-0.95), and a risk factor for the number of lost sextants (sextants with only one tooth or without any teeth) RR = 1.12(CI 95% 1.00-1.28). Living in municipalities with more than 90% fluoridation coverage was a protective factor for the number of lost sextants RR = 0.89(CI 95% 0.78-0.99). CONCLUSIONS: The study showed evidence that individual (gender and self-perceived skin color), contextual (coverage of the family health strategy and water fluoridation) and social support factors (feeling unhappy) are associated with the clinical outcomes of periodontal diseases in Brazilian elders. This reinforces the need for transdisciplinary actions in the FHS, stimulating work together and intersectoral collaboration between FHS and NASF (Family Health Support Center).


Assuntos
Doenças Periodontais/epidemiologia , Idoso , Brasil/epidemiologia , Inquéritos de Saúde Bucal , Feminino , Humanos , Masculino , Análise Multinível , Fatores de Risco , Fatores Socioeconômicos
14.
Rev. bras. ginecol. obstet ; 40(11): 686-692, Nov. 2018. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-977795

RESUMO

Abstract Objective The aim of the present study was to assess the anthropometric measures, food intake and food cravings during the menstrual cycle of undergraduate students of the faculty of nutrition. Methods A cross-sectional study was performed with 27 students from a public university in the state of Mato Grosso do Sul, Brazil, who had their food intake evaluated through a 24-hour food recall, their nutritional status evaluated based on anthropometric measures, and food cravings evaluated using the Food Desire Questionnaire. Data were collected during an evaluation in the follicular phase (between the 5th and the 9th day of the menstrual cycle) and another in the luteal phase (LP) (between the 20th and the 25th day of the menstrual cycle). For food intake variables, the analysis of variance (ANOVA) test was used, followed by the Tukey test. The Mann-Whitney test was used for the analysis of food cravings, considering a significance level of 5% (p< 0.05). Results The desire for foods rich in sugar, salt, and fat, such as chocolate, pastries, snacks and desserts were higher (p< 0.05) during the premenstrual period, although it did not reflect neither a higher energy intake nor an alteration in the distribution of macronutrients. A higher intake of carbohydrates, proteins, fibers, and calcium was observed during the LP; however, without statistical difference between the groups. There were no differences either in the intake of any food group or in the anthropometric measurements (p> 0.05). Conclusion Food cravings of nutrition students differed between the phases of the menstrual cycle; however, with no difference in food intake and in anthropometric measures.


Resumo Objetivo Verificar alterações de medidas corporais, consumo e desejos alimentares durante o ciclo menstrual de acadêmicas de nutrição. Métodos Estudo transversal com 27 estudantes de uma universidade pública do Mato Grosso do Sul, as quais tiveram seu consumo alimentar avaliado por meio de recordatório alimentar de 24 horas, estado nutricional avaliado com base em medidas antropométricas, e desejos alimentares avaliados utilizando-se o Questionário de Desejo Alimentar. Os dados foram coletados durante uma avaliação na fase folicular (entre o 5° e o 9° dia do ciclo menstrual) e outra na fase lútea (entre o 20° e o 25° dia do ciclo menstrual). Para as variáveis de consumo alimentar, utilizou-se o teste análise de variância (ANOVA, na sigla em inglês), seguido pelo teste de Tukey. Já para a análise dos desejos alimentares, utilizou-se o teste de Mann-Whitney. Foi considerado o nível de significância de 5% (p< 0,05). Resultados Os desejos por alimentos ricos em açúcar, sal e gordura, como chocolates, produtos de pastelaria, lanches e sobremesas foram maiores (p< 0,05) no momento pré-menstrual, apesar de não refletirem em maior consumo energético e tampouco em alteração na distribuição de macronutrientes. Observou-se maior consumo de carboidratos, proteínas, fibras e cálcio na fase lútea; no entanto, sem diferença estatística entre os grupos. Não foram encontradas diferenças no consumo de nenhum grupo alimentar, tampouco nas medidas antropométricas (p> 0,05). Conclusão Os desejos alimentares das acadêmicas de nutrição diferiram entre as fases; no entanto, sem diferença no consumo alimentar e nas medidas corporais.

15.
Arch. Health Invest ; 7(9): 358-363, set. 2018. tab
Artigo em Inglês | BBO - Odontologia | ID: biblio-988589

RESUMO

This study evaluates the association of Non Carious Cervical Lesions (NCCLs), Oral Health-Related Quality of Life (OHRQoL) and Work Ability Index (WAI) in a Brazilian population of Workers. One hundred workers were evaluated in a CEREST (Worker´s Health Reference Center). Participants were examined for oral disease following WHO recommendations, and the Oral Health Impact Profile (OHIP) and Work Ability Index assessment was used to determine OHRQoL and capacity to work, respectively. Assessment of tobacco use and alcohol consumption was made by Fagestron tolerance and Audit test. Statistical analyses were performed using STATA version 13.0. Dimensions with highest OHIP scores were physical pain and psychological discomfort. In bivariate analyses, NCCLs was significant associated with OHIP-14 severity PR 3.8 (CI95%1.26-11.89) and with self-related of oral pain PR 2.16 (CI95% 1.06-4.40). In the multivariate logistic regression analyses, years of smoking habits OR 1.73 (CI95% 1.03-2.9) was significant associated with OHIP-14 severity, independent of other variables. OHIP14 was significant associated to WAI (p=0,02). Strategies for Monitoring oral health Brazilian workers and reduce tobacco use should be done by Brazilian Companies to support Work ability. For future investigations on OHRQoL, analyses of NCCLs should be included(AU)


Este estudo avaliou a associação de lesões cervicais não-cariosas (LCNCs), qualidade de vida relacionada à saúde bucal (QVRSB) e Índice de Capacidade para o Trabalho (ICT) em uma população brasileira de trabalhadores. Cem trabalhadores foram avaliados em um CEREST (Centro de Referência em Saúde do Trabalhador). Os participantes foram examinados para doença oral seguindo as recomendações da OMS, e a avaliação do Perfil de Impacto da Saúde Bucal (OHIP) e o Índice de Capacidade para o Trabalho (ICT) foram usados para determinar a qualidade de vida e a capacidade de trabalho, respectivamente. A avaliação do uso de tabaco e do consumo de álcool foi feita pela tolerância de Fagestron e pelo teste de Auditoria. As análises estatísticas foram realizadas utilizando o programa STATA versão 13.0. Dimensões com maiores pontuações OHIP foram dor física e desconforto psicológico. Nas análises bivariadas, as LCNCs foram significativamente associadas à gravidade do OHIP-14 PR 3,8 (IC95% 1,26-11,89) e com dor oral autorrelatada PR 2,16 (IC95% 1,06-4,40). Nas análises de regressão logística multivariada, anos de tabagismo OR 1,73 (IC95% 1,03-2,9) foram significativamente associados à gravidade do OHIP-14, independente de outras variáveis. OHIP14 foi significativamente associado ao ICT (p = 0,02). Estratégias para monitorar a saúde bucal e reduzir o consumo de tabaco pelos trabalhadores brasileiros devem ser feitas pelas empresas brasileiras para apoiar a capacidade de trabalho. Para futuras investigações sobre QVRSB, as análises de LCNCs devem ser incluídas(AU)


Este estudio evaluó la asociación de lesiones cervicales no cariosas (LCNC), calidad de vida relacionada a la salud bucal (QVRSB) e índice de capacidad para el trabajo (ICT) en una población brasileña de trabajadores. Cien trabajadores fueron evaluados en un CEREST (Centro de Referencia en Salud del Trabajador). Los participantes fueron examinados para la enfermedad oral siguiendo las recomendaciones de la OMS y la evaluación del perfil de impacto de la salud bucal (OHIP) y el índice de capacidad para el trabajo (ICT) se utilizaron para determinar la calidad de vida y la capacidad de trabajo , respectivamente. La evaluación del uso del tabaco y del consumo de alcohol se hizo por la tolerancia de Fagestron y por la prueba de Auditoría. Los análisis estadísticos se realizaron utilizando el programa STATA versión 13.0. Las dimensiones con mayores puntuaciones OHIP fueron dolor físico y malestar psicológico. En los análisis con dúas variables, las LCNC fueron significativamente asociadas a la gravedad del OHIP-14 PR 3,8 (IC95% 1,26-11,89) y con dolor oral auto-referida PR 2,16 (IC95% 1,06-4,40). En los análisis de regresión logística multivariada, los años de tabaquismo OR 1,73 (IC95% 1,03-2,9) fueron significativamente asociados a la gravedad del OHIP-14, independiente de otras variables. OHIP14 se asoció significativamente a las TIC (p=0,02). Estrategias para monitorear la salud bucal y reducir el consumo de tabaco por los trabajadores brasileños deben ser hechas por las empresas brasileñas para apoyar la capacidad de trabajo. Para futuras investigaciones sobre QVRSB, las análisis de LCNC deben ser incluidas(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Qualidade de Vida , Saúde do Trabalhador , Lesões do Pescoço , Erosão Dentária , Saúde Bucal
16.
Cad Saude Publica ; 34(7): e00104017, 2018 07 23.
Artigo em Português | MEDLINE | ID: mdl-30043847

RESUMO

The study aimed to investigate inequalities in the commitment of family income to private expenditures on dental care in Brazil. Data were analyzed from 55,970 Brazilian households that participated in the nationwide Family Budgets Survey in 2008-2009. The commitment of family income to private spending on dental care was calculated by dividing the mean annual per capita household spending on dental care by the mean annual per capita income, classified in four categories: > 0%, ≥ 5%, ≥ 10%, and ≥ 20%. Analysis of income commitment only included households with positive spending. Only 2,961 households (7%) reported positive spending on dental care. Mean annual per capita spending was BRL 42.19 (USD 12.78) overall and BRL 602.47 (USD 182.57) among those with positive spending. Households with the highest absolute expenditures on dental care were those from urban areas and the wealthiest quintile. Meanwhile, households with the highest proportional income commitment were from rural areas and the poorest quintile. Among those that reported positive spending, 55% of the households in the poorest quintile committed ≥ 20% of their income to dental care. The proportion was only 6% in the wealthiest quintile of the population. The poorest households in the wealthiest regions of Brazil (Central, South, and Southeast) showed the highest income commitments. There were striking socioeconomic inequalities in spending and income commitment to dental care. The evaluation of these inequalities is relevant for the evaluation and orientation of public health policies.


Assuntos
Assistência Odontológica/economia , Financiamento Pessoal/economia , Disparidades em Assistência à Saúde/economia , Renda/estatística & dados numéricos , Brasil , Orçamentos/estatística & dados numéricos , Estudos Transversais , Família , Humanos , Pobreza/estatística & dados numéricos , População Rural , Fatores Socioeconômicos , População Urbana
17.
Gerodontology ; 35(4): 350-358, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29956368

RESUMO

INTRODUCTION: The objective of the present study was to evaluate the association of socioeconomic status (SES) as a latent variable on oral health-related quality of life (OHRQoL) using four definitions of functional dentition (FD) for elderly people. METHODS: Four sets of multilevel generalised structural equation models (GSEM) were used: (i) WHO Functional Dentition (FDWHO); (ii) Well-distributed teeth (WDT); (iii) FDclass5 ; and (iv) FDclass6 . The indirect effects of SES on OHRQoL were measured in 5951 elderly participants in the São Paulo Oral Health 2015 (SBSP-15) survey. The latent variable (OHRQoL) was extracted from the Oral Impacts on Daily Performances questionnaire, and GSEM was used to estimate the direction of association among the variables. RESULTS: SES was directly and strongly associated with FDWHO (Total effects [SC] = 0.56, P < .001); WDT (Total Effects [SC] = 0.55, P < .001); FDclass5 (Total effects [SC] = 0.07, P < .001); and FDclass6 (Total effects [SC] = 0.05, P = .001). All FD outcomes mediate effects of SES on OHRQoL (P < .05). SES had a direct effect on happiness which, in turn, had a direct effect on OHRQoL ([SC] = 0.05, P < .001). CONCLUSIONS: All definitions of FD were good at mediating the effects of SES on OHRQoL, showing the importance of occlusal and periodontal statuses of elderly individuals.


Assuntos
Análise de Classes Latentes , Saúde Bucal , Qualidade de Vida , Classe Social , Idoso , Brasil , Estudos Transversais , Dentição , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Inquéritos e Questionários
18.
Cien Saude Colet ; 23(4): 1119-1130, 2018 Apr.
Artigo em Português | MEDLINE | ID: mdl-29694584

RESUMO

The aims of this study were to estimate the prevalence of prosthetic requirements and dental treatment needs among the elderly Brazilian population and the associations with contextual and individual determinants. Data were taken from the Brazilian Oral Health Survey (SB Brasil 2010) and a sample of 7,619 Brazilian people aged 65-74 years were investigated. Multilevel logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals between treatment needs and contextual variables (Municipal Human Development Index, Gini coefficient and oral health coverage in the Family Health Strategy) and individual (gender, income, education and skin color). The prevalence of treatment need ranged from municipalities (p < 0.05). Of the individual variables, gender was associated with dental treatment need (OR = 1.18, 95% CI 1.05 to 1.31); lower education and non-white skin were risk factors (OR = 1.18; 95% CI 1.05 to 1.31 and OR = 1.28, 95% CI 1.15 to 1.43); the non-white skin color represented a risk factor (OR = 1.83; 95% CI 1,38- 2,42) and for the need for prosthesis income was a protection factor (OR = 0.39; 95% CI 0, 30-.51). The results showed an association between the individual factors and treatment needs.


Assuntos
Assistência Odontológica/métodos , Prótese Dentária/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Saúde Bucal , Idoso , Brasil/epidemiologia , Assistência Odontológica/estatística & dados numéricos , Inquéritos de Saúde Bucal , Escolaridade , Feminino , Humanos , Renda , Modelos Logísticos , Masculino , Análise Multinível , Prevalência , Fatores de Risco
19.
Ciênc. Saúde Colet ; 23(4): 1119-1130, abr. 2018. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-952634

RESUMO

Resumo Este estudo teve como objetivos estimar a prevalência da necessidade de prótese e tratamento dental em idosos brasileiros, e verificar a associação entre essas necessidades e fatores contextuais e individuais. Realizou-se estudo com dados (n = 7.619) da Pesquisa Nacional de Saúde Bucal - SB Brasil 2010. Modelos de regressão logística multinível foram utilizados para estimar odds ratio e intervalos de 95% de confiança entre as necessidades de tratamento e as variáveis contextuais (Índice de Desenvolvimento Humano Municipal, Coeficiente de Gini e cobertura de saúde bucal na Estratégia de Saúde da Família) e individuais (sexo, renda, escolaridade e cor da pele). Para a necessidade de tratamento dental, ser homem, apresentar menor escolaridade, menor renda, cor da pele autorrelatada como não branca e residir em municípios com menor IDH -M foram fatores que aumentaram as chances de os indivíduos necessitarem de tratamento; para a necessidade de prótese, a cor da pele autorreferida como não branca, menor renda e menor escolaridade também aumentaram as chances dos idosos necessitarem de prótese. Os resultados indicaram associação entre as necessidades de tratamento e determinantes individuais e contextuais.


Abstract The aims of this study were to estimate the prevalence of prosthetic requirements and dental treatment needs among the elderly Brazilian population and the associations with contextual and individual determinants. Data were taken from the Brazilian Oral Health Survey (SB Brasil 2010) and a sample of 7,619 Brazilian people aged 65-74 years were investigated. Multilevel logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals between treatment needs and contextual variables (Municipal Human Development Index, Gini coefficient and oral health coverage in the Family Health Strategy) and individual (gender, income, education and skin color). The prevalence of treatment need ranged from municipalities (p < 0.05). Of the individual variables, gender was associated with dental treatment need (OR = 1.18, 95% CI 1.05 to 1.31); lower education and non-white skin were risk factors (OR = 1.18; 95% CI 1.05 to 1.31 and OR = 1.28, 95% CI 1.15 to 1.43); the non-white skin color represented a risk factor (OR = 1.83; 95% CI 1,38- 2,42) and for the need for prosthesis income was a protection factor (OR = 0.39; 95% CI 0, 30-.51). The results showed an association between the individual factors and treatment needs.

20.
Cien Saude Colet ; 23(3): 945-952, 2018 Mar.
Artigo em Português | MEDLINE | ID: mdl-29538574

RESUMO

The scope of this study was to identify individual and contextual factors associated with the self-perceived need for dental treatment and for prostheses among elderly Brazilians. An analysis was performed with data from the SB Brazil 2010 epidemiological survey conducted by the Ministry of Health with a sample of 7,619 elderly individuals. Multilevel logistic regression models of mixed random and fixed effects were used to the estimate odds ratio (OR) with 95% confidence interval (95% CI) between the dependent variables and individual and contextual factors. Of the individuals assessed, 3,848 (50.5%) reported a need for dental treatment and 4,236 (55.6%) believed they have the need for prostheses. The results of multilevel logistic regression showed that gender, self-reported skin color, income and coverage by the oral health teams in the Family Health Program were associated with self-perception. This study revealed a greater influence of individual factors on the self-perceived need for dental treatment and prostheses by elderly Brazilians. This information can help to identify the inequalities that affect this population group and in setting priorities for the planning of health services.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Prótese Dentária/psicologia , Saúde Bucal , Idoso , Brasil , Inquéritos de Saúde Bucal , Autoavaliação Diagnóstica , Feminino , Humanos , Renda , Modelos Logísticos , Masculino , Fatores Sexuais , Fatores Socioeconômicos
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