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1.
Int J Paediatr Dent ; 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33263186

RESUMO

Early childhood caries (ECC) is a global problem, disproportionately affecting disadvantaged populations. The aim of this study was to evaluate systematically the available scientific evidence on the effectiveness of methods for ECC prevention. Six electronic databases were searched. Two independent reviewers selected the publications and analysed the quality of the included systematic reviews. Thirteen studies were included. Overall, eight reviews were classified with methodological quality critically low using the AMSTAR 2, whereas five reviews achieved a high risk of bias using the ROBIS tool. The methods identified that were positively related to the prevention of ECC were: preventive dental programs for pregnant women; advice on diet and feeding; prenatal oral health care; integration of maternal and children's oral health promotion into nursing practice; maternal oral health programs undertaken by non-dental health professionals; dental health education in combination with the use of fluoride for children; early preventive dental visits; the use of fluoride varnish and toothpastes with more than 1,000 ppm of fluoride. The currently available evidence supporting the effectiveness of methods for prevention of ECC, although suggesting some methods of greater potential, is still lacking due to the methodological quality of the systematic reviews and the included primary studies.

2.
Cad Saude Publica ; 36(11): e00184719, 2020.
Artigo em Português | MEDLINE | ID: mdl-33237203

RESUMO

The study aimed to analyze public governance in the regionalized healthcare network in the state of Santa Catarina, Brazil, and its influence on decision-making in the organization of oral healthcare. This was an exploratory analytical study with a qualitative approach, with the methodology based on Grounded Theory. Thirty in-depth interviews were held with managers from the Regional Inter-Managers Commissions and Bipartite Commissions (CIR and CIB, respectively, in Portuguese), under the State Health Department, representatives from the State Health Councils, and administrators of specialized oral healthcare services, in two sample groups, in addition to non-participant observation in CIB meetings. After comparative data analysis, the theoretical model was formulated in which the central category was expressed in the title Influence of Failures in Governance on the Oral Healthcare Network: The Erratic Expansion of Services by Vertical Induction and Confirmation of the Peripheral Status Assigned to Oral Health. The governance practiced in the Santa Catarina State Health System displays well-established formal support structures, such as the consolidation of the CIR. However, weaknesses were identified that reveal problems in the governance systems' legitimacy. The situation perpetuates the peripheral status assigned to the structuring of oral healthcare in network format and the erratic expansion of services, characterized by vertical induction and without contextualized recognition of oral health problems as guidance for planning the services. There is a need for greater public awareness and the inclusion of professionals and managers that can advocate for the importance of oral health as a major priority in public health policies.

3.
Glob Public Health ; : 1-15, 2020 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-32912074

RESUMO

This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (N = 7381), population-based survey. The outcomes under analysis were 'self-perception of oral health' and 'self-reporting of problems affecting the mouth, teeth and gingiva (gums)'. The qualitative component comprised a focus group, with 12 individuals recruited from a drug treatment clinic. Lower self-perception of oral health problems vis-à-vis a higher prevalence of problems affecting the mouth, teeth, and gingiva were found in users who had a lower level of education, used substances daily, had worse self-perception of physical health, did not receive health care and regularly used alcohol and/or tobacco. The results show an association between substance use and decline in oral health, as well as the lack of health services focusing on such issues. Oral health services should be emphasised as a gateway to the health system. So far, the putative cross-referral between services and professionals working in oral health and other health professionals working in the field of drug dependence has not been observed.

4.
Cad. Saúde Pública (Online) ; 36(11): e00184719, 2020. graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1142626

RESUMO

Resumo: Objetivou-se analisar a governança pública empreendida na rede regionalizada de atenção à saúde em Santa Catarina, Brasil, e sua influência sobre a tomada de decisão quanto à estruturação da atenção à saúde bucal. Estudo exploratório-analítico, com abordagem qualitativa e sustentação metodológica na Teoria Fundamentada nos Dados. Realizaram-se 30 entrevistas em profundidade com gestores das Comissões Intergestores Regional (CIR) e Bipartite (CIB), da Secretaria Estadual de Saúde, representantes do Conselho Estadual de Saúde e gestores de serviços especializados em saúde bucal, em dois grupos amostrais, além de observação não participante em reuniões da CIB. Após análise comparativa dos dados, formulou-se o modelo teórico cuja categorial central foi expressa sob título Influência das Falhas da Governança sobre a Rede de Atenção à Saúde Bucal: A Expansão Errante de Serviços por Indução Vertical e Ratificação do Caráter Periférico Dado à Saúde Bucal. A governança empreendida no sistema de saúde catarinense apresenta estruturas formais e de apoio bem estabelecidas, como a consolidação das CIR. No entanto, identificaram-se fragilidades as quais revelam problemas na legitimidade do sistema de governança. Perpetua-se a posição periférica dada à estruturação da atenção à saúde bucal em rede e à expansão errante dos serviços, caracterizada por indução vertical e sem o reconhecimento contextualizado dos agravos em saúde bucal como guia para o planejamento dos serviços. Há a necessidade de maior conscientização pública e inclusão de profissionais e gestores com espírito de advocacy para propugnar um novo protagonismo da atenção à saúde bucal nas políticas públicas de saúde.


Abstract: The study aimed to analyze public governance in the regionalized healthcare network in the state of Santa Catarina, Brazil, and its influence on decision-making in the organization of oral healthcare. This was an exploratory analytical study with a qualitative approach, with the methodology based on Grounded Theory. Thirty in-depth interviews were held with managers from the Regional Inter-Managers Commissions and Bipartite Commissions (CIR and CIB, respectively, in Portuguese), under the State Health Department, representatives from the State Health Councils, and administrators of specialized oral healthcare services, in two sample groups, in addition to non-participant observation in CIB meetings. After comparative data analysis, the theoretical model was formulated in which the central category was expressed in the title Influence of Failures in Governance on the Oral Healthcare Network: The Erratic Expansion of Services by Vertical Induction and Confirmation of the Peripheral Status Assigned to Oral Health. The governance practiced in the Santa Catarina State Health System displays well-established formal support structures, such as the consolidation of the CIR. However, weaknesses were identified that reveal problems in the governance systems' legitimacy. The situation perpetuates the peripheral status assigned to the structuring of oral healthcare in network format and the erratic expansion of services, characterized by vertical induction and without contextualized recognition of oral health problems as guidance for planning the services. There is a need for greater public awareness and the inclusion of professionals and managers that can advocate for the importance of oral health as a major priority in public health policies.


Resumen: El objetivo del trabajo fue analizar la gobernanza pública emprendida en la red regionalizada de atención en salud en Santa Catarina, Brasil, y su influencia sobre la toma de decisiones respecto a la estructuración de la atención en la salud bucal. Se trata de un estudio exploratorio-analítico, con enfoque cualitativo, y apoyado metodológicamente en la Teoría Fundamentada en Datos. Se realizaron 30 entrevistas en profundidad, con gestores de las Comisiones Intergestoras Regional (CIR) y Bipartita (CIB), de la Secretaría Provincial de Salud, representantes del Consejo Provincial de Salud y gestores de servicios especializados en salud bucal, en dos grupos de muestras; además de la observación no participante en reuniones de la CIB. Tras el análisis comparativo de los datos, se formuló un modelo teórico, cuya categoría central se expresó bajo el título Influencia de los Fallos de la Gobernanza sobre la Red de Atención en Salud Bucal: La Expansión Errante de Servicios por Inducción Vertical y Ratificación del Carácter Periférico Otorgado a la Salud Bucal. La gobernanza emprendida en el sistema de salud catarinense presenta estructuras formales y de apoyo bien establecidas, como la consolidación de las CIR. No obstante, se identificaron fragilidades, que revelan problemas en la legitimidad del sistema de gobernanza. Se perpetúa su posición periférica, debido a la estructuración en red de la atención en salud bucal y la expansión errante de sus servicios, caracterizada por la inducción vertical, y sin el reconocimiento contextualizado de los problemas en salud bucal, como guía para la planificación de los servicios. Existe la necesidad de una mayor concienciación pública, así como la inclusión de profesionales y gestores con espíritu de advocacy para que propugnen un nuevo protagonismo de la atención en salud bucal dentro de las políticas públicas de salud.

5.
Cad. Saúde Pública (Online) ; 36(11): e00184719, 2020. graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1132842

RESUMO

Resumo: Objetivou-se analisar a governança pública empreendida na rede regionalizada de atenção à saúde em Santa Catarina, Brasil, e sua influência sobre a tomada de decisão quanto à estruturação da atenção à saúde bucal. Estudo exploratório-analítico, com abordagem qualitativa e sustentação metodológica na Teoria Fundamentada nos Dados. Realizaram-se 30 entrevistas em profundidade com gestores das Comissões Intergestores Regional (CIR) e Bipartite (CIB), da Secretaria Estadual de Saúde, representantes do Conselho Estadual de Saúde e gestores de serviços especializados em saúde bucal, em dois grupos amostrais, além de observação não participante em reuniões da CIB. Após análise comparativa dos dados, formulou-se o modelo teórico cuja categorial central foi expressa sob título Influência das Falhas da Governança sobre a Rede de Atenção à Saúde Bucal: A Expansão Errante de Serviços por Indução Vertical e Ratificação do Caráter Periférico Dado à Saúde Bucal. A governança empreendida no sistema de saúde catarinense apresenta estruturas formais e de apoio bem estabelecidas, como a consolidação das CIR. No entanto, identificaram-se fragilidades as quais revelam problemas na legitimidade do sistema de governança. Perpetua-se a posição periférica dada à estruturação da atenção à saúde bucal em rede e à expansão errante dos serviços, caracterizada por indução vertical e sem o reconhecimento contextualizado dos agravos em saúde bucal como guia para o planejamento dos serviços. Há a necessidade de maior conscientização pública e inclusão de profissionais e gestores com espírito de advocacy para propugnar um novo protagonismo da atenção à saúde bucal nas políticas públicas de saúde.


Abstract: The study aimed to analyze public governance in the regionalized healthcare network in the state of Santa Catarina, Brazil, and its influence on decision-making in the organization of oral healthcare. This was an exploratory analytical study with a qualitative approach, with the methodology based on Grounded Theory. Thirty in-depth interviews were held with managers from the Regional Inter-Managers Commissions and Bipartite Commissions (CIR and CIB, respectively, in Portuguese), under the State Health Department, representatives from the State Health Councils, and administrators of specialized oral healthcare services, in two sample groups, in addition to non-participant observation in CIB meetings. After comparative data analysis, the theoretical model was formulated in which the central category was expressed in the title Influence of Failures in Governance on the Oral Healthcare Network: The Erratic Expansion of Services by Vertical Induction and Confirmation of the Peripheral Status Assigned to Oral Health. The governance practiced in the Santa Catarina State Health System displays well-established formal support structures, such as the consolidation of the CIR. However, weaknesses were identified that reveal problems in the governance systems' legitimacy. The situation perpetuates the peripheral status assigned to the structuring of oral healthcare in network format and the erratic expansion of services, characterized by vertical induction and without contextualized recognition of oral health problems as guidance for planning the services. There is a need for greater public awareness and the inclusion of professionals and managers that can advocate for the importance of oral health as a major priority in public health policies.


Resumen: El objetivo del trabajo fue analizar la gobernanza pública emprendida en la red regionalizada de atención en salud en Santa Catarina, Brasil, y su influencia sobre la toma de decisiones respecto a la estructuración de la atención en la salud bucal. Se trata de un estudio exploratorio-analítico, con enfoque cualitativo, y apoyado metodológicamente en la Teoría Fundamentada en Datos. Se realizaron 30 entrevistas en profundidad, con gestores de las Comisiones Intergestoras Regional (CIR) y Bipartita (CIB), de la Secretaría Provincial de Salud, representantes del Consejo Provincial de Salud y gestores de servicios especializados en salud bucal, en dos grupos de muestras; además de la observación no participante en reuniones de la CIB. Tras el análisis comparativo de los datos, se formuló un modelo teórico, cuya categoría central se expresó bajo el título Influencia de los Fallos de la Gobernanza sobre la Red de Atención en Salud Bucal: La Expansión Errante de Servicios por Inducción Vertical y Ratificación del Carácter Periférico Otorgado a la Salud Bucal. La gobernanza emprendida en el sistema de salud catarinense presenta estructuras formales y de apoyo bien establecidas, como la consolidación de las CIR. No obstante, se identificaron fragilidades, que revelan problemas en la legitimidad del sistema de gobernanza. Se perpetúa su posición periférica, debido a la estructuración en red de la atención en salud bucal y la expansión errante de sus servicios, caracterizada por la inducción vertical, y sin el reconocimiento contextualizado de los problemas en salud bucal, como guía para la planificación de los servicios. Existe la necesidad de una mayor concienciación pública, así como la inclusión de profesionales y gestores con espíritu de advocacy para que propugnen un nuevo protagonismo de la atención en salud bucal dentro de las políticas públicas de salud.

7.
BMC Public Health ; 19(1): 1650, 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31818274

RESUMO

BACKGROUND: To verify the prevalence and profile of users and non-users of anabolic steroid (AS) among resistance training practitioners. METHODS: An observational, cross-sectional survey was performed in 100 gyms in Curitiba city, involving 5773 individuals and self-administered questionnaires. The chi-square and z-tests of proportions were used for comparison between the groups (p < 0.05). RESULTS: 83.2% did not use, 9.1% formerly used, 3.4% currently used, and 4.3% intended used AS. The prevalence of former or current AS users was 16.9 and 6.5% among men and women, respectively. The prevalence ratios were as follows: 1) 2.6 male users for each woman; 2) 3.3 individuals aged 30-44 years and 2.8 individuals aged 18-29 years for each individual aged over 45 years. Beginners were not interested in using AS, but individuals who had trained longer had higher prevalence of AS use. CONCLUSIONS: The gym environment encouraged the use of AS owing to aesthetic appeal. Thus, suggesting the need for actions to prevent abusive use of AS considering the practitioners profile (practitioners were young, university and single).


Assuntos
Anabolizantes/administração & dosagem , Treinamento de Resistência/métodos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Congêneres da Testosterona/administração & dosagem , Adolescente , Adulto , Imagem Corporal/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
8.
Rev. Saúde Pública Paraná (Online) ; 2(2): 107-114, 10 dezembro de 2019.
Artigo em Português | Coleciona SUS, CONASS, SESA-PR | ID: biblio-1128976

RESUMO

Este artigo apresenta os resultados de análise sobre a atenção secundária em saúde bucal na Rede de Atenção Materno-infantil em 136 municípios no estado do Paraná. Para avaliação do perfil dessa rede foi utilizado o Instrumento de Avaliação de Rede de Atenção Materno-infantil (IARAMI). Os participantes da pesquisa responderam a um questionário composto por 131 perguntas, sendo duas delas sobre saúde bucal. A organização da atenção secundária em saúde bucal foi identificada na maioria dos municípios avaliados (80,80%), porém falta integração com a atenção primária. Dos municípios avaliados apenas 13,13% apresentaram ótima integração entre esses pontos. A atenção à saúde bucal para gestantes e crianças deve ser organizada em redes de atenção integrada para garantir a qualificação da atenção. (AU)


This article presents the results of analysis of secondary care in oral health in the Maternal and Child Care Network in 136 municipalities in the state of Paraná. To evaluate the profile of this network, the Maternal and Child Care Network Assessment Instrument (IARAMI) was used. The participants answered a questionnaire consisting of 131 questions, two of them about oral health. The organization of secondary care in oral health was identified in most municipalities evaluated (80.80%), but there is notintegration with primary care. Of the municipalities evaluated, only 13.13% presented good integration between these points of attention. Oral health care for pregnant women and children should be organized into integrated care networks to ensure the qualification of care. (AU)


Assuntos
Atenção Secundária à Saúde , Cuidado da Criança , Saúde Bucal , Pesquisa , Inquéritos e Questionários
9.
Ciênc. Saúde Colet ; 24(11): 4285-4296, nov. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1039530

RESUMO

Abstract It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to "active listening", while those who prefer to be cared for by male dentists highlight the attributes of "care integration" and "community guidance". In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.


Resumo Investigou-se a percepção dos usuários do serviço quanto à prática profissional dos dentistas, com base em diferenças de gênero. O Primary Care Assessment Tool (PCATool) foi aplicado a 900 usuários do Serviço Público de Curitiba, PR, Brasil. Sessenta clínicas odontológicas foram selecionadas usando amostragem aleatória, divididas entre unidades de Atenção Primária à Saúde (APS) convencional e unidades de APS com Estratégia Saúde da Família. Os atributos da APS no PCATool foram analisados. Uma questão foi adicionada acerca da preferência do usuário em relação ao gênero do dentista, gerando quatro díades derivadas da combinação do gênero do usuário/gênero do dentista (FF, FM, MM, MF). Os atributos foram ligados às díades pelo teste t para amostras independentes. Por regressão logística, as díades foram relacionadas a 23 fatores referentes aos cuidados ampliados na APS. Muitos usuários mostraram preferência por dentistas mulheres. Esses tendem a avaliar melhor os cuidados de saúde primários quanto à "escuta ativa e qualificada", enquanto aqueles que preferem ser atendidos por homens destacam os atributos de "integração do cuidado" e "orientação comunitária". Em outros fatores e atributos estudados, não há diferença entre o atendimento prestado por homens ou mulheres, independentemente da unidade.


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde/estatística & dados numéricos , Relações Dentista-Paciente , Odontologia/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Prática Profissional , Brasil , Saúde Bucal , Saúde da Família/estatística & dados numéricos , Estudos Transversais , Inquéritos e Questionários , Odontólogas/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos
10.
Cien Saude Colet ; 24(11): 4285-4296, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664400

RESUMO

It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to "active listening", while those who prefer to be cared for by male dentists highlight the attributes of "care integration" and "community guidance". In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.


Assuntos
Relações Dentista-Paciente , Odontologia/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Brasil , Estudos Transversais , Odontólogas/estatística & dados numéricos , Saúde da Família/estatística & dados numéricos , Feminino , Humanos , Masculino , Saúde Bucal , Preferência do Paciente/estatística & dados numéricos , Prática Profissional , Inquéritos e Questionários
11.
PLoS One ; 14(10): e0223384, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618245

RESUMO

OBJECTIVE: To compare the use of anabolic steroids (AS), the motivation to use them, their side effects, the source of information and the form in which AS were obtained, the medical follow-up, and the periodic examinations in resistance training practitioners who are either current or former users of AS. METHODS: A prevalence survey was performed in the gyms of the city of Curitiba, including 719 current and former AS users who self-administered a questionnaire. The chi-square and z of proportions (p <0.05) statistical tests were conducted. RESULTS: Esthetics was the main motivation associated with AS intake, leading to satisfactory results. The information about the form in which to use AS was provided by doctors and AS were either purchased at the pharmacy with a prescription or illegally. Current users reported a higher number of cycles and doses, a longer duration of use, as well as larger economical investments into AS. This shows a higher consumption of such drugs, regardless of the medical follow-up and post-cycle therapy. CONCLUSION: Given that a change in the usage pattern was observed when increasing the AS consumption, this should be considered in the elaboration of public policies to inhibit such a trend.

12.
Arch Oral Biol ; 108: 104522, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31476523

RESUMO

OBJECTIVE: To present a genetic and protein interaction analysis associated with dental caries. MATERIAL AND METHODS: The first step was to conduct a systematic literature review (SLR) through an electronic database search. Case-controls that reported associations between genes and dental caries were the main type of study design used as inclusion criteria, retrieved from the PubMed and the Virtual Health Library databases, comprising the chronological range from 1982 to 2017. The SLR was guided by PRISMA protocol and the methodological quality of the studies was established through Newcastle-Ottawa Scale (NOS). In the second step, the String Protein Interaction (SPI) approach was used to analyze protein interaction (by esyN software) and also the Ingenuity Pathway Analysis (IPA) to check biological pathways associated with dental caries genes. RESULTS: A total of 51 articles were included to perform this SLR, describing a number of 27 genes associated with dental caries development. At the genetic level, 23 genes have at least one other gene with which they interact. The genes TUFT1, VDR, TFIP11, LTF, HLA-DRB1, MMP2, MMP3 and MUC5B were shown to be connected in interactive networks by at least 10 other genes. CONCLUSION: It is essential to apprehend the multifactorial pattern of inheritance in human disease. This study presents pathways which may be directly correlated with several dental caries phenotype and this contributes to a better understanding of this disease, opening up a wider range of biotechnology options for its effective control in the future.


Assuntos
Cárie Dentária , Predisposição Genética para Doença , Proteínas , Estudos de Casos e Controles , Cárie Dentária/genética , Humanos , Fenótipo , Proteínas/fisiologia
13.
Iran J Public Health ; 48(4): 673-680, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31110977

RESUMO

Background: The gerontoism, a neologism adopted here, is a form of discrimination regarding age and can occur in rational, emotional, and behavioral contexts, and could be influenced by many factors. This study aimed to identify if the social support and the family functionality interfere in the self-perception of gerontoism. Methods: Participants were 376 elderly in good physical and mental condition. They participated in the Group Living organization in the Municipality of Curitiba, State of Paraná, Brazil, in 2012. Information was collected about sociodemographic profile using a structured questionnaire. The social support, the family functionality, and the self-perception of gerontoism were defined by the Medical Outcomes Study, the Family APGAR index, and Ageism Survey, respectively. The variables were analyzed by Pearson's correlation coefficient, One Way ANOVA, Tukey's HSD test, and the Student's t-test. Results: Most of the participants came from small cities from the interior (48.7%), were female (94.4%), with age ranging 60-69 yr-old (45.5%), whites (76.1%), widowers (47.1%), with children (93.9%), with low schooling (55.3%), with family income from 1-2 minimum wage (31.4%), and retirees not working (44.1%). It was not observed correlation between sociodemographic variables and self-perception of gerontoism. Statistical significance was observed between self-perception of gerontoism and social support (r= -0.26, P=0.00), and between the self-perception and family functionality (r = -0.28, P=0.00). Once the scores of self-perception of gerontoism increased, the ones from social support and family functionality, decreased. Conclusion: Lower self-perception of gerontoism was observed in elderly with higher social support and family functionality.

14.
BMJ Open ; 9(1): e023283, 2019 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-30659038

RESUMO

OBJECTIVES: To compare two different models of public oral health in primary care services, a so-called family health strategy (FHS), as opposed to non-FHS services designated as 'conventional' healthcare (CHC), regarding the presence and extent of the attributes of 'good' primary healthcare (PHC). The null hypothesis of this study is that the attributes do not differ between the FHS and CHC. DESIGN: Cross-sectional. SETTING: Public PHC services in Curitiba, the state capital of Paraná. PARTICIPANTS: PHC users of the public oral health network (n=900) and dentists active in this municipal network (n=203). PRIMARY AND SECONDARY OUTCOME MEASURES: The Primary Care Assessment Tool (PCATool)-Dentists and PCATool-Users were used to analyse the primary outcomes ('essential' attributes) and secondary outcomes ('derived' attributes) in the PHC. RESULTS: Overall, the primary care services in oral health were well evaluated, both by users and by dentists, with mean scores ascribed to PHC attributes mostly above the cut-off point (6.6). The exception for users were affiliation (6.36; 95% CI 6.11 to 6.60) and accessibility (5.83; 95% CI 5.78 to 5.89); and for dentists the accessibility (5.80; 95% CI 5.63 to 5.96). When comparing FHS and CHC, there was a superiority of the FHS model, which reached a general mean score of 7.53 (95% CI 7.48 to 7.58) among users and 7.56 (95% CI 7.45 to 7.67) among dentists; on the other hand, the CHC general mean score was of 6.61 (95% CI 6.49 to 6.73) and 6.68 (95% CI 6.56 to 6.80) respectively for users and dentists. CONCLUSIONS: The results reveal a reasonable level of attainment of PHC attributes in the services investigated. Nevertheless, public health managers should make efforts to reduce the difficulties faced by users in accessing dental care. The more positive results achieved by FHS services indicate that the provision of oral healthcare under this strategy should be expanded.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Atenção Primária à Saúde/métodos , Autorrelato
15.
Eur J Dent Educ ; 23(2): 168-174, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30632666

RESUMO

INTRODUCTION: In Brazil, the undergraduate dental education still remains fragmented and dissociated from its social context, with emphasis on the individualistic and private aspects of dental health. This study aimed to analyze the training and development of university professors of dentistry in stricto sensu postgraduate programs in Brazil. MATERIALS AND METHODS: Delphi electronic methodology was used within a qualitative-quantitative design to gather data from a panel of 58 experts. Discussions representing the analytic axis focused on: (i) the evaluative processes of higher education, in particular stricto sensu postgraduate programs, and their influence on academic activities in undergraduate dentistry courses and (ii) policies for training and developing university professors. RESULTS: Of the experts, 30 participated in the first round, 24 in the second, and 19 in the third. They considered the training of university professors in dentistry to be highly specialized and technologically focused and indicated the review of political-pedagogic aspects of the educational sphere, as well as the social, economic, cultural, epidemiologic, and professional aspects of training and preparation prescribed by the National Curricular Guides for graduate courses in dentistry. An adequate process of evaluating the official organs and regulators of postgraduate stricto sensu programs, as well the programs themselves, should be implemented. CONCLUSION: The experts stated that changes to the university teaching system are necessary, even in the field of dentistry. Mechanisms for evaluating areas and professors were inadequate, and the training was overly specialized and not consistent with the social reality of the country.


Assuntos
Odontologia , Educação de Pós-Graduação em Odontologia , Docentes/educação , Brasil , Currículo , Humanos , Ensino
16.
Rev. Cient. CRO-RJ (Online) ; 3(3): 49-55, Sept.-Dec. 2018.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1022021

RESUMO

Objective: To assess the association between dental caries in adolescents and the use of dental care services in Brazil. Method: Cross-sectional study based on secondary data obtained in the last two National Oral Health Surveys (2003 - 2010), considering the estimated prevalence of dental caries and dental hygiene in adolescents aged 15 to 19 years and dental care services. Results: In Brazil, the dental care index (DCI) has increased on average from 41.2 (2003) to 50.8 (2010). The dental mutilation index (DMI) has decreased on average from 11.7 (2003) to 7.4 (2010). The healthy permanent teeth index (HPTI) showed an increase of 4.9% in the above period. In 2010, the Central West was the only region in the country to show a decrease in the dental care index (DCI). Conclusion: There have been quantitative improvements in regard to dental restoration (dental care), and qualitative improvements in what concerns to tooth loss in the oral health of Brazilian adolescents.


Objetivo: Avaliar a associação entre cárie dentária em adolescentes e a utilização de serviços odontológicos no Brasil. Métodos: Estudo transversal, baseado em dados secundários relativos às duas últimas Pesquisas Nacionais de Saúde Bucal (2003 ­ 2010), considerando a prevalência estimada de cárie dentária e higidez dental em adolescentes (15 a 19 anos) e a assistência odontológica. Resultados: Para o Brasil, o índice de cuidados odontológicos (ICO) registra um aumento, na média, de 41,2 (2003) para 50,8 (2010); o índice de mutilação dental (IMD), uma diminuição, na média, de 11,7 (2003) para 7,4 (2010); quanto à média de dentes permanentes hígidos, um aumento de 4,9% para o período analisado. Em 2010, a região Centro-Oeste do Brasil é a única que sofre redução, em relação ao índice de cuidados odontológicos. Conclusão: Há melhorias, ao menos quantitativamente, quando se analisa a questão do cuidado odontológico por meio do componente restaurado, e qualitativamente na redução do componente perdido, na saúde bucal de adolescentes brasileiros.


Assuntos
Adolescente , Cárie Dentária , Higiene Bucal , Saúde Bucal , Adolescente , Assistência Odontológica
17.
Cad Saude Publica ; 34(8): e00130817, 2018 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-30208187

RESUMO

Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Saúde Bucal , Cuidado Pré-Natal/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Complicações na Gravidez , Gestantes
18.
Rev. adm. pública (Online) ; 52(4): 571-592, jul.-ago. 2018. graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-957563

RESUMO

Resumo A reforma administrativa no Brasil, iniciada com a Constituição de 1988, permitiu a efetivação de políticas públicas descentralizadas, incluindo a municipalização do setor saúde e participação popular. Objetivando apreender como essas mudanças democráticas ecoaram na literatura internacional, o artigo analisou a produção científica da administração pública da saúde no Brasil, adotando o estudo de redes sociais. A pesquisa foi feita na base do Web of Science, utilizando termos relacionados com administração, delimitada por "Brazil" e "health", e softwares auxiliares BibExcel e Ucinet. A rede de publicações da administração se mostrou coesa, com práticas de democracia deliberativa e participação social. Ao incluir o termo "saúde", houve maior variação de temas, com destaque para a Reforma Sanitária e descentralização do Sistema Único de Saúde, de forma crítica e reflexiva, e notada ausência do controle social.


Resumen La reforma administrativa en Brasil, iniciada con la Constitución de 1988, permitió la efectuación de políticas públicas descentralizadas, tales como la municipalización del área de salud previendo mayor abertura para la participación popular. Objetivando aprehender como la efectuación de esos cambios tuvo eco en la literatura internacional, el presente artículo analizó la producción científica a respecto de la administración pública de la salud en Brasil, adoptando el estudio de redes sociales. La investigación se realizó con base en la Web of Science, utilizando los términos relacionados a la administración, delimitada por "Brazil" y "health", y los programas BibExcel e Ucinet. La red de publicaciones de la administración se mostró coherente, conteniendo prácticas de democracia deliberativa y participación social. Al incluir el término "salud", hubo una mayor variación de temas, con destaque para la Reforma Sanitaria Brasileña y la descentralización del Sistema Único de Salud, con enfoque más crítico y reflexivo, e importante laguna relativa al control social.


Abstract The Brazilian administrative reform was included in the 1988 Constitution, and it has promoted decentralized policies, including the municipalization of health and popular participation. The objective of this article is to understand how the implementation of these democratic changes were studied in the international literature. The scientific production on Brazilian public health administration was analyzed by studying social networks. The search was conducted in the Web of Science database, using administration terms, delimited by "Brazil" and "health," and using BibExcel and Ucinet software. The network of publications in administration was cohesive, containing practices of deliberative democracy and social participation. By including the term "health," more variations were found, particularly on the Brazilian Health Reform and on the decentralization of the National Health System, with a more critical and reflexive focus, albeit with a clear gap on social accountability.

19.
Caries Res ; 52(1-2): 139-152, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29316548

RESUMO

Despite the fact that dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to identify and analyze the determinants of dental care attendance during pregnancy. We performed a systematic literature search in the electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Library in Dentistry, Cumulative Index to Nursing and Allied Health Literature, and Medline using relevant keywords. Studies were filtered by publication year (2000-2016) and language (English, Portuguese, Spanish, and French). The included studies were assessed for quality. Their characteristics and statistically significant factors were reported. Fourteen papers were included in the review. The prevalence of dental service usage during pregnancy ranged from 16 to 83%. Demographic factors included women's age, marital status, parity, and nationality. The socioeconomic factors were income, educational level, and type of health insurance. Many psychological and behavioral factors played a role, including oral health practices, oral health and pregnancy beliefs, and health care maintenance. Referred symptoms of gingivitis, dental pain, or dental problems were perceived need. Demographic, socioeconomic, psychological, behavioral factors and perceived need were associated with the utilization of dental services during pregnancy. More well-designed studies with reliable outcomes are required to confirm the framework described in this review.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Feminino , Humanos , Gravidez , Complicações na Gravidez/prevenção & controle
20.
Cad. Saúde Pública (Online) ; 34(8): e00130817, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-952436

RESUMO

Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.


Algumas barreiras aos cuidados de saúde bucal durante a gravidez são mal compreendidas, principalmente aquelas relacionadas a fatores psicossociais, que são exploradas melhor com estudos qualitativos. Esta revisão sistemática teve como objetivo explorar as barreiras e facilitadores dos cuidados odontológicos durante a gravidez, através de uma síntese temática de estudos qualitativos. Foram incluídos estudos qualitativos ou de métodos mistos, publicados em inglês, português, espanhol ou francês entre 2000 e 2016. As buscas foram realizadas nas bases PubMed, Scopus, Web of Science, LILACS, BBO e CINAHL. Para avaliar a qualidade dos estudos, usamos a ferramenta Critical Appraisal Skills Programme. A síntese temática teve como objetivo interpretar e resumir os resultados. Entre os 2.581 estudos identificados, dez foram incluídos na síntese. Encontramos 14 temas analíticos relacionados a barreiras e facilitadores dos cuidados odontológicos na gravidez, e que interagiram de maneira complexa: condições fisiológicas, baixa importância atribuída à saúde oral, estigma negativo em relação à odontologia, medo ou ansiedade frente ao tratamento dentário, mobilidade e segurança, barreiras financeiras, emprego, limitações de tempo, apoio social, falta de informação, barreiras produzidas pelo profissional de saúde e conselhos de amigos e familiares, além de crenças e mitos sobre a segurança do tratamento dentário. Os mitos e crenças sobre a saúde oral e o tratamento dentário durante a gravidez parecem ser as barreiras mais importantes, tanto para as gestantes quanto para os odontólogos e outros profissionais de saúde. Os achados da revisão podem apoiar novos estudos, principalmente para testar protocolos de intervenção e orientar políticas públicas efetivas para a promoção da saúde oral durante a gravidez.


Algunas barreras al tratamiento dental durante el embarazo no se han entendido adecuadamente, especialmente aquellas relacionadas con factores psicosociales, que están mejor examinados en estudios cualitativos. El objetivo de esta revisión sistemática fue examinar las barreras y facilitadores para el cuidado dental durante el embarazo, a través de una síntesis temática de estudios cualitativos. Se incluyeron métodos cualitativos, o estudios de métodos mixtos, publicados en inglés, portugués, español y francés, desde el 2000 al 2016. La búsqueda de estrategias se realizó en PubMed, Scopus, Web of Science, LILACS, BBO y CINAHL. Con el fin de evaluar la calidad de los estudios, usamos la herramienta Critical Appraisal Skills Programme. Se realizó la síntesis temática para interpretar y resumir los resultados. De los 2.581 estudios seleccionados, diez fueron incluidos en la síntesis. Encontramos 14 temas analíticos, relacionados con barreras y facilitadores para la atención dental durante el embarazo, que interactuaron de forma compleja: condiciones fisiológicas, baja importancia de la salud oral, estigma negativo referente a la odontología, miedo/ ansiedad al tratamiento dental, movilidad y seguridad, barreras financieras, empleo, restricciones de tiempo, apoyo social, falta de información, barreras a la salud profesional, consejo de familia y amigos, creencias y mitos sobre la seguridad del tratamiento dental. Mitos y creencias sobre la salud oral y el tratamiento dental durante el embarazo parecen ser las barreras más frecuentes, tanto en el caso de las mujeres embarazadas, como en el caso de dentistas y otros profesionales de salud. Los hallazgos de esta revisión tal vez susciten nuevos estudios, especialmente para probar protocolos de intervención y guiar políticas públicas efectivas, orientadas a la promoción de la salud oral durante el embarazo.


Assuntos
Humanos , Feminino , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Saúde Bucal , Assistência Odontológica/estatística & dados numéricos , Complicações na Gravidez , Conhecimentos, Atitudes e Prática em Saúde , Gestantes
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